Be Glad Your Policy Was Dropped?


TPM Reader BN explains why those dropped policies are often a good thing …

I live in a state with its own exchange and don’t need the subsidy, so I don’t have any experience with the federal exchange, but I think my experience is still relevant to the overall discussion.

I’ve been self-employed for 13 years. Most of that time, I’ve had an HSA with a high-deductible policy; the deductible has ranged from $3,000 to $5,500. A traditional individual policy would be cost-prohibitive because–although I have low blood pressure, heart rate, and cholesterol, work out regularly, take no prescriptions, and have no chronic conditions–I’m deemed to have preexisting conditions, basically because I’ve dared seek medical attention in the past. I was once rejected by an insurer based on a single episode of sciatica five years earlier. I don’t think people who have had employer-provided coverage have any idea what the individual health insurance market has been like.

Anyway, you may have seen in the past couple of days how some insurers are being forced to drop thousands of individual policies because they’re not ACA-compliant. My current policy is among those, so I’ve looked for a new policy with my insurer (Anthem). And, thanks to the ACA, I can finally get a more traditional policy because the insurer has to offer ACA-compliant plans and can’t exclude for preexisting conditions. As a result, I’m switching to a Silver level plan with a $2,000 deductible, free preventive care, reasonable co-pays ($30-$45) for doctors’ visits pre-deductible and reasonable co-insurance (25%) post-deductible, all for a premium that’s only $20 than what I was paying. Significantly better coverage, in other words, for about $240 more per year. The media, however, are depicting the end of those policies as a bad thing, apparently because insureds may have to pay more now. But they don’t mention that these insureds will be getting much better coverage. It’s not an apples-to-apples comparison.

I’ve spent years making medical decisions based on the out-of-pocket cost. I’ve passed on doctor-advised MRIs because they would cost me $1,000 (and don’t even get me started on the myth of how patients can negotiate with providers–a notion propagated largely by people who’ve never had to try it), and just this week I had to decide whether to have a follow-up visit with a neurologist for vertigo or see a podiatrist about an ongoing running injury. I’m ecstatic to have this coverage. And I would not have had it without the ACA.


Josh Marshall is editor and publisher of