Worried about ACA Obamacare repeal or collapse in 2017

[Salty]

Hi everyone-
We currently live in Massachusetts, where Obama care " type" insurance has been available for 10 years now. We early retired 3 years ago ( we are now 54 and 63), and purchase our insurance through the " Health Connector" ( the MA exchange). We have a plan with a $1750 ded each and a $5250 OOP max from Harvard Pilgrim. It runs about $14K per year for the two of us. So far the plan has worked well, and other than a 16% price increase this past year we are generally pleased. One saving grace is that one of us has 18 months to go until Medicare. I am hoping future ACA premium increases can be absorbed for the younger one of us, by the fact that the other will be on Medicare.

Here is my major concern- we are considering a move to Pennsylvania within the next year, and they do not have a state run exchange. Their plans are through Healthcare.gov the federal exchange. I am very worried that if we move there, and the ACA is either repealed or collapses, we will be without the ability to buy " affordable" insurance without pre-existing conditions. I have the same concern in MA, but to a lesser degree, given the fact we have has a version of the ACA for 10 years and it seems to be working.

What do you think will happen to health insurance availability if it is repealed, do you think more insurers will pull out and it will fail?
Nervous about making a big move like this ( selling our home, buying a new one in PA etc) with such a large unknown looming!

insights appreciated!

 

[MasterBlaster]

Don't believe anyone's predictions, especially about the future !

If I were to speculate, I would guess that you'll pay a lot more, get a lot less, have a lot fewer (good) choices, and wait a lot longer.

But you'll be covered.

 

[MichaelB]

Most of the previous efforts to discuss this have ended with locked threads when the topic shifted into politics. Hopefully we can avoid that this time.

Here's one recent thread that discussed some options http://www.early-retirement.org/forums/f52/gotta-cover-those-pre-existing-conditions-80939.html

 

[pb4uski]

IMO the elimination of pre-existing conditions is so universally popular that the chances that any future will have medical underwriting is very, very remote.

Affordability is a whole other issue, but only time will tell and there is not much one can do about it.

 

[Senator]

Hi everyone-
We currently live in Massachusetts, where Obama care " type" insurance has been available for 10 years now. We early retired 3 years ago ( we are now 54 and 63), and purchase our insurance through the " Health Connector" ( the MA exchange). We have a plan with a $1750 ded each and a $5250 OOP max from Harvard Pilgrim. It runs about $14K per year for the two of us. So far the plan has worked well, and other than a 16% price increase this past year we are generally pleased. One saving grace is that one of us has 18 months to go until Medicare. I am hoping future ACA premium increases can be absorbed for the younger one of us, by the fact that the other will be on Medicare.

Here is my major concern- we are considering a move to Pennsylvania within the next year, and they do not have a state run exchange. Their plans are through Healthcare.gov the federal exchange. I am very worried that if we move there, and the ACA is either repealed or collapses, we will be without the ability to buy " affordable" insurance without pre-existing conditions. I have the same concern in MA, but to a lesser degree, given the fact we have has a version of the ACA for 10 years and it seems to be working.

What do you think will happen to health insurance availability if it is repealed, do you think more insurers will pull out and it will fail?
Nervous about making a big move like this ( selling our home, buying a new one in PA etc) with such a large unknown looming!

insights appreciated!

Worse case, you move back to MA. There will always be a place to buy health insurance. There always was. I would not worry about it at all. Prices will continue to rise, ACA or not.

 

[neihn]

Prices will continue to rise, ACA or not.

Very ironic, and we just accept it. There's absolutely nothing that we can do.

 

[littleb]

I think no matter what happens they will not repeal Obamacare because so many people are currently covered under the plan. However, I do think the plan might be overhauled to make sure it is sustainable in the future. It would be a huge mistake to allow insurance companies to exclude pre-existing conditions again. This would be going backwards.

We are retiring this year with the same concerns but I feel confident it will all work out.

 

[Sunset]

I think no matter what happens they will not repeal Obamacare because so many people are currently covered under the plan. However, I do think the plan might be overhauled to make sure it is sustainable in the future. It would be a huge mistake to allow insurance companies to exclude pre-existing conditions again. This would be going backwards.

We are retiring this year with the same concerns but I feel confident it will all work out.

Yep, if you can't trust your politicians, who can you trust......

 

[youbet]

Yep, if you can't trust your politicians, who can you trust......

Aw...... Youse just sayin' dat cuz you from Chicaaago!

 

[MRG]

Before ACA I couldn't buy insurance due to pre-existing conditions. Think many others are in the same situation. As long as I can buy insurance without preexisting issues I'll do it and focus on IRA to Roth conversions vs. managing income.

Along the lines I read CO. is voting on an amendment to do single payer. Maybe it's time to move!

 

[Ronnieboy]

IMO the elimination of pre-existing conditions is so universally popular that the chances that any future will have medical underwriting is very, very remote.

Affordability is a whole other issue, but only time will tell and there is not much one can do about it.

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.

 

[bUU]

While I agree with what those above have said, there is a legitimate concern regarding coverage for pre-existing conditions. The sustainability of ACA alluded to above, with respect to coverage for pre-existing conditions is underwritten mostly by the insurance mandate. If the insurance mandate is compromised, coverage for pre-existing conditions is compromised - they go hand-in-hand, one effectively carrying most of the load for the other.

Even with the insurance mandate, we see some insurers opting out of offering coverage under ACA. That's partially the predictable preference for cherry-picking the marketplace for the most profitable customers, but also partially a reflection of how close to the razor's edge the balance is struck within ACA. It would be relatively easy to effect populist-driven changes to ACA that would not have direct adverse impact, but because such changes are ham-fisted placation rather than careful reformulation of the balance, the indirect impact of such changes would compromise the whole.

Americans talk about sustainability, and even harangue those proposing changes that compromise sustainability, but in the end, sometimes structurally unsound changes are made because of an overriding, often populist-driven, imperative.

 

[Senator]

A larger risk to retirement lifestyle, especially if you do not have a COLA pension or SS, is inflation. Could you survive if we had 7%+ inflation for a few years.

That is a higher probability than losing any health insurance.

I think we are still in a deflationary period, and likely to stay there, but it could happen.

 

[Winemaker]

The 18% tax on liquor in PA to rebuild the city of Johnstown after the flood is still collected to this day. The flood occurred in 1936 and the city was rebuilt and paid for by 1942.

 

[travelover]

The 18% tax on liquor in PA to rebuild the city of Johnstown after the flood is still collected to this day. The flood occurred in 1936 and the city was rebuilt and paid for by 1942.

Well, yea, but I'm sure they are putting the money away in case it happens again.

 

[ziggy29]

The 18% tax on liquor in PA to rebuild the city of Johnstown after the flood is still collected to this day. The flood occurred in 1936 and the city was rebuilt and paid for by 1942.

Just like the Golden Gate Bridge was funded by tolls which were supposed to be stopped once the bridge was paid off. It was paid off in the 1960s, I think, but the tolls remained.... and are rising faster than inflation.

 

[ziggy29]

A larger risk to retirement lifestyle, especially if you do not have a COLA pension or SS, is inflation. Could you survive if we had 7%+ inflation for a few years.

That is a higher probability than losing any health insurance.

I think we are still in a deflationary period, and likely to stay there, but it could happen.

We may be in a deflationary period, but not for health insurance which continues to rise in cost much faster than inflation. So people are getting no COLAs because of little or no overall inflation (or even deflation) even as their health care burden continues to rise sharply, whether in the form of higher premiums or higher deductibles/copays/OOP maximums.

 

[Corporateburnout]

We live in MA. When we decided to retire the ACA was still in the discussion phase but Romneycare was in place and MA will revert back to it if the ACA is repealed.

No worry there since we have no plans to move to another state anytime soon.

 

[AllDone]

While I agree with what those above have said, there is a legitimate concern regarding coverage for pre-existing conditions. The sustainability of ACA alluded to above, with respect to coverage for pre-existing conditions is underwritten mostly by the insurance mandate. If the insurance mandate is compromised, coverage for pre-existing conditions is compromised - they go hand-in-hand, one effectively carrying most of the load for the other.

Even with the insurance mandate, we see some insurers opting out of offering coverage under ACA.

More precisely, we've seen one insurer who was never in the individual market prior to the ACA withdraw from the individual market after mispricing its new product. They were still making a hefty profit. There was also a new insurer with a unique new business plan that has just failed. OTOH experienced individual market insurers are expanding their offerings in many markets. I'm not worried about the insurance market at all, just bad legislative decisions.

Sooner or later everybody develops a pre-existing condition....

 

[Options]

Were I to use the ACA--and I have no intention of doing so--I'd be more worried about upcoming premium hikes:

https://www.washingtonpost.com/business/significant-premium-hikes-expected-under-obama-health-law/2016/04/28/7030d49e-0d15-11e6-bc53-db634ca94a2a_story.html?utm_campaign=KHN%3A+First+Edition&utm_source=hs_email&utm_medium=email&utm_content=29019630&_hsenc=p2ANqtz-8SeDLMrkO9u6Fkgz4FOUrF5x8ArmJxKsyfw5M9wEBiw-6qhJ5ivbNW2B4OYTjW_UvliLNFNBNYqv77JYWBQVq2_xLLcA&_hsmi=29019630

The health law is “likely in for a significant market correction over the next year or two,” said Larry Levitt of the nonpartisan Kaiser Family Foundation. “There have been a lot of signals from insurers that premiums are headed up.”

For those of you in the Bay Area, also see this:

Huge health care price differences even within same area, by state

Jeanne Pinder, a former journalist who founded Clearhealthcosts.com, calls HCCI's data "bowdlerized" and says some of the most interesting data her site collects comes when consumers wind up paying a far greater share of cost of a procedure than the insurer did. Some insurance policies require consumers to pay the insurer's negotiated rate, while others require the insured person or the insurers and the consumer to pay the entire sticker price, says Pinder.

In San Francisco, that left one person facing out-of-pocket costs of more than $1,900 for that same lower back MRI that cost less than $500 in the same area.

 

[jim584672]

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.

 

[MichaelB]

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.

 

[Options]

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.

 

[Fermion]

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.

 

[Gone4Good]

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.