Join Early Retirement Today
Closed Thread
 
Thread Tools Search this Thread Display Modes
Old 04-30-2013, 11:55 AM   #441
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
youbet's Avatar
 
Join Date: Mar 2005
Location: Chicago
Posts: 9,965
Quote:
Originally Posted by Mulligan View Post
I would certainly agree with your assessment. I also want to reinforce that I am not saying this is bad policy in general either. My concerns on potential "rate shock" is directed specially for my situation. Healthy, under 50, male, underwritten policy, with no premium subsidy from government. Someone in my same state in the "high risk pool" (assuming there is one) or low income maybe even my same age, might come out better financially than what they now are paying, so yes, generalizations are impossible. But for me, I appear to be the "poster boy demographic" for a nice rate increase.
Earlier on this thread, we established that there will be winners and losers as a result of Obamacare. While the overall net outcome may be a postive good for the country (by someone's standard of measure), it's a shame that the changes weren't written to avoid having "losers."

An "everyone wins or stays the same" outcome would have been nice. But, so be it.........
__________________

__________________
"I wasn't born blue blood. I was born blue-collar." John Wort Hannam
youbet is offline  
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 04-30-2013, 12:11 PM   #442
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,907
Quote:
Originally Posted by Texas Proud View Post
Interesting.... but I want to see if I am understanding what you are writing... the $6,750 is a hard limit.... which includes the co-pays to doctors
I wouldn't call it a hard limit. It's a formula based on a bunch of variables. But in a specific year, yeah, it would be a "hard limit".

Quote:
Originally Posted by Texas Proud View Post
What about drugs? Are these included in that limit, or are they still separate?
I really don't remember all the details. Now I'm going to have to look this stuff up. Check ACA Section 1302

(c) REQUIREMENTS RELATING TO COST-SHARING.
(1) ANNUAL LIMITATION ON COST-SHARING.—
(A) 2014.—The cost-sharing incurred under a health plan with respect to self-only coverage or coverage other than self-only coverage for a plan year beginning in 2014 shall not exceed the dollar amounts in effect under section 223(c)(2)(A)(ii) of the Internal Revenue Code of 1986 for self-only and family coverage, respectively, for taxable years beginning in 2014.

(3) COST-SHARING.—In this title—
(A) IN GENERAL.—The term ‘‘cost-sharing’’ includes—
(i) deductibles, coinsurance, copayments, or similar charges; and
(ii) any other expenditure required of an insured individual which is a qualified medical expense (within the meaning of section 223(d)(2) of the Internal Revenue Code of 1986) with respect to essential health benefits covered under the plan.
(B) EXCEPTIONS.—Such term does not include premiums, balance billing amounts for non-network providers, or spending for non-covered services.

Quote:
Originally Posted by youbet View Post
Any change is promoted by those benefitting from it.
That's actually not the case in many cases.

Quote:
Originally Posted by youbet View Post
it's a shame that the changes weren't written to avoid having "losers."
No such thing: Someone will always claim to be aggrieved by anything ever proposed.
__________________

__________________
bUU is online now  
Old 04-30-2013, 12:27 PM   #443
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
youbet's Avatar
 
Join Date: Mar 2005
Location: Chicago
Posts: 9,965
Quote:
That's actually not the case in many cases.
Not true IMO. I think that most of the time people are in favor of changes that benefit themselves, loved ones or that enhance or support their personal value system.
Quote:


No such thing: Someone will always claim to be aggrieved by anything ever proposed.
OK, I suppose someone will. But that doesn't justify writing a plan that omits some form of relief to individuals and families who will suffer negative consequences from the plan.
__________________
"I wasn't born blue blood. I was born blue-collar." John Wort Hannam
youbet is offline  
Old 04-30-2013, 12:28 PM   #444
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,424
Here's a paper by KFF that discusses cost sharing http://www.kff.org/healthreform/upload/8303.pdf . The insurance companies are free to design any combination of cost sharing between deductible and copay, but the policy must meet the actuarial value targets established by HHS.

I would call the total out of pocket a pretty hard limit for in network, covered services.
__________________
MichaelB is offline  
Old 04-30-2013, 12:32 PM   #445
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,907
Quote:
Originally Posted by youbet View Post
Not true IMO. I think that most of the time people are in favor of changes that benefit themselves, loved ones or that enhance or support their personal value system.
That's a lot different from what a typical reader would infer from, "Any change is promoted by those benefitting from it."

It is true that people will not support things that they don't care about.

Quote:
Originally Posted by youbet View Post
But that doesn't justify writing a plan that omits some form of relief to individuals and families who will suffer negative consequences from the plan.
What do you feel, specifically, was omitted, that could have been included without omitting something else or otherwise undercutting the whole in some other way? Omitting something that if included would undercut the whole is sometimes or often very appropriate. It's the nature of compromise.

Quote:
Originally Posted by MichaelB View Post
I would call the total out of pocket a pretty hard limit for in network, covered services.
Except I believe that it changes every year. That is what I meant earlier.
__________________
bUU is online now  
Old 04-30-2013, 12:37 PM   #446
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,424
Let's keep the discussion on what the PPACA is and implementation issues. Further need for health care change or reform can be take up in a new thread.
__________________
MichaelB is offline  
Old 04-30-2013, 12:39 PM   #447
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,424
Quote:
Originally Posted by bUU View Post

Except I believe that it changes every year. That is what I meant earlier.
Are you referring to inflation or COL adjustment?
__________________
MichaelB is offline  
Old 04-30-2013, 12:40 PM   #448
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,907
Quote:
Originally Posted by MichaelB View Post
Are you referring to inflation or COL adjustment?
I'm not sure. All I know is that the HSA threshold (which is used as the cost-sharing limit for ACA) changes year to year.
__________________
bUU is online now  
Old 04-30-2013, 12:42 PM   #449
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
youbet's Avatar
 
Join Date: Mar 2005
Location: Chicago
Posts: 9,965
Quote:
Originally Posted by bUU View Post
.

What do you feel, specifically, was omitted, that could have been included without omitting something else or otherwise undercutting the whole in some other way?
You can review the twenty-some pages of this thread for examples.

I'm mystified as to why some people seem to be pleased that there are "losers" in the new plan. What satisfaction are they getting from it? Is it because Obamacare was a political battle and, now won, must extract some blood from the losers for the delight of the "winners?"

Edit: I'm now seeing the mod warning above posted while I was typing. I'll exit this discussion.
__________________
"I wasn't born blue blood. I was born blue-collar." John Wort Hannam
youbet is offline  
Old 04-30-2013, 12:52 PM   #450
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,907
Quote:
Originally Posted by youbet View Post
You can review the twenty-some pages of this thread for examples.
Though I don't agree that any such examples were included that meet the criteria I outlined.

Quote:
Originally Posted by youbet View Post
I'm mystified as to why some people seem to be pleased that there are "losers" in the new plan.
I don't know of any people who are.

I'm going to keep my ears open on Friday; I might overhear from the other room some updates on the educational aspects we've been referring to. I can tell you that the were supposed to be a lot more efforts to roll out the information we're talking about here, many of which were short-changed by inadequate funding. I'll try to share as much as I am legitimately able given the means by which I'm obtaining the info.
__________________
bUU is online now  
Old 04-30-2013, 01:03 PM   #451
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,424
Quote:
Originally Posted by bUU View Post
I'm not sure. All I know is that the HSA threshold (which is used as the cost-sharing limit for ACA) changes year to year.
Neither, as I just found out. Again, from KFF
Quote:
Generally, the limits are based on the maximum out-of-pocket limits for Health Savings Account-qualified health plans ($5,950 for single coverage and $11,900 for family coverage in 2010), which will be indexed to the change in the Consumer Price Index until 2014 when the provision takes effect.6 After 2014, the limits will be indexed to the change in the cost of health insurance
http://www.kff.org/healthreform/upload/7962-02.pdf
__________________
MichaelB is offline  
Old 04-30-2013, 02:10 PM   #452
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,263
Quote:
Originally Posted by youbet View Post
You can review the twenty-some pages of this thread for examples.

I'm mystified as to why some people seem to be pleased that there are "losers" in the new plan. What satisfaction are they getting from it? Is it because Obamacare was a political battle and, now won, must extract some blood from the losers for the delight of the "winners?"

Edit: I'm now seeing the mod warning above posted while I was typing. I'll exit this discussion.

I don't see that people are glad that there are losers at all... I do see where some are happy that the system has changed and that more people will be covered by insurance... but even the ones that like the law do not seem to be gloating about losers...

I do see where the facts are coming out and people say that is the way it is.... and they are right... no malice IMO...

I am kinda in the middle about the law (however, I would rather it not have passed, but it did and it is the law).... I do think there are a lot of good things in the law, my biggest beef is that the gvmt is going to be spending $100 billion a year more than before... that money comes from somewhere... and I believe that without some kind of real structural change in the costs of the system, the costs are going to continue to skyrocket and make our debt worse than it already is.....
__________________
Texas Proud is offline  
Old 04-30-2013, 06:26 PM   #453
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
travelover's Avatar
 
Join Date: Mar 2007
Posts: 9,878
Quote:
Originally Posted by Texas Proud View Post
......... and I believe that without some kind of real structural change in the costs of the system, the costs are going to continue to skyrocket and make our debt worse than it already is.....
Bingo. As Warren Buffet says, trees don't grow to the sky. Equilibrium will be reached either by Americans being bled dry or more radical reform implemented to bring us into synch with other Western nations in terms of cost / outcome.
__________________
Yes, I have achieved work / life balance.
travelover is offline  
Old 05-01-2013, 07:55 AM   #454
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,612
Haven't seen if posted elsewhere but HHS just released the application that a single individual will need to apply for the exchange and the subsidy process. Article on it is here:

HHS releases form to apply for Obamacare coverage - May. 1, 2013
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline  
Old 05-01-2013, 12:45 PM   #455
Dryer sheet wannabe
 
Join Date: Apr 2013
Location: Bemidji
Posts: 15
This is my first posting here - I just joined your group yesterday - but I have taken the time to read the entire thread and find it to be the most comprehensive discussion I've found online. Thanks to all of you for the comments and resources!

As my husband and I plan for our ER (once our house which could take awhile), what to do about health coverage has been one of our major worries. DH stayed with a megacorp for over twenty years because one of the benefits was going to be subsidized retiree insurance if he left anytime after 55, at the same cost as when working. Just before he qualified, megacorp #1 sold to megacorp #2; inspite of promises to the contrary during the transition, it now looks as though retiree coverage under #2 will be much more expensive, and would limit us to choosing one healthcare provider, which won't work for us since we'll be traveling.

So unlike others who have posted here, we HOPE the retiree coverage will be dropped so it doesn't prevent us from using the exchange (still investigating the details on that but it looks like it would be about a quarter the cost of the employer coverage). Until full retirement age, I believe we will be able to stay under the 400% cap by using interest/dividends much less than $60,000 and after tax dollars; once we are eligible for Medicare, supplemental plans are much cheaper, even if we are living on before tax IRA income at that point. We hope the exchange eventually also will offer reasonable LTC plans, and dental too. (Although we know many who get great, reasonable dental care in Canada or Mexico, provided it is not an emergency.)

A couple of additional observations to comments discussed here: high deductible plans are by far the most profitable for insurance companies, which is why they like them (on a premiums collected vs. payments made basis). The HSA tax savings that insurers receive do reduce the cost to the insured, but this is a government/taxpayer subsidy, just as the Affordable Care Act provides subsidies. High deductible plans, then, are cheaper because the insured is receiving less of a benefit and because of the tax subsidy. Also as mentioned here, some purchased these plans because it was all they could afford, going without needed preventive care, etc. and still at times being forced into bankruptcy. Uncompensated care (absorbed by providers but then cost shifted to the rest of us) grew dramatically with the advent of high deductible plans, because patients couldn't afford to pay for the care beneath the deductible limit. So (if I recall correctly) as a matter of public policy, if subsidies were going to be used (whether via HSAs or PPAACA subsidies) the idea was to try to get the most bang for the tax payer buck in terms of money spent actually paying for care. (Let me know if I'm too far off thread).

I will be following this forum closely for as much information as we can glean about how this will work, in the event we are fortunate enough to sell our home soon and have to decide whether to pull the plug before the ACA is implemented. If we do decline the retiree insurance, there will be no going back later.
__________________
Northwoods Mary is offline  
Old 05-01-2013, 12:54 PM   #456
Recycles dryer sheets
 
Join Date: Nov 2011
Posts: 127
Very well done article in the WSJ yesterday April 30. Documents the huge increases in premiums apparently imminent. They estimate damage to 30-40 million people caused by increases and employment cutbacks!! Premiums expected to rise for 30 percent of us alone. Article was written by Daniel Kessler a Professor at Stanford.

Daniel Kessler: The Coming ObamaCare Shock - WSJ.com
__________________
Malcolm2 is offline  
Old 05-01-2013, 02:17 PM   #457
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,263
Quote:
Originally Posted by Northwoods Mary View Post
This is my first posting here - I just joined your group yesterday - but I have taken the time to read the entire thread and find it to be the most comprehensive discussion I've found online. Thanks to all of you for the comments and resources!

As my husband and I plan for our ER (once our house which could take awhile), what to do about health coverage has been one of our major worries. DH stayed with a megacorp for over twenty years because one of the benefits was going to be subsidized retiree insurance if he left anytime after 55, at the same cost as when working. Just before he qualified, megacorp #1 sold to megacorp #2; inspite of promises to the contrary during the transition, it now looks as though retiree coverage under #2 will be much more expensive, and would limit us to choosing one healthcare provider, which won't work for us since we'll be traveling.

So unlike others who have posted here, we HOPE the retiree coverage will be dropped so it doesn't prevent us from using the exchange (still investigating the details on that but it looks like it would be about a quarter the cost of the employer coverage). Until full retirement age, I believe we will be able to stay under the 400% cap by using interest/dividends much less than $60,000 and after tax dollars; once we are eligible for Medicare, supplemental plans are much cheaper, even if we are living on before tax IRA income at that point. We hope the exchange eventually also will offer reasonable LTC plans, and dental too. (Although we know many who get great, reasonable dental care in Canada or Mexico, provided it is not an emergency.)

A couple of additional observations to comments discussed here: high deductible plans are by far the most profitable for insurance companies, which is why they like them (on a premiums collected vs. payments made basis). The HSA tax savings that insurers receive do reduce the cost to the insured, but this is a government/taxpayer subsidy, just as the Affordable Care Act provides subsidies. High deductible plans, then, are cheaper because the insured is receiving less of a benefit and because of the tax subsidy. Also as mentioned here, some purchased these plans because it was all they could afford, going without needed preventive care, etc. and still at times being forced into bankruptcy. Uncompensated care (absorbed by providers but then cost shifted to the rest of us) grew dramatically with the advent of high deductible plans, because patients couldn't afford to pay for the care beneath the deductible limit. So (if I recall correctly) as a matter of public policy, if subsidies were going to be used (whether via HSAs or PPAACA subsidies) the idea was to try to get the most bang for the tax payer buck in terms of money spent actually paying for care. (Let me know if I'm too far off thread).

I will be following this forum closely for as much information as we can glean about how this will work, in the event we are fortunate enough to sell our home soon and have to decide whether to pull the plug before the ACA is implemented. If we do decline the retiree insurance, there will be no going back later.


I have nothing to back it up, but I would bet that having health coverage offered to ex-employees does not come into the picture.... heck, you no longer are employed....


My mega had the same kind of coverage... when there was a merger, they decided to stop offering it for future retirees.... but did have the cut off age of 50 to qualify (could not sign up until 55)... I was 49 at the time...
__________________
Texas Proud is offline  
Old 05-01-2013, 02:57 PM   #458
Dryer sheet wannabe
 
Join Date: Apr 2013
Location: Bemidji
Posts: 15
Actually, I think there is something about this (retiree coverege) in the ACA. Don't quote me, but I think it has to do with whether the employer is paying at least 50% of the cost of the policy, and whether it is considered "affordable" as a percentage of you income. I don't think everyone (retired or not) to just opt out of an employee-paid plan and go to the exchange for coverage. Our problem is that we can't get much specific information from the megacorp - seems like they don't want to commit to anything. So it's hard to know where we will be.
__________________
Northwoods Mary is offline  
Old 05-01-2013, 03:51 PM   #459
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
travelover's Avatar
 
Join Date: Mar 2007
Posts: 9,878
Quote:
Originally Posted by Malcolm2 View Post
Very well done article in the WSJ yesterday April 30. Documents the huge increases in premiums apparently imminent. They estimate damage to 30-40 million people caused by increases and employment cutbacks!! Premiums expected to rise for 30 percent of us alone. Article was written by Daniel Kessler a Professor at Stanford.

Daniel Kessler: The Coming ObamaCare Shock - WSJ.com
Funny, this appears to me as an opinion piece, not a "news" article. And it is from a newspaper owned by Rupert Murdock, famous for his impartiality - especially regarding Fox News network.
__________________
Yes, I have achieved work / life balance.
travelover is offline  
Old 05-01-2013, 03:58 PM   #460
Full time employment: Posting here.
Birdie Num Nums's Avatar
 
Join Date: Mar 2010
Location: Seattle-ish
Posts: 776
Quote:
Originally Posted by travelover View Post
Funny, this appears to me as an opinion piece, not a "news" article. And it is from a newspaper owned by Rupert Murdock, famous for his impartiality - especially regarding Fox News network.
And Daniel Kessler seems to have an agenda himself, if his previous articles are any indication.
__________________

__________________
Birdie Num Nums is offline  
Closed Thread


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


 

 
All times are GMT -6. The time now is 05:19 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.