King v Burwell (ACA Subsidies) Decision Announced

[Nunthewiser]

^^ Yes. The "retail price" of our policies is now $11K. The subsidy is $10K . If the retail price goes to $13K and I have to pay $3K rather than $1K, well OK. I can shop a bit harder. So the subsidy serves as a pretty big insulator to policy increases, at least in our case.

[Big_Hitter]

Quote:

Originally Posted by DFW_M5 I am surprised at how costly this plan is for a 23 yo

the reason these plans are so expensive for young people is the ACA 3 to 1 rule - you can't charge someone more than 3 times what another pays so young people pay more

[utrecht]

Quote:

Originally Posted by scrabbler1 Before the ACA, trying to buy an affordable individual HI policy here in New York was impossible. I had used ehealthinsurance to find my first policy in 2009. That's the one whose premiums rose nearly 50% in 2 years. It was either that or the policy which left me vastly underinsured. Let's say there was no ACA and I stayed with that policy instead of dropping it in early 2011 when I was paying nearly $700 per month (1 person, me). If the premiums rose only 7% per year over the next 4 years, bringing me to this year. I'd be paying about $900 per month (again, for ONE person only). This makes the ACA a bargain even without any subsidies. Anthem had filed for a 14% increase this year but the NY Insurance Dept. cut it back to about 7%. They are filing for another 14% for 2016 but who knows if the NYID will cut that back, too. But, unlike the days before the ACA, I have lots more choices now than I had in 2011. I can change the type (i.e. metal) of my plan from Silver to Bronze. There are many more companies selling insurance now than there were in 2011 I can switch to. The ACA has been a godsend for me, making insurance affordable without being underinsured.

Can you explain this? Im still really confused about the whole ACA thing. If you're not eligible for a subsidy, is there any difference between an ACA policy and buying a policy using ehealthisurnace or healthsherpa?

[Big_Hitter]

Quote:

Originally Posted by utrecht Can you explain this? Im still really confused about the whole ACA thing. If you're not eligible for a subsidy, is there any difference between an ACA policy and buying a policy using ehealthisurnace or healthsherpa?

shouldn't be

[Mulligan]

Quote:

Originally Posted by utrecht Can you explain this? Im still really confused about the whole ACA thing. If you're not eligible for a subsidy, is there any difference between an ACA policy and buying a policy using ehealthisurnace or healthsherpa?

New York pre ACA had guarantee issue like ACA. However it did not have the subsidies and such to help bring in a healthier pool of insured to keep premium costs down. If you were healthy and not a high income person it wasn't worth the cost of the insurance. NY had at one point only 15,000 or so population in the individual market out of 20 million people. It just cost too much. MO where I live had 4-5 times the amount of people with individual insurance despite being a quarter of the population. Of course its insurance was way more affordable, but they underwrote the policies so they could reject unhealthy people applying.
As far as today....There really isnt a meaningful difference in where you get your plan now if you don't get a subsidy. I went through ehealth to avoid all the hassle of .gov.


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[MichaelB]

Quote:

Originally Posted by Big_Hitter the reason these plans are so expensive for young people is the ACA 3 to 1 rule - you can't charge someone more than 3 times what another pays so young people pay more

Actually, ACA pricing makes policies for younger people less expensive. Large group policies offered by employers do not charge for age, the rate is the same for all employees. The premium for a 30 year old is higher for the employer policy compared with an individual plan. The introduction of age based pricing was intended to make policies for young people less expensive, thus encouraging them to enroll.

[Mulligan]

Quote:

Originally Posted by MichaelB Actually, ACA pricing makes policies for younger people less expensive. Large group policies offered by employers do not charge for age, the rate is the same for all employees. The premium for a 30 year old is higher for the employer policy compared with an individual plan. The introduction of age based pricing was intended to make policies for young people less expensive, thus encouraging them to enroll.

In my state anyways, individual insurance was always charged in relation to age. Compared to group plans I imagine you are correct. Especially if your company was all 50 year olds and you were the only 25 year old.
But in the individual market pre ACA you were always charged in relation to your age band. I am going off total memory and could be faulty. But there was a minor uproar when rules were being set that the young were in effect subsidizing the older at 3-1. I could have sworn in traditional pre ACA individual market the ratio difference was closer to 5-1.


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[Big_Hitter]

Quote:

Originally Posted by MichaelB Actually, ACA pricing makes policies for younger people less expensive. Large group policies offered by employers do not charge for age, the rate is the same for all employees. The premium for a 30 year old is higher for the employer policy compared with an individual plan. The introduction of age based pricing was intended to make policies for young people less expensive, thus encouraging them to enroll.

that's certainly an issue for employers to consider, I was talking about individual plans on the exchanges

if someone jumps the company ship and goes to an exchange to get a subsidy then there is a penalty involved

[Big_Hitter]

Quote:

Originally Posted by Mulligan I am going off total memory and could be faulty. But there was a minor uproar when rules were being set that the young were in effect subsidizing the older at 3-1. I could have sworn in traditional pre ACA individual market the ratio difference was closer to 5-1.

Your memory is correct. The true cost is closer to 5-1 so the 3 to 1 rule sticks it to the young uns.

[Texas Proud]

Quote:

Originally Posted by Big_Hitter that's certainly an issue for employers to consider, I was talking about individual plans on the exchanges if someone jumps the company ship and goes to an exchange to get a subsidy then there is a penalty involved

I do not think you qualify for a subsidy if you are working and offered a plan....

OR, do you mean actually quitting a job just to get on an exchange to get a subsidy That does not make much sense to me....

[MichaelB]

Quote:

Originally Posted by Big_Hitter that's certainly an issue for employers to consider, I was talking about individual plans on the exchanges if someone jumps the company ship and goes to an exchange to get a subsidy then there is a penalty involved

Quote:

Originally Posted by Mulligan In my state anyways, individual insurance was always charged in relation to age. Compared to group plans I imagine you are correct. Especially if your company was all 50 year olds and you were the only 25 year old. But in the individual market pre ACA you were always charged in relation to your age band. I am going off total memory and could be faulty. But there was a minor uproar when rules were being set that the young were in effect subsidizing the older at 3-1. I could have sworn in traditional pre ACA individual market the ratio difference was closer to 5-1.

Most insured 30 year olds in the US were, and still are, in group plans. The rate for them is higher than in the individual market. It doesn't matter who pays, the rates are still higher.

Individual policy premiums for some 30 year olds in the pre-ACA days were lower. That is an artificial point of comparison, however, because so many were excluded and insurers regularly rescinded policies after the fact.

Introducing age into insurance pricing was, and still is, a way to exclude individuals from groups and keep costs artificially low.

[Big_Hitter]

Quote:

Originally Posted by Texas Proud I do not think you qualify for a subsidy if you are working and offered a plan.... OR, do you mean actually quitting a job just to get on an exchange to get a subsidy That does not make much sense to me....

I think you can still qualify if your employer coverage isn't "affordable" (exceeds 9.5% of agi) and you are under the 400% fpl

[Mulligan]

Quote:

Originally Posted by MichaelB Most insured 30 year olds in the US were, and still are, in group plans. The rate for them is higher than in the individual market. It doesn't matter who pays, the rates are still higher. Individual policy premiums for some 30 year olds in the pre-ACA days were lower. That is an artificial point of comparison, however, because so many were excluded and insurers regularly rescinded policies after the fact. Introducing age into insurance pricing was, and still is, a way to exclude individuals from groups and keep costs artificially low.

Not really disagreeing with you, just commenting. If we are talking insurance, age is prevalent in many forms of insurance so it isn't that unusual. It can also work the opposite way such as auto. Mentally I am still caught in the middle. If we are going to call it insurance its cost is usually based on age, usage factor, and sometimes financial condition. Make the system "national healthcare" instead of insurance and I can clear my brain of the confusion!


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[NW-Bound]

Quote:

Originally Posted by MichaelB Most insured 30 year olds in the US were, and still are, in group plans. The rate for them is higher than in the individual market. It doesn't matter who pays, the rates are still higher...

This is a valid point. Group insurance has to provide coverage without individual underwriting, so they have to make it up somehow.

The healthy people always pay for the sick. I guess that's what it boils down to.

[utrecht]

Dont take this as meaning I want subsidies taken away or anything, but...

This Supreme Court decision seems like its kind of bogus to me. The Supreme Court is supposed to look at issues and decide the case on its merits. In this case it seems to me that they said "Hmmm...there's no way we can overturn the ACA. Its too big and too important to too many people. If we overturn it, it will take forever for those lawmakers to come up with a new plan that satisfies everyone, so lets dig thru it and find a way to interpret the wording to make the law able to stay in effect". That bothers me a bit, although I agree that overturning it would've been a nightmare.

[travelover]

Quote:

Originally Posted by utrecht Dont take this as meaning I want subsidies taken away or anything, but... This Supreme Court decision seems like its kind of bogus to me. The Supreme Court is supposed to look at issues and decide the case on its merits. In this case it seems to me that they said "Hmmm...there's no way we can overturn the ACA. Its too big and too important to too many people. If we overturn it, it will take forever for those lawmakers to come up with a new plan that satisfies everyone, so lets dig thru it and find a way to interpret the wording to make the law able to stay in effect". That bothers me a bit, although I agree that overturning it would've been a nightmare.

Unlike some constitutional interpretations, the people that wrote the ACA were on hand to explain what their intention of the law was.

[brewer12345]

Quote:

Originally Posted by utrecht Dont take this as meaning I want subsidies taken away or anything, but... This Supreme Court decision seems like its kind of bogus to me. The Supreme Court is supposed to look at issues and decide the case on its merits. In this case it seems to me that they said "Hmmm...there's no way we can overturn the ACA. Its too big and too important to too many people. If we overturn it, it will take forever for those lawmakers to come up with a new plan that satisfies everyone, so lets dig thru it and find a way to interpret the wording to make the law able to stay in effect". That bothers me a bit, although I agree that overturning it would've been a nightmare.

Frankly, who knows what they really thought. And aside from what the ruling actually says, who cares? We live in a country that is well into the transition from a republic (SPQR, represent) to an imperial kleptocracy. The big boys do as they please and the rest of us like it or lump it.

[easysurfer]

I don't use a subsidy for my HI. But next year, I may have to go back to a cheap bronze plan where my doctor is not even covered. At least there's a 6K deductible per year limit.

[NW-Bound]

Quote:

Originally Posted by travelover Unlike some constitutional interpretations, the people that wrote the ACA were on hand to explain what their intention of the law was.

Are they still all there? I thought some got voted out.

[utrecht]

Lots of people have been charged with crimes or sued for things that judges have acknowledged weren't the intention of the laws and the judge says "Im sorry my hands are tied".

How about someone who gets life in prison for a drug charge and then 2 months later the penalty for the same charge is changed to a max of 2 yrs? The lawyer files for an appeal or a hearing before a judge to lesson the sentence and the judge says "I agree your clients sentence is excessive but that was the law at the time. My hands are tied". There are all kinds of injustices like this in our country, but this time the Supreme Court searched high and wide to find to find a way to interpret the law the way they wanted to fit their predetermined outcome. That's my opinion, although like I said I agree with the result.