BEFORE ACA - what did retirees do?

[travelover]

.........Denial of health insurance coverage was real and quite systematic. No spin, nothing to do with social media.

Amen and not to be political, but it is back in the courts but the Federal government is no longer defending the ACA.

 

[harllee]

My experience pre ACA was that if you had a preexisting condition (even a fairly minor one) you were often totally excluded from individual health insurance. Most companies would not give you a policy at all. I guess if the ACA is repealed we might see this again.

 

[daylatedollarshort]

BCBS of FL issued me a pre-[A]CA health insurance policy with an addendum that specifically excluded coverage for my pre-existing condition: an unrepaired inguinal hernia. This was either (1) an insurance company being evil; or (2) an insurance company trying to run a business. Check your favorite social media outlet for the spin on this topic that suits your fancy.

I don't know what your comment about social media means. Are there any other developed countries other than the U.S that don't have some form of universal health care?

 

[unclemick]

I am NOT in any way trying to have a political discussion. I'm seriously curious.

Very possible I may retire next year - my age would be 45 and I find myself rather thankful that no matter how costly or imperfect ACA plans are.....at least I can buy insurance without having an employer.

Then I see there's some powerful folks trying to end ACA as we speak.

My question.... if ACA goes away - what do early retirees do for insurance? Yes, COBRA - but that is only 18 months.

If COBRA runs out, and you don't have a job - how do you buy insurance especially with pre-existing condition? Thanks

I went 12 years without health insurance (1993 to 2006) age 50 to 62. Paid cash - one hairline wrist fracture and generic BP pills. Ballpark $298/mo for BC/BS of Kansas City age 62 to 65. Did not have the income in LA. Would have had to go back to work to afford even high deductible.

heh heh heh - I was lucky.

 

[NW-Bound]

I went 12 years without health insurance (1993 to 2006) age 50 to 62. Paid cash - one hairline wrist fracture and generic BP pills. Ballpark $298/mo for BC/BS of Kansas City age 62 to 65. Did not have the income in LA. Would have had to go back to work to afford even high deductible.

heh heh heh - I was lucky.

You also have big, er, manly assets.

 

[Dtail]

Amen and not to be political, but it is back in the courts but the Federal government is no longer defending the ACA.

Let it keep getting delayed.
4 more years for me after lasting through 2020. Hope it lasts.

 

[GTFan]

It depended on the state. It might have been true for where Marko lives, but pre-existing conditions were issues in all but around 5 states, pre-ACA. If the ACA is repealed, we could be going back to that situation

Strictly speaking yes, but guaranteed issue is here to stay in the public's mind and there would be a lot of pressure to get something passed to enforce it. This is the best thing about the ACA and most likely to stick around no matter what happens.

The ACA is so intertwined in the whole insurance market now that I can't see any repeal not resulting in a quick 'replacement' whatever that may be. Way too much change since 2012, way too many invested interests wanting to keep the status quo.

The other alternative if things really go south is to move to a state that has their own exchange and laws.

 

[agh1]

Strictly speaking yes, but guaranteed issue is here to stay in the public's mind and there would be a lot of pressure to get something passed to enforce it. This is the best thing about the ACA and most likely to stick around no matter what happens.

The ACA is so intertwined in the whole insurance market now that I can't see any repeal not resulting in a quick 'replacement' whatever that may be. Way too much change since 2012, way too many invested interests wanting to keep the status quo.

The other alternative if things really go south is to move to a state that has their own exchange and laws.

But cost matters. Many want ACA repealed because costs went up for those without pre-existing conditions in order to subsidize the premiums of those who had them. If you take that away to lower premium costs that would raise the price for those with pre-existing conditions. In that case, even if it must be offered, the price would often make it out of reach.

 

[Aerides]

But cost matters. Many want ACA repealed because costs went up for those without pre-existing conditions in order to subsidize the premiums of those who had them. If you take that away to lower premium costs that would raise the price for those with pre-existing conditions. In that case, even if it must be offered, the price would often make it out of reach.

And therein lies a big part of the problem. Costs were previously artificially low because insurers could exclude those with conditions, and cap their lifetime payouts. Consumers just see the before and after price tag, not realizing how much was truly excluded in the before.

 

[MichaelB]

But cost matters. Many want ACA repealed because costs went up for those without pre-existing conditions in order to subsidize the premiums of those who had them. If you take that away to lower premium costs that would raise the price for those with pre-existing conditions. In that case, even if it must be offered, the price would often make it out of reach.

And therein lies a big part of the problem. Costs were previously artificially low because insurers could exclude those with conditions, and cap their lifetime payouts. Consumers just see the before and after price tag, not realizing how much was truly excluded in the before.

In addition to Aerides’ point, costs went up for people with individual coverage, which was less than 10% of the private insurance market. Employer coverage for the other 90% was already high. It’s not talked about becasue those costs were paid by employers.

 

[scrabbler1]

But cost matters. Many want ACA repealed because costs went up for those without pre-existing conditions in order to subsidize the premiums of those who had them. If you take that away to lower premium costs that would raise the price for those with pre-existing conditions. In that case, even if it must be offered, the price would often make it out of reach.

Also remember that someone who doesn't have a pre-existing condition today may become sick later on and develop a pre-existing condition. Part of the subsidy the healthy people pay to lower the costs of sicker people is for the possibility that a healthy person may become sicker later on.

 

[agh1]

Also remember that someone who doesn't have a pre-existing condition today may become sick later on and develop a pre-existing condition. Part of the subsidy the healthy people pay to lower the costs of sicker people is for the possibility that a healthy person may become sicker later on.

There is no way around that covering pre-existing or not just shifts the cost around but does nothing for the real problem of the high cost of healthcare. Employee plans tend to hide this reality from those who are covered in this way as too many are unaware of how much their employer is subsidizing the true cost of their insurance.

 

[W2R]

As for what retirees did before ACA.... I chose a job working for the federal government (rather than a much higher paying, vastly more prestigious, and more intellectually stimulating job that I was also offered) because of the benefits offered with the government job. Well, and job security too. Anyway these benefits that came with the federal job included a pension and reasonably priced health insurance that I could eventually carry over into retirement at the same price as when working.

I thought that medical costs were going to go through the roof for demographic reasons, and had predicted that out loud to everyone who would listen to me from the 1970's or 1980's on, over and over until I was blue in the face. Nobody listened but I truly believed it even if everyone else told me I was a total idiot for thinking that, which they did as often as they possibly could.

I still decided to act on the assumption that medical costs were going to skyrocket, whether that assumption turned out to be correct or not, thank goodness. There was no ACA, and federal employment/retirement seemed like the best choice for me under the circumstances.

I worked two years beyond FI, in order to qualify for federal retiree health insurance. Those were two doggone tough years and every day seemed like a century. So when people say, "Oh my, you were so LUCKY to get that health insurance" I am likely to get a strange look on my face.

 

[travelover]

.......... It’s not talked about because those costs were [-]paid by[/-] withheld from wages by employers.

FIFY

 

[agh1]

I worked in HR during my senior year in college. Part of my job was to add people to the company insurance, pay the insurance company and bill former employees for Cobra. I can tell you for sure that none of the employees had a clue how much they were being subsidized until they became former employees and found out what Cobra was going to cost them. It was always a HUGE shock and my company did not charge the extra 2% fee they were allowed to add. Almost everyone believed that the company contribution was less than what the employee paid and this was simply not the case.

With group insurance the healthy employee & the employee with healthy family members subsidize those who cost more because there is just one rate for each category-employee only, emp + spouse, etc. In the individual ACA market this is less true because in most states the cost of the policy increases with the age of the insured. Obviously it was even worse when taking a person's actual health history into account was allowed.

 

[agh1]

As for what retirees did before ACA.... I chose a job working for the federal government (rather than a much higher paying, vastly more prestigious, and more intellectually stimulating job that I was also offered) because of the benefits offered with the government job. Well, and job security too. Anyway these benefits that came with the federal job included a pension and reasonably priced health insurance that I could eventually carry over into retirement at the same price as when working.

I thought that medical costs were going to go through the roof for demographic reasons, and had predicted that out loud to everyone who would listen to me from the 1970's or 1980's on, over and over until I was blue in the face. Nobody listened but I truly believed it even if everyone else told me I was a total idiot for thinking that, which they did as often as they possibly could.

I still decided to act on the assumption that medical costs were going to skyrocket, whether that assumption turned out to be correct or not, thank goodness. There was no ACA, and federal employment/retirement seemed like the best choice for me under the circumstances.

I worked two years beyond FI, in order to qualify for federal retiree health insurance. Those were two doggone tough years and every day seemed like a century. So when people say, "Oh my, you were so LUCKY to get that health insurance" I am likely to get a strange look on my face.

I took a job in the private sector that promised a pension and retiree health insurance. After almost 25 years on the job, the company was sold. Bye pension. Bye retiree health insurance. Even those already retired lost their health insurance.

 

[Big_Hitter]

getting individual coverage pre-aca was somewhat of a cluster but people did it

 

[Big_Hitter]

I took a job in the private sector that promised a pension and retiree health insurance. After almost 25 years on the job, the company was sold. Bye pension. Bye retiree health insurance. Even those already retired lost their health insurance.

how was the pension eliminated?

 

[explanade]

Work at Starbucks enough hours to get health care?

 

[explanade]

Easy, move to a country with socialize medicine, which is pretty much every other country in the world.

Is it easy?

Some European countries have retirement visas if you show you have assets to support yourself. But I don't know that those visas let you enroll in their health care systems.

Even if they put you on the track to get on their systems, don't you have to deal with paying taxes on US income and assets over there?

Then the red tape of bank accounts, leases or even worse, buying property there.


Finally, it's not easy to move to a new country, leaving behind family, friends and other social infrastructure you may be used to here.

 

[explanade]

Let it keep getting delayed.
4 more years for me after lasting through 2020. Hope it lasts.

It may actually be taken up by the Supreme Court in this session, in which case they'd have a ruling this summer.

Otherwise, it's likely to have some final disposition in a couple of years.

 

[Big_Hitter]

corporate retiree medical plans were very prevalent until FAS106 became effective - circa 1988?

 

[MichaelB]

It may actually be taken up by the Supreme Court in this session, in which case they'd have a ruling this summer.

Otherwise, it's likely to have some final disposition in a couple of years.

This summer sounds ambitious. The appeals court ruled againt the individual mandate, then sent the case back to the lower court to determine which specific components should be overturned. That has to happen first, and that ruling would be subject to challenge. https://www.kff.org/health-reform/f...on-key-provisions-of-the-affordable-care-act/

 

[explanade]

Actually last week they submitted briefs.

The Democratic attorney generals trying to defend the ACA petitioned the Supreme Court to take it up now, because the uncertainty affects people.

Of course they also believe they'd have a political advantage if the SCOTUS abolished the ACA. Would be a big campaign issue.

 

[Dtail]

Actually last week they submitted briefs.

The Democratic attorney generals trying to defend the ACA petitioned the Supreme Court to take it up now, because the uncertainty affects people.

Of course they also believe they'd have a political advantage if the SCOTUS abolished the ACA. Would be a big campaign issue.

With the current feelings on ACA, even if it was abolished, the replacement would probably look somewhat similar but just not be called......