Many Americans Opt to Skip

Health Insurance in 2016

By Floyd Arthur

According to the provisions of the Affordable Care Act, as of January 1,

2016, most

Americans are required to have health insurance or pay a penalty of

up to 2.5 percent

of their total household income to the IRS. Nonetheless, according to

Obama

administration sources, about 10.5 million adults who were eligible for

health

insurance coverage remained uninsured as of fall 2015.

Health Insurance in 2016

According to some of those who have chosen to pay the penalty

rather than purchase

health insurance, the decision makes financial sense. Susan Reardon, 61,

of

Kalamazoo, Michigan, for example, said in an interview with the NY

Times that after

calculating the cost of the cheapest plan available to her, which included

a $500

monthly premium and a $6,850 deductible, she was most likely going

to forgo health

insurance this year. Like many others, she believes it will be cheaper to pay

out of

pocket for her doctor visits and medications, even after paying the

approximately

$1,500 penalty.

And if something catastrophic occurs?

“I feel like it’s better just to die,” she said.

High Deductibles A Barrier to Health

Insurance

For many Americans, it seems that high deductibles rather than monthly

premiums

are the biggest obstacle to being insured. Said Tim Fescoe, a California

resident who

purchased health insurance on the state’s healthcare marketplace,

Covered California,

in 2014, “It literally covered zero medical expenses,” because the

policy included a

$6,000 deductible for both him and his wife. As a result, they opted to

drop their

insurance and pay the penalty in 2015.

The cost of going uninsured is going up this year, to $695 per adult family

member or

2.5 percent of the total household income, from $325 per adult or 2

percent of the

household income in 2015. Nonetheless, according to an analysis

by the Henry J.

Kaiser Family Foundation, about 7 million Americans would pay less in

penalties

than they would for the cheapest insurance available to them on the

federal health

insurance exchange. Furthermore, over half would not qualify for

subsidies because

their incomes are too high.

Going Without Health Insurance -- A

Big Risk

Going uninsured is a big gamble, however. According to the Health

Care Cost and

Utilization Project of the federal Agency for Healthcare Research and

Quality, there

were 36.5 million hospital stays in the United States in 2012, which

averaged four and

a half days and cost about $10,400 each. Nearly 50 percent of those

hospitalizations

involved Americans between the ages of 18 and 64 -- the demographic

that is most

likely to skip health insurance coverage in the hopes of staying

healthy.

What’s more, participation in the health insurance marketplace by the

majority of

Americans is a prerequisite for the long-term viability of the Affordable

Care Act ,

according to insurance industry experts. Younger, healthier people

offset the high cost

of caring for the sicker, older patients who have already signed up.

Whether higher penalties will encourage that increased

participation remains to be

seen. According to administration sources, about 2.5 million new

enrollees purchased

health insurance on the federal exchange since open enrollment

began on Nov. 1,

2015 -- a 29 percent increase over last year at this time.

Open enrollment for this year ends Jan. 31, 2016.

Health insurance decisions are complex and difficult, and making a

bad choice can

spell financial ruin for you and your family. So don’t try to navigate the

system alone.

Our health insurance experts will provide you with sound advice and

guide you

through the process. Just call us at 516-292-3780 any weekday between

9 a.m. and

6 p.m. ,or request a free consultation online now.

Visit www.CarmoonGroup.com