insurance advice with pre-existing condition after election

[Global1]

The election and the Republican promise of ACA repeal leaves me with some questions.

Situation - my DW has a pre-existing condition (cancer). I retired 10/2015 and have been on cobra which I can extend until 4/2017.

If nothing changed then my plan was to change to ACA insurance at the end of this year (even though it is more expensive than the cobra plan). By doing this I was going to avoid paying 2017 deductible for the cobra plan through April then having to pay 2017 deductible again if with a new ACA plan which would start in 5/2017.

Republicans have promised that repeal of ACA will be one of the first things on the agenda when Trump is in office. My assumption is that this would eliminate my ability to get insurance given the pre-existing condition. So here are my options:

1. Keep to my original plan - Move to ACA plan at the end of this year and hope that they will grandfather those of us who are already on an ACA plan. The problem with this is that I don't want my coverage eliminated mid-year and have to scramble to find a job to get insurance coverage.

2. Keep the Cobra Plan until 4/2017 and then switch in 5/17. It allows me to keep coverage for as long as possible with no fear of losing coverage. Then I either get a job to get insurance or assume that there will be either an alternative Republican plan that covers pre-existing conditions or that they do not repeal ACA by this time.

3. Go back to work immediately to get health insurance - Since I am relatively FI I hate this idea but I worry that it may be the best option given my situation.

Which option is best? Are there other options that I am missing? It seems to me that in any scenario I will end up having to go back into the work force in the end to get health coverage. "Just when I thought I was out, they pull me back in"

Please let me know your thoughts.

Global1

 

[2017ish]

I would lock in a plan for the entire 2017 year, thereby buying time. [once purchased, the odds are exceedingly low that you will be terminated mid-policy year.]

We plan similar approach. Switch to DW's yucky work plan over my very attractive work plan for the 7 months we plan to work in 2017. Her's is COBRA eligible, while mine is not. While not a great plan, that guarantees one option for all of '17 and '18, while the dust settles.

(The election had no impact on our analysis, as no matter what the results, ACA was in for a major overhaul ....)

--Brackets added to flesh thought out---

 

[bamsphd]

Remember that not all individual policies are sold through the health exchanges. While I had planned to buy another (no subsidy) policy during open enrollment through healthcare.gov, I'm currently seriously considering buying a 2017 off-exchange policy instead. Doing so would cost more, but I think it would increase my odds of being able to "keep my policy" in 2018 and beyond.

 

[Aerides]

I would be extremely surprised by any repeal that negated coverage in 2017. Then again, I've already been extremely surprised once in the past 24 hours.

There are so many millions of people on ACA that "repeal and replace" doesn't make much sense unless you put Replace first. I'm on severance coverage thru 8/2017, then cobra, so I have a little more time to wait and see.

 

[Global1]

Thanks bamsphd - I did apply for individual insurance at the end of last year to avoid cobra. Unfortunately, I was declined by 2 insurers due to the pre-existing condition. I assume that I would have the same problem this year. I believe that my only option is ACA. Yes?

 

[euro]

I would go with option 1. While the promise was that this would be an early agenda item for the Trump administration, I don't see a realistic possibility that anything will happen in the first half of next year. Even if something does get initiated, the process will take A LOT of time, despite an all-republican cast (Trump just got elected POTUS, not dictator, and congress will make sure he understands that - even if they are from the same party).
Finally, even with a repeal (and a lot of question about what "replace" actually means), there will be grandfathered policies and extended transition timelines. It's not feasible, even after a resounding verdict at the ballot box, to just kick 20 million people to the curb without any options.

 

[exnavynuke]

While I strongly expect that the ACA will be repealed to some extent early in the next Congressional session, I don't expect that any legislation changes would impact existing policies, and certainly not cancel them entirely.

 

[Senator]

You worry too much. There will not be a pre-existing exclusion implemented. That genie is already out of the bottle.

 

[Global1]

You worry too much.

With dealing with my DW's condition and, at least, the prospect of repeal without a definitive replacement I feel entitled to worry a little bit. Believe me I would rather be on the sidelines but I am right in the middle of the game!

 

[Senator]

With dealing with my DW's condition and, at least, the prospect of repeal without a definitive replacement I feel entitled to worry a little bit. Believe me I would rather be on the sidelines but I am right in the middle of the game!

Worse case, you do it like you would have 10 years ago.

Get a medical bill, and make payments. With some plans and deductibles that I have heard, even a $1,000 per month payment would be cheaper than insurance under ACA.

No one goes, or went to jail, for not paying. Everyone was taken care of, one way or another. That will continue to be the case.

 

[jim584672]

I would be uninsurable at any reasonable price due to pre existing conditions. This situation is very unsettling.

 

[fh2000]

3. Go back to work immediately to get health insurance - Since I am relatively FI I hate this idea but I worry that it may be the best option given my situation.


Global1

DW (55) and I (60) have planned for our RE for few years. Now, it appears that we will need to stay on OMY until a new health plan is revealed. This is an uncertain time for many of us.

 

[euro]

With dealing with my DW's condition and, at least, the prospect of repeal without a definitive replacement I feel entitled to worry a little bit. Believe me I would rather be on the sidelines but I am right in the middle of the game!

I hear you - we all have a lot to worry about until we know how this situation unfolds - read some international news sources. There is significant concern/panic about MANY items, not just healthcare. We have taken a huge risk yesterday, but there is always a possibility that it will work out ok in the end. It is what it is now, so we have to make the best of it

 

[Dash man]

Calm down and wait to see what the changes are. Nothing will likely take affect until 2018 at the earliest.

 

[Global1]

I am calm, just trying to get some perspective given my situation. I appreciate all of the feedback!

Senator, wouldn't that strategy risk being sued at some point if my bills became extraordinarily large? I'm not sure that I'd like to risk my nestegg.

 

[MichaelB]

Which option is best? Are there other options that I am missing? It seems to me that in any scenario I will end up having to go back into the work force in the end to get health coverage. "Just when I thought I was out, they pull me back in"

This is the question the OP is asking and looking for advice. Please, no more elections or partisan comments.

 

[growing_older]

I am similarly uninsurable, so I have had to stay employed and likely will need to continue to do so until this is settled or I reach Medicare age.

 

[Senator]

I am calm, just trying to get some perspective given my situation. I appreciate all of the feedback!

Senator, wouldn't that strategy risk being sued at some point if my bills became extraordinarily large? I'm not sure that I'd like to risk my nestegg.

No, you just negotiate a payment plan. Or declare bankruptcy. I understand you do not want to risk your nest egg, no one does. (skip political banter).

No one was ever denied healthcare pre ACA, or during ACA, and no one will after ACA. It may look different. It may cost different. It may be more complex, or more simple. Maybe we will all be able to get on the federal healthcare plan.

Rest assured, there are more important things to worry about, like preparing for zombies..

 

[GrayHare]

IMO it's not politically possible to yank health coverage, even of those with pre-existing conditions, once someone has had such coverage. At this point I'd be most concerned if I were one of the people who decided to take the penalty hit rather than become insured. The only specific I've heard was Pence talking about eliminating the state exchanges and replacing them with a single national one.

 

[Another Reader]

I don't think anyone will commit political suicide by pulling plans mid-year. Something has to be substituted in a minimally disruptive way. I can see a gradual elimination of the mandated exchanges and some sort of pooled risk plans for the previously uninsurable.

 

[MichaelB]

There is a thread here for a more general discussion on healthcare insurance. Once again, please limit comments here to the OP specific issue.

 

[bamsphd]

Thanks bamsphd - I did apply for individual insurance at the end of last year to avoid cobra. Unfortunately, I was declined by 2 insurers due to the pre-existing condition. I assume that I would have the same problem this year. I believe that my only option is ACA. Yes?

You applied for INDIVIDUAL insurance in the USA and were declined because of a pre-existing condition? I am not a lawyer, but I think that is illegal under the PPACA which for the moment is still the law of the land.

Of the nongroup and small group market reforms effective in 2014, the following apply both inside and outside of exchanges:

Eligibility for health insurance coverage may not be based on health factors

from page 3 of http://www.ncsl.org/documents/health/Inside_vs_OutsideExchange.pdf

 

[gauss]

I am calm, just trying to get some perspective given my situation. I appreciate all of the feedback!

Senator, wouldn't that strategy risk being sued at some point if my bills became extraordinarily large? I'm not sure that I'd like to risk my nestegg.

Is your nestegg in 401k accounts that are governed by ERISA? If so then they are likely off limits to nearly all creditors (under current Federal law). An Asset Protection attorney could give you further details.

-gauss

 

[gauss]

You applied for INDIVIDUAL insurance in the USA and were declined because of a pre-existing condition? I am not a lawyer, but I think that is illegal under the PPACA which for the moment is still the law of the land.

Perhaps ACA individual policies are required to be issued only if you don't have access to employer sponsored health insurance (such as Cobra)?

Would need to research this further to verify if this is the case.

-gauss

 

[audreyh1]

You worry too much. There will not be a pre-existing exclusion implemented. That genie is already out of the bottle.

I wish I were so sanguine. If you read Ryan's work, he likes to treat people with pre-existing conditions as a separate class from "healthy" people for health insurance purposes. Treating them all the same (and thus spreading the risk) doesn't make sense to him as it means "healthy" people pay more for insurance.