ACA- true story for a younger person.

[pb4uski]

I smell Porky....

 

[Mulligan]

Will you share with us what makes you worse off now?

PB, is smelling porky, so I will word this in a way to keep my streak of never causing a thread to close. BTW, I am not against ACA, just commenting it has a negative effect on me, just like it has a positive effect on someone who has been denied coverage and needs it. My rate for a $5500 deductible no copay after deductible this year is $88 a month for a 49 year old. If I were to buy it in January it would be about $290 for a $6300 deductible. I got the one year extension loophole, so I do not have to pay that until December of next year. The reasons mine are going up are obviously because the insurance pool has changed. Being underwritten, I was in a healthy "individual group". In addition, I had no maternity coverage, drug dependence coverage, or mental health coverage. Now, I have to pay for those too.
Fours years ago, when I got my policy, I didn't really know why everyone complained about insurance costs because I thought $73 a month was nothing. I just filled out an application and they gave me the price. Throw in the HSA deduction, and my net insurance costs were actually less than zero. This forum let me understand the outrageous costs some were paying and why. I am sure I wasn't the only clueless person who has always been healthy and didn't realize the enormous costs others pay and why. That is probably the reason the backlash is occurring from some segments, is they don't understand how they were protected from the costs until now.

 

[F4mandolin]

I just consider myself really lucky to be on my govt insurance. $300 a month for basic coverage for my wife and I. I have always considered my insurance to be a nice bonus. My cousin and her husband run/own a family restaurant (small town-Castle Rock WA). When I told them how much I was paying they said they were around $1000 a month. Haven't seen them for a while so I don't know how the ACA will effect them. Now that I have been retired the last 2 years.....and talking to people I golf with during the summers......$300 is really really really cheap. Something needed to be done with the health system.....is ACA going to work out? Sure hope so.... although I could eventually drop my insurance completely at some point in the future if we are back in the UK.

 

[audreyh1]

Agree that media stories are often slanted, but reality "unfiltered by partisan politics" is that folks like Mulligan (& others) will be worse off under ACA- at least as things stand now.

And there are yet others here who are better off.

So what's the point?

 

[ERhoosier]

Wonder if the OP's 30-something will really be better off. Serious illness/injury would still mean likely bankruptcy. How many folks with $20k annual income have the liquid assets to handle $6+k OOPmax, particularly if hitting that for mult years?

 

[ERhoosier]

And there are yet others here who are better off.

So what's the point?

OP posted "......if I knew of somebody worse off under ACA I would have also mentioned that". Even White House admits there are winners & losers under ACA.

 

[NW-Bound]

Mulligan, you've just got to try to live long enough to get into the "winner" group. Geezers cost Medicare a lot. If you die young, you "lock in your losses".

So, remember to do your jumping jacks everyday.

 

[NW-Bound]

Wonder if the OP's 30-something will really be better off. Serious illness/injury would still mean likely bankruptcy. How many folks with $20k annual income have the liquid assets to handle $6+k OOPmax, particularly if hitting that for mult years?

I believe that hospitals do allow people to pay off the debt in installment with low or no interest. For very serious life threatening illnesses or injuries, a $6K cost is quite "affordable", compared to what it was before. So, our young man or woman will have to drive the old car for a few more years and eat out less, but he/she stays alive. And that's more important.

My state has a program to help indigenous people with healthcare. It may be a form of Medicaid, I think, and my friend has a nephew who was saved from a serious cancer with this program.

All the above existed prior to ACA, by the way.

 

[Mulligan]

Mulligan, you've just got to try to live long enough to get into the "winner" group. Geezers cost Medicare a lot. If you die young, you "lock in your losses". So, remember to do your jumping jacks everyday.

NW, my dad has definitely established the blueprint to be a winner..I think his only hobby now is body replacement surgeries. He has the old school plan of Medicare with union insurance benefits as the supplement. The only bills he has ever paid for his hip, knees, and shoulder replacements is the gas it takes back and forth to get there. And when I drive it's totally free! He is paying for all the years of hard labor bless his heart, but still it wouldn't take a math genius to determine he has consumed more Medicare dollars than he paid in the past 40 years....

 

[NW-Bound]

My own late father also cost Medicare plenty, but being a desk worker, he did not require any bone or joint work. I am not sure, but the bill probably added up to more than $500K. Inflated dollars from the hospitals, most likely, but the cost to Medicare was certainly real.

 

[audreyh1]

I believe that hospitals do allow people to pay off the debt in installment with low or no interest. For very serious life threatening illnesses or injuries, a $6K cost is quite "affordable", compared to what it was before. So, our young man or woman will have to drive the old car for a few more years and eat out less, but he/she stays alive. And that's more important.

My state has a program to help indigenous people with healthcare. It may be a form of Medicaid, I think, and my friend has a nephew who was saved from a serious cancer with this program.

All the above existed prior to ACA, by the way.

And the resulting debt to pay off should be way lower than if they had no insurance.

 

[nun]

I'm 55 and making the choice between Cadillac COBRA plan with a $425 premium but almost no out of pocket costs and a bronze $2000/$6500 plan that will cost $166 after a $100 subsidy. I live in MA so have been required/guaranteed insurance irrespective of pre existing conditions for a while. As an early retiree the current situation despite the terrible implementation and all the complexities is an improvement. It could be a lot better, but I'll thank heaven for small mercies

 

[Hamlet]

Mulligan, that rate is low enough that I'd be worried that there is some major catch in the fine print.

There are an awful lot of policies out there that don't actually work as insurance once the person gets sick.

Do you mind me asking what state you are in?

PB, is smelling porky, so I will word this in a way to keep my streak of never causing a thread to close. BTW, I am not against ACA, just commenting it has a negative effect on me, just like it has a positive effect on someone who has been denied coverage and needs it. My rate for a $5500 deductible no copay after deductible this year is $88 a month for a 49 year old. If I were to buy it in January it would be about $290 for a $6300 deductible. I got the one year extension loophole, so I do not have to pay that until December of next year. The reasons mine are going up are obviously because the insurance pool has changed. Being underwritten, I was in a healthy "individual group". In addition, I had no maternity coverage, drug dependence coverage, or mental health coverage. Now, I have to pay for those too.
Fours years ago, when I got my policy, I didn't really know why everyone complained about insurance costs because I thought $73 a month was nothing. I just filled out an application and they gave me the price. Throw in the HSA deduction, and my net insurance costs were actually less than zero. This forum let me understand the outrageous costs some were paying and why. I am sure I wasn't the only clueless person who has always been healthy and didn't realize the enormous costs others pay and why. That is probably the reason the backlash is occurring from some segments, is they don't understand how they were protected from the costs until now.

 

[Mulligan]

Mulligan, that rate is low enough that I'd be worried that there is some major catch in the fine print. There are an awful lot of policies out there that don't actually work as insurance once the person gets sick. Do you mind me asking what state you are in?

Hamlet it is Missouri. Originally it was Anthem Blue Cross ( I switched to Coventry a couple months ago as they guaranteed coverage through 2014, while Anthem at the time hadn't clarified whether they would). It is a legitimate full blown policy, originally had 7 million dollar max limit, which did not concern me. I guess the underwriting was the key as all the major networks were included. I have read these HD low cost plans were very profitable for them. I guess the strategy was charge a small amount and expect no one to make a claim. It worked on me. The only claim I ever made was this year when I went for my "free annual visit". Figured since I paid for it, I might as well go. Coincidently my biggest premium jump ($10) for the four years was late last year right before the free visit was included into plan. Hmm, $10 times 12 months equals just about the cost of the regular visit paid with cash. Maybe it wasn't so free after all.

 

[MichaelB]

A higher premium, or the potential of one, is not enough to conclude one is worse off under the ACA , because this possibility always existed in the individual insurance marketplace. Prior to 2010 health insurance policies were subject to recission and underwriting, so at any time each of us could find ourselves without coverage or facing a steep price increase. There was never any assurance that the low price someone had would continue into the future.

We all now enjoy the benefit of guaranteed access, and while I would not venture to assign a dollar value to that, it is safe to assume that our premiums will rise in a very predictable way, limited to age, geographic location and overall healthcare inflation, but not any other personal factor.

In 2012 the average premium for private group coverage was $5615. That's a good baseline, as it covers over 85% of the private insurance market. A policy with a rate far below that enjoys an advantage no one else has. That advantage will go away for some, and it is a loss, but it puts them back onto a level playing field.

 

[Mulligan]

A higher premium, or the potential of one, is not enough to conclude one is worse off under the ACA , because this possibility always existed in the individual insurance marketplace. Prior to 2010 health insurance policies were subject to recission and underwriting, so at any time each of us could find ourselves without coverage or facing a steep price increase. There was never any assurance that the low price someone had would continue into the future. We all now enjoy the benefit of guaranteed access, and while I would not venture to assign a dollar value to that, it is safe to assume that our premiums will rise in a very predictable way, limited to age, geographic location and overall healthcare inflation, but not any other personal factor. In 2012 the average premium for private group coverage was $5615. That's a good baseline, as it covers over 85% of the private insurance market. A policy with a rate far below that enjoys an advantage no one else has. That advantage will go away for some, and it is a loss, but it puts them back onto a level playing field.

Well stated and accurate assessment. I am heading your way, but still find myself reducing all insurance to a nuisance cost that is like throwing money into the trash can. If I had every penny spent on insurance by me or for me and invested it the past 30 plus years, I would be...well I don't even want to know. Good fortune and good health have clouded my judgement into thinking of being a "loser" on cost basis alone. But I think that on all insurance, as I have maybe had $500 worth of claims in all insurance combined my whole life. Yes, I know tomorrow could be different, but I prefer it not to be so I can continue to complain about paying for it.

 

[ERhoosier]

I believe that hospitals do allow people to pay off the debt in installment with low or no interest. For very serious life threatening illnesses or injuries, a $6K cost is quite "affordable", compared to what it was before. So, our young man or woman will have to drive the old car for a few more years and eat out less, but he/she stays alive. And that's more important.

My state has a program to help indigenous people with healthcare. It may be a form of Medicaid, I think, and my friend has a nephew who was saved from a serious cancer with this program.

All the above existed prior to ACA, by the way.

Of course $6k OOPmax is less $$$ than full bill with no insurance, but "affordable". Servicing a single yr's $6+k ($12k family) med debt (plus HI premiums, etc) on $20k income could work out over several yrs, but for chronic serious illness (i.e. mult yrs of OOPmax) it is not sustainable. Billing dept's now generally expect payment plans to be reasonable (e.g. specific pay off target date vs 'perpetual $25/mo'). And in many areas copays (below deductible) are now usu collected at time of service. Sadly, if the provider's 'charity care quota' is full the eventual outcome in high debt-to-income cases is too often either bankruptcy or cutting one's income (& living standards) enough to qualify for Medicaid (depending on state). ACA has not solved this dilemma for low income workers just because they now "have health insurance".
Maybe a bit OT, but this is an argument many 'young invincibles' give for not buying HI. With the big co-pays/OOPmax, even with HI they're busted anyway if they get seriously ill. Study this Fall by (pro-ACA) Robert Wood Johnson Fdn found that most young adults believe they need HI, but sizable minority (35+%) say it's not worth the cost.
http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf407851

 

[Ticker]

The ACA also did away with health insurance policy limits. My wife has benefited tremendously from this feature. I am not totally broke due to her sickness, thanks to the ACA. No anecdotes, my personal experience.

Remember that there was gnashing of teeth for both SS and Medicare.

 

[M Paquette]

Of course $6k OOPmax is less $$$ than full bill with no insurance, but "affordable". Servicing a single yr's $6+k ($12k family) med debt (plus HI premiums, etc) on $20k income could work out over several yrs, but for chronic serious illness (i.e. mult yrs of OOPmax) it is not sustainable.

A person with chronic illness or with a somewhat higher need of medical services at that income level would best be served by selecting a Silver plan with the cost-sharing reductions.

http://www.kaiserhealthnews.org/fea...chelle-andrews-on-cost-sharing-subsidies.aspx

In California, for example, a standard silver plan will have a $2,000 deductible, a $6,400 maximum out-of-pocket limit and a $45 copayment for a primary care office visit. Someone whose income is between 150 and 200 of the poverty level, on the other hand, will have a silver plan with a $500 deductible, a $2,250 maximum out-of-pocket limit and $15 copays for primary care doctor visits.

 

[Buck2520]

Another true story. I will retire in January. Only reason I can retire is the ability to buy health insurance under the ACA. Due to pre-existing health issues I am not sure we could have gotten insurance at any cost, little lone one we could afford. Thought I was going to have to work until 65 just to keep insurance. Just one couples story.

 

[Malcolm2]

The beauty of anecdotes is that you can find one to fit whatever your agenda is. I'm going to just sit back and see how this all plays out. Me, with my secure, ex-employer supplied insurance.

True, best to see how things play out. Anecdotes aside, the fact is that most young folks just have no incentive to sign up as they are smart enough to know they will merely be subsidizing the older or sick folks. The numbers certainly bear that out thus far.

This is not gloom and doom, just the facts with a healthy dose of common sense. To pretend (hope?) otherwise since it may benefit us individually as early retirees, if you receive an entitlement/subsidy or not, is really to just bury your head in the sand.

 

[AllDone]

Actually young people should sign up, if they are smart. A medical bankruptcy is still a bankruptcy. Granted they don't have assets to protect, but a bankruptcy affects credit ratings and makes it hard to buy a car, rent housing and even get a job resulting in lower life time earnings. Additionally, a high percentage of young people can be predicted to have pregnancies and some unlucky ones do get bad diseases. There are also a lot of reasonably healthy young people with pre-existing conditions who wish to be covered. Most young people qualify for subsidies and cost sharing and would be foolish to not take the opportunity to protect their financial futures.

Mulligan, you may make it to 65 unscathed, but I'm not betting my retirement on my own prospects, myself. If you do get sick, that low premium would soar under the pre-ACA system. There are some cost controls built into the ACA, but any really powerful cost containment would set somebody squawking. Remember "gutting Medicare" and "death panels"? One estimate is that 99% of insured Americans have limited networks already, so the fussing about that effect from the ACA is really just silly.

 

[reubenray]

I am not a young person, but ACA is going to be great for us (DW and myself). Being I retired last year our cost for health insurance was the biggest hit of our fixed income. Last year it cost us $514/month and this year it will be $348/month. Plus I have a better policy and we have dental insurance again.

 

[Gatordoc50]

Actually young people should sign up, if they are smart. A medical bankruptcy is still a bankruptcy. Granted they don't have assets to protect, but a bankruptcy affects credit ratings and makes it hard to buy a car, rent housing and even get a job resulting in lower life time earnings. Additionally, a high percentage of young people can be predicted to have pregnancies and some unlucky ones do get bad diseases. There are also a lot of reasonably healthy young people with pre-existing conditions who wish to be covered. Most young people qualify for subsidies and cost sharing and would be foolish to not take the opportunity to protect their financial futures. Mulligan, you may make it to 65 unscathed, but I'm not betting my retirement on my own prospects, myself. If you do get sick, that low premium would soar under the pre-ACA system. There are some cost controls built into the ACA, but any really powerful cost containment would set somebody squawking. Remember "gutting Medicare" and "death panels"? One estimate is that 99% of insured Americans have limited networks already, so the fussing about that effect from the ACA is really just silly.

. The fact is that medical costs are the easiest debts to discharge in bankruptcy. If student loans were as easy to discharge then they would be the number 1 reason for bankruptcy filings.

 

[Mulligan]

Actually young people should sign up, if they are smart. A medical bankruptcy is still a bankruptcy. Granted they don't have assets to protect, but a bankruptcy affects credit ratings and makes it hard to buy a car, rent housing and even get a job resulting in lower life time earnings. Additionally, a high percentage of young people can be predicted to have pregnancies and some unlucky ones do get bad diseases. There are also a lot of reasonably healthy young people with pre-existing conditions who wish to be covered. Most young people qualify for subsidies and cost sharing and would be foolish to not take the opportunity to protect their financial futures. Mulligan, you may make it to 65 unscathed, but I'm not betting my retirement on my own prospects, myself. If you do get sick, that low premium would soar under the pre-ACA system. There are some cost controls built into the ACA, but any really powerful cost containment would set somebody squawking. Remember "gutting Medicare" and "death panels"? One estimate is that 99% of insured Americans have limited networks already, so the fussing about that effect from the ACA is really just silly.

I agree as currently I would much rather complain about paying the premium than worrying about a possible health issue while being uninsured. But I do worry about the premium "death spiral" occurring. Once it reaches a certain point if it occurs, I must admit, I will drop it too and take my chances.