Explaining Obamacare to a German

First, you start with the four packages (platinum, gold, silver, bronze):

- Platinum cost the most on monthly premiums, bronze costs the least.
- If using a lot of healthcare, then platinum is the best deal, and bronze is the worst deal.
- If using very little healthcare, then platinum is the worst deal, and bronze is the best deal.
- You typically choose silver because it balances the monthly payments and the deductible as a reasonable cost, but it's not as good as platinum. You usually end up paying around 25-to-30 percent of the general costs of the care (mostly via deductibles).

Second, you must separate these into fifty state programs.  The cost varies....state by state.

Third, deductibles and co-pay matter.  Platinum: 10-percent.  Gold: 20-percent.  Silver: 30-percent.  Bronze: 40-percent.  Some with the Bronze deductible can opt for a $12,000 deductible, making the monthly premium extremely low.  Some with the Platinum deductible can opt for the $6,000 deductible and make it less.  Virtually everyone in the poverty class can get healthcare for $75 per month on the premium, but they all would have the deductible of several thousand dollars...which they don't normally have that kind of cash laying around.

Fourth, subsidy coverage.  If you are at 100-percent poverty, then on average, the government covers $6,500 for the individual or $13,000 for the family).  If you are at 130-to-150-percent above poverty, the government covers around $2,500 for the individual or $4,500 for the family).  That subsidy only covers the premium.  The deductible is back to your responsibility.  This individual will typically try to get the better package to avoid the high deductible/co-pay situation.

Fifth, every year....the rate goes up.  An example: Oregon (2015), eleven companies offered coverage. The rate increase to 2016 ranged from 8.3-percent up....to 37.8-percent up.  Five companies had a 20-percent or more increase. For 2017 in Oregon?  One company had a zero-rate increase.  Most asked for 10-to-20 percent.  Moda asked for a 32-percent increase.  For the 2018 period in Oregon, most companies asked for a 12-to-20 percent increase.  You can figure by 2024 in Oregon, the rate difference between 2017 and 2024 will be nearly 100-percent for each company offering.

Sixth, policies must be open to all individuals, regardless of health condition.

Seventh, you can decline to buy healthcare and pay a yearly fee.  It's paid via your yearly taxes.  There are two methods to paying the fee: (1) Per person, $695 and children $347 with a max of $2,085 per family.  (2) 2.5-percent of household income.  The estimate varies but it's generally believed that 20 million Americans carry no insurance.  Some people suspect it's closer to thirty million. 

Eighth, the cost difference in one year.....before Obamacare and after Obamacare....in thirty states, an increase of 60-percent or more.  In Arizona, some policies went up by 100-percent.

Ninth, the poverty line is drawn at a family of four at $24,000 roughly.  For one person, the poverty line is drawn at $12,000 roughly. With the subsidy, you'd typically pay around $80-to-$90, without the subsidy, the monthly premium would be in the $280-$300 range.

Tenth, whatever you are paying today....without the subsidy in effect....you can figure a 200-percent increase in your premium within six years (in some states, within four years).  By 2025, most healthcare premiums and deductibles will be at the level of a new car every single year.