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Once 2014 rolls around, do you think insurance uncertainty will ease?
Old 09-12-2012, 08:59 AM   #1
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Once 2014 rolls around, do you think insurance uncertainty will ease?

We want to ER in 2014. We have company paid cadillac insurance now.

Based on other large changes in law (the new deal, etc.), how much do you think we can depend on things staying the same if the current healthcare plan is implemented in 2014?

I am maybe not being clear enough. What I am asking is, based on past history in the USA, how likely is it that major changes would happen to the AHA after 2014 if it is implemented then exactly as it is now planned?

I would guess that once it goes into effect, it is pretty much irreversable, much like medicare and social security are now. Changes to those programs seem to happen in relatively small doses once they are implemented.

I don't want to ER in 2014, depend on things like ability to access insurance with a pre-existing condtion, then have the game changed on me in 2017 when I have not been working for 3 years and will have a much harder time getting a job. They seem to try not to do this with SS...when they raise the age limit, they do it in steps and don't do it to people already on SS. Is it likely the same thing would happen with the AHA?

It would totally bite to be paying $900 a month for a high deductable plan in 2014, then have the law abandoned in 2017 and find we cannot get any insurance, get sick in 2018 and have 25 years of savings wiped out.

Maybe I just worry too much.
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Old 09-12-2012, 10:19 AM   #2
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Originally Posted by Fermion View Post
I don't want to ER in 2014, depend on things like ability to access insurance with a pre-existing condtion, then have the game changed on me in 2017 when I have not been working for 3 years and will have a much harder time getting a job. They seem to try not to do this with SS...when they raise the age limit, they do it in steps and don't do it to people already on SS. Is it likely the same thing would happen with the AHA?

It would totally bite to be paying $900 a month for a high deductable plan in 2014, then have the law abandoned in 2017 and find we cannot get any insurance, get sick in 2018 and have 25 years of savings wiped out.

Maybe I just worry too much.
There are no guarantees in life. That said, I don't know any major legislation that once in effect got pulled, unfortunately most of the meat of the act goes in effect in 2014. You can expect changes just like you can expect changes to SS or Medicare. Even before AHA, once you got HI (and there was no lapse in premium payments), you were guaranteed coverage. We should have a lot better of idea of what the future holds after the election.
TJ
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Old 09-12-2012, 10:27 AM   #3
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Originally Posted by Fermion View Post
I don't want to ER in 2014, depend on things like ability to access insurance with a pre-existing condtion, then have the game changed on me in 2017 when I have not been working for 3 years and will have a much harder time getting a job. They seem to try not to do this with SS...when they raise the age limit, they do it in steps and don't do it to people already on SS. Is it likely the same thing would happen with the AHA?

It would totally bite to be paying $900 a month for a high deductable plan in 2014, then have the law abandoned in 2017 and find we cannot get any insurance, get sick in 2018 and have 25 years of savings wiped out.
One can never be sure, but I think it would be highly unlikely that if 2014 comes and the law as it exists today is fully implemented, there would be a change in the law that suddenly allows insurers to drop folks with preexisting conditions and resume underwriting to make them uninsurable. Again, no guarantees, but this doesn't seem likely to me.
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Old 09-12-2012, 10:28 AM   #4
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Agreed. It seems to me that the AHA remains quite vulnerable now but once (and if) the major changes go into effect they will be baked into the system and will change (hopefully improve) incrementally.
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Old 09-12-2012, 10:41 AM   #5
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Thanks for the replies. It does make me feel a bit better that others also think that once the plan is in place, it pretty much stays (perhaps with small to medium tweaks, but nothing that would wipe you out).

I guess we are lucky to have 2014+ as our ER year, since this will give us some flexibility if things in AHA don't go as planned (no bridges will have been burned in the job arena). It is tough though, because the excitement is to plan NOW and with this huge black hole in our budget (I didn't buy the right lottery ticket with the software firm I signed on) it makes healthcare too significant to ignore.
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Old 09-12-2012, 11:12 AM   #6
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There's a very long thread discussing what folks think will happen on the FAQ page.

Patient Protection and Affordable Care Act

I learned a lot from reading the (many) pages of that thread.
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Old 09-12-2012, 12:09 PM   #7
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There's a very long thread discussing what folks think will happen on the FAQ page.

Patient Protection and Affordable Care Act

I learned a lot from reading the (many) pages of that thread.
Thanks for the link! It looks like right now we will be in the range of 150% to 200% of poverty level since our budget is low and we have a lot of already taxed cash due to some company stock sales. I was estimating maybe $800 a month for a high deductable plan, but from that thread maybe we can get a silver plan for a whole lot less with the subsidies. I actually kind of worry what would happen if we fell below 150% of poverty level one year. Would we lose the subsidy and be forced onto medicaid? I am not sure I want us on medicaid, and we have over $1M in investments. It would be quite ridiculous to be scrambling for some income such that you were not forced onto medicaid lol.
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Old 09-12-2012, 04:16 PM   #8
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One big reason I'm hanging out working until 2014 is health insurance. While all the details may not be set in stone I'm hoping the picture will be a little clearer. I plan to make the decision in April 2014 and go from there.
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Old 09-12-2012, 11:45 PM   #9
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We are already within the 18 month COBRA eligibility window of Jan 1, 2014. I don't think there's a serious risk of the PPACA not getting implemented regardless of the election. After all, Romney put into place a nearly identical system in Massachusetts upon which the Federal legislation was modeled.

As others have said, entitlements appear to be immortal in USian society. The key risk as I see with exchange sold plans for ER is the reimbursement rate structure. If reimbursement rates are low or are lowered (e.g. they become medicare-ish) then it may become hard to find doctors and hospitals which accept the coverage. This could make it desirable to remain on employer provided group policies.
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Old 09-18-2012, 11:06 AM   #10
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Fermion,

I find your worries/concerns valid. I am not knowledgeable enough about how things had happened in the mast with major changes to comment. I do know that even without AHA, there were already states with high-risk pools for people with pre-existing conditions. If you should find yourself uninsurable in your state, and AHA repealed, it may be worth doing the research on states with favorable health care regulations for you and move there.
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Old 09-18-2012, 11:14 AM   #11
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Originally Posted by teejayevans View Post
There are no guarantees in life. That said, I don't know any major legislation that once in effect got pulled, unfortunately most of the meat of the act goes in effect in 2014. You can expect changes just like you can expect changes to SS or Medicare. Even before AHA, once you got HI (and there was no lapse in premium payments), you were guaranteed coverage. We should have a lot better of idea of what the future holds after the election.
TJ

You must have missed this one:

Medicare Catastrophic Coverage Act of 1988, Public Law. 100-360 (July 1, 1988). The 1988 Catastrophic Act focused on providing protection against catastrophic medical expenses under Medicare. Specifically, the Act expanded the Medicare program to provide protection against catastrophic medical expenses and for the first time, provided coverage under the Medicare program for prescription drugs. To pay for these benefit expansions, a new supplemental premium tax on all persons eligible for Medicare was enacted. After massive protests by seniors, the law was essentially repealed the next year.
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Old 09-18-2012, 11:23 AM   #12
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The act is still unpopular with a great percent of the people (the newest poll I could find had 47% against).. edit to add: as long as there are a high % of people who want to get it changed, I do not believe it will be baked into the system when it starts....

I think most people like a lot of the parts of the plan, but do not like the whole...

The items you seem to fear is being denied coverage... I think that this will stay either in the current plan or a plan that replaces this one.. this is a popular part....
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Old 09-18-2012, 11:33 AM   #13
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I am hanging on until things become clear re: health insurance and we should have some good infromation by 2014. I would imagine that an Obama re-election would mean that it would be pretty unlikely to see outright repeal. The more tricky questions all surround how the law will be implemented in different states and I would imagine that there will be significant variation around the country.
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Old 09-18-2012, 11:57 AM   #14
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Definitely agree with the consensus here. 2014 should bring more clarity, and by 2015 if things are working out ok and there aren't any new huge issues, I think it will become a permanent fixture of american society. Or some form of similarly broad "socialized" medicine will replace it.

I expect an Obama victory to also make the Obamacare much more of a certainty since Obama would retain veto power over legislation gutting or significantly altering the Obamacare law. Which veto a majority Senate could not overrule absent a super majority of 60 senators (unlikely to happen at least in 2012 election).

I am also not planning on making any retirement moves until 2014 or 2015 since free or very cheap healthcare is part of the FIRE plan, and not having it would lead to working a few more years.
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Old 09-18-2012, 01:10 PM   #15
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I would hope that if you obtained a low-cost underwritten plan before 2014 you would be allowed to maintain that cost advantage in 2014 and beyond. DW plans to retire in 2013. We'll shop around to see if we can beat COBRA. In 2014 we should have more choices, possibly including subsidies if Roth conversions are minimized.
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Old 09-22-2012, 08:36 PM   #16
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No one knows what future holds, but IMHO huge fiscal challenges will force significant changes in ACA regardless of Nov's election results. Recently updated CBO analysis predicts 50% more Americans (6 million) subject to penalty ("tax") for being without health insurance than thought last year. Hospitals (& providers) will facing economic challenge of far more uninsured that initially predicted along with significant decrease in revenues (e.g. hospital DISH payments). Aging population & shortages of providers (docs, nurses, etc) will further pressure the system. Looks like 2014 & beyond will see continued "uncertainty" in health insurance market.
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