Healthcare insurance and retirement - again!

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(My bold above) Any changes to the ACA at this point are pure speculation.

Third grade? I guess that is where you learned to follow the agreed upon community rules? Some here must have forgotten.

Yeah, my education definitely peaked about that time. From there on I took a divergent path. Evidently just barely within the rules is the way to go. I learn from those at the top.:cool:
 
Due to strange turns of events, and demographic factors that nobody seems to understand, I can find myself in a really weird situation.

If I cannot get my MAGI to below $64K, it is going to cost $24K for the premium for a Silver HMO, with a deductible of $14K. That means if I get really sick, it can cost $38K for healthcare.

Now, to get that $38K/year, one needs around another $1M (3.8% WR of $1M is $38K). Then, when one gets to Medicare age, who's to say that our millionaire will not have to pay more, because he can afford to? When the costs go up, people who can afford to pay have to pay more. How do you argue with that?

But then, see how having money makes you spend more that you normally would not have to? Having that extra million does not change your standard of living any, because that extra money just makes you pay more, and you are back to where you were.

So, a lower level of FI may be better. It's less stressful, takes less planning and tax crunching. And you get to that lower level of FI sooner, and retire earlier and live happily, well, not forever, but to whenever.
 
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We all know that cost is growing out of hand. I truly do not understand why getting people to recognize the importance of cost control is politics! Why is cost control partisanship? So far, nobody has done anything in this area as I can tell. We do not even know where the money goes.

But that's OK. I will stop.

Yes, the key is cost, not who pays for it. We all pay for it, let's face it. the problem is we have a third-party pay system. Name another service in which neither the consumer nor the provider knows the cost of the service at delivery?

So to me a key focus of insurance reform needs to be:

Published prices for every service, so people can shop price. You know like everything else.

Published performance stats, so we know who provides the best service.

Expanded health saving accounts, so people have skin in the game of what things cost.

Also, as far as the policies, we need to get rid of the one-size-fits all. it is more coverage than a lot of people are willing to pay for, and too high-cost. Let people buy less coverage if they wish to. You know just like we do not all drive BMW's.

Just some thoughts.

M
 
The URL is early-retirement.org, but the title I see on the front page is "Early Retirement & Financial Independence Community".

<<shrugs>>
Darn..now I really feel like an imposter 😀
 
So, a lower level of FI may be better. It's less stressful, takes less planning and tax crunching. And you get to that lower level of FI sooner, and retire earlier and live happily, well, not forever, but to whenever.
But deliberately putting one's self into a status of increased dependency on external policies/decisions may increase stress. For most people, being in a position in which they are less able to control/predict what lies ahead causes an increase in stress.
 
I will say that a week ago, the thought of staying with my current part time job with good health insurance for another 8.5 years until I can retire with it in 2025 seemed like a possibility, but not one I was really obsessing about. Now, all of a sudden, it feels like a must-do, a given.

I would say its a good thing to do until we have some real proposals and see how they are accepted by the House and Senate.

Right now I think I am going to look for a part time job with benefits, but that may be a pipedream. Worst case I go back to work full time for a few years. I've had my taste of retirement and while I'd hate to go back to the grind perhaps I could find a job doing something I'm passionate about to take some of the deep and heavy sting away.

And if it turns out that the replacement for ACA is as least as good as ACA then I can add the extra income I've made to my travel budget.
 
Guys, this is the ER Forum, not the FI Forum. Some of us are more FI than others, some less. We are ALL trying to ER whether that involves a lot of risk, or very little risk. In fact if everyone here was as FI as you implied we would never need to discuss SWRs or even budgets.

Almost no one here is actually financially independent

Those who think they are, are deluding themselves

Sucking it up vis a vis food, housing, cars, locations, even the kids college are doable. Medical care? Not. If you are fortunate you can string it along, have things end well for you then declare some kind of victory. But don't confuse that with having any control over the situation or having been actually financially independent
 
I don't think anyone should be criticized for re-evaluating their retirement spending plans wrt healthcare. I update my plan and calculate worst case scenarios all the time. Even without any changes to how health insurance is delivered I've been playing around with extra high inflation rates on insurance/OOPs.

I also would be interested in full disclosure of where folks get their insurance when they state this is nothing to worry about - or accuse others of not being FI enough...

Here's my full disclosure. I purchase healthcare (HDHP with HSA) through the exchange. Starting in Jan 2017, DH will be on medicare B, D and F+. We currently qualify for a subsidy - but up through this year I was paying the full rate, and getting the subsidy back at tax time since CoveredCA had a glitch that precluded having separate providers for different family members and DH wanted a different insurance network.

Like many here - I hope I am FI "enough" - I currently have a 3% WR - so that gives me *some* headroom to increase withdrawals if I need to, for healthcare. We also have some discretionary spending that can be cut if healthcare continues to inflate at it's current high rate. But like many here - if the system radically changes, I will have to be flexible and adaptable to that change and rework the plan accordingly.
 
But deliberately putting one's self into a status of increased dependency on external policies/decisions may increase stress. For most people, being in a position in which they are less able to control/predict what lies ahead causes an increase in stress.
+1

Exactly what I said in an earlier post elsewhere, when I say that I prefer not having to rely on a subsidy (which can be yanked).

However, some people may not be able to hang on to work longer to accumulate a larger sum of money to retire. If they plan on a living standard of $70K, they now need to plan for $90K of income or more, and work longer. Or they can reduce down to $60K, and have about the same living standard.

I did not plan on any subsidy because I retired and bought insurance before ACA. But for people planning to retire now, these are the 2 choices.

Oops, ACA may metamorphose into something none of us can predict, so I guess I should not talk about the current situation.

Back on planning, how does one plan for something so unpredictable as healthcare cost? It is always a step of blind faith unless you have $5M (maybe $3M). Or if you have a whole lot less. :) And it is easier to have less than to get more.
 
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I also feel sorry for people that now have all this uncertainty. I almost switched from our state plan to the ACA but when I noticed I could not go back I changed my mind. People should not have to be super wealthy in order to retire and I find the criticizing of people that retired with ACA in their plans not helpful. Some people may not be able to return to f.t. work due to health issues, lack of jobs, etc.
 
Almost no one here is actually financially independent

Those who think they are, are deluding themselves

Sucking it up vis a vis food, housing, cars, locations, even the kids college are doable. Medical care? Not. If you are fortunate you can string it along, have things end well for you then declare some kind of victory. But don't confuse that with having any control over the situation or having been actually financially independent
I can refuse medical care. Maybe I die, maybe I eventually die of something else first. But to say I can never be financially independent because of a possible large medical bill is silly. Might as well say you can't be financially independent at any amount because someone could steal your money and you couldn't get it back.
 
Right now I think I am going to look for a part time job with benefits, but that may be a pipedream.

If my former employer stops subsidizing my HI (and that is possible) I might very well be right with you. I'm on Medicare but it'll be another five years before DW is.

Several years ago Home Depot offered HI coverage for part timers starting at 20 hours/week. I have no idea if they still do. We were talking to the lady stirring paint who was a single mom, they structured her hours around school hours. She was thrilled to have the job. Evidently a good company (or at least that store) to work for.
 
The current healthcare system is unsustainable. No matter who was elected it would have crashed and burned if it had not already. When you have a very few people paying the cost for many, it cannot work forever.

I am thinking that Healthcare decisions can now be made based on solid financial considerations, not who has been given the most political contributions. The common man has risen up, and will expect that solid cost effective improvements will be made in a business like fashion. Some of the brightest minds and best negotiators in the business world will now be be working on solutions. They have a vested interest in succeeding. Doctors salaries may change. CEOs may be expected to make less.

It is a shame that doctors who save hundreds or even thousands of lives a year, are paid near as much as an NFL bench warmer. Who do these doctors think they are...?/sarc It does say a thing about the public's priorities.

My healthcare is free, with the VA. I expect it will get even better. I gave the government a blank check, and let them fill in any amount, "up to, and including my life". I do not feel that it is to much to ask.

My 45 yo DGF has 'free' healthcare, for now. Her income is low enough to get a $0 premium, $0 deductible plan. Of course, she has no housing and food bills. She is a bit more concerned, but until we see what will happen there is no reason to worry. If you are married, get a divorce and split the assets un-evenly.. It may help your situation. Since we have never been married, it helps us immensely. Marriage is nothing more than a piece of paper anyway, 2016 years ago no marriage license was needed, yet people still got married.

Making healthcare more efficient will go a long way to making it more affordable. Other countries can do it, so can we. Many countries rely on waiting periods and rationing, but it works.

The USA is the most innovative country in the world, and the profit motive makes the innovation faster. The medicare and HMO options will likely be the path going forward. Doctor choice may go by the wayside, and a primary care doctor be the hurdle between a person and a specialist. That will save quite a bit.

Prescribing exercise and diet, rather than medications and surgery, will also help. Staying healthy goes a long way towards saving healthcare expenses. Carrying too much weight on ones body is a huge factor in healthcare costs.

Malpractice insurance should also change, that will save a lot. Arbitration, where a doctor cannot be sued but a government panel determines any harm and damages. And pays the award. Unnecessary tests and procedures may be eliminated, unless you pay out of pocket for them.

Making prescriptions available to the USA, at the cheapest price available, should be a no-brainer. If an epi-pen is sold in some small African nation for 0.39, that should be he price here. It should not be $650. The USA does not need to subsidize the healthcare for the entire world. We have enough people here that need help.

It will take some work, but I expect to see great changes.
 
I can refuse medical care. Maybe I die, maybe I eventually die of something else first. But to say I can never be financially independent because of a possible large medical bill is silly. Might as well say you can't be financially independent at any amount because someone could steal your money and you couldn't get it back.

All of teh above in teh practical real world= just silly. Sorry. Have a nice day
 
I joined the class of 2013 after the Supreme Court upheld the ACA when I knew Cobra could bridge me to ACA coverage. Prior to that a preexisting condition made individual health insurance unavailable to me at any price. I've been buying our insurance in the marketplace (no subsidy). I was planning to buy an exchange policy again this year, but for about $3,000/year more I could buy an off-the-exchange policy instead.

Given the Republican sweep, the ACA's days certainly seem numbered. However, I've yet to see any credible plan for the "replace" part. Though it certainly seems likely that this is the last year exchange policies will be offered.

My biggest question now is should I buy an off-the-exchange policy to minimize (but not eliminate) my risk of not being able to buy a policy at all for 2018, and to minimize the smaller risk that 2017 exchange policies might be terminated during 2017?

I am NOT an industry expert but I opt for buying health insurance off-the-exchange (since I haven't been receiving a subsidy anyway) and I believe and hope the insurer will not drop me in 2017 when ACA is repealed. I took ER in 2013 and went on COBRA for 6 months then bought an off-the-exchange policy since then. It is quite expensive at $600 a month premium but it has excellent coverage etc. I hope the insurer will not cancel my plan when I go in for major surgery in the future etc. I am not sure what the future will hold for us?!:(
 
I would normally agree with you but remember that the ACA was originally passed in part without needing 60 votes in the Senate because Reid used a senate rule to bypass the 60-vote requirement (Scott Brown had just won the MA Senate seat, reducing the Dems to 59 senators). Couldn't the crafty McConnell use the same tactic to repeal it?

Dear Scrabbler---what have you been doing for your health insurance?
 
Just watching the news. It looks like perhaps a softening of the issue. For those who propose waiting for legislation to be presented - Wake up. Make your opinion known to your reps now. Sheep never lead.
This IS important and beyond the scope of politics. Thank-you
 
I am NOT an industry expert but I opt for buying health insurance off-the-exchange (since I haven't been receiving a subsidy anyway) and I believe and hope the insurer will not drop me in 2017 when ACA is repealed. I took ER in 2013 and went on COBRA for 6 months then bought an off-the-exchange policy since then. It is quite expensive at $600 a month premium but it has excellent coverage etc. I hope the insurer will not cancel my plan when I go in for major surgery in the future etc. I am not sure what the future will hold for us?!:(
Have you checked to see what the premium is for 2017? $600/month is not really that bad.

Where I am, for 2017, for either on or off-exchange, it is about $1K/month for an individual of 60, and the deductible is around $6-7K.

My current insurer drops all policies for next year, on or off-exchange.
 
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All of teh above in teh practical real world= just silly. Sorry. Have a nice day
Yep, I forgot no one ever refuses any medical treatment, even if it costs all the money they want to leave to spouse and children to live another year.

And I guess I remember it wrong when my father-in-law refused aggressive treatment for prostate cancer and then he lived until a heart attack at 92.

Whatever...
 
The health care policy s changing quickly. Campaign documents are being removed and old ideas are replacing ideas floated during the campaign:

In the whirlwind few days since Donald Trump’s election, his healthcare plans have gone through some serious editing—with a very red pen.

Trump’s central agenda item to repeal Obamacare and replace it—something the Republican establishment has long and desperately wanted—still stands firm. But other items have conspicuously disappeared and been replaced by core Republican agenda items.

Gone from the seven-point list (PDF) Trump put forth during his election campaign is a plan to allow the import of prescription medications. Also gone is a plan to require price transparency in healthcare, something the vast majority of Americans would likely support. There’s also no further mention of reforming mental health programs in the country or making individuals' healthcare premiums tax-deductible.

Trump’s healthcare plans get swift Republican makeover | Ars Technica
 
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