<p>Yes. I was always an advocate of the catastrophic only plan.</p>
<p>At these prices, the healthy will pay the fine, the unhealthy will get the insurance.</p>
<p>So pay the fine and self insure if you don’t want to spend the money on insurance.</p>
<p>Insurance companies were able to offer cheaper policies to 55-year-olds when they were allowed to enroll only healthy 55-year-olds, and deny insurance to people who might end up making claims. This should not be a shock to anyone.</p>
<p>I agree that for a family of four, with an income of $100K, $20K per year for insurance is mighty expensive. I would like to see the ACA amended in some way to deal with this problem. But in the previous system, some 55-year-olds, the ones who needed it least, could buy health insurance more cheaply and other 55-year-olds, the ones who were sick and needed health insurance, couldn’t buy it at any price. That’s even worse.</p>
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<p>There’s no fine if the premium cost is more than 8% of income. </p>
<p>For an individual earning $46,000 (the amount at which the person loses subsidy eligibility), that equates to an insurance premium of $308+ per month.</p>
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Not true – if you can’t find a policy with premiums within 8% of household income, then you are eligible to buy a catastrophic plan. </p>
<p>I’d note that a family of 5 would qualify for subsidies up to above $110K in household income. That’s more than double the median household income in the US.</p>
<p>Premium alone or premium plus deductible?</p>
<p>I see. So these 50+ uninsured people can buy catastrophic insurance. What are the terms of such insurance, and what kind of premium would a single 55-year-old have to pay? I didn’t see any listing of catastrophic plans on Covered California, but I don’t find the website entirely clear so I might have missed them.</p>
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<p>So you have a family income of more than $94,000, combined mortgage and taxes of less than $16,000 a year, but can’t afford to pay a premium of $1350 a month to cover 4 people? The problem is that you don’t know or appreciate what your husband’s employer-provided coverage actually costs. If your husband lost his job and you had to buy via COBRA I think you would be shocked.</p>
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<p>Premium costs.</p>
<p>The deductible is not a cost. It’s a shared risk.</p>
<p>Then that’s why the deductible is so high. And you got our facts wrong. But this isn’t about us. It’s about whether the scheme will work at all.</p>
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<p>My guess is that those plans would pop up if a person’s income and age data showed them to be eligible. I do think that the plans showed up as an option to purchase for me, but don’t want to go through the hassle of logging in again to find out. The basic way the plan is structured is that the deductible is the same as the maximum yearly payout - $6250 – the insurance pays nothing* until that amount is reached, then 100%. (“Nothing” of course still means that your patient responsibility amount to network providers is reduced to whatever amount the insurance company offers, and you get free preventive care).</p>
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. I took your facts from your post. You wrote that you had 2 kids in college, and that the cost of a years’ premium was more than the combined cost of mortgage and property tax.</p>
<p>emilybee:
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<p>Exactly! Then go use the ER which is obligated to treat you independent of ability to pay. Oh wait, that’s the problem we have now…um…never mind. :rolleyes:</p>
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<p>Since I’m not actually shopping, I just put in some random income the first time. But when I tried putting in income numbers where the premium was clearly greater than 8% of the income I supplied, I still didn’t see the catastrophic plans on the site. But maybe I missed them.</p>
<p>The site’s a little screwy, and puts up a popup that you are supposed to delete, with the actual information underneath. I didn’t realize that the cheapest Bronze plan would only be $1190/month ($14,280/year) for my family. Still, a family would have to earn $175K/year for that premium to be “affordable.” And I’m not seeing the catastrophic plan offered when I give a family income less than that.</p>
<p>Deductible is a cost if it comes out of your pocket. “Shared risk” - does that mean I don’t pay?? (sarcasm)</p>
<p>“Then go use the ER which is obligated to treat you independent of ability to pay. Oh wait, that’s the problem we have now…um…never mind.”</p>
<p>You will still be billed and someone who has enough income to not receive a subsidy will have to pay - unless they want to see their credit trashed. They aren’t in the habit of writing off treatment for people who make over 6 figures.</p>
<p>And not every medical problem can be treated in an ER. Good luck finding a doctor to treat you if get cancer, or 1000’s of other diseases if you have no insurance.</p>
<p>Remember that the emergency room is obligated to treat you. But it is certainly not obligated to treat you for free. They will bill you, and they can send debt-collectors after you and ruin your credit.</p>
<p>Plus, emergency rooms don’t offer chemotherapy, rehabilitation, well-baby checks, immunizations, diabetes monitoring or many other health treatments people need. [Although I’m a little ashamed to admit that if you go to an emergency room for a strep throat test, you will get one. But I was sick, and I’d already ridden my bike 50 miles that day with a full touring load…]</p>
<p>TatinG, do you usually use up your entire deductible? Most people don’t.</p>
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No, that means that if you go for a year without getting sick or injured, you pay -0-. The insurance company is giving you a significantly reduced premium in exchange for your gambling that you won’t have significant medical expenses during the year. So far I have been running that gamble for my own insurance for about 20 years and I’ve “won” every time. If you take the insurance company up on that gamble, your overall risk is limited. No matter what, you are guaranteed that you won’t have to pay more than $12,700 for the year on top of the premium for your family. Someone gets injured and spends 10 days in the hospital, with a $60,000 bill? The insurance company is on the hook for $47,300.</p>
<p>The risk value of the deductible is built into the premium. That is, the insurance companies have calculated a premium difference for each level where the odds favor them. But the insured sometime have the advantage of superior knowledge-- that is, a person may know that he needs surgery which can safely be postponed for a few months – so be able to predict with greater accuracy what near term medical costs will be. </p>
<p>One way or another, the family is potentially on the hook for that extra $12,700 (unless they pay top dollar for a platinum plan) – but with the higher metal tiers it will take longer until they get to that point, because the insurance company is paying a larger percentage of expenses along the way.</p>
<p>What happens if they offer only one insurance company in your area and you don’t like the provider? Is there any way to go to another provider?</p>