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Old 05-04-2013, 10:03 PM   #501
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Originally Posted by Gatordoc50

Very few people have any assets to speak of. The very reasons why those who are healthy and earn above 400% of the poverty limit don't buy insurance now is why they won't buy insurance under the exchanges. Except under the ACA, they can buy if they get sick. Maybe the adverse selection will be insignificant. Heck, we are giving free insurance coverage to tens of millions. I'm just saying there will be a boat load of people opting for the penalty. Just my opinion.
I take a dimmer view. Not only will a decent portion of the public not acquire the insurance, they will not pay the penalty either, nor will they even know they are supposed to pay it until it is disclosed on their tax form. I can't see the IRS taking millions to court to try to get a judgement since they can't seize anything but a refund. I wouldn't be surprised at all if that part of the law gets tightened up somehow, down the road.
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Old 05-05-2013, 05:59 AM   #502
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Originally Posted by Gatordoc50 View Post
You don't think there are going to be significant numbers of people who opt out of being insured until they are diagnosed with needing care? If one can sign up for home insurance after their house burns down, why would they pay premiums beforehand?
Once the exchanges are operating I think many more people that are currently underinsured or uninsured will have health insurance, and health care. The exchanges will have problems in the beginning, and they will be resolved.

All 50 states plus DC are already being serviced by health insurance carriers. They will go wherever the market goes. If there is demand for policies on the exchanges the insurers will be there.
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Old 05-05-2013, 07:05 AM   #503
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Once the exchanges are operating I think many more people that are currently underinsured or uninsured will have health insurance, and health care.
That may happen. But I wonder how the economy will be impacted when $10K per household X (multiplied by) 'millions' is diverted from the family spending column and instead goes to premiums.

That's a lot of money that won't be going to eating out, a new suit/car/vacation or other minor luxuries that drive our recovery.
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Old 05-05-2013, 07:10 AM   #504
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That's a lot of money that won't be going to eating out, a new suit/car/vacation or other minor luxuries that drive our recovery.
Where, exactly, will that money be going, instead? Presumably, it will go toward paying folks in the healthcare industry better, which they'll use to eat out more, buying new clothing/cars/vacations or other minor luxuries, etc. Now, if the effect is to direct money to people who would stuff all of it under a mattress, then that would be a different problem, but discussion of the solution to that problem doesn't belong in this forum.
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Old 05-05-2013, 07:35 AM   #505
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Old 05-05-2013, 07:42 AM   #506
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That may happen. But I wonder how the economy will be impacted when $10K per household X (multiplied by) 'millions' is diverted from the family spending column and instead goes to premiums.

That's a lot of money that won't be going to eating out, a new suit/car/vacation or other minor luxuries that drive our recovery.
The total cost of healthcare in the US is already greater than $10K per household, but most people don't directly pay that much, for many different reasons. What we are seeing on the exchanges is not so much a cost increase as it is the real cost of our health care for the first time.
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Old 05-05-2013, 08:24 AM   #507
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Once the exchanges are operating I think many more people that are currently underinsured or uninsured will have health insurance, and health care. The exchanges will have problems in the beginning, and they will be resolved.

All 50 states plus DC are already being serviced by health insurance carriers. They will go wherever the market goes. If there is demand for policies on the exchanges the insurers will be there.
i agree with Michael about the implementation. I'm a pharmacist and in the first 3 months of medicare part d implementation at the time seemed like the proverbial train wreck. today it works smoothly but at the time it was a disaster.

The acapa will go the same way. there will be stories by the news with people saying how hard it was to sign up but after a while it will die down.


should be interesting though
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Old 05-05-2013, 09:23 AM   #508
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I used the Obamacare insurance calculator for two people age 60 & 61 with an MAGI in the lower 60K with a net income in the mid 50K. The premium was calculated at $16047 annually for the 30% silver plan with an additional maximum out of pocket of $12,500. The subsidy was Zero. Using Ehealthinsurance, I calculated my premium at $5400 for a similar deductible and co-pay. My wife is retired and I will retire January 1, 2014, when I will loose my employer based health insurance. It will be very hard to budget for potential medical expenses that are more then 51% of your net income. Is anyone else here seeing these numbers and increases for early retiree’s in the Obamacare exhanges?
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Old 05-05-2013, 09:48 AM   #509
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Where, exactly, will that money be going, instead? Presumably, it will go toward paying folks in the healthcare industry better, which they'll use to eat out more, buying new clothing/cars/vacations or other minor luxuries, etc. Now, if the effect is to direct money to people who would stuff all of it under a mattress, then that would be a different problem, but discussion of the solution to that problem doesn't belong in this forum.
So, what you're saying is that instead of the working stiff taking his family out to dinner, it'll be the doctor's families getting a nice meal?
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Old 05-05-2013, 10:05 AM   #510
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So, what you're saying is that instead of the working stiff taking his family out to dinner, it'll be the doctor's families getting a nice meal?
So, what you're saying is that rich doctors are the only ones who make money from our nation's healthcare system?

See how ridiculous such silliness is?

Among those who will see the lowest subsidies from ACA are the people who spend their money (when they spend it) on "nice meals"; and among those who will see the biggest subsidies from ACA are the "working stiffs". So I ask you again, where, exactly, will that money be going, instead?
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Old 05-05-2013, 10:34 AM   #511
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It seems that this thread is getting dragged into political squabbling as opposed to discussion the ins and outs of dealing with the new law.

If you want a political squabble, perhaps this is the wrong thread / forum for you.
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Old 05-05-2013, 10:46 AM   #512
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I appreciate your pointing the thread back to how to apply for and utilize the ACA, rather than commentary on whether or not is going to help or hinder whom.
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Old 05-05-2013, 11:24 AM   #513
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I used the Obamacare insurance calculator for two people age 60 & 61 with an MAGI in the lower 60K with a net income in the mid 50K. The premium was calculated at $16047 annually for the 30% silver plan with an additional maximum out of pocket of $12,500. The subsidy was Zero. Using Ehealthinsurance, I calculated my premium at $5400 for a similar deductible and co-pay. My wife is retired and I will retire January 1, 2014, when I will loose my employer based health insurance. It will be very hard to budget for potential medical expenses that are more then 51% of your net income. Is anyone else here seeing these numbers and increases for early retiree’s in the Obamacare exhanges?
Can you make income adjustments to get under the subsidy threshold? (As a side note does anybody have a link/reference that discusses how ER folks can manage earnings to meet this subsidy?)

Also are you budgeting the max out of pocket expense every year?
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Old 05-05-2013, 11:32 AM   #514
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Originally Posted by joe8012 View Post
I used the Obamacare insurance calculator for two people age 60 & 61 with an MAGI in the lower 60K with a net income in the mid 50K. The premium was calculated at $16047 annually for the 30% silver plan with an additional maximum out of pocket of $12,500. The subsidy was Zero. Using Ehealthinsurance, I calculated my premium at $5400 for a similar deductible and co-pay. My wife is retired and I will retire January 1, 2014, when I will loose my employer based health insurance. It will be very hard to budget for potential medical expenses that are more then 51% of your net income. Is anyone else here seeing these numbers and increases for early retiree’s in the Obamacare exhanges?
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Can you make income adjustments to get under the subsidy threshold? .....
Joe, is the lower $60k MAGI you indicate before or after your retire? If after, is the nature of your income such that you can lower it a tad to qualify? 2012 400% FPL for 2 is about $60,520. http://www.dhs.ri.gov/Portals/0/Uplo...%20DHS/FPL.pdf

In many cases, you can arrange your financial affairs to get under 400% FPL. If your income is SS and pension it becomes more difficult.
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Old 05-05-2013, 11:38 AM   #515
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Originally Posted by joe8012 View Post
I used the Obamacare insurance calculator for two people age 60 & 61 with an MAGI in the lower 60K with a net income in the mid 50K. The premium was calculated at $16047 annually for the 30% silver plan with an additional maximum out of pocket of $12,500. The subsidy was Zero. Using Ehealthinsurance, I calculated my premium at $5400 for a similar deductible and co-pay. My wife is retired and I will retire January 1, 2014, when I will loose my employer based health insurance. It will be very hard to budget for potential medical expenses that are more then 51% of your net income. Is anyone else here seeing these numbers and increases for early retiree’s in the Obamacare exhanges?

the ehealth quotes though accurate today will not be the same after 1/1/2014.

i don;t think you can compare the 2. having said that i am on the massachusettes exchange which is the model for acapa. currently as a single- the wifes on medicare-i get no subsidy-the plan i have is 575 per month with 2000 deductible-4000 max out of pocket. it is not the least expensive plan-it is massachusettes version of a silver plan.
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Old 05-05-2013, 11:58 AM   #516
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Originally Posted by Gatordoc50 View Post
Very few people have any assets to speak of. The very reasons why those who are healthy and earn above 400% of the poverty limit don't buy insurance now is why they won't buy insurance under the exchanges. Except under the ACA, they can buy if they get sick. Maybe the adverse selection will be insignificant. Heck, we are giving free insurance coverage to tens of millions. I'm just saying there will be a boat load of people opting for the penalty. Just my opinion.
+100

I am quite sure this will happen. Especially for the 35 percent that would see huge premium increases to pay for the uninsured and 'subsidized' members.
Thankfully market and other forces of reason will likely prevail to alter this OC train wreck first. I know many are hoping they will somehow get new free medical care. Disappointment imminent.
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Old 05-05-2013, 12:05 PM   #517
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Joe, is the lower $60k MAGI you indicate before or after your retire? If after, is the nature of your income such that you can lower it a tad to qualify? 2012 400% FPL for 2 is about $60,520. http://www.dhs.ri.gov/Portals/0/Uplo...%20DHS/FPL.pdf

In many cases, you can arrange your financial affairs to get under 400% FPL. If your income is SS and pension it becomes more difficult.
since he and his wife are 60 and 61 ss does not come into play yet.
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Old 05-05-2013, 12:45 PM   #518
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I'm not going to be covered by ACA since I will be on Medicare as of next month. However, reading the costs others have had for health insurance surprises me.

My COBRA was ~$500/month (from a group with 8500+ subscribers that self-insured). I was rejected for health insurance when I applied (I had a 16 month gap between COBRA and Medicare) and ended up in the MO high risk pool. It's $941/month for just me.

My health care costs last year were ~$14K. I think it will be half that on Medicare - this year will be off because part was on one plan and part on another. I do take a lot of prescription meds but this doesn't include any fancy tests or ER visits or hospitalizations.

So if you are healthy and paying $150/month or whatever for health insurance - it sounds so wonderful but not what I encountered at all. I didn't have a choice with COBRA (only one plan was available, not high-deductible). I did have a choice with the high-risk pool but the low end was over $800 month and had bad prescription coverage - this worked out better.

I will be curious to see how the new insurance works out for everyone. I hope that having most if not all people get coverage brings about more preventative care and better outcomes.
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Old 05-05-2013, 01:13 PM   #519
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Thanks for all of your replies. I am budgeting 10,000 a year for medical including the 5400 premium cost thru ehealthinsurance for my wife and I. We only have a few rx. I found that most plans that offer rx is a wash or cost more for us. I can control my income a little as it is traditional ira's and annuities. I fear that anyone in a position to control that income will loose that flexability with future regulations. What I am concerned about is the huge difference in premiums at ehealthcare and the Obamacare calculator can it really be 3 times the cost?
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Old 05-05-2013, 01:28 PM   #520
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Thanks for all of your replies. I am budgeting 10,000 a year for medical including the 5400 premium cost thru ehealthinsurance for my wife and I. We only have a few rx. I found that most plans that offer rx is a wash or cost more for us. I can control my income a little as it is traditional ira's and annuities. I fear that anyone in a position to control that income will loose that flexability with future regulations. What I am concerned about is the huge difference in premiums at ehealthcare and the Obamacare calculator can it really be 3 times the cost?
Joe I will reinforce what others have said. Do not use ehealthinsurance quotes. Those first of all, are for people who are in perfect health. Second of all, they are meaningless quotes come January. And yes it is possible it could cost 3X more but it is all speculation at this point. The calculator is showing me going from $76 a month with a $5500 deductible to $500 for a silver plan. They are not true apples to orange comparisons due to coverage changes, but since I have no medical expenses, it in effect to me could possibly be a 5X increase. But, at this point all I can do is wait, because it truly is speculation.
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