After reading several of these health care threads, I am amazed at how much risk younger Mustachian are willing to assume, either knowingly or naively. As a current 60year old who would have FIRE'd in 2017 if not for the last election, I have experienced unexpected health costs that have escalated since age 52. I currently have recurring annual expenses that exceed $47,000. Luckily I have excellent employer insurance that costs approx $3,300 for employee premiums, deductibles and copays. These conditions make me uninsurable if not for guaranteed issue under ACA. My wife has separate insurance which is more expensive and poorer coverage and her family history and conditions make her uninsurable as well, even though she has few actual claims.
A risk I don’t see discussed is the plan many Republicans want to enact that allows association plans to be offered at lower cost. What many don’t realize is that even if guaranteed issue is preserved, any people who become high cost patients will need to retain their current coverage if community rating is allowed in these association plans. The reason is that anyone with health concerns won’t meet underwriting requirements. As a result as premiums rise, healthy people will leave and join a new lower cost plan with a 'healthy' association. Those unable to do so will be forced to stay with ever increasing premiums until they are broke, reach Medicare age (65) or die. My family experienced this in Minnesota when I was young and my Dad had a heart attack. Over time the affordable group coverage premiums rose exponentially and yet he was unable as a farmer to join a reasonable cost group due to underwriting concerns. Luckily he was successful enough to be able to afford the coverage.
FYI, 2 years ago when I looked at coverage on the exchange, the premium was approx $14,000 for my wife and I, and we would have had to pay $15,000 out of pocket for my treatments on top of that. If I could be sure of that continuing to be available, we would still retire this year. However, we plan for one of us to work to age 63.5 at Chico time we will be able to buy Cobra coverage to span 18 months till Medicare eligibility.