Adria and Bruce Rusk of Falmouth, who married a few weeks ago, said they’re excited to buy insurance in the new marketplace after having gone without or being underinsured for many years.
With a combined income of $80,000, they would not be eligible for subsidies, although if they had children in future years they would more likely qualify. A family of four can earn up to about $90,000 per year and still qualify for subsidies, and the subsidies will adjust for cost-of-living increases in future years.
Bruce is an independent contractor working in information technology, while Adria is a self-employed artist. For the past five years, Adria has gone without insurance about half of the time, while Bruce has a plan offered through the company he contracts with, but it offers few benefits.
“It’s insurance in that it keeps you from being completely destitute if something really bad happens to you,” Bruce said. “But you’ll still be mostly destitute.”
Bruce, 51, said the plans being offered through the contractor kept getting worse in recent years. He had major abdominal surgery several years ago, and he still owes on $5,000 in out-of-pocket costs. But he said if he had instead had surgery last year, he would have been on the hook for more than $20,000, based on the deteriorating coverage in his health plan. He said his plan also keeps restricting the number of doctors in the network, reducing his choices.
Adria, 34, crossed her fingers and went without insurance for a few years, getting her primary care coverage from the Portland Community Health Center. But she said without insurance, there’s a reluctance to go to the doctor.
“When you don’t have insurance, you definitely delay going to the doctor, just letting your sickness work itself out more,” Adria said.
Without subsidies, the two would be paying a combined $500 to $600 per month depending on what plan they choose in the marketplace.
They said even without a subsidy, it would be worth having good insurance. Bruce said just being able to go to the doctor without paying “through the nose” will be a relief.
“I want the doctors to know me. I don’t want to be the next guy in the waiting room,” Bruce said.