Imagine the frustration a young self-employed veteran might feel when deciding to enroll in the relatively simple VA health care program, a benefit earned, rather than in an expensive complicated Obamacare marketplace place. He finds the VA’s Benefit Explorer tool (buggy IMO), enters some basic information, and then reads:
“Based on the information you provided, it appears we cannot enroll you in VA Health Care at this time due to your income exceeding the established income thresholds for enrollment. Although you might not be eligible for enrollment at this time, VA strongly encourages you to apply now. This will allow VA to automatically reassess your application information if there is a change to the Public Law or other qualifying criteria is met.”
“Other qualifying criteria?” “Public Law” changes? The door to confusing VA-Land is shut when he comes knocking.
In this post, I decided to see what a vet might have to pay for private insurance as a painter (Dept. of Labor occupation SOC #47-2141) across several states, if excluded from Priority 7 or 8. Here are the characteristics I used. Gender: male; Age 35; Non-smoker; Single; did not serve in any combat zone; takes no medications. He recently injured a knee hiking and it didn’t heal correctly. Now painful, it is interfering with his work. He anticipates minor outpatient surgery and determines that he needs a GOLD plan.
A top-notch painter, he earns in the 90th percentile in his state. I picked these states because they all allow interstate insurance sales. These are my best guess estimates using government data and may not be accurate.
Fair? In this example, Congress excludes four out of five veterans from VA health care for working hard as a self-employed painting contractor. If this vet hurts himself on the job, there is no workman’s compensation to back him up. So the choice is go without and pay the penalty or pay for insurance. The other choice is not to work so hard or be so honest.
In Lexington, Kentucky, our hypothetical vet could see one of eight orthopedic surgeons for his knee treatment. He gets to decide, go VHA or private, because he isn’t allowed to have both. The Maine and Wyoming veterans will pay high premiums. Neither system makes much sense but the veterans should at least be able to access VA care if he/she chooses–especially for preventative services. This is why young people are balking at paying these high premiums to for-profit companies; they realize that bronze plans are a bad deal altogether.