Who is worrying about ACA going away???

[ut2sua]

I am still working and having MC's HI, so I have not bought HI thru the exchange etc.
I am, however, a bit worried about the possibility of the ACA going away. Pre-existing conditions, kids getting covered under parents' HI until 26 among other things. It could be a big set back to many's FIRE plan. For me, it opens an uncertainty door where I may need to deal with getting HI as an individual. For those who are about to FIRE, and those who are already FIRE'd, what is your thought? Am I thinking down the wrong path here?

 

[pj.mask]

I’m worried about the potential changes - pre-existing conditions.. but also worried that with the current system insurance is so complex there doesn’t seems to be an easy to understand way to buy it. (Recent dentist operation is bouncing between health and dental coverage each pointing to the other).

I honestly hope we can move to a basic universal system and I don’t think we will get there if we keep Obama care. I think we will need an amplifying wave to reach that. (Repeal, dissatisfaction, move towards universal)

Insurance is the biggest wildcard on my ability to early retire.

 

[pb4uski]

DW went on Medicare in March and I'm in November, so if it does happen then it won't impact us. I'm hopeful that ACA will be upheld by SCOTUS. If it is found unconstitutional, I suspect that denial of coverage for pre-existing conditions will be prohibited and that children can remain on your policy until 26 since both of those are popular.

Denial of coverage for pre-existing conditions might be predicated on continuous coverage... coverage for at least 6 of the last 12 months... and I'd be ok with that as it would be a check on people waiting until they are sick to buy health insurance. IOW, if you are a responsible citizen and keep yourself insured then you don't have to worry about medical underwriting even if you have to switch to ACA... but if you're trying to game the system then you might be subject to pre-existing conditions.

 

[Sarah S]

ACA helped people on medicare too. If I understand correctly the part D donut hole will expand again and preventive services will be subject to deductibles and coinsurance. It won’t be nearly as catastrophic as for those who rely on ACA but it will affect those on Medicare ( and those with employer insurance- remember copays for physicals? Deductibles for mammograms and colonoscopies?)

I am extremely worried. I rely on ACA. Selfishly I hope to limp through until Medicare next summer

 

[Morgan22]

I'm worried. It will hurt the healthcare system where I w*rk. And it will possibly delay my retirement depending on what, if anything, replaces it.

 

[Buckeye]

I am thankful I get my healthcare from the VA. Otherwise, I'd be very concerned. DH is already on Medicare, thankfully.

 

[daylatedollarshort]

I'm pretty sure in California the governor and legislature will at least ban pre-existing condition clauses and we have enough to pay for full coverage if we need to until Medicare.

I do worry about our adult kids keeping affordable coverage if they ever had a disability or job lapse. It seems very real that the ACA could be overturned in a relatively short period of time and with no replacement plan in sight. Our experience with retiring before the ACA and trying to keep individual coverage in force with COBRA and COBRA continuation coverage was a super expensive nightmare. We were thinking about leaving the country until Medicare age if the ACA had not come along. Our medical costs the year before the ACA, with one expensive surgery, were $50K for the year, between premiums, out of network costs, deductibles, etc.

Pre-ACA, DH had come back from a trip to Europe with a real estate ad of really nice villas in Spain where we could live the whole year on $50K or maybe a bit more for all our expenses, instead of paying that for healthcare alone in the U.S.

 

[Boose]

I'm very concerned since I'll be retiring on the cusp of my 50s. But husband will use VA (disability rating) and I'll be on his COBRA for as long as possible. We also have money, unlike a lot of Millennials and Gen Zers. I'm hoping younger voters get as PO'd as I am.

 

[ocean view]

I agree with Daylatedollarshort that CA will continue to offer coverage through the state marketplace. I’m not so sure, however, that the state can afford to pick up the Federal share of the subsidies.

 

[DenverGuy42]

Colorado checking in here.

There are four states that have enshrined in law many of the ACA protections. Colorado has

o guaranteed health insurance coverage for pre-existing conditions - https://www.colorado.gov/pacific/do...age-pre-existing-conditions-part-colorado-law

o community based pricing (not individual based), so pre-existing would not affect your rate versus others in your community

o guaranteed issuance

o limits on how much older people can be charge versus younger

and they instituted a statewide plan to provide a fund for "the really sick, those that use insurance the most" in order to lower the rates for the rest of the people.

https://www.colorado.gov/pacific/do...se-premiums-individual-health-insurance-plans

Massachusetts, New York and Virginia do similar (but not exactly the same) for pre-existing conditions.

zero chance I'll be leaving here as long as the ACA is under attack.

 

[ShokWaveRider]

Me! I still find it difficult to believe it will go away just like that, with no replacement.

 

[daylatedollarshort]

I agree with Daylatedollarshort that CA will continue to offer coverage through the state marketplace. I’m not so sure, however, that the state can afford to pick up the Federal share of the subsidies.

Just to clarify, by "we" I meant DH and I have enough to pay for coverage, not the state. If the ACA goes away I expect the subsidies would end as well. For us at our ages that would be something like $25K a year in premiums and a $14K OOP max, so $40K exposure. But now we are closer to Medicare age and it would not be for too many years we would have to pay for that amount out of pocket, unless Medicare benefits get lowered / premiums increased as well at some point down the line.

 

[Dtail]

I am concerned about it being overturned. I believe the Supreme Court will overturn it now.
I do believe any substitute plan will protect pre existing conditions. However as many others here do, my brother and I get 11k in tax subsidies each and any substitute might not cover the managing of income aspect. Yeah I know many of you pay full freight, nevertheless...
We need the coverage for 4 more years.
There could end up being a Medicare coverage concept from 60 y.o. onward.

So a separate question is if it is overturned, does it revert to pre Obamacare rules with a pre existing exception and how would the coverage work for next year?

 

[ut2sua]

I am concerned about it being overturned. I believe the Supreme Court will overturn it now.
I do believe any substitute plan will protect pre existing conditions. However as many others here do, my brother and I get 11k in tax subsidies each and any substitute might not cover the managing of income aspect. Yeah I know many of you pay full freight, nevertheless...
We need the coverage for 4 more years.
There could end up being a Medicare coverage concept from 60 y.o. onward.

So a separate question is if it is overturned, does it revert to pre Obamacare rules with a pre existing exception and how would the coverage work for next year?

My concern is the SC can strike down the ACA (as was asked for by the plaintiffs in Texas vs California). And that is it. The ACA would be going away with no substitution since the SC can't make/modify new/existing law. Unless the 2021 Congress, the 2021 Senate and the 2021 President can agree to a new law, there will not be one. I am concern for the xx millions of recently laid off folks/families who won't have HI without a job (+ the xx millions of families currently having ACA who will lose the HI coverage).

 

[cyber888]

I'm worried .. If the new S.C. nominee gets the S.C. seat and the S.C. completely eliminates ACA, that's 39 Million without healthcare during the time of Covid19 .. what's the alternative ? I still have a job, but I could imagine the chaos for millions.

 

[scrabbler1]

After being off the ACA subsidy train for the last 3 years and having to pay the entire premium including 10%+ increases, I finally got back on that train this year after adjusting the stock portion of my portfolio. It would really suck to see those subsidies go away and back to the pre-2014 world of individual policies here in New York. In 2010 and 2011, I saw increases of 20% and 25% before I dumped that policy. The ACA has been a godsend, especially after I got diagnosed with diabetes in 2015 and spent 12 days in the hospital for it and another unrelated ailment which got fixed.


I am still 8 years away from Medicare age, which is better than 17 years when I got onto the exchanges, it's still a long way away.

 

[Ian S]

Another feature of the ACA that would disappear is the maximum permitted ratio of premium cost for older folks vs younger folks. Insurers will be forced to compete for healthy younger folks and thus charge older sicker people far more than permitted under ACA. I'm skeptical that a few bandaids like protections against coverage for people with pre-existing conditions would do all that much to prevent the health insurance/healthcare segment of the economy from imploding.

We're lucky I guess: as I'm a dual citizen, we could move to a country that provides universal healthcare. We certainly don't want to but it would be a backstop if an untenable situation evolves.

 

[pb4uski]

Colorado checking in here.

There are four states that have enshrined in law many of the ACA protections. Colorado has

o guaranteed health insurance coverage for pre-existing conditions - https://www.colorado.gov/pacific/do...age-pre-existing-conditions-part-colorado-law

o community based pricing (not individual based), so pre-existing would not affect your rate versus others in your community

o guaranteed issuance

o limits on how much older people can be charge versus younger

and they instituted a statewide plan to provide a fund for "the really sick, those that use insurance the most" in order to lower the rates for the rest of the people.

https://www.colorado.gov/pacific/do...se-premiums-individual-health-insurance-plans

Massachusetts, New York and Virginia do similar (but not exactly the same) for pre-existing conditions.

zero chance I'll be leaving here as long as the ACA is under attack.

Vermont was one of the first states to ban medical underwriting and require community rating/prohibit age rating... even pre-ACA, individual health insurance was essentially similar to large group insurance.

 

[easysurfer]

Concerned. But really have to wait and see how the chips fall .

 

[DenverGuy42]

Vermont was one of the first states to ban medical underwriting and require community rating/prohibit age rating... even pre-ACA, individual health insurance was essentially similar to large group insurance.

yeah, I should have said "there are at least four" instead of "there are four".

 

[MRG]

I am concerned about it being overturned. I believe the Supreme Court will overturn it now.
I do believe any substitute plan will protect pre existing conditions. However as many others here do, my brother and I get 11k in tax subsidies each and any substitute might not cover the managing of income aspect. Yeah I know many of you pay full freight, nevertheless...
We need the coverage for 4 more years.
There could end up being a Medicare coverage concept from 60 y.o. onward.

So a separate question is if it is overturned, does it revert to pre Obamacare rules with a pre existing exception and how would the coverage work for next year?

On the "if it's overturned?" My belief is it's going to take a little time. Even if it's the law of the land there's no ACA, systems have to be changed. Either automated computer systems or internal processes. How soon? I don't know. I'm fortunate I only have another 17 months. I'm hopeful nobody will ever go through this again.

 

[camfused]

I would like to know what happens the day after it might get overturned. I would like to think that the subsidies would stop, but the policies would be good until the end of 2021 (maybe congress/senate would step in and force this to be so).

DW is retiring at the end of this year. We can either go with ACA or COBRA. I would like to go with ACA, but will it survive? COBRA is $1000 more per month than ACA. So, yeah, we are worried too. It's a roll of the dice.

I would also like to think that there will be some sort of replacement if ACA goes away.

 

[SecondCor521]

I am not worried.

I doubt the SC will issue a broad ruling finding the entire ACA unconstitutional. I recognize that in this political season there are people on both ends of the spectrum saying that, but I honestly think that is both sides trying to score political points. A broad ruling would be extremely unpopular and disruptive. I think a narrower ruling is therefore more likely. They tend to like narrower rulings anyway most of the time.

To the degree that the SC finds parts of the law unconstitutional, I think that what happens is those parts of the law are just null and void, and we'd be left with the way it was before. There are a million outcomes where different combinations of the law that remain would form various kinds of patchworks. The Texas lawsuit claims generally I think that the various parts of the ACA are not severable and that the whole thing must therefore be thrown out whole cloth. I really think that is a stretch legally speaking (but IANAL) and won't happen.

I'm 51, and the health insurance landscape has changed several times over my life time. In every case, I was able to have a solution that worked for me. So I think it is likely that if the landscape changes again - whether it be large or small - there will be a solution that works for me.

 

[rodi]

< mod hat on >
Hot topic was enabled because this is a topic that has a tendency to stray into partisan politics... But it's also a very important topic for early retirement. Please keep this thread going by refraining from politics.
< /mod hat >

For me, I am worried. That worry is mitigated a bit since I live in California. I'm pretty sure California would put laws in place to handle some of the guarantees provided by the ACA. I'm not positive, though. Pre ACA California's high risk pool program was pretty awful. You had to be denied coverage to qualify for some expensive, far from cadillac insurance. Hopefully, if ACA is eliminated, CA will do something similar to the ACA - even if it's without the subsidies.

DH is on medicare... but I have 6 more years and kids are 17 and 19... So health insurance is a big deal issue in our house.

 

[mountainsoft]

If the ACA were to go away, we would probably have to postpone retirement for a few more years. We're still three years away, so hopefully this will all be settled one way or the other before we jump for good.