The Money Mustache Community

Other => Off Topic => Topic started by: MaxRules on December 04, 2014, 07:54:15 PM

Title: Will I ever be able to get health insurance?
Post by: MaxRules on December 04, 2014, 07:54:15 PM
I'm a 31 y/o male and I have not been to a doctor my entire adult life. I know my luck will have to run out sometime so I always told myself I'd get health insurance at age 30. Of course that was last year and the government tried to save me from myself with the unAffordable care act. I am not getting political here, I am going off facts I have found while trying to procure my own health insurance. Before this act, I checked for very basic high deductible coverage and found I could buy it at only $50/month. Reasonable enough. That was when I was 29. I turned 30 last year and in an attempt to keep my promise, I applied for coverage through healthcare.gov. The rates were outrageous. Fast forward another year and I just checked again. Absolutely outrageous prices. FIVE TIMES higher than the rate I got just before the unAffordable care act. That's right, an unbelievable $250 month with a $6200 deductible!!! I do not qualify for assistance and even if I did, I am not taking a government handout or letting others pay for my insurance!!!

My plan is and always has been:  1) stay healthy.  2)If I do need to go to the hospital, manage the costs there like I manage costs in anything else I do. Don't let the doctors just pile on the bullshit. They are salesman just as much as they are doctors, this is fact.  3)Negotiate the final bill and make payments... probably less than the $250/month the insurance wants up front.

Meanwhile, crackheads all over town get monthly checkups and full health care for free and contribute nothing to society. I won't even waste time on this one.

<Rant Off> Anyone else in the same boat? Any possible solutions?
Title: Re: Will I ever be able to get health insurance?
Post by: MoneyCat on December 04, 2014, 08:01:28 PM
You could always choose the pay the tax penalty if you don't want to pay for health insurance under the ACA.  $250/mo is actually not bad for a healthy thirtysomething male.
Title: Re: Will I ever be able to get health insurance?
Post by: La Bibliotecaria Feroz on December 04, 2014, 08:02:53 PM
Sorry, nothing to say except to suck it up and pay it unless you want to get a job that covers it. (I only work 20 hours a week, and I can cover me and my kids for less than that price with a $500/person deductible HMO).

Not all health costs can be managed. One tiny piece of bad luck and it's bankruptcy city (or, you know, death). Insurance is to protect you from potential financial catastrophe. Dental insurance? Optional, because a person with reasonable savings can whether any dental emergency as there's pretty much an upper limit. Health insurance? There is no upper limit what it can cost.

The old individual insurance plans had a ton of caveats. The new ones cost more because they cover a lot more--no lifetime maximums, for instance.
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 04, 2014, 08:16:56 PM
I'm 34. I never had health insurance, my entire life, until last year.

If you go without insurance, do not call 911, go to the emergency room, or check into a hospital unless you're dying.  They charge absolutely obscene prices when you are uninsured -- often 10x what they charge insurance companies. Of course this means you can negotiate down quite a bit. But you are still gonna get reamed, every day in the hospital extra for observation is at least a couple thousand, another couple thousand for the ambulance ride, a hundred bucks for every valium they give you to keep you calm, etc.

Of course you find out none of that until the bills start rolling in a few weeks later. And if you ask in the hospital, nobody knows what the prices for anything is. It's just "the doctor ordered it, swallow this". You have to always be alert, ask questions, don't let them blow you off if you really need an answer to something. Blah blah. And that's just to come out only costing 1 arm and leg instead of all of them.

Like I said, I went without health insurance my whole life as well, only been to a doctor a couple times. I didn't even get vaccinated when I was a kid (religious parents). So I can relate.

Honestly, if you're in decent health, at age 31 I wouldn't be too scared of not having health insurance.  Yeah your life will go to total shit if something bad happens like appendicitis. You will have to go to a hospital, get an appendectomy (or you WILL die), and your net worth will suddenly be reduced by $10k-$20k probably. If you're at zero or below net worth like much of the population, this can ruin your life. Bankruptcy is getting harder for medical debt but I think it's still an option though.

Anyway.  Grim discussion.  BUT.  If I were you, (and I was 3 years ago basically, except now there is the ACA), I would not get insurance yet and pay the fine ($95 or 1% of your income, whichever is higher, this year I think -- so 1% of your income if you have any income at all essentially).

However I was offered a job with the State of California last year, so now I pay $65/month for my healthcare.  Although my employer pays $400/mo, and that is money they can't pay me, so it's part of the cost of having me as an employee, so I guess it's really costing me the $500/month anyway.  Just like your employer has to pay 7.6% for fica or whatever same as you, so its really 15% (and if you're self employed you have to pay the full 15%). So either way its 15% tax you're paying, it's just which side it's listed on your paystub but it still could have been your money. :(
Title: Re: Will I ever be able to get health insurance?
Post by: SporeSpawn on December 04, 2014, 08:18:11 PM
$250/month is not outrageous.
Title: Re: Will I ever be able to get health insurance?
Post by: Lynski on December 04, 2014, 08:31:22 PM
So I have maybe a different perspective on this. I'm a childhood cancer survivor, and as a result have had four major surgeries throughout my life thus far. Definitely not typical for most people, but it taught me the lesson that no matter how great I was at taking care of myself, sometimes bad things happen to good people.

Even if you qualified for government assistance, but would NEVER take a "handout" towards insurance  - isn't having to declare bankruptcy because of a medical bill relying on others to help foot your bill anyways?

For reference, my last two surgery bills came in at $80,000 and $70,000 respectively, and of that I paid less than $10K because of insurance through my employer.
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on December 04, 2014, 09:34:57 PM
I am certain that the so-called health insurance pre-Obamacare for 50 bucks was not legitimate insurance.  This was the kind of "insurance" that Fox News reported people were "losing" due to Obamacare, that were outpatient only, no prescription coverage; in other words, not actual insurance.  The real cost of health care as other have alluded to are hospitalization, which can have essentially unlimited cost, and unexpected diagnoses, such as cancer, which these outpatient only plans certainly would not cover.  Paying for a $250 per month that you are looking at now back then would have maybe bought you a $8-10k deductible plan with a say $100k yearly or lifetime maximum, which would leave you with both predeductable and after maximum cost to pay out of pocket. If say you were diagnosed with leukemia or any other high cost cancer diagnosis, you would likely have to file for bankruptcy. 

As the saying goes, pre-Obamacare health insurance plans were like hospital gowns... you think that your ass is covered but its not!

You are definitely crossing the line between frugal and cheap by not bucking up and paying for your very reasonable and secure (meaning the policy will prevent you from bankruptcy, because that is the purpose of Obamacare if you are too politically biased to appreciate it) health insurance policy.  You would never have been able to pay that low of a price for a similar policy in the good old day (sarcasm). 
Title: Re: Will I ever be able to get health insurance?
Post by: BlueMR2 on December 05, 2014, 09:31:04 AM
$250/month is not outrageous.

Yikes.  That's obscenely high to me for a single male.  I had my own personal insurance just before ACA came about, and I had VERY good insurance for only $62/mo.  Single female for the same time period was running $250ish though.  Apparently men usually manage to kill themselves whereas women just maim themselves in accidents?  :-)

It's really scary how much costs have skyrocketed under ACA.  It's taking insurance and making unaffordable for the very people that need to be drawn in to help support it.  I like the concept, but the current version is a trainwreck, it needs a serious overhaul.
Title: Re: Will I ever be able to get health insurance?
Post by: kendallf on December 05, 2014, 09:46:59 AM
You should re-title this post something like "I am able to get health insurance, but I'd rather gamble and whine about it."
Title: Re: Will I ever be able to get health insurance?
Post by: Louisville on December 05, 2014, 10:01:27 AM
....or letting others pay for my insurance!!!
That's what insurance does. Spreading costs around a pool of participants.
You should re-title this post something like "I am able to get health insurance, but I'd rather gamble and whine about it."
+1
Title: Re: Will I ever be able to get health insurance?
Post by: James on December 05, 2014, 11:16:09 AM
Nothing wrong with noting that health insurance costs have risen dramatically due to obamacare. Whether this is good or bad depends on your philosophy of life and insurance, but the rise is an objective fact, and it is due to the mandates of the coverage. You can't buy true "catastrophic" insurance on the exchanges, they all must contain all sorts of coverage that catastrophic policies didn't cover in the past, like birth control, wellness visits, vaccinations, etc, etc... This isn't about politics, this is just what the law did. It removed an option that many young people used with good results, they had savings to cover health care expenses and just wanted insurance to cover anything above $6-10,000. And now they need to purchase more expensive insurance and move on with life. Elections and laws have consequences, and that is regardless of whether you think the consequences are good or bad.
Title: Re: Will I ever be able to get health insurance?
Post by: surfhb on December 05, 2014, 11:36:02 AM
$250/month is not outrageous.

Yikes.  That's obscenely high to me for a single male.  I had my own personal insurance just before ACA came about, and I had VERY good insurance for only $62/mo.  Single female for the same time period was running $250ish though.  Apparently men usually manage to kill themselves whereas women just maim themselves in accidents?  :-)

It's really scary how much costs have skyrocketed under ACA.  It's taking insurance and making unaffordable for the very people that need to be drawn in to help support it.  I like the concept, but the current version is a trainwreck, it needs a serious overhaul.

What was your coverage for that?    I'd imagine if you were hospitalized for and an extended period you'd have thousands of out of pocket costs....which basically negates the point of insurance

Maybe someday we will wake up and provide medical care for every citizen in this country.

Not losing my life, savings, credit rating, ect if I get sick should be a fucking right in this country and age people!   

I hope people will wake up and see that the ACA was basically a blank check written out to the health care industry presented to them by the people we elected.   Yep!  Keep voting the status quo people !   :)
Title: Re: Will I ever be able to get health insurance?
Post by: SporeSpawn on December 05, 2014, 12:09:37 PM
$250/month is not outrageous.

Yikes.  That's obscenely high to me for a single male.  I had my own personal insurance just before ACA came about, and I had VERY good insurance for only $62/mo.  Single female for the same time period was running $250ish though.  Apparently men usually manage to kill themselves whereas women just maim themselves in accidents?  :-)

It's really scary how much costs have skyrocketed under ACA.  It's taking insurance and making unaffordable for the very people that need to be drawn in to help support it.  I like the concept, but the current version is a trainwreck, it needs a serious overhaul.

Like surfhb, I'm curious what that covered.
Title: Re: Will I ever be able to get health insurance?
Post by: BlueMR2 on December 05, 2014, 01:49:06 PM
What was your coverage for that?    I'd imagine if you were hospitalized for and an extended period you'd have thousands of out of pocket costs....which basically negates the point of insurance

It was better than I had at work, and that was pretty solid coverage.  I don't know the numbers off-hand.  The low price was the benefit of being in a very low risk/low usage group.  Family coverage at the same time was 10x as much because families are high risk.
Title: Re: Will I ever be able to get health insurance?
Post by: Numbers Man on December 05, 2014, 01:58:08 PM
You should re-title this post something like "I am able to get health insurance, but I'd rather gamble and whine about it."

^ This.

Title: Re: Will I ever be able to get health insurance?
Post by: tracylayton on December 05, 2014, 08:09:13 PM
You should re-title this post something like "I am able to get health insurance, but I'd rather gamble and whine about it."

^ This.

Yep.
Title: Re: Will I ever be able to get health insurance?
Post by: MaxRules on December 05, 2014, 08:54:35 PM
I'm 34. I never had health insurance, my entire life, until last year.

If you go without insurance, do not call 911, go to the emergency room, or check into a hospital unless you're dying.  They charge absolutely obscene prices when you are uninsured -- often 10x what they charge insurance companies. Of course this means you can negotiate down quite a bit. But you are still gonna get reamed, every day in the hospital extra for observation is at least a couple thousand, another couple thousand for the ambulance ride, a hundred bucks for every valium they give you to keep you calm, etc.

Of course you find out none of that until the bills start rolling in a few weeks later. And if you ask in the hospital, nobody knows what the prices for anything is. It's just "the doctor ordered it, swallow this". You have to always be alert, ask questions, don't let them blow you off if you really need an answer to something. Blah blah. And that's just to come out only costing 1 arm and leg instead of all of them.

Like I said, I went without health insurance my whole life as well, only been to a doctor a couple times. I didn't even get vaccinated when I was a kid (religious parents). So I can relate.

Honestly, if you're in decent health, at age 31 I wouldn't be too scared of not having health insurance.  Yeah your life will go to total shit if something bad happens like appendicitis. You will have to go to a hospital, get an appendectomy (or you WILL die), and your net worth will suddenly be reduced by $10k-$20k probably. If you're at zero or below net worth like much of the population, this can ruin your life. Bankruptcy is getting harder for medical debt but I think it's still an option though.

Anyway.  Grim discussion.  BUT.  If I were you, (and I was 3 years ago basically, except now there is the ACA), I would not get insurance yet and pay the fine ($95 or 1% of your income, whichever is higher, this year I think -- so 1% of your income if you have any income at all essentially).

However I was offered a job with the State of California last year, so now I pay $65/month for my healthcare.  Although my employer pays $400/mo, and that is money they can't pay me, so it's part of the cost of having me as an employee, so I guess it's really costing me the $500/month anyway.  Just like your employer has to pay 7.6% for fica or whatever same as you, so its really 15% (and if you're self employed you have to pay the full 15%). So either way its 15% tax you're paying, it's just which side it's listed on your paystub but it still could have been your money. :(

That's pretty much how I go about it. You and I seem to be on the same level with health and how we go about taking care of ourselves as well as how we would approach getting care at a hospital. If more people would save money like this when at the hospital, care would be much more affordable. The way it is now, it is basically a free for all for the hospital since they are allowed to sell us as much "care" as they can fit into the time you're there.

$250/month is not outrageous.

Yikes.  That's obscenely high to me for a single male.  I had my own personal insurance just before ACA came about, and I had VERY good insurance for only $62/mo.  Single female for the same time period was running $250ish though.  Apparently men usually manage to kill themselves whereas women just maim themselves in accidents?  :-)

It's really scary how much costs have skyrocketed under ACA.  It's taking insurance and making unaffordable for the very people that need to be drawn in to help support it.  I like the concept, but the current version is a trainwreck, it needs a serious overhaul.

What was your coverage for that?    I'd imagine if you were hospitalized for and an extended period you'd have thousands of out of pocket costs....which basically negates the point of insurance

Maybe someday we will wake up and provide medical care for every citizen in this country.

Not losing my life, savings, credit rating, ect if I get sick should be a fucking right in this country and age people!   

I hope people will wake up and see that the ACA was basically a blank check written out to the health care industry presented to them by the people we elected.   Yep!  Keep voting the status quo people !   :)


You come from a different walk of life than me if $250/mo is not outrageous for basically no coverage. Value is a relative thing, probably based mostly on your income and your need for the product. The major problem I have with the cost is the simple fact that it provides so little value to me. I would gladly pay the $250 if I actually got something for it in the event I needed to visit the doctor. BUT, it doesn't... I donate this high monthly rate and then when I need care, I still have to fund every expense myself up to the $6200 deductible.  That is a full $3000 I donate by the end of the first year just in the monthly rate. Then if I need the most unlikely extended hospital care and blow through the deductible, I am already out nearly $10k in costs after only the first year... AND THEY CALL THAT INSURED??? How many people have $6200 saved to cover this deducible? Very few as we all know.

You should re-title this post something like "I am able to get health insurance, but I'd rather gamble and whine about it."

^ This.

Yep.

It's always easy to see who voted for Obama. Stand by him no matter how his Majesty rules. I'll admit I have hated the guy since day one and can't believe even one sound-minded person could vote for him, but like I said in the first post this is not about politics. This is about the fact that before his "Affordable" care act, my insurance was cheaper. Simple fact. And it was just as good if not better for what I need than what the ACA is offering me for $250. On top of that I was buying insurance on the free market just as I do when buying any other product. That's what it means to be a free American instead of being forced into something that a few rich guys living in another world has said is best for me. I'll take my money and my freedom, you can keep the change.
Title: Re: Will I ever be able to get health insurance?
Post by: merula on December 05, 2014, 09:02:56 PM
I don't think you can say that everyone who disagrees with your assessment of health insurance value must be an Obama supporter, and then say in the same sentence that this isn't about politics.
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 05, 2014, 09:23:26 PM
Well.  Do consider this, though, MaxRules.  The cheaper health insurance MAY not have been "real" like the other posters have suggested.  I have read a lot of instances of people having their insurance cancelled right when they get a serious illness or condition (saves them from having to payout) by going back and looking for omissions on your application, things like that.  So if you never mentioned you had asthma when you were 8 or whatever, sorry you're screwed.  Now they can't do that

So Obamacare makes it so that we know the price of "real" insurance, or at least a better (more accurate) understanding of the price/cost.  Yeah it's higher than we thought it was, and any promises that it would be cheaper were total bullshit but we already knew that. What's important is we know the REAL price now, that's a good thing too

Now *forcing* people to buy it (individual mandate), I don't think that's right. And I don't think that it's constitutional either, to be candid.  But it is what it is, nobody else seems interested in adjudicating the matter so I can't force the supreme court to hear the case.

One other thing -- It is a *really* nice boon for FIRE / early retirement peeps.  Before PPACA, the longterm budget line item entitled Healthcare had a big ?? next to it.  Now you can have a better idea of the number that should go there. Makes it much, much safer to FIRE.

So although I think it's kinda bullshit and possibly illegal and don't really like it....   it probably *IS* better than what we had before....  except for those of who were willing to go without, like you and me.  We no longer have that option.

Which I'm surprised more people aren't defending, because Mustachianism is all about cutting expenses to the bone, and taking calculated risks.
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on December 05, 2014, 10:06:25 PM
You anger about Obamacare is purely emotional.  The fact of the matter is that most people on this forum do have  $6200 laying around for this deductible but that is not the point.

When people say that costs "have skyrocketed" under Obamacare, this demonstrates profound ignorance of real facts.  Pre-Obamacare, the cost of insurance was going up between 10-20% per year for the previous decade or so! The increase in cost for 2015 compared to 2014 (this is the only year Obamacare has been in effect) is 1-4% depending on your state. In some instances the rate of increase was actually less than inflation so it is actually getting cheaper for some.

This, many would say, is a miracle. However, it is an expected effect of putting reasonable constraints on a previously out of control market.

If anyone believes they could get real unsubsidized coverage for 50-60 dollars per month at any point in the last 10-20 years, they are dreaming.  Healthcare costs real money.  A doctor's visit costs at least $100.  A visit to the ER costs around $1000.  Cancer protocols cost hundreds of thousands of dollars.  You can't magically change $50 per month into something that will pay for all of these things plus the cost of maintaining the insurance company (profits and all).

I am an Obama supporter, but I agree with others that Obamacare is in many ways a giveaway to the insurance industry.  If we really wanted to cover everyone at a reasonable cost we would have cut out the middle man of insurance and instituted a single-payer system.  This, however, would make the right-wingers' heads explode.  So we are stuck with the imperfect semi-compromise that is Obamacare. 

Obamacare is a conservative idea (brought to the world by the Rush Limbaugh supported Heritage foundation) that strongly emphasizes the importance of personal responsibility.  Obamacare depends on people who can afford coverage to pay for it so that the rest of us don't have to bail you out by indirectly paying for uncompensated care. Because, if you don't buy the (oh so expensive!) policy, and tomorrow you are diagnosed with colon cancer, you will get treated and we will pay for it for you.  We would rather that you are at least paying something into the system instead of nothing like you are right now.

A note specific to the original poster, it sounds like your circumstance is such that you will qualify for a subsidy.  This is not a handout; it is what is required for us to have a stable healthcare system and overall economy. We want you to accept this money so that you are covered.  It is better for our society if you use that subsidy and buy coverage that will protect you from bankruptcy and will pay for your care if you get sick.

The saying goes "Pride comes before the Fall." Stop complaining and buy the policy. You complain that you aren't getting anything for your money.  In fact, you are getting a lot from the policy, the confidence that catastrophic illness will only cost you $6200, not everything.

You also get 0 deductible preventive care but who is counting.
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 05, 2014, 10:23:47 PM
We spend around $500,000,000,000.00 more than we have every year as a nation.

Don't tell me "Obamacare depends on people who can afford coverage to pay for it so that the rest of us don't have to bail you out by indirectly paying for uncompensated care"

because this nation runs on funny money anyway

How about we just pay for it with inflation, so everybody pays, instead of unfairly taxing the young and the healthy that had nothing to do with pre-existing conditions that may or may not (plenty both ways) have anything to do with poor life/health choices...

(EDIT: I just want to say, I hope I'm not offending anyone with what I'm saying...  I'm just trying to consider all sides of the issue and don't mean to offend)
Title: Re: Will I ever be able to get health insurance?
Post by: firedup on December 05, 2014, 11:11:07 PM
In my 35 years of working and having employer sponsored insurance I can testify how much things have changed. From terrific insurance, no charge, low deductibles, low out of pocket to sky high premiums, 5000/pp deductible, 6550 pp out of pocket, currently. The whole issue has grown out of control.

Not to get on a soap box but the whole "who pays for Obamacare" gets me. Any tax deduction is a "subsidy". Kids, daycare, mortgage interest, any deduction anyone takes above and beyond the standard is getting a subsidy. Anyone who doesn't pay taxes on long term gains and dividends due to current tax laws is getting a subsidy. Anyone who pays for any goods and services is paying for the healthcare of the workers who provide those goods and services as it is factored into those costs. If Sears said $50.00 on this $700.00 fridge goes to pay for the factory worker's health insurance and the whole Sears team who sold it to you, would people have the same attitude? I don't get why people are so up in arms about all this. Until you or a loved one faces the repercussions of not having health insurance and are faced with going without or losing everything it's hard to see it. I have seen the other side of this in my career and it's horrible to watch people lose everything and do so while fighting for their lives due to ill health. No-one should be faced with that. I'm not sure the whole healthcare ball of wax was handled correctly but I am in favor of some sort of a universal healthcare system. It really is time we stopped sending money out of this country and started taking care of our own people. The governor where I live raised all our taxes to pay the hospitals who were failing due to all the uninsured patients they legally could not turn away and the Medicaid shortfalls the state had no money to cover. We all pay, no matter how you look at it.
Title: Re: Will I ever be able to get health insurance?
Post by: surfhb on December 06, 2014, 12:41:53 AM

It's always easy to see who voted for Obama. Stand by him no matter how his Majesty rules. I'll admit I have hated the guy since day one and can't believe even one sound-minded person could vote for him, but like I said in the first post this is not about politics. This is about the fact that before his "Affordable" care act, my insurance was cheaper. Simple fact. And it was just as good if not better for what I need than what the ACA is offering me for $250. On top of that I was buying insurance on the free market just as I do when buying any other product. That's what it means to be a free American instead of being forced into something that a few rich guys living in another world has said is best for me. I'll take my money and my freedom, you can keep the change.

I dont like Obama as our president or the ACA either.   There are some great points to the ACA but it should have been a single payer system with socialized healthcare for all Americans.    Sorry but I refuse to believe anyone should die or lose what little savings they have because they get injured or sick or are refuse coverage.    This was the healthcare  scenario before the ACA.   

Similar to when I call the police or fire dept......When I turn on a faucet i expect clean water......when my children are school aged.      These are common sense rights as humans living in a civilized society.   
Title: Re: Will I ever be able to get health insurance?
Post by: MoneyCat on December 06, 2014, 07:56:17 AM

It's always easy to see who voted for Obama. Stand by him no matter how his Majesty rules. I'll admit I have hated the guy since day one and can't believe even one sound-minded person could vote for him, but like I said in the first post this is not about politics. This is about the fact that before his "Affordable" care act, my insurance was cheaper. Simple fact. And it was just as good if not better for what I need than what the ACA is offering me for $250. On top of that I was buying insurance on the free market just as I do when buying any other product. That's what it means to be a free American instead of being forced into something that a few rich guys living in another world has said is best for me. I'll take my money and my freedom, you can keep the change.

I dont like Obama as our president or the ACA either.   There are some great points to the ACA but it should have been a single payer system with socialized healthcare for all Americans.    Sorry but I refuse to believe anyone should die or lose what little savings they have because they get injured or sick or are refuse coverage.    This was the healthcare  scenario before the ACA.   

Similar to when I call the police or fire dept......When I turn on a faucet i expect clean water......when my children are school aged.      These are common sense rights as humans living in a civilized society.   

It's always easy to see who's a member of the GOP, because they hate on anything a Democrat does, even if the idea originally came from a Republican.  The ACA isn't perfect, but it's a heck of a lot better than what we had before, which was "wait until you get sick, go to an emergency room and get substandard treatment before being kicked out onto the street, declare bankruptcy, and have people with insurance foot the bill."  People need to get over the "Elephant vs. Donkey" nonsense and look at the actual benefits of the law and how it works.  This isn't a college football game.  It's life or death for people in the USA.
Title: Re: Will I ever be able to get health insurance?
Post by: jawisco on December 06, 2014, 08:28:55 AM
You are risking a lot by not having health insurance (all your non-retirement account savings, future earnings unless you are willing to do bankruptcy).  I think 3K/year is pretty cheap insurance against this, but it really depends on what you have and how you feel about bankruptcy.

If you have plenty of money, and you are willing to spend 30-50K on an emergency situation (where you will get reamed financially because you don't have insurance - if it was non-emergency, you could always go overseas for reasonably priced treatment) on the unlikely possibility of major health emergency, you could just pay the penalty and go without and play the odds.  Think about increasing your medical payments in auto insurance since this would be most likely path towards major health emergency.

The nice thing about Obamacare is if you develop a health issue, you can always get insurance the next year.  Before obamacare, you would have been cut off from buying health insurance for your whole life if you develop a pre-existing condition.
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on December 06, 2014, 10:04:40 AM
In response to pzxc's comment "Which I'm surprised more people aren't defending, because Mustachianism is all about cutting expenses to the bone, and taking calculated risks."

I think that this would be a poor "calculated risk" to take."  Because the downside risk prior to Obamacare was essentially infinite. Let's say you were essentially at FIRE, you had a large enough stash to never work for money again. Since you are Mustachian, let's say you have $1 million and live off of $40k per year.

Then you get sick... Let's make the condition CML (a reasonably common condition, about 1 per 50-70,000 people per year) because that is about the most expensive condition you could ever have because the yearly treatment costs between $80-120K depending on which tyrosine kinase inhibitor you oncologist chooses. The life expectancy on this treatment is pretty good (20 plus years) assuming you continue to respond.   You cannot just die yourself out of this financial snaffu. If you fail to respond at any point, your only option for survival is a bone marrow transplant, which will cost around $1 million dollars (your entire stash) or more depending on how many complications you have.

Pre-Obamacare:

Option 1 No Insurance - You would be uninsurable and there was essentially no insurance company who would give you insurance. Your only option would be to find a job at a large company who would give you insurance (which thanks to discrimination policy may have been an option). Note the strong link between insurance and employment. Without getting a job with insurance, you will be forced to file for bankruptcy. Either way, your stash would dwindle to below FIRE levels within days to months.

Option 2 you have a non-group (not employer sponsored) insurance policy -  The insurance will pay for your initial care but will then raise your rate to the point where your no longer financially independent.  The insurance company will do all that is possible to cancel your policy, and legally they could and eventually would. Either way you are no longer FI.

(This is where I originally left off but I wanted to finish this one up because it is a significant point.)

Obamacare

Option 1 - choose to be whinypants who hates Obama and rebels by not coughing up for reasonable high deductible polity - The patient is diagnosed early in the year when uninsured.  The patient presents to hospital in blast crisis (very high white blood cell count - basically lethal condition and common initial symptoms for CML).  The patient is hospitalized for 5 days, has all of the appropriate procedure to treat his acute condition (leukoreduction for those interested in the medical aspect) as well as the appropriate pathologic work up for his cancer (bone marrow biopsy, molecular analysis) and is started on the previously mentioned life saving medication.  Let's put a random cost on this hospital stay (most hospital bills are pretty random anyway by the way but we are stuck with this for now) plus enough meds to get through the year: $300,000.  Stash is now potentially still above FIRE  ($700,000 or $28k per year withdrawal) with some frugality muscle flexing.   But now, since the patient is eligible for open enrollment the following year, the patient can buy a reasonable low-deductible Gold policy (remember he knows he is going to blow through a high-deductible policy with his yearly medication costing up to $120k) without be shut out like before.  He had a significant trimming of the stash but has still preserved a good chunk. Obamacare saved this skeptical patient's FIRE.

Option 2 - emotionally stout Mustachian who may not like the current government but sees how he can benefit from a reasonable ($250 per month) Bronze high-deductible policy - The patient gets same diagnosis and treatment as previous patient. However, he is insured. Patient pays $6200 deductible and incurs no additional expenses. Patient cuts back a little bit this year from his normal 4% withdrawal rate and continues to groom his pinpoint sharp handle bar mustache.  The following year he can upgrade his policy to a Gold policy to save additional money going forward. FIRE preserved, continues to enjoy his previous life-style and hopefully tells everyone about his Obamacare experience.

As others have mentioned there are other scenarios, like acute heart attacks, motor vehicle accident, etc., where Obamacare will come through for people. 

My greatest advice is to listen to your stash not your political bent.  Politics is an emotional game that if you allow to interfere with your otherwise sound financial thinking can cost you big time.

Title: Re: Will I ever be able to get health insurance?
Post by: bacchi on December 06, 2014, 11:18:54 AM
The costs are high because of a number factors, mainly the insurance company cut, provider wages, and hospital profits. It's not as if Obama is skimming money off the top of each month's premium.

If you want to rail against the costs, an obvious choice would be that $15 aspirin at the hospital.
Title: Re: Will I ever be able to get health insurance?
Post by: Gin1984 on December 06, 2014, 11:24:54 AM
$250/month is not outrageous.

Yikes.  That's obscenely high to me for a single male.  I had my own personal insurance just before ACA came about, and I had VERY good insurance for only $62/mo.  Single female for the same time period was running $250ish though.  Apparently men usually manage to kill themselves whereas women just maim themselves in accidents?  :-)

It's really scary how much costs have skyrocketed under ACA.  It's taking insurance and making unaffordable for the very people that need to be drawn in to help support it.  I like the concept, but the current version is a trainwreck, it needs a serious overhaul.
LOL, I was not able to get insurance prior to ACA so had to COBRA.  My COBRA cost was over $500/month.  And I was under 30.
Title: Re: Will I ever be able to get health insurance?
Post by: MayDay on December 06, 2014, 07:08:35 PM
My H was 37, in good health, no habits (smoking) or family history that was a risk factor.  He went from a weird EKG to a stress test to a cardiac cath to a triple bypass in about a week.  If we hadn't been insured, the cost would have been about 700k.  Insurance negotiated down to ~350k.  You might get a 10 or 25% discount if you pay cash.  We paid about 10k OOP with our high deductible HSA plan. 

The reason you buy insurance when you are healthy and 31 isn't for if you get a sinus infection or strep throat or want a flu shot.  It's so if you suddenly need a triple bypass, or get cancer, or get in a terrible accident, you don't have a million dollars of medical bills.

If you are ok with the risk of having your net worth go to literally zero, and declaring bankruptcy, and also increasing your odds of not even getting the cancer surgery or whatever (since the hospital knows you can't pay) then fine, don't get insurance and break the law/pay the fine.  But I, and most people here from what I have seen, think 250$ a month is pretty damn cheap and you should stop being a complainy-pants and pay up. 
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 08, 2014, 03:16:52 PM
The reason you buy insurance when you are healthy and 31 isn't for if you get a sinus infection or strep throat or want a flu shot.  It's so if you suddenly need a triple bypass, or get cancer, or get in a terrible accident, you don't have a million dollars of medical bills.

I agree completely, and I would love to get a catastrophic plan, but those are no longer allowed under ACA.  We are required to buy health insurance (individual mandate), and the only kind we can buy is the kind that covers sinus infections and strep throat and flu shots.
Title: Re: Will I ever be able to get health insurance?
Post by: SporeSpawn on December 08, 2014, 03:30:20 PM
The reason you buy insurance when you are healthy and 31 isn't for if you get a sinus infection or strep throat or want a flu shot.  It's so if you suddenly need a triple bypass, or get cancer, or get in a terrible accident, you don't have a million dollars of medical bills.

I agree completely, and I would love to get a catastrophic plan, but those are no longer allowed under ACA.  We are required to buy health insurance (individual mandate), and the only kind we can buy is the kind that covers sinus infections and strep throat and flu shots.

Really? My maximum out-of-pocket for everything from colds to cancer is around $6k. And I live in a state with pretty awful insurance all around, so I"m surprised that you can't find anything.
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 08, 2014, 08:10:36 PM
Colds shouldn't be covered at all -- perhaps you missed the word "catastrophic"
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 08, 2014, 08:13:52 PM
As an analogy, I want the home insurance that covers tree limbs falling on it, not the much more expensive home insurance that covers light bulbs and gutter cleanings.  I don't think there is such a thing -- are you listening insurance companies?? Untapped new market!
Title: Re: Will I ever be able to get health insurance?
Post by: GizmoTX on December 08, 2014, 08:29:18 PM
Insurance companies are not allowed to tap new markets, thanks to ObamaCare.
Title: Re: Will I ever be able to get health insurance?
Post by: SporeSpawn on December 09, 2014, 07:46:19 AM
Colds shouldn't be covered at all -- perhaps you missed the word "catastrophic"

I was being facetious. My point was that if I get hit by a tractor trailer tomorrow, lose four limbs, and discover a tumor in my left lung, my out-of-pocket is around 6k a year. So I'm skeptical that you simply cannot find something that covers "catastrophes."
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 09, 2014, 08:54:39 AM
Your facetiousness caused you to miss my point, then.

I said that I wanted to buy a catastrophic insurance plan, and can't do so because of ACA.

Taking a catastrophic plan and tacking on a whole bunch of other stuff, with the higher premiums to go with it, makes it NOT a catastrophic plan. Even if it covers catastrophes, it covers a bunch of other stuff too and at higher cost, so it is not a catastrophic plan.

That's like me saying, "Man, I can't find a good video card upgrade for my computer anywhere!" And you saying, "Sure you can just buy a new computer!"

NOT the same thing.
Title: Re: Will I ever be able to get health insurance?
Post by: beltim on December 09, 2014, 09:22:46 AM
Your facetiousness caused you to miss my point, then.

I said that I wanted to buy a catastrophic insurance plan, and can't do so because of ACA.

Taking a catastrophic plan and tacking on a whole bunch of other stuff, with the higher premiums to go with it, makes it NOT a catastrophic plan. Even if it covers catastrophes, it covers a bunch of other stuff too and at higher cost, so it is not a catastrophic plan.

That's like me saying, "Man, I can't find a good video card upgrade for my computer anywhere!" And you saying, "Sure you can just buy a new computer!"

NOT the same thing.

While you're right that no true catastrophic plan exists any more for health care, I did a little calculation and found that the cost difference between a "catastrophic" and ACA-approved health plan wasn't very much.

http://forum.mrmoneymustache.com/ask-a-mustachian/healthcare-self-insurance/msg388808/#msg388808

I'd be interested in adding more data points to that analysis if the numbers for you are different.
Title: Re: Will I ever be able to get health insurance?
Post by: Gin1984 on December 09, 2014, 09:29:21 AM
Your facetiousness caused you to miss my point, then.

I said that I wanted to buy a catastrophic insurance plan, and can't do so because of ACA.

Taking a catastrophic plan and tacking on a whole bunch of other stuff, with the higher premiums to go with it, makes it NOT a catastrophic plan. Even if it covers catastrophes, it covers a bunch of other stuff too and at higher cost, so it is not a catastrophic plan.

That's like me saying, "Man, I can't find a good video card upgrade for my computer anywhere!" And you saying, "Sure you can just buy a new computer!"

NOT the same thing.
Here is the thing, most people would would go for a catastrophic plan can't afford it.  I'd have no problem if we changed the law to you can get one, if you have X amount in a health care savings account (or the ability to do so), similar to how Ca allows you to wave car insurance with a $50,000 bond (or it did five years ago).  However, that would require people to stop trying to gut the bloody thing and fix the issues.  Another issue I see is the affordable is 9.5% of the employee, no mention of spouse and kids.  Another fix, but again that would require cooperation and not the attitude that was behind the statement "my number one priority is making sure president Obama’s a one-term president.".
Title: Re: Will I ever be able to get health insurance?
Post by: Cpa Cat on December 09, 2014, 09:52:19 AM
Ha - My home insurance company includes something like a $100K coverage for all my furs. I don't have any F-ing furs or anything of value at all. I just want to protect my house not the personal contents. They said they couldn't separate things because it was all bundled together.

Your comment made me laugh... I've had the exact same conversation with my insurance company about my non-existant furs. It's even listed separately on the policy as a supplement. Why is it listed separately if it can't be removed?!

Regarding Obamacare - $250 is a lot. I priced out some insurance with Obamacare this year and it was $350 for both my husband and I (healthy 30 somethings - but I was pricing an HSA eligible plan with roughly twice the deductible). Things have improved in my state this year, because a new insurance company entered our market. Things are supposedly going to get better again next year, because a third insurance company announced they would be offering ACA plans in my state for 2016.

But the local paper did a story that showed that prices for the exact same plan vary drastically depending on what state/region within the state you're in. I wasn't a big supporter of ACA (I thought universal was the way to go) - but it's done some good things. I think it's too bad that they forced through something so politically inpopular though - it means that its supporters will essentially be powerless to improve its faults, while its detractors try to weaken it.

The next step for ACA should have been to systematically lower costs for everyone - by addressing hospital charge lists, drug costs and the extreme geographic variation in the cost of plan [Of course, that stuff is easy when you have the massive negotiating power of universal health care - alas]. But that won't happen now.

I really wish we weren't bearing the burden of a health care policy that is essentially only half finished. Hopefully, in the next year or two, you'll see more insurance companies enter your ACA market with more options and your costs will come down.
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on December 09, 2014, 10:42:38 AM
Continuing to be the moderator of facts about Obamacare...

The things in the high-deductible policies that are included with zero or low deductible for are preventative care services (not treatment of common cold or other incidentals, which would require deductible pay down).  Real examples are colonoscopies and birth control.  These are included because encouraging patients to have these medications and procedures will lead to lower costs in the long run for the insurer. Remember insurers cannot just boot people off of their policies once they get expensive.  Birth control is less expensive than a child; colonoscopies are less expensive (in general) than a long fight with colon cancer.

While these little bonuses in your otherwise high deductible catastrophic policies may increase your cost now (in the early years of Obamacare), the point of them is to bend the cost curve over time.  And year over year healthcare will be less expensive than it would have been if Obamacare had not been instituted. 

If you are a young male and think that birth control and colonoscopies don't matter to you, well you are very naive. You will eventually need colonoscopies and men who have relations with women should consider themselves co-beneficiaries of these free little pills (or devices).

There are some relevant debates as to which of these inclusions actually save money and which ones don't.  There is also debate about whether covering most people is less expensive than allowing 20% of the population to be uninsured.  These things should become more clear over time.

The regional difference in cost is a tough nut to crack just like housing can vary dramatically.  One must remember that there are fixed costs of healthcare facilities that are regionally dependent.  The most important one is cost of labor.  As CPA Cat indicates, the market for insurance is becoming more robust as more insurers enter the various markets.  This will only improve the situation as time goes on.

Obamacare also offers some protection for patients otherwise from insurers... It is somewhat weak but insurers are now required to spend around 80% (I don't remember the exact number) on actual healthcare.  In the recent past, insurers were known to funnel 30-40% of premiums for administration and profits.

Please feel free to comment on my facts...
Title: Re: Will I ever be able to get health insurance?
Post by: NumberCruncher on December 09, 2014, 10:57:18 AM
...Of course that was last year and the government tried to save me from myself with the unAffordable care act.
(emphasis added)

You even started this discussion with a political bent.

You can't say you've always hated Obama and then say that you don't want the conversation to be political. :P

My personal health insurance costs haven't changed much since the ACA, for what it's worth, but I live in a good state for it and have had employer-subsidized plans. My HDHP costs me $80/mo, while my employer pays $280/mo - so $250/mo for an unsubsidized plan seems about right. Being a young, healthy man doesn't mean you get a big break on health insurance anymore, which sounds like the biggest reason for the price jump.

Continuing to be the moderator of facts about Obamacare...

Thanks for that! I learned something new today. :)
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on December 09, 2014, 11:33:49 AM
You are welcome! It is amazing that so far Obamacare is looking to be an amazing success story (especially when compared to what Americans were dealing with before)!

However, the success of the law so far has been basically ignored by the media (liberal and conservative alike)! And it seems to be the popular thing to say it is an unmitigated disaster!

For others, I have written extensively on this in the preceding posts.

It is not perfect as I have mentioned but it really is doing what it was supposed to do despite all of the opposition/obstruction from detractors.

Obamacare will be considered a success story at some point (It might take 10-20 years) in time just like Single-payer was in Canada.  There will always be opposition but the vast majority of Americans should be happy with it as soon as they learn the facts.  Just ask most Canadians how popular instituting a Pre-Obamacare American Healthcare System in Canada now would be.  The American healthcare system has been a laughingstock around the world for decades.  Unfortunately, we are told over and over again that we "have the best healthcare system in the world." 


It is true that we have always had world class care for a small subset of the population; however, we have always spent 50-200 per cent more per person (Thanks to beltim for correcting my previous exaggeration) to cover a small portion of the population.  Obamacare is bringing that worldclass care to most Americans and this should be lauded not detracted.



Title: Re: Will I ever be able to get health insurance?
Post by: beltim on December 09, 2014, 11:50:05 AM
It is true that we have always had world class care for a small subset of the population; however, we have always spent 5-10 time more per person to cover a small portion of the population.  Obamacare is bringing that worldclass care to most Americans and this should be lauded not detracted.

While most of your posts on this are factual, the bolded part is not.  The US spends more on health care than other countries, to be sure, but the difference is much smaller than you indicate: about 50% more than countries like Norway, Switzerland, and the Netherlands, and less than 3 times most of the rest of the developed world, including Canada, the UK, France, Germany, Australia, and Japan).  Furthermore, much of this difference is due to overall standard of living, as indicated by the percentage of GDP that goes towards health care; by this measure, the US spends about 50% more than most developed countries.

http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on December 09, 2014, 12:10:13 PM
Thank you for correcting me on that.  I believe my source, which was a presentation, a few years ago was projecting 5-10 years out assuming continued growth at the previous pace.  50% more is much more accurate.

It is still a crazy fact.  If we were to spend the same amount per person as Canada, who covers everyone, that would save over $1 trillion!
Title: Re: Will I ever be able to get health insurance?
Post by: simplified on December 09, 2014, 08:29:32 PM
To the OP: You think you may not need insurance and that when you need some care, you will pay out of pocket. What will happen when you get something like Appendicitis or you get into an accident or worse yet you get diagnosed with cancer? There are some things that you can not anticipate and things that you have no control over.

I'm outraged at the cost of healthcare in this country (I'm an immigrant). I'm also conservative. However, I fully support obamacare. It is not perfect, but thats the best congress could pass. I would take it any day compared to what existed before. The insurance that existed before was just an illusion. You should read up on countless stories where people had catastrophic insurance but denied coverage because some of the conditions were preexisting. Then there are people who couldn't get coverage after they got diagnosed with cancer or other costly disease. I'm pretty sure if something like that happened to you, you would be more outraged compared to your current outrage over increase in your premiums.

Obamacare shifts some costs around. People with low incomes get some subsides. The wealthy pay more, and it is kind of a tax. The overall costs have not gone up because of obamacare itself. If you want someone to blame, blame the big pharma, hospitals, doctors and medical workers for outrageous profits and salaries.

Obamacare is also beneficial to early retirees who have low incomes (premium subsidies!) but otherwise may be wealthy. So may be when you retire early, you will be happier!

Title: Re: Will I ever be able to get health insurance?
Post by: rocksinmyhead on December 10, 2014, 07:13:25 AM
I'm 34. I never had health insurance, my entire life, until last year.

If you go without insurance, do not call 911, go to the emergency room, or check into a hospital unless you're dying.  They charge absolutely obscene prices when you are uninsured -- often 10x what they charge insurance companies. Of course this means you can negotiate down quite a bit. But you are still gonna get reamed, every day in the hospital extra for observation is at least a couple thousand, another couple thousand for the ambulance ride, a hundred bucks for every valium they give you to keep you calm, etc.

Of course you find out none of that until the bills start rolling in a few weeks later. And if you ask in the hospital, nobody knows what the prices for anything is. It's just "the doctor ordered it, swallow this". You have to always be alert, ask questions, don't let them blow you off if you really need an answer to something. Blah blah. And that's just to come out only costing 1 arm and leg instead of all of them.

That's pretty much how I go about it. You and I seem to be on the same level with health and how we go about taking care of ourselves as well as how we would approach getting care at a hospital. If more people would save money like this when at the hospital, care would be much more affordable. The way it is now, it is basically a free for all for the hospital since they are allowed to sell us as much "care" as they can fit into the time you're there.

easy to say now, probably harder to act on when you're actually IN the hospital especially if you're unconscious, extremely ill, etc. I've never even had a major health issue and even I can figure that one out.

On top of that I was buying insurance on the free market just as I do when buying any other product. That's what it means to be a free American instead of being forced into something that a few rich guys living in another world has said is best for me. I'll take my money and my freedom, you can keep the change.

ha, ha, oh my god. the U.S. healthcare system pre-ACA was not a functional free market. it isn't now, but it wasn't then, either.

thanks everyone else for the interesting and helpful comments, especially BCBiker, I was going to refute pzxc's claim that you "can't get insurance that doesn't cover strep throat" (um, I have it) but you beat me to it :)
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on December 10, 2014, 07:09:04 PM
I wanted to paste this down to the bottom in hopes of getting a larger audience.  I basically have sought to prove that going without insurance is not a calculated risk worth taking and that Obamacare basically makes the situation sweeter than before whether you choose to buy insurance or not. Enjoy!


In response to pzxc's comment "Which I'm surprised more people aren't defending, because Mustachianism is all about cutting expenses to the bone, and taking calculated risks."

I think that this would be a poor "calculated risk" to take."  Because the downside risk prior to Obamacare was essentially infinite. Let's say you were essentially at FIRE, you had a large enough stash to never work for money again. Since you are Mustachian, let's say you have $1 million and live off of $40k per year.

Then you get sick... Let's make the condition CML (a reasonably common condition, about 1 per 50-70,000 people per year) because that is about the most expensive condition you could ever have because the yearly treatment costs between $80-120K depending on which tyrosine kinase inhibitor you oncologist chooses. The life expectancy on this treatment is pretty good (20 plus years) assuming you continue to respond.   You cannot just die yourself out of this financial snaffu. If you fail to respond at any point, your only option for survival is a bone marrow transplant, which will cost around $1 million dollars (your entire stash) or more depending on how many complications you have.

Pre-Obamacare:

Option 1 No Insurance - You would be uninsurable and there was essentially no insurance company who would give you insurance. Your only option would be to find a job at a large company who would give you insurance (which thanks to discrimination policy may have been an option). Note the strong link between insurance and employment. Without getting a job with insurance, you will be forced to file for bankruptcy and will rely on charity care (if available) for the rest of your life. Either way, your stash would dwindle to below FIRE levels within days to months.

Option 2 you have a non-group (not employer sponsored) insurance policy -  The insurance will pay for your initial care but will then raise your rate to the point where your no longer financially independent.  The insurance company will do all that is possible to cancel your policy, and legally they could and eventually would. Either way you are no longer FI.

(This is where I originally left off but I wanted to finish this one up because it is a significant point.)

Obamacare

Option 1 - choose to be whinypants who hates Obama and rebels by not coughing up for reasonable high deductible policy - The patient is diagnosed early in the year when uninsured.  The patient presents to hospital in blast crisis (very high white blood cell count - basically lethal without treatment condition and common initial scenario for CML).  The patient is hospitalized for 5 days, has all of the appropriate procedure to treat his acute condition (leukoreduction for those interested in the medical aspect) as well as the appropriate pathologic work up for his cancer (bone marrow biopsy, molecular analysis) and is started on the previously mentioned life saving medication.  Let's put a random cost on this hospital stay (most hospital bills are pretty random anyway by the way but we are stuck with this for now) plus enough meds to get through the year: $300,000.  Stash is now potentially still above FIRE  ($700,000 or $28k per year withdrawal) with some frugality muscle flexing.   But now, since the patient is eligible for open enrollment the following year, the patient can buy a reasonable low-deductible Gold policy (remember he knows he is going to blow through a high-deductible policy with his yearly medication costing up to $120k) without be shut out like before.  He had a significant trimming of the stash but has still preserved a good chunk. Obamacare saved this skeptical patient's FIRE.

Option 2 - emotionally stout Mustachian who may not like the current government but sees how he can benefit from a reasonable ($250 per month) Bronze high-deductible policy - The patient gets same diagnosis and treatment as previous patient. However, he is insured. Patient pays $6200 deductible and incurs no additional expenses. Patient cuts back a little bit this year from his normal 4% withdrawal rate and continues to groom his pinpoint sharp handle bar mustache.  The following year he can upgrade his policy to a Gold policy to save additional money going forward. FIRE preserved; patient continues to enjoy his previous life-style and hopefully tells everyone about his Obamacare experience.

As others have mentioned there are other scenarios, like acute heart attacks, motor vehicle accident, etc., where Obamacare will come through for people as well. 

My greatest advice is to listen to your stash not your political bent.  Politics is an emotional game that if you allow to interfere with your otherwise sound financial thinking can cost you big time.

I appreciate the positive feedback. I really don't have time for posting on forums like this but I think this information is really important to get out to people.
Title: Re: Will I ever be able to get health insurance?
Post by: pzxc on December 10, 2014, 08:13:03 PM
Meh.
Title: Re: Will I ever be able to get health insurance?
Post by: MaxRules on March 04, 2015, 09:16:38 PM
Lots of good information and input on this topic. First I'd like to apologize for my absence since starting this topic. I'm glad I have been to busy to post but this forum has the best collection of knowledge I've found online so I can't stay away long!

In a most unlikely turn of events, I am now fully insured under the ACA. I guess it was just something new that didn't sit well with me, since I now have a near $200/month payment where there was no payment before. I think any Mustachian can relate. As of three days ago I am covered for all the future illness and disease that has been building up for the past 31 years. Even Obama sent me a personal letter of thanks for my support of his program. Just kidding about that one, of course! :)

I guess there is nothing to do now but post back when this plan actually saves me money. Here's to good health and a long frugal life!
Title: Re: Will I ever be able to get health insurance?
Post by: TreeTired on March 04, 2015, 09:41:58 PM
I will tell you my son's experience because it is much closer to yours than my own.   He is 29.   He had been paying $150/month for a private health insurance policy.  His policy was grandfathered, so he kept it last year (If you like your policy you can keep your policy,  no, it's canceled, wait, you can keep it after all).   This year he got a part time low paying job, so he qualifies for ACA subsidies.   His new ACA policy has a list price of $250/month but he is paying $46/month.    ACA definitely sucks big time for people who don't make enough money to qualify for subsidies and live in a state where they cannot get Medicaid.   It also sucks for people who make just too much to qualify for subsidies because the policies tend to have higher list prices.
Title: Re: Will I ever be able to get health insurance?
Post by: Gin1984 on March 05, 2015, 07:47:35 AM
I will tell you my son's experience because it is much closer to yours than my own.   He is 29.   He had been paying $150/month for a private health insurance policy.  His policy was grandfathered, so he kept it last year (If you like your policy you can keep your policy,  no, it's canceled, wait, you can keep it after all).   This year he got a part time low paying job, so he qualifies for ACA subsidies.   His new ACA policy has a list price of $250/month but he is paying $46/month.    ACA definitely sucks big time for people who don't make enough money to qualify for subsidies and live in a state where they cannot get Medicaid.   It also sucks for people who make just too much to qualify for subsidies because the policies tend to have higher list prices.
Really?  You have a source for that.  Because it is false.  Health insurance, if you were not 100% healthy and remember they could kick you off if you got sick, has always been expensive.  Comparing employer based insurance to the exchanges, in the same states, they are not much different (if you take into account the increase in historical premiums).
Title: Re: Will I ever be able to get health insurance?
Post by: netskyblue on March 05, 2015, 08:24:12 AM
A year ago I was a completely healthy 30 year old.  Never, ever sick.   Literally, my only use of health insurance was my annual women's exam and birth control.

Then on Easter Sunday I went outside to play with my parents' dog.  In a freak accident, I fell and shattered my femur.  2 ambulance rides, X-rays, surgery, a rod & 2 screws through my leg, 3 days in the hospital, several bags of blood, months of physical therapy, more months of chiropractic care, and I STILL can't walk quite right.  Over $70,000 worth of care. 

But still some small part of me feels like I "won."  I was a good risk for the insurance company.  The likelihood of their having to pay out more than I paid in premiums was low.  If something like that happened to you, you'd have to pay premiums for over 20 years to equal what they paid out for one accident.
Title: Re: Will I ever be able to get health insurance?
Post by: Sibley on March 05, 2015, 09:09:24 AM
I will tell you my son's experience because it is much closer to yours than my own.   He is 29.   He had been paying $150/month for a private health insurance policy.  His policy was grandfathered, so he kept it last year (If you like your policy you can keep your policy,  no, it's canceled, wait, you can keep it after all).   This year he got a part time low paying job, so he qualifies for ACA subsidies.   His new ACA policy has a list price of $250/month but he is paying $46/month.    ACA definitely sucks big time for people who don't make enough money to qualify for subsidies and live in a state where they cannot get Medicaid.   It also sucks for people who make just too much to qualify for subsidies because the policies tend to have higher list prices.

I've seen in the news that more states are giving in and expanding Medicaid, so that helps on that end.

For the fact that policies cost more - of course they do. They cover more, including people that previously either would have paid obscene premiums or would have been denied coverage entirely.

The ACA stuff is new. The insurance industry is in turmoil adjusting, and the political dust hasn't settled yet. The current framework has problems, so expect changes. If nothing else, it'll be amusing (in a sick, sad way because I don't like either party) to see the blowback that happens if the Republicans scrap ACA. I can see the commercials now "Grandma didn't have insurance for years, and finally got it because of ACA. Then [insert name] took it away, and grandma's real sick and can't afford the doctor..."
Title: Re: Will I ever be able to get health insurance?
Post by: GuitarStv on March 05, 2015, 09:39:21 AM
Please forgive my ignorance . . . but my understanding of Health practices in the US are that health care is private and must be paid for, but is provided at emergency rooms to people who have no means to pay.

If you want to avoid buying health insurance couldn't you just leave all your identifying information at home and collapse at the nearest ER when in distress?
Title: Re: Will I ever be able to get health insurance?
Post by: bacchi on March 05, 2015, 10:28:49 AM
Please forgive my ignorance . . . but my understanding of Health practices in the US are that health care is private and must be paid for, but is provided at emergency rooms to people who have no means to pay.

If you want to avoid buying health insurance couldn't you just leave all your identifying information at home and collapse at the nearest ER when in distress?

If a hospital accepts Medicare, ER has to treat an emergency. They won't treat, for example, cancer.
Title: Re: Will I ever be able to get health insurance?
Post by: sol on March 05, 2015, 11:03:51 AM
This thread confused me at first.  OP seemed to be saying that with the new ACA he could buy insurance but didn't want to, without recognizing that before the ACA there were millions of people who could not buy health insurance at any price due to pre-existing conditions.

Right now all Americans can get health insurance for the first time in history.  So the obvious answer to the original question is YES you can now get health insurance.  Uncle Sam will even help you pay for it.
Title: Re: Will I ever be able to get health insurance?
Post by: Gin1984 on March 05, 2015, 11:16:19 AM
Please forgive my ignorance . . . but my understanding of Health practices in the US are that health care is private and must be paid for, but is provided at emergency rooms to people who have no means to pay.

If you want to avoid buying health insurance couldn't you just leave all your identifying information at home and collapse at the nearest ER when in distress?

If a hospital accepts Medicare, ER has to treat an emergency. They won't treat, for example, cancer.
And they only have to stabilize you, nothing else. 
Title: Re: Will I ever be able to get health insurance?
Post by: paddedhat on March 05, 2015, 11:38:21 AM
Meh.


LOL.  Predictable, but still a good laugh.
Title: Re: Will I ever be able to get health insurance?
Post by: GuitarStv on March 05, 2015, 12:20:14 PM
Please forgive my ignorance . . . but my understanding of Health practices in the US are that health care is private and must be paid for, but is provided at emergency rooms to people who have no means to pay.

If you want to avoid buying health insurance couldn't you just leave all your identifying information at home and collapse at the nearest ER when in distress?

If a hospital accepts Medicare, ER has to treat an emergency. They won't treat, for example, cancer.
And they only have to stabilize you, nothing else.

So in the US ERs they'll let you die of cancer, but not of a gun shot wound?
Title: Re: Will I ever be able to get health insurance?
Post by: Sibley on March 05, 2015, 12:29:39 PM
Please forgive my ignorance . . . but my understanding of Health practices in the US are that health care is private and must be paid for, but is provided at emergency rooms to people who have no means to pay.

If you want to avoid buying health insurance couldn't you just leave all your identifying information at home and collapse at the nearest ER when in distress?

If a hospital accepts Medicare, ER has to treat an emergency. They won't treat, for example, cancer.
And they only have to stabilize you, nothing else.

So in the US ERs they'll let you die of cancer, but not of a gun shot wound?

If you meet the requirements, you can get government provided health insurance (Medicare or Medicaid). If you don't qualify and don't choose to buy insurance, then yes, that could happen. It's not perfect, but ACA has been a step in the right direction at least.
Title: Re: Will I ever be able to get health insurance?
Post by: GuitarStv on March 05, 2015, 01:13:11 PM
It just seemed weird to me that the ERs will treat some conditions for free but not others.
Title: Re: Will I ever be able to get health insurance?
Post by: Gin1984 on March 05, 2015, 01:35:41 PM
It just seemed weird to me that the ERs will treat some conditions for free but not others.
The law requires them to treat all emergencies regardless of ability to pay, if it is not an emergency you should not be going to the emergency department.  You still owe the money but they can write off the loss on their books (for taxes) and they do that based on ability to pay.
Title: Re: Will I ever be able to get health insurance?
Post by: Sibley on March 05, 2015, 01:46:34 PM
It really comes down to what an Emergency Room's purpose is. ERs are not meant to be ongoing care providers. They're the "I'm hurt or sick suddenly out of the blue, it's bad and I need to see a doctor asap" place. But they then transition you to somewhere else, who will do the ongoing care.

You break a bone, yes they stabilize you and set the bone. But they don't do the follow up care, make sure it's healing right, remove the cast, etc. That's not their job.

Say you get extremely ill suddenly, like with diabetes. The ER will see you, try to figure out what the problem is and stabilize you. But then it's turned from an emergency to long term management and care. Not their job - by design.

The problem is when people don't have access to medical care on a regular basis, they start to treat the ER differently. Ideally, if you have diabetes, that should have been identified by your PCP, who would have started the treatment so it didn't become an emergency.

But because sometimes things do happen unexpectedly - like some illnesses, or injuries, you need a place for urgent, unexpected care. That's the ER.
Title: Re: Will I ever be able to get health insurance?
Post by: beltim on March 05, 2015, 02:00:54 PM
Please forgive my ignorance . . . but my understanding of Health practices in the US are that health care is private and must be paid for, but is provided at emergency rooms to people who have no means to pay.

If you want to avoid buying health insurance couldn't you just leave all your identifying information at home and collapse at the nearest ER when in distress?

If a hospital accepts Medicare, ER has to treat an emergency. They won't treat, for example, cancer.
And they only have to stabilize you, nothing else.

So in the US ERs they'll let you die of cancer, but not of a gun shot wound?

Oddly enough, the US has better cancer care than Canada (indeed, better than most of the rest of the world, depending on type of cancer):
http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-027766.pdf
http://www.webmd.com/cancer/news/20080716/cancer-survival-rates-vary-by-country
http://theincidentaleconomist.com/wordpress/how-do-we-rate-the-quality-of-the-us-health-care-system-disease-care/
Title: Re: Will I ever be able to get health insurance?
Post by: merula on March 05, 2015, 09:11:09 PM
It just seemed weird to me that the ERs will treat some conditions for free but not others.

The tow truck driver will give you a jump, but he's not going to fill your tank and change your oil.
Title: Re: Will I ever be able to get health insurance?
Post by: randymarsh on March 08, 2015, 09:20:24 PM
It just seemed weird to me that the ERs will treat some conditions for free but not others.

They didn't even have to do that until 1986. http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

It's also not really free. Patients are legally responsible for payment. Much of this debt will end up charged off though.
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on March 13, 2015, 08:07:51 PM
It just seemed weird to me that the ERs will treat some conditions for free but not others.

As thefinancialstudent notes, it is not free.  In fact many people in the US go through bankruptcy as a result of required emergent care provided in the ED. Dead or bankrupt? Pretty crappy choice...

Obamacare will likely reduce the number of folks who end up in this situation by requiring (potentially poorly enforced, we shall see...) people to be insured.

Despite our good numbers on cancer care, it should be noted that the people with inadequate access in the past definitely receive care far inferior to places like Canada (and well every other advance country) that guarantees care to its citizens.
Title: Re: Will I ever be able to get health insurance?
Post by: BCBiker on March 13, 2015, 08:10:33 PM
Lots of good information and input on this topic. First I'd like to apologize for my absence since starting this topic. I'm glad I have been to busy to post but this forum has the best collection of knowledge I've found online so I can't stay away long!

In a most unlikely turn of events, I am now fully insured under the ACA. I guess it was just something new that didn't sit well with me, since I now have a near $200/month payment where there was no payment before. I think any Mustachian can relate. As of three days ago I am covered for all the future illness and disease that has been building up for the past 31 years. Even Obama sent me a personal letter of thanks for my support of his program. Just kidding about that one, of course! :)

I guess there is nothing to do now but post back when this plan actually saves me money. Here's to good health and a long frugal life!

Awesome to read! I'm glad you came around! I think this thread could serve a lot of people.  I emailed MMM himself about potentially writing a guest post spin off of this thread.  He tentatively agreed. I just have not had time to organized it properly.
Title: Re: Will I ever be able to get health insurance?
Post by: Sibley on March 22, 2015, 03:43:24 PM
The supreme court may mess things up though, depending on their ruling. If they eliminate the subsidies unless your state runs the marketplace, then things are going to be very interesting. I suspect that if that happens, Congress will have to put a patch in - the negative publicity will be extreme.
Title: Re: Will I ever be able to get health insurance?
Post by: cbgg on March 22, 2015, 07:10:47 PM
We spend around $500,000,000,000.00 more than we have every year as a nation.

Don't tell me "Obamacare depends on people who can afford coverage to pay for it so that the rest of us don't have to bail you out by indirectly paying for uncompensated care"

because this nation runs on funny money anyway

How about we just pay for it with inflation, so everybody pays, instead of unfairly taxing the young and the healthy that had nothing to do with pre-existing conditions that may or may not (plenty both ways) have anything to do with poor life/health choices...

(EDIT: I just want to say, I hope I'm not offending anyone with what I'm saying...  I'm just trying to consider all sides of the issue and don't mean to offend)

I can't tell if you are being sarcastic…I hope you are?  If you aren't…WTF?  You're thinking is totally illogical.