all insurances NOT in ACA subsidized plans

[sengsational]

Quote:

Originally Posted by marko I"m always amazed at a mindset to penalize those who've LBYM, pay their bills, paid millions in taxes over their lifetimes and entered into social contracts (SS/Medicare) and then when it's time to pay up are being questioned as to their being deserving. THAT'S whats not fair.

Agreed. And it's the same story with financial aid for college: penalize the family who saved, reward the guy who spent. I'm sure there's holes to be poked in my alternative, but if two families have the same income on the on their social security statement (mine shows every dollar earned since my grocery bag-boy days in 1975), then the two families should get the same treatment, irrespective of what they did or did not save. The FAFSA formulas expect the parent to drop about 6% of their savings per year into the college bucket. Two kids, 8 years, your savings gets cut in half, so the ant and the grasshopper are much closer in assets now, that's fair, hehe. Back around to health care, though, and even in financial aid, you can't get blood out of a turnip. Or the reason why the bank robbers rob banks. --Dale--

[gerrym51]

i just studied the page for the 5 subsidized plans that are available on the massachusettes health care connector. they are carbon copies of masshealth(the massachusttes medicaid program). the only differences i see are larger co-pays for non approved drugs.

the problem with this is they also give providers the same fees as masshealth which are so low many providers won't accept the plan.

the more i study this the madder i get. if obamacare is a copy of mass. in mass the subsidies only apply to health plans designated for subsidies, the subsidies do not apply to the gold,silver,bronze plans

only to the same exact plan that all the providers of the subsidized plan uses.

[pb4uski]

Quote:

Originally Posted by bondi688 I strongly believe in and practice LBYM, but my thought was that it is slightly unseemly to pass oneself off as having minimal income to take advantage of subsidy not meant for those who are actually worth millions.

While I understand your point, I have decided that I will structure my finances to optimize my taxes and benefits. The way I rationalize it is that I paid mucho taxes during my accumulation phase, many years I paid more in taxes than many people earn in a year and since my earnings were 99% wages, there wasn't much that I could do other than max out my 401k and suck it up. It's payback time.

We don't seem to view optimizing SS by using various claiming strategies as a problem, nor taking advantage of 0% capital gains taxes by keeping withing the 15% bracket, or being tax efficient by putting bonds in our tax-deferred accounts so why would people who have no concerns with such things view optimizing the subsidy as unseemly?

[heeyy_joe]

I intend to play by the rules. That's fair isn't it?

[ERhoosier]

Quote:

Originally Posted by MichaelB If you make your financial decisions based entirely on your needs and requirements you should have no worries. If your decisions result in tax credits, they are no different than any other credit you are entitled to.

Agree 100%

Many financial items in ACA are rather arbitrary, but SCOTUS has ruled it is now the law of the land. I see no reason that managing one's affairs consistent with this law should cause any heartburn. Should a 71yo millionaire feel guilty about taking his/her annual IRA required min distribution (RMD) instead of paying the IRS's 50% excise tax?

[wanaberetiree]

Quote:

Originally Posted by marko THAT'S whats not fair.

+1

[obgyn65]

This is my understanding also. I would wait until additional details emerge, specific to each state.

Quote:

Originally Posted by MichaelB State exchanges will determine which plans are offered. So far, 18 states have firm plans for single state exchange, 7 will partner, and 26 (including DC) will default to a feredally run exchange. Until they actually start putting plans out there, we really don't know what they will offer.

[foxfirev5]

Quote:

Originally Posted by heeyy_joe I intend to play by the rules. That's fair isn't it?

I also plan to play by the rules -whatever they may be. First it was the loss of my pension, now it's retiree medical coverage going away.

[bondi688]

I understand all the points. I think there is a very subtle difference between passive avoidence of having to do something and active acquiring of something. I am not really saying it is wrong and doing all that are still following the rules.

[frank]

I saved and was frugal all my working life and now I will continue to play by the rules to get the best deal possible for myself and my wife. If it means working the system then so be it. but if working the system is withdrawing less earnings than possible to get a subsidy, then why are tax deductions and lower withdrawal rates to avoid taxes also not working the system?

[harley]

Quote:

Originally Posted by youbet It's just not in my genes to sip from the public pond when I have my own bucket of water.

If my bucket of water was left alone for me to use, I'd be right there with you. However, the gov't has a big siphon sticking in my bucket. When I follow THEIR rules to minimize the amount of the suction being applied, I don't feel anything other than slight satisfaction.

[Zantastic]

If California insurers mirror those in MA, it makes me wonder what the difference in benefits would be between a Medicaid plan and a subsidized one.

This CHART is adding to my confusion, with a minimum income for a subsidy that's much lower than what the calculator shows for Medi-Cal eligibility. My first thought was that the first column was for Medi-Cal, but I don't think that's correct.

[gerrym51]

One thing that will be to my benefit with Obamacare. assuming massachusettes will have to make adjustments for Obamacare income standards.

Massachusettes adds all forms of income to their income guidlines.I did not qualify.

under obamacare because MAGI can be manipulated i would qualify.

even both i and wife receive ss since its not a direct addition to income

i havefigured out we can have over 60,000 of total income and still qualify for a 1/2 to 2/3 subsidy.

thats is if mass is required to use federal guidline. this seems to be a big loophole for taking ss at 62 especially if one spouse is over 65.

good for me-not so good for the country

however i will only do this if it affects my silver plan i bought.,and can keep it-i,m not sure the mass. silver plan that already existed is the same as Obamacares.

[gerrym51]

Quote:

Originally Posted by Zantastic If California insurers mirror those in MA, it makes me wonder what the difference in benefits would be between a Medicaid plan and a subsidized one. This CHART is adding to my confusion, with a minimum income for a subsidy that's much lower than what the calculator shows for Medi-Cal eligibility. My first thought was that the first column was for Medi-Cal, but I don't think that's correct.

looking at the chart it appears that the 2 lower sections a almost copies of med-cal. the 2 highest subsidy sections are of the bronze,silver,gold platinum catagories.

in mass currently under ROMNEYCARE(i stress this because obamacare is simiiliar but not exact copy) all subsidized plans are same and restricted

[jollystomper]

Quote:

Originally Posted by pb4uski While I understand your point, I have decided that I will structure my finances to optimize my taxes and benefits. The way I rationalize it is that I paid mucho taxes during my accumulation phase, many years I paid more in taxes than many people earn in a year and since my earnings were 99% wages, there wasn't much that I could do other than max out my 401k and suck it up. It's payback time.

+1

While I do not feel it is "payback time", I feel no guilt about optimizing my taxes and benefits when it is done legally. Goodness knows we paid a whole lot into taxes for many years and were eligible for very few credits.

This is why I favor a flat tax approach. The "gaming" of the system is taken out by the most objective mathematical means possible - a straight percentage. Otherwise, I don't blame folks going into retirement (like myself) who are trying to live as financially independent as possible to do what they call legally to ensure that it happens.

[gerrym51]

As an adjunct to this thread that i started.

I went and checked if my doctor was in the 5 plans that the state of massachusettes subsidized.

my doctor WAS NOT in any of the subsidized plans.

as i've stated before the subsidized plans a state will offer will most likely be in

medicaid networks-which fewer doctors take

[Live And Learn]

Quote:

Originally Posted by gerrym51 As an adjunct to this thread that i started. I went and checked if my doctor was in the 5 plans that the state of massachusettes subsidized. my doctor WAS NOT in any of the subsidized plans. as i've stated before the subsidized plans a state will offer will most likely be in medicaid networks-which fewer doctors take

thats what scares me most. While getting a $12k subsidy would be great, we need to think about the costs (in terms of medical care) that would offset it. Makes it impossible to budget for anything except full freight costs.

[samclem]

Quote:

Originally Posted by youbet I too hold little respect for folks with huge financial resources tapping into public funds just because they're smart enough to work the system.

"The system" has no brain. It has no feelings. It has no logic (just look at what it has wrought!). All we have are rules, and any attempt to read logic into them is perverse.
I feel it is 100% proper to take advantage of every legal tax break and subsidy that is offered.
This isn't a private charity where well-meaning people have donated funds to help the less fortunate--any person who can afford to make their own way should properly feel ashamed at taking a free meal at the soup kitchen. Nope, this is tax money taken from people who had other good uses for it, and doled out by the government in a very arbitrary fashion. To fail to take the subsidy, or to structure your finances so as to be eligible for it, is just the same as failing to take a tax deduction you deserve.
In my opinion the "most right" thing to do is take every one of these obtuse tax breaks and subsidies and do something useful with the money--maybe give it to the truly needy. And also crow loud and long about how you are taking advantage of these giveaways so people get fed up with it and put pressure on their representatives to change the rules.
Failing to take these subsidies just serves as a tax on those with the biggest sense of misplaced guilt.

[REWahoo]

Quote:

Originally Posted by Live And Learn thats what scares me most. While getting a $12k subsidy would be great, we need to think about the costs (in terms of medical care) that would offset it. Makes it impossible to budget for anything except full freight costs.

Careful that you don't budget for "worst case" in every case leaving you a basket case...and still at work.

[kmt1972]

Given the cost of insurance in NY I am counting on the subsidized plans as being not too bad. My plan is to control my MAGI (but for sure not my withdraw) at $65K which would cap my premium around $6K given I will have a family of 3.

Just to show you what we in NY are up against, using

Health Insurance - Find Affordable Health Insurance Plans and Buy Medical Coverage Online

and doing a search on health plans for a family of 3, you can get an insurance policy from Empire Blue similar to the one from my mega-corp (is that the right terminology for this board?) for almost $60K a year, or one from EmblemHealth for about $24K. EmblemHealth has a much lower rating and I suspect that it will be the one that will be available on the exchange.

Looking at

New York Health Benefit Exchange | The Official Health Exchange for New York State

It does not even make clear which insurance providers will participate so this is one giant mystery until October when it when then somehow magically work which I doubt.

Anyhow, I did a search on EmblemHealth and it does have doctors and pediatrics that work out of here in Scarsdale. I figure if they work out my pretty good neighborhood, they cannot not be too bad. Right now my wife and I use our doctors in the New York City but that will change once we retire.

My plan is, while our health is good, keep using the subsidized plan, and then later in our life and since we will have the money for it, go to a non-subsidized plan when we need better care.