Preview 2017 ACA plans now active

[NW-Bound]

The government has acknowledged that ACA premium increase is about 25% over the nation. It varies wildly from state to state, as shown in a map I link from USA Today.

I live in one of the states colored black in the map. It says ">50%".

How much greater than 50% for a 60-year old like ourselves? It was shocking! More on this later.

Map from: Regulators approve higher health premiums to strengthen Obamacare insurers, published 10/18/2016.

[RunningBum]

My state of VA only shows 10-19%, but one problem is that my carrier with the lowest cost plan last year has pulled out. I could believe that the Anthem policy I'll probably have to go with is in that range, but this is like saying that the price of cars hasn't gone up much, but you can't buy a Toyota or Honda anymore, only a Lexus or Acura. And I'm not sure the new policy is any better than what I have now.

[ShokWaveRider]

From my doctors; They did not like united healthcare for primary insurance (Not Medicare Supplements) They said united required the most paperwork and they had to wait at least 2 x as long for payments than others. So The DOCTORS stopped taking them.

[EastWest Gal]

In our area premiums more than doubled. In PA. I'm going to shop outside the exchange out of curiosity. Next year we will be able to get a subsidy. In fact, if my adult son is included, our subsidy will be almost double what we paid two years ago.

No one in the health care industry has a conscience any more.

[MBSC]

Quote:

Originally Posted by EastWest Gal Next year we will be able to get a subsidy. In fact, if my adult son is included, our subsidy will be almost double what we paid two years ago.

Member SecondCor521 has an excellent post on this subject.

Quote:

ACA subsidies are based on (among other things) your taxable household size - basically the number of exemptions that you claim on line 6d of your 1040. Once your kids graduate from college, hopefully before 26, they are likely not to be your dependent, and thus not end up on line 6d, and thus adversely affect your ability to qualify for ACA subsidies.

[Texas Proud]

Quote:

Originally Posted by RunningBum My state of VA only shows 10-19%, but one problem is that my carrier with the lowest cost plan last year has pulled out. I could believe that the Anthem policy I'll probably have to go with is in that range, but this is like saying that the price of cars hasn't gone up much, but you can't buy a Toyota or Honda anymore, only a Lexus or Acura. And I'm not sure the new policy is any better than what I have now.

Well, not a good comparison as a Lexus or Acura is better.... more like you have to buy a Kia or Ford (I do not like Ford).....

Or, you used to buy a Lexus or Acura but now have to buy a Honda or Toyota for the same money....

[NW-Bound]

As promised, here's the situation at my locale.

In 2016, I chose a Bronze plan because I expected to use little healthcare and wanted a low-cost plan. The premium is $879/month, and that's for 2 of us, both at 60 years of age. I forgot what the deductible is, because we would not come anywhere near it (and if we exceed it, I would have more things to worry about than money).

Anyway, with only 1 insurer left, I have been waiting to see what the number is going to be. Here it is.

The lowest plan is one of the two Bronze plans, with a premium of $1,892/month and a family deductible of $13,600, again for two 60-year olds.

Out of curiosity, I looked up the info at my 2nd home, in the more rural high-country part of the state. Still only one insurer, but a different one. A Bronze plan will cost $1,911/month, with a family deductible of $13,100. Again, this is for a couple.

With the premium so high, undoubtedly more people will qualify for a subsidy. So, I entered in the median family income for the two areas. It is $55,000 for the metropolitan area, and $48,000 for the rural area.

After subsidy, the monthly premium is down to $192 for the metro area, and $0 for the rural area.

One heck of a good deal! I hope this does not bankrupt the gummint, so that it can last.

PS. A Silver plan runs about $2,700/month for two. That's $32,400/year. Add to that the deductible of $13,100 we are up to $45,500 out of the $48,000 median family income. Nice! I believe the $48K income is before taxes and FICA too.

[NW-Bound]

Quote:

Originally Posted by Texas Proud Well, not a good comparison as a Lexus or Acura is better.... more like you have to buy a Kia or Ford (I do not like Ford)..... Or, you used to buy a Lexus or Acura but now have to buy a Honda or Toyota for the same money....

But when the new Honda is guaranteed for 300K miles, all repairs and even maintenance included, it is gonna cost more. In comparison, you are on your own with the Lexus a lot sooner. You pay now, or you pay later. There's never free in this world.

[Big_Hitter]

adverse selection - healthy people pay the penalty and unhealthy people use the insurance

[ShokWaveRider]

Quote:

Originally Posted by NW-Bound Out of curiosity, I looked up the info at my 2nd home, in the more rural high-country part of the state. Still only one insurer, but a different one. A Bronze plan will cost $1,911/month, with a family deductible of $13,100. Again, this is for a couple. With the premium so high, undoubtedly more people will qualify for a subsidy. So, I entered in the median family income for the two areas. It is $55,000 for the metropolitan area, and $48,000 for the rural area. After subsidy, the monthly premium is down to $192 for the metro area, and $0 for the rural area. One heck of a good deal! I hope this does not bankrupt the gummint, so that it can last. .

So the ACA does work for some. It is a shame it was not applied equitably in all locals. Makes me think it is in the implementation on a state by state basis and how they interact with the insurance companies.

It should definitely be equitable for all, not just based on local. Should be an easy fix though.

[FUEGO]

Quote:

Originally Posted by FUEGO Not bad. For family of 5: $137/mo instead of $125. Deductible will be going up to $1000 instead of zero currently. Max OOP goes up from $1000 to $1600 next year. We also get lower copays, and more coverage (out of network; nationwide network but I bet it's limited). Very happy that this choice is available. But maybe we cheap out, and go with the $56/month plan with $200 deductible (but no child dental and no out of network coverage). Odds are we'll be paying about the same or less than we are in 2016 for overall medical and dental coverage. ACA isn't dead yet. In fact, the unsubsidized premiums dropped significantly for both plans vs. the plan we have currently (which was 2nd lowest cost silver plan I think). Current plan is $1034/mo for HMO w/ limited network and no nationwide coverage. New plan options are $872/mo (for the crappier plan) and $954/mo for the BCBS plan we'll probably go with. And that's quoting coverage for 5 in 2017 vs. only 4 covered currently in 2016. Surprising to say the least.

I messed up. Comparing apples to apples (literally the exact same plan ID) with BCBS that was available last year and this year, the rates went up 25%. 26% if you look at cheapest silver to cheapest silver plan.

Our UHC plan disappeared but a new plan from Cigna showed up.

The interesting and quirky impact of UHC and Aetna dropping out of the market in NC is that the "second lowest cost silver plan" that determines our subsidy has disappeared, thereby making the cheapest BCBS plan (the one that offers a nationwide network and covers out of network too) our "second lowest cost silver plan". So the BCBS plan that would have cost $204 last year now costs $138.

Bottom line to us: we will see a 32% reduction in our health insurance premiums comparing the exact same plan (which is admittedly better than our current plan given the breadth of nationwide coverage and out of network coverage of the new plan).

[2017ish]

Quote:

Originally Posted by ShokWaveRider So the ACA does work for some. It is a shame it was not applied equitably in all locals. Makes me think it is in the implementation on a state by state basis and how they interact with the insurance companies. It should definitely be equitable for all, not just based on local. Should be an easy fix though.

Only for those who are specialists in squaring circles or, perhaps, a corps of platonic guardians--neither of which seem to be on the horizon. I've taught healthcare policy, read far too many scholarly books/papers, and spent years editing professional journals on the topic. Don't think I've ever seen that statement before. No matter what is done, tradeoffs will be necessary. Any change will negatively impact some and, maybe, benefit others.

[Texas Proud]

Quote:

Originally Posted by ShokWaveRider So the ACA does work for some. It is a shame it was not applied equitably in all locals. Makes me think it is in the implementation on a state by state basis and how they interact with the insurance companies. It should definitely be equitable for all, not just based on local. Should be an easy fix though.

Not quite... around here we have a company that does medicaid.... and they got into the ACA plans.... so they have a LOW COST silver option which means that we do not get as much subsidy if only BCBS was offering plans...

Another problem is even with BCBS.... they offer a number of plans that are very similar.... so there might be 2 or 3 low cost silver that are not that good instead of just 1... so again, the second lowest silver is not a good silver plan but it determines the subsidy...

[Sue J]

Quote:

Originally Posted by NW-Bound As promised, here's the situation at my locale. In 2016, I chose a Bronze plan because I expected to use little healthcare and wanted a low-cost plan. The premium is $879/month, and that's for 2 of us, both at 60 years of age. I forgot what the deductible is, because we would not come anywhere near it (and if we exceed it, I would have more things to worry about than money). Anyway, with only 1 insurer left, I have been waiting to see what the number is going to be. Here it is. The lowest plan is one of the two Bronze plans, with a premium of $1,892/month and a family deductible of $13,600, again for two 60-year olds. Out of curiosity, I looked up the info at my 2nd home, in the more rural high-country part of the state. Still only one insurer, but a different one. A Bronze plan will cost $1,911/month, with a family deductible of $13,100. Again, this is for a couple. With the premium so high, undoubtedly more people will qualify for a subsidy. So, I entered in the median family income for the two areas. It is $55,000 for the metropolitan area, and $48,000 for the rural area. After subsidy, the monthly premium is down to $192 for the metro area, and $0 for the rural area. One heck of a good deal! I hope this does not bankrupt the gummint, so that it can last. PS. A Silver plan runs about $2,700/month for two. That's $32,400/year. Add to that the deductible of $13,100 we are up to $45,500 out of the $48,000 median family income. Nice! I believe the $48K income is before taxes and FICA too.

Just for comparison -

We are both 61. For 2016 we have the lowest cost Bronze plan with $6650 each deductible. The full cost is $976. For 2017 the plan changes to a $6850 each deductible and raises the PCP co-pay a little . The full cost for the 2017 plan is $1068 (9.4% increase). This is for both people.

In 2016 the SLCSP was $935, for 2017 it's $1102 (17.8% increase).

We live in a fairly low cost of living area. If low income is $35,000 the subsidy is $896, if average income is $45,000 the subsidy is $760/mo. At a $55,000 income the subsidy is $658/mo. At $60,000 the subsidy is $618/mo, at $64,079 it's $585/mo, at $64,080 it's $0. There's that cliff!

[NW-Bound]

I do not remember what the SLCSP (Second Lowest Cost Silver Plan) was for 2016, but there's only one Silver Plan now at both of my homes, and it's $2,700/month at the boondock home, and $2,017 at the metropolitan home.

The Bronze Plan full-fare will be $1,892 against $879 in 2016. That's more than double!

I wonder what it is that makes Arizonans so much sicker than the rest of the nation. Or is it that drugs and hospitals cost a lot more here? What is going on?

Maricopa County, which encompasses the greater Phoenix area, has a population of more than 4 million, and there are more than 250,000 ACA subscribers. You would think it would attract more than just one insurer, and at that horrendous premium to boot.

PS. I am so disheartened that I have not bothered to check to see what hospitals or doctors are included in the new insurer's plan. What difference does it make to rush to find out, if there's only a single insurer, and with only one plan that I can buy? What other choice do I have?

My current primary care doctor does not show up in the roster. I am hoping that the data is not up-to-date. Else, I have to look around for a new one.

[niven]

We have a major healthcare provider that it would make sense is included in most of the plans for my area. Where yesterday only Aetna and Optima listed it as included, today Anthem started showing up. So they must still be updating the information before Nov 1st. I still only see HMOs though, no PPOs.

[jkern]

I don't have ACA coverage, but my employer retiree premiums are going up 35%. Ouch!

[Big_Hitter]

Quote:

Originally Posted by jkern I don't have ACA coverage, but my employer retiree premiums are going up 35%. Ouch!

the plan may have an employer cost cap

[RockyMtn]

Quote:

Originally Posted by Big_Hitter the plan may have an employer cost cap

Mine does...cost went up 26% this year.

[eta2020]

Quote:

Originally Posted by NW-Bound With the premium so high, undoubtedly more people will qualify for a subsidy. So, I entered in the median family income for the two areas. It is $55,000 for the metropolitan area, and $48,000 for the rural area. After subsidy, the monthly premium is down to $192 for the metro area, and $0 for the rural area. One heck of a good deal! I hope this does not bankrupt the gummint, so that it can last. PS. A Silver plan runs about $2,700/month for two. That's $32,400/year. Add to that the deductible of $13,100 we are up to $45,500 out of the $48,000 median family income. Nice! I believe the $48K income is before taxes and FICA too.

I think as long as it is below about 63k MAGI you are fine. But once you cross ACA subsidies cliff God have mercy on you .

Good idea is to have pile of cash and Roth money to bridge one from FIRE date to age 65. Another card up my sleeve is EU citizenship.

It is amazing that we pay so much for medical care and live shorter and less healthy life then most of EU nations who pay nothing compared to US. On the other hand Wealth Tax of Spain, France and Netherlands is not too appealing as well.