There’s a new story about how Obamacare neglects entrepreneurs. I’m sad to say that I discovered the story by living it, and I know others are living it as well.
I left my job in April to start my own business. I knew that I’d need to navigate the individual health-insurance market eventually, but my first priority was the work of building my business. By choosing to enroll in COBRA, I knew my husband and I could maintain the good coverage my employer had provided to me until we took the time to investigate other options. We’re paying $1,500 a month for our plan, which is terribly expensive, but it’s a very fine plan, and I thought we’d only be eating the high cost for a few months.
Last week, I felt I had the time to put my business on hold for a day and find a cheaper health insurance plan. By searching online, including significant time on healthcare.gov, I found a couple of decent options from Blue Cross/Blue Shield — high-deductible plans in the “bronze” category that would cost us from about $530 to $700 a month.
Happy with my search, analysis and decision, I started clicking away on the Blue Cross website to apply for one of these more affordable plans. I quickly discovered I would need to qualify for a “special enrollment period” to purchase a new plan at this time. Otherwise, it appeared, I would need to wait for open-enrollment season in November … to apply for a plan that begins in January.
In short, a “life event” needs to have happened to me or my husband to qualify for special enrollment. One of us needs to have lost a job or had coverage canceled. We’d be in luck if we’d gotten divorced or moved or had a baby. But none of this has happened to us.
I believe that I had a huge life event; I chose to leave my job and start my own business. But that is not a qualifying event under the Affordable Care Act.
I called Blue Cross twice, and talked to two different sales representatives, to make sure I was reading all of this correctly. Each real person confirmed for me that someone on COBRA coverage is not eligible to purchase “an ACA-compliant plan” until open enrollment season.
Then I looked back at the eight, small-print, single-spaced pages I received from my employer with COBRA information back in April. My heart sank. At the bottom of one of the incredibly dense and confusing pages, there is, in fact, a note that reads:
That was the moment I accepted that it’s true. I’m stuck. For the first time in my life, I literally cannot choose to buy a different product for reasons of cost. My government will not allow it.
If I drop my $1,500-a-month COBRA coverage, my husband and I will be uninsured, at risk and in violation of federal law. If we keep it, we’ll end up spending $12,000 on health insurance in my first eight months of self-employment.
The expense is going to be devastating. It will decimate what I’ve earned as a sole proprietor so far. It makes me feel like I’m trying to fill a hole that someone else is digging. I’m pretty sure that’s not what the goal of the health care law was, right?
While most of the blame for this predicament can, I believe, be squarely placed on the terrible health care law that we now live under, I’m willing to take some responsibility for what I should have known. I have real, awful, feelings of regret. After all, I have spent about half of my career learning and writing about health care policy. When I read my COBRA packet, I thought I really understood it.
But I also find myself thinking, “My God, if I couldn’t figure this out, how could someone who had zero familiarity with the health care law?”
Which is why I asked one of the Blue Cross sales agents whether she’d received a lot of calls like mine. She said that, indeed, they have. People on COBRA are calling in the hopes of switching to more affordable plans and they are being turned away.
I’ve known for a long time that the Affordable Care Act all but ignored the pressing cost concerns of the self-employed. I’ve written and talked about it as a professional for years. But I’ve just discovered the hard way that the perspective of an entrepreneur must have been completely, 100 percent missing from both the legislative debate and the regulatory process surrounding this law. The president likes to say that the Affordable Care Act helps entrepreneurs and small-business owners. I can tell you plainly: He is lying.