Venting about ACA and requesting suggestions

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Synergy

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I very seldom post at this website but read it often because it's made up of people that are bright and well educated. Over the years I have learned a lot here.

This post is mostly venting and a little bit asking questions. I live in Oregon and just shopped for my health care for 2019. (61 year old male, single, healthy, no drug use of any kind, no alcohol or tobacco, healthy weight, 2 hours of exercise a day) Income: Pension + rental income + dividends = about 60,000 a year. The bronze plan is going to be about 880.00 a month, with about 7000 deductible. With the high deductible you can pretty much figure anytime you might require a doctors visit that the cost will be entirely out of pocket. The year before Obama care took place I had a policy with Moda with 5000 deductible and the monthly premiums were only 200.00.

One of the reasons I'm angry is because I suspect that the main reason the cost is so high is to provide good quality health care for the large percentage of the population that practices self destructive behavior (alcoholics, drug addicts, people that totally ignore the advice of the health experts by overeating, not exercising, etc. people more likely to require health care and less likely to be employed). I think this falls under the category of " your right to swing your fist about wildly ends at the tip of my nose". Well, that fist has done more than just brush peoples noses; It has pummelled us to the ground and left us a bloody mess. I'm not suggesting that we eliminate all the programs to assist people in need. I'm suggesting the system needs changing and very strict policing. I also suspect that there has probably been an increase of middle class people dying as a result of Obama care because they are forced to have such a high deductible on their insurance that they don't go to the doctor when they should (minor chest pain, etc). Furthermore, while I know it's not reasonable to price heath insurance exactly like auto or life insurance, there should be a financial reward/penalty for good/bad practices. Hypothetical situation: A guy on the street standing there hitting himself in the head with a hammer. Government man walks up to me and says "see that guy hitting himself with the hammer? Well he's going to need medical care and he doesn't have any money, so you're going to pay for it". That's exactly how I feel it's going down.

Phew, that was a lot of complaining :) Now for the questions- Is 880.00 a month pretty typical for the Bronze plan? Anyone here have knowledge of any options or strategies I might have to reduce this high cost?
(Other than "short term" coverage. I'm too active for short term policies. The sports I practice would not be covered).

Thank you,
RDW
 
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Well what you said no doubt is true. Some of my neighbors live like that. On the other hand very few retired folks make 60k a year as a single. So you might say they want you to pay up. You could sell the rental and go 100% index funds maybe that would get you under 48k?
 
I would say your Bronze plan is really close to my DW's.. (I'm a Medicare Baby now)..

And I get where you are coming from with your rant about having to share the risk with people who don't take better care of themselves, but to put your mind (maybe) at ease, healthy people get sick too.

My DW does not smoke, drink, or do drugs. She eats carefully, exercises, maintains a good weight. 3 years ago she was diagnosed with breast cancer. (She's doing fine, it's unlikely to be what kills her),

I don't smoke or do drugs, I drinks a bit, I maintain a good weight. Resting heart rate below 60, good BP, I eat a healthy diet... 2 years ago got knocked on my butt with ruptured discs/sciatica, and 10 weeks ago I ruptured my achilles pursuing my active healthy lifestyle.
 
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That's all well and good but someday you might be the one that walks into the doctors office and gets blindsided by a Stage 4 cancer diagnosis.

Or perhaps you'll suffer a life threatening injury doing one of your activities.

You just described my DH who is all of the things you listed and ended up needing treatment for a genetic heart issue and has probably gone through 750K in medical bills in the last 5 years. Everyone getting medical care isn't the "lowlife" you seem to imply.

In fact you are aging which is one of the risk reward ratios you mention and a reason your cost go up every year.

You have 4 years until Medicare only you can decide if it's worth to sell your rental and lower your income to subsidy levels. Is that price typical for a bronze 61 year old, what difference does it make, you can't do anything about it anyway.
 
Now for the questions- Is 880.00 a month pretty typical for the Bronze plan? Anyone here have knowledge of any options or strategies I might have to reduce this high cost?(Other than "short term" coverage. I'm too active for short term policies. The sports I practice would not be covered).

IMO, you have a right to be aggravated: Obamacare demands that you pay 17.6% of your MAGI for your 2019 health insurance premiums, when the law itself claims that any percentage greater than 8.05% is 'unaffordable'. To look at it another way, any single person in your county with a MAGI between $48k and $131k :)eek:) is being forced to pay 'unaffordable' insurance premiums according to Obamacare's own definition of 'affordability'. It seems that only about one American health care article in thirty appearing in the mass media addresses the plight of these unfortunate folks. :nonono:

Personally, I wouldn't write off 'short-term' insurance so quickly. I've been through the medical underwriting process many times and don't recall any questions specifically asking about any risky sports I might be into. However, maybe my memory is faulty so YMMV. I haven't yet arranged for my 2019 health insurance; it almost certainly won't be Obamacare.

Good luck! :greetings10:
 
Could you posters use the proper term which is ACA instead of the constant references to Obamacare?
 
(61 year old male, single, healthy, no drug use of any kind, no alcohol or tobacco, healthy weight, 2 hours of exercise a day) The year before Obama care took place I had a policy with Moda with 5000 deductible and the monthly premiums were only 200.00.

You are also 5+ years older, and in your 60's instead of 50's. Your individual health habits are not much of a factor with group plans - much like employer plans - or the person who has struggled with their weight, or is diabetic, or was born with congenital defects, or had childhood lukemia, would also have their medical status factored in, and have premiums 10x yours. Not the way the plan, or society, can function. Before ACA such folks were 99% un-insurable outside of employer plans. So, yes, healthy people pay more because insurers now have to cover everyone, not just healthy people.

One of the reasons I'm angry is because I suspect that the main reason the cost is so high is to provide good quality health care for the large percentage of the population that practices self destructive behavior (alcoholics, drug addicts, people that totally ignore the advice of the health experts by overeating, not exercising, etc. people more likely to require health care and less likely to be employed).

Agreed there must be a number of people in this category, but I doubt it's the "main reason" unless you have some data to share. Much of the increase is because plans now actually have to provide comprehensive coverage whereas they often refused many services before.

I'm suggesting the system needs changing and very strict policing.
Well, I doubt many would disagree improvements are due, and would be very welcome. As far as policing? Not sure what you mean there but I don't think anyone here is looking for more governmental overreach.

Is 880.00 a month pretty typical for the Bronze plan? Anyone here have knowledge of any options or strategies I might have to reduce this high cost?
All plans are specific to your geography, age, income, as well as the features you pick. It sounds like it's in the normal range for quotes I've seen shared here.
 
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Could you posters use the proper term which is ACA instead of the constant references to Obamacare?


Yep >>> I brought this up before and one poster (pb4uski) schooled me on that same suggestion. LOL
 
Yep >>> I brought this up before and one poster (pb4uski) schooled me on that same suggestion. LOL

It's trying to take some of the political stuff out of the picture....for better or worse it's here for the indefinite future...
 
Not for everyone but have you looked at 'healthshare ministries'? There are several older threads on this forum discussing them. The cheapest ACA bronze plan (before subsidy) I have to choose from for 2019 is $917/month.
 
Synergy...I am a couple of years older than you and my Bronze Anthem plan is going to be $1019/mth next year. It has an HSA component and deductible of $4,900. My deductible was $6000 so they lowered it a bit. The HSA piece at least allows me to deduct the amount of the HSA contribution (Health Savings Account) from income reducing my income and my taxes a tad bit.
So yes...this is typical. I am in Virginia.

Regarding strategies, investigate the "subsidy cliff". It used to be $42,000 or $45,000 ish. Not sure what it is for next year. Income amounts below "the cliff" = subsidies from the government. So the key is to try to get your income below the subsidy cliff level.

Some do Roth IRA conversions to lower their income below the "cliff" level.

Some "donate" to charities, etc. to reduce their income.

Some have looked into Christian based policies such as "Medi-Share". I have a friend who signed up and others here locally that use a different Christian Based Policy.

Other than those three options or other ways to lower your income unique to your own circumstances I don't know of anything. Perhaps others may chime in.
 
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The sports you practice wouldn't be covered.....
So the rest of your Bronze plan members are subsidising your risky behaviour.
Little hypocritical in regards to the rest of your comment.
 
Regarding strategies, investigate the "subsidy cliff". It used to be $42,000 or $45,000 ish. Not sure what it is for next year. Income amounts below "the cliff" = subsidies from the government. So the key is to try to get your income below the subsidy cliff level.

Some do Roth IRA conversions to lower their income below the "cliff" level.

Some "donate" to charities, etc. to reduce their income.
Roth IRA conversions ADD to income, they do not lower it. Some here LIMIT their Roth IRA conversions, taking less than they might (or might not) take otherwise to stay away from the cliff.

Donations are deductions, and deductions do not help control MAGI income.

Cap gains losses and HSA contributions reduce MAGI. So does anything else on lines 2335 of the old 1040. Not sure where all those are on the new forms.
 
The reason that your previous plan was so inexpensive was probably because it provided poor coverage. Did you read the entire policy? What was the out of pocket maximum? What was the lifetime maximum? Were prescription drugs included? If you developed a chronic condition (i.e. cancer), in the pre ACA, non guaranteed issue days, you most likely would have lost your insurance and been completely without coverage. The reality is that many of those cheap plans weren't really insurance at all,
 
I used to pay 750 monthly for a family plan before I retired. This amount was of course Megacorp subsidized.
As we all know, the ACA costs range quite a bit for the same MAGI depending where one lives.
 
Roth IRA conversions ADD to income, they do not lower it. Some here LIMIT their Roth IRA conversions, taking less than they might (or might not) take otherwise to stay away from the cliff.

Donations are deductions, and deductions do not help control MAGI income.

Cap gains losses and HSA contributions reduce MAGI. So does anything else on lines 2335 of the old 1040. Not sure where all those are on the new forms.

IRA contributions are a big one too. if you are a little lower on the earned income scale and have other funds to live on you can do an HSA and IRA and perhaps even get a saver's credit. And you will increase your subsidy amount.
 
I feel your pain, Synergy. My wife and I have an Anthem Bronze plan in Colorado, and our 2018 premiums were $1,704 per month (no other dependents....just my wife and me). This is also a high deductible plan. Interestingly, our 2019 premiums are $1,631 - a slight decrease from 2018. Nevertheless, this is still $19,572 of after tax dollars per year....plus deductibles for lab work and most everything else.
 
I feel your pain, Synergy. My wife and I have an Anthem Bronze plan in Colorado, and our 2018 premiums were $1,704 per month (no other dependents....just my wife and me). This is also a high deductible plan. Interestingly, our 2019 premiums are $1,631 - a slight decrease from 2018. Nevertheless, this is still $19,572 of after tax dollars per year....plus deductibles for lab work and most everything else.

This alone sounds like a prime reason to overwhelmingly support Medicare for all. At least for those over 50 - 55 perhaps. A Partial Medicare for some maybe?
 
+1.
Obamacare is a politically loaded word.
ACA is the proper term.

Those who know how the ACA was passed know that ACA is a politiacally charged acronym. Hopefully the left and right can get together and find some ways to make the ACA better going forward.
 
Synergy, we're in a similar situation and have learned to manage our income carefully. The income threshold for a single in 2019 is $48560. Choose a plan with an HSA and contribute the full amount for a +55 individual ($4500) and now you're looking at an income limit of $53,060. You mentioned that you were around $60k so you're close. A couple of thoughts: sell your dividend assets this year and/or somehow pull January's rent into this year and push next December's rent payments into 2020.

Keep in mind that 2019 subsidies are based on 2019 income. Pull what you can into 2018 and push what you can into 2020. If you can do this every other year, your subsidy will be about $4500 every other year.

Also, keep in mind that most preventative care is free and whatever's not free is billed at the rate that the insurance company bargained. Our only healthcare this year has been preventative and we were billed about $80 for the lab fees.
 
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