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View Poll Results: What is Your Health Insurance Choice for 2016
Medicaid - I'm on a medicaid eligible state and will use that 3 1.35%
Exchange - I'm getting a plan through the exchange 51 22.87%
Individual - I'm getting a plan directly through insurance company or broker 38 17.04%
Company - I'll be insured through w*rk or from a spouse, partner 87 39.01%
Medicare - I'm on medicare 29 13.00%
Fine me baby - I'll take the penalty 0 0%
Other 15 6.73%
Voters: 223. You may not vote on this poll

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Old 08-16-2016, 12:14 AM   #41
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I know this is an old thread but thought some might still read it. For those of us without a retiree health plan from employer, it seems to make sense to manage your income so as to qualify for subsidy with ACA. Seems pretty doable for early retirees who are living off their taxable accounts anyway.

Do many folks use this strategy?
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Old 08-16-2016, 07:00 AM   #42
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I haven't even tried. We have a lot in after-tax accounts and, between mutual fund distributions and occasional trades as I tweak the portfolio, there are capital gains. I have two other issues with the exchange- first of all, in our state, I'm pretty sure the "exchange" has only one participating company, so not much choice. Second, I feel like the subsidies are there for people to poor to afford full premiums. I just paid $1,600 to have some jewelry remounted (that included buying another diamond and a platinum setting) and it barely made a dent in the budget. We aren't poor.


I turn 65 in early 2018; DH is 78 so already on Medicare. So, I pretty much just need to get through the 2017 renewal now.
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Old 08-16-2016, 07:17 AM   #43
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For those of us without a retiree health plan from employer, it seems to make sense to manage your income so as to qualify for subsidy with ACA. Seems pretty doable for early retirees who are living off their taxable accounts anyway.

Do many folks use this strategy?
That is exactly what we do.
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Old 08-16-2016, 08:58 AM   #44
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I haven't even tried. We have a lot in after-tax accounts and, between mutual fund distributions and occasional trades as I tweak the portfolio, there are capital gains. I have two other issues with the exchange- first of all, in our state, I'm pretty sure the "exchange" has only one participating company, so not much choice. Second, I feel like the subsidies are there for people to poor to afford full premiums. I just paid $1,600 to have some jewelry remounted (that included buying another diamond and a platinum setting) and it barely made a dent in the budget. We aren't poor.


I turn 65 in early 2018; DH is 78 so already on Medicare. So, I pretty much just need to get through the 2017 renewal now.
Well it sounds like portfolio composition is different. My taxable accounts, which are about a third of my portfolio is the most conservative part, comprised almost completely of low-beta individual stocks which i hold for the longterm, muni funds, and cash equivalents. I harvest losses and do charitable giving with large gain positions. Accordingly, I tend to have loss carryforwards (I seldom sell gain positions outright), qualifying dividends, and tax-free interest. With most of my portfolio in tax-advantaged accounts, my taxable income would naturally be low as i am not tapping them.

We are also well off. However, I did not get that way by paying more than necessary for the same thing. The government designed the ACA including its pricing. As a taxpayer I am paying subsidies for ACA. I see no reason why I should pay more than I owe.

Just another view.
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Old 08-16-2016, 09:49 AM   #45
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I know this is an old thread but thought some might still read it. For those of us without a retiree health plan from employer, it seems to make sense to manage your income so as to qualify for subsidy with ACA. Seems pretty doable for early retirees who are living off their taxable accounts anyway.

Do many folks use this strategy?
I can't say I tried to manage my income to qualify for subsidies under the ACA, but for a few years I tried to manage my itemized deductions to lessen my federal income tax bill. I did this through "bunching" my deductions because by doing so I could move some itemized deductions from January into December (or vice versa) to enable me to take the standard deduction in the "off" year. But with my medical expenses having risen in 2016 due to more doctor visits and higher HI premiums, I can itemize my deductions every year whether I bunch some others or don't bunch them.

My history with HI has been varied in the last 9 years. Back in 2007 when I was still working, I reduced my weekly hours worked (again) and fell below the minimum 20 weekly hours to be eligible for the company's group plan. I went on COBRA but that lasted only 18 months until the end of 2008 when I FIREd.

I found an individual group plan but here in New York, a hostile state for finding affordable individual plans (pre-ACA), it was expensive and became more expensive when my insurance company increased its rates 50% in the next 2 years, putting a strain on my ER budget.

In mid-2011, after the ACA had been thankfully passed, I got rid of that costly policy and switched to a much cheaper, bare-bones policy which left me underinsured. It was meant to hold me over until the end of 2013 when the ACA's exchanges would become active.

I signed onto a Silver plan in 2014 through BCBS which, even without any subsidy, was cheaper than my older plan before its big rate increases. My income is near the top end of the income limit, so the subsidy is pretty small.

BCBS raised its premium in 2015 but the subsidy also went up a little. However, I became sick in 2015 so BCBS paid for most of the bills (including the big hospital bill) once I exceeded the deductible and max OOP cost. But I also saw the weaknesses in the policy long-term so I ditched it, especially after it had another fairly large increase for 2016.

I am now with OSCAR which has been much better. All of my doctors are in their plan. Their drug plan is much better (no ExpressScript mail-order nonsense), as is their customer service. The monthly premium is lower than BCBS's even excluding the subsidy which OSCAR is allowing me to take as a monthly reduction even though I didn't even ask for it! OSCAR did file for a pretty big increase for 2017 but they are still lower than what I'd be paying BCBS in 2016 had I stayed with them. Also, a drug which was originally slated for a $50 copay per month ended up having no copay, a $50 per month savings to offset any premium increase.
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Old 08-16-2016, 10:01 AM   #46
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Originally Posted by Montecfo View Post
I know this is an old thread but thought some might still read it. For those of us without a retiree health plan from employer, it seems to make sense to manage your income so as to qualify for subsidy with ACA. Seems pretty doable for early retirees who are living off their taxable accounts anyway.

Do many folks use this strategy?
I live in a state where I can qualify for Medicaid because of my extremely low taxable income. I'm sure this isn't what Obamacare intended but I don't feel guilty about taking advantage of it, at all. Health care in this country has been too expensive for what we get out of it.
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Old 08-16-2016, 08:09 PM   #47
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I'm not convinced that all health insurance plans are created equal. Back when I had a private Coventry policy, my gyno's office told me they accepted that, but not the Coventry policy from the exchange. I also read somewhere that MD Anderson, the highly-respected cancer treatment center in Houston, doesn't accept the insurance policy from the TX exchange.
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Old 08-16-2016, 09:10 PM   #48
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Well it sounds like portfolio composition is different. My taxable accounts, which are about a third of my portfolio is the most conservative part, comprised almost completely of low-beta individual stocks which i hold for the longterm, muni funds, and cash equivalents. I harvest losses and do charitable giving with large gain positions. Accordingly, I tend to have loss carryforwards (I seldom sell gain positions outright), qualifying dividends, and tax-free interest. With most of my portfolio in tax-advantaged accounts, my taxable income would naturally be low as i am not tapping them.

We are also well off. However, I did not get that way by paying more than necessary for the same thing. The government designed the ACA including its pricing. As a taxpayer I am paying subsidies for ACA. I see no reason why I should pay more than I owe.

Just another view.
Thats why ACA should be asset based and not income based.
As a taxpayer I shouldn't have to subsidize the "Well off"
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Old 08-16-2016, 09:49 PM   #49
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Originally Posted by Montecfo View Post
I know this is an old thread but thought some might still read it. For those of us without a retiree health plan from employer, it seems to make sense to manage your income so as to qualify for subsidy with ACA. Seems pretty doable for early retirees who are living off their taxable accounts anyway.

Do many folks use this strategy?
For us, in the long run the benefit of doing low tax cost Roth conversions from when we ERed at 56 until my pension starts and we start drawing SS at 66 or later exceeds any ACA benefits that we would receive. However, our situation may be unique in that we live in a state where health insurance is not age rated and we also qualify for low cost catastrophic health insurance coverage so the benefit of ACA is only ~$5k a year.

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Thats why ACA should be asset based and not income based.
As a taxpayer I shouldn't have to subsidize the "Well off"
I agree, but it isn't and probably will never change so I suggest you get used to it.
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Old 08-16-2016, 11:37 PM   #50
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Thats why ACA should be asset based and not income based.
As a taxpayer I shouldn't have to subsidize the "Well off"
Is there any current situation where taxpayers are required to report all assets to the IRS? Can't imagine how complicated that would get - look at how complicated the tax code is now, mostly involved in determining what constitutes 'income'. And given unanticipated consequences, the next step after asset reporting would likely be using assets to means test Social Security.

That being said, I'm taking advantage of the ACA subsidy. I've calculated that at least for the next couple of years, it's more to my advantage to take the ACA credit rather than do Roth conversions. Roth conversions will be most of my income, I just won't convert much so as to keep the subsidy.

I didn't write the tax code, but I'll take advantage of it. Mitt Romney gets carried interest in his IRA, after all.
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Old 08-17-2016, 02:10 AM   #51
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I know this is an old thread but thought some might still read it...
Yes, I forgot about this thread. I am surprised that for an ER forum, the most votes went for "employer insurance".

With insurers dropping out like flies, who will be left for us to shop in the exchange next year?

For next year, I would change my vote to "Other", as I may have to go to Mexico or Thailand for healthcare.
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Old 08-17-2016, 03:34 AM   #52
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I am single and in my late 50's. I have purchased my insurance through the Exchange starting in 2014. I am technically a HNWI (barely). With paid off vehicles and home my expenses are modest. I was working P/T in '14 and '15. Using my maximum contributions to an IRA and HSA I was able to pay nothing in taxes and still get a refund. Much of my taxable income is CGD's and dividends and although they count towards income for ACA purposes the CGD's are not taxed and the dividends are at 15% and are offset greatly by my personal and standard deduction. In 2015 I had a gross taxable income of about 40K, I paid no federal tax and received a refund for about $3200. This year I am not working so the trick is to have taxable income to put me into subsidy range, I turn 59 1/2 in October so I will take what I need out of a deferred account to get a decent subsidy (aka refundable tax credit). Does it make sense for the government to subsidize me, no, but in my mind when money is blowing down the street it would be stupid not to go catch some it. Odd as it is I will have to start paying taxes at age 65 again but for now I am enjoying the ride.
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Old 08-17-2016, 06:46 AM   #53
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Is there any current situation where taxpayers are required to report all assets to the IRS? Can't imagine how complicated that would get - look at how complicated the tax code is now, mostly involved in determining what constitutes 'income'. And given unanticipated consequences, the next step after asset reporting would likely be using assets to means test Social Security.
Shortstop14-
The only situation I can think of there is for estate taxes, which of course exempts a lot of folks. I sincerely doubt this will happen, but it certainly would be easy for financial institutions to report account balances. The means testing of social security generally ends up being an income test, where social security is taxed more heavily as income grows.

With government finances careening toward some future debacle, I would be more worried about government trying to tax retirement assets such as Roths which are supposed to be tax-free.

Let's hope these things do not come to pass. In the meantime, as a low-taxable income person, subsidized ACA makes a lot of sense for me-when we get there. Not yet retired.
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Old 08-17-2016, 07:05 AM   #54
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Is there any current situation where taxpayers are required to report all assets to the IRS? .....
Medicaid long-term care coverage is asset based as I recall.

If you are married, you are required to spend down assets to a certain level before long-term care coverage begins and once you die Medicaid can claim against any remaining assets up to the amount paid for your care (like a house, which is protected while you are alive).
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Old 08-17-2016, 08:40 AM   #55
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Medicaid long-term care coverage is asset based as I recall.

If you are married, you are required to spend down assets to a certain level before long-term care coverage begins and once you die Medicaid can claim against any remaining assets up to the amount paid for your care (like a house, which is protected while you are alive).
So in certain states including MN, you do not have to report all your assets to qualify for ACA Medicaid HEALTH INSURANCE COVERAGE, however if you are over 55 and have hard assets, IE real estate, a home, a business the state will file a lien against your estate for the entire cost of the coverage. It's payable when both you and a spouse are dead, or possibly at any sale of the assets.

I have no idea how many states do this, but it can be a pitfall for some. A few people in this state were complaining because there is a written disclosure signature page included, but apparently you are not told about it upfront and might not realize it not a standard sign up signature page.
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Old 08-17-2016, 08:49 AM   #56
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Medicaid long-term care coverage is asset based as I recall.

If you are married, you are required to spend down assets to a certain level before long-term care coverage begins and once you die Medicaid can claim against any remaining assets up to the amount paid for your care (like a house, which is protected while you are alive).
This is only true if you are 65+, disabled, or blind.

The ACA Medicaid "expanded group" are 18 through 64 yo and have no resource (asset) test. Each state decides on whether to make the "expanded group" eligible. Some states can claim estate recovery for benefits recd for 55 yo or greater depending on how they interpret the Federal law.

If one was under 65 and needed long term nursing home care they would be deemed to be disabled and come under the DAB (disable, aged, blind) group and its rules.
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Old 08-17-2016, 11:05 AM   #57
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Leaning more and more to that Healthcare Ministries and Selfpay .....
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Old 08-17-2016, 11:36 AM   #58
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Leaning more and more to that Healthcare Ministries and Selfpay .....
LakeRat..do you want to start a new thread so it's easier to follow and explain why you are leaning this way. There have been mentions of this in various threads but it gets buried in other subjects.
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Old 08-17-2016, 04:34 PM   #59
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I know this is an old thread but thought some might still read it. For those of us without a retiree health plan from employer, it seems to make sense to manage your income so as to qualify for subsidy with ACA. Seems pretty doable for early retirees who are living off their taxable accounts anyway.

Do many folks use this strategy?
Variation on a theme: If you can work part time and participate in a 401k plan, then you can use the 401 and a traditional IRA to tune your taxable income to be in the sweet spot for the ACA subsidy. And if you do this, ALWAYS choose a Silver plan. At the lower MAGI levels, Silver plans come with cost-sharing (reduced deductibles and maximum OOP's). Other plans do not.
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Old 08-17-2016, 05:03 PM   #60
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LakeRat..do you want to start a new thread so it's easier to follow and explain why you are leaning this way. There have been mentions of this in various threads but it gets buried in other subjects.
GotRDone Looking forward to peoples thoughts
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