As many as nine in 10 Texans buying health insurance on the new federally run exchange will get a break on costs, according to federal health officials. Steve and Maegan Wolf won’t be among them.
The Wolfs, who live in an upscale area outside Austin, make too much money to qualify for the new Patient Protection and Affordable Care Act (PPACA) tax credits that will help other people afford coverage. That leaves them wondering how much they’ll wind up paying.
Steve Wolf, 50, coordinates stunts and special effects for feature films and TV shows. Last year, he helped the Discovery Channel blow up scale replicas of the Hindenburg. He owns Stunt Ranch, where schoolchildren come to learn about the science and math of movie stunts.
His wife, 34, is a full-time mom who spends many hours each week getting their three boys, 16-year-old Clayton, 12-year-old Paxton and 8-year-old Dashton, to school, swim lessons, speech therapy and math tutoring appointments.
Like many who run family businesses, the Wolfs’ annual income varies, but it’s typically $115,000 to $140,000. That means they make too much to be eligible for the tax credits that will help some Americans pay for health insurance under PPACA. They also worry that changes in coverage required by the law will mean their premiums will increase. That includes setting minimum coverage requirements for insurance companies that go well beyond what many offer now and prohibiting insurers from banning those with pre-existing medical conditions.
The Wolfs have purchased their family’s health insurance on the individual market for about 12 years, during which time their premiums have risen steadily.
They now pay about $650 a month for insurance. And while their general health is excellent, each of them has had their share of medical expenses. Their policy has a $5,000 annual deductible for each adult, meaning the Wolfs in many years have had to pay $10,000 out of pocket toward medical bills on top of the $25 copays for doctor visits and $20 copays for covered generic medicine.
Next to their mortgage ($2,300 a month with property taxes), their health insurance is one of their biggest expenses. Private school for two of the three boys adds nearly $3,000 per month. One of the boys is both dyslexic and has celiac disease, requiring additional educational and grocery expenses. There also are bills for life insurance, orthodontia, utilities, cellphones, car insurance for a teenage driver, and home and auto maintenance.