Insured, At Least 

We need to agree on what "affordable" means

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It was New Year's Eve when I received a call from John Saltas, City Weekly's founder and publisher. There was already some bubbly in my glass, so I let it go to voicemail. Not only was I marking the end of 2014, I was also toasting to my imminent departure from Utah. Earlier that morning, I had signed up for health insurance at—yes, the infamous Marketplace. I didn't enroll for coverage in Utah, though, because I couldn't qualify. I was moving to southern Oregon.

There, I'd live closer to my daughter and relish, among other things, the Oregon Shakespeare Festival, redwood forests and Harry & David pears. But beyond all that, my real motivation for moving to Oregon (or to Colorado, New Mexico, Arizona or Nevada, to name a few closer states) was that I could enroll in health insurance not available to me in Utah.

After a glass or two of bubbly, curiosity got the better of me, and I listened to John's message. It seemed there was a changing of the guard in the editorial department of City Weekly. Rachel Piper, the wunderkind editor of the paper since June 2014, had accepted an editing job at The Salt Lake Tribune. Would I come back and put my finger in the dike until new arrangements could be made?

The following day, we talked. I told him I'd already put down a deposit on a rental in Oregon, the moving van was coming later that week, and I'd even packed a few boxes. But I felt torn. For one thing, John Saltas—someone I can barely say "no" to—was asking. For another, I could feel my inner pilot-light igniting. Could it be? After leaving City Weekly in 2013, literally to take a break, would I get another chance to do this journalism dance?

But, but, but ... what about health insurance? Could I get back on City Weekly's plan? Because, God forbid there is a break in coverage. Do I cancel my benefits in Oregon if I still plan to move there later this year? (Answer: No, because I did, and now I am told I won't be eligible to re-up until the next enrollment period.)

I can't be the only person navigating this maze. The uproar on Capitol Hill about Gov. Gary Herbert's Healthy Utah plan is proof of that. Turns out there are lots of folks who don't like being in the gap (I call it the hole). If, as a single person in Utah without a disability, your yearly income is below $11,670, the Marketplace website will tell you to apply for Utah Medicaid. Once there, you'll find there isn't a program for you.

Medicaid in Utah, you learn, is basically for the very poor and the very ill. But there are still those who work part-time, or as freelancers and contractors. There are entrepreneurs who don't take paychecks as they start up their businesses. There are artists and performers who receive commissions and stipends for the creative work they do. And there are those, like I was, on unpaid sabbatical. We're not all asking for handouts; I daresay, most are willing to pay for affordable insurance.

In an attempt to not leave 100,000 people in the gap, Herbert tried to reinvent the program for Utah and make it palatable for lawmakers, who have to fund it. His Healthy Utah plan ties expanding Medicaid funding to imposing a job-search requirement on those hoping to avail themselves of it.

I know compromise is needed to get the ball rolling in the remaining days of the session, but this requirement is exactly what Republicans typically rail against: government infringing on one's personal life. Why should entrepreneurs and innovators be required to go on a job search to qualify for affordable health insurance? Should musicians and performers give up on their art to work at a call center?

Why can't we just make health insurance affordable, minus the damned hoops? My checkbook is ready. The problem is, when it comes to health-insurance premiums, it's nigh impossible to figure out what "affordable" really means.

Nowadays, most of us with employer-sponsored insurance pay a part of our monthly premium. Since it's deducted from our paychecks, we gradually adjust to the monthly bite. But, when you leave the company, try paying the entire premium under the COBRA program (designed to help you remain insured for up to 18 months after you leave your job). That's when you realize your actual insurance costs—and when you find yourself saying, "This is not affordable."

In the taxpayer-subsidized Marketplace, the majority of those enrolling have lower incomes and, as such, qualify for an advance premium tax credit. According to a 2015 Health and Human Services report, this keeps their average monthly premiums closer to $100/month. Now, that's what I call affordable, and I realize that all of us taxpayers are making it affordable.

The nonprofit Kaiser Family Foundation pegs the average monthly premium per person in the individual market at $158 in Utah, and $235 nationally. Because the figures are based on an average of adults and children, the premiums are likely to be lower than what most single adults actually pay.

Not only do we need to agree on what "affordable" means, there must be a way to pay for insurance that doesn't require registering with the state and making (perhaps idle) promises that we're looking for work. I'm still holding out for the single-payer system. In the meantime, I'm the fully insured "interim" editor at City Weekly.

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