Alternatives to Obamacare

There are alternatives to Obamacare other than paying a thousand dollars a month for family health insurance, paying a fine for lack of coverage or joining a federal program like Medicaid or Medicare. All solutions for avoiding Obamacare in this article avoid the need to use the Healthcare.gov health insurance marketplace and its government approved health insurance plans.

Health sharing ministries operate on a principal similar to the Amish community’s practice of the community sharing in the costs of high medical bills. The Affordable Care Act, also known as Obamacare, carved out an exemption that allowed only health sharing ministries that existed before 1999 to be considered legal alternatives to Obamacare. In 2014, a Catholic only health sharing ministry was set up under the umbrella of the existing Protestant health sharing ministries.

These three ministries are: Samaritan Ministries, Medi-share, and Christian Healthcare Ministries. Due to the wording of the law, new health sharing ministries could be created but wouldn’t exempt members from the Obamacare mandate.

You must be a Christian to join any of these organizations. You will pay part of others’ medical bills so that others will help you in times of need. These programs are allowed to deny coverage to medical bills related to behavior that they find unacceptable. For example, none cover abortion or a sex change operation. Some will not cover treatment of an STD acquired outside of wedlock or an unmarried teen’s pregnancy.

The cost per “share” or member is advertised as lower than standard health insurance. This is in part due to the healthier lifestyle of the members, the higher deductible the plans carry and limited coverage. However, it is far cheaper than the plans on the federal health insurance marketplace.

We signed up for Medishare as an alternative to health insurance. The interesting parts included mandatory (and cost-increasing) wellness programs due to health metrics not within ideal range and having to set up a savings account at a credit union they mandated. It is less expensive than the health insurance we were offered through the ACA marketplace and COBRA, and unlike other health sharing ministries, our doctors were on their preferred provider network.

Temporary health insurance is intended to cover someone for several weeks or months. You could get temporary health insurance to have coverage for at least part of the year in order to avoid the Obamacare fines. You could theoretically shift from temporary health insurance plan to temporary plan to gain coverage for the whole year. Repeatedly signing up for temporary health insurance could also provide coverage until you find a job with health benefits.

A final alternative to Obamacare is finding one of the few remaining private insurers that offer health insurance on the open market. You must be careful of fraudsters who will offer health insurance that is actually a discount plan that almost no doctor or hospital will accept. The rates you will pay for private health insurance on the open market will be several hundred dollars a month than the premiums charged before 2012.

However, you remain in the open market, free to pick a plan that suits you (though still subject to coverage mandates from the federal government). Health insurance premiums paid out of pocket remain a tax-deductible expense, though the Democrats increased the health expense deduction to 10% from its prior 7.5%. Ironically, 10% of your household income is becoming the default price point for most insurance plans.

Millions of people who buy health insurance on the open market have been dropped by their insurers. While it is debatable as to whether it is fair to say that even single men must pay for a health insurance policy with obstetrics and pediatric coverage (increasing the price dramatically), the fact remains that the policies for millions have been cancelled. Millions more have seen premiums double and triple, because their insurance is legally required to pay for preventative care. Preventative care isn’t free - the cost is simply shifted to the higher monthly premiums.

Catastrophic coverage essentially became illegal, where having plan that only covers you in case of a car crash or heart attack no longer meets federal guidelines requiring mental health coverage, maternity care, obstetrics, drug and alcohol treatment and other niches many won’t use or cannot afford to cover. For many people, paying more to stay with their current employer’s health insurance is not an option. Finding a job with the fewer firms that do offer health insurance is an option. Smaller companies that self-insure for health insurance are a good bet. So are large companies that still offer health insurance as one of their benefits.

It is a major source of ire that federal, state and local governments have far better health benefits than the private sector, in addition to higher average hourly pay. However, if you are looking for a job with good health insurance, that is one sector where you could go looking for a job.

For individuals, there is an option to self-insure. This would take the form of building up a large savings account, especially if you have the option of contributing to an HSA or HCRA account. Note that an HSA balance can grow year after year, whereas an HCRA account’s remaining balance at the end of the year is forfeit. Therefore, the Health Savings Account is the better choice for long term savings to insure against future medical costs.

For the first year, the the fine is $95 or 1% of income, whichever is higher. Anyone who doesn’t buy Obamacare qualified insurance has just had a 1% tax increase imposed on him. The fine will increase over time to $500 and eventually thousands of dollars.

Theoretically, the IRS is not allowed by the Affordable Care Act to collect the fine via garnishment of wages, liens against property or other enforcement mechanisms used by the IRS. The ACA states the fine can only be paid through tax payments or withheld from the filer’s tax refund. For example, an EITC credit may be reduced by the ACA fine for failing to have health insurance.

However, the Obama administration has ignored immigration law repeatedly. For example, it decided not to deport DREAM Act eligible people though the bill had not been approved by Congress, and it has even modified provisions of the Affordable Care Act by dictate, delaying various provisions at will without bothering with an actual change to the law itself. This means while the law says the IRS cannot go after your bank account if you fail to pay the fine, the federal government may ignore law like it already has ignored so many others.

You have the option to build up your savings account, pay for the doctor yourself, and hope that you can pay your bills in a disaster. You may pay the fine or refuse to pay it as a conscientious objector, though the IRS will probably start going after this money at some point, because it cannot afford to have billions in unpaid fines needed to prop up the billions in subsidies it pays out.

Those who do not want to rely upon federal programs like Medicaid and Medicare or face the risk long waits for care have alternatives to Obamacare. You can search for private insurance, self-insure, join a health sharing ministry, find a job with health insurance, or get temporary health insurance.