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Old 05-22-2013, 03:55 PM   #121
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Originally Posted by pb4uski View Post
I think Medicaid is 100% FPL for states that do not expand and 138% FPL for states that do expand. For a 57 yo couple with no kids, 100% FPL is ~$15,750.

At $16k of income, after rent, food and other living costs for two there can't be much left to pay for health care. According to the calculator a couple with that amount of income would pay 2% of their income for health insurance after a 98% subsidy.

The same couple earning $70k would get no subsidy and pay ~$15k for medical insurance (21% of income). The same couple with $200k income will also not be subsidized but their health insurance will "only" be 7.3% of their income.

Subsidy Calculator | The Henry J. Kaiser Family Foundation

I have not done subsidy calculations before.... but decided to take a look...

From what I see, the couple can save by choosing a Bronze plan...

For example, you could enroll in a Bronze plan for about $3,277 per year (which is 5.37% of your household income, after taking into account $8,915 in subsidies).

Not quite as bad on the premiums... still, the premiums seem pretty high to me...
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Old 05-22-2013, 04:04 PM   #122
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Now...now....let's don't get too political on here, pointing fingers because others have a different view. The same can be said for the system we had. No need to have changed it - just tweak it to work. There was a lot that could have been done with that first, without this massive social change. But I digress before I get too political.
No, I think there was no way to simply "tweak" the existing dysfunctional system. Every year, more Americans have no health insurance. Every year, a major cause of personal bankruptcy was due to individuals who HAD health insurance who found themselves with enormous medical bills far beyond their lifetime caps. Every year people who had health insurance were dropped by their insurers when they got sick. Every year, millions of people with pre-existing conditions were unable to obtain health insurance at any price, or any realistic price. The current system is untenable.

And as you said, "before I get too political", the bill is not perfect but amendments to improve the PPACA became impossible because one side was only concerned with stopping the bill completely. Those opposed never offered an alternative which would have provided near-universal coverage and fixed the major problems I mentioned above.

There has been an enormous amount of speculation in this and other threads about the PPACA. After October 1, we should all have real numbers and other specific information to go by. I think that all of this speculation at this time is pointless.
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Old 05-22-2013, 04:08 PM   #123
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....still, the premiums seem pretty high to me...
I agree and the 2014 proposed premiums are out for our state and the calculator premiums are much higher. I expect my HDHP Bronze plan to be ~75% of the bronze plan premiums shown by the calculator. It might be a California thing as I know costs are higher out there.
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Old 05-22-2013, 04:10 PM   #124
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Old 05-22-2013, 04:27 PM   #125
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Lets stay away from blame and speculation and try to stick with with what we know. The healthcare threads have been informative and useful.
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Old 05-22-2013, 04:36 PM   #126
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Originally Posted by sheehs1 View Post
The same can be said for the system we had.
But there were unequivocal differences: Pre-existing conditions; lifetime caps; no means to keep insurers from making insurance prohibitively expensive; etc.

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No need to have changed it - just tweak it to work.
In essence, that's all ACA is: Just those few tweaks: the assurance of insurability, the minimum standards for coverage, and the subsidy. The mandate, recall, was only part of a deal to make the changes acceptable to the insurance industry.
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Old 05-22-2013, 06:57 PM   #127
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One interesting thing, for some of us at least, is how the premium and subsidy numbers will change for a smoker.

In the Berkeley / Colorado calculator, the effect is a double whammy: the calculator assumes a whopping 50% tobacco use surcharge on the non-smoker premium. Then, in applying the subsidy calculation, per federal rules the subsidy only applies to the base rate.

So, for example, if the non-smoker base rate is $400 per month and the subsidy is 60%, the net premium would be $400 x 40% = $160.

If the same person is a smoker, his payment would be $160 + 0.5($400) tobacco surcharge = $360.

On another thread, there is a link to actual rate filings in Oregon.
Colorado Health Exchange now online

I clicked on four of the company names I recognized, then scanned their filings to see what they propose for their actual tobacco surcharge. Three of four propose no tobacco surcharge. The fourth is at 20%.

Smoke 'em if you got 'em, I guess.
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Old 05-22-2013, 08:22 PM   #128
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The feds posted sample exchange application forms about three weeks ago, if anyone wants to get a head start on October 1

It is amazing how short they are, until you realize that under ACA they don't need any health information.

Found them here on the CMS site
Other Resources - Centers for Medicare & Medicaid Services
(about halfway down the page at Forms)

Quote:
Use this application to see what coverage you qualify for
  • Affordable private health insurance plans that offer comprehensive coverage to help you stay well
  • A new tax credit that can immediately help pay your premiums for health coverage
  • Free or low-cost insurance from Medicaid or the Children’s health insurance Program (ChiP)
Single application:
http://www.cms.gov/CCIIO/Resources/F...ntB_042913.pdf

Family application:
http://www.cms.gov/CCIIO/Resources/F...ntC_042913.pdf

Single or family application without financial assistance request:
http://www.cms.gov/CCIIO/Resources/F...ntD_042913.pdf
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Old 05-22-2013, 11:47 PM   #129
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From what I gather from your posts, you think the subsidy should continue for people making more than the 400%.... just have it less and less.... this is where I do not agree...
Yes, I think it should be a gentler slope BUT I also see where that can be problematic in driving up the cost.

On another note: Called Anthem today. No answers for any of my questions.
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Old 05-23-2013, 12:22 AM   #130
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m.
There has been an enormous amount of speculation in this and other threads about the PPACA. After October 1, we should all have real numbers and other specific information to go by. I think that all of this speculation at this time is pointless.
I don't think this thread has been about speculation or is pointless. It certainly has me delving into the links and becoming more informed. Trying to do it prior to this for me was pointless, as I wasn't sure how much would change. Now we are within the 6 month mark. Hopefully there are others it has helped as well.
Thanks to all who posted links, calculators, etc.
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Old 05-23-2013, 06:42 AM   #131
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The feds posted sample exchange application forms about three weeks ago, if anyone wants to get a head start on October 1

It is amazing how short they are, until you realize that under ACA they don't need any health information.

Found them here on the CMS site
Other Resources - Centers for Medicare & Medicaid Services
(about halfway down the page at Forms)

Single application:
http://www.cms.gov/CCIIO/Resources/F...ntB_042913.pdf

Family application:
http://www.cms.gov/CCIIO/Resources/F...ntC_042913.pdf

Single or family application without financial assistance request:
http://www.cms.gov/CCIIO/Resources/F...ntD_042913.pdf
+1@ how simple the forms are. I'm still a little in the "it's never that easy, something must be missing" stage, but it'll get better.

Great links! Thanks for posting them.

Edit: looking over the second form, the family application for people expecting premium assistance, I didn't see any reference to adult children age 26 and under that do not live at home.
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Old 05-23-2013, 10:23 AM   #132
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Yes, I think it should be a gentler slope BUT I also see where that can be problematic in driving up the cost.

On another note: Called Anthem today. No answers for any of my questions.
Glad to see somebody else got no farther with Anthem than I did. No matter what question I asked, or how it was worded I received the same answer. Something to the effect that information will be sent out concerning these matters at a later time in the year.
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Old 05-23-2013, 10:54 AM   #133
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Am reading IRS rules and regulations link that was provided. The part about "determining affordability" (page 30388-30389) for employers could get confusing. Employers with employees near the cusp of the cutoff may have to be careful about bonuses and overtime hours. What may have started as "affordable at the beginning of the year may not be so during the year based on bonuses, overtime, etc. and may possibly throw the employee to non-subsidized status on the exchanges if his pay goes up. (if employee is on the exchange).

The difference between a single filer making $45K a year and one making $50K a year is a subsidy of $1,115 a year (Kaiser calculator). Also will have to factor affect of taxes. Wages are taxed and premium payments are net of tax.

Is it possible that for employees using the exchanges, employers might start hearing the words, "No don't give me that bonus or overtime, I will loose my subsidy status!!!

Wow...wow....wow...this is very complicated for employers and employees. In any event, there may have to be much more communication between employer and employee as to what "changes in pay" will do to the employee status thru out the year.

Just absorbing some of these details now so hoping I'm interpreting correctly.
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Old 05-23-2013, 10:57 AM   #134
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Edit: looking over the second form, the family application for people expecting premium assistance, I didn't see any reference to adult children age 26 and under that do not live at home.
I also don't see any place where they are asking for income stated on your last tax return in the core application. I just see them asking about your current income. That would be good news for us personally as we'd not be eligible for any subsidy under our 2012 (or 2013) income -- just a tax credit well after the fact -- but a rather significant one under expected 2014 income.
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Old 05-23-2013, 12:20 PM   #135
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There has been an enormous amount of speculation in this and other threads about the PPACA. After October 1, we should all have real numbers and other specific information to go by. I think that all of this speculation at this time is pointless.

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Originally Posted by sheehs1 View Post
I don't think this thread has been about speculation or is pointless. It certainly has me delving into the links and becoming more informed. Trying to do it prior to this for me was pointless, as I wasn't sure how much would change. Now we are within the 6 month mark. Hopefully there are others it has helped as well.
Thanks to all who posted links, calculators, etc.
You replied to something different from what I actually wrote. I did not say this thread is pointless or that it is solely contains speculation. However, there have been many, many posts in this thread and others about the PPACA which have, for example, speculated and/or made claims about insurance rates in 2014 and beyond. I am as curious as the next person about what my own premiums will actually be, but I will wait until my state plan choices and rates are finally published before I comment on them.

Also, the bulk of my post (which you didn't quote) explained why I believe it was not possible to simply "tweak" (as you put it) the existing system in order to fix the multitude of problems with the current system. The PPACA has many aspects I hope get improved upon in the future. However, it makes relatively few changes to the existing private insurance (often employer-based) framework while still addressing the very serious problems we have with the current system. Other solutions to fix all of the health insurance issues this country currently has would have been far closer to "massive social change", as you described the PPACA.
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Old 05-23-2013, 12:40 PM   #136
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You replied to something different from what I actually wrote. I did not say this thread is pointless or that it is solely contains speculation. However, there have been many, many posts in this thread and others about the PPACA which have, for example, speculated and/or made claims about insurance rates in 2014 and beyond. I am as curious as the next person about what my own premiums will actually be, but I will wait until my state plan choices and rates are finally published before I comment on them.
The private insurers that are "invited" to sell in the exchanges are not going to tip their hand as far as premiums. We simply do not know what rates will be once the federal exchanges are set up. We have seen rates increase substantially the last couple years leading up to now. That may be prepositioning by the insurers or a sign of things to come. The slashing of Medicare to help fund this new national health care plan could have ominous results in a couple years.........
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Old 05-23-2013, 12:46 PM   #137
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The private insurers that are "invited" to sell in the exchanges are not going to tip their hand as far as premiums. We simply do not know what rates will be once the federal exchanges are set up. We have seen rates increase substantially the last couple years leading up to now. That may be prepositioning by the insurers or a sign of things to come. The slashing of Medicare to help fund this new national health care plan could have ominous results in a couple years.........
Private insurers are not invited, all are free to sell their policies. So far rates look pretty much unchanged from 2013. Insurers have been raising rates at a double digit pace for over a decade and long before the PPACA was even a thought. If anything, rates are steady for the first time. As for that last thought, well, lets not go there.
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Old 05-23-2013, 01:19 PM   #138
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You replied to something different from what I actually wrote. I did not say this thread is pointless or that it is solely contains speculation. However, there have been many, many posts in this thread and others about the PPACA which have, for example, speculated and/or made claims about insurance rates in 2014 and beyond. I am as curious as the next person about what my own premiums will actually be, but I will wait until my state plan choices and rates are finally published before I comment on them.

Also, the bulk of my post (which you didn't quote) explained why I believe it was not possible to simply "tweak" (as you put it) the existing system in order to fix the multitude of problems with the current system. The PPACA has many aspects I hope get improved upon in the future. However, it makes relatively few changes to the existing private insurance (often employer-based) framework while still addressing the very serious problems we have with the current system. Other solutions to fix all of the health insurance issues this country currently has would have been far closer to "massive social change", as you described the PPACA.
That's because I chose not to get into a tit for tat or "going back and forth" on the "old" versus the "almost new" and to stay away from which political party is responsible for "what" or any political type statements or "who deserves what" based on gosh knows what.
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Old 05-23-2013, 01:45 PM   #139
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Private insurers are not invited, all are free to sell their policies. So far rates look pretty much unchanged from 2013. Insurers have been raising rates at a double digit pace for over a decade and long before the PPACA was even a thought. If anything, rates are steady for the first time. As for that last thought, well, lets not go there.
How are rates unchanged when they have not been released yet? I am talking about national exchange, not state..........
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Old 05-23-2013, 01:53 PM   #140
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How are rates unchanged when they have not been released yet? I am talking about national exchange, not state..........
We have seen a few states release preliminary pricing data, and proposed premiums are generally holding at current levels. That's why I wrote "so far". California preliminary pricing is especially encouraging, the population size and diversity makes it more easily applicable to other locations.

No national exchanges. All are State exchanges. Some will be built and run by HHS, but will remain state specific, and will have policies designed and licensed for residents of that state. Each will also offer at least two policies that provide coverage in all states.
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