Whatcha gonna do if ACA goes away?

[anothercog]

I'd either need to keep working for a group plan, live overseas, or at least in a state that doesn't permit insurers to drop you when you get sick.

Many pre-ACA policies were "insurance" in name only. Lots of fine print capping or excluding payouts.

 

[marinauser]

Just smile and go on with our lives. The only impact ACA has had on us was to increase our taxes to pay for the supplements that others have enjoyed.

 

[GenXguy]

So, yeah, these are some of the many reasons I don't see it getting canned. There are 24+ million of us, on ACA-covered plans alone, and another how-many millions of 18-26 year olds on their parents insurance who would no longer be covered.

Plus another 15 million or so covered under the Medicaid Expansion. That's part of the ACA also.

Could subsidies be slashed? Sure, then it's just money. But the whole thing? My bet is that each year it stays makes it less and less likely to go.

If by "slashed", you mean just reduced a little rather than eliminated, that is one thing, but if the subsidies were slashed from the law, it would be unaffordable for many millions.

 

[GenXguy]

Just smile and go on with our lives. The only impact ACA has had on us was to increase our taxes to pay for the supplements that others have enjoyed.

Supplements? What supplements are you talking about? That sounds like a Medicare thing.

 

[JDARNELL]

Not a player for ACA but I suspect if it did go away there would be a huge uproar. I think its popularity makes it like the third rail.

 

[jollystomper]

During my retirement planning I knew I would not be eligible for ACA subsidiaries at all, due to my pension income. So I just saved for the worst case, at the time expecting premiums of 24K/year before SS hit.

Fortunately Megacorp retirement insurance became a much better deal for me, and the actual premiums we paid before Medicare were less than a third of that, along with lower deductibles that what we could get from ACA policies. In addition, almost none of our existing doctors accepted public ACA plans.

It is the same approach I take for the "Whatcha gonna do if SS benefits are reduced based on the current forecast?' Prepare so that our desired lifestyle will not be impacted.

 

[kgtest]

Lots of folks going back to work if it ever does go away. Unless there is a substitute or equivalent alternative.

 

[statsman]

Do you feel like the ACA has increased, decreased, or had little effect on the amount you pay for your pre-ACA high deductible plan? Do those plans allow for exceptions for ACA required coverages like drug treatment and mental health?

My megacorp's Under-65 retiree medical plan a year after ACA was implemented was close to $0/mo with a $2500 maximum OOP for an employee with 20+ years with the company. It had been that way for many years.

Soon after, it started going up. This year, the plan costs me $930/mo with a $4000 maximum OOP. I've been on this Under-65 plan for six years, watching the monthly premiums spiral upward. In a couple of months, I will be on Medicare and done with that plan.

 

[MichaelB]

I wonder which provisions of the ACA people here think would be changed, and what would replace them.

Elimination of the Medicaid expansion might affect some here, but not many.

Elimination of essential health benefits would have a meaningful impact and allow for reduced coverage policies. This is the section that mandates coverage for things like emergencies, preventive care, mental health, chronic treatment, prescription drugs, and pre & post natal care.

Guaranteed access to comprehensive health care insurance is what allows us to get comprehensive coverage without underwriting. Without this provision insurers could pick and choose, and drop at will. Changing this would be a big upset, as insurers have designed their business model around guaranteed access, and removing it would be very disruptive for them.

Premium assistance to help pay the cost is the most visible provision. The average employer paid family policy has a premium that’s about 1/3 of the median household income before tax. The full price of healthcare insurance is basically unaffordable for the median household.

Since the ACA was introduced we have yet to see a single proposal to reform or alter any of the above provisions with specifics. The individual mandate and some reproductive health measures were changed, and early on the methodology for reinsurance was dropped.

There is currently no proposal to under consideration or even introduced to change the ACA in any way.

 

[Sunset]

I can only pay attention to what politicians say they will do and BELIEVE they will do what they say.

Then vote.

Funniest thing I saw on TV was a reporter interviewing a person.
Reporter asked the person what if a politician made "X" go away. The lady said "they can't I depend on that"
Reporter said: "Politician said he would make it go away".
Lady said: "I voted for him, but I didn't believe he would do it"

 

[Fermion]

I wonder which provisions of the ACA people here think would be changed, and what would replace them.

Elimination of the Medicaid expansion might affect some here, but not many.

Elimination of essential health benefits would have a meaningful impact and allow for reduced coverage policies. This is the section that mandates coverage for things like emergencies, preventive care, mental health, chronic treatment, prescription drugs, and pre & post natal care.

Guaranteed access to comprehensive health care insurance is what allows us to get comprehensive coverage without underwriting. Without this provision insurers could pick and choose, and drop at will. Changing this would be a big upset, as insurers have designed their business model around guaranteed access, and removing it would be very disruptive for them.

Premium assistance to help pay the cost is the most visible provision. The average employer paid family policy has a premium that’s about 1/3 of the median household income before tax. The full price of healthcare insurance is basically unaffordable for the median household.

Since the ACA was introduced we have yet to see a single proposal to reform or alter any of the above provisions with specifics. The individual mandate and some reproductive health measures were changed, and early on the methodology for reinsurance was dropped.

There is currently no proposal to under consideration or even introduced to change the ACA in any way.

Very well stated.

I will go so far as to say if there were a investment that would pay 10% return a year over the next 5 years if ACA stuck around but would lose 100% if it got cancelled, I would take the investment with some of my bond money.

That is how confident I am it is not going anywhere.

 

[GenXguy]

Very well stated.

I will go so far as to say if there were a investment that would pay 10% return a year over the next 5 years if ACA stuck around but would lose 100% if it got cancelled, I would take the investment with some of my bond money.

That is how confident I am it is not going anywhere.

I would go with two years. It should be safe through the end of 2025. I would bet on that.

There have been proposals to change it which included a change in the subsidies that passed the House in the past:

American Health Care Act

https://en.wikipedia.org/wiki/American_Health_Care_Act_of_2017

and the American Rescue Plan Act made changes that passed:

https://en.wikipedia.org/wiki/American_Rescue_Plan_Act_of_2021

 

[5Miler]

DGF has been on ACA since she moved from her company retirement plan in 2015 as ACA was much cheaper due to managing income. If ACA wasn't here today, she would enroll in her Mega Corp retirement plan once more although she goes on Medicare in July.

I retired 12 years ago and was on DGF's health plan for many years as my company plan had pathetic benefits and was stupidly expensive. A few months after I retired, her company announced that would be the last year different sex domestic partners would be eligible for coverage which would put me out in the cold. Fortunately, I found out on this board that the VA was once again accepting Priority 7 & 8 veterans for health coverage and I have been using them since then although I am now fully covered on Medicare. The VA has always been my fall back option.

 

[Fermion]

I would go with two years. It should be safe through the end of 2025. I would bet on that.

There have been proposals to change it which included a change in the subsidies that passed the House in the past:

American Health Care Act

https://en.wikipedia.org/wiki/American_Health_Care_Act_of_2017

and the American Rescue Plan Act made changes that passed:

https://en.wikipedia.org/wiki/American_Rescue_Plan_Act_of_2021

Changes yes, but cancelled totally, no.

 

[GenXguy]

Changes yes, but cancelled totally, no.

But the post you had responded in agreement to specifically said "Since the ACA was introduced we have yet to see a single proposal to reform or alter any of the above provisions with specifics."

 

[Fermion]

But the post you had responded in agreement to specifically said "Since the ACA was introduced we have yet to see a single proposal to reform or alter any of the above provisions with specifics."

The American Rescue Plan Act didn't reform or alter any of the provisions MichaelB listed did it? I thought it only expanded some Medicaid.

Oh. Didn't see that was first on his list. I guess it did expand it, which is a change.

I don't think the OP is worried about changes to ACA that make it even more available though. He/She seemed to be worried about it going away.

 

[Proteus126]

Nothing has changed since 2017. ACA is still in the crosshairs. Retirement planners should not blithely assume that ACA subsidies will be available.

My plan is to work 3 more years until I reach my MRA, keeping my Fed health insurance into retirement. I just couldn't trust in ACA enough to pull the plug early. Fed retiree benefits are safe, right? Right?

 

[Time2]

Status quo for me.

I've stayed on my HSA/High deductible pre-ACA plan since the ACA came into being.

Same here. But I'll admit it has cost me about $60k.

 

[Time2]

Do you feel like the ACA has increased, decreased, or had little effect on the amount you pay for your pre-ACA high deductible plan? Do those plans allow for exceptions for ACA required coverages like drug treatment and mental health?

I feel the ACA had a dramatic affect on my HDHC plan cost. If I remember in the morning, I'll try to locate my records, I was pretty Po'ed about the increase.

 

[GenXguy]

The American Rescue Plan Act didn't reform or alter any of the provisions MichaelB listed did it? I thought it only expanded some Medicaid.

Oh. Didn't see that was first on his list. I guess it did expand it, which is a change.

It also made temporary changes with the subsidies.

I don't think the OP is worried about changes to ACA that make it even more available though. He/She seemed to be worried about it going away.

The American Health Care Act would have moved in that direction, which is the other one I mentioned.

 

[pb4uski]

I’m 53 and thinking to retire in 2-3 years. No employer insurance. How to budget for medical expenses (premiums and deductibles) until Medicare kicks in? What if ACA goes away?

Well, to begin with, I think ACA subsidies are popular enough and the political will to kill ACA subsidies or even change them is so weak with divided government that any significant changes are very unlikely.

But if you want belts and suspenders then assume no ACA subsidies so you are paying the full premium and see if you can still retire.

 

[FLSUnFIRE]

I think the ACA also impacted the growth of the gig economy. There are a lot of gig workers that buy their own insurance and the ACA benefits them as well. Just my theory but I would not be surprised if there are more users of ACA because of ACA. That is, the ACA reduced their perceived risk in taking the leap from traditional employment, so they leapt and now are taking advantage of ACA.

 

[TickTock]

Well, to begin with, I think ACA subsidies are popular enough and the political will to kill ACA subsidies or even change them is so weak with divided government that any significant changes are very unlikely.

But if you want belts and suspenders then assume no ACA subsidies so you are paying the full premium and see if you can still retire.

+1.

I don't *think* ACA will go away. But I've been wrong before. Our backup plan is taking DW's megacorp retiree healthcare plan (which is worse than ACA). That option gave us a ceiling for healthcare spending and the confidence to proceed with FIRE.

 

[marko]

Income wise, I was unable to use ACA premiums so I was stuck with a $25k annual for 13 years. DW just got on Medicare last year. It's been a nice change.

I'd imagine in the unlikely event that premium subsidies went away that it would alter the "RE" and "FI" designation for many members of this forum.

 

[The Cosmic Avenger]

Nothing has changed since 2017. ACA is still in the crosshairs. Retirement planners should not blithely assume that ACA subsidies will be available.

My plan is to work 3 more years until I reach my MRA, keeping my Fed health insurance into retirement. I just couldn't trust in ACA enough to pull the plug early. Fed retiree benefits are safe, right? Right?

Seriously though, it's probably much safer than the ACA, which I think is fairly safe. If there are changes in benefits for Federal employees, they would very likely start with new employees or at least those not yet retired, as trying to change the benefits promised and accrued would be a political and legal mine field.