Am I the only one having to work until 65 just for healthcare?

[gauss]

Why is spreading the load in Healthcare a bad thing, but OK for Auto, Home etc.? I would think it all works itself out in the wash. Prices would then most likely be a lot more stable.

Exactly

If there is no "spreading the load" then the product that you are selling is not really insurance.

IMHO, Before ACA, with the ability to medically underwrite everyone individually and price premiums accordingly, you were not buying "insurance", but rather accessing a negotiated "group purchasing" of medical services.

 

[USGrant1962]

...

ETA - a simple solution would be to allow insurance companies to once again offer 'catastrophic' plans. Really makes one wonder why the ACA prohibited them from doing so..

Yes, remember when health insurance used to be called "Major Medical"? I think that many people with MAGI exceeding ACA tax subsidy levels would prefer that approach.

 

[ShokWaveRider]

Yes, remember when health insurance used to be called "Major Medical"? I think that many people with MAGI exceeding ACA tax subsidy levels would prefer that approach.

Don't they do that now with "Short Term" insurance that has been extended to 12 months and is renewable?

 

[USGrant1962]

Don't they do that now with "Short Term" insurance that has been extended to 12 months and is renewable?

Good question. I have not yet studied that option.

I'm going off of COBRA at the end of the year. An unsubsidized ACA PPO similar to my current plan is over twice the premium ($3400/mo), so that is not going to work even if we get a subsidy. We'll probably go with an ACA HMO; DW is not happy about that.

 

[ivinsfan]

Yes, that income cliff is a weak point of the legislation. Somebody ought to fix that.

Actually, we're feeling a little sticker shock this year while transitioning from our free-after-subsidy Bronze ACA plan to Medicare. Looks like DW and I will shell out about $500/mo for Medicare B, a supplemental policy and Medicare D plan starting next year. I wish Medicare had a high-deductible option.

As far as subsidy cliff I agree, I also feel that anybody who doesn't qualify for Medicaid should pay something towards their insurance. The idea you can pay ZERO for your insurance when you have assets and income is not affordable in the long run,

 

[daylatedollarshort]

Our premiums decreased when we went to an ACA plan from a COBRA conversion policy, even without the subsidies. Insurance before ACA for us was crazy expensive. We started out on a COBRA plan that was around a $1K a month plus deductibles, then the next year premiums went to over $2K a month plus high deductibles and out of pocket maximums. We had a ~$50K total medical cost year before the ACA for a family with kids and one pricey surgery that included some medical travel and out of network charges.

The issue with health care costs isn't so much the ACA plans but that health care in the U.S. is incredibly expensive compared to other developed countries:

"Healthcare in America is more expensive than in any other rich country. In 2016, the average American spent $4,571 on their health – a figure five times higher than the average out-of-pocket spending of other countries in the Organization for Economic Cooperation and Development (OECD)."
https://www.theguardian.com/us-news/datablog/2017/jul/02/us-healthcare-broken-system-one-chart

 

[Yarnstormer]

So far, I find my high decuctible hsa aca plan is cheaper than the plan I had when I was working. The work plan seemed better due to deductibles and copays but I only take a few generic meds. They are not subject to copays so they are actually cheaper - $5-7.
I cash pay my gyno cause I’ve seen her for decades. My primary care is on the plan.
I do get a $750 subsidy - otherwise it would be insane.
No idea if it would be acceptable if I had an expensive recurring treatment need but it’s nice to be able to get insurance. I was refused back in the days before the aca due to history of acne (yes really) and undiagnosed back pain. Back then they would refuse you for anything.

 

[Dtail]

As far as subsidy cliff I agree, I also feel that anybody who doesn't qualify for Medicaid should pay something towards their insurance. The idea you can pay ZERO for your insurance when you have assets and income is not affordable in the long run,

I am guessing that the % of folks who manage their income for ACA purposes is probably quite low across the USA and thus is not the cause for the current issues.
It appears to be high because this option is used by enough folks on this site.

 

[Fedup]

I don’t know when health insurance turns expensive, but in 2003, we paid $250 per month for a family of 4. Our COBRA was $1000 per month for a family of 4. But I didn’t use it, it was not a high catastrophe insurance either.

 

[ShokWaveRider]

No idea if it would be acceptable if I had an expensive recurring treatment need but it’s nice to be able to get insurance. I was refused back in the days before the aca due to history of acne (yes really) and undiagnosed back pain. Back then they would refuse you for anything.

This I think is the real underlying problem, a pre-existing condition can be anything the Insurance Company wishes to call as such. If there is one thing the ACA fixed was this. Unfortunately potentially pulling the ACA plug removes this valued protection.

Why should someone that is working for a company that subsidizes HC get Pre-Existing conditions included and a self employed person or person paying their own way get penalized for having them. That is certainly not fair.

 

[ownyourfuture]

If you have only 2 years, remember, Cobra is available to you for up to 18 months after leaving your employer for any reason.

Many ACA plans look expensive at first, but if you are eligible for subsidies based on your expected 2019 income, they might become more viable.

Very good points.

 

[ivinsfan]

I am guessing that the % of folks who manage their income for ACA purposes is probably quite low across the USA and thus is not the cause for the current issues.
It appears to be high because this option is used by enough folks on this site.

It doesn't matter if the utilization is high or not, even if qualify because you are working and with a family you should pay at least something out of pocket...IMO

 

[Fedup]

This I think is the real underlying problem, a pre-existing condition can be anything the Insurance Company wishes to call as such. If there is one thing the ACA fixed was this. Unfortunately potentially pulling the ACA plug removes this valued protection.

Why should someone that is working for a company that subsidizes HC get Pre-Existing conditions included and a self employed person or person paying their own way get penalized for having them. That is certainly not fair.

I do agree that people who have been covered by some sort of health insurance policy, should never be denied of pre-existing conditions. Let the people who play game with be in and out pay for this pre-existing conditions. Either that they go on Medicaid, that’s for the poor.

 

[VanWinkle]

I am guessing that the % of folks who manage their income for ACA purposes is probably quite low across the USA and thus is not the cause for the current issues.
It appears to be high because this option is used by enough folks on this site.

The law was written and passed with "Income" qualifications only without reference to assets. Not a brilliant way to subsidize people in poverty, but the law is the law. If I can get a deduction for my house interest, but don't really need the deduction, should I pass up the tax deduction? It is ok to pay obscene property taxes(I'm in Illinois) to support schools that don't teach my grown children. Life is not always fair, and I am fine with that. Live within the laws and do the best you can!!

 

[ShokWaveRider]

Wouldn't it be so much easier and cheaper for EVERYONE including the providers if everyone paid a % of their income annually and just automatically get HC for the following year based on some pre-defined benefits (maybe including limited drug coverage too). There would be a lot less agents to pay, a lot less exchanges to maintain etc. Then if they wanted more coverage) they could buy a supplemental style policy to cover extras like private room in hospital, brand name drugs etc. No that would be too easy.

 

[joeea]

When the mandate was eliminated, many have found that costs are actually starting to stabilize.

You thing setting the penalty to $0 has caused costs to stabilize?
That's funny.

 

[Dtail]

It doesn't matter if the utilization is high or not, even if qualify because you are working and with a family you should pay at least something out of pocket...IMO

Not a negative question, but is your opinion the same with someone who is retired and not working?

 

[simple girl]

This I think is the real underlying problem, a pre-existing condition can be anything the Insurance Company wishes to call as such. If there is one thing the ACA fixed was this. Unfortunately potentially pulling the ACA plug removes this valued protection.

Why should someone that is working for a company that subsidizes HC get Pre-Existing conditions included and a self employed person or person paying their own way get penalized for having them. That is certainly not fair.

+1

 

[Dtail]

The law was written and passed with "Income" qualifications only without reference to assets. Not a brilliant way to subsidize people in poverty, but the law is the law. If I can get a deduction for my house interest, but don't really need the deduction, should I pass up the tax deduction? It is ok to pay obscene property taxes(I'm in Illinois) to support schools that don't teach my grown children. Life is not always fair, and I am fine with that. Live within the laws and do the best you can!!

As you know, I am one of those ACA Management folks as you are.
My retirement came about in not being able to get another job, which despite many contacts and a good rep, did not work out truly due to age; thus another unfair concept and we all just need to do what we can.
I would not have retired to FLA before 65 yo without the ACA subsidies. Would have gone elsewhere with my tighter budget.

 

[Yarnstormer]

This I think is the real underlying problem, a pre-existing condition can be anything the Insurance Company wishes to call as such. If there is one thing the ACA fixed was this. Unfortunately potentially pulling the ACA plug removes this valued protection.

Why should someone that is working for a company that subsidizes HC get Pre-Existing conditions included and a self employed person or person paying their own way get penalized for having them. That is certainly not fair.

Exactly. I am self employed - if the aca pre existing condition protection goes away I’ll be job hunting because I have an asthma diagnosis even if it’s a non issue for me.

 

[ivinsfan]

Not a negative question, but is your opinion the same with someone who is retired and not working?

Yes because retired people can't live on air....no one who isn't under the Medicaid cutoff should get free health insurance..

 

[Dtail]

Yes because retired people can't live on air....no one who isn't under the Medicaid cutoff should get free health insurance..

Okay, but you know that most ACA managed folks are still paying more than zero, unless that was a catchall reference.

 

[ivinsfan]

As you know, I am one of those ACA Management folks as you are.
My retirement came about in not being able to get another job, which despite many contacts and a good rep, did not work out truly due to age; thus another unfair concept and we all just need to do what we can.
I would not have retired to FLA before 65 yo without the ACA subsidies. Would have gone elsewhere with my tighter budget.

And so I don't have a problem with anyone working within the system I just feel that part of the system isn't working properly..ie people getting free healthcare because it does have to be paid for by somebody.

 

[ivinsfan]

Okay, but you know that most ACA managed folks are still paying more than zero, unless that was a catchall reference.

Well I've seen a few here that talk about their zero cost bronze plans...

 

[scrabbler1]

If the pre-existing condition protection is the "candy" we all want to have, then the individual mandate is the "spinach" many people don't want to have. The latter is the price for the former.