FIREd: What are you going to do about healthcare if Obamacare gets overturned?

[FIREin2018]

it looks like a 6th conservative judge will be on the supreme court.
there's an Obamacare case on the docket to be decided by end of Nov.

if FIREd, what are you going to do for health insurance if Obamacare gets overturned?

[toocold]

This will depend on if it's partial or full.  If fully repealed, then it will depend on my state. 

If our state passes a bill that is similar to the ACA, then nothing changes for me.  I doubt that the state will subsidize health premiums, but this won't impact us.

Also at the federal level, there could be some additional actions especially if the democrats win the senate and WH.

[cool7hand]

If the ACA is overturned, I'll still be pushing to fix the insurance model's incentives to favor health instead of kicking the chronic condition can down the road.

[use2betrix]

I have insurance through my employer so I wouldn’t expect an impact.

The good news is that since the minimum mandate was repealed, you can now get the catastrophic plans that were unavailable for so long. For those that are relatively healthy and taking sabbaticals, this is a huge advantage. I took two, 4 month sabbaticals in 2017, and my income was still to high to get subsidies, and my wife and I were healthy enough we didn’t want a “full plan” but had no option. Huge pain.

[Mr. Green]

it looks like a 65th conservative judge will be on the supreme court.
there's an Obamacare case on the docket to be decided by end of Nov.

if FIREd, what are you going to do for health insurance if Obamacare gets overturned?

They hear the case in November. The decision won't come until June 2021. Should the ACA be completely struck down, no replacement legislation is passed by 2022, the system reverts to pre-ACA logistics, and we're deemed uninsurable by an insurer, then one of us would return to work to provide health insurance for the family. But that's a long list of if, thens for an event that is possibly 15 months in the future.

[bacchi]

Catastrophic plans are currently only available for those under 30. There's a hardship exemption but it has specific rules, like being homeless.

World travel is my last ditch plan but, hopefully, moving to a state with a plan is feasible.

I really don't want to work at a corporate or government job until I'm eligible for medicare (65?).

[NotJen]

Can't exactly say without knowing what will be available at that future date.

I never tried to purchase insurance pre-ACA, and I don't know where I'll be living when all this goes down, so I don't know what to expect.

The plan is to make do with what's available to me.  If I need to work some to pay the premiums, or get employer-sponsored insurance, I'll do that.

[the_fixer]

What states currently or are likely to offer affordable insurance?

My fire date is in October 2021 and I am not sure what I am going to do as I had planned on the ACA.

Move to a state that I can get coverage?
Move out of the country?
Go without and put a gun in my mouth if I get something massive like cancer?
Keep working just for insurance?

Not sure I hope something works out... worked way too hard for it all to fall apart at this point.


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[seattlecyclone]

Impossible to say without knowing the specifics of what the state/federal governments put in place after the decision. We won't be going without health insurance. We have money that we can spend on a private plan; the only question is whether anyone will sell one to us.

If it comes down to needing to search for a corporate job again, I wouldn't rule out searching for one a couple hundred miles north of my current location, where I wouldn't need to work indefinitely to have access to health insurance.

[Loren Ver]

We would compare plans and buy private insurance or drop our income low enough to get medicaid.  I had private insurance back when I was a contractor and my job didn't provide health insurance. 

Loren

[jim555]

We would compare plans and buy private insurance or drop our income low enough to get medicaid.  I had private insurance back when I was a contractor and my job didn't provide health insurance. 

Loren

If the entire ACA goes away Medicaid expansion goes with it, so that will no longer be an option.  You would need to be elderly, disabled, or blind, and have almost no assets or income.

My Plan B is hop the pond to England for 9 years until Medicare comes in.

[OtherJen]

We would compare plans and buy private insurance or drop our income low enough to get medicaid.  I had private insurance back when I was a contractor and my job didn't provide health insurance. 

Loren

If the entire ACA goes away Medicaid expansion goes with it, so that will no longer be an option.  You would need to be elderly, disabled, or blind, and have almost no assets or income.

This.

Topic: we aren't FIREd and get insurance through husband's job. His small employer only provides insurance because of the ACA and will cut it off as soon as he can. Mine is based out of the US and doesn't provide health insurance because the government where it is based and all the governments where the other full-time employees are based all provide health insurance to residents (go figure).

If the ACA is repealed, one or both of us will have to give up our jobs to get corporate positions for health insurance. I just took this job, after working towards it for years, and love it. Husband was hoping to branch out into self-employment, but that will be a non-starter (he has pre-existing conditions).

Yeah, it's still 18 months out, but considering that people here are making financial decisions over decades, it doesn't seem unreasonable to plan for something that is reasonably likely to happen.

[MonkeyJenga]

Also at the federal level, there could be some additional actions especially if the democrats win the senate and WH.

This is one of many, many reasons that I am working hard to make sure Democrats win. If anyone else wants to preserve their healthcare, let me know. I can direct you to the best ways to help.

[Eurotexan]

Move back to the UK. When my daughter graduates from HS in 2022 I have been giving serious thought to moving home (I moved to the US in 2001) but the uncertainly of healthcare has pretty much made my mind up for me. Even if ACA stays in some shape or form I am tired of living in a country which doesn’t give a shit about its citizens health and I am yearning to return to a more caring and inclusive society.

[RedmondStash]

Buy private insurance, just like I did before the ACA. It will be expensive, and coverage probably won't be great, but basically, you have to play the cards you have, not the cards you want.

It's not like my ACA coverage is cheap or great now. But it is better than private insurance was.

[dresden]

Also at the federal level, there could be some additional actions especially if the democrats win the senate and WH.

This is one of many, many reasons that I am working hard to make sure Democrats win. If anyone else wants to preserve their healthcare, let me know. I can direct you to the best ways to help.

I agree, I am an independent that voted for both parties in the past but I likely would never vote republican again over the healthcare issue.

It seems ridiculous that the supreme court would throw out the entire law - that would definitely be legislating from the bench.  Especially the thought of taking away healthcare from so many people during a pandemic - I certainly hope 5 justices would oppose that and would limit rulings to specific portions of the law.

It's not just early retirees - the economy has adapted to ACA and many gig workers rely on this for healthcare.

[soccerluvof4]

Maybe I will be proven wrong but I think as others have mentioned in some form if it will be overturned there will be other options that come available. The uncertainty of it all though is why the DW and I looked for a job for just one of us in 2016 to cover our ass with HC and would keep doing the same thing if need be.

[OtherJen]

Maybe I will be proven wrong but I think as others have mentioned in some form if it will be overturned there will be other options that come available. The uncertainty of it all though is why the DW and I looked for a job for just one of us in 2016 to cover our ass with HC and would keep doing the same thing if need be.

Can you elaborate those options? My state legislature is controlled by Republicans who have no plan other than opposing the Democrats. They certainly are not interested in providing a healthcare option to residents. We're in our mid-40s and husband has pre-existing conditions. ACA repeal will mean that his employer will no longer provide a health insurance option. We're pretty much screwed unless we both leave our jobs that we like to compete for one of the local corporate jobs that will be in huge demand (during a recession), or uproot ourselves to move away from our home of 17 years and both sets of elderly parents.

[OzzieandHarriet]

You all know that if the ACA goes away you probably won’t be able to buy insurance at all because of preexisting conditions, right?

Back in the dark ages c. 1985 (in my 20s), I tried to get a policy and was denied because I had had therapy for depression. I went without insurance until I went to grad school and got on the student plan. One semester I forgot to pay the premium (no reminders of course) and ended up paying out of pocket for a routine test, about $800 IIRC.

Those catastrophic plans are junk.

This is the kind of thing we will be experiencing.

[OtherJen]

You all know that if the ACA goes away you probably won’t be able to buy insurance at all because of preexisting conditions, right?

Back in the dark ages c. 1985 (in my 20s), I tried to get a policy and was denied because I had had therapy for depression. I went without insurance until I went to grad school and got on the student plan. One semester I forgot to pay the premium (no reminders of course) and ended up paying out of pocket for a routine test, about $800 IIRC.

Those catastrophic plans are junk.

This is the kind of thing we will be experiencing.

Yep. It's why I'm horrified by the dismissal of concerns about the situation. When I was a teenager, the number one criterion for an adult job, as drilled into my head by my parents, was "make sure it provides health insurance," because for working-class families like mine, there was no feasible way to obtain it otherwise.

[BicycleB]

Short term: Pay premiums on existing policy (about $500/month)

Medium term: Look around for ACA-quality policies available to small business owners. If ACA isn't replaced by something similar to its current version, choose between starting a tiny business and getting small-business type policy versus getting some job that has insurance. In other words, accept that my thin FIRE "plan" is at risk and work my out for a few years if possible, though perhaps only a few hours per week.

Long term: I'm roughly 5 years away from a pension-related insurance option and 10 from Medicare, so hoping those options remain stable.

[bacchi]

You all know that if the ACA goes away you probably won’t be able to buy insurance at all because of preexisting conditions, right?

Or, if you can get a policy, your policy will be rescinded the moment you have a claim for a serious illness. Because you forgot to tell them about your tonsillectomy at age 15.

States can regulate that and those who can will move to the more health-friendly states.

[scantee]

I don't have a pre-existing condition per se, but I do have a high likelihood of a specific type of cancer and I get screened for that every six months. My assumption is that it will be treated as a pre-existing condition should I ever need to get private market insurance in the absence of the ACA.

Were the ACA to go away I would not be able to moving into consulting work in the next few years as I have long been planning. I would need to work until my kids were grown and out of the house, another 8 years. At that point, I'd either look into moving to another state that adopts a stand-in policy for the ACA. California or New York, I guess. I'd also look into continuing to work for a Megacorp that can offer me a job in another country. I would be willing to work until retirement age if it meant living in a country where healthcare isn't so constantly precarious. I'm tired of of forever thinking and worrying about this.

Long-term I vote Dem because this healthcare situation is just untenable and needs to change. This is the biggest policy issue for me and I'm not willing to vote for anyone who will not consider at least a public option. The ACA isn't great, but it is something. But I also want something better.

[EscapeVelocity2020]

I'm not FIRE'd, but might ER soon-ish.  If we needed HC, my DW would teach full time (she's been working on her certification and substitute teaching for years) or become a full time sub (lots of teachers are out for extended periods due to pregnancy, serious illness, family, etc).  HC through the school district is pretty good. 

Once both kids are out of the house (in 6 years), we'd re-evaluate.

[Much Fishing to Do]

My current Non-ACA private plan is better than the ones offered on my exchange given I am still working and making too much to qualify for any subsidy.  Once I do RE I plan to switch to an ACA one and get a good subsidy, unless it isn't there anymore at which point I guess I'll just keep what I have now, which is what I assumed I'd be doing before the ACA.

[OtherJen]

My current Non-ACA private plan is better than the ones offered on my exchange given I am still working and making too much to qualify for any subsidy.  Once I do RE I plan to switch to an ACA one and get a good subsidy, unless it isn't there anymore at which point I guess I'll just keep what I have now, which is what I assumed I'd be doing before the ACA.

The ACA isn't just marketplace insurance plans, it's a set of laws that, among other things, prohibit discrimination of service on the basis of pre-existing medical conditions and the refusal of employers to provide insurance plans to their full-time employees, and allow young adults to remain on their parents' plans until age 26 (particularly important as young people graduate into a recession).

[use2betrix]

My current Non-ACA private plan is better than the ones offered on my exchange given I am still working and making too much to qualify for any subsidy.  Once I do RE I plan to switch to an ACA one and get a good subsidy, unless it isn't there anymore at which point I guess I'll just keep what I have now, which is what I assumed I'd be doing before the ACA.

The ACA isn't just marketplace insurance plans, it's a set of laws that, among other things, prohibit discrimination of service on the basis of pre-existing medical conditions and the refusal of employers to provide insurance plans to their full-time employees, and allow young adults to remain on their parents' plans until age 26 (particularly important as young people graduate into a recession).

It certainly has some great sets of laws, but it also churned out a ton of really shitty insurance plans for people.

When I was taking my first sabbatical in 2017, the only place that I could get insurance was through the marketplace (in Texas). At that time, the ONLY plans available were HMO plans with a super small network. Other than life threatening conditions, zero coverage outside that normal area.

When my wife and I want hit the road for several months, we had nothing more than a super expensive catastrophic plan (because that’s all it was good for in other states).

To add to this, because of the minimum requirement mandates, catastrophic plans were no longer available. So for a young couple in their 20’s with no debt and several hundred thousand dollars in savings, that catastrophic plan would have been perfect!

Instead, we paid $300-$400 each for a useless plan outside our county. The alternative of no insurance has other countless downsides that I don’t think need to be explained.

[FIREin2018]

we aren't FIREd and get insurance through husband's job.
His small employer only provides insurance because of the ACA and will cut it off as soon as he can.

wait.. the aca mandates small businesses give health insurance?
kinda lost on this part

[use2betrix]

we aren't FIREd and get insurance through husband's job.
His small employer only provides insurance because of the ACA and will cut it off as soon as he can.

wait.. the aca mandates small businesses give health insurance?
kinda lost on this part

As of March 2020, employers with over 50 employees were required to provide health insurance:

https://www.ehealthinsurance.com/resources/small-business/health-insurance-requirements-small-businesses

[friedmmj]

Is it reasonable to assume that the price of private plans will be approximately the same as the current ACA plans if paid in fill without a subsidy?  If not, why not?

[firestarter2018]

Is it reasonable to assume that the price of private plans will be approximately the same as the current ACA plans if paid in fill without a subsidy?  If not, why not?

Probably not. If the ACA is overturned in such a way that the subsidies, exchanges and coverage requirements (no max lifetime limits, essential benefits, etc.) are just gone, then insurance companies have to completely restructure their individual plans to adapt to the new rules (or lack thereof).  If they can go back to risk rating (charger sicker patients more), that will be reflected in premiums.  Also, whether or not the ACA is overturned, with the economic recession we're seeing a lot of people shift from employer coverage to Medicaid or the Exchange, so that influx of people onto individual plans will also likely change premiums if they end up being a poorer/sicker group.

People often forget that many individual plans pre-ACA used to be pretty cheap -- if you were healthy and could get approved for them, that is.  Most featured small networks, had max lifetime limits of $1,000,000, didn't cover many benefits that are now considered essential under the ACA, and could rescind your coverage under the flimsiest of pretexts.  If you were sick, the companies would either turn you down outright or make the premiums so high no consumer could ever afford them.  Let's hope we don't head back in that direction.

[FIREin2018]

Is it reasonable to assume that the price of private plans will be approximately the same as the current ACA plans if paid in fill without a subsidy?  If not, why not?

ugg.. i'm FiREd.
i'm loving the subsidies. would suck if it went away.

Probably not. If the ACA is overturned in such a way that the subsidies, exchanges and coverage requirements (no max lifetime limits, essential benefits, etc.) are just gone, then insurance companies have to completely restructure their individual plans to adapt to the new rules (or lack thereof).  If they can go back to risk rating (charger sicker patients more), that will be reflected in premiums.  Also, whether or not the ACA is overturned, with the economic recession we're seeing a lot of people shift from employer coverage to Medicaid or the Exchange, so that influx of people onto individual plans will also likely change premiums if they end up being a poorer/sicker group.

People often forget that many individual plans pre-ACA used to be pretty cheap -- if you were healthy and could get approved for them, that is.  Most featured small networks, had max lifetime limits of $1,000,000, didn't cover many benefits that are now considered essential under the ACA, and could rescind your coverage under the flimsiest of pretexts.  If you were sick, the companies would either turn you down outright or make the premiums so high no consumer could ever afford them.  Let's hope we don't head back in that direction.

if aca went away, i'll probably go on Medicaid and wont artificially increase my income to the Obamacare minimum of $17k by doing Roth conversions.

in my state (VA), i dont think they'll drop you.
before ACA, what the insurance companies did was create a new plan every 3 years.
if you were healthy (ie: profitable), you automatically got moved to the new plan with cheap rates. (these cheap rates were much more than Obamacare with full subsidies.)

those that cost them $ stayed under the old plan.
and the old plan got a huge premium increase because only sick people were left. (no healthy people to offset the sick.)

[MonkeyJenga]

if aca went away, i'll probably go on Medicaid and wont artificially increase my income to the Obamacare minimum of $17k by doing Roth conversions.

Medicaid expansion is part of the ACA. If the ACA goes away, you're not getting on Medicaid unless you're disabled or pregnant.

[BicycleB]

As the discussion above reminds us, ACA is much better for consumers than what went before.

I'm guessing that if it's overturned, a version similar to today's or slightly better gets passed after a rapid period of panic. Though of course, I'm assuming a Biden win. In the Trump no-ACA scenario, I agree we get status quo ante plus chaos.

Just pondering all this has even the insurance companies sweating. Mine informed me the no-subsidy cost of my policy is rising from $520/mo to $660/mo next year. Am waiting for open enrollment to see if there are better options. And that's a bronze policy. :(

The prospect of losing those subsidies makes the premium very, ah, daunting. That's over a third of my FIRE budget. Which does not have that kind of wiggle room in it!

[Wintergreen78]

Seems to me like a whole lot of “ifs” and worst case scenarios that folks are getting themselves worked up into a case of the vapors over. 

So IF a new justice would change the final decision (maybe, but probably not) and IF the entire law gets thrown out (unlikely), and IF the legislative and executive branches do absolutely nothing to prevent millions of people from losing their insurance (unlikely as well), and IF the market doesn’t come up with any alternatives (also not likely), and IF all the states decide to sit on their hands (not likely, either), and IF people who see this disaster developing do absolutely nothing to mitigate the impact on themselves, THEN yes, things will definitely suck.

Republican leaders have said it is their goal to get rid of Obamacare ever since it was passed. During Obama’s time in office Senate Republicans fought to keep judges from getting confirmed at every level of the judiciary. During Trump’s time in office McConnell’s top priority as majority leader of the Senate has been to confirm judges that he believes have his same ideology.

28 States have filed lawsuits challenging some or all of Obamacare. There is an active lawsuit asking to strike down the entirety of the law with arguments scheduled before the Supreme Court on November 10th. McConnell is doing everything he can to get another judge confirmed before then.

When Republicans held the House, Senate, and White House they completely failed to even bring a bill up for a vote. I haven’t seen a single republican even present a concept of what an Obamacare replacement bill would look like.

So, while I normally share your attitude that one shouldn’t worry too much about remote possibilities, I think it is ridiculous to pretend like this isn’t a possibility. This has been the top priority of one political party for over a decade now. They have made a lot of progress toward achieving their goal.

Have you seen any evidence that Trump or McConnell or McCarthy could come up with complex legislation to replace Obamacare and get it through congress and signed? I haven’t seen anything from this administration that makes me think that is a possibility.

As for the market solution: it would be what we had before (as people have already pointed out). If you’ve ever had a serious illness or injury before you won’t be able to get private insurance. If you have a family history or other risk factor for serious illness you won’t be able to get private insurance. If you don’t have insurance and you end up in the hospital for any length of time you will be bankrupt. If you have a chronic condition you won’t be able to get continuing care, so you’ll have to do the best you can, then end up in the emergency room whenever it becomes acute because you haven’t been treating it. They will patch you up, send your emergency room bill to collections, then send you back out for the whole cycle to start over again.

Before Obamacare health insurance in the US was disaster unless you could get it through work or you were young, healthy, and relatively well off. I fit that description, so personally I’m sure I’ll be ok if it goes away, but a huge chunk of the country won’t be.

[Wintergreen78]

Is it reasonable to assume that the price of private plans will be approximately the same as the current ACA plans if paid in fill without a subsidy?  If not, why not?

No, it is not reasonable to assume that. One of the problems with the old insurance market was that insurance companies had to assume (correctly) that healthy people were less likely to get health insurance. So, somebody who wanted to buy insurance had an above-average chance of getting sick.

One of the original parts of the ACA (before it was removed in 2017) was the tax penalty if you didn’t have insurance. The idea was that everyone has to get insurance, there are more healthy people paying into the system so premiums are lower. The Congressional Budget Office analyzes legislation to try and estimate its costs and impacts. These are projections, so they should be taken with a grain of salt, but they projected 13 million fewer people would have health insurance by 2027 and premiums would go up about 10% a year more than they would if the tax penalty stayed in place.

[friedmmj]

if aca went away, i'll probably go on Medicaid and wont artificially increase my income to the Obamacare minimum of $17k by doing Roth conversions.

Medicaid expansion is part of the ACA. If the ACA goes away, you're not getting on Medicaid unless you're disabled or pregnant.

Well, not exactly.  If you are poor and have no assets (below $2k) and little or no income then you can get onto Medicaid in most states pre-ACA.

[wenchsenior]

if aca went away, i'll probably go on Medicaid and wont artificially increase my income to the Obamacare minimum of $17k by doing Roth conversions.

Medicaid expansion is part of the ACA. If the ACA goes away, you're not getting on Medicaid unless you're disabled or pregnant.

Well, not exactly.  If you are poor and have no assets (below $2k) and little or no income then you can get onto Medicaid in most states pre-ACA.

You have to be really really poor in Texas. My mother didn't qualify with no assets and income of 1200/month.

[the_fixer]

if aca went away, i'll probably go on Medicaid and wont artificially increase my income to the Obamacare minimum of $17k by doing Roth conversions.

Medicaid expansion is part of the ACA. If the ACA goes away, you're not getting on Medicaid unless you're disabled or pregnant.

Well, not exactly.  If you are poor and have no assets (below $2k) and little or no income then you can get onto Medicaid in most states pre-ACA.

In Calif (pre-ACA) you could only get Medicaid if you were under 18 or over 65 regardless of your financial situation. With the exception of certain people who were exempted due to certain circumstances such as disability, legally refugees, pregnent, etc. That left a whole lot of 18 - 65 year old truly poor people without healthcare. There were things like free clinics but sometimes it took hours, often days, days waiting long lines to be seen.  Calif is a very liberal state and will likely keep an Ombamacare kind of thing if the ACA goes away but between the wildfires and pandemic the state may just not have the needed funding.

If the ACA goes away and some states keep their own version I suspect the financial burden will be even greater on those states due to people relocating and becoming residents just to obtain the insurance.


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[Exflyboy]

All of this to say, you better have a plan to fund your own HC if the Senate is not flipped.

I read that the Investors Business Daily.. ("arguably" the only polling group that predicted a Trump win back in 2016) is saying that the Biden lead is a lot narrower than the other polls predict.

Personally I think we are looking over the edge of the abyss!.. With the exception of MAYBE SCOTUS will leave the majority of the ACA in place.

[jim555]

Individual states can't afford to replace the ACA, the Feds pay for 100% of the subsidies and 90% of the Medicaid expansion.  We would go back to pre-ACA days.  Your stack better be big enough to pay full freight or go back to work.

My hunch is the SCOTUS is not going to throw millions off health coverage in the middle of a pandemic.

[John Galt incarnate!]

I

My hunch is the SCOTUS is not going to throw millions off health coverage in the middle of a pandemic.

Agree.

The body politic's reliance ("reliance interest") on the ACA was axiomatic before the damnable scourge of COVID19.

[Paul der Krake]

Seems to me like a whole lot of “ifs” and worst case scenarios that folks are getting themselves worked up into a case of the vapors over. 

So IF a new justice would change the final decision (maybe, but probably not) and IF the entire law gets thrown out (unlikely), and IF the legislative and executive branches do absolutely nothing to prevent millions of people from losing their insurance (unlikely as well), and IF the market doesn’t come up with any alternatives (also not likely), and IF all the states decide to sit on their hands (not likely, either), and IF people who see this disaster developing do absolutely nothing to mitigate the impact on themselves, THEN yes, things will definitely suck.

That's my view too, losing sleep over this is silly. Early retirement was a thing before the ACA, and will be a thing if it's gone too.

Everyone here is a grown ass adult with agency, creativity, flexibility, and money. We're all going to be more than fine.

If the ACA goes away and some states keep their own version I suspect the financial burden will be even greater on those states due to people relocating and becoming residents just to obtain the insurance.

I'm skeptical of this. Some states have treated their citizens a lot better on all sorts of metrics since forever, whether it's voting rights, tax burden, or even just the weather. ACA and medicaid expansion recipients are poor and largely checked out of civic life. They're not going to suddenly find $10,000 to move somewhere else over a law they barely understand. They'll just go back to being uninsured. And even there was a sudden mass migration, a state can legislate the problem away with waiting periods.

[the_fixer]

Seems to me like a whole lot of “ifs” and worst case scenarios that folks are getting themselves worked up into a case of the vapors over. 

So IF a new justice would change the final decision (maybe, but probably not) and IF the entire law gets thrown out (unlikely), and IF the legislative and executive branches do absolutely nothing to prevent millions of people from losing their insurance (unlikely as well), and IF the market doesn’t come up with any alternatives (also not likely), and IF all the states decide to sit on their hands (not likely, either), and IF people who see this disaster developing do absolutely nothing to mitigate the impact on themselves, THEN yes, things will definitely suck.

That's my view too, losing sleep over this is silly. Early retirement was a thing before the ACA, and will be a thing if it's gone too.

Everyone here is a grown ass adult with agency, creativity, flexibility, and money. We're all going to be more than fine.

If the ACA goes away and some states keep their own version I suspect the financial burden will be even greater on those states due to people relocating and becoming residents just to obtain the insurance.

I'm skeptical of this. Some states have treated their citizens a lot better on all sorts of metrics since forever, whether it's voting rights, tax burden, or even just the weather. ACA and medicaid expansion recipients are poor and largely checked out of civic life. They're not going to suddenly find $10,000 to move somewhere else over a law they barely understand. They'll just go back to being uninsured. And even there was a sudden mass migration, a state can legislate the problem away with waiting periods.

I doubt we would see mass migrations but for example.

When Colorado legalized recreational weed we had a large influx of people that moved here for various reasons related to weed.

Or states that have favorable tax treatment for retirement attract people who are retiring and want to save on taxes.

In the full time RV or van life crowds they have a few select states that they choose as their state of residence then travel due to various reasons.

I could see the FIRE, nomads and others moving for affordable insurance, not a mass migration but you think it would have an impact.


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[bacchi]

We’re being played. I think you hit on the nut of the truth when you noted that the GOP had both legislative chambers and the Presidency and a golden opportunity to repeal the ACA and what did they do?

Nothing.

So McCain was in on it? He was the fall guy?

One of the most important things to remember about politics (other that it’s all smoke, mirrors, and BS) is watch what they do, don’t listen to what they say.  The GOP has had every opportunity to repeal and replace ACA and they haven’t even bothered. That’s because they want they exact same thing as their corporatist brethren in the Democratic faction; single-payer socialized medicine.

The trending scare word is "Marxist," like so:

single-payer Marxist medicine! :-o

[mathlete]

We’re being played. I think you hit on the nut of the truth when you noted that the GOP had both legislative chambers and the Presidency and a golden opportunity to repeal the ACA and what did they do?

Nothing.

One of the most important things to remember about politics (other that it’s all smoke, mirrors, and BS) is watch what they do, don’t listen to what they say.  The GOP has had every opportunity to repeal and replace ACA and they haven’t even bothered. That’s because they want they exact same thing as their corporatist brethren in the Democratic faction; single-payer socialized medicine.

Please don't listen to this poster on ACA, they don't know what they're talking about.

They didn't do "nothing".

-Ditched the individual mandate , which is critical for the health of the insurance pool
-Cut the open enrollment period in half
-Reduced outreach/advertising for federally run marketplaces, causing states defaulting to the federal market place to lag behind states running their own markets in terms of enrollment

Beyond that, while Republicans had both houses and the presidency, they had a very slim margin in the Senate, 52-48, so any major change they wanted to make would have had to go through in the budget reconciliation window. Their repeal and replace bill, the American Health Care Act, was projected by the CBO to drop tens of millions of people from coverage over the next several years. The version that went to vote in the Senate failed 49-51 and required a few very high profile defections.

This is to say nothing of the blocked attempts to make the ACA better from 2011 to 2016.

If your plan is to retire on $100 / year and collect Medicaid or ACA subsidies, please pay attention because all of this very much affects you.

[mathlete]

Even if you're not relying on Medicaid expansion or ACA subsidies in your FIRE plans, there are several provisions of the ACA that, if gone, could affect you.

PreEx is the obvious one. It would be the most politically divisive to get rid of, but if that ever happened, you're taking a dramatic gamble by retiring at 35 and hoping you go 30 years without a medical event that will render you uninsurable

Minimum medical loss ratio provision requires insurers to mail out refund checks if they don't spent a certain dollar amount on claims per premium collected. If they're no longer required to do this, that will work its way into pricing and you could face higher premiums.

The ACA set out of pocket maximums and deductible limits. Those could potentially go away.

[SpecialSnowflake]

My DH will have to keep working his well paid remote management job if he can’t retire early with reasonable health care via ACA, The only reason he is working is because there is a good chance ACA will not be there when we need it and we have pre-existing conditions

Another facet of this  to consider is that older less healthy employees Can’t retire and have to keep working because there is no where safe to get the insurance that will keep them from Medical bankruptcy.  They often farther along in their career and are keeping younger workers from getting promoted into higher paying jobs, and it prevents new young first line workers From getting their first serious good paying jobs that will allow them to buy houses and spend into the economy to build families.  Not allowing older folks to fire just to keep insurance prevents everyone below them from moving up.

[Exflyboy]

My DH will have to keep working his well paid remote management job if he can’t retire early with reasonable health care via ACA, The only reason he is working is because there is a good chance ACA will not be there when we need it and we have pre-existing conditions

Another facet of this  to consider is that older less healthy employees Can’t retire and have to keep working because there is no where safe to get the insurance that will keep them from Medical bankruptcy.  They often farther along in their career and are keeping younger workers from getting promoted into higher paying jobs, and it prevents new young first line workers From getting their first serious good paying jobs that will allow them to buy houses and spend into the economy to build families.  Not allowing older folks to fire just to keep insurance prevents everyone below them from moving up.

Remember though that often older employees get laid off or are forced to retire because they are expensive or their medical issues forces them to stop work.

I read somewhere that the average age of retirement is 62. This is not early from our perspective but many people are assuming they can work till 70 in order to maximise their SS checks.

So many can't afford to retire but consequently can't work either.

[slappy]

My DH will have to keep working his well paid remote management job if he can’t retire early with reasonable health care via ACA, The only reason he is working is because there is a good chance ACA will not be there when we need it and we have pre-existing conditions

Another facet of this  to consider is that older less healthy employees Can’t retire and have to keep working because there is no where safe to get the insurance that will keep them from Medical bankruptcy.  They often farther along in their career and are keeping younger workers from getting promoted into higher paying jobs, and it prevents new young first line workers From getting their first serious good paying jobs that will allow them to buy houses and spend into the economy to build families.  Not allowing older folks to fire just to keep insurance prevents everyone below them from moving up.

Remember though that often older employees get laid off or are forced to retire because they are expensive or their medical issues forces them to stop work.

I read somewhere that the average age of retirement is 62. This is not early from our perspective but many people are assuming they can work till 70 in order to maximise their SS checks.

So many can't afford to retire but consequently can't work either.

This is literally my entire argument for FIRE. People say all the time, including on this forum, "I love my job, I won't retire even if I am FI." That's all well and good, up until your job doesn't love you. As you say, lots of people don't have a choice. They are laid off and can't find a new job due, and then they have to retire, take SS early, etc. I have seen this happen to a lot of people that I worked with when I worked at the local bank. Having money saved up gives people a lot of choices, even if they are not FI.