Who Obamacare has helped the most

[shotgunner]

No mention of it helping folks under 65 retire early. It has sure helped me.

http://www.nytimes.com/interactive/2014/10/29/upshot/obamacare-who-was-helped-most.html?_r=1

 

[Totoro]

Wish there would be an objective analysis somewhere of whether it will reduce the overall cost of healthcare in the medium to long term.

Hard to find that in a polarized topic such as this one.

 

[gauss]

After the 2012 Presidential election was complete and the future of ACA was fairly certain, I was confident enough to pull the plug on w*rk at age 47.

Although we currently have access to subsidized employer sponsored retiree health insurance and we are also in good health, who is to say that this will continue for the next 18 years or so?

With the new restrictions on premium discrimination in the individual market in ACA, I felt that I had enough safety nets in place to make the leap.

We can argue until we are blue in the face (well not in this forum ) about whether ACA was the best solution for the country as a whole, from the perspective of a potential ER it was a timely solution to manage the individual risk that I would have been facing without it.

-gauss

 

[athena53]

Really interesting study. I'm glad to see that so many of the under-served segments of the population are getting insurance. It would go a long way towards cutting costs if they learn the benefits of prevention, and seeking care before things get serious.

Anyway- I agree that Obamacare helped my decision to retire early. I rarely go to doctors for anything other than checkups because overall I'm blessed with very good health, but like most over- 60s, I have a few blips in my medical history that might have caused an insurer to deny coverage in the past. It is a huge relief to know that can't happen now. I quit at age 61.5 and would have been able to hang onto COBRA for 18 months, but would still have had to find something for the last 2 years before I hit 65.

 

[scrabbler1]

In my ER decision back in 2008, there was a small leap of faith when it came to then-candidate Obama promising health insurance reform in the 2008 campaign. At the time, I had lined up an affordable individual HI policy to begin in 2009. But that policy's premium rose 50% in 2 years, far more than I had anticipated and was beginning to strain my ER budget.

But in 2011, a year after the ACA had passed, I dropped my old and costly policy and switched to a bare-bones policy, leaving me rather underinsured (a term not mentioned at all in the linked NY Times article BTW) but only for 20 months until I could enroll in my state's exchange and return to a broader policy but paying a premium lower than my old indivdual policy even without any subsidy (I still qualify for a small subsidy which is helpful).

Interesting how the last map in the NYT article, the one about where the biggest areas of uninsured people live, greatly corresponds to the states (deep south, many Rocky Mountain states) which did not expand Medicaid.

 

[2B]

Until the ACA, Texas had an unlimited access high risk pool which guaranteed brone plan like coverage for not much more than I'll have to pay for my ACA bronze plan. Health insurance was never an issue with my retirement plans. Only the cost was important as a major budget item which the ACA didn't change.

I realize some states weren't as aggressive in making sure insurance was availble to those wishing to buy it. If anyone was delaying retirement because of this, moving to Texas was always an option.

I deleted a section of my original text because I assumed the moderators would think it too political in pointing out the ways I feel the ACA isn't meeting its objectives. The article presented in the original post is nothing but a "puff piece" cheerleading the ACA.

 

[travelover]

I was retired with my former employer providing health insurance, but that benefit was never guaranteed, so I breathed a sigh of relief when the ACA was passed. I don't need to worry about getting shut out of the insurance pool with a pre-existing condition or God forbid, moving to Texas.

 

[Mulligan]

Well if no one had their premium increase by less than 326% then I am obviously the clear winner in Obamacare. Do I get a prize for winning?


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[Chuckanut]

I can think of three people who it helped get insurance. Two are young folks who did not have insurance available through work (I could tell you a story there about that.) And, one a person who was able to retire early thanks to insurance being available.

So, I figure that's six people that ACA has helped.

The three persons who got insurance.
The one person who found a job that the now retired person left.
The parents of the two younger persons who can sleep better at night knowing their children are insured.

OK, I may be pushing it a bit on the last one. But, the person who got the job is, IMHO, a legitimate though indirect benefit.

 

[target2019]

It helped us, as we are not bound to current employers or insurers. Pre-existing conditions...

 

[jabbahop]

It made early retirement an option for me.

In the last year I discovered I had
1) hodgkin's lymphoma - treated and gone now
2) enlarged aorta - watch and wait

Both of these would be huge costs if they need to be treated before I get to medicare so being able to get insurance @ a "reasonable" rate is a huge benefit for me.

 

[MichaelB]

We probably won't know for a few more years just how how the ACA helps. Most of us below age 65 already benefit because coverage has been guaranteed, standardized, is more comprehensive and cannot be cancelled.

The average family group policy premium is $15K and the median household income is $52K. At 30% of gross income, healthcare insurance is unaffordable for at least half the US population. Those receiving employer sponsored insurance already receive substantial taxpayer support. The ACA extends that support to individuals.

 

[daylatedollarshort]

It has been a huge benefit to us. Pre-ACA our premiums alone were over 2K a month. Because of pre-existing conditions, we were captives to a post COBRA conversion policy with no caps on the premiums and very high deductibles or a small business policy also with high premiums and even worse out of pocket maximums.

I don't remember the exact final tally, but our total medical costs the year before the ACA kicked in were on the order of $40K -$50K due to premiums, out of pocket max and out of network costs.

 

[brewer12345]

Well if no one had their premium increase by less than 326% then I am obviously the clear winner in Obamacare. Do I get a prize for winning?


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As I understand it, you never really tried to use this old policy. I think if you had actually done so, you would feel very, very differently about PPACA.

 

[ERhoosier]

Until the ACA, Texas had an unlimited access high risk pool which guaranteed brone plan like coverage for not much more than I'll have to pay for my ACA bronze plan. Health insurance was never an issue with my retirement plans. Only the cost was important as a major budget item which the ACA didn't change.

.....The article presented in the original post is nothing but a "puff piece" cheerleading the ACA.

Excellent point that pre-ACA many states already had functioning provisions for pre-existing conditions (inc. "shall issue" regs, hi-risk pools, etc.). I know many who chose their state of residence (for w@rk, self-employment, or ER) due to HI (inc big regional differences in premiums-which unfortunately remains an issue).
I think gauss is spot on in predicting pre-existing condition coverage in HI is here to stay regardless of how ACA may be modified (even repealed) over the years. This provision has widespread support among the public & leaders from both parties.

Of course the original article is a pro ACA puff piece. Every law has winners and losers (inc among FIRE's), and title of the piece tells ya it would only cover the former.
FWIW- Here's another NYT piece on some of the losers under ACA-
http://douthat.blogs.nytimes.com/2013/10/28/obamacares-losers-and-why-they-matter/

 

[dtbach]

The article presented in the original post is nothing but a "puff piece" cheerleading the ACA.

This post seems to be pretty political. I agree, it's a puff piece for ACA.

 

[Mulligan]

As I understand it, you never really tried to use this old policy. I think if you had actually done so, you would feel very, very differently about PPACA.

That may be true, Brewer. I will admit I have tended to view insurance in all areas of life as money thrown down the drain, so I must admit I view it only in terms of cost. But in the next few years I am going to get around to getting a "medical" hot tub for my achy back. The cost of that combined with the high premiums will get me a nice tax refund and I will get my subsidy that way.


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[RetireBy90]

Although I disagree with many parts of the new program, I have to say that guaranteed coverage is priceless, and keeping kids on your policy till 26 is a win for all. I assume you still pay a premium for the kids, and I'm sure premiums went up to pay for guaranteed coverage. However, I'd say it is a price I'm willing to pay.

 

[brewer12345]

That may be true, Brewer. I will admit I have tended to view insurance in all areas of life as money thrown down the drain, so I must admit I view it only in terms of cost. But in the next few years I am going to get around to getting a "medical" hot tub for my achy back. The cost of that combined with the high premiums will get me a nice tax refund and I will get my subsidy that way.


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Insurance that actually covers very bad events that you cannot otherwise hedge or afford is worth a lot. Before the PPACA reforms, most states did not have such policies available in the individual marketplace and in those that did massive negative selection often resulted in premiums being completely out of reach for most people in that market. Now we have a usable product and the price is a lot less than it was in the few states where it used to exist. Yep, a lot of the time you never get anything for your insurance premium dollars. We should all be so lucky.

 

[daylatedollarshort]

I guess the winners under the ACA include the additional 10 million people to date, the equivalent of the entire population of Portugal, going from uninsured to having health insurance.

 

[photoguy]

ACA passing removed the last roadblock to our ER. We had considered various state plans for individual insurance but considered that too risky.

 

[ERhoosier]

It has been a huge benefit to us. Pre-ACA our premiums alone were over 2K a month. Because of pre-existing conditions, we were captives to a post COBRA conversion policy with no caps on the premiums and very high deductibles or a small business policy also with high premiums and even worse out of pocket maximums.

I don't remember the exact final tally, but our total medical costs the year before the ACA kicked in were on the order of $40K -$50K due to premiums, out of pocket max and out of network costs.

Ouch! That is a huge $$$ hit. Hope things will indeed be better for you & yours in the future ($$ & health-wise).

Unfortunately, folks with MAGI a bit to high for subsidy are still open to financially devastating total HC costs. In my region, 2014 Exchange Silver premiums for early 60's couple are over $1,700/mo with an OOP max of $12,700 (in-network) and NO OON coverage. So a serious health issue could easily push total annual HC costs (inc. OON & non-covered services) into the $40-50+k range you had pre-ACA. That's a massive bill to try to manage on a MAGI of $55-60k/yr

 

[brewer12345]

Ouch! That is a huge $$$ hit. Hope things will indeed be better for you & yours in the future ($$ & health-wise).

Unfortunately, folks with MAGI a bit to high for subsidy are still open to financially devastating total HC costs. In my region, 2014 Exchange Silver premiums for early 60's couple are over $1,700/mo with an OOP max of $12,700 (in-network) and NO OON coverage. So a serious health issue could easily push total annual HC costs (inc. OON & non-covered services) into the $40-50+k range you had pre-ACA. That's a massive bill to try to manage on a MAGI of $55-60k/yr

Easily solved if we go to single payer.

 

[ERhoosier]

I guess the winners under the ACA include the additional 10 million people to date, the equivalent of the entire population of Portugal, going from uninsured to having health insurance.

Actually we do not know that- at least not yet. The rough 10M figure is an estimate that includes all who enrolled in HI. That figure is likely somewhat higher than the number who were insured for the whole year. It is not known how many of those who enrolled never paid premiums or cycled out of HI by paying only a premium or 2. Regardless, some 30+ million remain uninsured.

http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html#/uninsured

 

[athena53]

Insurance that actually covers very bad events that you cannot otherwise hedge or afford is worth a lot. Before the PPACA reforms, most states did not have such policies available in the individual marketplace and in those that did, massive negative selection often resulted in premiums being completely out of reach for most people in that market.

I agree. I remember that about 20 years ago, an actuary I knew who was an independent consultant told me he'd tried to get a very high deductible plan. He understood the risk but figured he could handle the smaller expenses and didn't want to pay the insurer's profit and expense loading on the additional coverage for smaller claims. He couldn't find a deductible as high as he wanted (probably $10K family at the time).

I do have concerns about the people buying High Deductible plans because that's all they can afford, when they really don't have the means to meet the out-of-pocket max. I wonder if they'll avoid getting care beyond the preventative things that are fully covered.