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Old 06-28-2012, 12:58 PM   #41
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Sounds like wishful thinking to me. I think the reality will be that almost all health insurance premiums will go up and I hope I am totally wrong.
I'm pretty sure my premiums will go up. Of course, before the ACA existed, I was pretty sure my premiums would go up. I budgeted for a medical inflation rate twice the broader consumer inflation rate.

I'd also bet that if the ACA were repealed, that my insurance rates would go up. Funny how that works. R-squared = 0...
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Old 06-28-2012, 12:59 PM   #42
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Are you referring to the full, unsubsidized cost of this insurance or just your portion under cost-sharing? For example, I pay a little more than 20% of the full unsubsidized cost of my policy. That comes to about 1.5% of my income. But if I look at the unsubsidized cost, it would be closer to 7%.
My plan is unsubsidized individual plan through Anthem. I pay $72 a month for a $5500 deductible no copay after deductible. When I take my $3100 HSA deduction, my insurance policy makes me a couple hundred bucks profit each year. I am 48. I certainly cant complain about current costs. So I guess currently the cost is 0.8% of my current income, and less than zero after HSA deduction. I certainly feel myself fortunate.
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Old 06-28-2012, 01:01 PM   #43
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The Obamacare term once had a distinct negative connotation but it has been used so much to refer to the PPACA that it is now commonplace. I no longer think of it being improper any more than using the term Xerox for copying or Kleenex for tissue....
I could play around with the term Obamacare and call it something else, but that would start the sound of bacon sizzling, so I better not.

As for the law itself, right now I have a high deductible HSA, with only a $5 Million lifetime limit. Should my health situation change in the future, it's nice to know that I have other options without a lifetime limit cap.

Got some relatives with pre-exisitng conditions that would make it difficult to get insurance as it is today. So 2014 is a year to look forward to for them.
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Old 06-28-2012, 01:01 PM   #44
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$72 a month with a $5500 deductible for a 48 yo is amazingly good. I pay over $550/month for self and DW with a $10k deductible - and consider myself lucky.
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Old 06-28-2012, 01:03 PM   #45
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I could play around with the term Obamacare and call it something else, but that would start the sound of bacon sizzling, so I better not.
Mmmm.... bacon. The thing is, I suspect a *lot* more people know what "Obamacare" is than what the "PPACA" is. That in itself shows the usefulness of the term, whether originally used pejoratively or not.

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As for the law itself, right now I have a high deductible HSA, with only a $5 Million lifetime limit. Should my health situation change in the future, it's nice to know that I have other options without a lifetime limit cap.
My Megacorp plan eliminated the $5 million cap about three years ago even before Obamac PPACA was passed into law.
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Old 06-28-2012, 01:10 PM   #46
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Originally Posted by pb4uski
$72 a month with a $5500 deductible for a 48 yo is amazingly good. I pay over $550/month for self and DW with a $10k deductible - and consider myself lucky.
Since you are paying for 2 that isn't so bad I agree if you are getting a nice tax break from an HSA and avoiding deductible expenses. Stay healthy my friend!
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Old 06-28-2012, 01:13 PM   #47
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I'm pretty sure my premiums will go up. Of course, before the ACA existed, I was pretty sure my premiums would go up. I budgeted for a medical inflation rate twice the broader consumer inflation rate.

I'd also bet that if the ACA were repealed, that my insurance rates would go up. Funny how that works. R-squared = 0...
This. I have tracked the insurance cost changes through the year - both the subsidizes rates (employee portion) and the full rates (cobra rates). Not only has full health care rates gone up consistently at a 10% rate/year since before PPACA, The portion paid by the employee, at my megacorp, has also gone up. From 20% paid by employee to now 40%. So it's been doubly painful.

The only good news is that I'm getting used to paying a larger percentage of my health insurance - which means it will hurt less, budget wise, when I finally say goodby to the megacorp.
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Old 06-28-2012, 01:15 PM   #48
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I guess I am an exception to the rule. Looking at the link, my premium cost is actually cheaper than paying the penalty of 1% coming soon and obviously less than the future 2% penalty for not buying it. So I would currently have no incentive to pay the penalty and forgo insurance.
Congrats on your extreme wealth, using income as the measure. If your HI costs $7,000/yr (which is dirt cheap from what I've seen), your income would have to be more than $700,000/yr (at 1% penalty in 2014) for the "premium cost is actually cheaper." I must be missing something...


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My plan is unsubsidized individual plan through Anthem. I pay $72 a month for a $5500 deductible no copay after deductible. When I take my $3100 HSA deduction, my insurance policy makes me a couple hundred bucks profit each year. I am 48. I certainly cant complain about current costs. So I guess currently the cost is 0.8% of my current income, and less than zero after HSA deduction. I certainly feel myself fortunate.
That's $864/yr. Anthem quoted DW (age 56) and I (57) $500-600 month for a high deductible plan and we're in relatively excellent health. Let's just say your plan is unheard of for an unsubsidized policy and leave it at that.
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Old 06-28-2012, 01:18 PM   #49
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My plan is unsubsidized individual plan through Anthem. I pay $72 a month for a $5500 deductible no copay after deductible. When I take my $3100 HSA deduction, my insurance policy makes me a couple hundred bucks profit each year. I am 48. I certainly cant complain about current costs. So I guess currently the cost is 0.8% of my current income, and less than zero after HSA deduction. I certainly feel myself fortunate.
Your policy does not meet the requirements of the new law (I think your deductible is too high, your cap is too low, and you'd need to check to assure it includes all the required "preventative" services mandated by the legislation.) Anyway, when your insurance company raises your rates in order to include the new bells and whistles, the "good news" is that you'll be among those who save money by dropping your insurance and just paying the tax. Of course, you wouldn't have insurance then. But you can buy it the day you need it.
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Old 06-28-2012, 01:23 PM   #50
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Congrats on your extreme wealth, using income as the measure. If your HI costs $7,000/yr (which is dirt cheap from what I've seen), your income would have to be more than $700,000/yr (at 1% penalty in 2014) for the "premium cost is actually cheaper." I must be missing something...
I wish! I doubt I will ever have $700k in assets before I die let alone income! You missed a follow up post, Midpack. My premium is only $72 a month for a $5500 individual plan deductible through Anthem. $7 million max lifetime.
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Old 06-28-2012, 01:27 PM   #51
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I am very relieved. I have a child with an eye injury from 10 years ago. Thankfully, she can't be denied treatment for a "preexisting condition."
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Old 06-28-2012, 01:28 PM   #52
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It looks like your policy might not meet the requirements of the new law (I think your deductible is too high, and you'd need to check to assure it includes all the required "preventative" services mandated by the legislation.) Anyway, if you insurance company raises your rates in order to include the new bells and whistles, the "good news" is that you'll be among those who save money by dropping your insurance and just paying the tax. Of course, you wouldn't have insurance then. But you can buy it the day you need it.
No, the plan was bought prior to the healthcare act being passed so I am exempted. It certainly seems that health insurance is a lot cheaper in MO, than other places. But it appears the reason has been the high rejection rate of applicants here. I THINK that anyone who has a policy purchased prior to the act it exempted from all of the provisions. For example I have a lifetime cap of $7 million and do not get a free preventive care physical either. I will gladly give those up if my plan stays exempted.
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Old 06-28-2012, 01:28 PM   #53
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Perhaps I should plan to game the system and drop health insurance on 1/1/2014, pay the penalty and then buy guaranteed issued insurance if I have a health event. I think the way it works that I would only be screwed if I had such an immediate health event that I couldn't get the time to buy the insurance (liek a heart attack requiring immediate surgery).
You're probably covered anyway unless PPACA voids EMTALA...
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Old 06-28-2012, 01:32 PM   #54
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I wish! I doubt I will ever have $700k in assets before I die let alone income! You missed a follow up post, Midpack. My premium is only $72 a month for a $5500 individual plan deductible through Anthem. $7 million max lifetime.
As I added above, you're paying $864/yr. That's totally unheard of based on everything I have ever read about HI for an unsubsidized plan even high deductible.To say you're an exception may be a gross understatement.
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Old 06-28-2012, 01:37 PM   #55
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Congrats on your extreme wealth, using income as the measure. If your HI costs $7,000/yr (which is dirt cheap from what I've seen), your income would have to be more than $700,000/yr (at 1% penalty in 2014) for the "premium cost is actually cheaper." I must be missing something...

That's $864/yr. Anthem quoted DW (age 56) and I (57) $500-600 month for a high deductible plan and we're in relatively excellent health. Let's just say your plan is unheard of for an unsubsidized policy and leave it at that.
Not unheard of, Midpack. Anyone in MO can get this provided they are healthy. Here is my plan copied right off ehealthinsurance. It is now $76. The healthcare act only raised it $4. I am surprised.


Lumenos HSA Plus 0% 5500/11000

AM Best Rating: A Plan Type Deductible Coinsurance Office Visit
PPO $5,500 0% 0% after deductible
$76.18​/mo*



HSA Options
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Old 06-28-2012, 01:39 PM   #56
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No, the plan was bought prior to the healthcare act being passed so I am exempted. It certainly seems that health insurance is a lot cheaper in MO, than other places. But it appears the reason has been the high rejection rate of applicants here. I THINK that anyone who has a policy purchased prior to the act it exempted from all of the provisions. For example I have a lifetime cap of $7 million and do not get a free preventive care physical either. I will gladly give those up if my plan stays exempted.
There's some uncertainty about how "sturdy" the grandfathering will be. From the Congressional Research Service:
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PPACA is silent on the question about whether changes to a plan or coverage would make it a new plan. It is not clear whether changes to covered benefits, cost-sharing requirements, actuarial value, or other plan features would be allowed under a grandfathered plan. Also, PPACA does not address instances when there are changes to the insurance carrier offering the plan (e.g., new corporate owner); it is not clear whether organizational changes would make grandfathered plans into new plans.
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Old 06-28-2012, 01:45 PM   #57
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DH and I currently pay nearly $600 a month for health insurance and this is as a full retiree under the Virginia Retirement System. I can only hope this means we'll have a more affordable alternative but somehow doubt it.
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Old 06-28-2012, 01:53 PM   #58
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DH and I currently pay nearly $600 a month for health insurance and this is as a full retiree under the Virginia Retirement System. I can only hope this means we'll have a more affordable alternative but somehow doubt it.
Ours is closer to $700/mo currently, for retiree (both) under my former employer plan.

What get's interesting is that we will both be on Medicare next year, but our medigap coverage will still be supplied (for a price) by my former employer.

It's too early to question, but the possibility arises that we will "go alone" and get that medigap coverage on our own.
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Old 06-28-2012, 01:57 PM   #59
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To prevent people from trying to game the new law by going without insurance, paying the penalty/tax, then buying coverage just when they get sick, could there be a law change which does somethign similar to what is done in the homeowners insurance market: I believe a homeowner has to buy insurance at least 30 days before he can collect on certain types of damage to prevent someone who is without insurance from seeing weather reports of a hurricane approaching and quickly buying a policy. This required lead time could be made longer in the health insurance area but the principle is the same.
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Old 06-28-2012, 01:59 PM   #60
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One ramification for us is that we've been considering having me kiss Megacorp goodbye after my wife more or less becomes a full time, ordained pastor. She'd have group coverage available to her through the churchwide body, and right now it would considerably exceed 9.5% of her income. Other complicating factors would be that unlike now, she would be considered self-employed as an ordained pastor (with 1099 income and self-employment taxes). As I try to understand PPACA, there may be no subsidy for people who have employer group coverage costing them less than 9.5% of income. BUT -- on the other hand, as a self-employed would this option be considered "employer sponsored" health insurance at all?

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I suspect that everyone was focused on the commerce clause and item 2 above indicates that the individual mandate is not constitutional under the commerce clause and then the tax argument sneaked in the back door.
Yep, in their rush to "scoop" the competition, as soon as they saw Roberts' opinion denying the use of the Commerce Clause as justification, they assumed that meant Roberts voting it down. They had no idea that he'd soon uphold it on other grounds.
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