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Old 04-28-2016, 10:17 AM   #21
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I don't see how the ACA can fail as it is now a legal requirement to have health coverage. The rumors of its demise are greatly exaggerated.

The real threat is a change to the law.
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Old 04-28-2016, 10:50 AM   #22
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Premiums have been rising for 20 years. This is no different. Is it time for insurers to submit their rate requests for 2017? Then we should probably brace ourselves for an onslaught of articles on insurance pricing. Same as last year.

When it comes to individual insurance, we can safely say two things. First, it will be expensive, and second, insurer policy options will be different everywhere we look. Other than that, the media reports are fluff, with no meaningful takeaways for us.
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Old 04-28-2016, 10:55 AM   #23
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Premiums have been rising for 20 years. This is no different. Is it time for insurers to submit their rate requests for 2017? Then we should probably brace ourselves for an onslaught of articles on insurance pricing. Same as last year.

When it comes to individual insurance, we can safely say two things. First, it will be expensive, and second, insurer policy options will be different everywhere we look. Other than that, the media reports are fluff, with no meaningful takeaways for us.
Well of course premiums have been "rising" (more like skyrocketing) for the past 15-20 years, but premiums under the ACAwill rise substantially in the next couple of years as its initial revenue projections are ironed out (articles regarding its faulty, as in overly optomistic, revenue projections date back to before its inception). I've been expecting rising ACA premiums for some time. For this reason (among others), I am glad I do not have to depend on the ACA for pre-Medicare insurance. I am not against the ACA, just happy not to rely on it.
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Old 04-28-2016, 11:05 AM   #24
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This is so hard to talk about without discussing politics, because the decision this year on the president is pretty vital to determining what happens over the next four years to ACA.

I think it is pretty non political to say we will be able to guess a lot better after this November.

My personal opinion is ACA will not change much, just based on past history with large government programs that significant portions of the population have gotten a bit used to.
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Old 04-28-2016, 11:06 AM   #25
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There's more than one way to kill ACAt. Repeal isn't the only, or even the most likely, option at this point. Pulling out essential but unloved components, like the individual mandate, can precipitate a collapse while also providing plausible deniability to the perpetrators.

It's a legitimate fear for those of us who now rely on the individual health insurance market that it may devolve into something as bad or worse than what came before.

But it's also a fear I can't protect myself against. Aside from amassing ever more cash, I don't see any way to hedge against our ridiculous health care system.

Some risks you just have to live with and hope for the best. This, I think, is one.
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Old 04-28-2016, 11:24 AM   #26
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Well of course premiums have been "rising" (more like skyrocketing) for the past 15-20 years, but premiums under the ACAwill rise substantially in the next couple of years as its initial revenue projections are ironed out (articles regarding its faulty, as in overly optomistic, revenue projections date back to before its inception). I've been expecting rising ACA premiums for some time. For this reason (among others), I am glad I do not have to depend on the ACA for pre-Medicare insurance. I am not against the ACA, just happy not to rely on it.
There are no "ACA" premiums, and the ACA is not insurance, it is regulation. Insurance policies have been rising forever, and will continue to do so, because health care in the US is expensive.

State exchanges that have many options, such as Florida, have seen some insurers (like BCBS) increasing rates each year by 20% - 30%, while others (Humana) for the same coverage and similar networks have seen much lower increases. It is impossible to generalize, as each insurer is acting differently.
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Old 04-28-2016, 11:35 AM   #27
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Salty, I live in a state that does not have an exchange. I am 4 years away from Medicare. Insurers such as Anthem, as well as others, offer private individual policies that are priced just like the ones offered on the exchange. Currently and unless you are entitled to a subsidy, there really is no reason to mess with the exchanges or healthcare.gov. I do not qualify for a subsidy. From your numbers it looks like you do not either.

My current cost for a Bronze level plan is $579/mth (just me) with a $6,000/yr deductible and $6350 MOP. Deductible and MOP are the same bucket. Lower deductibles mean much higher premiums. I elected to go with Bronze and throw the dice, so to speak. One either pays up front with higher premiums or one pays as they go until they meet their deductible. I had a 33% increase in premium cost from prior year.

I would not be worried about moving to a state without an exchange as I think whatever changes are made, if any, will apply to both on or off exchange policies.

For grins, you could contact an insurer in PA and get a quote and research which insurers are in PA.

Health Care cost will probably rise…whether on or off an exchange. The good part is that at least one of you will be Medicare eligible in 18 months.
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Old 04-28-2016, 11:43 AM   #28
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There are no "ACA" premiums, and the ACA is not insurance, it is regulation. Insurance policies have been rising forever, and will continue to do so, because health care in the US is expensive.

State exchanges that have many options, such as Florida, have seen some insurers (like BCBS) increasing rates each year by 20% - 30%, while others (Humana) for the same coverage and similar networks have seen much lower increases. It is impossible to generalize, as each insurer is acting differently.
Well said. IIRC, there were pre ACA yearly premium rate increases that exceeded those of the ACA era increases. I suspect ACA will be tweaked (and improved) through the upcoming years, and that insurance availability and premiums will become more acceptable.
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Old 04-28-2016, 11:48 AM   #29
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Some risks you just have to live with and hope for the best. This, I think, is one.
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Old 04-28-2016, 11:58 AM   #30
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I think it will most likely come down to how easily the government can wrest away currently employed people from employer plans. There's way more healthy/younger people on employer plans and sicker/older people on the exchanges. Several rules come down the pipes starting in 2017 and beyond so only time will tell...
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Old 04-28-2016, 12:14 PM   #31
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I think it will most likely come down to how easily the government can wrest away currently employed people from employer plans. There's way more healthy/younger people on employer plans and sicker/older people on the exchanges. Several rules come down the pipes starting in 2017 and beyond so only time will tell...
I think it will come down to the willingness of young healthy people to pay ever higher prices to support older sicker people. As prices escalate more young healthy people are likely to not participate. In that case then prices need go up causing more young healthy people to drop out.

If there is too much resistance for young healthy people to join and pay, the system will collapse in the so-called death spiral.
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Old 04-28-2016, 12:20 PM   #32
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...........If there is too much resistance for young healthy people to join and pay, the system will collapse in the so-called death spiral.
Even if that happened, that would not be the end. Are we all going to quit needing health care or will we bankrupt ourselves buying insurance? Equilibrium will be reached, by what ever works. Health care costs may be artificially controlled like in other developed countries, more non professionals may offer services where a "real" doctor is not needed (think doc in the box services), more travel to other countries for elective surgeries, etc.
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Old 04-28-2016, 12:31 PM   #33
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Even if that happened, that would not be the end. Are we all going to quit needing health care or will we bankrupt ourselves buying insurance? Equilibrium will be reached, by what ever works. Health care costs may be artificially controlled like in other developed countries, more non professionals may offer services where a "real" doctor is not needed (think doc in the box services), more travel to other countries for elective surgeries, etc.
What you suggest is true.

Nonetheless, the present system could collapse. What follows in that case is anybody's guess.
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Old 04-28-2016, 01:00 PM   #34
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I think it will come down to the willingness of young healthy people to pay ever higher prices to support older sicker people.
It's hard to know.

Young healthy people are also likely to be relatively "poor," which means they're the most likely to be shielded from the true cost of insurance because of subsidies.

Young people "rich" enough to not qualify for subsidies face paying 2.5% of their income as a penalty for not buying a policy.

It's possible these carrots and sticks are still insufficient to get full participation, but it's hard to say whether young people are really better off skipping insurance.

Of course whether people who skip buying insurance fully understand all of this is an entirely different matter. As is whether young people who generally consider themselves invincible give much thought to health insurance at all.
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Old 04-28-2016, 01:06 PM   #35
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I would like to see all gov't employees (especially Fed employees) switched from employer based plans to the ACA system. They could be given a stipend adequate to cover the cost of the average silver plan (or similar compensation scheme). This would show that the gov't has confidence in the ACA. Providing gov't employees with employer provided plans simply says the opposite.

In additional to displaying confidence in the system, this would give the ACA providers greater economy of scale and would also add additional young, healthy folks to the pool. And, IMHO, the question of survivability of the ACA system, as discussed in this thread, would be greatly diminished. Folks could ER using ACA with greater confidence since they would be part of the same system which includes tens of millions of gov't employees.
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Old 04-28-2016, 01:26 PM   #36
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The system we have now is the ACA. Until congress passes a new law, I will plan for, and use the current system.
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Old 04-28-2016, 02:06 PM   #37
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This is my belief too. I don't think it will be fully repealed, maybe overhauled but pre-existing condition exclusions are a thing of the past. It has been shown that the insurance industry and healthcare didn't implode because of the removal of the clause, which seemed to be one of the many fears....

Come to think of it, does anything ever get repealed in government

I remember when a 1% sales tax was added to eating establishments to fund an arena at the local state college. The extra 1% was only supposed to be on the bill for about 10 years when the arena would be paid in full, now 20+ years later it is still being collected As usual they have found other uses for the cash.

I do not know if you remember... but the phone company gave us back some money a decade or so ago... it was based on a tax that they established for the Spanish-American war!!! My BIL was wanting to sue the gvmt since that war had long ago stopped... but his lawyer would not take the case... someone else sued and won..

On a side note, my BIL wanted to sue GM when they had that engine controversy many many years ago.... he thought he had bought a "Rocket 88" engine but found out it was a Chevy... his lawyer also refused to try that case... when someone else won he said he had wished he had listened to my BIL....


Here is a link on the tax...

https://en.wikipedia.org/wiki/Federa...one_excise_tax
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Old 04-28-2016, 02:26 PM   #38
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The system we have now is the ACA. Until congress passes a new law, I will plan for, and use the current system.
+1. The same with tax rates, Social Security, Roth IRA rules, tIRA rules, mortality tables, vehicle MPGs, gas prices, etc.

You play the cards you have in your hand, not the ones in the deck.
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Old 04-28-2016, 02:28 PM   #39
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This is my belief too. I don't think it will be fully repealed, maybe overhauled but pre-existing condition exclusions are a thing of the past. It has been shown that the insurance industry and healthcare didn't implode because of the removal of the clause, which seemed to be one of the many fears....

Come to think of it, does anything ever get repealed in government

I remember when a 1% sales tax was added to eating establishments to fund an arena at the local state college. The extra 1% was only supposed to be on the bill for about 10 years when the arena would be paid in full, now 20+ years later it is still being collected As usual they have found other uses for the cash.
I agree, we will never get back to eliminating those with pre-existing conditions, and as has been pointed out, sooner or later most of us will have some pre-existing condition.

And in order to cover pre-existing conditions, everyone must be covered, there is no other way, otherwise of course, people will just join when they are sick.

So mostly universal coverage and no pre-existing conditions exclusion are both pretty much here to stay. But as time passes there will likely be a lot of changes and fixes as both parties eventually have to come to the table and actually solve problems.

However we will never get away from rising health care costs. Nobody wants to go back to 1950s life spans, or 1950s health care, we all expect to be living longer and healthier, and the age distribution is continually shifting upwards.

Actually, that is why I have the Vanguard health care fund, I am betting on healthcare taking up a larger percentage of GDP in the future. I don't see any way around it, unless we are willing to be sicker and die younger.

So there will be changes and rising costs, but no repeal.
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Old 04-28-2016, 03:08 PM   #40
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It's hard to talk about this without diverting into politics. In the news just today are reports that congress is considering changing provisions of the heath insurance mandates.

Paul Ryan has a message for those with pre-existing conditions | MSNBC

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U.S. House of Representatives Speaker Paul Ryan called on Wednesday for an end to Obamacare’s financial protections for people with serious medical conditions, saying these consumers should be placed in state high-risk pools.
It makes sense to be concerned about this issue for early retirees, but without any definite idea of what might happen, it's impossible to make definite plans.
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