Fear ACA will be repealed at some point - how do you "plan" for that?

[ziggy29]

it's a known unknown, so you need to assign some probability of the event occurring - pick a number....

This may well be true, but the problem is that we can't really come up with a "Plan B" or even a "Plan C" if we have *no* idea what the landscape would look like after significant pieces of the law were repealed or radically changed. Some economic and political uncertainties you can deal with by hedging your bets; not so much here.

 

[Big_Hitter]

This may well be true, but the problem is that we can't really come up with a "Plan B" or even a "Plan C" if we have *no* idea what the landscape would look like after significant pieces of the law were repealed or radically changed. Some economic and political uncertainties you can deal with by hedging your bets; not so much here.

how about "well there's a 5% chance I'm going to have to spend another $40K a year on healthcare"? or something similar? that's just an example, not my best estimate


one could also return to w*rk to get HI....


I would anticipate a two-year delay of the Cadillac tax, not an outright repeal of ACA, just my two cents

 

[2017ish]

....

There is a reason why medical costs are the number one reason for bankruptcy.

....

Getting a little far afield, but this is probably not correct, even though one tends to see it employed quite a bit. Himmelstein/Warren, et al., is generally the source referenced in support, but Dranove and Millenson pretty much destroyed their methodology.

Maybe there is a more recent/better study out there?

 

[daylatedollarshort]

We started our semi-ER before the ACA and went on COBRA. Our health care costs were a big budget item but affordable. Our second year of COBRA and our post COBRA policy (captive market prices) our premiums alone were over 2K a month for poor coverage with high deductibles, and we were put through hell trying to even sign up for that. (Legally policies had to be offered that did not exclude pre-existing conditions, but in practice the insurance companies seemed to try their best not to comply because they knew only those with pre-existing conditions would choose such expensive, poor coverage policies.) We had one year with a major surgery and the total health expenses and premiums were close to $50K total out of pocket for us.

There was a way to have "group" coverage (no pre-existing condition exceptions) before with a small business of one or two employees (depending on your state's definition of a group). For us it would have been two, and that was our plan B. We also considered getting a job with insurance, moving to a universal coverage state or an EU country (there are at least a couple in the Caribbean.)

I am not sure what we would do now as we are off our one time move to a post COBRA policy because of the ACA, so there is no going back to that option.

 

[Alan]

how about "well there's a 5% chance I'm going to have to spend another $40K a year on healthcare"? or something similar? that's just an example, not my best estimate

If you knew the OP's history then you'd maybe appreciate the type of costs she would be looking at, and why she is concerned. I don't think $40k/year on healthcare would cover the situation she found herself in a few years ago if she had no health insurance.

http://www.early-retirement.org/forums/f38/i-have-breast-cancer-57207.html

 

[Big_Hitter]

If you knew the OP's history then you'd maybe appreciate the type of costs she would be looking at, and why she is concerned. I don't think $40k/year on healthcare would cover the situation she found herself in a few years ago if she had no health insurance.

http://www.early-retirement.org/forums/f38/i-have-breast-cancer-57207.html

No I didn't and I'm sorry to hear that. Thanks for pointing that out.

I wasn't trying to be sardonic that's just how I approach things.

 

[donheff]

I believe the only remotely likely scenario any young ERer need be concerned with is a price hike for health insurance premiums. No one is talking about going back to the days when pre-existing conditions could effectively make you uninsurable. All the proposals I have heard of involve what amount to variations on the ACA theme. Less subsidies, openness to less comprehensive insurance options, one year delays on enrollment eligibility for people who choose not to get insurance, etc. The insurance companies would go nuts if legislation simply cancelled the existing structure with no replacement.

 

[Fermion]

Well, if they do end subsidies, I hope they do it for everyone. When military, government and private sector start getting taxed on their employer provided insurance it will be an eye opener.

 

[MRG]

We retired in the pre Obamacare days (2003) and found that we were unable to purchase individual health care policies at any price due to pre existing conditions. What we ended up doing was to create a small hobby business and then as a business, we were able to purchase a group policy (for a group of 2!) Lousy, very expensive policy but it was better than nothing. Obamacare was a godsend. I suppose that approach would still be an option if Obamacare were to be repealed.

That's my plan.

 

[scrabbler1]

When I ERed in late 2008, it was a few days before that year's election of Obama. While I had lined up a reasonably affordable individual HI plan for 2009 (about $470 a month in the HI-hostile state of New York), I was very glad Obama made good on his promise to pass health insurance reform (ACA). By 2011, my so-called affordable HI plan had risen nearly 50%, to just under $700 a month. (At that rate of increase, I'd be paying $5,000 a month in 10 years, pretty much killing my ER.)

In early 2011, I switched to a bare-bones hospital-only plan. It didn't cost much (about $200 a month) but it left me badly underinsured. My plan was to keep it through the end of 2013 when I could get a more affordable plan through the NY Marketplace (exchange). The plan I am in now, but will be changing next month, was a decent plan whose flaws didn't become exposed until earlier this year when I, for the first time in my life, became sick and had to be hospitalized for 2 weeks.

I now have a pre-existing condition and am taking a costly drug ($10 a pill per day) which is covered or mostly covered. I would absolutely dread losing the ACA and either be woefully underinsured or be paying through the nose for an individual plan which covered my new pre-existing condition (if one existed). My whole ER would be in danger because making it to age 65 (Medicare age) financially intact would become a real challenge. I have a good stockpile of money but how could I budget for 20-25% annual increases in premiums as well as high OOP costs for my expensive drug?

 

[Big_Hitter]

I now have a pre-existing condition and am taking a costly drug ($10 a pill per day) which is covered or mostly covered.

same boat - on xarelto here, permenantly

 

[Exit 2024]

I am in the red state that had blue governor so we have state run exchange, heard today on the radio that after this year election where conservative won that post - he is already planning to close state exchange, end medicare expansion and push all to federal exchange. observers say that because exchange was set by executive order, nothing will stop new governor to end it the same way go figure ...

 

[jim584672]

It will be interesting to see what KY will do with the new Governor.

 

[MichaelB]

In her OP simple girl asked to leave politics out of the discussion, we should respect her wishes and stay on topic...

 

[teejayevans]

It's worst than just a cancelling ACA, based on prices and decline of providers, ACA is collapsing under its own weight, even with Obama still president.



Sent from my iPad using Early Retirement Forum

 

[REWahoo]

Is that hoofprints I hear?

 

[M Paquette]

Our plan is pretty simple. We continue to budget for full insurance coverage at a 7.5% annual premium increase, which is about $17,500 for this year, and additional funds sufficient to keep our HSA account at the max out-of-pocket amount.

If we don't happen to spend it all, as is the case for the past few years, well, that's nice. We operate under the assumption that recent changes can revert at any time. In reviewing proposed replacement legislation, our current budget appears to be adequate as long as we maintain our health. Worst case is the 'guaranteed issue with underwriting and no pricing restrictions' proposal (Strain, AEI), which has the potential for annual insurance costs tending to infinity. (This is NOT the Burr-Hatch-Upton proposal, which has a 5::1 range limit for age and no underwriting for those with continuous, uninterrupted coverage after the one-time (not annual) open enrollment period.)

Longer term programs, such as the age 65 Medicare eligibility, are a bit more likely to remain, so our baseline spending assumptions still include that, with a substantial reserve for the known coverage anomalies.

 

[Texas Proud]

Things will be very clear on November 9, 2016.

Actually, not really.... even if a Rep wins the WH, they will not have enough members to get past a filibuster... now, if a Dem wins I think you are right...

Not wanting to get too deep into politics, I will leave it at that...

 

[Texas Proud]

Just as I wrote on a thread talking about tax laws etc., you can only plan for what laws exist right now...

Even if you know something will change, the probability of knowing what exactly that change will be is pretty slim...

So, you can plan ahead that IF something changes you will have to get up to speed on what options are available and what is best for you...

 

[Corporateburnout]

We live in MA and when we first considered early retirement we were counting on enrolling in Romney care. If the ACA is to ever be repealed our state will go back to Romney care. One of the main differences between the two plans is the MA universal system income qualification for subsidies stops at 300% of poverty rather than 400% for the ACA.

Simple girl, you're more than welcome to move to MA if the ACA is repealed.

 

[Ian S]

I turn 65 next August so changes to the ACA after the next election will not affect me. I do sympathize with those whose retirement plans include years of relying on the ACA. The problem is that tinkering around the edges of the ACA could have dreadful unexpected consequences. A worst case scenario might have insurance companies abandoning the individual market entirely. The fallout from a collapse of Obamacare could also have negative repercussions for medicare, Medicaid and even employer provided insurance.

 

[AllDone]

Hawai'i had near-universal HI prior to the ACA. Can you afford to move there? I imagine that California would get on board with a MA style plan pretty quickly too, if the ACA went away. The legislature passed one way back when, but the Governator vetoed it.

I don't honestly think that the ACA will go anywhere. It'll mostly just be used as a fund raising issue. However, my spouse is eligible for citizenship in an EU country and I've been married to him long enough to qualify too.

 

[daylatedollarshort]

I know the media is filled with scare stories about the ACA collapsing, but if you look at the actual data, there are 17 million more people who now have insurance. That is a pretty big voting block to tick off if there was ever to be a full repeal.

Plus, regardless of the media hype, again looking at the facts alone, the "CBO and JCT’s best estimate is that repealing the ACA would increase federal budget deficits by $137 billion" over ten years. Increasing budget deficits is also not usually popular with voters, nor would raising taxes or cutting benefits in other areas to make up the difference be popular.

I do think much of the full repeal stories are likely just kabuki theater at this point, though the cost to consumers may rise and benefits may decrease, so some pad in the ER budget to allow for that is probably not a bad idea.

 

[marko]

Simple girl, you're more than welcome to move to MA if the ACA is repealed.

Just be sure to factor in the 5.15% flat income tax, car/boat excise tax and 6.25% sales tax before you load up the truck!

 

[pb4uski]

....Plus, regardless of the media hype, again looking at the facts alone, the "CBO and JCT’s best estimate is that repealing the ACA would increase federal budget deficits by $137 billion" over ten years. Increasing budget deficits is also not usually popular with voters, nor would raising taxes or cutting benefits in other areaa to make up the difference be popular.

However, it looks like that analysis doesn't consider the impact of whatever replaces it in the unlikely event ACA is repealed. I don't see a lot of momentum to repeal and do nothing... more to repeal and replace... and until there is some clarity on what the replacement would be it is impossible to estimate the impacts.