For many families, Obamacare is probably very helpful. People getting tax credits find insurance more affordable. People are getting pre-existing conditions covered. If you have a chronic illness, losing the lifetime maximum is huge.
The costs of these benefits are mostly dispersed widely, and so it's not easy to directly compare the costs to the benefits. But sometimes the costs are pretty measurable. With my own family, for instance, it's easy to see.
We have a high-deductible health plan and we pay our medical expenses through a health savings account. This year, even before our baby was born, we reached our deductible — for in-network care. After the deductible, the insurer pays 90 percent of costs. Plus my out-of-pocket max is $5,000, which includes my deductible. So once I hit the deductible (and thus got halfway to my out-of-pocket max), I Iooked in our HSA, saw there was more than $2,500 and thought, "Good, we can afford any health care expenses that might come with a new baby."
But then my wife reminded me that some of the doctors or specialists who see us at the hospital might not be in network. And we have a totally separate (and higher) deductible for out-of-network care. We'd pay every penny for doctor out-of-network.
My wife called the hospital. The hospital said that some specialists are in network, some are out. Can we request an in-network anesthesiologist? Nope. We get whoever is on duty at the moment the contractions get too painful.
Obamacare has contributed to the narrowing of networks. This can be, on net, a good thing for health care in cases where people can shop around. But in other cases, where you can't shop around — like which specialists are working at the hospital when you're admitted unexpectedly (or where your doctor sends your bloodwork) — narrower networks are a huge threat.
My family is lucky that we have good insurance and that we have enough saved up in our HSA to cover our in-network out-of-pocket max. Now, thanks to narrower networks, narrowed further by Obamacare, we're relying more and more on continued good luck.