Healthcare insurance and retirement - again!

[kevink]

I'd be interested in hearing from anyone else whose situation is at all similar to mine. My wife and I are frugal ER's living solely off of savings and have alternated between a highly-subsidized silver plan in years that bump our MAGI up above 138% of FPL and Medicaid.

Our experience in both Colorado, where we lived for a couple of years, and (especially!) in Arizona where we are now is that Medicaid, at least for childless adults like us, is essentially hospital-only coverage, since docs that take Medicaid are hard to find and the huge increase in the number of eligible patients hasn't been accompanied by any meaningful increase in funding for new providers.

It also seems pretty clear from what I'm reading that Medicaid expansion will be one of the first things elimiated under Trump and they can do it by reconciliation and just giving the states block grants.

Any thoughts on the lay of the land going forward appreciated!

 

[Major Tom]

I'd be interested in hearing from anyone else whose situation is at all similar to mine. My wife and I are frugal ER's living solely off of savings and have alternated between a highly-subsidized silver plan in years that bump our MAGI up above 138% of FPL and Medicaid.

Our experience in both Colorado, where we lived for a couple of years, and (especially!) in Arizona where we are now is that Medicaid, at least for childless adults like us, is essentially hospital-only coverage, since docs that take Medicaid are hard to find and the huge increase in the number of eligible patients hasn't been accompanied by any meaningful increase in funding for new providers.

It also seems pretty clear from what I'm reading that Medicaid expansion will be one of the first things elimiated under Trump and they can do it by reconciliation and just giving the states block grants.

Any thoughts on the lay of the land going forward appreciated!

I'm on Medi-Cal, which is what we call Medicaid in California, and I'm on it because of the Medicaid expansion under the ACA. In my county (Alameda county), a lot of the care seems to be clinic based. I lucked out and chose a clinic with brand new, airy facilities, and staff that I like. Although it typically takes 3 or 4 weeks to get an appointment, if it's a more pressing issue they will see me within a few days. If it's more pressing than that, they have an urgent care facility I can visit on a walk-in basis. If it's an emergency, then I can visit any ER. The system works well for me, and I'm happy with it.

If the medicaid expansion is rolled back, I'm assuming I'll go back to a county-based system for low income folk similar to what was in place before the ACA took effect. That system worked OK for me too, though I don't think the coverage was as extensive. If that happens, I'll be using the very same clinic.

 

[John Galt III]

Kevink, I'm in a similar situation, in Pa. I don't know how good or bad life is here on Medicaid, but I've heard good stories and bad stories about Medicaid in general. Some people here on the board say they are on Medicaid and love it, but I don't think they are in Pa. I have been afraid of Medicaid, so I have bumped my income up each year with Roth IRA conversions to qualify for a subsidized Silver ACA plan. You mentioned that you think the expanded Medicaid will be withdrawn by the next administration. I am worried about that also. Currently I do qualify for Medicaid if I want it, since there is no ASSET TEST currently. I am wondering if in 2017 Medicaid will be returned to the pre ACA state (which I would not qualify for due to assets) I can't find any info on this, not even from the Pa Medicaid website. Lots of talk about "block granting Medicaid to the states" but no one says what effect that has on eligibility, if any. I suppose it's possible for states to keep the "expanded" Medicaid, with no asset test, in place if they choose to. But it might cost the states a lot of state taxpayer money to do so. I am getting some long-postponed blood tests done now while I still have my silver ACA HMO!

 

[John Galt III]

Major Tom, was there an asset test for that county program?

 

[Teacher Terry]

At one point my DH had catastrophic insurance and it did not cover his cancer coming back. Since they have tried to repeal the ACA 50 times already I don't see any reason to doubt that will be what they do. I think that people that retired early had a reasonable expectation that the coverage would remain. After being laid-off at the age of 53 my DH has found it really hard to work. He has had some consulting projects and a p.t. engineering job for about a year.

 

[Suppertime]

However, for those of us that are newly retired or contemplating retirement we do need to consider if our plans will / should / may change.

I'm in this boat. Quitting at year end, currently shopping for ACA insurance. I will have to maintain contacts and groundwork to go back to work if necessary, gives me about a year max to experiment with retirement. Another option is to move to a country with socialized medicine. We'd love to live in Vancouver but housing is too expensive. Cheaper areas in British Columbia are an option I'm keeping in my back pocket. Most likely course is to try to stay healthy, maybe get catastrophic insurance until Medicare mercifully kicks in.

Links shared on this thread have been helpful, it appears we'll have at least 1 year of ACA as we transition out. Also, posters who've share their experiences in the pre-ACA insurance world.

As for speculating being useless, some things we know for certain. We've been told non-stop for 5 years ACA will be repealed. If there is guaranteed issue, you have to have an individual mandate and subsidies. If you get rid of the individual mandate or subsidies, you cannot have guaranteed issue.

 

[bamsphd]

I'm trying to figure out the safest choice available at a reasonable cost for this open enrollment period. This is what I have reasoned out so far, your situation may certainly vary. I appreciate suggestions to make it safer or cheaper which do not require defaulting on debts, going back to work, or assuming a government always acts reasonably.

Background: I'm class of 2013, retired in NH when Cobra would bridge to ACA after the Supreme Court upheld it. I would have retired earlier but the only insurer in my state issuing individual policies back then declined to issue me a policy. Wife and I are currently on an HSA compatible healthcare.gov policy but are not getting a subsidy. I've been doing partial Roth conversions and capturing 0% capital gains instead of trying to manage income below 400% of poverty. I'm still 10 years from Medicare under current rules. Younger wife was insurable pre-ACA and probably still is, but is also more than 20 years from Medicare. For the rest of this post I'm ignoring possible changes to Medicare.

Had I enrolled last week, I would have selected another HSA compatible family policy from either Anthem or Harvard Pilgrim via healthcare.gov. Now I'm assuming that some unknown portion of the PPACA will be repealed in 2017, and that some unknown provisions will be enacted as replacements. I'm basically trying to hedge my risks without panic spending.

My price checking indicates Anthem and Harvard Pilgrim have very different approaches to on/off exchange policies. As far as I can tell so far, Harvard Pilgrim is offering all their on-exchange policies off the exchange at the exact same price.

Anthem offers First Class policies off-exchange, and Steerage policies on-exchange in NH. We used their Silver HSA ACA offering the first year. Apparently Anthem's ACA policies squeeze providers on price (not all bad for an HSA policy), has a narrower network for ACA policies, and automates interactions with their ACA customers in cases where off-exchange policy holders would talk with a human.

So far based on which networks include my doctors, HSA compatibility, and cost I've narrowed my choices to these policies:

Provider	Metal	Annual Premium (Best Case)	Premium + OOPM (Worst Case)	on/off exchange?
Anthem	Bronze	$9,390.00	$22,490.00	on
Harvard Pilgrim	Bronze	$9,414.72	$22,314.72	both
Harvard Pilgrim	Silver	$10,820.64	$20,820.64	both
Anthem	Bronze	$12,867.96	$25,867.96	off

I can not guarantee what if any pre-existing condition protection will exist in the future. However, probably the weakest form of pre-existing condition protection is a requirement that insurers let sick people renew their policies. So I am inclined to follow the advice

“I would advise people who are sick to get good coverage now and hang onto it,” said Jost.

from Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile | Kaiser Health News

As I wrote in post 33 of http://www.early-retirement.org/forums/f38/healthcare-insurance-and-retirement-again-84072-2.html#post1798671

By definition, if the healthcare.gov exchange goes away exchange policies go away. So there is no possibility people with exchange policies can be grandfathered on their existing policy.

Unless the market crashes I don't expect to want a subsidy in 2017. While I am certainly willing to buy through healthcare.gov doing so is at best a minor advantage. Thus it seems safest to purchase an off-exchange policy.

Provider	Metal	Annual Premium (Best Case)	Premium + OOPM (Worst Case)	on/off exchange?
Harvard Pilgrim	Bronze	$9,414.72	$22,314.72	both
Harvard Pilgrim	Silver	$10,820.64	$20,820.64	both
Anthem	Bronze	$12,867.96	$25,867.96	off

Harvard Pilgrim did not write individual coverage in NH prior to the ACA. Anthem was NH's only individual market insurer and turned me down prior to the ACA. I am more confident that Anthem will continue to write individual policies in NH than I am about Harvard Pilgrim. I'm particularly sensitive to that because my current 2016 insurer withdrew and will not be writing any policies in NH for 2017. However, the point of buying an off-exchange policy is that I might be stuck with it for a long time. I wouldn't have FIRED if I didn't avoid recurring charges, so paying an extra $3,453.24/year for a bronze Anthem policy is just too expensive. I believe I'll be cheap and pick a Harvard Pilgrim policy.

Provider	Metal	Annual Premium (Best Case)	Premium + OOPM (Worst Case)	on/off exchange?
Harvard Pilgrim	Bronze	$9,414.72	$22,314.72	both
Harvard Pilgrim	Silver	$10,820.64	$20,820.64	both

The prices in the table above are for a family policy covering both of us. However, at least from Harvard Pilgrim, the cost of two individual policies for 2017 is exactly the same as one family policy. To preserve flexibility getting two individual policies seems like the risk free choice. Before the PPACA shopping for better rates was a great way to save money if and only if you were healthy. I also don't know if my wife could stay on a family policy if I died or enrolled in Medicare. So maintaining flexibility for free seems the obvious choice.

I have not found one offered in NH for 2017, but I wish I could select a PPO policy with a nationwide provider network. My current insurance company (formerly Maine) Community Health Providers offered such policies, but decided to withdraw from the NH market for financial reasons. Maine Community Health Providers was one of the coops created by the PPACA. I wonder what will happen to the coops when/if the PPACA is repealed.

 

[socca]

I wouldn't assume that off-exchange policies are less likely to be cancelled than on-exchange policies. Insurance companies are not charities - when they perceive that canceling an off-exchange policy is in their own best financial interest, they will not hesitate to do so if permitted by law. That said, given a choice between an otherwise identical on-exchange or off-exchange policy, I would go with the off-exchange policy to insulate myself from the immediate consequences of an attempt to dismantle the exchange.

 

[NW-Bound]

Insurers have canceled individual plans both on and off the exchange, some just for some states, and some across the nation. So, there is no guarantee with an off-exchange policy either.

 

[Katsmeow]

I noticed something today that says it is not just a matter of the ACA. Apparently, Ryan indicated today that the ACA repeal would also include changes to Medicare. I assume that those reforms would be something close to what was proposed in 2015. I am 2 1/2 years away from Medicare and DH is already on Medicare.

The reforms at the time included the following (there are others but these are the main ones I was interested in from a financial standpoint):

1. Starting in 2024, would raise Medicare age by 2 months per year until reaching 67 in 2035. -- This doesn't apply to me but note that if ACA is repealed this may make people who are between 65 and 67 unable to obtain insurance unless they have employer insurance.

2. Increasing income-based premiums by freezing the income threshholds (they now rise each year based upon inflation) until 25% of beneficiaries are subject to income related premiums. -- This is going to cause a lot of people to pay a lot more.

3. Most importantly - Converting medicare from a guarantee of health coverage to a flat premium support payment. With that you would get $X and could buy coverage (sort of like on the exchanges now). People over 55 could retain traditional Medicare. But there is a huge catch. The premium support might not be enough to cover the cost of traditional Medicare. -- This is what is really problematical. The premium support is based upon the average bid for Medicare coverage in the region. It is likely that the insurance policies offered on the Medicare exchange would primarily be narrow network plans much like exchange policies now. Traditional Medicare would be more expensive. Much like PPO plans it would tend to attract people with health problems who want more options to see doctors. As a result, its premiums would likely far exceed that of the premium support so people would have to pay more. Also, as time went on it would get more and more expensive since new people wouldn't be coming into it. A classic death spiral would result.


4. Greater cost sharing - Higher deductible and potentially a percentage cost sharing with no upper limit that could not be covered by a supplemental policy. - The higher deductible would be a hardship for some but probably not a deal breaker for me. Having to pay a percentage cost sharing that couldn't be gotten rid of through a supplemental policy and which had no stop loss on it would be very anxiety producing.

I am actually working on my future budget right now trying to model vastly more expensive Medicare coverage. I would lean to buying traditional Medicare as long as I could afford it.

Bear in mind -- this was what was in Ryan's 2015 budget. What is proposed now might be more expensive - it might start immediately for example and the premium support might be less and traditional Medicare might not be an option for anyone not on it, etc.

Here is an article that analyzed the 2015 proposal:

Medicare in Ryan's 2015 Budget | Center on Budget and Policy Priorities

 

[zinger1457]

I can not guarantee what if any pre-existing condition protection will exist in the future. However, probably the weakest form of pre-existing condition protection is a requirement that insurers let sick people renew their policies. So I am inclined to follow the advice from Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile | Kaiser Health News

I'm also of the belief that it will take time to make any changes to ACA and so I'll continue on as planned for 2017 and wait for the changes to come. One problem with the requirement that insurers renew policies for those with pre-existing conditions is what happens if the insurer stops offering policies in your area. I've had to switch to a different insurer each of the last four years because the insurer I had decided to no longer offer policies in my area. I've gone thru Aetna, BCBS, and United Healthcare. Now I have to switch back to BCBS for 2017.

 

[NW-Bound]

I noticed something today that says it is not just a matter of the ACA. Apparently, Ryan indicated today that the ACA repeal would also include changes to Medicare...

When we fail to control healthcare cost, it is not surprising that it would happen. People think that "outsourcing" healthcare to the government is the solution, but even the government eventually runs out of money.

When can we as a nation really define and address the causes, instead of keep looking for somebody else to foot the bill? Can we have the Chinese finance this, like they allowing the US to run a trade deficit? There's nobody else but ourselves as a nation to pay for our own bills.

 

[Texas Proud]

OMG.... 11 pages in a couple of days (if that).... I have not read all comments and might never be able to... but, I will throw this in which might have already been stated...


I saw a Repub pollster on TV today saying that they might have a plan that fixes the ACA, but it will have enough language in it so the Repubs can say they 'repealed' Obamacare without really repealing it...


I saw a small talk with the CEO (I think) of Aetna and he was talking about extending Medicare to younger people... he said that those plans are 80% liked and do a great job... that they actually work with the members to have a good outcome and they are paid more if needed... extending it to 55 or even 50 would fix a good amount of the problem...

He also said that 80% ish of people do not like their insurance... wow....

 

[Katsmeow]

I saw a small talk with the CEO (I think) of Aetna and he was talking about extending Medicare to younger people... he said that those plans are 80% liked and do a great job... that they actually work with the members to have a good outcome and they are paid more if needed... extending it to 55 or even 50 would fix a good amount of the problem...

He also said that 80% ish of people do not like their insurance... wow....

And, see my post a couple of posts before you. It seems like the Medicare proposal from the Ryan 2015 budget (which is apparently going to be part of the ACA repeal according to him today) seems to extend to Medicare the worst parts of ACA. Cheap plans with narrow networks that are paid for through premium support. Traditional Medicare available only for those over 55 but likely costing much more (which the individual has to pay the difference) leading to a death spiral and premium problem (much like that which caused most insurers to take PPOs off the exchange).

NW-Bound - Not responding to your response to my post since I don't want to derail this thread by anything which gets into politics.

 

[NW-Bound]

We all know that cost is growing out of hand. I truly do not understand why getting people to recognize the importance of cost control is politics! Why is cost control partisanship? So far, nobody has done anything in this area as I can tell. We do not even know where the money goes.

But that's OK. I will stop.

 

[daylatedollarshort]

Having to pay a percentage cost sharing that couldn't be gotten rid of through a supplemental policy and which had no stop loss on it would be very anxiety producing.

Excellent post, katsmeow. I agree with you on the Medicare changes. It's a long term concern for retirement budgeting.

 

[Mulligan]

As is your speculation that pre existing condition will be covered in whatever replaces Obama Care.

I recall when DS graduated from college in 2007, without a job immediately, we insisted and paid for a "catastrophic" policy for him to make sure that in the event of an accident or serious illness, that the Bank of Mom and Dad would not be on the hook. As I recall, that policy was good for nothing other then the catastrophic scenario, which of course (luckily) did not happen. The premium was around $250 a month covered no office visits, no medications, labs or ER visits and certainly no pre-existing conditions until the extremely high deductible had been met.

At the time that the ACA was enacted I remember a lot of grumbling from folks that the plan that they loved had gone away as they weren't compliant. They all wanted those plans back. But those plans didn't cover anything. I remember Obama trying to explain that point in his pitches to the American public.


Sent from my iPad using Early Retirement Forum

My experience was different Golden. I had a 5k deductible, robust network, $7 million maximum policy limit coverage for $85 a month. 22 months later I am $329 (going to $369 in 2 months) with $6500 deductible, narrow network, and no out of network coverage.
For me anyway, if they changed nothing but allowed health insurance premiums to be tax deductible as the president elect has often stated as a goal, that would cut my premium 31%. And if they increased HSA deduction limit, I would think I was back in tall cotton!

 

[samclem]

1. Starting in 2024, would raise Medicare age by 2 months per year until reaching 67 in 2035. -- This doesn't apply to me but note that if ACA is repealed this may make people who are between 65 and 67 unable to obtain insurance unless they have employer insurance.

Please be realistic, you're just "awfulizing" here. Is it remotely possible that Medicare eligibility age would be pushed back but the insurance programs that covered younger people wouldn't have concomitant higher eligibility ages? Answer: no.

2. Increasing income-based premiums by freezing the income threshholds (they now rise each year based upon inflation) until 25% of beneficiaries are subject to income related premiums. -- This is going to cause a lot of people to pay a lot more.

Unstated assumptions: There will be no effective control on health care/insurance costs (through competition, etc), that costs passed on to taxpayers due to escalating ACA subsidies wouldn't also be "people paying a lot more."

I am actually working on my future budget right now trying to model vastly more expensive Medicare coverage. I would lean to buying traditional Medicare as long as I could afford it.

Bear in mind -- this was what was in Ryan's 2015 budget. What is proposed now might be more expensive - it might start immediately for example and the premium support might be less and traditional Medicare might not be an option for anyone not on it, etc.

It's going to take years to make and implement significant changes. If I were in your boots, I'd probably wait to at least see what is actually proposed before crunching personal budget numbers. Remember how many times the ACA changed as the sausage was made? Sure, keep up to date with the state of play, but lets not get worked up about an old plan that >everyone< knew would not be signed into law. Proposals get a lot more serious when there's a chance that they might be implemented. And, after the folks in DC just saw what happened to some of their compatriots, I think/hope they'll be very focused on taking the time to build something that works this time.

Does it matter if its called "repeal and replace" or if the present ACA is very extensively modified? Either way, it's going to have some significantly different attributes if it is going to work. And it is clear that the ACA was going to >need< significantly different attributes >anyway<. Does anybody think the thing that we've got now is okay and could realistically go even one more year without a stem-to-stern overhaul?

 

[Major Tom]

Major Tom, was there an asset test for that county program?

No there wasn't. It was one of my concerns at the time, and I couldn't find out by doing the research online. As I was signing up, I had to ask several people before getting even a partial satisfactory answer, which was along the lines of, "We don't ask about your assets". Being a little paranoid, and also the kind of person who wants to do the right thing, I was concerned that might mean that technically, that might have meant they didn't want to offer it to people with assets, but didn't have the resources/collective willpower to apply an effective test. Alternatively, it might have meant it was fine to be on the program with significant assets (though low income).

I never did find a definitive answer but I was very upfront about my assets, providing tax returns, and details of all my accounts during the application process. I had a slight suspicion that the county system simply wasn't designed to deal with people who had income from sources such as brokers accounts, and they didn't know how to process it, but I was very upfront with them, and they approved me. I felt happier when the ACA came along and the requirements for qualifying for Medicaid under the expansion were much more clearly laid out.

The problem I had with my county program was lack of adequate information about both the requirements to qualify, and the resulting coverage. I never did find out what was covered, as it wasn't health coverage in the traditional sense. It was more of a "come to our clinic, and we'll do what we can to help you with the resources we have. If we can't help you, we'll send you to County Hospital" kind of a thing. I never did receive a comprehensive list of what my county program covered. I'm sure there was one somewhere, but they didn't seem to have made it available to us, the people.

If we lose the Medicaid expansion and I go back to the county program, I'm going to miss it. The first clinic I signed up with was grim, but the next one I found was wonderful, and it is at least comforting that I'll be able to remain with them if the old county-based program returns.

 

[Katsmeow]

Please be realistic, you're just "awfulizing" here. Is it remotely possible that Medicare eligibility age would be pushed back but the insurance programs that covered younger people wouldn't have concomitant higher eligibility ages? Answer: no.

Most of the proposals I have seen to repeal/replace the ACA don't provide guaranteed insurance programs for younger people. Remember before ACA? Some people -- particularly older people with preexisting conditions -- couldn't get coverage at any price. That wasn't true in every state but was true in many. It is entirely possible that the ACA repeal will return things to that state. Another possibility is to make insurer have to provide coverage but without the mandate the premiums for an older person could be astronomical (as they were in states pre-ACA that had such laws).

Unstated assumptions: There will be no effective control on health care/insurance costs (through competition, etc), that costs passed on to taxpayers due to escalating ACA subsidies wouldn't also be "people paying a lot more.

"

I wasn't talking about the ACA. I was talking about Medicare. I am comparing the costs under the Ryan proposal to the actual current Medicare costs. It isn't absurd to think it would be more expensive. It is one of the stated goals of the plan...to cause people to pay more. That is a desired outcome.

It's going to take years to make and implement significant changes. If I were in your boots, I'd probably wait to at least see what is actually proposed before crunching personal budget numbers. Remember how many times the ACA changed as the sausage was made? Sure, keep up to date with the state of play, but lets not get worked up about an old plan that >everyone< knew would not be signed into law.

I am not doing hugely serious budgeting but I am looking at it to see what impact various increases might have. I am not sure there will be that many changes to this plan FWIW. It is Ryan's serious plan and is what he wants. And I'm pretty confident that he will be able to get what he wants. I could see some changes on dates and such but unless there is a huge backlash from the public I would expect it to pass fairly easily.

I think that one reason it is being coupled with the ACA repeal is to make it easier to pass quickly and to do it during the honeymoon period with the hope that AARP and other groups won't mobilize.

I actually hope you are right. That is a comforting thought. My point here though is to simply discuss it and make others aware.

Does it matter if its called "repeal and replace" or if the present ACA is very extensively modified? Either way, it's going to have some significantly different attributes if it is going to work. And it is clear that the ACA was going to >need< significantly different attributes >anyway<. Does anybody think the thing that we've got now is okay and could realistically go even one more year without a stem-to-stern overhaul?

Personally I don't care what they call it. While I probably have more positive feelings about the ACA than you do, I certainly agree that -- like almost all major statutes -- it needs some changes at this point. But, if the goal is to provide universal coverage that is affordable, I have a hard time seeing how any of the repeal and replace proposals achieve that. But, if they do and it is called a repeal and replacement, then fine by me.

 

[explanade]

More on privatizing Medicare:

Paul Ryan Says Medicare Privatization Is On

According to this writer the ACA had actually improved the long term prospects of Medicare, in contradiction to Ryan's claim.

 

[shotgunner]

I have been reading this thread and possible changes to the ACA have made my crystal ball very foggy again with regards to the impact on ER. I am fully retired with no pension, I will be 60 this Spring. The ACA has been good for me, I'm healthy and use very little in the way of medical services, I also qualify for a subsidy. Worst case scenario, I have to pay out of pocket for 100% of my individual HI policy. This could increase my withdrawal rate from 3 to 4 percent until I turn on early Social Security. I can weather the storm although paying more than I do now will be unpleasant. I could also go get a P/T job and make a few thousand a year to help with the cost until SS starts. Bottom line, I am have no thoughts of returning full time to the drama filled office at Camp Big Fun ever again. This will all get sorted out. It is unfortunate that the ACA did not work out like Social Security and Medicare, planning for early retirement is hard enough without Lucy moving the football when Charlie goes to make the kick.

 

[jim584672]

Kevink, I'm in a similar situation, in Pa. I don't know how good or bad life is here on Medicaid, but I've heard good stories and bad stories about Medicaid in general. Some people here on the board say they are on Medicaid and love it, but I don't think they are in Pa. I have been afraid of Medicaid, so I have bumped my income up each year with Roth IRA conversions to qualify for a subsidized Silver ACA plan. You mentioned that you think the expanded Medicaid will be withdrawn by the next administration. I am worried about that also. Currently I do qualify for Medicaid if I want it, since there is no ASSET TEST currently. I am wondering if in 2017 Medicaid will be returned to the pre ACA state (which I would not qualify for due to assets) I can't find any info on this, not even from the Pa Medicaid website. Lots of talk about "block granting Medicaid to the states" but no one says what effect that has on eligibility, if any. I suppose it's possible for states to keep the "expanded" Medicaid, with no asset test, in place if they choose to. But it might cost the states a lot of state taxpayer money to do so. I am getting some long-postponed blood tests done now while I still have my silver ACA HMO!

If they totally get rid of the expansion then only the elderly, blind, and disabled could get. After spending down almost all assets it kicks in.

 

[MichaelB]

Just a reminder, there are no proposals currently under consideration, all we have is media talk, which we have not found to be helpful when discussing any other topics.

Many members have personal situations that may be affected, and want to discuss them here. Unfortunately, no one knows what will happen, or when. Still, perhaps some suggestions can be made, some advice to be given.

This discussion can still be helpful, but we need to keep it centered on things we can do and should be thinking about as we consider our retirement plans.

Please stay away from campaign rhetoric and the politics of health care reform.

 

[RockyMtn]

Just a reminder, there are no proposals currently under consideration, all we have is media talk, which we have not found to be helpful when discussing any other topics.

Exactly, and we know how right the media was calling the election! Maybe we should ask the all knowing "pollsters" what they think?