ACA's age curve

perinova

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On a recent thread someone mentionned that Vermont ACA does not cost more for older people. Since I will soon be in the <55 ER, this got me thinking of looking for the following information. Currently I am in California. Below the cliff the cost is, I guess, bearable, maybe,...
It looks like to avoid paying much in ACA one would need to go to VT or NY. Of course, this is where State Taxes are sky high, I believe.
MA's age curve is also a little less steep.

https://www.valuepenguin.com/how-age-affects-health-insurance-costs#state

"
New York does not permit using age as a factor when determining health insurance rates. That means health insurance premiums in the Empire State don’t vary based on age across the board. This usually means premiums are higher for people ages 21–50 and lower for those who are older, when compared to other states.

Vermont also doesn’t permit insurers to use age as a factor when calculating health insurance premiums. Insurers must charge the same premiums regardless of health status, age or gender in the state. Like New York, younger citizens of Vermont typically pay relatively higher premiums while seniors pay lower premiums when compared to other states.

Utah has the same 3:1 ratio when it comes to health insurance premiums, but the scaling in the different age groups tend to be more aggressive. For instance, consumers ages 27–36 pay almost 40% more than the base rate in the state, whereas the same group would pay anywhere from 13%–27% more under the federal guidelines. Children under the age of 14 are also more expensive, with medical insurance costs fixed at 79% of the base rate.

Minnesota has an age curve similar to the federal guidelines. But for policyholders younger than 21, premium multiples are 89% of the base rate.

Massachusetts allows insurers to adjust premiums based on age to a maximum of 2 times the premiums charged to a 21-year-old. This makes for a narrower variation of premiums based on the age of the policyholder. Additionally, Massachusetts has the highest premium age curves for younger applicants: 21- to 26-year-olds pay 118% of the base rate set by federal guidelines.

Alabama, Mississippi and Oregon all follow the same federal premium multiples for anyone over the age of 21. However, for people under 21, these states do not use the same federal scale for health insurance. Instead, this age group pays a health insurance premium set at 63.5% of the base premium rate.
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It is interesting to look at. But I view it like price of housing in a specific area, or car insurance, or state taxes, or property taxes... and weight that against the pros/cons of there areas (view, beaches, lifestyle, weather, local culture/values, etc.)

I don't think I'd change which state I lived in based just on health care premiums... but the overall value/lifestyle... it could be one factor of many.
 
NY doesn't age rate and it also has something called the "Essential Plan". It is $20 a month, per person, for those under 200% FPL, which is about $25.5K for a 1 person house.
 
If I am not mistaken, if you are under the cliff income-wise (ie MAGI < 400 % Fed. Pov. level) then your out of pocket rates for the second lowest cost silver plan, will be determined by your income. The Federal subsidy will make up the difference between the retail price and your out of pocket price.

Assuming that this is all correct, then it would not make sense to worry about age-based rates as it wouldn't effect you as long as you keep your income below the cliff.

IRS Form 8962 and its associated instructions
will walk you through this. Of particular note is the "applicable figure" table on page 9 of the instructions which determines what percentage of your income would be your out of pocket contribution to your health insurance premium (assuming you choose the 2nd lowest cost silver plan). Note that it is not a function of your age.

Of course all of this is off if you income exceeds the cliff point or if the existing ACA law is changed.

-gauss
 
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As long as you are in the subsidy zone the age related cost increase is mitigated since the cost is capped at a percentage of income for the benchmark Silver plan.
 
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