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Within the portal? I don’t see how you can go back to change income numbers once you have navigated past the eligibility determination point. It sounds like you are just using the “Shop and Compare” or the “Preview” tool, rather than the portal for selecting a plan.</p>
<p>Igloo, you don’t have to buy on the exchange – you just have to go to the exchange if you want subsidies. If there are other insurers who will sell to you, then of course you can buy directly from them.</p>
<p>hard for a lot of people to afford their current plans with the new premiums. My oldest son, who has been self-employed and/or working for companies without insurance, finally got the information from his current insurance plan. His new plan with comparable coverage will cost him almost twice his current rate. I feel sorry for young people who thought they could keep their existing plans.</p>
<p>Yes, I was using the shop & compare. I don’t need to buy a plan; I was just curious. I get the impression that the exchange plans are in the same ballpark as what my husband’s employer is paying.</p>
<p>wbow, I don’t know how old your son is, but I am in one of the priciest regions in California and the bronze plans on the exchange are all under $300 a month for a 32 year old. A person with $30,000 annual income would pay slightly over $200 a month for the silver plan after premium credits. </p>
<p>I do think that the private insurance companies are purposefully boosting their premiums on off-exchange plans, probably with the intent of pushing the people off those plans onto the exchanges. I think that’s something that was probably unanticipated or not fully appreciated by the people planning the launches of the exchanges – they didn’t know how many insured people would get notices on September 30th telling them that their policies were being discontinued or their rates boosted. </p>
<p>But I think that for individual policies, the full exchange rates for bronze and silver policies are unlikely to be a problem until you get to age 45 and up. Obviously it’s tough for a 59 year old with income close to the 400% mark like myself-- but I think the youngsters for the most part are going to find the exchange rates to be very favorable.</p>
<p>The ACA includes a number of cost-control mechanisms. One of the most famous is the readmission penalty: hospitals are now penalized if they discharge too many patients who are then readmitted within the month for the same diagnosis. Right now, the readmission penalty only is effective for heart attack, pneumonia and heart failure, but it is due to be expanded for other diagnoses. A large hospital readmission rate is a quality failure, but it is also a big expense, so reducing readmissions both improves quality and lowers cost.</p>
<p>Another cost control mechanism trial included in the ACA is bundled payments, which paying hospitals and doctors per diagnosis, rather than per procedure. Zeke Emanuel, one of the authors of the ACA and a champion of bundled payments, tells the story of the San Antonio Baptist Health System’s experience with bundled payments. The COO enrolled the hospital system in a bundled payments trial without consulting the doctors (who tend to resist change). The hospital system ended up saving money using bundled payments, which they shared with both doctors and patients. At the same time, various quality metrics improved. </p>
<p>Here’s one example of how they saved money: They had previously used all eight different artificial hips in hip replacement operations. The device cost didn’t matter, since they were passing it on to Medicare anyway. But under a bundled payment per hip replacement, they wanted to get the cost down. So they called up all eight manufacturers, and said, by such and such a date we need a bid from you, less than $X, for your artificial hip, or we will stop using it. But midnight of that date, three of the manufacturers had submitted a conforming bid, one had submitted a bid that was too high, and four manufacturers had not submitted any bid. So the hospital was down to three devices. But then the five manufacturers who didn’t come up to scratch realized they were frozen out; by 6 am, the hospital had conforming bids from all manufacturers. And, remember, the hospital system could keep the savings, which in the biggest case was a $6000 difference between the old cost and the new cost.</p>
<p>what’s the deal with kids staying on parents policy until 26? With BC/BS in RI, the premium cost for a family plan is now just the sum of everyone’s individual premium in the family(up to 4-5 kids, I forget).
Is this not the case in other states? If so, why would it matter? If the kid gets an individual policy or is part of a family plan, it would be the same price. What am I missing?</p>
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<p>no way is it 44m…especially if you factor in the young and healthy who choose not to have insurance.</p>
<p>“what’s the deal with kids staying on parents policy until 26? With BC/BS in RI, the premium cost for a family plan is now just the sum of everyone’s individual premium in the family(up to 4-5 kids, I forget).
Is this not the case in other states? If so, why would it matter? If the kid gets an individual policy or is part of a family plan, it would be the same price. What am I missing?”</p>
<p>My family plan is one fixed price regardless if I have no children and it’s just insuring spouses or I have 10 childen. I think most employer subsidized insurance is similar.</p>
<p>Premium notice finally came today for my son (27 yrs old so can’t be on our plan). Was supposed to come mid-September. Finally got here today. He had been paying $110. His premium for 2014 for an equivalent plan will be $294. He will not be eligible for subsidies (Income is too LOW, NC has not expanded Medicaid). I guess we will price out catastrophic plans, and if he doesn’t graduate this December maybe he can go on the university plan (which we have waived every semester because he had his own insurance)or maybe… just maybe… he will get a job in 2014 that will produce enough income to make him subsidy eligible… how odd is that?</p>
<p>(emilybee, just read your post. Beats me! Maybe that advantage of adding your 25 year old is really an advantage only for employer paid plans that used to exclude kids after age 18 or 22 if nonstudent )</p>
<p>**Moderator’s note: If you want to discuss politics, go to a venue outside of CC. You are liable to lose your posting privileges here. **</p>
<p>emilybee, just to add another data point, the way it works at my company is this: Employee pays nothing. You can add a spouse, OR kid(s), OR spouse + kids. Employee pays full cost for any of those options, and they are EXTREMELY pricey. Adding my DH and D would cost me almost $1400 a month, on top of the $1000 which my employer pays for my coverage.</p>
<p>“emilybee, just read your post. Beats me! Maybe that advantage of adding your 25 year old is really an advantage only for employer paid plans that used to exclude kids after age 18 or 22 if nonstudent )”</p>
<p>Yes, but since 58% of people are insured by their employers that equals a lot of 18-26 year olds now covered by insurance. </p>
<p>I think if you polled most of the parents on this board you would find a huge majority very happy they can keep their kids on their insurance until 26 if they have to.</p>
<p>La Mas, obviously different companies have different benefit costs and it’s up to the employee to decide if they want to keep their kids on or not - but before there was no option. </p>
<p>No one is making you keep your kid on your insurance.</p>
<p>^ right, but the money has to come from somewhere. I can see many companies not wanting to add that extra expense. It’s not s gift.</p>
<p>Has anyone here been able to purchase insurance from the federal exchange site yet? I’m not talking about state exchanges – I mean the site for those whose states don’t have their own. Here it is Day 4 and I’m still unable to get past the log in screen (and some days it won’t even get that far). Has anyone gotten Live Chat to work yet?</p>
<p>Some companies will pay for it and some will make the employee pay for it. If the employee has to pay extra for their kids to stay on and doesn’t want to they don’t have to. Personally, if my kid needed insurance and it would cost me more to keep them on my plan, I would have no problem paying as it’s extremely important to me that my kid have insurance.</p>
<p>“right, but the money has to come from somewhere. I can see many companies not wanting to add that extra expense”</p>
<p>Many companies have had policies that count college students (22?) as being part of the family as long as the employee certified them as being in college. When my daughter turned 19 this year, they sent a note asking to certify that she is in college. The interesting part of it was that they said base insurance can’t be removed even if not in college due to the new law but dental and vision will not continue without such certification.</p>
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<p>She’s not on my employer-sponsored plan. She’s on DH’s individual policy. And no, no one is “making” us to that either, but we consider health insurance to be imperative. Our problem was finding a way to make it affordable because both she and DH have preexisting conditions. </p>
<p>In fact, when things settle down a bit on the exchanges, we’re going to do a little comparison shopping about how much it would cost to keep her on DH’s (non-subsidized) policy versus getting her own (subsidized) policy. It may very well be that it’ll be cheaper overall to take her off DH’s. But as you say, we now have a choice, and yes, I am indeed very happy about that.</p>
<p>It all depends on the company plan as to whether an additional dependent costs more. In our plan, the cost is the same regardless of how many children, once you designate that you want children covered. Employee (DH) is covered at no cost. Additional fee for spouse to be covered and then for children. I have seen plans where it’s either just self or family, doesn’t matter who else is covered or how many more. There are plans that will charge per kid as well. I have a friend for whom it was less expensive to have college kid be put on the university health care plan as he was a full time college student, than it was for her to keep him on their coverage. They want to price out the difference between what the university plan will charge vs ACA choices and compare coverages, co pays and other such features.</p>
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<p>this is what I was asking about. In RI. it doesn’t matter, a family plan total cost is just the sum of each individual. I thought this was the case for all states with the ACA…is it not? Gender doesn’t matter, just age.</p>