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Old 07-02-2012, 07:14 AM   #61
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Still 98% of MA residents have healthcare and 74% like Romneycare.
Those numbers speak loudly to our national concerns since Romneycare is the model for Obamacare. You rarely get 74% of Americans liking anything. And of the 26% who don't like it probably half think we should have a tax based single payer system and would thus be unlikely to want to dump Romneycare without their preferred alternative guaranteed.
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Old 07-02-2012, 09:37 AM   #62
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Nun: I'm guessing, but I suspect that the ACA will raise the MA $35K threshold to the national $45K (?) subsidy at some point.
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Old 07-02-2012, 10:08 AM   #63
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One thing I noticed playing around with the Health Reform Subsidy Calculator - Kaiser Health Reform calculator.

The health insurance premiums are substantially more than what I am paying for my high deductible health plan today. I'm currently paying $552 for me and DW or $278 each. I input my current age and the projected unsubsidized health insurance premium ranges from $588 to $882 a month for a single person. My current maximum out-of-pocket cost is $5,950 and the maximum out-of-pocket costs for the silver plan quoted by the calculator is $6,250.

It seems that ignoring the subsidy that health insurance would be significantly higher than what I am paying now. I realize that I am somewhat comparing apples-to-oranges but are others getting similar impressions? And the amount of the increase is staggering!
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Old 07-02-2012, 10:19 AM   #64
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I noticed that as well. Would that imply a subsidy that is even more beneficial against a lower premium? Or is it a percentage?

But...please tell me where you can get HC for two @ $552 a month. Here in MA, the cheapest I can find is about $1000. Even after the ACA subsidy, my premium is about $600 a month.
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Old 07-02-2012, 10:20 AM   #65
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It seems that ignoring the subsidy that health insurance would be significantly higher than what I am paying now. I realize that I am somewhat comparing apples-to-oranges but are others getting similar impressions? And the amount of the increase is staggering!
I haven't played around with the calculator but what you are describing is exactly what I would expect. You probably have an individual policy underwritten using your individual health history and probably have a relatively clean bill of health. As I understand it, the premiums in the calculator are estimates of what the insurance companies will charge when they can no longer exclude those with pre-existing conditions. Even when including a greater number of young and presumably healthy individuals, I would expect costs to go up just as the calculator shows.
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Old 07-02-2012, 11:05 AM   #66
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Do I understand that High Deductible policies do not qualify under ALPACA (or whatever those initials are)?

If MegaCorp kicks me off of our retirement plan, I'd want to go for a high-deductible policy, just like I do for my car, house, etc. If they don't qualify, that's a problem for me.

Or could I go High-deductible, and pay the 'fine'? That might be cheaper in the long run.

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Old 07-02-2012, 11:26 AM   #67
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....As I understand it, the premiums in the calculator are estimates of what the insurance companies will charge when they can no longer exclude those with pre-existing conditions. Even when including a greater number of young and presumably healthy individuals, I would expect costs to go up just as the calculator shows.
Makes sense, but if I was still working and not eligible for the subsidy I would be pretty unhappy as my living expenses would have skyrocketed (assuming the amount of the employer subsidy remained the same).

Even my COBRA which would have been the full cost and did not exclude prexisting conditions was only ~$850/month for a couple (albeit our employee population was probably younger and healthier than the general public).
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Old 07-02-2012, 11:56 AM   #68
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I noticed that as well. Would that imply a subsidy that is even more beneficial against a lower premium? Or is it a percentage?

But...please tell me where you can get HC for two @ $552 a month. Here in MA, the cheapest I can find is about $1000. Even after the ACA subsidy, my premium is about $600 a month.
My MO Anthem BCBS had this on their website concerning the question of whether this will change cost of premiums.
No. The Supreme Court ruling has no immediate impact on your benefits or on the premium you pay.

I take the view this means not until 2014. After seeing the numbers quoted by various people, I wonder if I am in for a shock in a few years. A healthy 60 year old can get a $5500 deductible in my county for under $150, and I get it for $72 as an almost 48 year old. I have a feeling I may get a big kick in the wallet. I will assume the worst and be happy if it isn't. I really hope the HSA's survive the final regulations and changes.
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Old 07-02-2012, 12:08 PM   #69
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One thing I noticed playing around with the Health Reform Subsidy Calculator - Kaiser Health Reform calculator.

The health insurance premiums are substantially more than what I am paying for my high deductible health plan today. I'm currently paying $552 for me and DW or $278 each.
The Kaiser Family Foundation calculator is using an estimated nationwide average rate for a fairly comprehensive plan ("Silver"). That has a lower max out of pocket than what most folks here pay, among other things, so the monthly payment is higher. As I recall, the subsidy is set to be 70%,of the second highest rate Silver plan for a state, and then scaled to adjusted gross income from 135 to 400 percent of the poverty level.

The online calculator numbers should be taken as a very rough estimate. The actual numbers will vary from stat to state.
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Old 07-02-2012, 12:14 PM   #70
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Nun: I'm guessing, but I suspect that the ACA will raise the MA $35K threshold to the national $45K (?) subsidy at some point.

I don't know. The situation in MA is that you get a sliding scale of subsidy for Commonwealth Care up to 3x the official poverty level, so thats $33.5k for a single person. If you earn just over that, paying the premiums could be difficult. I assume under ACA MA would cut back on Commonwealth Care and use expanded Medicaid for people with 133% of the poverty level and below.
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Old 07-02-2012, 12:16 PM   #71
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I don't know. The situation in MA is that you get a sliding scale of subsidy for Commonwealth Care up to 3x the official poverty level, so thats $33.5k for a single person. If you earn just over that, paying the premiums could be difficult. I assume under ACA MA would cut back on Commonwealth Care and use expanded Medicaid for people with 133% of the poverty level and below.
Another question for MA residents is: How is the state subsidy going to be reconciled with the federal law's subsidy? I'm pretty sure "double dipping" won't be allowed. Is the state working on addressing this? I'd assume this means the state would eliminate its subsidy (or at least reduce it by the amount of the federal subsidy if the state subsidy is larger), but I haven't heard anything concrete there.
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Old 07-02-2012, 12:54 PM   #72
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Another question for MA residents is: How is the state subsidy going to be reconciled with the federal law's subsidy? I'm pretty sure "double dipping" won't be allowed. Is the state working on addressing this? I'd assume this means the state would eliminate its subsidy (or at least reduce it by the amount of the federal subsidy if the state subsidy is larger), but I haven't heard anything concrete there.
I imagine that if there's federal money available MA will take it and reduce it's subsidies accordingly. MA has moved on from the availability issues to the cost problem. There is a bill going through the legislature now that proposes to limit any premium increases to the level of state economic growth. What that will mean for the amount and standard of care is to be seen

The MA Connector is the model for the exchanges and it's interesting to hear the familiar terms like Bronze, Silver and Gold plans
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Old 07-02-2012, 01:11 PM   #73
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The MA Connector is the model for the exchanges and it's interesting to hear the familiar terms like Bronze, Silver and Gold plans
Good to hear (from your previous posts) the plan offerings and selection are fairly straight forward and the interface is easy to use. Hopefully the federal/state Exchanges will follow suit when they are developed.
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Old 07-02-2012, 01:15 PM   #74
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Good to hear (from your previous posts) the plan offerings and selection are fairly straight forward and the interface is easy to use. Hopefully the federal/state Exchanges will follow suit when they are developed.
I don't live in Massachusetts but I have been to that site to check out some examples of quotes and coverage levels. I think I used a zip code from Worcester or something like that just so I could get the quotes. If that represents a ballpark estimate of what the costs would be (keeping in mind that MA is a somewhat high-cost state), at least I have a rough idea of what we could be looking at if we had to budget our own health insurance.
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Old 07-02-2012, 03:22 PM   #75
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I don't live in Massachusetts but I have been to that site to check out some examples of quotes and coverage levels. I think I used a zip code from Worcester or something like that just so I could get the quotes. If that represents a ballpark estimate of what the costs would be (keeping in mind that MA is a somewhat high-cost state), at least I have a rough idea of what we could be looking at if we had to budget our own health insurance.
Yeah, it's nice to have the plans all in one place and compare costs. There are big cost differences between plans with the same level of coverage because of the different networks and hospitals you have access to without special referrals etc. For example I can get a silver plan for either $450 with Neighborhood or $750 with Blue Cross because Blue Cross lets me go to Mass General for everything and Mass General is really expensive.

Mass costs are higher than most states, but so is everything else.
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Old 07-02-2012, 03:47 PM   #76
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Another question for MA residents is: How is the state subsidy going to be reconciled with the federal law's subsidy? I'm pretty sure "double dipping" won't be allowed.
Are you kidding? This is a Mass scamster's dream! Double dipping won't be allowed unless you have 'connections'.
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Old 07-02-2012, 06:08 PM   #77
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I don't know if Medicaid will be defined differently under the new health care act, but as it is now, it is considered a welfare program. For those that are planning to ER on income within the Medicaid guidelines, I doubt that any non-disabled person under 65 will be allowed to do this.

I tried this with food stamps when I retired from the Navy at age 42 back in 1995. Even though my pension income was within food stamp guidelines, I was told to get a j*b. I went to w*rk for another 5 years, and then was fortunate enough to receive an inheritance, that with my pension, allowed me to comfortably ER.

I'm not saying that this will work the same way with this health care law, but I would be surprised if they let someone with say a $500k portfolio, throwing off $20k per year, go on Medicaid.
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Old 07-02-2012, 06:37 PM   #78
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I don't know if Medicaid will be defined differently under the new health care act, but as it is now, it is considered a welfare program. For those that are planning to ER on income within the Medicaid guidelines, I doubt that any non-disabled person under 65 will be allowed to do this.
This is an expansion of Medicaid to cover able bodied people earning up to 133% of the poverty level (or something close to that) - no requirement that they have dependent children or anything. It is because it is substantially different than the original Medicaid that Roberts justified treating it as a "new" program and concluding that the Feds can't deny funding for the old program if states don't agree to take this new one on.
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Old 07-02-2012, 07:20 PM   #79
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This is an expansion of Medicaid to cover able bodied people earning up to 133% of the poverty level (or something close to that) - no requirement that they have dependent children or anything. It is because it is substantially different than the original Medicaid that Roberts justified treating it as a "new" program and concluding that the Feds can't deny funding for the old program if states don't agree to take this new one on.
It's just when I hear Medicaid, I think welfare. Meaning the individual is incapable of earning enough money to provide health care for themselves and/or their dependents. I don't see able bodied young retirees falling into that category, just because they called it quits, and decided to live a spartan lifestyle.
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Old 07-02-2012, 07:51 PM   #80
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It's just when I hear Medicaid, I think welfare. Meaning the individual is incapable of earning enough money to provide health care for themselves and/or their dependents. I don't see able bodied young retirees falling into that category, just because they called it quits, and decided to live a spartan lifestyle.
Folks earring 133% or less of the federal poverty level don't have to go on Medicaid. They are eligible for the subsidy and any plans offered through their state health insurance exchange program. In general, if someone can afford it, they will probably prefer the more flexible alternatives to Medicare coverage. Subsidies at this low income level will be such that they shouldn't have to pay more than 2% of their earnings for the second lowest priced Silver plan on their exchange.
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