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Old 12-04-2015, 01:46 PM   #41
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Old 12-04-2015, 01:47 PM   #42
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Our plan is pretty simple. We continue to budget for full insurance coverage at a 7.5% annual premium increase, which is about $17,500 for this year, and additional funds sufficient to keep our HSA account at the max out-of-pocket amount.

If we don't happen to spend it all, as is the case for the past few years, well, that's nice. We operate under the assumption that recent changes can revert at any time. In reviewing proposed replacement legislation, our current budget appears to be adequate as long as we maintain our health. Worst case is the 'guaranteed issue with underwriting and no pricing restrictions' proposal (Strain, AEI), which has the potential for annual insurance costs tending to infinity. (This is NOT the Burr-Hatch-Upton proposal, which has a 5::1 range limit for age and no underwriting for those with continuous, uninterrupted coverage after the one-time (not annual) open enrollment period.)

Longer term programs, such as the age 65 Medicare eligibility, are a bit more likely to remain, so our baseline spending assumptions still include that, with a substantial reserve for the known coverage anomalies.
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Old 12-04-2015, 02:12 PM   #43
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Things will be very clear on November 9, 2016.

Actually, not really.... even if a Rep wins the WH, they will not have enough members to get past a filibuster... now, if a Dem wins I think you are right...

Not wanting to get too deep into politics, I will leave it at that...
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Old 12-04-2015, 02:15 PM   #44
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Just as I wrote on a thread talking about tax laws etc., you can only plan for what laws exist right now...

Even if you know something will change, the probability of knowing what exactly that change will be is pretty slim...

So, you can plan ahead that IF something changes you will have to get up to speed on what options are available and what is best for you...
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Old 12-04-2015, 02:19 PM   #45
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We live in MA and when we first considered early retirement we were counting on enrolling in Romney care. If the ACA is to ever be repealed our state will go back to Romney care. One of the main differences between the two plans is the MA universal system income qualification for subsidies stops at 300% of poverty rather than 400% for the ACA.

Simple girl, you're more than welcome to move to MA if the ACA is repealed.
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Old 12-04-2015, 02:29 PM   #46
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I turn 65 next August so changes to the ACA after the next election will not affect me. I do sympathize with those whose retirement plans include years of relying on the ACA. The problem is that tinkering around the edges of the ACA could have dreadful unexpected consequences. A worst case scenario might have insurance companies abandoning the individual market entirely. The fallout from a collapse of Obamacare could also have negative repercussions for medicare, Medicaid and even employer provided insurance.
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Old 12-04-2015, 03:29 PM   #47
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Hawai'i had near-universal HI prior to the ACA. Can you afford to move there? I imagine that California would get on board with a MA style plan pretty quickly too, if the ACA went away. The legislature passed one way back when, but the Governator vetoed it.

I don't honestly think that the ACA will go anywhere. It'll mostly just be used as a fund raising issue. However, my spouse is eligible for citizenship in an EU country and I've been married to him long enough to qualify too.
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Old 12-04-2015, 04:02 PM   #48
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I know the media is filled with scare stories about the ACA collapsing, but if you look at the actual data, there are 17 million more people who now have insurance. That is a pretty big voting block to tick off if there was ever to be a full repeal.

Plus, regardless of the media hype, again looking at the facts alone, the "CBO and JCT’s best estimate is that repealing the ACA would increase federal budget deficits by $137 billion" over ten years. Increasing budget deficits is also not usually popular with voters, nor would raising taxes or cutting benefits in other areas to make up the difference be popular.

I do think much of the full repeal stories are likely just kabuki theater at this point, though the cost to consumers may rise and benefits may decrease, so some pad in the ER budget to allow for that is probably not a bad idea.
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Old 12-04-2015, 04:03 PM   #49
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Simple girl, you're more than welcome to move to MA if the ACA is repealed.
Just be sure to factor in the 5.15% flat income tax, car/boat excise tax and 6.25% sales tax before you load up the truck!
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Old 12-04-2015, 04:07 PM   #50
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....Plus, regardless of the media hype, again looking at the facts alone, the "CBO and JCT’s best estimate is that repealing the ACA would increase federal budget deficits by $137 billion" over ten years. Increasing budget deficits is also not usually popular with voters, nor would raising taxes or cutting benefits in other areaa to make up the difference be popular.
However, it looks like that analysis doesn't consider the impact of whatever replaces it in the unlikely event ACA is repealed. I don't see a lot of momentum to repeal and do nothing... more to repeal and replace... and until there is some clarity on what the replacement would be it is impossible to estimate the impacts.
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Old 12-04-2015, 04:30 PM   #51
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However, it looks like that analysis doesn't consider the impact of whatever replaces it in the unlikely event ACA is repealed. I don't see a lot of momentum to repeal and do nothing... more to repeal and replace... and until there is some clarity on what the replacement would be it is impossible to estimate the impacts.
Replace is certainly always a possibility, but it has been several years now since the ACA has been crafted and I have not seen any politically tenable full replacement proposals developed yet.
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Old 12-04-2015, 04:36 PM   #52
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I personally do not think ACA will suffer much change. It isn't the type of program where you can keep the parts you like and remove the parts you don't like as that makes the whole not work.

The only way now that they can scrap ACA is to move to single payer, which would also solve the OP's problem. About 400,000 people would be unemployed then, which means that option is also off the table.

The most likely outcome by far then is that there is a lot of talk and no action. That is where I would place my betting money.
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Old 12-04-2015, 04:48 PM   #53
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simple girl, your concern is certainly legitimate, but you really can't build a specific contingency plan because we don't know what the "replacement" scenario looks like. Health care coverage is about access and cost. For financial planning purposes I assume we will always need to pay full cost with no subsidy, including Medicare. As for access, no plan but lots of hope, in the past we found a way.

OK, you and several others suggested projecting being able to pay full premiums if need be, so I will model for that financial scenario as well, in case they take the subsidy part away. Thank you!

There is no way to model for the scenario that I may be uninsurable if they take away access to those with pre-existing conditions. That would require one of us to return to work for benefits, so we just have to be ready to accept that is a remote possibility. I'm not going to let that remote possibility keep us from retiring early. I've learned nothing is promised in this life!
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(49, married; DH 53. I am fully retired as of 2015 (well ok, I still work part-time but only because I love the job and have complete freedom to call off if I want to travel with hubby for work), DH hopes to fully retire 2018 when he turns 55 to access 401K penalty-free...although he may decide to do part-time consulting)
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Old 12-04-2015, 04:48 PM   #54
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Replace is certainly always a possibility, but it has been several years now since the ACA has been crafted and I have not seen any politically tenable full replacement proposals developed yet.
True, but I'm not aware of anyone who proposes repeal and do nothing.. which was my point (and what the CBO analysis was based on).
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Old 12-04-2015, 04:50 PM   #55
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Simplegirl, It's hard for me to say how I would feel now as I'm almost 61 and only a few years away from Medicare, but I remember how desperate I was to retire at age 55 and I did budget to pay full price for HI should my Megacorp pull the rug.

However, I didn't have a medical condition that would automatically exclude me from HI under the old system so I understand why that would be a huge concern. For now my advice would be to wait and see, 2018 is a long time politically and the picture may be clearer then. IIRC you have an occupation that is in demand so you could plan to RE at 55 with the knowledge that you could always get a job with HI if need be.

Yes, you are absolutely right. Good point! Even if I retire for several years, it is highly likely I can get a job in my profession easily. Thank goodness for a good career choice in terms of job security!
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(49, married; DH 53. I am fully retired as of 2015 (well ok, I still work part-time but only because I love the job and have complete freedom to call off if I want to travel with hubby for work), DH hopes to fully retire 2018 when he turns 55 to access 401K penalty-free...although he may decide to do part-time consulting)
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Old 12-04-2015, 04:51 PM   #56
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I personally do not think ACA will suffer much change. It isn't the type of program where you can keep the parts you like and remove the parts you don't like as that makes the whole not work.

The only way now that they can scrap ACA is to move to single payer, which would also solve the OP's problem. About 400,000 people would be unemployed then, which means that option is also off the table.

The most likely outcome by far then is that there is a lot of talk and no action. That is where I would place my betting money.
Spot on. This is where I'm placing my money , by taking ER in '16 for better or worse.
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Old 12-04-2015, 04:53 PM   #57
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....There is no way to model for the scenario that I may be uninsurable if they take away access to those with pre-existing conditions. That would require one of us to return to work for benefits, so we just have to be ready to accept that is a remote possibility. I'm not going to let that remote possibility keep us from retiring early. I've learned nothing is promised in this life!
As another poster mentioned you may be able to get access to group insurance which is not underwritten.

In our first year of retirement (pre ACA) I formed an LLC for consulting, joined the local chamber of commerce, and then bought into their group health insurance program. I did it because it was more affordable but it also ducks medical underwriting.

Or move residence to a state that prohibits medical underwriting and buy insurance there.
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Old 12-04-2015, 04:53 PM   #58
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I'm not too worried about it. Possible contingency plans:

1. Relocate to a state with universal coverage/ACA type healthcare. Massachusetts for example. Vermont? I imagine many other states (probably blue - hope that's not too political to say!) who currently enjoy the universal coverage aspect of the ACA might keep it in some form or another. The longer the ACA remains in place, the more it becomes status quo and considered a "right".

2. Relocate to overseas destination - Thailand and Mexico are commonly mentioned here but YMMV. It's a huge step just to get healthcare.

3. Go back to work, quit, get COBRA. Repeat.

4. Emigrate to a developed nation (they all have some form of public healthcare but there are strings attached and barriers to entry).

None of these have to be permanent solutions. You can come back at age 65 and get Medicare. Assuming Medicare remains intact.

For our plans, I'm pretty sure we can afford the premiums as long as we are paying for an average policy. If they ever go back to risk-priced, then we might be screwed if we have a medical issue that puts us in high risk territory.

Worst case, there's a starbucks down the street, so maybe I can learn to be a middle-aged barista. Working with a bunch of 19 year olds might keep me young, too.
Ha ha ha thanks Fuego, good list to keep for reference! Appreciate the humor as well!
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(49, married; DH 53. I am fully retired as of 2015 (well ok, I still work part-time but only because I love the job and have complete freedom to call off if I want to travel with hubby for work), DH hopes to fully retire 2018 when he turns 55 to access 401K penalty-free...although he may decide to do part-time consulting)
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Old 12-04-2015, 04:58 PM   #59
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I would plan to pay for all health expenses using your own money. Then if an insurance company or government pays instead it is a bonus.
Impossible. It would ruin us financially. I feel bad for my current insurance company. God knows how much they've paid out for my care over the past 5 years. I've never been more thankful for good insurance coverage. Hoping the worst expenses are behind me, but I still have one more reconstruction surgery to go (5 so far, radiation fibrosis sucks).
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(49, married; DH 53. I am fully retired as of 2015 (well ok, I still work part-time but only because I love the job and have complete freedom to call off if I want to travel with hubby for work), DH hopes to fully retire 2018 when he turns 55 to access 401K penalty-free...although he may decide to do part-time consulting)
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Old 12-04-2015, 05:01 PM   #60
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Xxxxx Xxxxx wants to repeal Obamacare and replace it with "something terrific"...

Pfhew, and I was getting nervous for nothing. "Something terrific" sounds fantastic.
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