ACA plans for 2015

[M Paquette]

Quote:

Originally Posted by EastWest Gal Politics--will the SCOTUS gut the ACA? Will Congress try to repeal it (of course the POTUS will veto). What would you do?

Ignore the politics. The Supreme Court case hasn't even started yet, and the earliest they could possibly rule would be in June 2015. Internally the various political factions do not expect any legislative change to be done before 2017. (That is, real, non-showboat legislation is being planned for that session of Congress, not the upcoming one.)

Note to others: Please, please do not turn this into a political thread.

If you may be eligible for a subsidy, I suggest going through the official exchange.

[EastWest Gal]

Thanks for the reassurance. I, too, don't want this to be political. My mind and emotions say: save the money.

Please can anyone give a rational reason not to go for ACA insurance?


Sent from my iPhone using Early Retirement Forum

[ERhoosier]

Quote:

Originally Posted by M Paquette Ignore the politics. The Supreme Court case hasn't even started yet, and the earliest they could possibly rule would be in June 2015. Internally the various political factions do not expect any legislative change to be done before 2017. (That is, real, non-showboat legislation is being planned for that session of Congress, not the upcoming one.) Note to others: Please, please do not turn this into a political thread. If you may be eligible for a subsidy, I suggest going through the official exchange.

With all due respect, you were "political" by using term "showboat" re-possible legislation. One legislator's "showboat" is another's advocacy of a deeply held cause .
Given that many of the senators voting for ACA passage in 2010 are no longer in office and control of the senate changed parties, most pundits feel some ACA changes will pass this next Congress ('15-16). Certain provisions (e.g. medical device tax,30hr workweek HI mandate, IPAB, etc.) have much bipartisan support for repeal.
Republican Wave Put Obamacare In Surgery, And These Parts Could Be Amputated - Forbes
Much of ACA funding is "discretionary" and subject to the normal budgetary process. Most believe that some of that "discretionary" funding will be cut (since discretionary funds require passage of legislation to continue). That said, short of (very UNlikely) full ACA repeal subsidies will continue as these are part of "mandatory" ACA funding. According to Congressional Research Service, major ACA provisions like Exchange & subsidies would continue even during a gov't budgetary shut down.
http://www.coburn.senate.gov/public/...c-b222c18fcb1d

Bottom line is I 100% agree most should ignore the current politics. Any 2015 ACA legislative changes are unlikely to alter the big picture for most folks. I would make 2015 HI decisions based on present situation and not what SCOTUS/Congress might or might not do in the coming months.

[Mulligan]

Quote:

Originally Posted by EastWest Gal Thanks for the reassurance. I, too, don't want this to be political. My mind and emotions say: save the money. Please can anyone give a rational reason not to go for ACA insurance? Sent from my iPhone using Early Retirement Forum

I would if I was getting a 30% discount. I was offered an "off exchange" plan to replace the plan they are dropping me from. I found a cheaper one on exchange from same carrier. I will just call them after 11/15 and have them change it. So in essence I am going to an exchange plan without the hassle of signing up through the exchange.


Sent from my iPad using Tapatalk

[tomz]

I just browsed healthcare.gov to see what my options for 2015 in Florida are. Unsubsidized premiums went from $1296 to $1641 (26% increase). Subsidy is basically unchanged from 2014. However, the $345 premium increase means my subsidized premium increase is 170% (from $182 to $493). The plan is basically identical to the 2014 plan with a few tweaks. Despite the changes, I will still be paying about half of what I paid before the ACA for a barebones catastrophic policy.

[rbmrtn]

Some changes for my state, last year only one issuer and the premiums were way on the high side. This year this issuer has cut premiums by ~40%. Two additional issuers have joined, both now have higher premiums than the original issuer. One is in the ballpark while the other entered with much higher premiums ( unless things change when the real numbers are posted ). There are now some HSA plans but the premium is higher compared to similar plans. Given the premium cut I'll likely stay with the original issuer, but need to revisit the HSA option.

[rbmrtn]

Quote:

Originally Posted by tomz Subsidy is basically unchanged from 2014. However, the $345 premium increase means my subsidized premium increase is 170% (from $182 to $493).

I would think your subsidy would increase as well. Your total premium is limited to 9.5% of your income. Your subisidy is then calculated using the second least expensive silver plan. If the premiums go up, your subsidy should as well.

[tomz]

Quote:

Originally Posted by rbmrtn I would think your subsidy would increase as well. Your total premium is limited to 9.5% of your income. Your subisidy is then calculated using the second least expensive silver plan. If the premiums go up, your subsidy should as well.

There are more plans this year - mostly HMOs. The 2nd least expensive plan is about the same cost as last year's and is from a company that didn't participate in the exchange last year. The healthcare.gov browse option didn't show all the different versions of the plan (based on % of poverty level). It only showed the basic silver plan. Maybe when I apply the subsidy will be larger.

[ERhoosier]

Quote:

Originally Posted by Mulligan I would if I was getting a 30% discount. I was offered an "off exchange" plan to replace the plan they are dropping me from. I found a cheaper one on exchange from same carrier. I will just call them after 11/15 and have them change it. So in essence I am going to an exchange plan without the hassle of signing up through the exchange.

Hassle factor can certainly be a reason to buy off-Exchange. In some areas, more choice in individual plans is available off-Exchange. And some folks are eligible for decent group plans (via professional societies, etc.). Provider networks can be another big factor. Networks can be very different between Exchange and non-Exchange plans even for same insurance company.
Whether or not these outweigh the possibility of getting a subsidy is a personal decision. A lot of unforeseen things can happen during a year to cut MAGI (j#b loss, stock market downturn, etc.).

[Mulligan]

Quote:

Originally Posted by ERhoosier Hassle factor can certainly be a reason to buy off-Exchange. In some areas, more choice in individual plans is available off-Exchange. And some folks are eligible for decent group plans (via professional societies, etc.). Provider networks can be another big factor. Networks can be very different between Exchange and non-Exchange plans even for same insurance company. Whether or not these outweigh the possibility of getting a subsidy is a personal decision. A lot of unforeseen things can happen during a year to cut MAGI (j#b loss, stock market downturn, etc.).

I will try to get as much info as possible before selecting, but nothing short of driving 200 miles to find a provider and the medical facility is not an open air tent, I will go cheapest route possible. With insurance, ultimately you are paying for someone else's health issues or someone is paying for yours. As long as I am paying for others (and hopefully that will continue for an extended period) I will attempt to pay as little as possible in premiums.


Sent from my iPad using Tapatalk

[jetpack]

I'm in PA, looks like my rate is going up 20%. I thought the rates were suppose to be going down in my state?

[brewer12345]

Quote:

Originally Posted by jetpack I'm in PA, looks like my rate is going up 20%. I thought the rates were suppose to be going down in my state?

Shop around. You will likely do a lot better, and now there is no penalty to doing so aside from the time it takes to do so.

[MichaelB]

Quote:

Originally Posted by brewer12345 Shop around. You will likely do a lot better, and now there is no penalty to doing so aside from the time it takes to do so.

+1

Don't forget to check the websites of the insurers. Starting the 15th they will likely have many additional plans available.

[sengsational]

Quote:

Originally Posted by MooreBonds When I looked at it briefly over the weekend, I had to put my age in as 29 to get any catastrophic pricing, since the standard rule is under 30 only. So despite there being tons of exemptions, they set up the website without all of the proper info. So, to get an estimate, you have to enter your age as 29, see what the approximate ratio is between the catastrophic and bronze plans, then input your real age to see what the same bronze plan is at your real age, and then apply your ratio to get a SWAG on what the catastrophic plan might be roughly. Granted, it's a very big SWAG, but a reasonable guesstimate without any other info.

This is a great suggestion! I will do it now.

Quote:

Originally Posted by Mulligan I will try to get as much info as possible before selecting, but nothing short of driving 200 miles to find a provider and the medical facility is not an open air tent, I will go cheapest route possible. With insurance, ultimately you are paying for someone else's health issues or someone is paying for yours. As long as I am paying for others (and hopefully that will continue for an extended period) I will attempt to pay as little as possible in premiums.

Great way to think about it. You are wise!

[sengsational]

Age 55 is universally double of a 29 year old in the bronze level (the one I checked):

[eytonxav]

DD's PPO Gold BCBS Plan in Texas increased 13.4% for 2015, while DW's coverage on my mega-corp plan (non-ACA) went up 15%. I am waiting to see how much my Medigap plan will increase.

[shotgunner]

I live in New Hampshire and in 2014 we had only one insurer in the MarketPlace, Anthem BC/BS. In 2014 I qualified for a $295 a month subsidy for a Bronze plan costing $442 a month. Due to some additional insurers entering the NH Exchange my subsidy, if my income is the same, drops by $65 a month to $230. The cost of the same Anthem Bronze plan dropped by $6 a month to $436. The medical deductible and out of pocket annual max increased by $100. The new plans in the Exchange don't have hospitals and doctors in my area and I have been happy with my Anthem policy so far. I plan to keep Anthem for 2015. If the subsidies remain in place my out of pocket cost will go from $147 a month to $206. That is a pretty big jump, 40%, but it's less than half of what I was paying two years ago.

I am sure shortly after tomorrow there will be stories in the news of people complaining they can't afford their 2015 policy because of the reduction in subsidies.

This article talks about the reduction in subsidies due to competition in NH and some other states.

http://www.msn.com/en-us/money/insurance/surprises-lurk-in-health-site-re-ups/ar-BBdr2PK

It also seems the Subsidy Calculator at Kaiser has not been updated to reflect this change for NH and it is grossly overestimating the subsidy available to me for 2015 compared to what Healthcare.gov is showing.

[pb4uski]

Quote:

Originally Posted by zinger1457 Catastrophic plans are only available to those under 30 years old or with a special hardship exemption.

Two of the more common exemptions are 1) if your 2013 pre-ACA plan was cancelled and 2) if the lowest cost bronze plan available to you exceeds 8% of your MAGI (assuming your employer does not provide health insurance).

Quote:

For example, if the health coverage options available to you would cost more than 8 percent of your income or if your insurance plan was canceled because it didn't meet the law's new standards, you may ask for a hardship exemption to apply for catastrophic coverage. Read more: Is An Obamacare Catastrophic Plan For You? | Bankrate.com Follow us: @Bankrate on Twitter | Bankrate on Facebook

[shotgunner]

Quote:

Originally Posted by EastWest Gal Politics--will the SCOTUS gut the ACA? Will Congress try to repeal it (of course the POTUS will veto). What would you do? Let me know what you think. Thanks for any and all opinions.

It's all unpredictable, so given that if you qualify for a subsidy I strongly suggest you apply for it and buy a policy through the exchange. IF and WHEN something in regard to the subsidies and the ACA changes you deal with it at that time.

The subsidy is a good deal for me being semi-retired and I have and will take advantage of it as I would any tax credit I am eligible for.

It's really that simple.

[sengsational]

Quote:

Originally Posted by sengsational This is a great suggestion! I will do it now.

Using the proportional pricing swag suggested by MooreBonds I have come to the conclusion that the catastrophic policies are not much better.

Catastrophic 6600 ded, 6600 opm, Non-HSA, $40 PCP co-pay:
$235 for a 29 YO and $470(est'd) for a 55 YO.

Bronze 6275 ded, 6400 opm, HSA, pay in full for PCP:
$245 for a 29 YO and $489 for a 55 YO.

At first I thought, hey, $228 in premium savings, and maybe $400 on PCP visits...maybe I need to decide if the hassel of filling out forms and stuff to prove that the lowest silver is more than 8% of my O-MAGI is worth it.

But getting deeper into the analysis, there's more to it. $628 savings, but I loose $1700 in tax savings, not having the HSA! (thanks to jane1 on Bogleheads for the spreadsheet that highlighted this fact).

So it appears that for me, the catastropic plan is not in the cards.