Patient Protection and Affordable Care Act

[FinanceDude]

It will help certain groups of people. It WILL raise premiums substantially for all. As long as the taxpayers as a group are ok with that, there will be no major upswell to undo any of it.

If anyone can SHOW me how this lowers the national debt or spending I am all ears.........

 

[ziggy29]

A "hospital only" policy would not meet the requirements because it presumably would not include "first collar" coverage of preventative care which is to be mandatory as of 1/1/2014.

 

[Mulligan]

If your premiums now are large group with employer subsidy or individual with underwriting, it may be painful. OTOH if your premiums are small group unsubsidized they will not likely increase due to the PPACA.

I locked in my individual HI plan before the act went into effect. Since my policy is not under its domain, I assume that this ruling has little effect concerning my future premiums?

 

[pb4uski]

I locked in my individual HI plan before the act went into effect. Since my policy is not under its domain, I assume that this ruling has little effect concerning my future premiums?

Sounds like wishful thinking to me. I think the reality will be that almost all health insurance premiums will go up and I hope I am totally wrong.

 

[MichaelB]

It will help certain groups of people. It WILL raise premiums substantially for all. As long as the taxpayers as a group are ok with that, there will be no major upswell to undo any of it.

If anyone can SHOW me how this lowers the national debt or spending I am all ears.........

If you have any hard data or analysis to support the conclusion that all premiums will rise I would appreciate a link. So far I haven't seen any, and have looked.

Regarding your other point, let's keep the thread focused on health care.

 

[FinanceDude]

If you have any hard data or analysis to support the conclusion that all premiums will rise I would appreciate a link. So far I haven't seen any, and have looked.

Regarding your other point, let's keep the thread focused on health care.

I don't see how this ruling will make for better health care in the US. Young people, who are for the most part healthy, would no doubt rather pay a 1% penalty (tax) if they make $30,000 a year, let's say, than pay $250 a month for healthcare. So, the pool of healthy people will shrink, and the pool of unhealthy people will rise dramatically. If you have fewer people paying in overall, the cost burden will fall on fewer people, and costs will rise. That's simple logic.

It WILL help uninsured people get coverage. One could argue they already get covered at literally every ER in the country, as noone is refused medical help, but that's another issue. It will help folks who want to retire early like those on this forum, because it removes the gap between ER and Medicare eligibility. The SCOTUS has ruled this is a TAX, so I am calling it so.........

 

[Mulligan]

Sounds like wishful thinking to me. I think the reality will be that almost all health insurance premiums will go up and I hope I am totally wrong.

I have been fortunate that my premium has not went up in the 2 years I have had it. I played around with a link from a previous poster. I looked at current individual plans and saw that each plan had a rejection rate of 35% - 51% in my state. I also noticed the premium quotes are over double what I am paying for the same plan that was bought prior to the passage of the healthcare act. No wonder my insurance is so relatively cheap in my state as the companies are rejecting a high percentage of applicants.

 

[ziggy29]

No wonder my insurance is so relatively cheap in my state as the companies are rejecting a high percentage of applicants.

Hope they enjoy their last 18 months of being allowed to do so...

The Obamacare term once had a distinct negative connotation but it has been used so much to refer to the PPACA that it is now commonplace. I no longer think of it being improper any more than using the term Xerox for copying or Kleenex for tissue....

This.

 

[Midpack]

If you have any hard data or analysis to support the conclusion that all premiums will rise I would appreciate a link. So far I haven't seen any, and have looked.

A big part of the problem is no one seems to have much in the way of hard facts, at least that I can find/comprehend. I wish I could find any reassurance that premiums won't increase significantly.

It was asked earlier, but how will PPACA prevent free-riders among people who can (well) afford to pay for health insurance, given guaranteed issue? I've read that state(s) have gotten into this fix already, MA among them? The penalties are small relative to current premiums, which will give employers and individuals an incentive to pay penalties until they need HI, then enroll. And then drop coverage and resume penalties again. Does GI enable this?

I've tried to answer my own question via Google, but come up mostly empty so far. FWIW Game On! How guaranteed issue coverage and PPACA will cause employers and individuals to cancel their coverage, and join the ranks of the uninsured. - I don't know anything about this organization, but I've read about the potential issue from other sources.

 

[ziggy29]

It was asked earlier, but how will PPACA prevent free-riders among people who can (well) afford to pay for health insurance, given guaranteed issue? I've read that state(s) have gotten into this fix already, MA among them? The penalties are small relative to current premiums, which will give employers and individuals an incentive to pay penalties until they need HI, then enroll. And then drop coverage and resume penalties again. Does GI enable this?

I've long said that if there is a penalty for "going naked", it should be (at minimum) equal to the cost of the lowest-priced qualifying policy available. That would eliminate all incentive to do without.

I have heard that Massachusetts is (or was) having a problem in that (a) more low-income people were rushing to sign up than they anticipated and (b) the penalties weren't enough to stop the young and healthy from "paying the penalty" instead of buying insurance.

 

[Mulligan]

A big part of the problem is no one seems to have much in the way of hard facts, at least that I can find/comprehend.

It was asked earlier, but how will PPACA prevent free-riders among people who can (well) afford to pay for health insurance, given guaranteed issue? I've read that state(s) have gotten into this fix already, MA among them? I've tried to answer my own question via Google, but come up mostly empty so far. FWIW Game On! How guaranteed issue coverage and PPACA will cause employers and individuals to cancel their coverage, and join the ranks of the uninsured. - I don't know anything about this organization, but I've read about the potential issue from other sources.

I guess I am an exception to the rule. Looking at the link, my premium cost is actually cheaper than paying the penalty of 1% coming soon and obviously less than the future 2% penalty for not buying it. So I would currently have no incentive to pay the penalty and forgo insurance.

 

[Midpack]

Scares me, note #3, 6 & 7...

There has been a lot in the national press about how health care reform in Massachusetts has worked.* There's a lot of blather on both sides of the political spectrum, and the Boston Globe*had a comprehensive article today reviewing how “RomneyCare” is working here.*

Conclusions:

1) Far more people are insured than before health care reform, despite the disastrous recession (98.1%)
2) More employers (up from 70 to 76%) are offering insurance, again despite the recession
3) The exchanges work for individuals - they haven't worked well for small employers yet
4) The cost of the care of the uninsured has declined.
5) There is inadequate primary care access, and ED visits have gone up rather than down.
6) The cost has been manageable - but the state has relied on some payments from the feds (stimulus dollars and Medicaid add-on dollars) that will not continue. The federal government has paid a disproportionate share of the total cost (as it will under the Affordable Care Act).
7) Health care reform promised incremental provider Medicaid payments that have not been funded. Hospitals say they must pass these costs on to other payers, which worries employers greatly.
8) Health care reform is actually pretty popular in Massachusetts.* The last Harvard School of Public Health poll said that 63% of residents support health care reform.*

 

[huusom]

Or, if you have the money for COBRA, many folks can start a countdown to July 2012, 18 months out from the implementation of most provisions of the act -- T-minus three days....

I would love to but I like add a little more to my 401K before I pull the switch.

 

[ziggy29]

I guess I am an exception to the rule. Looking at the link, my premium cost is actually cheaper than paying the penalty of 1% coming soon and obviously less than the future 2% penalty for not buying it. So I would currently have no incentive to pay the penalty and forgo insurance.

Are you referring to the full, unsubsidized cost of this insurance or just your portion under cost-sharing? For example, I pay a little more than 20% of the full unsubsidized cost of my policy. That comes to about 1.5% of my income. But if I look at the unsubsidized cost, it would be closer to 7%.

 

[pb4uski]

Agree ziggy. My health insurance premiums today are much higher than the penalty would be.

Perhaps I should plan to game the system and drop health insurance on 1/1/2014, pay the penalty and then buy guaranteed issued insurance if I have a health event. I think the way it works that I would only be screwed if I had such an immediate health event that I couldn't get the time to buy the insurance (like a heart attack requiring immediate surgery).

 

[M Paquette]

Sounds like wishful thinking to me. I think the reality will be that almost all health insurance premiums will go up and I hope I am totally wrong.

I'm pretty sure my premiums will go up. Of course, before the ACA existed, I was pretty sure my premiums would go up. I budgeted for a medical inflation rate twice the broader consumer inflation rate.

I'd also bet that if the ACA were repealed, that my insurance rates would go up. Funny how that works. R-squared = 0...

 

[Mulligan]

Are you referring to the full, unsubsidized cost of this insurance or just your portion under cost-sharing? For example, I pay a little more than 20% of the full unsubsidized cost of my policy. That comes to about 1.5% of my income. But if I look at the unsubsidized cost, it would be closer to 7%.

My plan is unsubsidized individual plan through Anthem. I pay $72 a month for a $5500 deductible no copay after deductible. When I take my $3100 HSA deduction, my insurance policy makes me a couple hundred bucks profit each year. I am 48. I certainly cant complain about current costs. So I guess currently the cost is 0.8% of my current income, and less than zero after HSA deduction. I certainly feel myself fortunate.

 

[easysurfer]

The Obamacare term once had a distinct negative connotation but it has been used so much to refer to the PPACA that it is now commonplace. I no longer think of it being improper any more than using the term Xerox for copying or Kleenex for tissue....

I could play around with the term Obamacare and call it something else, but that would start the sound of bacon sizzling, so I better not.

As for the law itself, right now I have a high deductible HSA, with only a $5 Million lifetime limit. Should my health situation change in the future, it's nice to know that I have other options without a lifetime limit cap.

Got some relatives with pre-exisitng conditions that would make it difficult to get insurance as it is today. So 2014 is a year to look forward to for them.

 

[pb4uski]

$72 a month with a $5500 deductible for a 48 yo is amazingly good. I pay over $550/month for self and DW with a $10k deductible - and consider myself lucky.

 

[ziggy29]

I could play around with the term Obamacare and call it something else, but that would start the sound of bacon sizzling, so I better not.

Mmmm.... bacon. The thing is, I suspect a *lot* more people know what "Obamacare" is than what the "PPACA" is. That in itself shows the usefulness of the term, whether originally used pejoratively or not.

As for the law itself, right now I have a high deductible HSA, with only a $5 Million lifetime limit. Should my health situation change in the future, it's nice to know that I have other options without a lifetime limit cap.

My Megacorp plan eliminated the $5 million cap about three years ago even before [-]Obamac[/-] PPACA was passed into law.

 

[Mulligan]

$72 a month with a $5500 deductible for a 48 yo is amazingly good. I pay over $550/month for self and DW with a $10k deductible - and consider myself lucky.

Since you are paying for 2 that isn't so bad I agree if you are getting a nice tax break from an HSA and avoiding deductible expenses. Stay healthy my friend!

 

[rodi]

I'm pretty sure my premiums will go up. Of course, before the ACA existed, I was pretty sure my premiums would go up. I budgeted for a medical inflation rate twice the broader consumer inflation rate.

I'd also bet that if the ACA were repealed, that my insurance rates would go up. Funny how that works. R-squared = 0...

This. I have tracked the insurance cost changes through the year - both the subsidizes rates (employee portion) and the full rates (cobra rates). Not only has full health care rates gone up consistently at a 10% rate/year since before PPACA, The portion paid by the employee, at my megacorp, has also gone up. From 20% paid by employee to now 40%. So it's been doubly painful.

The only good news is that I'm getting used to paying a larger percentage of my health insurance - which means it will hurt less, budget wise, when I finally say goodby to the megacorp.

 

[Midpack]

I guess I am an exception to the rule. Looking at the link, my premium cost is actually cheaper than paying the penalty of 1% coming soon and obviously less than the future 2% penalty for not buying it. So I would currently have no incentive to pay the penalty and forgo insurance.

Congrats on your extreme wealth, using income as the measure. If your HI costs $7,000/yr (which is dirt cheap from what I've seen), your income would have to be more than $700,000/yr (at 1% penalty in 2014) for the "premium cost is actually cheaper." I must be missing something...

My plan is unsubsidized individual plan through Anthem. I pay $72 a month for a $5500 deductible no copay after deductible. When I take my $3100 HSA deduction, my insurance policy makes me a couple hundred bucks profit each year. I am 48. I certainly cant complain about current costs. So I guess currently the cost is 0.8% of my current income, and less than zero after HSA deduction. I certainly feel myself fortunate.

That's $864/yr. Anthem quoted DW (age 56) and I (57) $500-600 month for a high deductible plan and we're in relatively excellent health. Let's just say your plan is unheard of for an unsubsidized policy and leave it at that.

 

[samclem]

My plan is unsubsidized individual plan through Anthem. I pay $72 a month for a $5500 deductible no copay after deductible. When I take my $3100 HSA deduction, my insurance policy makes me a couple hundred bucks profit each year. I am 48. I certainly cant complain about current costs. So I guess currently the cost is 0.8% of my current income, and less than zero after HSA deduction. I certainly feel myself fortunate.

Your policy does not meet the requirements of the new law (I think your deductible is too high, your cap is too low, and you'd need to check to assure it includes all the required "preventative" services mandated by the legislation.) Anyway, when your insurance company raises your rates in order to include the new bells and whistles, the "good news" is that you'll be among those who save money by dropping your insurance and just paying the tax. Of course, you wouldn't have insurance then. But you can buy it the day you need it.

 

[Mulligan]

Congrats on your extreme wealth, using income as the measure. If your HI costs $7,000/yr (which is dirt cheap from what I've seen), your income would have to be more than $700,000/yr (at 1% penalty in 2014) for the "premium cost is actually cheaper." I must be missing something...

I wish! I doubt I will ever have $700k in assets before I die let alone income! You missed a follow up post, Midpack. My premium is only $72 a month for a $5500 individual plan deductible through Anthem. $7 million max lifetime.