Are we allowed to talk about it yet?

[simple girl]

Insurers have to put plan prices for 2018 out by June or July, right?

Just wondering when this would need to pass by in order for it to have impact on the 2018 offerings...

 

[EastWest Gal]

Joe, I thought you was going to tell me, your letter is what influenced them to increase the deduction, lol.
Thanks for the brief summary link. It was short enough for my small brain to soak in.
We know things will get adjusted in senate if even approved....But with that being said, I guess I am being more cynical as I am older. It appears to just be a constant game of cost shifting since ACA originated without any real solutions for the underlying costs... One first blush, I lose points on old age ratio premium caps to younger people. But score on larger HSA deductions and maybe some old age premium assistance. Im sure this weak self analysis will change by the time the senate gets a hold of it.

+1

As an underpaid pediatrician my entire career (they said I needed to see patients faster and care less) I have seen greed largely get in the way in medical care. Not to mention fraud and waste.

 

[rodi]

Insurers have to put plan prices for 2018 out by June or July, right?

Just wondering when this would need to pass by in order for it to have impact on the 2018 offerings...

I read through (skimmed) the bill and it appears that it is not immediate. Most of the defunding of subsidies, high risk pools, etc wouldn't kick in till 2020... so 2018 should still be under the existing ACA rules.

Similar to the way the ACA phased in with exchanges not in place for several years after the ACA passed.

 

[JoeWras]

I read through (skimmed) the bill and it appears that it is not immediate. Most of the defunding of subsidies, high risk pools, etc wouldn't kick in till 2020... so 2018 should still be under the existing ACA rules.

Similar to the way the ACA phased in with exchanges not in place for several years after the ACA passed.

The one thing that does seem to take hold in 2018 are the new higher HSA contribution limits. At least the PBS summary says so.

 

[imoldernu]

Will be interesting to see what changes will be made to this last CBO estimate. (see page 6)

https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/americanhealthcareact.pdf

 

[24601NoMore]

All these changes and talk of pre-existing not being covered in all cases (ie: state opt-out) is seriously going to make me think twice about RE this year.

I was never a fan of the ACA for various reasons but at least we could RE and be covered.

Now..who knows? The House version seems to say States can opt out. Senate will come up with their own bill that may or may not contradict that.

SO frustrating when it comes to thinking about RE this year - which I seriously would do "now" due to unmanageable stress and health issues if it weren't for all the uncertainty about what will / won't be covered, IF I will be able to get HC for me and DW and how much it will cost (probably lots, since the insurance companies can now charge us "old" people up to 5X the "young" people compared to 3X under the ACA..and premiums were already $18K/yr for 2 of us with a PPO..what's it supposed to go to? $25-30K? UGHHHH!!!)

I'm not going to sleep well until this all gets ironed out and finalized..hopefully with some coverage for pre-existing and not gouging us "old" people, or we'll be in a world of hurt..

Someone please re-assure me and convince me that they won't do away with coverage for pre-existing..that will screw up my entire plan to RE this year.

 

[AllDone]

Reliable healthcare economists are saying that the high risk pools proposed in this bill are severely underfunded.

 

[photoguy]

You should read more without getting way too emotional. Wordings like getting screwed is to that effect. From what I've read, Arkansas implemented the high risk pool with very limited cost, $55 million, if I remember correctly, and was able to reduce premiums overall.

Do you know what was the mechanism for reduced premiums? I'm struggling with this because if there's a fixed amount of health care that is needed, separating people into different buckets shouldn't change the overall and average cost.

Did they deliver less healthcare on net? or were they getting more healthy people on the insurance market due to price sensitivity.

All these changes and talk of pre-existing not being covered in all cases (ie: state opt-out) is seriously going to make me think twice about RE this year.

What's the practical advantage of opting out for a state? And if this clause remains, what states would be likely to do so?

 

[Fedup]

Do you know what was the mechanism for reduced premiums? I'm struggling with this because if there's a fixed amount of health care that is needed, separating people into different buckets shouldn't change the overall and average cost.

Did they deliver less healthcare on net? or were they getting more healthy people on the insurance market due to price sensitivity.
For example, Alaska had multiple 40% premium increase back to back, when they paid $55 million to the high risk pool, the premium for the non-existing conditions people only rises 7%. Granted, Alaska is a small state. But it's the same principle.





What's the practical advantage of opting out for a state? And if this clause remains, what states would be likely to do so?

From what I've read, people with predicting conditions need to be taken care off separately. When you lump people with preexisting conditions and the people with no existing conditions, you raise the premium overall.

 

[eytonxav]

I am not going to pay much attention or speculate until there is something more concrete coming from the Senate. What I will say, is that I am not holding my breath waiting for that to happen.

 

[Lisa99]

I believe there is no point in worrying about something I can do nothing about so I did the one thing I could do, write my Senators and Representative.

I've never done that before, but now that it's done, all I can do is plan for the various outcomes.

 

[littleb]

All these changes and talk of pre-existing not being covered in all cases (ie: state opt-out) is seriously going to make me think twice about RE this year.

I was never a fan of the ACA for various reasons but at least we could RE and be covered.

Now..who knows? The House version seems to say States can opt out. Senate will come up with their own bill that may or may not contradict that.

SO frustrating when it comes to thinking about RE this year - which I seriously would do "now" due to unmanageable stress and health issues if it weren't for all the uncertainty about what will / won't be covered, IF I will be able to get HC for me and DW and how much it will cost (probably lots, since the insurance companies can now charge us "old" people up to 5X the "young" people compared to 3X under the ACA..and premiums were already $18K/yr for 2 of us with a PPO..what's it supposed to go to? $25-30K? UGHHHH!!!)

I'm not going to sleep well until this all gets ironed out and finalized..hopefully with some coverage for pre-existing and not gouging us "old" people, or we'll be in a world of hurt..

Someone please re-assure me and convince me that they won't do away with coverage for pre-existing..that will screw up my entire plan to RE this year.

Many of us are in the same boat you are in regarding retirement this year.

It is a double edge sword for us because the ACA where we live is down to one insurance carrier and according to some articles they might not renew next year. The only plan available to us might be the American Health Care Act.

I am not feeling warm and fuzzy.

However, the main thing we have learned is to be flexible after we retire. We might need to move to another state that has better insurance coverage or get a part time job that offers health benefits. Moving to another country where we can stretch our retirement money is looking more attractive at this point.

We have health coverage until the end of this year so hopefully plenty of time to review available options.

 

[simple girl]

All these changes and talk of pre-existing not being covered in all cases (ie: state opt-out) is seriously going to make me think twice about RE this year.

I was never a fan of the ACA for various reasons but at least we could RE and be covered.

Now..who knows? The House version seems to say States can opt out. Senate will come up with their own bill that may or may not contradict that.

SO frustrating when it comes to thinking about RE this year - which I seriously would do "now" due to unmanageable stress and health issues if it weren't for all the uncertainty about what will / won't be covered, IF I will be able to get HC for me and DW and how much it will cost (probably lots, since the insurance companies can now charge us "old" people up to 5X the "young" people compared to 3X under the ACA..and premiums were already $18K/yr for 2 of us with a PPO..what's it supposed to go to? $25-30K? UGHHHH!!!)

I'm not going to sleep well until this all gets ironed out and finalized..hopefully with some coverage for pre-existing and not gouging us "old" people, or we'll be in a world of hurt..

Someone please re-assure me and convince me that they won't do away with coverage for pre-existing..that will screw up my entire plan to RE this year.

I feel your pain. We were hoping to RE in 2018 (without counting on subsidies), but until I can get a clearer picture of what future options are, I cannot make firm plans.

Question for all: under the current AHCA bill, I read that if you do not drop coverage they cannot ask you about preexisting conditions. First, is this true? What if the plan you are on shuts down, or you want to switch plans? Can they then ask about preexisting conditions?

My thinking is if I never lose coverage perhaps I will not have to go into a high risk pool. However I can't control if my plan is shut down, so trying to get clarity on this rule about when they can and can't ask about pre-existing conditions.

Also, are there provisions in the AHCA that allow insurers to switch you to a high risk pool if you start having excessive claims or claims for one of the 8 diagnoses they listed? I thought I saw something in that white paper about that before my eyes glazed over (whew!).

RetireSoon, hoping answers to these questions provide some strategies we can possibly utilize.

And, as a back up, I will be keeping my part-time job to keep my skills current, should I ever have to return to full-time work for benefits only. Will also look for something similar for hubby - or possibly he may open his own part-time consulting business, which would keep his skills current in case of need to return to FT work.

 

[Aerides]

The bill will likely change somewhat before it gets to a Senate vote, which is likely more than a month away, if not more. So anything that is currently in or out is not firm.

So we have no more to react to or plan around now than we did yesterday. Just remember to those about to ER - you can cobra for 18 months. Expensive, but usually good+known, and I would AHCA minimum costs for many won't be cheaper going forward.

 

[ivinsfan]

The bill will likely change somewhat before it gets to a Senate vote, which is likely more than a month away, if not more. So anything that is currently in or out is not firm.

So we have no more to react to or plan around now than we did yesterday. Just remember to those about to ER - you can cobra for 18 months. Expensive, but usually good+known, and I would AHCA minimum costs for many won't be cheaper going forward.

Congress is in recess for 2 weeks so a month seems quick and then there are all the committees it has to pass through....I'm thinking multiple months..

 

[GTFan]

It is a double edge sword for us because the ACA where we live is down to one insurance carrier and according to some articles they might not renew next year. The only plan available to us might be the American Health Care Act.

You might want to do some more reading - the AHCA is not a health 'plan'. If you have no insurers under the ACA, the AHCA doesn't change that.

 

[littleb]

You might want to do some more reading - the AHCA is not a health 'plan'. If you have no insurers under the ACA, the AHCA doesn't change that.

I am well aware the AHCA is not a health care plan.

Nobody knows if the changes will keep the current insurer in our state or encourage other insurance carriers to return since they will have more leverage with pricing and benefits than under the ACA.

 

[bradaz2488]

As other have stated it is too early to draw any conclusions and make changes to RE plans. We are still on a grandfathered BCBS high deductible plan which is "supposable" scheduled to end at the end of the year. We have purposely avoided ACA to wait for the dust to settle and after 4 years of RE the dust keeps getting blown around. We are both very healthy with no pre-existing conditions or meds. All we can do is roll with the punches since we really have no control on where HC costs will land between now and when we reach age 65 for Medicare (12 years from now). I know one thing for sure, there is a limit on what I'm willing to pay for HC premiums. I do not know what that is right now, but there is a limit. I understand we all want to live as long as possible, but when I'm paying x-amount more per year then what I pay to enjoy life (vacations, dinning out, hobbies, etc.) I have to question the ROI. Would it be better to live shorter and have a lot more happy/fun experiences vs. paying unreasonable amount of money to keep me alive and not having any money to enjoy life.... Nothing will ever get fix until they address the real issue. Not the cost of HC insurance, but why are healthcare costs so outrages and varies so much? It is just so out-of-control... Has long as healthcare providers get paid what they are charging, nothing will change. I feel like we need to "starve the beast", but how do we that when we all (including me) want to live forever.....

 

[zinger1457]

Question for all: under the current AHCA bill, I read that if you do not drop coverage they cannot ask you about preexisting conditions. First, is this true? What if the plan you are on shuts down, or you want to switch plans? Can they then ask about preexisting conditions?

My thinking is if I never lose coverage perhaps I will not have to go into a high risk pool. However I can't control if my plan is shut down, so trying to get clarity on this rule about when they can and can't ask about pre-existing conditions.

Also, are there provisions in the AHCA that allow insurers to switch you to a high risk pool if you start having excessive claims or claims for one of the 8 diagnoses they listed? I thought I saw something in that white paper about that before my eyes glazed over (whew!).

My take on the new bill is a little different. An insurance company could charge more for anyone with pre-existing conditions in a state if that state applies to waive the prohibition to charge more for those with pre-existing conditions. To get the waiver the state has to first set up a high risk pool. But, as others have stated this bill is far from being final so I wouldn't start losing sleep over it just yet.

 

[bmcgonig]

There was a question earlier about when the loss of subsidies would take effect if the bill passed in the present form. According to this op piece it would be 2020.


http://www.washingtonexaminer.com/o...-by-philosophical-incoherence/article/2622181

 

[EastWest Gal]

I believe there is no point in worrying about something I can do nothing about so I did the one thing I could do, write my Senators and Representative.



I've never done that before, but now that it's done, all I can do is plan for the various outcomes.

I've attended one town hall and have called the local office of my representative. With Congress on an 11 day break, they should be in their home districts. You get through easier to the home offices and you might be able to get through to the Rep him/herself.

In my case all I get are form letters in return.

 

[donheff]

On the idea of private sector companies removing caps I have read several articles addressing it. They noted that the ACA has a provision that companies to adopt the minimum benefits requirements of any state - not just there home state. This is presumably because all states had to conform to at least the ACA minimums. All provisions of the ACA continue in the ACHA unless specifically changed. That provision is untouched so companies could presumably select to implement the requirements of a waiver state.

I wouldn't lose sleep over this since the Senate is going their own way and will be cognizant of the angst this would cause the corporately insured majority.

 

[easysurfer]

The bill will likely change somewhat before it gets to a Senate vote, which is likely more than a month away, if not more. So anything that is currently in or out is not firm.

So we have no more to react to or plan around now than we did yesterday. Just remember to those about to ER - you can cobra for 18 months. Expensive, but usually good+known, and I would AHCA minimum costs for many won't be cheaper going forward.

Perhaps even more than change somewhat as read that the Senate won't vote on the House-passed healthcare bill but write their own legislation instead.

In other words, IMO, way too early and plenty of dust to settle before considering what impact.

 

[pb4uski]

There is so much to be decided on the healthcare bill that I find it hard to get excited about one way or another. The Senate needs to deliberate and approve a similar statute... that could take months. A conference committee would need to work out a compromise bill... that could take months. The president needs to sign the compromise bill.

If the final bill retains the ability of states to change pre-existing conditions then a similar legislative process would presumably happen in the states.... and states will likely react differently. There are some states that prohibited medical underwriting even before ACA... I don't see those states backtracking to allow medical underwriting. I do find the reporting on the bill that was passed yesterday to be a bit disingenuous in that as I understand it the bill it allows states to change pre-existing conditions/medical underwriting but the reporting is as if it is mandated... or certainly the headlines are.

I'm somewhat surprised that with the whole pre-existing conditions/medical underwriting debate that we haven't heard boo about a continuous coverage exemption of sort.... IOW if someone has had continuous coverage for some period of time that they would be covered for pre-existing conditions and if someone has not continuous coverage and is applying for health insurance that they would need to go through underwriting... ... but perhaps that will come later.

 

[LARS]

I'm somewhat surprised that with the whole pre-existing conditions/medical underwriting debate that we haven't heard boo about a continuous coverage exemption of sort.... IOW if someone has had continuous coverage for some period of time that they would be covered for pre-existing conditions and if someone has not continuous coverage and is applying for health insurance that they would need to go through underwriting... ... but perhaps that will come later.

What I have read is that PreExisting Conditions only comes into play if there is a lapse in coverage. And if there is a lapse, the policy pricing can only be impacted for one year, after that you are no longer considered to have a Pre Existing.

Moreover, PreExisting can only occur if state requests a waiver, which will only be granted if a high risk, subsidized, pool is put in place.

Caveat: That is what I've pieced together but there is a lot of conflicting info. And, of course, as others have stated, it will all most likely change with Senate involvement.