Obamacare

[Mulligan]

Quote:

Originally Posted by mpeirce Maybe it's your state or you circle of friends, but when I FIREd a couple of years ago, me (49 at the time) and my wife (58 at the time) had no problem getting (what we considered) a reasonable priced policy in Ohio. Yes, it was a HDHP/HSA plan, but that's what we had before I retired from the mothership and it worked well for us.

MPeirce, if you still have this policy, you could possibly be in the cross hairs of a big premium increase. The only people who I have ever read on this forum besides me have come from Ohio who have reasonable rates. And all of the potential "rate shock" stories cite Ohio individual participants facing upwards of 80% increase for certain people. I have not heard anything about my home state of Mo yet, but I assume to be in a position that would mirror that possibility. Whether it comes to fruition, I certainly don't know, but it concerns me. I have learned a lot about the individual insurance market and it's good and bad. Currently a very odd system, when you get into it. There are probably way more participants using it on this forum, than the country as a whole.

[mpeirce]

Quote:

Originally Posted by Mulligan MPeirce, if you still have this policy, you could possibly be in the cross hairs of a big premium increase.

We still have it. We're practicing watchful waiting to see what happens going forward.

The one change they made late last year that caught our attention was that we can no longer pay a year of premiums at once. Kind of annoying. We figure it's because they intend to make big changes to the policy mid-year - it's one of those policies that is now out of favor since it has a large deductible. But that's pure speculation on our part.

[Texas Proud]

Quote:

Originally Posted by bUU From the samples provided in a lot of the literature. Like I said, it's the result of a computation which is actually based on the annual out-of-pocket maximum, which is around $6,750 for an individual IIRC.

Then I guess that what the insurance company told us was wrong... I just looked and my policy has a max out of pocket of $7,500 per individual and $15K per family.

Also, the copays do not apply toward the deductible or max out of pocket... so, if you have to keep going back to the doc for whatever reason, that does not count.... IOW, you keep paying the $50 copay (or $75 to a specialist).... that can add up when you have to do 3 or 4 trips to get everything done...


Time will tell on what will happen... I can always pay a few hundred dollars more per month to get the $5K deductible with 100% insured after that.... but I thought it was a waste of money.... so far I have been proven correct....

[marko]

Overall, with only seven (7) months left before implementation and (I think) only 5 months before starting a rollout, it sure sounds like there's not a lot of firm information floating around.

This is a remarkably knowledgeable forum. If the folks here are confused........

I'm getting myself a helmet and a seat belt for December!...could be quite a ride!

[Mulligan]

Quote:

Originally Posted by Texas Proud Then I guess that what the insurance company told us was wrong... I just looked and my policy has a max out of pocket of $7,500 per individual and $15K per family. Also, the copays do not apply toward the deductible or max out of pocket... so, if you have to keep going back to the doc for whatever reason, that does not count.... IOW, you keep paying the $50 copay (or $75 to a specialist).... that can add up when you have to do 3 or 4 trips to get everything done... Time will tell on what will happen... I can always pay a few hundred dollars more per month to get the $5K deductible with 100% insured after that.... but I thought it was a waste of money.... so far I have been proven correct....

I believe bUU to be in the ball park. One thing that disappointed me is I believe they have not allowed your HSA contributions to count toward meeting that coverage amount which would have been a huge plus for some policies to reach accepted coverage. Someone please correct me about this if I am wrong, but Texas if you are on an individual plan now, it is too late to jump ship to the $5k deductible. Yes, you could do it for the rest of the year, but then you would definitely be in the exchange next year. You have to have been signed up for a plan back in 2010, to have any chance of maintaining grandfathered status.
Take some solace in knowing Texas is an second lower tier of states expecting possible significant rate increase... I found mine today, and I am in with the group expected to get hit the hardest.

We compared the average premiums in states that already have ObamaCare-like provisions in their laws and found that consumers in New Jersey, New York and Vermont already pay well over twice what citizens in many other states pay. Consumers in Maine and Massachusetts aren't far behind. Those states will likely see a small increase.

By contrast, Arizona, Arkansas, Georgia, Idaho, Iowa, Kentucky, Missouri, Ohio, Oklahoma, Tennessee, Utah, Wyoming and Virginia will likely see the largest increases—somewhere between 65% and 100%. Another 18 states, including Texas and Michigan, could see their rates rise between 35% and 65%.

http://online.wsj.com/article/SB1000...968100984.html

[travelover]

Quote:

Originally Posted by Mulligan ....... Matthews and Litow: ObamaCare's Health-Insurance Sticker Shock - WSJ.com

I'd take any article written by a Rupert Murdock owned paper with a grain of salt.

[pb4uski]

Quote:

Originally Posted by Mulligan .....We compared the average premiums in states that already have ObamaCare-like provisions in their laws and found that consumers in New Jersey, New York and Vermont already pay well over twice what citizens in many other states pay. Consumers in Maine and Massachusetts aren't far behind. Those states will likely see a small increase.....

The thing about this that doesn't make sense to me is that I'm in Vermont and currently pay ~$630/month for HDHI coverage for DW and I. I expect to pay $750/month for similar coverage next year (before subsidies)...BUT my HDHI COBRA from a large national firm (more than 25,000 employees across the US) was $900.

If this article is right and we pay twice what other citizens in many other states pay then I would think that my COBRA should have been less that what I was able to get in the individual market.

The claim in the article makes no sense to me.

[bUU]

The way it was explained to me, there's a single limit, which matches whatever the requirement for HDHPs is that year. Again, I think I remember seeing that that's going to be around $6,750 next year. That has to include the out-of-pocket maximum plus the deductible. The combined limit makes more sense than specific limits on the deductible (even though it makes things more complex) because if either the deducible or the co-pays weren't limited, then a plan could simply bypass the intent of the ACA by inflating the unlimited variable. So the law seeks to control how much any individual would have to pay, at most, and the specific policy can have either a high deductible or high co-pays or some medium-ground in between.

I think there are also some limitations on certain classes of health plans, some with hard limits on deductibles and/or out-of-pocket maximum (i.e., $2000 individual/$4000 family; which is what we have in our ACA-compliant health plan).

[Mulligan]

Quote:

Originally Posted by travelover I'd take any article written by a Rupert Murdock owned paper with a grain of salt.

It is definitely only a guess, I certainly concur. But let's be a bit realistic. I have founds hundreds of articles from many sources claiming how insurance costs in individual markets of "low cost states" will jump considerably. I haven't stumbled across one yet saying they are going down in these states, unfortunately. So in totality no matter where the source is I believe my costs are going to go up considerably if I am in the exchange. Btw- Kaiser estimated mine to be up more than 500%, so I would be jumping for joy if that article was correct and I only got a 75% increase hung around my neck.

[Mulligan]

Quote:

Originally Posted by pb4uski The thing about this that doesn't make sense to me is that I'm in Vermont and currently pay ~$630/month for HDHI coverage for DW and I. I expect to pay $750/month for similar coverage next year (before subsidies)...BUT my HDHI COBRA from a large national firm (more than 25,000 employees across the US) was $900. If this article is right and we pay twice what other citizens in many other states pay then I would think that my COBRA should have been less that what I was able to get in the individual market. The claim in the article makes no sense to me.

I think PB, some of the wild ranges in premium percent increases and guesstimates are based on some apple to orange comparisons. For example me... If I am forced to pay $500 up from my current sub $100 premium but now have a $2k deductible, instead of $5500, is that really a 500% increase for me? I would assume people more logical than me would say it is substantially less than 500% because I would have a significantly lower deductible. But to a hard head like me, I am sticking to the higher number because I never would reach either deductible...at least at this present moment.

[Fermion]

For those of us who will need to pick a state to call home because we are doing the RV thing, what are the plans looking like?

I estimate we will be around 150% to 200% of FPL using dividends and interest plus already taxed cash.

I was going to base our home state on low taxes (was thinking Nevada) and low vehicle registration/ability to re-register from out of state.

Now the smarter choice might be to pick a state with the best healthcare insurance exchange rates.

Or will we need to have some sort of national policy?

[pb4uski]

Quote:

Originally Posted by Fermion For those of us who will need to pick a state to call home because we are doing the RV thing, what are the plans looking like? I estimate we will be around 150% to 200% of FPL using dividends and interest plus already taxed cash. I was going to base our home state on low taxes (was thinking Nevada) and low vehicle registration/ability to re-register from out of state. Now the smarter choice might be to pick a state with the best healthcare insurance exchange rates. Or will we need to have some sort of national policy?

I don't know the answer but would agree that it seems likely that the deciding factor will likely be differences in health insurance rates rather than tax rates given your income is low.

[M Paquette]

Quote:

Originally Posted by travelover I'd take any article written by a Rupert Murdock owned paper with a grain of salt.

In particular, "articles" that appear in the Opinion section of the paper.

Last time I checked, the Opinions section had various opinion pieces in it, whose fact content might vary. (Facts measured by weight, not volume. Some settling may occur in shipment. Objects in mirror are closer than they appear. Dramatization only. Please obey all park rules. Professional driver; Do not attempt. Warning: Cape does not allow wearer to fly.)

[travelover]

Quote:

Originally Posted by Mulligan I think PB, some of the wild ranges in premium percent increases and guesstimates are based on some apple to orange comparisons. ...........

Quote:

Originally Posted by M Paquette In particular, "articles" that appear in the Opinion section of the paper.........

Exactly. Remember we are talking about an industry that consumes nearly 20% of the largest economy in the world - about $8000 for every man, woman and child in the country. Everyone is trying to shade the facts to make it favorable to them.

[ERD50]

Quote:

Originally Posted by travelover I'd take any article written by a Rupert Murdock owned paper with a grain of salt.

So just which paper/source can you read w/o any skepticism at all?

"The Economist" is probably the most balanced publication I can think of, yet I still consider whether the writer has an agenda - whether conscious or not. I'm not trading my salt-shaker for a pitcher of Kool-Aid anytime soon.


bold mine...

Quote:

Originally Posted by Mulligan It is definitely only a guess, I certainly concur. But let's be a bit realistic. I have founds hundreds of articles from many sources claiming how insurance costs in individual markets of "low cost states" will jump considerably. I haven't stumbled across one yet saying they are going down in these states, unfortunately. So in totality no matter where the source is I believe my costs are going to go up considerably if I am in the exchange. Btw- Kaiser estimated mine to be up more than 500%, so I would be jumping for joy if that article was correct and I only got a 75% increase hung around my neck.

So despite the fact that every source you have found agrees, travelover wants to discount that source you linked solely because of the owner. Incredible.

-ERD50

[MichaelB]

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Originally Posted by ERD50 So just which paper/source can you read w/o any skepticism at all?

Two excellent sites, I haven't seen any partisan l agenda in either and have found both to be extraordinarily helpful.

KFF The Henry J. Kaiser Family Foundation - Health Policy, Media Resources, Public Health Education & South Africa - Kaiser Family Foundation
Health Reform GPS Health Reform GPS: Navigating the Implementation Process

Quote:

Originally Posted by ERD50 So despite the fact that every source you have found agrees, travelover wants to discount that source you linked solely because of the owner. Incredible. -ERD50

Could be a thousand sources, still says nothing about quality. The one linked earlier was interesting in that it was authored by an actuary but the analysis was devoid of hard data and based on generalizations and assumptions that may not be representative of real life for any of us or healthcare in general in the US.

[Mulligan]

Quote:

Originally Posted by MichaelB Two excellent sites, I haven't seen any partisan l agenda in either and have found both to be extraordinarily helpful. KFF The Henry J. Kaiser Family Foundation - Health Policy, Media Resources, Public Health Education & South Africa - Kaiser Family Foundation Health Reform GPS Health Reform GPS: Navigating the Implementation Process Could be a thousand sources, still says nothing about quality. The one linked earlier was interesting in that it was authored by an actuary but the analysis was devoid of hard data and based on generalizations and assumptions that may not be representative of real life for any of us or healthcare in general in the US.

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.

[Texas Proud]

Quote:

Originally Posted by Mulligan I believe bUU to be in the ball park. One thing that disappointed me is I believe they have not allowed your HSA contributions to count toward meeting that coverage amount which would have been a huge plus for some policies to reach accepted coverage. Someone please correct me about this if I am wrong, but Texas if you are on an individual plan now, it is too late to jump ship to the $5k deductible. Yes, you could do it for the rest of the year, but then you would definitely be in the exchange next year. You have to have been signed up for a plan back in 2010, to have any chance of maintaining grandfathered status. Take some solace in knowing Texas is an second lower tier of states expecting possible significant rate increase... I found mine today, and I am in with the group expected to get hit the hardest. We compared the average premiums in states that already have ObamaCare-like provisions in their laws and found that consumers in New Jersey, New York and Vermont already pay well over twice what citizens in many other states pay. Consumers in Maine and Massachusetts aren't far behind. Those states will likely see a small increase. By contrast, Arizona, Arkansas, Georgia, Idaho, Iowa, Kentucky, Missouri, Ohio, Oklahoma, Tennessee, Utah, Wyoming and Virginia will likely see the largest increases—somewhere between 65% and 100%. Another 18 states, including Texas and Michigan, could see their rates rise between 35% and 65%. Matthews and Litow: ObamaCare's Health-Insurance Sticker Shock - WSJ.com

I am in a group plan.... still getting a paycheck.... our plan does not include an HSA as our company helps pay for the $5K deductible... you can not have this combined with and HSA....

[Texas Proud]

Quote:

Originally Posted by bUU The way it was explained to me, there's a single limit, which matches whatever the requirement for HDHPs is that year. Again, I think I remember seeing that that's going to be around $6,750 next year. That has to include the out-of-pocket maximum plus the deductible. The combined limit makes more sense than specific limits on the deductible (even though it makes things more complex) because if either the deducible or the co-pays weren't limited, then a plan could simply bypass the intent of the ACA by inflating the unlimited variable. So the law seeks to control how much any individual would have to pay, at most, and the specific policy can have either a high deductible or high co-pays or some medium-ground in between. I think there are also some limitations on certain classes of health plans, some with hard limits on deductibles and/or out-of-pocket maximum (i.e., $2000 individual/$4000 family; which is what we have in our ACA-compliant health plan).

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

What about drugs? Are these included in that limit, or are they still separate?


In the end I do not think it makes much difference to us as we have only hit our current max one time when my DW had foot surgery...


This might be a whole different thread, but it does not include dental.... we are going to have to pay $10K on my DW's teeth.... we have been to two highly trained specialist and both said the same thing.... not good for her....

[youbet]

Quote:

Originally Posted by travelover +1. Any change is opposed by those benefiting from the status quo.

Any change is promoted by those benefitting from it.