The liberal blogosphere is reeling with the information that Presidential-hopeful Senator Ted Cruz (R-TX) is signing his family up for an insurance plan using the Affordable Care Act exchange. It looks like the basest hypocrisy for him to be joining the ranks of Obamacare enrollees after he shut down the government over his distaste for the whole law, but I think it’s a great thing that he’s doing this as it illustrates some of the best parts of the program. The Cruz family is now learning what so many other Americans have about the real world of health insurance and they should be thanking their lucky stars that even though Ted is an ACA hater, they can still have access to it.
To understand what’s going on with Cruz’s new insurance situation you have to first understand what his situation would have been prior to ACA. What happened this week is that Cruz’s wife took a leave from her high level job at Goldman Sachs and, in so doing, lost her eligibility for her employer-provided plan. Before the ACA, the Cruz family would have had the option of continuing that insurance policy under COBRA, where they would have paid full price for the premiums (no more employer cost-sharing, as is typical in most employer-based insurance arrangements) for up to 36 months. After that, they could have applied for an individual plan under HIPAA if they weren’t eligible for a plan with a new employer. However, HIPAA eligibility can be tricky and if they got something wrong in the process, they could have been locked out of the individual insurance market due to any number of considerations, such as health ratings that insurers used to use exclude people based on medical history. They also could have found that the coverage available to them would exclude certain things that they need coverage for, such as maternity care or any pre-existing conditions members of their family might have.
Of course, this all would have been moot prior to the ACA since at that time, since members of Congress and their staffs were all eligible for the Federal Employees Health Benefits Plan, which operates like any other employer-based plan, albeit with more coverage choices than most employers are able to offer. But under ACA, members of Congress and their staffs gave up their eligibility and instead are required to get insurance from the exchanges. There was a period of uncertainty as to whether there would be cost-sharing on premiums, which was a major issue to many Hill staff for whom health benefit costs could triple without the cost sharing they had previously enjoyed. Ultimately, there was a cost sharing arrangement reached.
So, back to Senator Cruz’s situation: what we have is a family with no access to employer-based health benefits. Prior to ACA, this would have been a pretty scary situation for most families since there was no guarantee that they could find a way to secure affordable health coverage for the long term. However, what the Cruz family is now finding out is that the exchanges and the new must-issue laws that govern health insurers mean that they can have their pick of plans with guaranteed levels of coverage, at a variety of price points. They don’t have to give up coverage because an insurance company doesn’t want to pay for an existing health issue. They can choose from all the insurers operating in their state instead of just the ones that will consider their application.
You have to admit that simply being able to go to a website and purchase replacement insurance after a job-status change is a hell of a lot easier than dealing with the alphabet soup of HIPAA and COBRA regulations. And having insurance be a set of standard products, not contingent upon what insurers are willing to provide based on their assessment of your health, makes the whole process less uncertain. And having no possibility of denial or cancellation of a policy is the best insurance of all.
Ted Cruz’s insurance situation this week looks a lot like what many families face with a job loss or change. And like many families, the answer to the question “What will we do for health insurance now?” is a lot easier to answer thanks to Obamacare. Now that Cruz and his family need something that he built his political reputation on by trying to detroy, maybe he can teach his fellow Republicans how scary it is to be on that health care high wire with no safety net.
Rebekah Kuschmider is a DC writer with an over-developed sense of irreverence, socialist tendencies, a cable news addiction, and a blog. Rebekah has an undergraduate degree in theatre and Master’s in Arts Policy and Administration and a decade of experience managing arts organizations and advocating in the public health sector. Rebekah also blogs about her life, her thoughts, and her opinions at StayAtHomePundit.com. She was voted one of the Top 25 Political Mom Blogs at Circle of Moms. Her work has also been seen at Babble.com , Salon.com, Redbook online, and the Huffington Post.