Healthcare reform: Working class blues and health care reform

Published 5:26 pm Wednesday, July 31, 2013

Editor’s note: Robin Dixon, a benefits specialist with Main Street Financial Group Inc., will offer a regular column explaining the ins and outs of changes related to healthcare reform that citizens need to know.

In reviewing the pros and cons of health care reform, it is becoming increasingly clear the law may ill serve the working class more than any other population.

While all Americans must be insured to avoid a tax penalty, the issue of affordability is going to come into play for a significant section of the population.

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To better understand financial impact to area families, let’s take a look at an example family, the Smiths.

The Smith family is fairly healthy, with two parents in their mid 30s and a couple of pre-teen children.  Together, the Smiths earn about $45,000 a year. Using current pricing, they can find health insurance with moderate benefits for around $925 a month total.

Since the Smiths make less than $47,100 per year, it’s possible the children may be eligible for NC Health Choice or Medicaid, which offers children low or no premium medical and dental coverage to those who qualify.

In this example, the Smiths qualify for Health Choice, and reduce their family cost for coverage to around $645 a month.

Under Health Care Reform, the Smiths may qualify for 25-50 percent in premium subsidy, further reducing their cost to $323-$483 a month as long as they purchase their insurance through the exchange/marketplace.

If the Smiths are already insured and paying the $645 each month, they have been used to shouldering the higher cost and will be jumping with happiness at their new, lower price tag. If the Smiths are not currently insured, they are wondering where they are going to come up with the extra money in their budget.

Also, the example of the Smiths’ family is based on today’s pricing, and not the pricing under Health Care Reform effective Jan. 1, 2014. With federally mandated minimums in coverage, mandated maternity for females, increased preventive benefits, preventive dental coverage for children and more, premiums are expected to rise for some demographics, some significantly.