Author Topic: What comes after the ACA?  (Read 823309 times)

Paul der Krake

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Re: What comes after the ACA?
« Reply #4200 on: April 04, 2018, 07:33:01 PM »
These people are missng out! In this year of The Donald’s Reign, our Obamacare premiums are $0 and that is down from about $260/month last enrollment period. Score!

I am a new participant this year (COBRA ran out).  Our Bronze plan is a whopping $3.61/month after subsidies.
I love The Donald! And
Obama! Lets vote them all in again!

Last year when our COBrA ran out,  we took a blowout trip to
Romania, Switzerland, and Prague because we could afford it, not having to pay high health insurance premiums.
If your income was low enough for these bargain premiums, why did you stay on COBRA at all?

Exflyboy

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Re: What comes after the ACA?
« Reply #4201 on: April 04, 2018, 08:58:54 PM »
The NY Essential Plan (NY's Basic Health Program plan) was targeted when DJT ended the CSR payments, shorting NY 1 billion dollars.  The scheme backfired and now the EP is overfunded due to the rise in Silver premiums causing more subsidy money to be spent than if they would have kept the CSR funding in place.  The rise in the benchmark caused the subsidy amounts to rise.  So DJT has improved the ACA!

Exactly.. our premium went from $36 to $15.10...:)

iris lily

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Re: What comes after the ACA?
« Reply #4202 on: April 04, 2018, 10:26:11 PM »
These people are missng out! In this year of The Donald’s Reign, our Obamacare premiums are $0 and that is down from about $260/month last enrollment period. Score!

I am a new participant this year (COBRA ran out).  Our Bronze plan is a whopping $3.61/month after subsidies.
I love The Donald! And
Obama! Lets vote them all in again!

Last year when our COBrA ran out,  we took a blowout trip to
Romania, Switzerland, and Prague because we could afford it, not having to pay high health insurance premiums.
If your income was low enough for these bargain premiums, why did you stay on COBRA at all?

I just wanted No Complications for the first year after retirement. I wanted to be free of concern about health care, health insurance and with cobra which we could easily afford, that policy was a known entity. Therevwas another complicating factor I wont go into here but COBRA coverage simplified that, too.

Simplicity is a luxury good.

Mr. Green

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Re: What comes after the ACA?
« Reply #4203 on: April 05, 2018, 02:26:43 PM »
The Final Obamacare Tally Is In. About 400,000 Fewer People Signed Up This Year.

https://nyti.ms/2q2uV1G

"11.8 million people had signed up for health insurance through the Affordable Care Act marketplaces for 2018 — roughly 400,000 fewer than last year. The drop was relatively small, given that Mr. Trump had sharply cut federal outreach efforts and the open enrollment period was half as long as in past years.
Virtually the entire decrease came in the 39 states that use the marketplace run by the federal government, HealthCare.gov. In the 11 states that sell coverage for the Affordable Care Act — popularly known as Obamacare — through their own marketplaces, enrollment remained the same as last year. "
This is very impressive given the enrollment period for 2018 was cut in half and the budgets for the groups helping people enroll was cut by as much as 90%.

Exflyboy

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Re: What comes after the ACA?
« Reply #4204 on: April 05, 2018, 03:47:21 PM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.

Mr. Green

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Re: What comes after the ACA?
« Reply #4205 on: April 05, 2018, 04:56:58 PM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Exflyboy

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Re: What comes after the ACA?
« Reply #4206 on: April 05, 2018, 06:09:25 PM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Who knows how "the base" thinks... If indeed they do actually think.

Threshkin

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Re: What comes after the ACA?
« Reply #4207 on: April 05, 2018, 10:03:16 PM »
These people are missng out! In this year of The Donald’s Reign, our Obamacare premiums are $0 and that is down from about $260/month last enrollment period. Score!

I am a new participant this year (COBRA ran out).  Our Bronze plan is a whopping $3.61/month after subsidies.
I love The Donald! And
Obama! Lets vote them all in again!

Last year when our COBrA ran out,  we took a blowout trip to
Romania, Switzerland, and Prague because we could afford it, not having to pay high health insurance premiums.
If your income was low enough for these bargain premiums, why did you stay on COBRA at all?

If you drop COBRA before it expires you are not eligible for the subsidy.  I had to wait for COBRA to expire and then sign up for the ACA plan.

Exflyboy

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Re: What comes after the ACA?
« Reply #4208 on: April 05, 2018, 11:43:17 PM »
These people are missng out! In this year of The Donald’s Reign, our Obamacare premiums are $0 and that is down from about $260/month last enrollment period. Score!

I am a new participant this year (COBRA ran out).  Our Bronze plan is a whopping $3.61/month after subsidies.
I love The Donald! And
Obama! Lets vote them all in again!

Last year when our COBrA ran out,  we took a blowout trip to
Romania, Switzerland, and Prague because we could afford it, not having to pay high health insurance premiums.
If your income was low enough for these bargain premiums, why did you stay on COBRA at all?

If you drop COBRA before it expires you are not eligible for the subsidy.  I had to wait for COBRA to expire and then sign up for the ACA plan.

Huh?... We were offered COBRA, saw the price, said a four letter word and went straight to the ACA. Now of course if we had made a shit ton of money that year then we would not have got any subsidy on the ACA. But even without a subsidy the ACA was cheaper than COBRA.

Of course we made sure we managed our income such that we got a decent subsidy.

Paul der Krake

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Re: What comes after the ACA?
« Reply #4209 on: April 06, 2018, 12:20:49 AM »
Huh?... We were offered COBRA, saw the price, said a four letter word and went straight to the ACA. Now of course if we had made a shit ton of money that year then we would not have got any subsidy on the ACA. But even without a subsidy the ACA was cheaper than COBRA.
Totally depends on the underlying cost of the employer plan, which is tied to the local market, health of employee pool, and benefits offered. If I left my job tomorrow and didn't qualify for subsidies, I'd stay on COBRA for as long as possible.

Exflyboy

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Re: What comes after the ACA?
« Reply #4210 on: April 06, 2018, 01:27:50 AM »
Huh?... We were offered COBRA, saw the price, said a four letter word and went straight to the ACA. Now of course if we had made a shit ton of money that year then we would not have got any subsidy on the ACA. But even without a subsidy the ACA was cheaper than COBRA.
Totally depends on the underlying cost of the employer plan, which is tied to the local market, health of employee pool, and benefits offered. If I left my job tomorrow and didn't qualify for subsidies, I'd stay on COBRA for as long as possible.

I see, so COBRA isn't always the bankrupt inducing stupid cost then?.. At least no more stupid than the rest of the unsubsidised HC system.

swampwiz

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Re: What comes after the ACA?
« Reply #4211 on: April 06, 2018, 02:35:33 AM »
If you drop COBRA before it expires you are not eligible for the subsidy.  I had to wait for COBRA to expire and then sign up for the ACA plan.

It is not so much that a COBRA subscriber cannot get the premium tax credit because he is eligible to get COBRA, but because quitting COBRA does not qualify the subscriber for application outside of the open enrollment period.  I would presume that a change in income, or residential move to another state, etc., could qualify.

https://obamacarefacts.com/questions/can-i-switch-from-cobra-to-obamacare/

swampwiz

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Re: What comes after the ACA?
« Reply #4212 on: April 06, 2018, 02:42:49 AM »
If your income was low enough for these bargain premiums, why did you stay on COBRA at all?

I just wanted No Complications for the first year after retirement. I wanted to be free of concern about health care, health insurance and with cobra which we could easily afford, that policy was a known entity. Therevwas another complicating factor I wont go into here but COBRA coverage simplified that, too.

Simplicity is a luxury good.
[/quote]

Something else to think about is that the deductible/out-of-pocket-max counter resets with a new policy.

swampwiz

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Re: What comes after the ACA?
« Reply #4213 on: April 06, 2018, 03:04:05 AM »
"Democrats are heading toward some big losses in this fall's midterm Senate races, polls say"

https://www.cnbc.com/2018/03/08/democrats-heading-toward-big-losses-in-midterm-senate-elections-polls.html

There appears to be only 5 Democratic seats that are truly vulnerable: MO, IN, ND, MT, WV.  The first 2 were the result of the Republican candidate not being able to stop himself from saying that rape victims enjoy it.  However, the other 3 had legitimate popular victories, and of them, I only think WV is truly vulnerable.  But there are easily 3 or 4 Republican-held seats that look pretty good to switch: NV, AZ, TN (the latter because there is very popular Democratic ex-governor who will probably draw a Teat party whacko as an opponent), with McCain's current seat possibly being open.  I even give TX a chance due to the changing demographics. 

Monkey Uncle

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Re: What comes after the ACA?
« Reply #4214 on: April 06, 2018, 05:17:25 AM »
Huh?... We were offered COBRA, saw the price, said a four letter word and went straight to the ACA. Now of course if we had made a shit ton of money that year then we would not have got any subsidy on the ACA. But even without a subsidy the ACA was cheaper than COBRA.
Totally depends on the underlying cost of the employer plan, which is tied to the local market, health of employee pool, and benefits offered. If I left my job tomorrow and didn't qualify for subsidies, I'd stay on COBRA for as long as possible.

I don't think that's right.  When I signed up for the ACA, healthcare.gov did not ask about the cost of the COBRA policy that was available to me.  I was not required to consider signing up for COBRA, regardless of the price.

However, if I had chosen to sign up for COBRA, voluntarily dropping it would not be considered a qualifying event.  You have to involuntarily lose your coverage for it to be considered a qualifying event.

DreamFIRE

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Re: What comes after the ACA?
« Reply #4215 on: April 06, 2018, 05:26:58 AM »
These people are missng out! In this year of The Donald’s Reign, our Obamacare premiums are $0 and that is down from about $260/month last enrollment period. Score!

I am a new participant this year (COBRA ran out).  Our Bronze plan is a whopping $3.61/month after subsidies.
I love The Donald! And
Obama! Lets vote them all in again!

Last year when our COBrA ran out,  we took a blowout trip to
Romania, Switzerland, and Prague because we could afford it, not having to pay high health insurance premiums.
If your income was low enough for these bargain premiums, why did you stay on COBRA at all?

If you drop COBRA before it expires you are not eligible for the subsidy.  I had to wait for COBRA to expire and then sign up for the ACA plan.

You can drop COBRA and sign up for an ACA plan during the regular enrollment period, and you will be eligible for the same PCT and CSR whether or not you have had COBRA in the past.

jim555

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Re: What comes after the ACA?
« Reply #4216 on: April 06, 2018, 05:41:14 AM »
Some states have COBRA for 36 months.  If the ACA goes away then it might make sense to get a job long enough to qualify for COBRA and quit, then repeat.

Jrr85

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Re: What comes after the ACA?
« Reply #4217 on: April 06, 2018, 07:54:00 AM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.   

Paul der Krake

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Re: What comes after the ACA?
« Reply #4218 on: April 06, 2018, 08:45:23 AM »
Huh?... We were offered COBRA, saw the price, said a four letter word and went straight to the ACA. Now of course if we had made a shit ton of money that year then we would not have got any subsidy on the ACA. But even without a subsidy the ACA was cheaper than COBRA.
Totally depends on the underlying cost of the employer plan, which is tied to the local market, health of employee pool, and benefits offered. If I left my job tomorrow and didn't qualify for subsidies, I'd stay on COBRA for as long as possible.

I don't think that's right.  When I signed up for the ACA, healthcare.gov did not ask about the cost of the COBRA policy that was available to me.  I was not required to consider signing up for COBRA, regardless of the price.

However, if I had chosen to sign up for COBRA, voluntarily dropping it would not be considered a qualifying event.  You have to involuntarily lose your coverage for it to be considered a qualifying event.
You misunderstood me. I was only talking about COBRA attractiveness relative to ACA plans, not whether theoretical COBRA premiums determine ACA eligibility.

Basically I compared what I can get on the ACA with the amount of money paid by me and my employer (as reported on my W-2, box 12 code DD), and the plans are significantly worse. That won't be true for everyone.

protostache

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Re: What comes after the ACA?
« Reply #4219 on: April 06, 2018, 09:11:06 AM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.

Those are the expensive parts. Everything else is a rounding error when you're on the hook to cover expenses for anyone who walks in the door. They're also the parts that get less expensive when everyone participates, because the healthy people paying into the pool help take up the slack for the people with expensive conditions. If everyone participates, everyone pays less.

Mr. Green

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Re: What comes after the ACA?
« Reply #4220 on: April 06, 2018, 09:25:09 AM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.
I don't believe that creating poor coverage options as an alternative to the outrageous cost of healthcare in this country is an appropriate solution. It's great if we all want to continue paying $10 for a band-aid at the hospital but not so great and providing sensible healthcare for our citizenry. The ACA was one necessary step needed to set a standard of care for everyone. The next step should be fixing the cost. No one will ever want to address the real problem as long as we keep creating half measures that just cover it up.

Jrr85

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Re: What comes after the ACA?
« Reply #4221 on: April 06, 2018, 09:34:01 AM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.

Those are the expensive parts. Everything else is a rounding error when you're on the hook to cover expenses for anyone who walks in the door.
  The other coverage mandates are less expensive, but they are also almost entirely costs with no benefits.  You're taking what would already be an extremely large tax on anybody who is young or healthy and not low income that they might accept, and then adding on gratuitous costs.  Even if they are relatively small, you're pretty much guaranteed to be at the margin of acceptable costs just from guaranteed issue and no lifetime caps.   

They're also the parts that get less expensive when everyone participates, because the healthy people paying into the pool help take up the slack for the people with expensive conditions. If everyone participates, everyone pays less.

That's almost certainly wrong.  It's possible but unlikely that overall costs would go down by making it virtually free for people with low income (but still above medicaid cutoffs) to get healthcare.  But even if that were true (which woudl require that people use no or very little more healthcare even though it is suddenly available at a very cheap cost to them), you still have a lot of people paying a lot more to provide that coverage.  Basically you are sticking anybody who is young or healthy with a significant tax, unless they are low enough income to get subsidized. 

Young people were often foregoing insurance when they didn't have to pay extra to insurer older (and generally wealthier) people.  Of course they are not going to be thrilled to be forced to pay for their insurance and then an additional amount to subsidize wealthier older people.  Maybe they'll make their peace with it, just like social security taxes, and assume it's an ok tradeoff in order to be willing to take their turn screwing younger people.  But it's not surprising to me if in a lot of states, people aren't ok with that tradeoff. 

Jrr85

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Re: What comes after the ACA?
« Reply #4222 on: April 06, 2018, 09:42:17 AM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.
I don't believe that creating poor coverage options as an alternative to the outrageous cost of healthcare in this country is an appropriate solution. It's great if we all want to continue paying $10 for a band-aid at the hospital but not so great and providing sensible healthcare for our citizenry. The ACA was one necessary step needed to set a standard of care for everyone. The next step should be fixing the cost. No one will ever want to address the real problem as long as we keep creating half measures that just cover it up.

THe ACA was not a necessary step, except maybe politically if you really want to break healthcare because you think it will make nationalized healthcare or a relatively free market for health care politically viable. 

What we need to have reasonable healthcare costs, (such as a loosening of the stranglehold on supply; loosening regulation to allow innovative, lower cost treatments, even at the risk of a decrease in quality; lower third party payment; incentive alignment for preventative care and generally good health habits) are mostly politically unpopular. 

American voters want all the best care a relatively free health care market would provide, they want somebody else to pay for it, and they also want all the regulatory "protections" of a heavily regulated health care market.  Obamacare did a few good things, but for every good thing it did, it did as many bad things, basically because the politicians had to continue to give the american people the lies they demand and pretend that voters can actually have what they want. 


Mr. Green

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Re: What comes after the ACA?
« Reply #4223 on: April 06, 2018, 11:50:09 AM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.
I don't believe that creating poor coverage options as an alternative to the outrageous cost of healthcare in this country is an appropriate solution. It's great if we all want to continue paying $10 for a band-aid at the hospital but not so great and providing sensible healthcare for our citizenry. The ACA was one necessary step needed to set a standard of care for everyone. The next step should be fixing the cost. No one will ever want to address the real problem as long as we keep creating half measures that just cover it up.

THe ACA was not a necessary step, except maybe politically if you really want to break healthcare because you think it will make nationalized healthcare or a relatively free market for health care politically viable. 

What we need to have reasonable healthcare costs, (such as a loosening of the stranglehold on supply; loosening regulation to allow innovative, lower cost treatments, even at the risk of a decrease in quality; lower third party payment; incentive alignment for preventative care and generally good health habits) are mostly politically unpopular. 

American voters want all the best care a relatively free health care market would provide, they want somebody else to pay for it, and they also want all the regulatory "protections" of a heavily regulated health care market.  Obamacare did a few good things, but for every good thing it did, it did as many bad things, basically because the politicians had to continue to give the american people the lies they demand and pretend that voters can actually have what they want.
We'll have to agree to disagree. I don't consider the pre-ACA stance of "if you're more than a little bit sick you can fuck off and die (via refusal of coverage)" as an acceptable healthcare practice for a developed nation.

JayhawkRacer

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Re: What comes after the ACA?
« Reply #4224 on: April 06, 2018, 12:48:41 PM »
We'll have to agree to disagree. I don't consider the pre-ACA stance of "if you're more than a little bit sick you can fuck off and die (via refusal of coverage)" as an acceptable healthcare practice for a developed nation.

You clearly just hate capitalism. /s

Threshkin

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Re: What comes after the ACA?
« Reply #4225 on: April 06, 2018, 01:13:10 PM »
These people are missng out! In this year of The Donald’s Reign, our Obamacare premiums are $0 and that is down from about $260/month last enrollment period. Score!

We were not eligible for the subsidy in 16 or 17 because of income.  Once you start COBRA you have to stay on it until the end or you cannot get the subsidy.

I am a new participant this year (COBRA ran out).  Our Bronze plan is a whopping $3.61/month after subsidies.
I love The Donald! And
Obama! Lets vote them all in again!

Last year when our COBrA ran out,  we took a blowout trip to
Romania, Switzerland, and Prague because we could afford it, not having to pay high health insurance premiums.
If your income was low enough for these bargain premiums, why did you stay on COBRA at all?

If you drop COBRA before it expires you are not eligible for the subsidy.  I had to wait for COBRA to expire and then sign up for the ACA plan.

Huh?... We were offered COBRA, saw the price, said a four letter word and went straight to the ACA. Now of course if we had made a shit ton of money that year then we would not have got any subsidy on the ACA. But even without a subsidy the ACA was cheaper than COBRA.

Of course we made sure we managed our income such that we got a decent subsidy.

Jrr85

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Re: What comes after the ACA?
« Reply #4226 on: April 06, 2018, 01:51:40 PM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.
I don't believe that creating poor coverage options as an alternative to the outrageous cost of healthcare in this country is an appropriate solution. It's great if we all want to continue paying $10 for a band-aid at the hospital but not so great and providing sensible healthcare for our citizenry. The ACA was one necessary step needed to set a standard of care for everyone. The next step should be fixing the cost. No one will ever want to address the real problem as long as we keep creating half measures that just cover it up.

THe ACA was not a necessary step, except maybe politically if you really want to break healthcare because you think it will make nationalized healthcare or a relatively free market for health care politically viable. 

What we need to have reasonable healthcare costs, (such as a loosening of the stranglehold on supply; loosening regulation to allow innovative, lower cost treatments, even at the risk of a decrease in quality; lower third party payment; incentive alignment for preventative care and generally good health habits) are mostly politically unpopular. 

American voters want all the best care a relatively free health care market would provide, they want somebody else to pay for it, and they also want all the regulatory "protections" of a heavily regulated health care market.  Obamacare did a few good things, but for every good thing it did, it did as many bad things, basically because the politicians had to continue to give the american people the lies they demand and pretend that voters can actually have what they want.
We'll have to agree to disagree. I don't consider the pre-ACA stance of "if you're more than a little bit sick you can fuck off and die (via refusal of coverage)" as an acceptable healthcare practice for a developed nation.

Because that's exactly what happened.  It is nicer getting to work now that I don't have to dodge all the dead uninsured people littered about the road. 

Mr. Green

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Re: What comes after the ACA?
« Reply #4227 on: April 06, 2018, 02:31:33 PM »
I wonder when the goon squad will have another go at trashing the ACA? They do seem to be strangely quiet on the issue.

I hope they have forgotten about it personally.
The Feds shot down Iowa's attempt to flagrantly break the law regarding health insurance so that's a win. However the state is now trying to create a plan like the Tennessee Farm Beareu that is grandfathered into the ACA and it likely to be considered a legal option since it's not considered "health insurance." I can't say that I understand why the state wants to create plans that will likely harm their citizens long term by enrolling them in plans without the protections of the ACA's essential benefits.

Because they are not so dense to think that Obamacare only comes with benefits.
 Obamacare can be brutal for the non-subsidized, particularly in rural areas and it makes sense that states would try to find away to shield its residents from teh costs of some of the more ridiculous coverage mandates, even if some parts, such as guaranteed issue and no lifetime caps, would be seen as worth the cost by a majority of the residents.
I don't believe that creating poor coverage options as an alternative to the outrageous cost of healthcare in this country is an appropriate solution. It's great if we all want to continue paying $10 for a band-aid at the hospital but not so great and providing sensible healthcare for our citizenry. The ACA was one necessary step needed to set a standard of care for everyone. The next step should be fixing the cost. No one will ever want to address the real problem as long as we keep creating half measures that just cover it up.

THe ACA was not a necessary step, except maybe politically if you really want to break healthcare because you think it will make nationalized healthcare or a relatively free market for health care politically viable. 

What we need to have reasonable healthcare costs, (such as a loosening of the stranglehold on supply; loosening regulation to allow innovative, lower cost treatments, even at the risk of a decrease in quality; lower third party payment; incentive alignment for preventative care and generally good health habits) are mostly politically unpopular. 

American voters want all the best care a relatively free health care market would provide, they want somebody else to pay for it, and they also want all the regulatory "protections" of a heavily regulated health care market.  Obamacare did a few good things, but for every good thing it did, it did as many bad things, basically because the politicians had to continue to give the american people the lies they demand and pretend that voters can actually have what they want.
We'll have to agree to disagree. I don't consider the pre-ACA stance of "if you're more than a little bit sick you can fuck off and die (via refusal of coverage)" as an acceptable healthcare practice for a developed nation.

Because that's exactly what happened.  It is nicer getting to work now that I don't have to dodge all the dead uninsured people littered about the road.
It's easy to be non-chalant about it until you're the one who gets cancer at 40 and your insurance decides you're not profitable anymore and your spouse's biggest worry becomes figuring out how to stay employed so you can have insurance while balancing kids and a sick adult at home. That's just one of many examples. If I was an insurance company with no conscience, a bottom line to care about, and no law that says I had to keep insuring you then I'd drop you too.

bacchi

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Re: What comes after the ACA?
« Reply #4228 on: April 06, 2018, 02:46:41 PM »

Because that's exactly what happened.  It is nicer getting to work now that I don't have to dodge all the dead uninsured people littered about the road.
It's easy to be non-chalant about it until you're the one who gets cancer at 40 and your insurance decides you're not profitable anymore and your spouse's biggest worry becomes figuring out how to stay employed so you can have insurance while balancing kids and a sick adult at home. That's just one of many examples. If I was an insurance company with no conscience, a bottom line to care about, and no law that says I had to keep insuring you then I'd drop you too.

Or worse, if you didn't have employer coverage.

http://articles.latimes.com/2010/apr/28/business/la-fi-0428-insure-rescission-20100428

Quote
The practice [rescission] resulted in some people losing coverage through no fault of their own, often over trivial bits of health history that had nothing to do with the claims that triggered the investigations.

Quote
The lawyer won a $9-million judgment against Health Net in 2008 over its rescission of hairdresser Patsy Bates after she was diagnosed with breast cancer. Evidence showed the company paid bonuses to an employee based in part on rescission volume.
(emphasis added)

Thank you, Obama!

NoStacheOhio

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Re: What comes after the ACA?
« Reply #4229 on: April 06, 2018, 04:31:59 PM »
It's easy to be non-chalant about it until you're the one who gets cancer at 40 and your insurance decides you're not profitable anymore and your spouse's biggest worry becomes figuring out how to stay employed so you can have insurance while balancing kids and a sick adult at home. That's just one of many examples. If I was an insurance company with no conscience, a bottom line to care about, and no law that says I had to keep insuring you then I'd drop you too.

*Raises hand*

Except I'm the spouse, and it was 31, not 40.

I still worry about staying employed for insurance, especially now.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4230 on: April 06, 2018, 05:29:29 PM »
Thank you everyone for the intelligent responses and not allowing ourselves to have selective amnesia about the way insurance companies doled out health insurance when they went unregulated.

mm1970

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Re: What comes after the ACA?
« Reply #4231 on: April 06, 2018, 05:37:00 PM »
It's easy to be non-chalant about it until you're the one who gets cancer at 40 and your insurance decides you're not profitable anymore and your spouse's biggest worry becomes figuring out how to stay employed so you can have insurance while balancing kids and a sick adult at home. That's just one of many examples. If I was an insurance company with no conscience, a bottom line to care about, and no law that says I had to keep insuring you then I'd drop you too.

*Raises hand*

Except I'm the spouse, and it was 31, not 40.

I still worry about staying employed for insurance, especially now.
Yep.  I know many folks who were:
1.  Unable to get insurance due to pre-existing conditions - that were covered by the same insurer in a different state.  Move states, no insurance!
2.  Were unemployed for months and unable to pay for cobra
3.  Were diagnosed with cancer.  What if they lost their job?  After working 30 years? I guess, fuck off and die?
4.  My cousin died from a leg infection.  A fucking leg infection.
5.  My friend's brother died because he didn't have insurance and couldn't pay for medical care.

Just because you don't know anyone personally doesn't mean it doesn't happen.

obstinate

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Re: What comes after the ACA?
« Reply #4232 on: April 07, 2018, 04:25:02 PM »
Thank you everyone for the intelligent responses and not allowing ourselves to have selective amnesia about the way insurance companies doled out health insurance when they went unregulated.
I wouldn't necessarily blame the insurance companies. Under the laws we had then, any other course of action would quickly have run a company bankrupt because of all the adverse incentives in the market for healthcare. But it's important to recognize that this is not a problem that can be solved in a totally free market. That's why we need things like the ACA, to establish an environment in which an insurance company can provide effective insurance without going bankrupt.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4233 on: April 07, 2018, 09:39:23 PM »
Thank you everyone for the intelligent responses and not allowing ourselves to have selective amnesia about the way insurance companies doled out health insurance when they went unregulated.
I wouldn't necessarily blame the insurance companies. Under the laws we had then, any other course of action would quickly have run a company bankrupt because of all the adverse incentives in the market for healthcare. But it's important to recognize that this is not a problem that can be solved in a totally free market. That's why we need things like the ACA, to establish an environment in which an insurance company can provide effective insurance without going bankrupt.

Yes totally agree.

Gin1984

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Re: What comes after the ACA?
« Reply #4234 on: April 08, 2018, 12:20:41 PM »
Some states have COBRA for 36 months.  If the ACA goes away then it might make sense to get a job long enough to qualify for COBRA and quit, then repeat.
What states other than California?

Gin1984

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Re: What comes after the ACA?
« Reply #4235 on: April 08, 2018, 12:24:28 PM »
It's easy to be non-chalant about it until you're the one who gets cancer at 40 and your insurance decides you're not profitable anymore and your spouse's biggest worry becomes figuring out how to stay employed so you can have insurance while balancing kids and a sick adult at home. That's just one of many examples. If I was an insurance company with no conscience, a bottom line to care about, and no law that says I had to keep insuring you then I'd drop you too.

*Raises hand*

Except I'm the spouse, and it was 31, not 40.

I still worry about staying employed for insurance, especially now.
Mine was not cancer, I just locked up a muscle and then could not get ANY non-employer insurance for ANY sum of money even if it was a high deductible or excluded that issue.  I tried for over six months.

jim555

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Re: What comes after the ACA?
« Reply #4236 on: April 08, 2018, 06:04:33 PM »
Some states have COBRA for 36 months.  If the ACA goes away then it might make sense to get a job long enough to qualify for COBRA and quit, then repeat.
What states other than California?
NY, may be others too.

DreamFIRE

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Re: What comes after the ACA?
« Reply #4237 on: April 08, 2018, 06:45:16 PM »
I was reading back over some previous pages and a couple comments that I didn't see followed up on that I wanted to address better late than never:

Don't forget that if you can keep your AGI between 138%-400% of the federal poverty limit you get subsidies.

ACA actually uses a MAGI calculation, which will differ for many people at some point compared to AGI.

For a couple with three kids (like my family), 400% of the FPL is $98,400 in 2017.  If you can't keep your paper income below that as a retired mustachian, I think you're doing something wrong. 

Remember that when you sell stock from a taxable account only the gains are income, not the principal you've contributed. 
Remember that your Roth IRA contributions can come back out at any time for any reason, penalty free and tax free.
Remember that only a portion of your SS benefits count as taxable income.

Don't remember that third point in this context.  For purposes of MAGI and ACA, both taxable and non-taxable SS benefits are included for determining your eligibility for PTC & CSR.  This difference is significant enough for me that I have changed my long term road map to delay taking SS benefits until at least age 65 in order to keep my MAGI lower, assuming current ACA rules are still in place then.

https://www.healthcare.gov/income-and-household-information/income/

iris lily

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Re: What comes after the ACA?
« Reply #4238 on: April 10, 2018, 02:33:36 PM »
I was reading back over some previous pages and a couple comments that I didn't see followed up on that I wanted to address better late than never:

Don't forget that if you can keep your AGI between 138%-400% of the federal poverty limit you get subsidies.

ACA actually uses a MAGI calculation, which will differ for many people at some point compared to AGI.

For a couple with three kids (like my family), 400% of the FPL is $98,400 in 2017.  If you can't keep your paper income below that as a retired mustachian, I think you're doing something wrong. 

Remember that when you sell stock from a taxable account only the gains are income, not the principal you've contributed. 
Remember that your Roth IRA contributions can come back out at any time for any reason, penalty free and tax free.
Remember that only a portion of your SS benefits count as taxable income.

Don't remember that third point in this context.  For purposes of MAGI and ACA, both taxable and non-taxable SS benefits are included for determining your eligibility for PTC & CSR.  This difference is significant enough for me that I have changed my long term road map to delay taking SS benefits until at least age 65 in order to keep my MAGI lower, assuming current ACA rules are still in place then.

https://www.healthcare.gov/income-and-household-information/income/
We also are delaying SS due to ACA subsidies for our lowincome status.

Now I have a basic question about ACA: where do I find the estimated income figure I gave them for the year 2017? I didnt write it down anywhere, and I cannot access that on Healthcare.gov.

I ask because we had $20,000 in capital gain that I didnt anticipate and that counts on MAGI I guess. Yet, we dont have to pay back any subsidies and in fact we are getting an additional $610 from IRS due to pTC pay,ent. At least, this is how I am inyerpretting  my tax document, just received today from our preparer.

I want to i ow how much I told “them” our annual incme would be for 2017 since I now suspect I told them more than I thought I did.

geekette

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Re: What comes after the ACA?
« Reply #4239 on: April 10, 2018, 02:43:48 PM »
Log in to Healthcare.gov, go to "messages"  and download your "Eligibility Results Notice" for last year.  It shows your yearly household income in the results box, which I believe is what you entered.

iris lily

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Re: What comes after the ACA?
« Reply #4240 on: April 10, 2018, 05:03:32 PM »
Log in to Healthcare.gov, go to "messages"  and download your "Eligibility Results Notice" for last year.  It shows your yearly household income in the results box, which I believe is what you entered.
thanks for this, I did fnd it there. I had gone to Healthcare.gov previously but didnt read through the right sections of the right document.

DreamFIRE

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Re: What comes after the ACA?
« Reply #4241 on: April 10, 2018, 05:44:31 PM »
I was reading back over some previous pages and a couple comments that I didn't see followed up on that I wanted to address better late than never:

Don't forget that if you can keep your AGI between 138%-400% of the federal poverty limit you get subsidies.

ACA actually uses a MAGI calculation, which will differ for many people at some point compared to AGI.

For a couple with three kids (like my family), 400% of the FPL is $98,400 in 2017.  If you can't keep your paper income below that as a retired mustachian, I think you're doing something wrong. 

Remember that when you sell stock from a taxable account only the gains are income, not the principal you've contributed. 
Remember that your Roth IRA contributions can come back out at any time for any reason, penalty free and tax free.
Remember that only a portion of your SS benefits count as taxable income.

Don't remember that third point in this context.  For purposes of MAGI and ACA, both taxable and non-taxable SS benefits are included for determining your eligibility for PTC & CSR.  This difference is significant enough for me that I have changed my long term road map to delay taking SS benefits until at least age 65 in order to keep my MAGI lower, assuming current ACA rules are still in place then.

https://www.healthcare.gov/income-and-household-information/income/
We also are delaying SS due to ACA subsidies for our lowincome status.

Now I have a basic question about ACA: where do I find the estimated income figure I gave them for the year 2017? I didnt write it down anywhere, and I cannot access that on Healthcare.gov.

I ask because we had $20,000 in capital gain that I didnt anticipate and that counts on MAGI I guess. Yet, we dont have to pay back any subsidies and in fact we are getting an additional $610 from IRS due to pTC pay,ent. At least, this is how I am inyerpretting  my tax document, just received today from our preparer.

I want to i ow how much I told “them” our annual incme would be for 2017 since I now suspect I told them more than I thought I did.

Capital gains count.  So, you have me curious how you could have underestimated by $20K and don't have to pay back any of the PTC.  I understand CSR don't need to be paid back.

Exflyboy

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Re: What comes after the ACA?
« Reply #4242 on: April 10, 2018, 08:20:07 PM »
Remember a contribution to an HSA reduces MAGI as well.. as long as you choose a bronze plan.

If you contribute say $8k to an HSA you can then sell investments to generate $8k's worth of cap gains... Which in our case will release about $24k in real money..:)

iris lily

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Re: What comes after the ACA?
« Reply #4243 on: April 10, 2018, 09:29:56 PM »
I was reading back over some previous pages and a couple comments that I didn't see followed up on that I wanted to address better late than never:

Don't forget that if you can keep your AGI between 138%-400% of the federal poverty limit you get subsidies.

ACA actually uses a MAGI calculation, which will differ for many people at some point compared to AGI.

For a couple with three kids (like my family), 400% of the FPL is $98,400 in 2017.  If you can't keep your paper income below that as a retired mustachian, I think you're doing something wrong. 

Remember that when you sell stock from a taxable account only the gains are income, not the principal you've contributed. 
Remember that your Roth IRA contributions can come back out at any time for any reason, penalty free and tax free.
Remember that only a portion of your SS benefits count as taxable income.

Don't remember that third point in this context.  For purposes of MAGI and ACA, both taxable and non-taxable SS benefits are included for determining your eligibility for PTC & CSR.  This difference is significant enough for me that I have changed my long term road map to delay taking SS benefits until at least age 65 in order to keep my MAGI lower, assuming current ACA rules are still in place then.

https://www.healthcare.gov/income-and-household-information/income/
We also are delaying SS due to ACA subsidies for our lowincome status.

Now I have a basic question about ACA: where do I find the estimated income figure I gave them for the year 2017? I didnt write it down anywhere, and I cannot access that on Healthcare.gov.

I ask because we had $20,000 in capital gain that I didnt anticipate and that counts on MAGI I guess. Yet, we dont have to pay back any subsidies and in fact we are getting an additional $610 from IRS due to pTC pay,ent. At least, this is how I am inyerpretting  my tax document, just received today from our preparer.

I want to i ow how much I told “them” our annual incme would be for 2017 since I now suspect I told them more than I thought I did.

Capital gains count.  So, you have me curious how you could have underestimated by $20K and don't have to pay back any of the PTC.  I understand CSR don't need to be paid back.

I said the wrong thing above because I forgot how much I estimated our income for 2017 back when I made the estimate in October 2016. In fact, I estimated within $4,000 of our actual MAGI. That was me wild ass guessing, and damn, I did a nice job. How was I able to predict that The Donald would become President and the stock market would rise like an SOB on that news?  hire me as your futures broker haha.

« Last Edit: April 10, 2018, 09:32:23 PM by iris lily »

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4244 on: April 11, 2018, 06:30:38 AM »
There's a certain brilliance to keeping these ACA subsidies by making sure not to go above that 400% of the federal poverty limit.

iris lily

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Re: What comes after the ACA?
« Reply #4245 on: April 11, 2018, 07:02:27 AM »
There's a certain brilliance to keeping these ACA subsidies by making sure not to go above that 400% of the federal poverty limit.

Yep. It is good strategy because all the time I fail to draw Social Security, my SS acount climbs and will pay out more.



Roland of Gilead

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Re: What comes after the ACA?
« Reply #4246 on: April 11, 2018, 09:40:15 AM »
Can you convert from a silver plan to a bronze plan mid year and then fund a HSA?

I have been wildly successful with trading this year and rapidly approaching the subsidy cutoff (currently have made $43,000 in short term capital gains on a $100,000 account and it isn't even May yet).   We are signed up for a silver plan and I had estimated our MAGI to be $25,000 for the year.   I really don't know quite how one could estimate how lucky they will be in a given year trading stock.

I don't think you can switch plan levels outside open enrollment without a life changing event, like moving or getting a job...

Perhaps if I were to file as a professional trader, that would count as a job change...

A HSA would save me some $3,000 on taxes and subsidy.

Exflyboy

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Re: What comes after the ACA?
« Reply #4247 on: April 11, 2018, 03:04:54 PM »
Swing trading eh?.. I was almost tempted to do the same thing.

Not sure I could stand the shame though..:)

Besides there is a great feeling of gaming the system to be paying zero Fed taxes but getting nearly $1100/m back in subsidies..:)

DreamFIRE

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Re: What comes after the ACA?
« Reply #4248 on: April 11, 2018, 04:13:51 PM »
Remember a contribution to an HSA reduces MAGI as well.. as long as you choose a bronze plan.

The HSA is limited to only $3450 for an individual and doesn't look like a good option for me.  With a silver plan instead, I can get CSR, which can save thousands, and I can still spend close to $50K/yr through the first decade of retirement, which is about what the 4% rule allows based on my stash, meaning I don't want to spend any more than that, even if it didn't affect ACA.  I'm estimating almost $0 federal income taxes including $0 capital gains taxes through the first part of my retirement.  I can't quite escape state income tax unless I re-locate, but I have been considering that (mostly for other reasons).  Later in retirement, I will have to switch to sources realizing more capital gains and pull heavily from my pre-tax account, but I can use Medicare by that point instead of worrying about ACA subsidy cliffs.  I'll still have a $0 capital gains tax at that point, but I will have to start paying federal income tax on part of my retirement account withdrawals.  Whenever I take SS, that should significantly cut my stash needs based on the figures I get from my SS calculator.

Exflyboy

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Re: What comes after the ACA?
« Reply #4249 on: April 11, 2018, 07:42:04 PM »
So general ACA question..

Do we think the Washington GOP swamp is going to have another go at repealing the ACA? I know the individual senators got a lot of townhall pushback when they tried it last time.