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Old 03-23-2014, 09:06 AM   #61
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Originally Posted by Coffee Mavin View Post

What happens next year when ACA plans triple their rates as we hear some states expect (Florida) because the user population is so heavily skewed to older people?
"As we hear"? Oh, please. This sounds like bogus politically-based fear-mongering without any factual basis.
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Old 03-23-2014, 09:21 AM   #62
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Originally Posted by JOHNNIE36 View Post
Our lady house cleaner was here yesterday and told us a story about how the ADA has affected her. She takes some special kind of medicine and her insurance company sent a letter saying it was no longer covered. However, there was a new plan she could opt to have, an ACA plan that would then cover her medicine. The plan premium was $460/mo. She said it was twice what she was paying and had made a decision. She'll be 62 in two years so she has decided to drop the insurance and pay the fine/penalty for those two years. I don't quite understand all this and glad I'm not involved in Obamacare. However, if I was involved, it would mean that I was a lot younger and that would be a good tradeoff.
Was she eligible for a subsidy? If so, that would reduce the $460 cost. As someone else pointed out, she probably needs to shop around for a different plan from a different carrier rather than just go by what her current carrier is telling her.
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Old 03-23-2014, 09:54 AM   #63
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..... I'm pro-single payer myself, even if it is an 80/20 system like France.....
Most US pundits seem to use the term "single payer" in reference to a Canadian-style system where private pay is generally not allowed (unless leaving the country). By the "ratio definition", it could be argued that US has already become defacto "single payer" system. IOW- Overall gov't funding (fed + state/local) has grown over time to >50% of all HC costs (i.e. total funding of expanded Medicaid, Medicare, VA, gov't employee HI, ACA subsidies, tax deductions, etc.). According to CMS, in 2011 private insurance + individual OOP only accounted for ~44% of HC expenditures so US ratio may be closer to 56/44.
https://www.cms.gov/Research-Statist...act-Sheet.html
From an accounting perspective, net overall gov't HC funding is likely higher due to value of tax deductions for HI & OOP, gov't funding of private HI for its employees, etc.

Of course, how that HC funding is accessed in US is a whole separate issue.
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Old 03-23-2014, 10:00 AM   #64
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"As we hear"? Oh, please. This sounds like bogus politically-based fear-mongering without any factual basis.
http://www.kaiserhealthnews.org/Dail...ull+Text%29%29

O-Care premiums to skyrocket | TheHill

It appears both Sebelius & industry exec's agree HI premiums will be higher next year, though there is disagreement on how much.
We'll see who's right this Fall when those actual 2015 premiums are set.
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Old 03-23-2014, 10:19 AM   #65
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If you were under 55 and had not yet retired, how comfortable would you feel about jumping into the ACA? At this stage in the game, I'm not sure we'd risk it due to pricing and availability (or lack thereof) of doctors.
We are under 55 and retired about 18 months before the ACA was available. We started receiving our ACA plan the same month our Cobra benefit was scheduled to end.

The ACA plan we have is way cheaper than our Cobra plan but it is about the same cost as the private plan we had a few years prior--but the private plan had a much bigger network and much lower deductible limits.

Also, we just received a call from our kid's pediatricians this week that they have decided they will no longer be taking the BCBS choice silver ACA plan we have. Neither does my wife's or my doctors. So, we are shopping for all new doctors!
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Old 03-23-2014, 10:35 AM   #66
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Did she evaluate whether she would get a subsidy? Either way, there is so much misinformation flying around that these anecdotes are virtually useless.
They are worse than useless because they give the impression that lower income households will pay more or have to go without insurance when the opposite is usually true.
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Old 03-23-2014, 10:44 AM   #67
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Don't know if she did any searching on her own. Just said that her current insurance company told her what a ACA plan would cost.
There is a difference between an ACA compliant plan and an ACA subsidized plan. If she hasn't shopped for insurance on the exchanges then she has no idea what her best rate would be.

I can buy a sweater from Walmart or from Neiman Marcus. If I was a house cleaner I would shop at Walmart, not shop at Neimans and complain about the price.
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Old 03-23-2014, 10:53 AM   #68
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Higher Insurance Premiums Forecast For 2015 - Kaiser Health News

O-Care premiums to skyrocket | TheHill

It appears both Sebelius & industry exec's agree HI premiums will be higher next year, though there is disagreement on how much.
We'll see who's right this Fall when those actual 2015 premiums are set.
Weren't health care premiums going up every year, faster than inflation, prior to the ACA?
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Old 03-23-2014, 11:29 AM   #69
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Yup, health care costs and health insurance premiums go up virtually every year. My own actual experience, however, is that my insurance premiums for virtually identical plans went slightly down twice. The first time was when the Massachusetts plan went into effect. I was covered by BCBS of Massachusetts because my employer was based there. The 2nd time was this year. My premium for a near-identical plan with the same insurer under the ACA dropped a couple of dollars even though it was a year later and I was a year older.

There were lots of hysterics and crazy speculation before the ACA went into effect, and it appears the hysterics and crazy speculation continue. Rates in Florida tripling because of an older population? The older folks in Florida who are 65+ are covered under Medicare, not the ACA.
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Old 03-23-2014, 11:37 AM   #70
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Originally Posted by ERhoosier View Post
http://www.kaiserhealthnews.org/Dail...ull+Text%29%29

O-Care premiums to skyrocket | TheHill

It appears both Sebelius & industry exec's agree HI premiums will be higher next year, though there is disagreement on how much.
We'll see who's right this Fall when those actual 2015 premiums are set.

ER, my prediction is they are both going to be right and wrong. It will all depend on where you live, income, and possibly what carrier you have. Cigna has already been talking about huge triple digit increase in premiums in some locales, while WellPoint if memory serves has stated their profits rose some benefitting by ACA plans. It will probably be just like the rollout prices from initial year. Some people incurred huge savings, while others saw dramatic increases. It will be interesting to see how it unfolds for the following year.


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Old 03-23-2014, 12:39 PM   #71
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Weren't health care premiums going up every year, faster than inflation, prior to the ACA?
Depends on what recent years you look at. HI inflation dropped markedly from 07-09 (pre-ACA), then spiked again in '11 before dropping in '12 (post-ACA).

http://inflationdata.com/articles/wp...ion-vs-cpi.jpg
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Old 03-23-2014, 12:48 PM   #72
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....Rates in Florida tripling because of an older population? The older folks in Florida who are 65+ are covered under Medicare, not the ACA.
Agree that tripling seems unlikely, but ACA did cut significantly funding for Medicare Advantage.
https://www.cms.gov/apps/files/ACA-s...eport-2012.pdf
Premium increases may well be in the cards for those wishing to stay on that program.
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Old 03-23-2014, 01:02 PM   #73
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Anyone interested in looking at annual healthcare cost increases can find a wealth of data in the KFF Employer health benefits, here (2012 version) http://kaiserfamilyfoundation.files....nce-091112.pdf

I don't know any more than the next guy but my guess is premiums in 2015 will increase by around 4% - 5%, or about double the inflation rate. How that affects a particular policy depends on how close it already is to the average. Add to that the 3% step increase for age, so I expect to see my premium go up bay about 7% - 8%.
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Old 03-23-2014, 05:07 PM   #74
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Weren't health care premiums going up every year, faster than inflation, prior to the ACA?
Yup.

Our retirement budget included both an annual tweak for inflation, and a much larger (about two times) tweak for medical insurance cost increases., in addition to the age step-up.

Medical insurance premiums have been rising at a high rate, roughly twice inflation, for a long time. The past few years the rise was smaller than we had projected (the combined rate for our family actually dipped slightly for this year), so i expect a return to the mean (that is, a bigger increase) any year now.

There's nothing new in all this, in spite of all the spin of professional news readers and their pet pundits.
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Old 03-23-2014, 05:15 PM   #75
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Depends on what recent years you look at. HI inflation dropped markedly from 07-09 (pre-ACA), then spiked again in '11 before dropping in '12 (post-ACA).
It's way too soon to draw longer-term conclusions. There are aspects of ACA which seem to restrain costs, and others that seem to increase them -- at least in the near-term.

If we're honest and not ideological, IMO, I think we have to admit we have no idea how it will affect health care inflation in the long term. I wish the law hit the cost control issue harder, but it is what it is, so we need to see where it takes us and be willing to negotiate changes where they are obviously needed.
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Old 03-23-2014, 07:17 PM   #76
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But remember that workers in employer-based plans are not taxed on the employer subsidy portion of the premium, so they are also getting a government subsidy but in an indirect manner. The ACA subsidies merely try to even out this inequity.
But I wouldn't be subsidizing if they kept working, would I? It's not evening anything. It's just a payment to not work. What's reasonable is for there to be a deduction for every insurance payment or no deduction. I'm for none.
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Old 03-23-2014, 07:28 PM   #77
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Weren't health care premiums going up every year, faster than inflation, prior to the ACA?
What matters to one's finances is the premium & the deductibles. But what's important to the system is the overall cost of healthcare. My understanding is that is increasing faster now, but I can be corrected.
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Old 03-23-2014, 08:50 PM   #78
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But I wouldn't be subsidizing if they kept working, would I? It's not evening anything. It's just a payment to not work. What's reasonable is for there to be a deduction for every insurance payment or no deduction. I'm for none.
If they kept working and were receiving an employer subsidy which was not subject to income taxes, they you would be subsidizing them because their tax bill is lower. That's my point.

Elsewhere, I commented about the unequal tax treatment of health insurance premiums. I agree that the tax treatment should be equalized. The employer subsidy should be taxed as ordinary income and HI premiums should be an above-the-line deduction like IRA contributions, not subject to any 10%-of-AGI exclusion. Having none of it deductible would at least be consistent.

And your "payment not to work" statement is not necessarily true. In my last 17 months of working, I had become ineligible to remain in my company's group health plan because I had reduced my weekly hours worked from 20 to 12. I was on COBRA for those 17 months but had I kept working I would have had to buy my own insurance which I did just after I ERed. The ACA was not a law yet (this was 2008-09) but if had been I would have signed up through my state's exchange just I did after I ERed. So I would have been working and been receiving an ACA subsidy (my income back then is about the same as my larger investment income is today). Furthermore, many people receiving ACA subsidies were not workng to begin with, like us early retirees.
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Old 03-24-2014, 05:57 AM   #79
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Yes, I think costs go up to cover folks with pre-existing conditions. If the choice, however, is to cover or not cover people with pre-existing conditions, I'll go with covering them and paying more. You never know when it will by you or yours that falls in that category.

I never got the "younger, healthy" generation part of the ACA where college-aged students are being marketed to join the ACA. Now that parents can keep their kids through age 26 on their plans (even if they are married, employed, non-dependent, etc) I would think most of them are already covered and don't need to purchase their own plan. Most age 27+ folks I'm assuming have employer coverage. Or maybe not. Maybe there are a lot of employers that don't provide coverage.

In any case, I think there is very little in the ACA that will control the ever-escalating costs of healthcare that have been ongoing long before the ACA rolled around. There is zero political will on either side to address cost issues. There are far too many fingers in the healthcare pie and it is a complex, patchwork system across 50 states. It can't be fixed with a catchy soundbite solution. I admit that I have wondered if the mandate may be the catalyst that, at some future time, will force us all to figure out cost-control.

What usually seems to be left out in the discussion of keeping your children on your health insurance until age 26 is that it is NOT FREE! I am retired military and have Tricare health insurance. It would actually cost me more to keep my 23 year old son on my policy than it costs for him to get his own policy through his employer.

Also.....he is not even eligible to be placed on my Tricare policy.
 
You may not purchase TYA (Tricare Young Adult) coverage if you are:

 

 


  1. Eligible to enroll in an employer-sponsored health plan as defined in TYA regulations
  2. Otherwise eligible for TRICARE program coverage
  3. Married



So not every health insurance policy allows you to keep your adult children on it until age 26.

Mike


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Old 03-24-2014, 06:51 AM   #80
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But I wouldn't be subsidizing if they kept working, would I? It's not evening anything. It's just a payment to not work. What's reasonable is for there to be a deduction for every insurance payment or no deduction. I'm for none.
Person #1 quits working on April 1st. Person #2 is hired to take their place. On March 31st you were subsidizing person #2. On April 1st you stop subsidizing person #2 and start subsidizing person #1 who now has more time to volunteer/travel.
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