Minnesota Prairie Roots

Writing and photography by Audrey Kletscher Helbling

When you can no longer afford health insurance… October 26, 2016

I live on one of Faribault's busiest residential streets, also a main route for the ambulance which is based near my home.

Minnesota Prairie Roots file photo.

ABOUT A YEAR AGO, I penned a post expressing my outrage at the ever-rising cost of health insurance.

I expected those costs to stabilize. I was wrong. So here I am, writing and agonizing again about insurance rates that are through the roof nearly unaffordable for my husband and me.

Beginning on January 1, our monthly premiums will total $1,746, of which we will pay $1,310. Add in $3,700 deductibles for each of us and you can see the financial ridiculousness of this plan. Before we can benefit from this health insurance offered through Randy’s employer, we will spend thousands and thousands of dollars. Like $14,176 for me and $8,944 for Randy since his employer pays half ($437/month) of his premium.

We are not wealthy. Nor are we poor. We are lower middle income. I am self-employed. Randy has worked the same job for more than 30 years. His benefits are minimal.

This year we both turned sixty, bumping us up on January 1, 2017, into a newer and higher premium bracket. Lucky us.

In 2016, our health insurance premiums were $723/month each for policies with a $3,500 per person deductible. In the new year, we will pay $225 more a month (nearly a 21 percent increase) with $3,700 deductibles.

This cannot continue. The cost of health insurance premiums threatens our financial stability. Paying $15,720 a year in premiums is crazy and unaffordable. We are careful with our money. Thankfully, years ago we paid off the mortgage on our modest home. We don’t take big vacations. We seldom dine out. We don’t own new vehicles. We limit our spending. But we have to eat and pay other basic cost of living bills.

Something has to give. I wish I had the answer. Of one thing I am certain. I am sick and tired of health insurance costs that have skyrocketed. It’s to the point where we can’t afford to get sick or to seek medical treatment. We can’t save money for retirement. The cost of health insurance and healthcare is my greatest financial worry.

I know many others are in the same predicament. The Minnesota legislature intends to call a special session addressing the crisis, specifically for those buying individual plans. Up until a year ago, I had an individual plan, too. What am I missing here? I was advised that we cannot apply for coverage through the state run marketplace, MNsure, (thus qualifying for a subsidy) because we have insurance available through an (my husband’s) employer.

TELL ME: How about you? Are you in the same situation as us? Do you have a solution to this crisis?

© Copyright 2016 Audrey Kletscher Helbling

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41 Responses to “When you can no longer afford health insurance…”

  1. Isn’t the “Affordable Care Act” a wonderful gift from Washington? One presidential candidate has promised to repeal and replace it! I’d vote for that candidate..

    • I didn’t want to turn this in to a political discussion. But I suppose it’s difficult to separate the two. I will just say that politicians make a lot of promises and leave it at that.

      One of the positive things that came out of healthcare reform was the ability for individuals with pre-existing conditions (like me) to get health insurance coverage. We cannot be denied because of pre-existing conditions. So if the “good things” can be kept and the “bad things” (mainly astronomical costs) eliminated…

  2. Beth Ann Says:

    I thought of you the other day when I read an article about this very thing. I wish I had answers but I most certainly do not. The costs are ridiculous and I am afraid there is no end in sight. To not be able to save for retirement because you are spending so much on health care is not the goal for anyone at this stage in life. I am so sorry and wish I had the answer.

  3. Dan Traun Says:

    The state of health insurance is absolutely ridiculous. I am a State of Minnesota Employee and have not had to worry much about this issue. It makes me sick thought to think about this disaster. There are approx 38,000 state employees (Pioneer Press 2014); from that pool of employees health care packages are negotiated. There are 4 different levels: 100%, 75%, 50% and 0% employer (state) contribution. Even at the 0% state contribution (100% employee pay) to premium payment, the premiums are not as high as the figures you are quoting for an individual. There are 5.3 million people in MN (2010 Census); how is it that this amount of people do not demand a better bargaining position with the insurance companies through the exchange? I know I am putting this is very simple terms, but isn’t that the way it should be? The past effort was not the “Affordable Care Act, it was the get everyone insured no matter the cost act. It isn’t just individuals that are suffering. Small business owners are drowning with these premium hikes as well. I completely agree that something has to give here. I don’t want to get off on a rambling tangent here and come off as a conspiracy theorist, but there is so much money at stake here and there is little money in cures. It is insane what health care and drugs cost these days. I don’t watch regular broadcast TY on a regular basis, but every time I catch an hour or two when I am traveling all I see is ads from drug companies. Something is very wrong here. // end rant //

    • Rant all you want, Dan, because you are expressing the opinions of many.

      Up until last year, I bought my health insurance on the individual open market since I am self-employed. Last year I switched to join my husband’s plan at work because of cost. Had I stayed in the individual market, I believe I would be paying even more. I base that on info I’ve read and heard, although I have not checked.

      You are correct in that small business owners are also impacted.

      I agree also with your assessment that healthcare reform was “an effort to get everyone insured no matter the cost.”

      Something has to change. Now.

  4. treadlemusic Says:

    No solution here but one thing is certain….the outcome of this outrageous “plan” was seen very clearly by those who drafted it and put it in place. Pushing the $$$ to a point of insanity forces a government intervention to “save” the people from these escalating costs. Now, what could that solution be??? Hmmmm, could it be, ummm….the gov’t run socialized medicine that the Dems have pushed for over the years??? A “Washington will provide” attitude (with all its hand-out programs) is what will fuel this direction. Such lobby groups as AARP (yes!!!! AARP!!!!) stood firmly in favor of this fiasco (for this reason we dropped out of the group, despite the “perks”/tasty ‘carrot’ they dangle out there!!!)……just check the group’s voting record to confirm this. Solution? No, it is way too convoluted & intermeshed with private industry for a quick fix. In fact, the reality is that we have a mess in place right now for which (I believe) there is NO (earthly) solution! The following link provides interesting nuggets for thought (delete as you see fit)…..http://www.desiringgod.org/articles/the-gift-of-god-s-judgment . Prayerful hugs comin’ at ya..

  5. It is ridiculous!!! We spent hours and hours last year trying to figure out healthcare and it is that time again to do it all over again. It is like having a part-time job to some degree. Everything is going up while pay barely goes up – it is a sad state of affairs. How do you live, plan for the future, maybe buy a house or expand a family unit, put food on the table, have some fun playing and not working yourself into having health problems, etc.?!? How do you have a voice and take a stand?!? I am not completely sure, but some things are no longer working and not everything is great anymore. A little bit like that hamster on the wheel pushing and pushing that wheel and going and getting nowhere fast.

  6. cheryl Says:

    I will probably open up a can of worms here, but I believe and have observed when issues like this come up, it is to talk directly to the people who can do something about it, in this case our elected officials. Both national and state representatives. HOwever, this issue is on the radar and I believe it will be addressed. I know that in talking to our state candidates for my area, it is very much on their radar and they will work for a solution. I personally do not believe a repeal and redo is a solution. Partly because I do not believe there would be a redo; and, because there are some really good parts of the Affordable Care Act and we can probably build on that. However it is our responsibility to examine each candidate’s plan, both state and national, will do about this situation and what their plan is, paying attention how realistic it is and whether it will work for one’s own situation. This is a hard situation. I am not affected, nor is any of my immediate family, but I really have empathy for those who are and agree that it needs to be fixed. I have talked to a lot of people and have come to the conclusion that a public option is the best solution for all for a variety of reasons. Medicare had a great outcry when it first came out and has come to be a wonderful thing for our seniors. Maybe something like that would work for all. Our taxes might go up a bit, but not nearly as much as your premiums are. Food for thought.

  7. Almost Iowa Says:

    Last year, we experienced the same jolt in healthcare costs as you. This year, my wife left her previous employer and took a low-paying clerical job with Hormel. If she had not, we would have been paying at least half of her net salary on insurance. The savings on healthcare costs more than made up for the smaller check.

    I fear that the political solution will be to throw more (borrowed) money at the problem, instead of controlling costs.

  8. Littlesundog Says:

    I can’t say anything much that hasn’t already been said here. It is a terrible situation. I have had a very negative attitude about how the Affordable Care Act was marketed cleverly and pushed through without really going over those thousands of pages, and forced down our throats. Now there’s this turd in the punchbowl floating about. We can say all of the appropriate things like “Oh, that punch looks so refreshing” (those who say there are some “good things” about it), but really, who doesn’t see that turd? The punch and the turd need to be thrown out, and a completely new batch (plan) made. I’m with Doreen on this one… “it is way too convoluted & intermeshed with private industry for a quick fix”. I am voting for the candidate who will repeal and replace. Meanwhile, I’m sticking to the current healthy lifestyle (I haven’t been to a doctor in a decade) so I won’t need insurance, and I’m looking ahead to plan for financial security as we approach retirement. If we don’t see big change in the next administration, we might all be looking into survival prepping. And to think I always thought those were crazy people. It’s not so funny anymore.

  9. Sandra Smith Says:

    Truly, we need “medicare for all”–health care that removes most of the profit from the equation. What do insurance companies do?, Well, they take your money, fill out a lot of redundant forms, and pay your doctor. What makes them essential to the process? We all need to talk to our congresspeople and push them on expanding medicare. Push hard. On medicare, I pay the basic medicare premium withheld from my social security check, plus $168.00 for my advantage plan, which is the same good insurance, same company we’ve been with for over 40 years. I watch my kids struggle with things that were silk for me. Medicare for all! Everybody, make a big noise about it. Every other developed country does it, and no, they don’t have enormous waiting lists for treatment in Canada. National healthcare is cheaper and more efficient without the middle-man. We don’t need insurance companies. They need us.

  10. Don Says:

    Oh boy you hit a sensitive nerve in all of us! No easy solutions but solutions need to start somewhere. I wonder how much the drug companies spend a year on advertising? I for one see the same commercials over and over again during an evening of tv watching, how much did that cost and was it really necessary given the fact that most of the time the Doctor will be the deciding factor on drug necessities.

    Perhaps our elected politicians should have to pay for their own health insurance and use the insurance system too! Now that would be a real eye opener for them.

    One of the problems that I have seen on a constant bases is the abuse of the health insurance system. For instance a person I am familiar with at work goes to the doctor at least 2 times a week for whatever ailment they may think they have. I have asked on numerous occasions, WHY? The answer is always, why not insurance pays for it! Dah, when I try to explain that that is one of the reasons health care insurance skyrockets I get the blank stare routine because they have no understanding of economics and how it works.

    I have listened to most of the arguments about the pros and cons of a national health care system but in reality the pros seem to outweigh the cons. In Alaska we have many Canadian visitors and citizens and when asked about how they feel about their health system the vast majority indicate they like it and wonder why the US is so against it. They made the decision long ago to accept higher taxes or pay for spiraling insurance rates (which to a certain extent are dictated by the stockholders and their requirements for constantly larger returns on their investments) , either way, the bottom line is, it comes out of their pockets. They say that there are a few people that complain about having to wait but in reality these are the same people that want to go to the doctor a couple of times a week.

    Perhaps a system of national health care and private insurance options will keep some of the costs under control, too much profit too much abuse e.g. the EpiPen fiasco!

    • Don, I sincerely appreciate the details and insights you are offering to this discussion.

      I’ve often wondered how many folks “abuse” healthcare by unnecessary doctor visits because “insurance covers it.” Thanks for standing up to your co-worker.

  11. Virgil Says:

    So sorry for you.
    It is so frustrating. Your post needs to be sent to Governor Dayton. He was bragging when Mn became one of the first to join Obama Care. Now he is dragging his feet and pouting because the Metro legislators didn’t get their light rail transportation bill passed. Send it to Kurt Doud also to give him more ammo.

  12. So much for affordable… I’m not looking forward to that paperwork coming in the mail

  13. Maxson Academy Says:

    Mz Audrey, we too have entered the 60s of our life. My husband and I are feeling the push and pull of health care programs w/o choice. We have decided to vote for Trump. The forced health program initiated by the Democrats began and ended with HRC and we are the worse for wear. We firmly stand on the knowledge GOD is in charge. It is the belief of our heart and soul….it is our passion. My prayer for anyone confused and lost is to find the peace that comes with honoring God in all situations. I do not know what His plan will show or how He has determined to end this madness but, I do see the evil of abortion and government/dictatorship displayed by one side of our election choice and I see a strong and godly man sitting as possible second in command on the other. If this is really the ‘lesser of two evils’ as so many have stated, I will put my vote to Mike Pence. Donald is a business man so he sees things like this forced health ‘law’ to be detrimental to free enterprise. As a business man, he is willing to throw it all out and start over using the know-how of experts……he does not have all the answers but, he knows people who can help find the solutions. And businessmen find strength in being in the black so we have determined our national debt will no longer be tolerated.

    I sense you have gone through ‘the fires that burnish our souls’ and feel the Lord’s guidance in your walk. I am grateful for your beautiful face looking out at me when I have a moment to enjoy the beauty of your world through your eyes. My prayer for you and your husband is that you both experience a money miracle that reminds you God has heard your cries. always Debi and Rick Maxson

    ________________________________

    • Debi and Rick,

      You are correct about feeling the Lord’s guidance. He has always provided and I am certain He will continue to do so.

      One thought I’ve had is to add a “donate” button to my blog. However, I am lacking the the technological know-how to do that. This would offer readers an opportunity to support my writing and photography monetarily if they so choose. Maybe when the techie son is home for Christmas, he can make this happen.

  14. KathleenL Says:

    I make under $10,000 annual for teaching at an adjunct capacity at a college in Florida. I will turn 58 in 2017 the cheapest plan I can find is $500/mo & have to pay 100% out of pocket until my deductible of $7,000 is met. My husband retired early & will turn 64 next year. His premiums will be $950/month for the same out of pocket & deductible. We are both healthy & to get even 1 penny paid from insurance we must incur out of pocket that exceeds our deductible. So, We pay $17,400.00/yr just to have insurance that will only be used if there is a catastrophic need.

    • Kathleen, I am so sorry. I understand since my husband and I face similar outrageous premiums and high deductibles. You are correct in that this can only be used in catastrophic need. I feel the same. Something has to change.

  15. L. Says:

    We are a self-employed family of four living in a small Minnesota town where there is a Mayo Clinic. (Lucky us, because that raises the insurance rates.) Blue Cross Blue Shield is dumping us at the end of the year? Why? It’s just not feasible for them to make a profit, even when they charge us $1800 per month for insurance, and we almost never see a doctor–but when we do, we pay the bills up to our high deductible.

    Now, I can sign up for a new Blue Cross Plan called Blue Plus! Great news! But, that will cost $2,600 per month with an even higher deductible. So, in effect, our rate goes up $800.

    I am dumping Blue Cross.

    But even through the exchange, there’s nothing less expensive. Except for that lady on tv I see who only has to pay $46 per month.

    • I am so sorry. I feel your frustration, your pain, your “what the heck are we going to do?” worry. What are you going to do?

      I’d like to know who can get insurance coverage for $46/month.

      • L. Says:

        Not sure what we are going to do. Ever see something like this: http://samaritanministries.org ?

      • Yes, I have and I think it’s time for a second look at this. Thank you for the reminder of this possible option.

      • Thanks. Will check this out also…

      • L. Says:

        Well, Audrey, I have discovered that since our small business is structured as a sole proprietorship (“owned” by me) with my husband as my only employee to whom I pay a wage (he gets a W-2), we can qualify for small group insurance, at group rates. This was great news! It meant that I did not have to buy that Blue Cross Plus policy at $2600 / month. Rather, I could get a group rate of $1,100 for a family of four. Wow. That was $700 less than the $1,800 we had been paying.

        But, alas, the man helping me spoke too soon. Because we live in an area of Minnesota where there is a Mayo Clinic, companies don’t like to insure here. Too expensive. Sigh. . .we never asked Mayo to come to Red Wing. Grrrrr. . . So, the best he could offer was $1700 / month, with a $6,000 deductible.

        Still, that’s better than $2600 with a $12,000 deductible on the individual market.

        But it is no help at all for people without insurance who don’t own their own business. Things have to change.

        If anyone in a similar situation can structure their small business to have at least one employee, I recommend it. I should have looked into group rates years ago, obviously. The other benefit to having your own business is that 1) health care premiums are deductible and 2) contributions to a Health Savings account are also deductible. All of this effectively lowers the cost of the premiums, if you do the math,

        Still, it does seem way too high for responsible, sober and health-conscious families to pay, especially when we almost never go to the doctor and simply pay out of pocket when we do. This goes for prescriptions as well. I have learned to buy expensive prescriptions from Canada.

      • I am so thankful you found a way to keep your family’s insurance premiums at the same level. Still, $1,700/month is crazy. That will be our monthly premium for the two of us unless I unearth another option or learn something I didn’t already know.

  16. B. Prager Says:

    I was offered a plan through my ex-employer (Pre-65 retiree health care plan) for 2017 but the cheapest plan that I can find (from BCBS) will cost me around $1,000.00 a month or roughly $12,000.00 a year. That is a huge increase from my 2016 monthly premium. But here is the catch, the plan requires that I satisfy a $14,300.00 out-of-pocket deductible before the plan will share health care costs. Who can “afford” a health care plan like this? I must pay a total of $26.300.00 before my insurance company start paying my medical bills? I’d be better off putting this money in a HSA account and use it when I need it instead of being forced by ACA to buy a health insurance such as this plan. The ACA is nothing more than a crushing financial burden on middle class families across this county and it must be repealed.
    Now I can see why more and more people pay the tax penalty for not having a health insurance plan. Because it is out of their reach.

    • I am so sorry. These numbers are insanity.

      I was talking with friends last week whose insurance premium is rising to $3,000/month. It’s crazy, pure craziness. Who can afford this?

      That more people are paying the penalty does not surprise me. I’ve thought of that, too.

      What are you going to do?

  17. L. Says:

    Audrey, I just have to ad an addendum to our health insurance situation. Remember, I have the small business in RW with my husband as 1 employee. I ended up applying for group coverage AND completed the MNSure enrollment, just to see what would happen. Turned out that our income for 2016 fell well under the $92,000 cut off for a family of 4. We were able to receive insurance for $104 per month for me and my husband, and nothing for the children. You can’t imagine how this makes my head spin. Initially looking at $2,600 per month, with a $12,000 deductible then having to pay $104 per month and everything is covered.

    But it’s not all great news. The stress of the past 15 years, the mounting health insurance premiums, nearly broke my husband’s spirit. By my calculations we’ve paid over $600,000 in income tax over the past two decades. So when he could hardly manage to work in 2016, I didn’t feel one bit guilty applying for MNSure. We played by the rules all those years.

    Unlike, I am sad to say, a very nice family of Mexicans I know, who came here illegally and immediately started getting all their health care for free. I commented once to the mother that I had to pay $175 for just one of my son’s inhalers. She said, “Why don’t you just get it from the county? It’s only $1.”

    These sorts of experiences make one despair. Where do people think the money comes from?

    • L, I’m glad the health insurance situation has improved for your family. I fully understand the challenges of meeting these ever rising premiums. My husband just got his 2018 rates several days ago. I didn’t think it could get any worse. A post will be forthcoming.


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