AP: With health law, workers ponder the I-Quit option

[AllDone]

We would still be w*rking without the ACA despite our assets. Knowing that we had access to insurance was a key part of our retirement. We do not in any way qualify for a subsidy.

My mom fell off a cliff and broke her tibia, had a plate put in and then had it taken out because she is a jock. When my dad retired she was unable to get insurance that covered that leg. She's now 78 and hasn't had a problem with the leg for over a quarter of a century. When my cow*rkers mom had a colonoscopy at 50, they found diverticulae and so she was unable to get insurance at her older husband's retirement. She's now 78 too and hasn't had a colon problem ever. A patient finally got pregnant with a much desired baby late in life. The baby was found to have a fatal heart defect on ultrasound. When she was born she was taken from the OR where her mom had a C-section directly to the OR where the heart problem was corrected. The "baby" is now in a top rated PhD program, doing great, but "uninsurable". My BIL has two flaps on one of his heart valves rather than three. He is completely healthy, hikes as a hobby, runs a thriving one man business, and lives at high altitude. He is also "uninsurable" except through a high cost "high risk pool". I can keep telling these stories. None of these people are lazy, asking for a hand-out, or even sick. They have insurance for their homes and their cars and they just want insurance for their health care too.

 

[daylatedollarshort]

Our lady house cleaner was here yesterday and told us a story about how the ADA has affected her. She takes some special kind of medicine and her insurance company sent a letter saying it was no longer covered. However, there was a new plan she could opt to have, an ACA plan that would then cover her medicine. The plan premium was $460/mo. She said it was twice what she was paying and had made a decision. She'll be 62 in two years so she has decided to drop the insurance and pay the fine/penalty for those two years. I don't quite understand all this and glad I'm not involved in Obamacare. However, if I was involved, it would mean that I was a lot younger and that would be a good tradeoff.

Did she actually look for insurance through one of the exchanges? I find it curious that our ACA premiums would be so much lower than a house cleaners. The plan our insurance company sent us cost $1,500 a month for a non-exchange plan. Our Bronze plan rate from the exchange is currently under $200 a month.

 

[Coffee Mavin]

If I quit and have no income, just live off my assets for the next few years, then I would qualify for expanded Medicaid coverage under my state's plan. Assets are no longer considered. So long as my asset income does not exceed about $16500/year I get free health insurance?

I don't think this was an intended outcome of healthcare subsidy.

What happens next year when ACA plans triple their rates as we hear some states expect (Florida) because the user population is so heavily skewed to older people?

 

[Major Tom]

If I quit and have no income, just live off my assets for the next few years, then I would qualify for expanded Medicaid coverage under my state's plan. Assets are no longer considered. So long as my asset income does not exceed about $16500/year I get free health insurance?

That's the way it's been working for me.

 

[MBSC]

Our lady house cleaner was here yesterday and told us a story about how the ADA has affected her. She takes some special kind of medicine and her insurance company sent a letter saying it was no longer covered. However, there was a new plan she could opt to have, an ACA plan that would then cover her medicine. The plan premium was $460/mo. She said it was twice what she was paying and had made a decision. She'll be 62 in two years so she has decided to drop the insurance and pay the fine/penalty for those two years. I don't quite understand all this and glad I'm not involved in Obamacare. However, if I was involved, it would mean that I was a lot younger and that would be a good tradeoff.

The insurance company directs their members to plans that generate the most profit for the insurer. She needs to shop around and compare plans taking into account any premium subsidy she may be eligible for. It's like saying the Ford Escort is no longer available as a new car but we can put you in a new Ford Taurus but after shopping around you find the Ford Focus is an appropriate substitute.

 

[Mo Money]

I was, and remain, a fervent supporter of the ACA, even with its flaws. I have a pre-existing condition -- brought on a few years ago by a stress-related job incident -- and I was utterly uninsurable on my own. I could find no coverage at all, let alone at a decent premium.

I will soon be one of the 2 million or so who will be "losing" their jobs in the next year -- when I hand in my notice. The ACA will (it already really is) the fourth rail of American politics. As of today, March 23, 5.5 million are projected to be enrolled and paid through the exchanges. Millions more are covered by the under-26 provisions of the law. And millions more "woodworkers" came out of the woodwork to claim Medicaid benefits. The ACA is the next social security.

ACA is flawed, but I was imprisoned by the totally legit fear of bankruptcy if I left my high-paying, but very stressful job. The ACA is the light at the end of the tunnel for me. And that light is fresh air and sunshine -- not an oncoming train.

 

[MBSC]

If I quit and have no income, just live off my assets for the next few years, then I would qualify for expanded Medicaid coverage under my state's plan. Assets are no longer considered. So long as my asset income does not exceed about $16500/year I get free health insurance?

Medicaid rules vary by state. Depending on the state and your age, a portion of your estate may, or may not, be subject to "clawback" after your passing.

Estate Recovery - It's Worse Than You Thought.

 

[JOHNNIE36]

Did she actually look for insurance through one of the exchanges? I find it curious that our ACA premiums would be so much lower than a house cleaners. The plan our insurance company sent us cost $1,500 a month for a non-exchange plan. Our Bronze plan rate from the exchange is currently under $200 a month.

Don't know if she did any searching on her own. Just said that her current insurance company told her what a ACA plan would cost.

 

[donheff]

Don't know if she did any searching on her own. Just said that her current insurance company told her what a ACA plan would cost.

Did she evaluate whether she would get a subsidy? Either way, there is so much misinformation flying around that these anecdotes are virtually useless.

 

[Coffee Mavin]

Medicaid rules vary by state. Depending on the state and your age, a portion of your estate may, or may not, be subject to "clawback" after your passing.

Estate Recovery - It's Worse Than You Thought.

Thanks Gamecock. That's pretty frightening for my scenario. I'm not quitting soon, but will hope there is a way around this where I can just buy a policy in the future and not be forced onto Medicaid.

I agree with the comments on eliminating pre-existing condition exclusions and creating pooled rates. There were just so many more ways to do this that would have been more effective. My state for example had already enacted this independent of ACA and years before. So the available policy care was actually better here than what ACA has rolled out now. It is yet another disappointment in our legislature that they had to overcomplicate the entire scheme so horribly. That's what happens when the healthcare lobbyists get to influence how bills are written. Its just a bad evolution of our system.

 

[anethum]

What happens next year when ACA plans triple their rates as we hear some states expect (Florida) because the user population is so heavily skewed to older people?

"As we hear"? Oh, please. This sounds like bogus politically-based fear-mongering without any factual basis.

 

[pb4uski]

Our lady house cleaner was here yesterday and told us a story about how the ADA has affected her. She takes some special kind of medicine and her insurance company sent a letter saying it was no longer covered. However, there was a new plan she could opt to have, an ACA plan that would then cover her medicine. The plan premium was $460/mo. She said it was twice what she was paying and had made a decision. She'll be 62 in two years so she has decided to drop the insurance and pay the fine/penalty for those two years. I don't quite understand all this and glad I'm not involved in Obamacare. However, if I was involved, it would mean that I was a lot younger and that would be a good tradeoff.

Was she eligible for a subsidy? If so, that would reduce the $460 cost. As someone else pointed out, she probably needs to shop around for a different plan from a different carrier rather than just go by what her current carrier is telling her.

 

[ERhoosier]

..... I'm pro-single payer myself, even if it is an 80/20 system like France.....

Most US pundits seem to use the term "single payer" in reference to a Canadian-style system where private pay is generally not allowed (unless leaving the country). By the "ratio definition", it could be argued that US has already become defacto "single payer" system. IOW- Overall gov't funding (fed + state/local) has grown over time to >50% of all HC costs (i.e. total funding of expanded Medicaid, Medicare, VA, gov't employee HI, ACA subsidies, tax deductions, etc.). According to CMS, in 2011 private insurance + individual OOP only accounted for ~44% of HC expenditures so US ratio may be closer to 56/44.
https://www.cms.gov/Research-Statis.../NationalHealthExpendData/NHE-Fact-Sheet.html
From an accounting perspective, net overall gov't HC funding is likely higher due to value of tax deductions for HI & OOP, gov't funding of private HI for its employees, etc.

Of course, how that HC funding is accessed in US is a whole separate issue.

 

[ERhoosier]

"As we hear"? Oh, please. This sounds like bogus politically-based fear-mongering without any factual basis.

http://www.kaiserhealthnews.org/Daily-Reports/2014/March/20/implementation-issues.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+khn%2Ffulltext+%28All+Kaiser+Health+News+%28Full+Text%29%29

O-Care premiums to skyrocket | TheHill

It appears both Sebelius & industry exec's agree HI premiums will be higher next year, though there is disagreement on how much.
We'll see who's right this Fall when those actual 2015 premiums are set.

 

[AnIntentionalRoad]

If you were under 55 and had not yet retired, how comfortable would you feel about jumping into the ACA? At this stage in the game, I'm not sure we'd risk it due to pricing and availability (or lack thereof) of doctors.

We are under 55 and retired about 18 months before the ACA was available. We started receiving our ACA plan the same month our Cobra benefit was scheduled to end.

The ACA plan we have is way cheaper than our Cobra plan but it is about the same cost as the private plan we had a few years prior--but the private plan had a much bigger network and much lower deductible limits.

Also, we just received a call from our kid's pediatricians this week that they have decided they will no longer be taking the BCBS choice silver ACA plan we have. Neither does my wife's or my doctors. So, we are shopping for all new doctors!

 

[daylatedollarshort]

Did she evaluate whether she would get a subsidy? Either way, there is so much misinformation flying around that these anecdotes are virtually useless.

They are worse than useless because they give the impression that lower income households will pay more or have to go without insurance when the opposite is usually true.

 

[daylatedollarshort]

Don't know if she did any searching on her own. Just said that her current insurance company told her what a ACA plan would cost.

There is a difference between an ACA compliant plan and an ACA subsidized plan. If she hasn't shopped for insurance on the exchanges then she has no idea what her best rate would be.

I can buy a sweater from Walmart or from Neiman Marcus. If I was a house cleaner I would shop at Walmart, not shop at Neimans and complain about the price.

 

[daylatedollarshort]

Higher Insurance Premiums Forecast For 2015 - Kaiser Health News

O-Care premiums to skyrocket | TheHill

It appears both Sebelius & industry exec's agree HI premiums will be higher next year, though there is disagreement on how much.
We'll see who's right this Fall when those actual 2015 premiums are set.

Weren't health care premiums going up every year, faster than inflation, prior to the ACA?

 

[anethum]

Yup, health care costs and health insurance premiums go up virtually every year. My own actual experience, however, is that my insurance premiums for virtually identical plans went slightly down twice. The first time was when the Massachusetts plan went into effect. I was covered by BCBS of Massachusetts because my employer was based there. The 2nd time was this year. My premium for a near-identical plan with the same insurer under the ACA dropped a couple of dollars even though it was a year later and I was a year older.

There were lots of hysterics and crazy speculation before the ACA went into effect, and it appears the hysterics and crazy speculation continue. Rates in Florida tripling because of an older population? The older folks in Florida who are 65+ are covered under Medicare, not the ACA.

 

[Mulligan]

http://www.kaiserhealthnews.org/Dai...fulltext+(All+Kaiser+Health+News+(Full+Text))

O-Care premiums to skyrocket | TheHill

It appears both Sebelius & industry exec's agree HI premiums will be higher next year, though there is disagreement on how much.
We'll see who's right this Fall when those actual 2015 premiums are set.

ER, my prediction is they are both going to be right and wrong. It will all depend on where you live, income, and possibly what carrier you have. Cigna has already been talking about huge triple digit increase in premiums in some locales, while WellPoint if memory serves has stated their profits rose some benefitting by ACA plans. It will probably be just like the rollout prices from initial year. Some people incurred huge savings, while others saw dramatic increases. It will be interesting to see how it unfolds for the following year.


Sent from my iPad using Tapatalk

 

[ERhoosier]

Weren't health care premiums going up every year, faster than inflation, prior to the ACA?

Depends on what recent years you look at. HI inflation dropped markedly from 07-09 (pre-ACA), then spiked again in '11 before dropping in '12 (post-ACA).

http://inflationdata.com/articles/wp-content/uploads/2013/04/Health-Insurance-Inflation-vs-cpi.jpg

 

[ERhoosier]

....Rates in Florida tripling because of an older population? The older folks in Florida who are 65+ are covered under Medicare, not the ACA.

Agree that tripling seems unlikely, but ACA did cut significantly funding for Medicare Advantage.
https://www.cms.gov/apps/files/ACA-savings-report-2012.pdf
Premium increases may well be in the cards for those wishing to stay on that program.

 

[MichaelB]

Anyone interested in looking at annual healthcare cost increases can find a wealth of data in the KFF Employer health benefits, here (2012 version) http://kaiserfamilyfoundation.files...efits-chart-pack-private-insurance-091112.pdf

I don't know any more than the next guy but my guess is premiums in 2015 will increase by around 4% - 5%, or about double the inflation rate. How that affects a particular policy depends on how close it already is to the average. Add to that the 3% step increase for age, so I expect to see my premium go up bay about 7% - 8%.

 

[M Paquette]

Weren't health care premiums going up every year, faster than inflation, prior to the ACA?

Yup.

Our retirement budget included both an annual tweak for inflation, and a much larger (about two times) tweak for medical insurance cost increases., in addition to the age step-up.

Medical insurance premiums have been rising at a high rate, roughly twice inflation, for a long time. The past few years the rise was smaller than we had projected (the combined rate for our family actually dipped slightly for this year), so i expect a return to the mean (that is, a bigger increase) any year now.

There's nothing new in all this, in spite of all the spin of professional news readers and their pet pundits.

 

[ziggy29]

Depends on what recent years you look at. HI inflation dropped markedly from 07-09 (pre-ACA), then spiked again in '11 before dropping in '12 (post-ACA).

It's way too soon to draw longer-term conclusions. There are aspects of ACA which seem to restrain costs, and others that seem to increase them -- at least in the near-term.

If we're honest and not ideological, IMO, I think we have to admit we have no idea how it will affect health care inflation in the long term. I wish the law hit the cost control issue harder, but it is what it is, so we need to see where it takes us and be willing to negotiate changes where they are obviously needed.