Healthcare insurance and retirement - again!

[Big_Hitter]

That may or may not be the driver of high health care costs. I'd like to see a comprehensive analysis of where the money really goes. It seems like we have bits and pieces of anecdotes floating around, but no solid analysis, no common facts. With costs at $9000 a year per person, it might even be worth paying a few million dollars to have it done.

$9K a year? what gender/age band?

 

[scrabbler1]

MBSC, great read. Thanks for posting it.

 

[Big_Hitter]

Do you think you would ever go back to work just to get health insurance?

I have found it very difficult to find work at age 50+.

I had thought that the ACA would be tweaked, but now it looks like wholesale gut.

I'm going to wait and see how the dust settles on this.

 

[audreyh1]

I'm glad that I have let a cash buffer build up over the past few years. If there is repeal, and then a couple of years pass before some relief, who knows what we will have to pay out of pocket.

 

[bamsphd]

He didn't HAVE to sell because the depreciation rules changed.. he chose to. Big difference.

If he was going to pay his unexpected tax bill he had to raise cash. He sold the apartments as his best (only?) practical way to pay that tax.

Observing that drove home to me the difference between tax deferral and tax credit. As a hypothetical example, currently we can defer taxes on capital gains until we sell the asset. Suppose the tax law changed so that we could no longer defer realizing capital gains? Every year we had to mark-to-market and pay that year's capital gains. As a longtime buy-and-hold investor, I know I would have to sell something to pay my tax bill that first year!

While usually the feds are reasonable about their tax changes, sometimes a minority gets bitten. I can easily see congress planning to pass two bills, REPEAL and REPLACE. The REPEAL bill causes tax issues they plan to fix in the REPLACE bill, but then for some reason the REPLACE bill gets delayed, so people getting ACA subsidies get bitten. I'm not saying it is the most likely scenario, nor that anyone would want it, just that it is a believable scenario.

 

[Youngster]

get catastrophic coverage - like I posted earlier, the purpose of health insurance isn't to provide inexpensive healthcare, it's to indemnify an unexpected loss

Agreed. I would gladly pay a low premium for a catastrophic plan. Problem is that I am currently paying what I consider a high premium of around $350.00 for a $5,000 deductible.

 

[photoguy]

How can an individual who is in the beginning stage of early retirement, who doesn’t have access to retiree based or other health insurance coverage, with relatively low living expenses and MAGI (modified adjusted gross income), and potentially high health care costs (previous cancer diagnosis), manage his/her financial and investment affairs to maximize benefits and minimize costs as a health care consumer with Trump/Republican likely changes to the system.

Personally, I think trying to minimize costs is not the right strategy with all of the uncertainty. I would try to maintain flexibility and just the basic ability to obtain insurance.

For someone with low expenses and MAGI -- I don't think there's much actionable other than retain flexibility in living location (be willing to move states and/or zip codes within a state), build up taxable reserves (in case healthcare costs more), maintain continuous coverage, and don't undergo any financial transactions that are difficult to reverse.

 

[donheff]

I think it had to do with amounts the Government would pay for health services.

Certainly insurance companies make money on Medicare, they offer many plans, but they did not want to be part of the ACA. The ACA was severely flawed, and that needs to be changed. Even Medicaid patients have issues finding doctors.

I hope they add an additional payroll tax to help it, and stay away from any income tax increases. It would be funded more like medicare, which seems to work. Then offer Medicare to everyone in the USA. I suspect that any new plan would be closer to Medicare,

Under the ACA marketplace plans the government does not set rates -- the insurance companies negotiate them with the providers. For Medicare/Medicaid the government does negotiate the rates. But the Medicare supplements are, once again, handled by the insurance companies, not single government payer like Medicare.

 

[Senator]

I'm going to wait and see how the dust settles on this.

I predict, that it will not be as bad as the doom and gloom here predict...

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.

No politician is going to sacrifice votes to make a change most people do not want.

I would suspect this.

Healthcare will get cheaper, not more expensive. The new administration will make sure of that. Can you imagine their fate if it got worse?

Whether the cost is deferred, or paid through another means, it's hard to tell. It may be a payroll tax, made more efficient, or paid with printing money. There may be asset tests for subsidies, or not, like medicare.

It's hard to tell at this point, but it will be at least a year out.

 

[Big_Hitter]

I predict, that it will not be as bad as the doom and gloom here predict...

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.

without the 3 to 1 rule, it will get much more expensive for early retirees - remember the actual cost for a 60 year old is something like 5 to 8 times the cost of a 25 year old

so I'm looking forward to a productive 2017 on the j*b....

 

[MichaelB]

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.

WADR, bankruptcy or not paying may be fine for some people to deal with this, but they don't apply to a community where the goal is financial independence.

 

[W2R]

I predict, that it will not be as bad as the doom and gloom here predict...

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.

No politician is going to sacrifice votes to make a change most people do not want.

I would suspect this.

Healthcare will get cheaper, not more expensive. The new administration will make sure of that. Can you imagine their fate if it got worse?

Whether the cost is deferred, or paid through another means, it's hard to tell. It may be a payroll tax, made more efficient, or paid with printing money. There may be asset tests for subsidies, or not, like medicare.

It's hard to tell at this point, but it will be at least a year out.

Senator, I agree completely. What's more, there is just no benefit in worrying about the results of hypothetical legislation that hasn't even been articulated, much less proposed, much less passed.

Listening to dire predictions right now of what could happen with our health care system, is a parallel to listening to Nouriel Roubini about the stock market - - huge doses of doom and gloom, doom and gloom, and it really isn't very helpful to any of us to focus on that two days after the election. I think it's much more helpful to take a deep breath and wait for some facts to emerge before trying to figure out how to deal with said facts.

 

[travelover]

$9K a year? what gender/age band?

This is the total cost divided by the number of citizens. From 2012: Health Costs: How the U.S. Compares With Other Countries | PBS NewsHour

 

[audreyh1]

I predict, that it will not be as bad as the doom and gloom here predict...

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.

No politician is going to sacrifice votes to make a change most people do not want.

I would suspect this.

Healthcare will get cheaper, not more expensive. The new administration will make sure of that. Can you imagine their fate if it got worse?

Whether the cost is deferred, or paid through another means, it's hard to tell. It may be a payroll tax, made more efficient, or paid with printing money. There may be asset tests for subsidies, or not, like medicare.

It's hard to tell at this point, but it will be at least a year out.

I don't have your faith in the politicians because if they believe the negatives affect a small enough group, they won't worry about those votes. The millions affected by ACA is still a small number compared to the rest of the population and that makes us very vulnerable.

 

[Senator]

WADR, bankruptcy or not paying may be fine for some people to deal with this, but they don't apply to a community where the goal is financial independence.

I think if the choice is a cancer treatment, or being financially independent, all bets are off.

 

[Senator]

without the 3 to 1 rule, it will get much more expensive for early retirees - remember the actual cost for a 60 year old is something like 5 to 8 times the cost of a 25 year old

so I'm looking forward to a productive 2017 on the j*b....

It depends on how much the '1' costs, whether or not it will be more expensive.

If you mean policies will be put in place to encourage people to continue to work, and pay more taxes to run the country and to provide for the less fortunate, that could happen.

I predict, when looking back, the changes we have not yet seen will be a welcome relief.

 

[Big_Hitter]

The actual costs are more like 5 to 1 for males so the revised costs for early male retirees may only double

 

[Big_Hitter]

It depends on how much the '1' costs, whether or not it will be more expensive.

the "1" costs what the "1" costs; it's independent of health plans/coverage; I'm talking gross eligible charges here

going to be an interesting (and busy) year no doubt

 

[MichaelB]

Listening to dire predictions right now of what could happen with our health care system, is a parallel to listening to Nouriel Roubini about the stock market - - huge doses of doom and gloom, doom and gloom, and it really isn't very helpful to any of us to focus on that two days after the election. I think it's much more helpful to take a deep breath and wait for some facts to emerge before trying to figure out how to deal with said facts.

I agree with this.

 

[daylatedollarshort]

Why would they do that? To reduce sales? If they can cover their costs and make a reasonable return on required capital then they will be happy... premiums will ultimately get to that level if there is sufficient competition.

Speaker Ryan's proposal would cap premiums at 5x, compared to the current 3x. IOW, age-rated premiums for the oldest could only be 5x the premiums for the youngest.

To cherry pick having only younger, healthy people on their plans like they did pre-ACA. I've been down this road before. We had a lot of delay tactics, lost paperwork, lies, unreturned calls, the form is in the mail, etc. from the insurance companies to try to keep us from using the HIPAA laws to get coverage, even really expensive coverage, just a few years back. People with pre-existing conditions, even minor ones or medically controllable ones had trouble getting coverage at any price pre-ACA and had to worry about rescission once they had it. Friends of ours gave up and went back to work, when ironically both their health issues were ones that are usually considered stress related.

Repeal the ACA without a viable replacement plan in place and that is the logical assumption for me of what I would have to deal with again. 5X our current premiums and no subsidies would put our premiums alone at $2.5K a month with a possible $12.5K out of pocket + maybe some out of network or medical travel costs and we're back to a potential $50K a year for healthcare again if we stay in the U.S. We can afford that to Medicare age but it might make more financial sense to move outside the U.S. and do something like buy a condo with that money instead and get much less expensive or free healthcare elsewhere due to dual citizenship.

 

[photoguy]

What's more, there is just no benefit in worrying about the results of hypothetical legislation that hasn't even been articulated, much less proposed, much less passed.

I've never been a worrier and logically I agree with this especially since there's nothing really actionable right now for me. Still I've got this nagging feeling in the back of mind that I can't quite push away... I guess it's time to do a few more long hikes and get out and shoot a bit more.

 

[W2R]

I've never been a worrier and logically I agree with this especially since there's nothing really actionable right now for me. Still I've got this nagging feeling in the back of mind that I can't quite push away... I guess it's time to do a few more long hikes and get out and shoot a bit more.

Exercise is great for lowing anxiety levels.

 

[Big_Hitter]

Exercise is great for lowing anxiety levels.

so is stasis

 

[John Galt III]

Quote:
Originally Posted by Senator
I predict, that it will not be as bad as the doom and gloom here predict...

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.


-----------------------------

I have been bumping my annual income up each year to get above the $16,xxx minimum to avoid medicaid, which I would qualify for under Obamacare, since there is no asset test now.

But if they get rid of Ocare, will they also bring back the asset test for Medicaid? I'm in Pa. Then I'd be hosed. Can't find any answers to this question, even on the Pa state medicaid website, other than the fact that applying for straight Medicaid through that website does have an asset test.

 

[nico08]

sounds like a good idea. thank you. i thought it would be more complicated than that.

get catastrophic coverage - like I posted earlier, the purpose of health insurance isn't to provide inexpensive healthcare, it's to indemnify an unexpected loss