No, because many of those plans do not offer the same quality of benefits. The cheaper plans often are very limited in what they offer.</p>
<p>Post ACA, some of the plans will not qualify – so they will probably go off market entirely, or else they may be sold with some sort of rebranding that makes it clear that they don’t qualify to meet ACA requirements. (I’m not sure what will be legal, but I don’t think it will be legal to sell something that falls short of ACA without some sort of warning to consumers that it is not a “qualified” plan. )</p>
<p>ACA is going to force rate increases at the lower end of the market (price-wise) because (1) it eliminates cut rate plans with substandard benefits, and (2) it eliminates insurance pools selected specifically on the basis of health. At the same time, it is opening the market to many who were previously uninsurable, and reducing the cost of insurance for the previously hard-to-insure. If you are an actuary looking across the board, there is a net benefit: more people insured, at a comparable or lower rate per person. </p>
<p>At an individual level, obviously some will benefit and others won’t. There is a net societal benefit, and there is a long-term, abstract benefit to individuals because of reduced risk. (example: we healthy people no longer face the risk of exhausting our total benefits if we get cancer, because our insurance will no longer have a lifetime cap.)</p>
<p>I have Blue Shield (in California) & I just called them. I have verified that I will be able to keep my HSA ($3500 deductible, annual out-of-pocket maximum, $5000). I turn 60 in February; the open-enrollment period on the exchanges in California for the first year will continue through March 31st. So at least for me it looks like it makes sense to wait until after the first of the year when I get my notice of rate increase for the HSA and then see what my options are. I’m thinking that the HSA will probably still be the best bet for me, because of the additional tax write-off and the flexibility with HSA-expenditures. But I’ll revisit the issue down the line.</p>
<p>One of the issues with PPACA is that healthy people may choose to pay the penalty, which is likely to be less than the cost of insurance … thus robbing the plans of healthy people in the pool … driving rates up. Then when those healthy folks get sick, they will go out & buy a policy (no pre-ex exlusions) - which drives rates up.</p>
<p>I believe we need some type of national health care - I just don’t see this model as sustainable.</p>
<p>I am very curious about qualifying for a subsidy, what I have read is that you qualify this fall based on stated income. If a self employed person uses 2012 income for 2014 premium subsidies, what if they then fall below 133%? Will they have the subsidy taken away on their tax return because they should have qualified for medicaid? But did not use Medicaid? I say self-employed because they usually do not know their AGI or even schedule C income until the return is done. And will it be AGO or schedule C?</p>
<p>It is a pretty good deal, but it is still a LOT of money for that family – 10% of (pretax?) gross income. If those were my kids/grandkids, I’d recommend that they self-insure for the small stuff and just sign up when necessary, i.e., when they get really sick.</p>
<p><a href=“2”>quote</a> it eliminates insurance pools selected specifically on the basis of health. At the same time, it is opening the market to many who were previously uninsurable, and reducing the cost of insurance for the previously hard-to-insure. If you are an actuary looking across the board, there is a net benefit: more people insured, at a comparable or lower rate per person.
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<p>Because of point #2, the actuary is only a happy camper if a lot of really healthy people sign up. Otherwise, there is no “net benefit.” And therein lies the risk. The actuary (and we) just don’t know if the ‘penalty’ will be a perceived as a better “value” to the young and healthy.</p>
<p>“It is a pretty good deal, but it is still a LOT of money for that family – 10% of (pretax?) gross income.”</p>
<p>No argument from me. (though it will cost virtually the same, with the kids or without.) I’m quite ready to tax higher income earners at a higher rate to subsidize it further.</p>
<p>The administration is looking for about 7 million with individual health insurance or uninsured people to sign up for ACA the first year. If 2.7 million are between 18-30 years old, The plan is going to work…</p>
<p>Those arent huge expectations. As a percentage of potential insurance buyers it is low percentage.</p>
<p>No, the cost of insurance is the same, but if you make below a certain threshold, you qualify for a generous government subsidy. (The more your insurance costs, the more generous your subsidy seems). </p>
<p>If you are in favor of government subsidizing everybody’s care – then a single payer, government run model would have been a better choice. </p>
<p>But if you are philosophically or politically opposed to a single-payer, government run plan, then at some point there needs to be a cutoff for benefits. Congress decided on 4x the poverty rate. </p>
<p>I definitely feel the frustration because I am in a borderline spot for subsidies. But I am realizing that if you are eligible for a subsidy but near the cut-off, you are best to plan as if you are not eligible for a subsidy. Certainly you should not give up an affordable, grandfathered health plan in exchange for lower, subsidized premiums on the exchange … unless you know that your future income will stable or going down. You don’t want to put yourself in a situation where you get a huge bill from the insurance company because you got an unexpected end-of-year bonus. </p>
<p>It is possible that there will still be a market for qualified plans outside of the exchanges which sell on the private market, not eligible for subsidies, but at a somewhat lower premium for full-pay clients. I would think that this will be more likely in the states that do not have exchanges – or perhaps it might be something like a continuing market for HSA’s in a state like California which has not included HSA’s within the exchanges. </p>
<p>Barring a big financial set back, I’m going to act on the assumption that I won’t qualify for a subsidy, because I don’t want to run my business or financial affairs with a goal of making less money overall.</p>
<p>well actually we kinda do, dstark, at least most of 'em, and that is because those who are the sickest will sign up on Day 1, and others with any medical issues will follow shortly thereafter = adverse selection. Thus, from an actuarial standpoint, the plans will have to incur an immediate expense which can only be offset by enrolling a bunch of healthy folks, who themselves may have little incentive to do so.</p>
<p>I can’t make heads or tails of any of this and will need a professional to help me in October. How does one go about finding a good health insurance agent? (I’m in NJ) What qualifications should I look for? I have a somewhat complicated situation so I need to find someone who “gets it”. Thanks.</p>
<p>Not going to argue with you mini, but I will say that my mortgage - before property taxes and insurance is $1600. I live in a high tax state (not Washington). </p>
<p>After tax income is substantially less than gross income for most families. Most folks do not have an extra 20,000 or 30,000 per year - and this looks like the reality for a silver plan with deductibles plus out of pocket costs, if a family has something like surgery. People here on this board are wrestling with things like tuition which often takes another 10-20% of income. Your comment that people in that bracket “can afford it” is absurd. </p>
<p>I am lucky we have Kaiser now - but if we leave the state, our plan won’t be one offered there.</p>
The may in the early years but as the penalty goes up, the equation changes – especially for higher income earners. </p>
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They better hope they get sick in October. The exchanges will have an open enrollment period – and outside that period, people will have to wait before they can sign up. </p>
<p>And I don’t think anything in the plans will require payment of retroactive benefits. You aren’t going to be able to forego insurance, and then after you are injured and get out of the hospital, go in and sign up to pay that hospital bill from last month. I am guessing that they will also be able to maintain an exclusion or waiting period for pre-existing conditions as well. Up until 2017, that is a 365 days. (I think after that it might be 90 days, but can’t verify that). </p>
<p>Obviously these issues will need to be publicized, but it makes sense to wait until all of the people who are chomping at the bit to get insured have signed up first. </p>
<p>Keep in mind that many people in that uninsurable, pre-existing condition category are not all that expensive to insure. I have a friend who had breast cancer 10 years ago, caught in very early stages – treated with a simple lumpectomy - no recurrence - but she was unable to get any sort of insurance, and she’s now insured in a high-risk pool. But she is and has been perfectly healthy. I’m sure there are many like her-- people whose pre-existing “condition” was an acute, short-term health crisis that does not impact day-to-day health costs - as well as many who have chronic conditions that are not all that expensive to treat, but end up disqualifying them from insurance.</p>
<p>The Exchanges will determine Medicaid eligibility – that is, you will have one application to fill out, submitted to the exchange. If they decide that you are Medicaid eligible, they’ll transmit your paperwork to Medicaid for review. I assume they will have a process in place for changes in income status, and will coordinate your transfer to Medicaid if and when appropriate. </p>
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<p>It’s MAGI (Modified AGI) – but I can’t figure out what MAGI will mean – as that phrase seems to mean different things in different contexts for IRS. I’m assuming that eventually the IRS will give us a worksheet that explains it all… but we don’t have it that yet.</p>
And will you also promise to pick up the slack when they get injured or come down with an acute illness outside the enrollment period? </p>
<p>I hope that people will use some common sense – this is not a freeby system where you can just wait until you get sick and then go in and get retroactive benefits to pay that $50,000 hospital bill you just racked up after your motorcycle accident. The good news is that you won’t spend the rest of your life going without insurance because of that dumb mistake… but you are still on the hook for that $50K. You aren’t going to be able to waltz in for a low monthly premium and hand over the past due bill.</p>
<p>“I believe we need some type of national health care - I just don’t see this model as sustainable.”</p>
<p>I actually agree. I very much WANT it to succeed, but I really don’t believe it will. Everything that Obama could give to private insurers, hospitals, etc. in order to (later) effect cost controls as carrots, he already has, and fat rabbits are hard to move.</p>
<p>Most young people do want insurance. They might not think about it when they are 23, but by the time they are approaching 30, it’s on their mind – especially young married people.</p>
<p>And it is not a strict cost/benefit analysis. If it were, then I should have gone without insurance for myself and my kids for the past 30 years – we hardly ever even met our deductibles, much less recouped the value of our premiums. But then again, I haven’t had any big claims on my car insurance or homeowner’s insurance either. And why in the heck am I paying for pet insurance?</p>
<p>We buy insurance to protect against risk. No one in their right mind is going to pay $350/month for an insurance premium because they get one free physical every year. The amount of premiums paid is more than enough to pay for the preventive care several times over. We pay because we know that we can’t possibly afford what it will cost if we have an accident, or if we develop a serious illness. Some of the healthiest and most vigorous young people are also at higher risk for accidents because of their active lifestyles – that is, I’m sure that youngsters who enjoy skiing or biking are aware that they are at risk of injury whenever they are engaged in their favorite activities.</p>
<p>axw, I think the reason it doesn’t make sense is because it is dribbles and drabs, at this point. I really believe once something fuller is released, we’ll be on a new thread helping each other digest it. (Yay, CC.)</p>
<p>I’m satisfied to allow myself the following, til more comprehensive info appears:</p>
<p>Via the CA calculator, there is a link to a “national calculator.” The footnote to the CA, WA and Natl- and probably any of them: *Actual premiums in the Exchange are not yet known. *</p>
<p>We know this is for people who currently don’t have an affordable employer option or whose employer charges are above a certain % of their income. There can be a number of reasons one may want to explore.</p>
<p>Calmom seems to be finding one can remain on a satisfactory current plan, maybe. We don’t have enough info yet, but it seems to be an intention. If you look up grandfather, you can see how it applies. There are also ways a plan can lose this status. What I haven’t figured out is if insurers are likely to bust that status on purpose.</p>
<p>So, rather than say, if you make 110k, your outlay WILL be 9k more, I believe you have the option to stay with your current plan or shop off the exchange, not in it.</p>
<p>And, like so many things in life, you can look at an issue piecemeal and hope to glean a higher understanding. But, if you don’t have all the facts, it is dangerous to do more than collect and read those bits- and ask yourself questions. Not assume. Yet.</p>
<p>The whole point of the exchanges is that you won’t need an agent – the information will all be in one place. You’ll sign on to the exchange and see what choices you have.</p>
<p>How did you do it before? </p>
<p>I understand that it is confusing — but it’s been confusing for me for the past 35 years. I admit that way back when, insurance was cheap enough that I just signed up for whatever was offered to me via my professional organization without doing much shopping around. But throughout my married & post-married life I have had to try to make sense of competing plans and costs, and also have spent hours helping my son figure it all out, over the years. It’s been a lot of years trying to make sense of a HMO’s via PPO’s vs. Major Medical policies, etc. And probably a lot of premium dollars spent with a mistaken impression of what was covered. I had what I thought was good insurance when my son was born but somehow ended up with a hospital bill that took years to pay off. Between the deductible and the patient share of extra expenses I hadn’t anticipated because of minor birth complications, the process ended up costing a lot more than I thought it would. </p>
<p>I’m sure that the insurance companies on the exchanges will figure out ways to highlight whatever benefits they feel give them a potential competitive advantage over another. </p>
<p>And if you haven’t dealt with this very confusing landscape in the past – why not? If you are covered at work you probably will still be covered – and won’t have to shop around. I realize that there are life changes that might cause some people to coincidentally to lose their eligibility for previous coverage at the same time that Obamacare is implemented — but then the problem you are confronting is nothing new. It’s just a simplified version of what the rest of us has been dealing with for years.</p>
<p>You gotta get 2.7 million people out of 40 million people to buy insurance… Ok some of the 40 million will not be healthy…</p>
<p>Still… You gotta get just 2.7 million…</p>
<p>And this age group does want insurance… How many people here dont want their grown up kids to have insurance?</p>
<p>Many parents are going to chip in and help…
If your kid is going to grad school or med school or law school or doing low paid work…you arent going to help your kid if you can? </p>
<p>Of course I am posting in a place where 78 percent of the parents are helicopter parents. :)</p>