First look at next years rates

[Mulligan]

Ugh. I just window shopped my state's exchange. Our policy is still offered and the deductible and max OOP have not changed. However, the premium is up a bit over 20% versus the 2015 premium. It will not take more than a few years of this to put health insurance premiums out of reach for most people.


The challenge now is to figure out how much income to declare. My high paying contract gig is over at the end of the year, so I can essentially dial up anything I want. At a minimum it looks like we would want to stay under 260% FPL because that way the kids could go on a CHIP plan. Anyone have experience with CHIP plans?


Cripes, with the way premiums are shooting up it won't be long before I look for a permanent job again just to get employer-provided health insurance.

The problem is 80% will get subsidized premiums and wont feel the same sting. The other 20% will be left swinging in the wind. The only reason why I say that is that govt officials frequently mention "very few people" actually pay full cost when questioned about rate increases. Factually true, but doesn't strike any confidence in me that we are a priority. Any proposals that would benefit us would probably be a detriment to someone else I suppose.


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[brewer12345]

The problem is 80% will get subsidized premiums and wont feel the same sting. The other 20% will be left swinging in the wind. The only reason why I say that is that govt officials frequently mention "very few people" actually pay full cost when questioned about rate increases. Factually true, but doesn't strike any confidence in me that we are a priority. Any proposals that would benefit us would probably be a detriment to someone else I suppose.


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Even with a subsidy, the rack rate is pretty spicy. I have been fooling with my state's exchange website. When I plug in income at a hair under 250% FPL I get a sub $50/month premium subsidy when the cheapest option bronze plan for the four of us is close to $700. When I plug in a hair under 200% FPL I get a $18X/month subsidy. That still leaves a pretty big line item on the budget for premiums. And this is for a policy that has a $5000 individual/$10000 family deductible. You have to get pretty far down on the income scale to get a material subsidy.

Anyone know if CHIP is considered Medicaid and therefore subject to clawbacks?

 

[MichaelB]

It will not take more than a few years of this to put health insurance premiums out of reach for most people.

With median household income at $52K (US Census, 2015) and the average group policy costing $17.5K (KFF 2015), I think we're there.

The problem is 80% will get subsidized premiums and wont feel the same sting. The other 20% will be left swinging in the wind. The only reason why I say that is that govt officials frequently mention "very few people" actually pay full cost when questioned about rate increases. Factually true, but doesn't strike any confidence in me that we are a priority. Any proposals that would benefit us would probably be a detriment to someone else I suppose.

The data I've seen shows about 10M exchange policies and another 8M individual policies directly from the insurers. If 90% of the exchange policies have some level of assistance, that means 1/2 of all individual policies (exchange + direct) are paying full rate.

Anyone know if CHIP is considered Medicaid and therefore subject to clawbacks?

I thought with the Medicaid expansion, clawback now only affects >age 55 nursing home costs.

 

[Mulligan]

With median household income at $52K (US Census, 2015) and the average group policy costing $17.5K (KFF 2015), I think we're there.

The data I've seen shows about 10M exchange policies and another 8M individual policies directly from the insurers. If 90% of the exchange policies have some level of assistance, that means 1/2 of all individual policies (exchange + direct) are paying full rate.

I thought with the Medicaid expansion, clawback now only affects >age 55 nursing home costs.

I have no doubt your info is the correct one in totality. I imagine why it was quoted the way I mentioned was because they were probably only referencing the people using the exchange. So bottom line is more people are not shielded. I poked into BCBS which is not my carrier but had similar price. Looks like mine will be going up another 30%.


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[Fermion]

Even with a subsidy, the rack rate is pretty spicy. I have been fooling with my state's exchange website. When I plug in income at a hair under 250% FPL I get a sub $50/month premium subsidy when the cheapest option bronze plan for the four of us is close to $700. When I plug in a hair under 200% FPL I get a $18X/month subsidy. That still leaves a pretty big line item on the budget for premiums. And this is for a policy that has a $5000 individual/$10000 family deductible. You have to get pretty far down on the income scale to get a material subsidy.

Anyone know if CHIP is considered Medicaid and therefore subject to clawbacks?

Is all of your income pension or can you alternate years so you are 300% FPL one year and 150% of FPL the next year? Give up $50 a month one year and the next year get $500 a month subsidy and cost sharing on those family and individual deductions.

IE, sell your Google stock this year for a gain and sell your Seadrill stock next year for a loss

 

[homestead]

Just got my letter from Regence BCBS stating my pre-ACA plan is being terminated.
It was a HSA HD $295/mo. for the last 2 years. The new plan they are transferring me to is $594/mo. for a Silver HSA 2000 PPO plan. Of course I can take a lower cost bronze
plan or go on the ACA exchange and try to get a subsidy there.

 

[EastWest Gal]

My plan is also eliminated for next year. We chose a bronze plan which feels like catastrophic but isn't.

We'll look on November 1. If we have to change primary physicians we'll deal with that.

It is absolutely disgusting what is happening with health care. I know an orthopedic surgeon who makes $3million/year. The hospital charges for OR time and equipment are insane.

Generic prescription costs have generally increased 10 fold over the past 2 years, just because they can get away with it.

It sounds like collusion and monopolistic control by the health care industry. I've been a part of this industry my whole working life, but have never seen this outrageous cost before.

Now the insurance companies are partnering with health care and hospital groups. The consumer is getting screwed.

Yikes! What can we do?


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[MooreBonds]

I received noted from Anthem/BCBS that my old grandfathered Missouri plan will (once again) be extended for 1 more year. My increases on this $5,500 deductible plan over the recent past:
(monthly premiums)
2016 $97.94 +19%
2015 $82.25 +27%
2014 $64.55 +15%
2013 $56.38

I've taken peeks at what the cheapest bronze plan is for MO over the years, and have seen roughly $250/mo premiums. Guess I should enjoy this one final encore year...unless they extend it another year?

 

[brewer12345]

Is all of your income pension or can you alternate years so you are 300% FPL one year and 150% of FPL the next year? Give up $50 a month one year and the next year get $500 a month subsidy and cost sharing on those family and individual deductions.

IE, sell your Google stock this year for a gain and sell your Seadrill stock next year for a loss

My income flops around from year to year and is mostly 1099 and W2. 2015 we got no subsidy. When I plugged in 137% FPL the max subsidy I saw was $372/month.

 

[Mulligan]

I received noted from Anthem/BCBS that my old grandfathered Missouri plan will (once again) be extended for 1 more year. My increases on this $5,500 deductible plan over the recent past:
(monthly premiums)
2016 $97.94 +19%
2015 $82.25 +27%
2014 $64.55 +15%
2013 $56.38

I've taken peeks at what the cheapest bronze plan is for MO over the years, and have seen roughly $250/mo premiums. Guess I should enjoy this one final encore year...unless they extend it another year?

If anyone should file a protest its you, MooreBonds. How can you stand to take those increases! I remember 3 years ago when I was on same plan you had. BCBS stayed silent until the very end about allowing grandfathered plans to continue. I panicked as Coventry already said they would extend grandfathered plans a year so I jumped ship... Maybe one of the worst decisions in my life. If I had stayed calm like you, I could still be complaining like you about my 20% increases forcing me to pay $100 a month!


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[Fermion]

My income flops around from year to year and is mostly 1099 and W2. 2015 we got no subsidy. When I plugged in 137% FPL the max subsidy I saw was $372/month.

At 137% of FPL you need to be looking at silver plans, not bronze plans.

For a family of four with the adults in their 40s, you are going to be getting a $500+ subsidy on a silver plan with 137% FPL and your max out of pocket is going to be something ridiculously cheap, like $1000 a year.

Bronze plans are only for (income) rich people

 

[brewer12345]

At 137% of FPL you need to be looking at silver plans, not bronze plans.

For a family of four with the adults in their 40s, you are going to be getting a $500+ subsidy on a silver plan with 137% FPL and your max out of pocket is going to be something ridiculously cheap, like $1000 a year.

Bronze plans are only for (income) rich people

I was referring to premium subsidy only. If the rack rate for the silver plan is over $800, even the max premium subsidy still means a $450 monthly nut.

 

[Fermion]

I was referring to premium subsidy only. If the rack rate for the silver plan is over $800, even the max premium subsidy still means a $450 monthly nut.

Are you sure about that? Maybe for some reason your state is special? Let me check Washington state, but I think the subsidy here for a $800 premium for someone just over 133% FPL is a lot more than $350 even ignoring cost sharing. I think it is more like a $700 subsidy and you are left with a $100 nut.

Edit: I just ran the numbers for national average subsidy:

$22,000 MAGI, 140% FPL
Estimated financial help: $674 per month ($8,089 per year)
as a premium tax credit. This covers 91% of the monthly costs. Your cost for a silver plan: $63 per month ($753 per year)
in premiums (which equals 3.42% of your household income). The most you have to pay for a silver plan: 3.42% of income for the second-lowest cost silver plan Without financial help, your silver plan would cost: $737 per month ($8,842 per year)

 

[brewer12345]

Are you sure about that? Maybe for some reason your state is special? Let me check Washington state, but I think the subsidy here for a $800 premium for someone just over 133% FPL is a lot more than $350 even ignoring cost sharing. I think it is more like a $700 subsidy and you are left with a $100 nut.

Edit: I just ran the numbers for national average subsidy:

$22,000 MAGI, 140% FPL
Estimated financial help: $674 per month ($8,089 per year)
as a premium tax credit. This covers 91% of the monthly costs. Your cost for a silver plan: $63 per month ($753 per year)
in premiums (which equals 3.42% of your household income). The most you have to pay for a silver plan: 3.42% of income for the second-lowest cost silver plan Without financial help, your silver plan would cost: $737 per month ($8,842 per year)

I have not logged into the state exchange, so I can't see real numbers. Its possible I am seeing a distortion.

 

[Mulligan]

I know you were joking.... but remember that there is a maximum and minimum rate they can charge for all ages.... I believe it is 3X.... so the young folks are going to be paying this increase also.... not really age related...

Texas, I played with the website to see what age did. My plan this year is $288. Site says I will pay $335 next year. I added a year to my age (52) to see what it would cost. It was $351. So I assume about one third of my 16% increase is age related and not inflation. That is a bit higher of the percentage than I would have guessed.


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[Dawg52]

If anyone should file a protest its you, MooreBonds. How can you stand to take those increases! I remember 3 years ago when I was on same plan you had. BCBS stayed silent until the very end about allowing grandfathered plans to continue. I panicked as Coventry already said they would extend grandfathered plans a year so I jumped ship... Maybe one of the worst decisions in my life. If I had stayed calm like you, I could still be complaining like you about my 20% increases forcing me to pay $100 a month!

You guys must be young. I still have a grandfathered plan with BCBS of MS and pay 3 times that for a 10k ded plan. Plan to take another look at the ACA plans for next year.

 

[Mulligan]

You guys must be young. I still have a grandfathered plan with BCBS of MS and pay 3 times that for a 10k ded plan. Plan to take another look at the ACA plans for next year.

MooreBonds is younger than me, but at age 50 last year mine was still only $88 a month for a $5500 deductible before they cancelled it this past January. Live in MO. It did seem ours was considerably cheaper than other states. I really never knew why...Maybe they rejected everybody who ever admitted having a headache the previous 10 years on the application.


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[jim584672]

I know you were joking.... but remember that there is a maximum and minimum rate they can charge for all ages.... I believe it is 3X.... so the young folks are going to be paying this increase also.... not really age related...

In NY the rates do not change with age, we are a community rated state.
This is good for the old and bad for the young.

 

[Texas Proud]

Texas, I played with the website to see what age did. My plan this year is $288. Site says I will pay $335 next year. I added a year to my age (52) to see what it would cost. It was $351. So I assume about one third of my 16% increase is age related and not inflation. That is a bit higher of the percentage than I would have guessed.


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Thanks for the info.... maybe I will type in this years ages and see what the premium is so I can split it between age and just a price increase...

 

[ziggy29]

I don't have ACA coverage any more but for grins and "just in case" I checked. There seem to be NO PPO plans available for my zip code any more; I pull up 18 options, ALL are HMOs. Hmm.

 

[Dawg52]

MooreBonds is younger than me, but at age 50 last year mine was still only $88 a month for a $5500 deductible before they cancelled it this past January. Live in MO. It did seem ours was considerably cheaper than other states. I really never knew why...Maybe they rejected everybody who ever admitted having a headache the previous 10 years on the application.

$88 was an incredible deal. When I retired at 53(now 61), my rate was $145 for the same 10k ded I have today. I just checked the new ACA rates net estimated subsidy and the cheapest bronze plan is a little less($50). But not enough to hassle with imo. I know what I have and it has worked for me to this point.

Oh well......3.5 more years and I will be in the medicare bracket anyway. Just suck it up until then.

 

[MichaelB]

I don't have ACA coverage any more but for grins and "just in case" I checked. There seem to be NO PPO plans available for my zip code any more; I pull up 18 options, ALL are HMOs. Hmm.

In Florida it looks as if some of the insurers are keeping their HMO offerings on the exchanges and limiting their PPOs to direct sales. Not sure why.

 

[utrecht]

In Florida it looks as if some of the insurers are keeping their HMO offerings on the exchanges and limiting their PPOs to direct sales. Not sure why.

What is the website you use for the Florida exchange? Ive been looking at HealthSherpa but cant find the official State exchange.

 

[Theseus]

Well, I've found the 2016 plan selection and rates at https://www.healthcare.gov/see-plans/ this morning. Just for grins, comparing to an age 1 year less than actual I am seeing a 2.5% increase for age. Bad news is the non subsidized premium for the same plan as last year shows a 27.4% increase (24.4% if using same age as last year). That stumps me for now, as the rate request was for 18.67% with as far as I could tell, 18.25% being approved.

 

[ERD50]

I got another mailing from BCBSIL about my plan being discontinued at EOY. Big red letters "Open and read right away for details and to learn about your options".

Well, the 'details' are mostly, you can't really do anything until Nov 1, but you will need to pick your PCP by Dec 1. Great.

But there is a default plan I will be switched to. I can't seem to get details on it, but their brief info says my premium will go up about 33%, and every change they note is a negative (higher co-pays, higher deductibles, etc).

Hey, prices on lots of stuff goes up, that's no surprise. But 33% with less service is rather extreme. And the 'hurry up and wait then hurry up', on what will probably be a time consuming, frustrating, circular process is just salt in the wounds.

I wonder how responsive that website will be on Nov 1?

-ERD50