‘I Have Nothing Good to Say About Obamacare’

Although premiums have been rising each year under the Affordable Care Act, savvy customers could sometimes avoid higher costs by shopping for cheaper plans.

That’s not going to be possible for the majority of customers in 2017. Premiums across almost every state are set to rise an average 11 percent, according to a recent analysis by the McKinsey Center for U.S. Health System Reform. The issue, many feel, has to be addressed at Sunday night’s presidential debate between Hillary Clinton and Donald Trump.

“The whole thing is a disaster. I’m paying more and getting less,” said one small business owner.

“The whole thing is a disaster. Essentially I’m paying more and getting less,” said Donna Andersen, owner of lovefraud.com, a startup company based in Egg Harbor, New Jersey, that helps people recover from traumatic relationships with sociopaths.

“I can’t be emphatic enough about how terrible it is. I have nothing good to say about the whole ACA. Zero,” she added.

The Affordable Care Act can help low-income families who qualify for subsidies find insurance — but for the middle class, the lower middle class, and small businesses like Andersen’s, it’s a quickly tightening financial noose. The analysis of next year’s premiums only takes into account those states that have already published information — which, incidentally, are the states with the most stable markets. Premiums could more than double in those states with fewer choices, especially since insurance giants have been running for the exits from the public marketplaces.

Some experts from ACASignups.net estimate that the prices will increase in select states by as much as 24 percent.

Related: It’s Official: Obamacare Is Broken. Bill Clinton Said So.

Fewer choices for consumers mean substantial price hikes. Low-income families and individuals will still receive subsidies, although reports have shown that they’re still spending upward of 10 percent of their income on health care. But middle-class families often make just enough not to qualify for any help, so they’re paying massive financial bills all on their own. The typical middle-class family is spending 35 percent of their income on health care, according to a report from the Heritage Foundation.

More than half the insurance plans offered on HealthCare.gov have deductibles of $3,000 or more.

The insurance law carries a heavy toll for small-business owners, too. As of this year, owners of businesses with 50 employees or more have to provide their workers with health insurance. The cost per employee is about $5,800 per year, or an additional $3 an hour. And that’s just coverage for individuals; family coverage doubles that price. The average family plan costs employers $16,351 a year. Companies have had to offset these costs by asking employees to work fewer hours and pay a higher percentage of their premiums, which translates to dwindling paychecks.

Donna Andersen qualified for small group insurance with her business, but it hasn’t done her any favors. Before Obamacare, Andersen paid $400 a month, and when she went to the doctor she would pay $35 for her copay; insurance would cover the rest. Now she’s paying $500 a month, but her deductible is $2,500 each year. That means that she won’t get any help from insurance until she has paid out the full $2,500 — which she can’t afford. So she doesn’t go to the doctor anymore, even though she’s worried about skin cancer.

“I should get a checkup from the dermatologist. I live at the shore, I go to the beach, I’m outside all the time, so I should check for skin cancer. That is considered a specialist, and even if I’m going for a checkup, it’s not considered preventive care. So I would have to pay the full [price] of going to the dermatologist.” The only thing covered through her current insurance is a women’s wellness visit, a mammogram, and — oddly — maternity care. “I really need that in case my husband and I decide I’m going to have IVF at the age of 60,” she noted wryly.

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She’s not the only one struggling with deductible hikes. As of March 2015, silver plans in the exchange had an average deductible of $2,500; bronze plans had deductibles of $5,300 for single coverage. By comparison, more than half of enrollees in employer-sponsored coverage have deductibles around $1,000.

Related: Obamacare in 2017: Higher Prices, Fewer Choices

The financial strain on these families shows up in other sectors as well. The restaurant industry, for example, is languishing because middle-class families no longer have the expendable income to eat out, according to a study by CivicScience data.

For the Andersens, the price of health care has put a strain on their small-business startup. “There’s no extra money lying around to spend on health care,” she said. For her, and for many families like hers, the Affordable Care Act is anything but affordable.