ACA longevity

[GenXguy]

The individual mandate is gone which was the most contentious piece

The individual mandate is actually still there, but the penalty was reduced to $0 as I noted in my earlier post. And in fact, that was the basis for the ACA lawsuit that made its way to the Supreme Court.

 

[ShokWaveRider]

We cannot tell if it will go or stay, we can only speculate based on history.

What we know is part of the powers that be want ACA gone for reasons unknown, as well as a proposal being floated for Medicare and SS to be phased out in 5 years (In my opinion a very long shot). If the powers that be get a Super Majority or even a significant Majority in 2024, then ACA will be terminated with no replacement, allowing the Insurance Companies to take over, I am sure of that.

As far a Medicare and SS are concerned, it would be political suicide to phase them out.

Bottom line, we were lucky, DW retired when the first year of ACA came into play, we planned it that way. We did not need the ACA at the time, but it sure made the decision easier. She probably would have kept working to keep our healthcare.

In 2024 DW will be 65 so no more ACA. So frankly it will not affect us, but even the fact that proposals are being floated to phase out SS and Medicare SHOULD be a concern for all Seniors, even though it is a long shot. Unfortunately, one does not hear a lot about it on social media, so it will probably be ignored.

 

[FLSUnFIRE]

The individual mandate is actually still there, but the penalty was reduced to $0 as I noted in my earlier post. And in fact, that was the basis for the ACA lawsuit that made its way to the Supreme Court.

I would say at this point it effectively resolved regardless of my choice of words. There is no fine now, people are used to it being that way and they feel entitled so it would be political suicide to get away from it.



I could see some medical omnibus combining/consolidating ACA/Medicare/Medicaid at some point but not anytime soon as it would take bi/non-partisan leadership and support and most the current politicians are too busy trying to make us all hate each other to do anything productive.

 

[scrabbler1]

I ERed in late 2008, so I had to suffer through 5 years of HI before the exchanges were born in 2014. In those 5 years, I saw rate increases of 50% (overall in 2010 and 2011) before I ditched that policy for a bare-bones, hospital-only policy which got me through the end of 2013. Thankfully, I remained healthy in those 5 years.

When the exchanges were born in 2014, I was able to return to a broader policy like the one I had in 2009 through mid-2011. Even with only a small premium subsidy, I was still paying less than what I was paying in 2009 before the big rate increases. Good thing I had this decent policy when I got sick in 2015 and spent 12 fays in the hospital.

I was near the subsidy cliff until I went over it in 2017. Not a big deal because the subsidy was small. That is, until the forgone subsidy began rising a lot, along with the unsubsidized premium. After 3 years (2017-2019) of paying a pretty high, unsubsidized premium, I changed my portfolio to reduce my income and get back on the subsidy train in 2020. Now I am nowhere near the cliff. The ARP boosted my subsidy a bit more, but if that additional amount were to disappear I wouldn't be upset.

I am 59 now, so I'll be on the ACA for another 6 years. I surely don't want to see it disappear and send me back to those days of 2009-2013 where I either paid a lot (and faced big increases) or was underinsured. The latter is not an option any more due to my health issues which require 2 expensive drugs, mostly covered by my current ACA insurance.

 

[rodi]

I really hope nothing messes with guaranteed access to healthcare - regardless of pre-existsing conditions. DH is on medicare, I've got 4+ years till I go on Medicare... but we have college age kids on our plan. One has a pre-existing condition that prior to ACA would have pushed him onto the super expensive high risk pool insurance. He's actually ending ACA coverage starting 9/1/22 because his employer union is finally kicking in insurance after 18 months of part time work. He can't continue on subsidized ACA insurance if his employer offers affordable insurance. He's dreading finding new docs and specialists.

 

[MichaelB]

There is still a pretty big political divide over ACA so I don't think I would bank on it sticking around. I hope it does but you never know. I personally would be comfortable with 5 years but not 10. I think there is 0 chance it is eliminated before 2025 but could easily see it going away in that year and phased out over 2-3 years.

Engaging in political speculation is pointless IMHO, and it's also even more inaccurate than economic forecasting, and we all know how bad that gets. Predicting the demise of the ACA has become a regular thing, much like predicting the next recession or a stock market crash. It also brings politics into a thread discussion, which we all know is not a good thing.

To remind everyone, the ACA is not one thing, it’s a number of measures. Two have already been mentioned in this thread, subsidy assistance for health insurance and guaranteed access to coverage. A third element also impacts us which is the essential health benefits. In effect, it makes sure the coverage is comprehensive.

These three aspects of the ACA are very popular and also well integrated into our health care system. Changing them is not easy and is increasingly more difficult as time passes, as more people learn to work with them.

 

[GenXguy]

The Medicaid Expansion is also part of the ACA. Expect the worst, and you won't be disappointed.

 

[jim584672]

I don't see the point of worrying about something that may or may not happen. If it happens you make adjustments and move on with life.

 

[GenXguy]

I don't see the point of worrying about something that may or may not happen. If it happens you make adjustments and move on with life.

I found one way to deal with the uncertainty is to keep working.

 

[jim584672]

I found one way to deal with the uncertainty is to keep working.

I think you will keep finding new reasons to OMY. At some point you got to jump out the plane.

 

[FLSUnFIRE]

I found one way to deal with the uncertainty is to keep working.

That would certainly guarantee something!



Heath insurance is so regulated that even your employer sponsored plan is at the whim of politicians so you may as well just retire! IMO we will eventually go to a single payer system (not advocating but think it will eventually happen -maybe in 5 years, maybe in 30) and that will blow up the "private" market too (certainly will be supplemental plans but big changes). I actually think ACA probably delayed the likely move to single payer as it has alleviated some issues with access and excessive premiums that would be used to sell single payer.

 

[MichealKnight]

In a tribalistic population - anything is possible - and time and again people can be manipulated to blindly support things against their own interests. HOWEVER....... those in power who might seek to repeal ACA many times, if you look at the individual states - well, those shouting 'repeal' will have a million + constituents who rely on ACA. My hope.... is that this becomes just another dog-whistle issue that the carnival barkers say they want to repeal but really don't.

 

[ShokWaveRider]

In a tribalistic population - anything is possible - and time and again people can be manipulated to blindly support things against their own interests. HOWEVER....... those in power who might seek to repeal ACA many times, if you look at the individual states - well, those shouting 'repeal' will have a million + constituents who rely on ACA. My hope.... is that this becomes just another dog-whistle issue that the carnival barkers say they want to repeal but really don't.

Ha Ha, since when have the powers that be put their constituents needs and wishes over that of their doners? I.e. Big Pharma, Insurance companies etc.

 

[ivinsfan]

We cannot tell if it will go or stay, we can only speculate based on history.

What we know is part of the powers that be want ACA gone for reasons unknown, as well as a proposal being floated for Medicare and SS to be phased out in 5 years (In my opinion a very long shot). If the powers that be get a Super Majority or even a significant Majority in 2024, then ACA will be terminated with no replacement, allowing the Insurance Companies to take over, I am sure of that.

As far a Medicare and SS are concerned, it would be political suicide to phase them out.

Bottom line, we were lucky, DW retired when the first year of ACA came into play, we planned it that way. We did not need the ACA at the time, but it sure made the decision easier. She probably would have kept working to keep our healthcare.

In 2024 DW will be 65 so no more ACA. So frankly it will not affect us, but even the fact that proposals are being floated to phase out SS and Medicare SHOULD be a concern for all Seniors, even though it is a long shot. Unfortunately, one does not hear a lot about it on social media, so it will probably be ignored.

Could you point at any type of plan from any major party or group that wants to phase out Medicare and SS in 5 years? I'm talking about something concrete that isn't some lone wolf shooting off at the mouth....I'll wait....


A link would be best...

 

[MichealKnight]

True

Powers that be serve 'others' many times. Just look at those generous college administrators, professors, faculties -- extolling "fairness" - yet keeping the gates to professional lives....under a very pricey and exclusive lock and key. Plenty of greed and agendas to go around.

On ACA - I just wonder how in a 50-50 tribal entity (not a nation-state anymore)....how a Governor or Senator who needs to squeeze just 1-2% of the vote to win - will do so by trying to take something from a million of his constituents. Actually - I predict that in the long term, the very locales that object to the ACA most -- WILL be the ones who INSIST on more Medicare for All - albeit under a different name.

My hope is that the longer ACA stays, the more it's just normalized - a la Social Security.

Disclosure: I have an ACA gold plan. I do get some subsidy (I used to be against that, but now I figure - I used to pay tons of taxes and well, try this way for awhile). If subsidies go away - ok I'll take a few less trips. It's the overall accessibility I personally rely on.

With a side concern: I hope ACA plans pay providers and hospitals well. I don't want it to be where the "good" providers don't take it. We're about to have a serious health thing (spine surgery) with 14 yo DD....and thus far I"m thankful that the hospitals of choice take the insurance.

 

[ShokWaveRider]

Could you point at any type of plan from any major party or group that wants to phase out Medicare and SS in 5 years? I'm talking about something concrete that isn't some lone wolf shooting off at the mouth....I'll wait.... A link would be best...

Not without getting political. Google it.

 

[ivinsfan]

Not without getting political. Google it.

You believe what you want to believe.. Your statements about eliminating SS and Medicare are not accurate. Luckily most of us reading here are aware enough to realize that.

 

[ShokWaveRider]

You believe what you want to believe.. Your statements about eliminating SS and Medicare are not accurate. Luckily most of us reading here are aware enough to realize that.

You are over reacting little, all I said is that there were plans to phase it out if some get their way. I also said it would be political suicide. Not that is was cast in concrete or that it would get anywhere.

 

[ivinsfan]

Powers that be serve 'others' many times. Just look at those generous college administrators, professors, faculties -- extolling "fairness" - yet keeping the gates to professional lives....under a very pricey and exclusive lock and key. Plenty of greed and agendas to go around.

On ACA - I just wonder how in a 50-50 tribal entity (not a nation-state anymore)....how a Governor or Senator who needs to squeeze just 1-2% of the vote to win - will do so by trying to take something from a million of his constituents. Actually - I predict that in the long term, the very locales that object to the ACA most -- WILL be the ones who INSIST on more Medicare for All - albeit under a different name.

My hope is that the longer ACA stays, the more it's just normalized - a la Social Security.

Disclosure: I have an ACA gold plan. I do get some subsidy (I used to be against that, but now I figure - I used to pay tons of taxes and well, try this way for awhile). If subsidies go away - ok I'll take a few less trips. It's the overall accessibility I personally rely on.

With a side concern: I hope ACA plans pay providers and hospitals well. I don't want it to be where the "good" providers don't take it. We're about to have a serious health thing (spine surgery) with 14 yo DD....and thus far I"m thankful that the hospitals of choice take the insurance.

Best wishes for your DD and a good outcome for her and your family MK.


Your point about paying providers is a good one and something that certainly could happen.

 

[SecondAttempt]

Engaging in political speculation is pointless IMHO, and it's also even more inaccurate than economic forecasting, and we all know how bad that gets. Predicting the demise of the ACA has become a regular thing, much like predicting the next recession or a stock market crash. It also brings politics into a thread discussion, which we all know is not a good thing.

To remind everyone, the ACA is not one thing, it’s a number of measures. Two have already been mentioned in this thread, subsidy assistance for health insurance and guaranteed access to coverage. A third element also impacts us which is the essential health benefits. In effect, it makes sure the coverage is comprehensive.

These three aspects of the ACA are very popular and also well integrated into our health care system. Changing them is not easy and is increasingly more difficult as time passes, as more people learn to work with them.

I understand that political speculation is frowned upon here and I agree it is largely pointless.

But if your early retirement plan relies on ACA guaranteed access to healthcare and/or subsidies then I think you must assess the odds to make decisions and that requires some level of political speculation. In my case I never intended to rely on ACA but I was pleasantly surprised to find out I would likely get a pretty big subsidy in the years when I am withdrawing from taxable accounts. The OP asked for advice about the likely longevity of ACA. I think this is a legitimate retirement question that requires the political speculation of others. The OP can then make their own judgement about what may happen.

 

[EastWest Gal]

I don't see the point of worrying about something that may or may not happen. If it happens you make adjustments and move on with life.

A rather passive attitude is expressed here. Health care systems don’t just “happen.”

The only reason I went back to employed status, as opposed to working as an independent contractor is health insurance, the 100% jump in premiums between 2016 and 2017, and the near demise of the ACA in early 2017. The only adjustment I could make was to go back to w**king. Or moving to another country, which I actively investigated. And try to influence politics and elected officials.

Systems like the ACA, Medicare, and Social Security are not things that just “happen.” They are choices that our elected representatives make. The mishmash of health insurance, and private physicians and hospitals that choose not to accept certain plans, and the high costs of drugs in this country are all choices that have evolved over the years. Social Security was legislated into existence in 1935 and Medicare and Medicaid in 1965. A national health insurance system was proposed by Truman in 1945 but did not pass. Most developed countries developed national health care systems in the 20th century, many right after WWII.

Things that “happen” are things like illness, earthquakes, snowstorms, drought, and asteroids. Those are the things we need to prepare for and adjust to as they happen.

 

[jim584672]

A rather passive attitude is expressed here. Health care systems don’t just “happen.”

The only reason I went back to employed status, as opposed to working as an independent contractor is health insurance, the 100% jump in premiums between 2016 and 2017, and the near demise of the ACA in early 2017. The only adjustment I could make was to go back to w**king. Or moving to another country, which I actively investigated. And try to influence politics and elected officials.

Systems like the ACA, Medicare, and Social Security are not things that just “happen.” They are choices that our elected representatives make. The mishmash of health insurance, and private physicians and hospitals that choose not to accept certain plans, and the high costs of drugs in this country are all choices that have evolved over the years. Social Security was legislated into existence in 1935 and Medicare and Medicaid in 1965. A national health insurance system was proposed by Truman in 1945 but did not pass. Most developed countries developed national health care systems in the 20th century, many right after WWII.

Things that “happen” are things like illness, earthquakes, snowstorms, drought, and asteroids. Those are the things we need to prepare for and adjust to as they happen.

I said something may or may not happen (ACA goes away), not health systems just happen. I can't control it (the ACA goes away) so have a Plan B and move on with life.

I lived through the whole 2017/2018 repeal attempt nail biter too. That sucked.

I don't see how anyone can forecast the future winds of US politics, seems pointless to even speculate. The thread is just inviting politics talk here which is dangerous.

 

[Aerides]

Could you point at any type of plan from any major party or group that wants to phase out Medicare and SS in 5 years? I'm talking about something concrete that isn't some lone wolf shooting off at the mouth....I'll wait....
A link would be best...

You are correct it is lone wolf musing campaign rhetoric and not viable. There are many places you can find far more serious quotes directly contradicting this...position.

It's silly talk. And in threads about the ACA that are always already political and argumentative, it's just pot stirring.

 

[GenXguy]

That would certainly guarantee something!

Heath insurance is so regulated that even your employer sponsored plan is at the whim of politicians so you may as well just retire.

I'm not worried about that at all. And I certainly wouldn't retire now just because of a the chance something could change in 30 years. I plan to retire within a couple years, and I think it is extremely unlikely I would lose my health insurance through work in that time frame due to any political whims. So, I have to disagree with that suggestion. Plus, as long as I keep working, I'm building up my savings further and delaying the draw down, which will help compensate some for soaring inflation.

 

[explanade]

Every year it survives, the better the odds it sticks around longer. I am more confident that it will be here for the long haul now than I was when I retired, and I still have 12 years to go before medicare. No candidate has mentioned repealing it again, I don't expect to see them try, it's just too popular.

When they tried to repeal it in 2018, there were polls showing that it would be an unpopular move.

Big donors told certain Senators to vote it out or don't call them any more.

So a small number of donors pushed for repeal.

Certain states passed Medicaid expansion in ballot measures. The politicians in charge of those states refuse to implement it. But they're being re-elected despite their refusal of the ballot measure.