<p>lasma…as a self employed person for most of my life, I’ve always had health insurance for my family even when I made far less than I do now. I made it a priority. Of course, some peoples’ priorities are different and some like to spend way beyond their means and wonder why they can’t afford health insurance.</p>
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<p>The ACA doesn’t set the premium amount. If there was a “fade up” – so for example, a family earning 150% of the family line could get a subsidy so that they paid no more than 12% of family income went to health insurance – that would simply be an incentive to exchange providers to set plan rates even higher. You’d see the same mechanism in play that impacts college tuitions – you might see the companies aggressively marketing their Platinum plans to those higher-level earners. </p>
<p>The ACA formula is something that was run through the CBO with a lot of projections and number crunching. Insurance companies don’t set rates based on individual needs and Congress doesn’t pass law based on individual circumstances – rather these decisions are made based on collective concerns. This happens to be the formula they came up with.</p>
<p>I am very sure that my MAGI will be borderline, so that I may or may not qualify for a subsidy in this and future years. I’ve got 6 more years of paying for insurance before I qualify for Medicare. If I can continue to work and maximize income over the next 6-10 years, I can retire at age 70 and receive a higher base monthly Social Security benefit than if I earn less. Health insurance is a significant expense for me, but it is not my only expense. I want to fix up my house. I want to do all those things that were put off in order to put my kids through college – remodel the bathrooms & kitchen, new carpet, etc. Maybe a new car? Maybe some more travel? </p>
<p>What else would I be giving up in order to qualify for a few thousand dollars of an annual subsidy? Not just for the current year, but for future years? </p>
<p>Keep in mind that if the only available insurance is above a certain level of premiums relative to income, the person will not be subject to penalties. That doesn’t mean that people earning above a certain level will go uninsured – it means that if exchange rates go up too high, there will be a market for non-exchange qualifying policies with more reasonable premiums.</p>
<p>So it’s not true that access to care for Medicare recipients is decreasing. According to a survey–“Access to Physicians Services for Medicare Beneficiaries”–published 8-22-2013:</p>
<p><a href=“http://aspe.hhs.gov/health/reports/2013/PhysicianMedicare/ib_physicianmedicare.pdf[/url]”>http://aspe.hhs.gov/health/reports/2013/PhysicianMedicare/ib_physicianmedicare.pdf</a></p>
<ul>
<li>According to federal survey data, the percentage of all office-based physicians who report accepting new Medicare patients has not changed significantly between 2005 and 2012, with 87.9% of physicians accepting new Medicare patients in 2005 and 90.7% in 2012.</li>
<li>The percentage of physicians who report accepting new Medicare patients is similar to, and in recent years slightly higher than, the percentage accepting new privately insured patients.</li>
<li>Medicare beneficiary access to care is high and has remained stable over the past five years.</li>
</ul>
<p>90% of office based physicians are accepting new Medicare patients. Although 9,500 physicians have opted out of Medicare, this has to be balanced against 735,000 doctors who still accept Medicare, new doctors accepting in, and a total of 1,000,000 Medicare providers when you include non-physicians such nurse practitioners.</p>
<p>The authors of the surgery conclude: " Overall, Medicare beneficiary access to care has been consistently high over the last decade and continues to be high today."</p>
<p>"Ah yes, “someone I know knows someone.” One of the telltale marks of an urban legend. "</p>
<p>I know who it is but it is not important enough for me to convince strangers on CC about it.</p>
<p>It does not take rocket science to give up few grand in income to get under 95k either. It is a question of how much someone gains from it.</p>
<p>Lerkins post above provides evidence that people do consider that.</p>
<p>My college health insurance went from $700 a year and mandatory last year to $1500 a year and not required if you had alternate insurance this year.</p>
<p>They claimed they couldn’t ask students to pay $1000 more a year.</p>
<p>Just something to think about. Seems like this will lead to further increases in education costs.</p>
<p>Marcdvl, We’ve discussed the college health insurance issue before in this thread, but I’ll summarize: Previously, college health insurance plans had caps on total payout. That is, they’d cover you if you got sick, but not if you got very sick. Now, it is illegal to offer insurance with caps. It costs more money to offer insurance that actually insures, and that is why the premium has gone up.</p>
<p>Many college insurance plans had laughably low caps: $10,000, $20,000, $50,000, amounts that you could easily blow through in a single hospital stay. WUSTL’s was better than most, at $500,000, but still, insurance that doesn’t insure against catastrophes is phony. Now the insurance that WUSTL sells is real insurance.</p>
<p>Earlier this summer, I had a conversation with D2’s school’s health insurance provider (some info-seeking; she is covered by our plan, but had a twist.) That rep admitted they do not know how ACA will impact college health plans. She made it clear that the current sort of plan is limited, not meant to equate to more fully fledged insurance. Of course, ymmv.</p>
<p>I’ve been reading that those phony college non-surance plans were huge money makers for the insurance company. Taking $500 a year to “insure” a healthy college student against health claims less than $50,000 might be called “limited” but I’d call it a racket. The insurance companies were just skimming off half the premium or more as pure profit.</p>
<p>In good news, the rate of growth in Medicare spending per beneficiary has been slowing in the last decade. A lot. Here’s a paper examining the reasons for that slowdown:</p>
<p><a href=“http://www.cbo.gov/sites/default/files/cbofiles/attachments/44513_MedicareSpendingGrowth-8-22.pdf[/url]”>http://www.cbo.gov/sites/default/files/cbofiles/attachments/44513_MedicareSpendingGrowth-8-22.pdf</a></p>
<p>Short answer: they don’t know why the growth has been slowing, but it’s not the recession. Which is good news, because it suggests that the growth rate decline will continue as the economy improves.</p>
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<p>[Citing</a> Obamacare, 40,000 Longshoremen Quit the AFL-CIO](<a href=“http://www.breitbart.com/Big-Government/2013/09/01/Citing-Obamacare-40-000-Longshoremen-Quit-the-AFL-CIO]Citing”>http://www.breitbart.com/Big-Government/2013/09/01/Citing-Obamacare-40-000-Longshoremen-Quit-the-AFL-CIO)</p>
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The cap on the basic health plan at my daughter’s elite college was lower than that: $5000.
(And the one time she tried to use it to cover an expense of about $900, the insurance refused to pay despite the fact that it was clearly covered – we had to get the college health administrator involved to intervene)</p>
<p>When my son was finishing his undergraduate work, he had returned to college after several years in the work force. I worked with him to help make an insurance decision – he looked at the college policy and what it covered, and opted instead to buy an individual policy from Blue Shield, similar to the policy I had at the time. It was just easy to see that the coverage offered by the college was so minimal that it wasn’t worth paying for. It was worth paying a few hundred dollars more a year for real coverage.</p>
<p>Good, easy-to-understand website on shopping for health insurance under Obamacare, from the state of Nevada:</p>
<p>[Search</a> for Approved 2014 Health Insurance Rates](<a href=“http://healthrates.doi.nv.gov/Wizard.vbhtml]Search”>http://healthrates.doi.nv.gov/Wizard.vbhtml)</p>
<p>You say how old you are and where you live, you say what level of insurance, and it gives you a list. Nice job, Nevada.</p>
<p>Maybe I should move to Nevada. $387.50/month for bronze plan with Nevada Health Co-op at age 60. Sounds pretty good to me. ;)</p>
<p>Based on the little bit I have learned about the ACA I have been hoping that my wife and I will be eligible for subsidies that will significantly lower our healthcare costs. I have so far put that idea in the “too good to be true” category and figured maybe our premiums would go up dramatically and the subsidies will merely bring our cost back down to what we pay currently. I now read an article that suggests premiums for boomers like myself may indeed be much lower, to the point where significant numbers of people may choose to retire early. Under the current system I know many people in the 55 - 64 age range keep working only because they are afraid of losing their employer provided healthcare. They think that the private market will either be unavailable (due to pre-existing conditions) or prohibitively expensive. My wife and I have found good, affordable (not cheap, but we can afford it) private coverage, but it will be nice if we can save $5000 or more annually for the next 6 years.</p>
<p>[Retire</a> early thanks to Obamacare? - MarketWatch](<a href=“Retire early thanks to Obamacare? - MarketWatch”>Retire early thanks to Obamacare? - MarketWatch)</p>
<p>[Boomers</a> could benefit most from Obamacare - Encore - MarketWatch](<a href=“Opinion and Commentary - MarketWatch”>http://blogs.marketwatch.com/encore/2013/08/30/boomers-could-benefit-most-from-obamacare/)</p>
<p>Even if people in the 55-65 age group are not eligible for subsidies, we nevertheless benefit from the provisions of the ACA that say we can’t be denied insurance for pre-existing conditions, and our premiums can be no more than three times the premiums of subscribers in their twenties.</p>
<p>This would (if I were without insurance because of pre-existing conditons) save my life. I thank all you healthy people for subsidizing me. You should thank me for saving you money by not having to the hospital without insurance (with the costs passed on to you.) I apologize to all of you for living long enough to collect Social Security, and I might make it to Medicare. I apologize to my kids for their having to buy more expensive insurance, and you should all apologize to them for delaying their inheritance.</p>
<p>“delaying”? I apologize in advance to my children for spending their inheritance.</p>
<p>I already gave my kids all the inheritance they can reasonably expect: they have a college education and they have no loans. If that’s not a headstart on the 1%, I don’t know what is.</p>
<p>how can you spend their inheritance? Isn’t inheritance what is left over after you are done doing what you want to do?</p>
<p>You spend their inheritance indulging in those things after age 50 that wouldn’t technically be called “necessary expenses.” Unfortunately for my kids, I just spent part of their inheritance on a well that went dry at a rental.</p>