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Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: JohnGalt on April 25, 2014, 02:42:53 PM

Title: How has the ACA affected your current healthcare costs?
Post by: JohnGalt on April 25, 2014, 02:42:53 PM
Just got an email from my CFO letting me know that, because healthcare costs are now based on age (not sure why that wasn't the case before, would have thought age was already part of the risk underwriting process for the insurance company), my premiums are going down ~45%.  Since the company just pays a flat 75% of the total premium cost, that should mean the total cost for my plan went down that same amount.  As far as I know - this is for the same coverage as before. 

Has anyone else had their health insurance impacted by the ACA yet? 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: plantingourpennies on April 25, 2014, 02:59:55 PM
Just got an email from my CFO letting me know that, because healthcare costs are now based on age (not sure why that wasn't the case before, would have thought age was already part of the risk underwriting process for the insurance company), my premiums are going down ~45%. 

My company did the same thing, but in 2010 to get in on a grandfathered plan for ACA purposes.  My premiums dropped around 20% for same coverage. 

They're currently exploring HDHP options to see how much they could subsidize our HSA yearly in that case, so that might become an option for us soon, which I would be a fan of as currently only Mr PoP has an HDHP with a subsidized HSA, so we are fairly limited as to how much we can stow away in the HSA account each year.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: matchewed on April 25, 2014, 03:07:15 PM
Weird that he's saying they're just factoring age. My previous employer's healthcare costs had been increasing over the last four years primarily due to the general age of our workforce according to our management and the healthcare companies we've had.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: JohnGalt on April 25, 2014, 03:13:20 PM
Weird that he's saying they're just factoring age. My previous employer's healthcare costs had been increasing over the last four years primarily due to the general age of our workforce according to our management and the healthcare companies we've had.

Yeah it seemed weird to me too.  "As part of this act, medical insurance costs are now based on age as opposed to household formation." is how it was worded. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: BlueMR2 on April 25, 2014, 03:53:55 PM
Personally, mine only went up a couple dollars a week, but that's due to my employer taking the big hit and absorbing nearly all the of the increase (company was socked with a 30% increase overall due to ACA).
Title: Re: How has the ACA affected your current healthcare costs?
Post by: JohnGalt on April 25, 2014, 03:59:03 PM
I was curious so I asked what the larger impact to the company was. 

Response was basically that healthcare costs for the company as a whole were up about 6% due to ACA. 

Oh and he mentioned that my max out of pocket expenses went up about 25% so the 45% decreased costs wasn't a complete net gain for me.  Though I've never come anywhere close to hitting max out of pocket so that's more of an increased risk factor than a realized change for me.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Rural on April 25, 2014, 04:43:34 PM
Premium and deductible stayed the same, slightly more coverage, slightly higher coinsurance after deductible (85/15 instead of 90/10). Out of pocket max stayed the same.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: TreeTired on April 25, 2014, 07:14:41 PM
We are private pay because neither of us work.    We have very good coverage from BCBS and were paying just under $1k for the 2 of us, then when the premium went up to over $1k per month we increased our deductible and copay and our premium went down to $678 for 2013.   Now, in 2014 our ACA compliant plan has a list price of over $1500 per month but based on my estimated low income we are only paying a subsidized rate of $309.    I didn't write the law, but at the moment it is helping us.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: frugalmom on April 25, 2014, 08:44:28 PM
My husband carries our insurance and works for a large corporation.  The company was going to have to pay a penalty on our insurance coverage because we had a cadillac plan.

Our premiums went up approximately $1000 a year or 30% (not an issue)
Our deductible remains at $250 per person (no issue)
Lots of things are free outside of the deductible and co-insurance.
Our co-insurance remains at 80/20 (no issue)

Our annual family out of pocket went from $4000 to $25K (this is an issue)

Potentially if I am able to get pregnant again (and the pregnancy spans 2 insurance years) I will be paying 50K.  [I'm basically healthy but because of some chronic issues, doctors want lots of testing/monitoring just in case]

I actually told my husband if one of the non-executives gets sick with something like cancer, he should no longer send flowers or another feel good gift.  Since an admin is going to be subject to the same out of pocket maximum, I told him to just get a nice card and put cash inside and tell them to apply it to their out of pocket payment.

I'm really not loving the ACA at the moment.

Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cheddar Stacker on April 25, 2014, 09:10:12 PM
our company saw a 2% reduction overall but it was different for everyone. Mine went down slightly. Most of the 20 somethings saw an increase and most of the 40+ people saw a nice decline due to the new age disparity rules.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: msilenus on April 25, 2014, 09:10:41 PM
My company used to have something that wasn't exactly insurance, administered by an insurance company.  The way it worked was when we needed health care, we'd give our provider our insurance card, and the administrator would bill my company.  It's not insurance because there was nothing about risk --it was more like contracting out price negotiation and billing.  My family went something like eight years, and squeezed out two kids, without seeing any medical bills.

Not any more.  Under the ACA, that would result in a Cadillac tax.  So today, we have an HDHP with an HSA.  Our employer contributes to the HSA every year, and we can contribute more up to the IRS maximum.  We still don't pay premiums or anything.

Last year we had about $3k in medical expenses.  The combined employer contribution, and tax benefit from being able to contribute pretax money to the HSA add up to a financial benefit of about $4.5k at our marginal tax rate.

Yes.  My costs went down, from zero.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: spoonman on April 25, 2014, 09:59:19 PM
My premium went down by only $10 for the year, but I'm just glad it didn't go up.  This is the first year it hasn't gone up.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Rube on April 26, 2014, 08:48:03 AM
Premium has stayed the same for 3 years on the HSA. My employer offered PPO and HSA and we switched to HSA because the premium had gone up so much on the PPO. Now they only offer HSA. I liked the HSA since we don't go to the doctor much except for a miscarriage with some complications last year.

In previous years we may have actually hit the 7.5% deductible for non-reimbursed medical expenses on our tax return but because of ACA it's now 10%.  We didn't even calculate it.

The HSA premium has stayed the same but my employer cut their cash contribution by 60% or so over the last few years and the out of pocket max has doubled. 

My wife went back to FT late last year so we went with her insurance which is PPO and cheaper than we were paying with mine. I suspect that her employer will have some sort of HDHP option by next year.

Title: Re: How has the ACA affected your current healthcare costs?
Post by: BlueHouse on April 26, 2014, 10:51:07 AM
My premium decreased, but we're not exactly talking apples-to-apples until we factor in the availability of doctors that will accept the plan, ability to choose out-of-network, deductibles, etc. 
I haven't been to a doctor yet, but I can definitely tell you this:  I've been with the same healthcare company for years on an independent plan (not group coverage).  With ACA, I still use the same company, but I had to purchase through the exchange and seem to be treated as a group with all the other people in that group.  Customer service sucks.   Everyone I know (in the spendy world) is paying extra for concierge doctor service (pay a monthly fee to put the doctor on retainer so you get priority treatment).    If I get sick, I won't want to spend my time in coach with all the cattle.  I'll upgrade to first class.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: CarDude on April 26, 2014, 11:17:54 AM
   If I get sick, I won't want to spend my time in coach with all the cattle.  I'll upgrade to first class.

And this is why we need single payer.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: stevesteve on April 26, 2014, 02:09:18 PM
My husband carries our insurance and works for a large corporation.  The company was going to have to pay a penalty on our insurance coverage because we had a cadillac plan.

Our premiums went up approximately $1000 a year or 30% (not an issue)
Our deductible remains at $250 per person (no issue)
Lots of things are free outside of the deductible and co-insurance.
Our co-insurance remains at 80/20 (no issue)

Our annual family out of pocket went from $4000 to $25K (this is an issue)

Potentially if I am able to get pregnant again (and the pregnancy spans 2 insurance years) I will be paying 50K.  [I'm basically healthy but because of some chronic issues, doctors want lots of testing/monitoring just in case]

I actually told my husband if one of the non-executives gets sick with something like cancer, he should no longer send flowers or another feel good gift.  Since an admin is going to be subject to the same out of pocket maximum, I told him to just get a nice card and put cash inside and tell them to apply it to their out of pocket payment.

I'm really not loving the ACA at the moment.

That's just your husband's company using it as an excuse to save money.  The Cadillac tax doesn't kick in until 2017 and the out of pocket maximum for a family is $12,700 (on the exchanges).
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Thegoblinchief on April 26, 2014, 07:51:23 PM
Went up slightly, for the first time in years. They've kept it level mainly by doing wellness programs tied into insurance and presumably also absorbing some of the hit. DW's company generally does good by their employees.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: chucklesmcgee on April 26, 2014, 08:00:06 PM
My premiums roughly quadrupled. That's what happens when you're young and on a bare-bones plan and the ACA steps in and prevents such things.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: genesismachine on April 27, 2014, 08:07:37 PM
My work has a terrible policy, ~1000/month for my wife and I. If I chose similar coverage on the exchanges, I'd be paying $300/month. That's $700/month less. And I work for a very large engineering company, so this isn't some McDonald's policy or something.

Except, I switched to an even more basic HDHP and I now pay 190/month (without any subsidies, this is just due to the exchanges existing, and providing competition). I love it. So yeah, my health care costs went down ~80%.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on April 27, 2014, 09:00:33 PM
   If I get sick, I won't want to spend my time in coach with all the cattle.  I'll upgrade to first class.

And this is why we need single payer.

Would you keep BlueHouse from using his own cash to visit, for instance Harley Street style docs in a single payer scenario? Or would you limit him to the one-size-fits-all that I believe is the Canadian model? If my information is correct (and please let  me know if it is not) no physicians in Canada are allowed to accept private-pay clients.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: BlueMR2 on April 28, 2014, 06:28:44 PM
My work has a terrible policy, ~1000/month for my wife and I. If I chose similar coverage on the exchanges, I'd be paying $300/month. That's $700/month less. And I work for a very large engineering company, so this isn't some McDonald's policy or something.

Funny, reminds me of when I was laid off from work a number of years ago.  I had the option of going on COBRA at $600/month.  I was able to call up my insurance agent and get signed up on my own policy with better coverage for only $60/month.  :-)  Certain industries get especially hard hit due to the risks in them.  I was in the office, but it was still technically "construction industry"!
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on April 28, 2014, 06:43:52 PM
My costs increased... or maybe they've decreased depending on how you look at it. I am ER'd on a fairly low taxable income so pay for my own health insurance. My self-funded Blue Cross plan was cancelled as of Jan. 1st, 2014 and the new plan I got had a monthly premium increase three-times the former costs and a greater annual out of pocket costs by about $2,500 (from $4000 to $6500 annually).  It will now cost me over $14,000/year in premiums and deducibles BEFORE my insurance company has to start paying.  I do not qualify for subsidies because I am TOO low income, however I live in a Medicaid expanded state so could get that if I choose now that they no longer require means testing of assets. I don't wish to get Medicaid though. So, being that I have a military service-connected disability, I can use the VA hospital for free or low cost and that's what I intend to do. While I don't like doing that anymore than I would have liked going on Medicaid, I really don't like paying the new much higher private insurance costs I have too either. If I couldn't use the VA like most people, or wasn't in a Medicaid expanded state like many people, and had my same low income (mustachian income!) then I would be SOL and have to pay the increased amount (which is more than I live on per year), do without coverage, or go out a get a job (OH THE HORROR!)
Title: Re: How has the ACA affected your current healthcare costs?
Post by: nawhite on April 29, 2014, 07:26:00 AM
My costs went down because I changed jobs, totally unrelated to ACA. My wife though, has been on private insurance for years (we have VERY different medical needs).

This year the plans changed drastically with ACA but we were able to get what looked like a much better plan for her for only a little bit more money. The problem is that our insurer is now realizing that they underestimated the cost of that plan and got tons more sign ups on the exchange that they didn't expect because the plan was the best value available. So they are slowly, month after month, changing the policies making prescriptions more expensive every month. Its now not so good of a deal (its about as good as we had last year for slightly more cost).
Title: Re: How has the ACA affected your current healthcare costs?
Post by: socaso on April 29, 2014, 08:14:53 AM
Premium went up less than $5/month
Deductible went up from $2500 to $3000
Office visits went up from $30 to $40
 This is the private market policy I have had for a couple of years that covers my son and myself. Due to our income level and not being eligible for work insurance we should have qualified for ACA but Covered CA has absolutely horrible service. I spent months trying to get them on the phone and never got through. I tried going to the certified counselors only to be told that they didn't know how to fill out the forms and didn't want to risk making a mistake. ACA is a very sore subject with me because I feel extremely betrayed by it. I did everything I was supposed to do and the CA market didn't hold up their end of the deal and I got left out in the cold. I've been meaning to call them and see if something can't get worked out. Additionally I read that before the close of open enrollment Covered CA got something like $150 million to help them expand their call centers and it still didn't help. Their lines were so busy you couldn't even sit on hold and I tried to email them a couple of times and never got a response.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Daleth on April 29, 2014, 09:40:55 AM
My husband carries our insurance and works for a large corporation.  The company was going to have to pay a penalty on our insurance coverage because we had a cadillac plan.

Our premiums went up approximately $1000 a year or 30% (not an issue)
Our deductible remains at $250 per person (no issue)
Lots of things are free outside of the deductible and co-insurance.
Our co-insurance remains at 80/20 (no issue)

Our annual family out of pocket went from $4000 to $25K (this is an issue)

Potentially if I am able to get pregnant again (and the pregnancy spans 2 insurance years) I will be paying 50K.  [I'm basically healthy but because of some chronic issues, doctors want lots of testing/monitoring just in case]

I actually told my husband if one of the non-executives gets sick with something like cancer, he should no longer send flowers or another feel good gift.  Since an admin is going to be subject to the same out of pocket maximum, I told him to just get a nice card and put cash inside and tell them to apply it to their out of pocket payment.

I'm really not loving the ACA at the moment.

If I'm not mistaken, out of pocket maxes that high will only be allowed for one year, and they only exist now in plans that have a separate out of pocket max for medication (does your plan have  $12.5k max for drugs and a $12.5k max for everything else?). In 2015 all plans have to comply with the ACA requirement that a family's out of pocket max cannot exceed $12,700.
http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/061113-Michelle-Andrews-out-of-pocket-costs.aspx
Title: Re: How has the ACA affected your current healthcare costs?
Post by: homeymomma on April 29, 2014, 12:46:38 PM
Our monthly cost went up by about $100. We buy individual insurance. Our individual deductible went down from $1500 to $1000, but we now have a 10% coinsurance, up to $7500 as a family. This is not good since I'm pregnant! On the other hand, my pregnancy and delivery are covered, which was nearly impossible to find before. When we had our first baby, we had to shop around to find a company that even offered a maternity rider (not advertised! We had to call!). We had to pay an extra $70/ mo for the rider AND wait a 6 month waiting period before conceiving. It all worked out because we followed the rules but what a pain in the ass!

To get 0% coinsurance this time would have cost us $640 per month for my family of three. Probably would have been worth it just this year because of the pregnancy/delivery, but we couldn't bring ourselves do it because it was a $200 jump from last years plan!

Yuck. ACA did a lot of great things but it's far from solved all the problems of the individual insurance market.

Also, related: my mom, who "retired early" but wasn't actually financially ready to do so, has delayed getting a job by moving in with a boyfriend she met online. She has a ton of assets and has sold some real estate given to her by me grandparents in order to prolong her unemployment stint. She lives in Vermont now and qualified for Medicaid there! She'll be having a knee surgery this year 100% on the governments dime, even though she has PlENTY of money to pay for it. This is based simply on the fact that she is not employed and therefore has no income. This seems incredibly unfair to me, as a young person with no assets and a family to support.

What do you all think?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on April 29, 2014, 01:38:23 PM
 

Also, related: my mom, who "retired early" but wasn't actually financially ready to do so, has delayed getting a job by moving in with a boyfriend she met online. She has a ton of assets and has sold some real estate given to her by me grandparents in order to prolong her unemployment stint. She lives in Vermont now and qualified for Medicaid there! She'll be having a knee surgery this year 100% on the governments dime, even though she has PlENTY of money to pay for it. This is based simply on the fact that she is not employed and therefore has no income. This seems incredibly unfair to me, as a young person with no assets and a family to support.

What do you all think?
I also have a problem with this even though I am in the same situation as your Mom - I CAN go on Medicaid because my "taxable" income is low (although I have continued to buy and pay for my own policy at a greatly increased rate). It doesn't matter that if someone might have a gazillion in tax deferred or tax free investments, or they own 20 luxury homes, boats, cars, RVs and motorcycles, all that matters is my" taxable" income after certain deductions (MAGI). I personally think, that unless we have universal health insurance for everyone regardless of income or assets, then the ACA should require means testing for income AND assets in determining how much in subsidies and/or Medicaid someone can get. Heck even the VA hospitals require means testing for assets and income for any treatments a Vet gets besides something that they incurred while in the service. Why should higher income earners have to pay more in taxes to cover those who have the means to provide coverage for themselves? Especially when those higher earners can't get subsidies themselves.  No one should have to pay for my health insurance coverage so that I can retire early and play beach volleyball all day long - especially when I have money to pay "affordable" costs.

As a side question: does anyone know if someone who voluntarily quits their job and gave up the company health insurance to retire early can even apply for subsidies or Medicaid?  I thought there was some rule against that.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: brandino29 on April 29, 2014, 02:17:07 PM
As a health policy analyst, I feel compelled to jump in just to point out one thing --- healthcare costs have been rising an average of 10% for year for ever 20 years, in fact, it was exactly the reason we needed serious health reform (that and the fact that tens of millions of people were uninsured). 

Businesses and insurance companies have done a great job of passing off increases as a result of the ACA but in many cases its misleading, outright lies in some instances.  Health care inflation has been about double regular inflation for a long time, so it's not so easy to disentangle your health care costs going up due to the ACA or just general cost growth. 

There are certainly winners and losers in any sort of reform and there are millions in the U.S. today who have seen premiums and/or deductibles go up as a result of the ACA, but there are also millions who are seeing their rates go down or are obtaining health insurance for the first time.  The real impact of the ACA will not be known for years to come when we can determine, and no longer speculate, whether health care cost growth has slowed down and whether more people have access to care. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: brewer12345 on April 29, 2014, 02:46:28 PM
As a health policy analyst, I feel compelled to jump in just to point out one thing --- healthcare costs have been rising an average of 10% for year for ever 20 years, in fact, it was exactly the reason we needed serious health reform (that and the fact that tens of millions of people were uninsured). 

Businesses and insurance companies have done a great job of passing off increases as a result of the ACA but in many cases its misleading, outright lies in some instances.  Health care inflation has been about double regular inflation for a long time, so it's not so easy to disentangle your health care costs going up due to the ACA or just general cost growth. 

There are certainly winners and losers in any sort of reform and there are millions in the U.S. today who have seen premiums and/or deductibles go up as a result of the ACA, but there are also millions who are seeing their rates go down or are obtaining health insurance for the first time.  The real impact of the ACA will not be known for years to come when we can determine, and no longer speculate, whether health care cost growth has slowed down and whether more people have access to care.

+1.  Employers have been blowing a giant cloud of smoke up their employees' asses.  Deductible up?  Premiums up?  Copays up?  Oh, yeah, it was Obamacare, sure...
Title: Re: How has the ACA affected your current healthcare costs?
Post by: geekette on April 29, 2014, 03:50:12 PM
As a side question: does anyone know if someone who voluntarily quits their job and gave up the company health insurance to retire early can even apply for subsidies or Medicaid?  I thought there was some rule against that.

ACA subsidies are not (currently) means tested (and there's no difference for those who were shoved out of the work force and those who have chosen to drop out). 

Medicaid is still means tested in some states, like NC, AFAIK.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: rusty on April 29, 2014, 06:43:24 PM
As a broker, I wrote about 200+ policies for ACA.  I have seen both sides.  Some jumping up and down with delight, others boiling over with anger about their new premiums.  Large percentage increases and decreases.  It's all a reflection of your access to group coverage, your household size, your household income, and where you live.  Those determine what you pay for your premium.  If you get a subsidy, the federal government is paying the rest (ie tax payers).  I can say that 75% of all the premium I wrote was subsidy.  How heavily will the new plans be used and how we pay for it are the next big questions. 

As far as groups, i think a lot of it has to do with how large the group is.  If it's over 100, I believe they often self insure, which does not require them to follow some ACA guidelines. 

http://www.benefitspro.com/2014/02/26/self-insured-plans-seek-ppaca-protection
"The Patient Protection and Affordable Care Act exempts self-insured plans from some of the new insurance rules that apply to insured group health programs. "
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on April 29, 2014, 07:36:05 PM

What do you all think?

It's stupid and this country can't afford that stupidity, that's what I think. And I plan to take full advantage of that because when I retire I can keep my income low and get lotsa subsidies, pulling money for vacations and luxuries out of my stache.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on August 27, 2014, 03:31:27 PM
Looks like I'm late to the party.  I support the ACA as a flawed first-step towards a single payer system.  Hopefully we get there sooner rather than later.

I'm married, 2 kids.  I'm employed, wife is going back to school.  My employer offers good coverage.  On the exchange it would be a silver or gold plan.  Employer subsidizes almost 100% for each employee, but no subsidy for adding other family.  So to insure myself through work is nearly free.  But to insure the whole family is nearly $10K per year (over $800/mo)!!  Granted that's pre-tax money, but still outragous!!  Before the ACA, we were stuck paying that.  Ya, we could have opted out and let my wife or kids go with no insurance.  As a woman of child-bearing age, my wife couldn't get a plan cheaper that offered maternity coverage (before ACA).  We weren't brave enough to risk getting pregnant w no insurance for her, because of what a normal pregnancy/deliver would have set us back.

After the ACA, we were able to choose from plans to cover my wife and 2 kids.  Even accounting for the loss of buying with pre-tax money, we could save a few hundred dollars a year by going with a plan similar to what my employer offered, or saving several thousand (around $3500/year) by going a "bronze" plan offered by a new coop insurance company that started doing business in my state after the ACA was passed.

Our household income is well below the 400% of FPL, at which ACA subsidies go away.  So the frustrating part is: If I was self-employed or worked at a company small enough to avoid offering health insurance, our entire family of 4 could buy an affordable plan through the exchange AND get a subsidy.  But because I (and wife and kids thru me) have access to that plan, we are not eligible for the subsidized premiums, even though the cost of ~$10K is much more than the 9.5% or whatever of household income that the law uses as the benchmark to determine "affordable".  It's called the "kid glitch" because the law is only concerned with whether the employer-offered coverage is "affordable" when measuring the cost of covering the individual employee!  It completely ignores the cost to add other family to the plan.  The sad part is, there are employees here that make half what I make, have more than 2 kids, but have the same bad options.  Sign up the family for $10K a year or buy insurance on the exchange, but with no subsidy! no matter the proximity to the federal poverty level.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 27, 2014, 03:46:25 PM
My husband carries our insurance and works for a large corporation.  The company was going to have to pay a penalty on our insurance coverage because we had a cadillac plan.

Our premiums went up approximately $1000 a year or 30% (not an issue)
Our deductible remains at $250 per person (no issue)
Lots of things are free outside of the deductible and co-insurance.
Our co-insurance remains at 80/20 (no issue)

Our annual family out of pocket went from $4000 to $25K (this is an issue)

Potentially if I am able to get pregnant again (and the pregnancy spans 2 insurance years) I will be paying 50K.  [I'm basically healthy but because of some chronic issues, doctors want lots of testing/monitoring just in case]

I actually told my husband if one of the non-executives gets sick with something like cancer, he should no longer send flowers or another feel good gift.  Since an admin is going to be subject to the same out of pocket maximum, I told him to just get a nice card and put cash inside and tell them to apply it to their out of pocket payment.

I'm really not loving the ACA at the moment.
That is not because of the ACA, in fact, part of the ACA was to decrease unaffordable out of pocket expenses. 
"The maximum out-of-pocket cost limit for any individual Marketplace plan for 2014 can be no more than $6,350 for an individual plan and $12,700 for a family plan."
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
That is his employer doing it, and blaming the ACA.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: beltim on August 27, 2014, 03:51:05 PM
Our household income is well below the 400% of FPL, at which ACA subsidies go away.  So the frustrating part is: If I was self-employed or worked at a company small enough to avoid offering health insurance, our entire family of 4 could buy an affordable plan through the exchange AND get a subsidy.  But because I (and wife and kids thru me) have access to that plan, we are not eligible for the subsidized premiums, even though the cost of ~$10K is much more than the 9.5% or whatever of household income that the law uses as the benchmark to determine "affordable".  It's called the "kid glitch" because the law is only concerned with whether the employer-offered coverage is "affordable" when measuring the cost of covering the individual employee!  It completely ignores the cost to add other family to the plan.  The sad part is, there are employees here that make half what I make, have more than 2 kids, but have the same bad options.  Sign up the family for $10K a year or buy insurance on the exchange, but with no subsidy! no matter the proximity to the federal poverty level.

I hadn't heard about the kid glitch.  Thanks for sharing!  It's clear that this is one of the holes in the ACA that needs to be fixed.  That said, at least the ACA guarantees access to plans for your family members, even if it doesn't subsidize them.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: ENL on August 27, 2014, 07:42:37 PM
Up or down is irrelevant for us as our plans have changed twice now this year.  My family of three lost their health coverage through my husband's work when he lost his teaching job at the beginning of the summer.  Of course, as a teacher we knew he was not going to be able to find employment for several months.  If it weren't for the ACA we would have had to risk going uninsured during that time frame since I'm sure we could not have afforded the pre-ACA premiums.  This way we signed up for coverage on the exchange for a few months then cancelled when he got coverage through his new teaching job.

Thank God for Obamacare.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on August 27, 2014, 07:58:36 PM
I've seen a short-term decrease due to being under 26 and on my parents' plan.

Long-term, though, the cost is huge - after I turn 26. My work pays me $2K/year NOT to enroll in any paid health plan. All I need is a catastrophic plan, but the absolute cheapest on the exchanges is about $2K/ year (as enrolling in a work plans costs additional money, this saves me some, but not a ton). And the even catastrophic plans are just too much care! I don't need a 6K deductible and 3 free visits a year, but the plan is charging me for that. I'd be fine with a 20K deductible and no free visits - all I need insurance for is if I get cancer or something similarly catastrophic. And my guess is such a plan would cost more around $1K/year, but Obamacare doesn't allow it to exist.

Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: kite on August 27, 2014, 08:49:04 PM
Coverage is the same, premiums are doubled. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on August 27, 2014, 11:27:32 PM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: beltim on August 28, 2014, 12:14:45 AM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on August 28, 2014, 12:50:09 AM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf

Women are 3x as likely (http://www.news-medical.net/news/20110609/National-survey-finds-women-more-likely-to-see-doctor-on-regular-basis-than-men.aspx) to visit the doctor regularly. They also live longer, meaning they can die from conditions that men don't even live long enough to experience.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: BlueHouse on August 28, 2014, 04:39:42 AM
Our household income is well below the 400% of FPL, at which ACA subsidies go away.  So the frustrating part is: If I was self-employed or worked at a company small enough to avoid offering health insurance, our entire family of 4 could buy an affordable plan through the exchange AND get a subsidy.  But because I (and wife and kids thru me) have access to that plan, we are not eligible for the subsidized premiums, even though the cost of ~$10K is much more than the 9.5% or whatever of household income that the law uses as the benchmark to determine "affordable".  It's called the "kid glitch" because the law is only concerned with whether the employer-offered coverage is "affordable" when measuring the cost of covering the individual employee!  It completely ignores the cost to add other family to the plan.  The sad part is, there are employees here that make half what I make, have more than 2 kids, but have the same bad options.  Sign up the family for $10K a year or buy insurance on the exchange, but with no subsidy! no matter the proximity to the federal poverty level.

I hadn't heard about the kid glitch.  Thanks for sharing!  It's clear that this is one of the holes in the ACA that needs to be fixed.  That said, at least the ACA guarantees access to plans for your family members, even if it doesn't subsidize them.
Why is this a glitch?  It sounds as if he can afford it if there are others here who make half of what he makes.  If you can afford it, why on earth would you be looking for a handout in the form of a subsidy?  (Thats welfare!).  I know it's no longer PC to feel shame in accepting handouts, but if you can afford the cost (even if you feel the pain) then you should be ashamed to ask for a handout!  Subsidies are for people who really need them. Not for people who want to save money so they can retire early.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: beltim on August 28, 2014, 06:26:05 AM
I hadn't heard about the kid glitch.  Thanks for sharing!  It's clear that this is one of the holes in the ACA that needs to be fixed.  That said, at least the ACA guarantees access to plans for your family members, even if it doesn't subsidize them.
Why is this a glitch?  It sounds as if he can afford it if there are others here who make half of what he makes.  If you can afford it, why on earth would you be looking for a handout in the form of a subsidy?  (Thats welfare!).  I know it's no longer PC to feel shame in accepting handouts, but if you can afford the cost (even if you feel the pain) then you should be ashamed to ask for a handout!  Subsidies are for people who really need them. Not for people who want to save money so they can retire early.

It's a glitch because the ACA sets up a threshold for affordable care (premiums should not cost more than 9.5% of income), but then doesn't apply this metric equally to all groups.

Also, there's lots of subsidies in the tax code to incentivize particular behavior that are not anything close to welfare.  Do you take advantage of a 401k?  The child tax credit?  Home mortgage interest deduction?  These are all subsidies to encourage specific behaviors, and it's hypocritical to take those and criticize those who take ACA subsidies.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: BlueHouse on August 28, 2014, 06:34:42 AM
I hadn't heard about the kid glitch.  Thanks for sharing!  It's clear that this is one of the holes in the ACA that needs to be fixed.  That said, at least the ACA guarantees access to plans for your family members, even if it doesn't subsidize them.
Why is this a glitch?  It sounds as if he can afford it if there are others here who make half of what he makes.  If you can afford it, why on earth would you be looking for a handout in the form of a subsidy?  (Thats welfare!).  I know it's no longer PC to feel shame in accepting handouts, but if you can afford the cost (even if you feel the pain) then you should be ashamed to ask for a handout!  Subsidies are for people who really need them. Not for people who want to save money so they can retire early.

It's a glitch because the ACA sets up a threshold for affordable care (premiums should not cost more than 9.5% of income), but then doesn't apply this metric equally to all groups.

Also, there's lots of subsidies in the tax code to incentivize particular behavior that are not anything close to welfare.  Do you take advantage of a 401k?  The child tax credit?  Home mortgage interest deduction?  These are all subsidies to encourage specific behaviors, and it's hypocritical to take those and criticize those who take ACA subsidies.
Yes I do take advantage of 401k and mortgage interest deduction. I also accepted Survivor income benefits and took advantage of govt loans and grants for college.
For some reason these feel as if they're in a different category to me. When I was a child, my family qualified for free or subsidized lunches, but we never took them because we didn't want charity. (Or the appearance of it). We never went hungry but we also never had the toys that other kids in the neighborhood did either. I don't know why these seem different to me, but they do. I'm willing to have an open mind, but something still smacks of a handout. Feel free to change my mind.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on August 28, 2014, 06:58:02 AM
I got a letter from the VA telling me my healthcare needs were covered and that the VA qualifies and I wouldn't get a fine if I didn't have other insurance.  I guess I have free healthcare.  My family, myself included is currently covered under my wives plan at her office.  My understanding is that our cost went up, as did our deductible, and the companies cost also went up.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 28, 2014, 07:38:16 AM
I just got the news yesterday from our HR guy at work that our health care costs are going up 6% next year. That's a modest jump, given that it is health care. So no, I've not seen an increase due to Obamacare, this is a typical annual increase for us.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on August 28, 2014, 09:24:28 AM
Yes I do take advantage of 401k and mortgage interest deduction. I also accepted Survivor income benefits and took advantage of govt loans and grants for college.
For some reason these feel as if they're in a different category to me. When I was a child, my family qualified for free or subsidized lunches, but we never took them because we didn't want charity. (Or the appearance of it). We never went hungry but we also never had the toys that other kids in the neighborhood did either. I don't know why these seem different to me, but they do. I'm willing to have an open mind, but something still smacks of a handout. Feel free to change my mind.

Those are all government subsidies.  As a fellow taxpayer, I am paying for your subsidized student loans and grants, and I am paying higher taxes to subsidize the house that you bought.   Taking some government subsidies while criticizing others for taking different ones seems extremely hypocritical to me.  In all cases, our elected representatives have decided that it's worth providing government benefits to encourage certain behavior or to help people access services that they otherwise would find it difficult to afford. 

As a taxpayer and citizen, I don't agree with all of these policy choices.  I find the mortgage interest deduction ridiculous (even though I just bought a house and it will save me lots of money this year).  However, I would never expect someone to turn it down on principle just because they could afford to pay their mortgage without claiming the deduction! 

FWIW, the reason the "kid glitch" is a glitch is because it was not the intention of the people who drafted the legislation.  It was a drafting error that was unfortunately only noticed after the legislation was enacted.  In a less controversial piece of legislation, it probably would have been changed already.  However, because the ACA is so controversial, it's proven politically impossible to change it at all (Republicans are not interested in voting on bills for minor changes, since they prefer to repeal it entirely).  As a result, we are stuck with this kind of issue.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: beltim on August 28, 2014, 09:29:42 AM
Also, there's lots of subsidies in the tax code to incentivize particular behavior that are not anything close to welfare.  Do you take advantage of a 401k?  The child tax credit?  Home mortgage interest deduction?  These are all subsidies to encourage specific behaviors, and it's hypocritical to take those and criticize those who take ACA subsidies.
Yes I do take advantage of 401k and mortgage interest deduction. I also accepted Survivor income benefits and took advantage of govt loans and grants for college.
For some reason these feel as if they're in a different category to me. When I was a child, my family qualified for free or subsidized lunches, but we never took them because we didn't want charity. (Or the appearance of it). We never went hungry but we also never had the toys that other kids in the neighborhood did either. I don't know why these seem different to me, but they do. I'm willing to have an open mind, but something still smacks of a handout. Feel free to change my mind.

Without knowing why you feel they're in a different category, I'm not sure what to say.  There's really no difference among those various types of government aid.  The burden of proof is on you to establish that health insurance subsidies are any different than the government "handouts" you eagerly accept.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on August 28, 2014, 09:50:42 AM
Our household income is well below the 400% of FPL, at which ACA subsidies go away.  So the frustrating part is: If I was self-employed or worked at a company small enough to avoid offering health insurance, our entire family of 4 could buy an affordable plan through the exchange AND get a subsidy.  But because I (and wife and kids thru me) have access to that plan, we are not eligible for the subsidized premiums, even though the cost of ~$10K is much more than the 9.5% or whatever of household income that the law uses as the benchmark to determine "affordable".  It's called the "kid glitch" because the law is only concerned with whether the employer-offered coverage is "affordable" when measuring the cost of covering the individual employee!  It completely ignores the cost to add other family to the plan.  The sad part is, there are employees here that make half what I make, have more than 2 kids, but have the same bad options.  Sign up the family for $10K a year or buy insurance on the exchange, but with no subsidy! no matter the proximity to the federal poverty level.

I hadn't heard about the kid glitch.  Thanks for sharing!  It's clear that this is one of the holes in the ACA that needs to be fixed.  That said, at least the ACA guarantees access to plans for your family members, even if it doesn't subsidize them.
Why is this a glitch?  It sounds as if he can afford it if there are others here who make half of what he makes.  If you can afford it, why on earth would you be looking for a handout in the form of a subsidy?  (Thats welfare!).  I know it's no longer PC to feel shame in accepting handouts, but if you can afford the cost (even if you feel the pain) then you should be ashamed to ask for a handout!  Subsidies are for people who really need them. Not for people who want to save money so they can retire early.

Keep in mind that the ACA only concerns itself with providing subsidies to those families between 133% and 400% of the family poverty level!  That's right your family can earn up 4 times as much as a family at the poverty line and still get some subsidy for insurance premiums!!   That makes for a pretty large group of folks eligible for "handouts".  Don't forget there's a whole other government program to help families below 133% of the poverty line.

While we are on that subject, the "subsidy cliff" at 400% of the FPL is another unfair consequence of the ACA.  The ACA subsidy brackets are not marginal like tax brackets.  It your family's income comes in 398% of the poverty level, you get a significant subsidy.  Earn 402% and you get nothing.

BlueHouse, I hope you can see that the discussion here is about fairness of this law using anecdotes from affected participants.  There are guys at my company that have good jobs that pay $16 an hour, about twice the minimum wage.  By the way, the FPL for a family of 4 is $23,850, so at $33,280, they far from "poor".  They have always been "lucky" enough to work for a company that provides health insurance for them and their family.  The problem for folks like that, before the ACA, was that they had to pay $10K per year!! to buy insurance for their family (and that's with the employer "subsidizing" (there's your dirty word) the employee portion.  A family of 4, lucky enough to even have access to an employer plan, living on twice the minimum wage has to pay roughly 1/3 of their gross income for insurance.  Surely that scenario is enough for you to recognize there was a need for health insurance reform.  Surely you can see why a family in that situation would welcome reform. Surely you can see why those of us making more would see the need for reform, whether it affected us directly or not.

But that same family, after the ACA, is in the situation I first described.  Why does it matter to you whether that man is on this early retirement forum chatting with us, trying to save for early retirement or just trying to feed his family?  After the ACA, his options are more numerous, but no better.  He still has to pay the same (higher actually) to cover his family on is employer plan.  The cost to insure just himself on his work plan would cost him about .5% of their household gross.  The cost to insure his family would be 30.4% of gross!!  Is that affordable?  It doesn't meet 9.5% limit outlined by the ACA.  But do to the glitch, it's not the 30.4% that is used to measure.  It is the .5%.  Yes, the ACA now provides for an exchange for this family to go buy coverage for all 4 (or just the spouse and kids).  But they are forced to pay the sticker price AND lose the benefit of paying with pre-tax money.  If this couple is older, they will have no chance of buying an equivalent plan and saving on premiums.  If they are very young there's a chance they may save some.

This family could live next door to family of 4 in which the working spouse also makes $16 an hour, but works for an employer small enough to not provide insurance. This family gets to buy insurance on the exchange and get a "subsidy" to ensure that their cost is not more than 9.5% of their gross household income. Do you think this family should show some pride and pass on this subsidy like you passed on free lunch?  Or do you think they should feel guilty but take the handout the just like you take yours for your mortgage interest?

It's a shame that "subsidy" is such a loaded word that it has become the tree that hides the forest from you.  As beltim points out, there countless "tax incentives" out there for home owners, retirement savers, etc that are in effect subsidies.  Money is nothing but a tax credit anyway.  Which means every tax incentive you take advantage of is just as much a handout as an the free lunch you avoided due to avoid shame or maintain your pride.

Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on August 28, 2014, 10:34:09 AM
Quote
Subsidies are for people who really need them. Not for people who want to save money so they can retire early.

You should run a few test scenarios and see how the ACA had a HUGE positive impact on those who were already in a position to retire early.  As long as a family has enough saved to live off savings, but have that savings (or savings + some work) add up to income somewhere between 133 and 400% of the FPL they can get health insurance that's nearly completely subsidized.  Because of the outrageous cost of individual insurance policies before the ACA, there were many potential early retirees who were forced to maintain employment just so they could retain access to not-quite-so-outrageously-priced plans.  With the ACA, the savings they realized from cheaper policies on the exchange, plus the subsidy for a "low-income" household put many of these households in a position to go ahead and retire early rather than working just for health insurance as they'd been doing.

It's more than a little unfair that the law was such a boon to those in this situation, while providing no help at all to those in the same situation as that family, 10 to 15 years earlier!

Again, I'm not bashing the ACA.  It was a huge step in the right direction.  There are just some major gaps that need filled.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 28, 2014, 11:28:14 AM
Quote
Subsidies are for people who really need them. Not for people who want to save money so they can retire early.

You should run a few test scenarios and see how the ACA had a HUGE positive impact on those who were already in a position to retire early.  As long as a family has enough saved to live off savings, but have that savings (or savings + some work) add up to income somewhere between 133 and 400% of the FPL they can get health insurance that's nearly completely subsidized.  Because of the outrageous cost of individual insurance policies before the ACA, there were many potential early retirees who were forced to maintain employment just so they could retain access to not-quite-so-outrageously-priced plans. With the ACA, the savings they realized from cheaper policies on the exchange, plus the subsidy for a "low-income" household put many of these households in a position to go ahead and retire early rather than working just for health insurance as they'd been doing.

It's more than a little unfair that the law was such a boon to those in this situation, while providing no help at all to those in the same situation as that family, 10 to 15 years earlier!

Again, I'm not bashing the ACA.  It was a huge step in the right direction.  There are just some major gaps that need filled.
It was not JUST the cost.  Some people, my mother, myself etc, could not get a individual plan for ANY amount of money because of preexisting conditions.  My mom retired and can pay the full amount on COBRA or the exchanges, she is just happy to be able to buy it.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on August 28, 2014, 12:17:22 PM
So here's my question: why can't I buy a plan with a 25K deductible? I have that much in savings! Actually I'd like a plan with a 50K deductible. I have that much (and more) in savings. My guess is such a plan would cost $50 a month or less. The answer? Obamacare made those plans illegal.

Obamacare is great for early retirees, but it's awful for young middle class savers working towards FIRE who can afford to cover a high deductible, but are no longer allowed to. The only reason I would need health insurance is if something catastrophic happens to me. But the "catastrophic care" plans that are minimum coverage according to the law must offer a ~6K deductible and 3 free visits a year. I don't need that much coverage!

After I turn 26 and and off my parents' plan, I will be forced to spend $160/month for something far better than need, or else pay the tax, which is around the same cost for someone with my income level. That's over 10% of my monthly spending.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 28, 2014, 12:43:21 PM
So here's my question: why can't I buy a plan with a 25K deductible? I have that much in savings! Actually I'd like a plan with a 50K deductible. I have that much (and more) in savings. My guess is such a plan would cost $50 a month or less. The answer? Obamacare made those plans illegal.

Obamacare is great for early retirees, but it's awful for young middle class savers working towards FIRE who can afford to cover a high deductible, but are no longer allowed to. The only reason I would need health insurance is if something catastrophic happens to me. But the "catastrophic care" plans that are minimum coverage according to the law must offer a ~6K deductible and 3 free visits a year. I don't need that much coverage!

After I turn 26 and and off my parents' plan, I will be forced to spend $160/month for something far better than need, or else pay the tax, which is around the same cost for someone with my income level. That's over 10% of my monthly spending.
I could get behind a similar thing to the bonds for not having car insurance.  You have to put up $25000 in my old state to avoid car insurance.  If people wanted a private plan with that, AND had enough in savings/HSAs to do it, sure, great, go ahead.  But that require the GOP to not just go "repeal", and that won't happen.  I can say with 100% assurance that would pass the Dems, if the GOP agreed.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Dicey on August 28, 2014, 01:43:27 PM
Quote
Subsidies are for people who really need them. Not for people who want to save money so they can retire early.

You should run a few test scenarios and see how the ACA had a HUGE positive impact on those who were already in a position to retire early.  As long as a family has enough saved to live off savings, but have that savings (or savings + some work) add up to income somewhere between 133 and 400% of the FPL they can get health insurance that's nearly completely subsidized.  Because of the outrageous cost of individual insurance policies before the ACA, there were many potential early retirees who were forced to maintain employment just so they could retain access to not-quite-so-outrageously-priced plans.  With the ACA, the savings they realized from cheaper policies on the exchange, plus the subsidy for a "low-income" household put many of these households in a position to go ahead and retire early rather than working just for health insurance as they'd been doing.

It's more than a little unfair that the law was such a boon to those in this situation, while providing no help at all to those in the same situation as that family, 10 to 15 years earlier!

Again, I'm not bashing the ACA.  It was a huge step in the right direction.  There are just some major gaps that need filled.

What johnhenry said! This is so true and especially relevant for this readership. His words should be shouted from the MMM rooftops.

I was FI but afraid to retire because of potential and actual healthcare costs. I was literally counting the days until 2014. Happily and most unexpectedly (and indirectly because of insurance worries, but that's another story), I got married in 2013. Hooray! I was able to add the RE to FI and pull the trigger. And now I'm the most amazed and awed to say I'm living my happily ever after. It doesn't look like anything I ever imagined or planned for, but I love it.

To answer the specific question and hopefully stay somewhat on-topic, DH has outstanding insurance coverage, which has not changed. Nonetheless, I am grateful every day that ACA exists. Many lives will be improved and possibly even saved as a result. One huge first step out of the byzantine, elitist maze that is healthcare in the U.S.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on August 28, 2014, 02:17:40 PM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf

Women are 3x as likely (http://www.news-medical.net/news/20110609/National-survey-finds-women-more-likely-to-see-doctor-on-regular-basis-than-men.aspx) to visit the doctor regularly. They also live longer, meaning they can die from conditions that men don't even live long enough to experience.
I stand corrected! Of course I wonder if the fact that women visit a doctor more regularly then men is the reason they live longer? That plus not jumping off roofs just for the heck of it :-)!
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cheddar Stacker on August 28, 2014, 02:23:36 PM
I stand corrected! Of course I wonder if the fact that women visit a doctor more regularly then men is the reason they live longer? That plus not jumping off roofs just for the heck of it :-)!

I'm certain you're correct about the reasons, at least in most cases. Looking back, I can't even count on two hands the number of times I foolishly risked my life as a young man. I'm glad I'm still alive.

The thing is, insurance companies don't give a shit about the reasons, they only care about the profits.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on August 28, 2014, 02:24:10 PM
I got a letter from the VA telling me my healthcare needs were covered and that the VA qualifies and I wouldn't get a fine if I didn't have other insurance.  I guess I have free healthcare.  My family, myself included is currently covered under my wives plan at her office.  My understanding is that our cost went up, as did our deductible, and the companies cost also went up.
Ditto for me. I have a service-connected disability/injury so always used the VA for that but once my low cost catastrophic policy was cancelled in Jan. I decided to just use the VA for everything. I did buy a private policy for several months because of the all the problems with the VA (I never had any but have heard the horror stories) but eventually let it go as it was too expensive and I didn't qualify for subsidies. Also beware, any Vets who do sign up for VA healthcare and also have a private policy you pay for yourself, you can not use the VA and also receive subsidies.

From the VA website below:

I am enrolled in a VA health care program. Would I be eligible for assistance to pay health insurance premiums on the Marketplace if I choose to purchase health care outside of VA?

Since VA care meets the standard for health care coverage, you wouldn’t be eligible for assistance to lower your cost of health insurance premiums if you chose to purchase additional health care coverage outside of VA. However, you may still purchase private health insurance on or off the Marketplace to complement your VA health care coverage.

 http://www.va.gov/health/aca/
Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on August 28, 2014, 02:39:10 PM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf

Women are 3x as likely (http://www.news-medical.net/news/20110609/National-survey-finds-women-more-likely-to-see-doctor-on-regular-basis-than-men.aspx) to visit the doctor regularly. They also live longer, meaning they can die from conditions that men don't even live long enough to experience.
I stand corrected! Of course I wonder if the fact that women visit a doctor more regularly then men is the reason they live longer? That plus not jumping off roofs just for the heck of it :-)!

Ummm... babies. :)   The fact that women get pregnant, have regular checkups through the pregnancy and then have babies at hospitals that charge insane amounts just for a routine delivery....is one reason that women visit the doctor more and one huge reason their insurance rates used to be much higher before the ACA.

I'm glad the ACA at least spread out the cost of having babies across both sexes by not allowing different premiums based on gender.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cheddar Stacker on August 28, 2014, 02:46:52 PM
I'm glad the ACA at least spread out the cost of having babies across both sexes by not allowing different premiums based on gender.

I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 28, 2014, 03:44:55 PM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf

Women are 3x as likely (http://www.news-medical.net/news/20110609/National-survey-finds-women-more-likely-to-see-doctor-on-regular-basis-than-men.aspx) to visit the doctor regularly. They also live longer, meaning they can die from conditions that men don't even live long enough to experience.
I stand corrected! Of course I wonder if the fact that women visit a doctor more regularly then men is the reason they live longer? That plus not jumping off roofs just for the heck of it :-)!

Ummm... babies. :)   The fact that women get pregnant, have regular checkups through the pregnancy and then have babies at hospitals that charge insane amounts just for a routine delivery....is one reason that women visit the doctor more and one huge reason their insurance rates used to be much higher before the ACA.

I'm glad the ACA at least spread out the cost of having babies across both sexes by not allowing different premiums based on gender.
Only in private markets, at least in my state women were not charged more through a group plan.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: msilenus on August 28, 2014, 03:49:51 PM
I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.

I need more information about this hypothetical 70-year old man to form an opinion.  Was he born of a woman?  Or did he spring fully formed from Zeus' brow?

In the prior case, it seems like he has some vested interest in women having babies, and has benefited personally from the practice.  In the latter case, I agree that this seems unjust.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Chuck on August 28, 2014, 03:54:54 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 28, 2014, 04:10:14 PM
I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.

I need more information about this hypothetical 70-year old man to form an opinion.  Was he born of a woman?  Or did he spring fully formed from Zeus' brow?

In the prior case, it seems like he has some vested interest in women having babies, and has benefited personally from the practice.  In the latter case, I agree that this seems unjust.
So, I'd like not to cover prostate cancer, oh and any childhood diseases since I am no longer a child and so on and so forth.  The point of insurance is to pool risk.  If we did not pay for things that did not happen to us, it would not be insurance.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Daleth on August 28, 2014, 04:14:29 PM
So here's my question: why can't I buy a plan with a 25K deductible? I have that much in savings! Actually I'd like a plan with a 50K deductible. I have that much (and more) in savings. My guess is such a plan would cost $50 a month or less. The answer? Obamacare made those plans illegal.

Obamacare is great for early retirees, but it's awful for young middle class savers working towards FIRE who can afford to cover a high deductible, but are no longer allowed to. The only reason I would need health insurance is if something catastrophic happens to me. But the "catastrophic care" plans that are minimum coverage according to the law must offer a ~6K deductible and 3 free visits a year. I don't need that much coverage!

After I turn 26 and and off my parents' plan, I will be forced to spend $160/month for something far better than need, or else pay the tax, which is around the same cost for someone with my income level. That's over 10% of my monthly spending.

Laws are not designed to work perfectly for you personally. They're designed to work pretty effectively for society as a whole, i.e., all your fellow Americans. For all your fellow Americans to have access to affordable insurance, everyone who's insured but not on Medicare/Medicaid needs to be paying in at least enough for a catastrophic coverage plan... even though that doesn't work for you personally. So yes, you're subsidizing the rest of us now, just as we will subsidize you if you experience something so catastrophic that neither your insurance nor your savings are enough to cover (e.g. permanent serious disability).
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Daleth on August 28, 2014, 04:16:26 PM
I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.

I need more information about this hypothetical 70-year old man to form an opinion.  Was he born of a woman?  Or did he spring fully formed from Zeus' brow?

In the prior case, it seems like he has some vested interest in women having babies, and has benefited personally from the practice.  In the latter case, I agree that this seems unjust.

So, I'd like not to cover prostate cancer, oh and any childhood diseases since I am no longer a child and so on and so forth.  The point of insurance is to pool risk.  If we did not pay for things that did not happen to us, it would not be insurance.

:) High five, Msilenus and Gin1984.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on August 28, 2014, 05:54:18 PM
Laws are not designed to work perfectly for you personally. They're designed to work pretty effectively for society as a whole, i.e., all your fellow Americans. For all your fellow Americans to have access to affordable insurance, everyone who's insured but not on Medicare/Medicaid needs to be paying in at least enough for a catastrophic coverage plan... even though that doesn't work for you personally. So yes, you're subsidizing the rest of us now, just as we will subsidize you if you experience something so catastrophic that neither your insurance nor your savings are enough to cover (e.g. permanent serious disability).

I guess we're just going to have to agree to disagree then. IMO I should be paying per my amount of risk, not supporting everyone else. The problem is, there's this pervasive mentality that young singles do need to support everyone else. I see it even at work - the best excuse to leave early is always "kids". I don't have that kind of excuse.

I just think people should pay based on their choices in life. If you go to the doctor more, you should pay more. If you live unhealthy, you pay more. If you have kids, you pay more If you're old and need more care, you pay more. But of course I'm firmly opposed to single-payer and the like.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on August 28, 2014, 06:02:29 PM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf

Women are 3x as likely (http://www.news-medical.net/news/20110609/National-survey-finds-women-more-likely-to-see-doctor-on-regular-basis-than-men.aspx) to visit the doctor regularly. They also live longer, meaning they can die from conditions that men don't even live long enough to experience.
I stand corrected! Of course I wonder if the fact that women visit a doctor more regularly then men is the reason they live longer? That plus not jumping off roofs just for the heck of it :-)!

Ummm... babies. :)   The fact that women get pregnant, have regular checkups through the pregnancy and then have babies at hospitals that charge insane amounts just for a routine delivery....is one reason that women visit the doctor more and one huge reason their insurance rates used to be much higher before the ACA.

I'm glad the ACA at least spread out the cost of having babies across both sexes by not allowing different premiums based on gender.
DOH!!! Forgot about the expensive costs to bring the cute little critters into the world  :-)! Although I do think women overall (generalization here so may be WAY wrong) go to doctors more often then men just for check up things. So are more likely to have higher medical costs (that insurers have to pay) as well as a greater likelihood of finding bad things in the early stages and thus living longer. Lots of men I know sort of tough things out a lot longer.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on August 28, 2014, 06:45:34 PM
DOH!!! Forgot about the expensive costs to bring the cute little critters into the world  :-)! Although I do think women overall (generalization here so may be WAY wrong) go to doctors more often then men just for check up things. So are more likely to have higher medical costs (that insurers have to pay) as well as a greater likelihood of finding bad things in the early stages and thus living longer. Lots of men I know sort of tough things out a lot longer.

Yeah, I have to wonder if that explains some of women's extra life expectancy - men are just socially conditioned to be too "tough" to need to see a doctor.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 28, 2014, 06:56:50 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

It's important that you do not have more than I have.

We should all have equal stuff.

It is not fair that some have more than others.

You should be happy to spend your money to make certain that we are all equal.

Our Congressmen have spoken clearly on this, about how you need to pay more because you get more, and they are participating in the exchanges the same extent that you are. Oh, wait...well, almost. It's pretty close.

Some animals are more equal than others.

Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on August 28, 2014, 07:34:25 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

It's important that you do not have more than I have.

We should all have equal stuff.

It is not fair that some have more than others.

You should be happy to spend your money to make certain that we are all equal.

Our Congressmen have spoken clearly on this, about how you need to pay more because you get more, and they are participating in the exchanges the same extent that you are. Oh, wait...well, almost. It's pretty close.

Some animals are more equal than others.

This seems like a pretty big non sequiter.  A progressive taxation system -->  Orwellian socialism?   It's a pretty big leap, maybe you'd care to spell it out?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 28, 2014, 07:43:16 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

It's important that you do not have more than I have.

We should all have equal stuff.

It is not fair that some have more than others.

You should be happy to spend your money to make certain that we are all equal.

Our Congressmen have spoken clearly on this, about how you need to pay more because you get more, and they are participating in the exchanges the same extent that you are. Oh, wait...well, almost. It's pretty close.

Some animals are more equal than others.

This seems like a pretty big non sequiter.  A progressive taxation system -->  Orwellian socialism?   It's a pretty big leap, maybe you'd care to spell it out?

I'm killing two birds with one snarky post here to point out

1) the preachy idea that we should all want to help everyone in all things and at all times regardless of the cost to us

and

2) Congress gets perks that the rest of us do not because they are in a seat of power to pass laws dictating that we cannot get those same perks

Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 28, 2014, 07:48:57 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

Chuck, I would like it if an Obamacare apologist would step up here to explain why the employers of Chucks all over the country, employers who go above and beyond for their employees (I thought that was a good thing???) are being taxed this way.

I haven't delved into it, having been busy trying to identify how the POS legislation will benefit me. Because it really is all about me, haha.

But anyway--What's the idea behind this tax on "Cadillac" health plans, other than just another way this beast raises money to pay for itself?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Tetsuya Hondo on August 28, 2014, 07:52:29 PM

This seems like a pretty big non sequiter.  A progressive taxation system -->  Orwellian socialism?   It's a pretty big leap, maybe you'd care to spell it out?

You say that like it was a bad thing.

I can only assume that you are referring to the type of socialism that Orwell was in favor of and aligned himself with. You do realize that Orwell was a democratic socialist, right?

He wasn't a Stalinist. Perhaps that's what you were thinking of?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: bacchi on August 28, 2014, 07:56:46 PM
1) the preachy idea that we should all want to help everyone in all things and at all times regardless of the cost to us

Link to someone who wrote this?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 28, 2014, 07:58:09 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

Chuck, I would like it if an Obamacare apologist would step up here to explain why the employers of Chucks all over the country, employers who go above and beyond for their employees (I thought that was a good thing???) are being taxed this way.

I haven't delved into it, having been busy trying to identify how the POS legislation will benefit me. Because it really is all about me, haha.

But anyway--What's the idea behind this tax on "Cadillac" health plans, other than just another way this beast raises money to pay for itself?
My mother's (ex-)employer has a Cadillac plan, covered everything with the exception of massage with no copay, no deductible unless you went out of network.  Her employer is picking up the cost of the tax, for the same reason they have the great plan, they want to offer good benefits to attract good employees (and the PR).  And honestly, compared to the over $500/person, the tax is not too huge.  In fact, their cost went down this year (though of course it will go back up after the tax).  And you do realize that many people get these benefits tax free while others (often those who can least afford it) were left without insurance or spent 25-50% of their pay on insurance?  To COBRA my mom's insurance my last year of college cost me over 25% of my pay. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: BlueHouse on August 28, 2014, 08:15:02 PM
Keep in mind that the ACA only concerns itself with providing subsidies to those families between 133% and 400% of the family poverty level!  That's right your family can earn up 4 times as much as a family at the poverty line and still get some subsidy for insurance premiums!!   That makes for a pretty large group of folks eligible for "handouts".  Don't forget there's a whole other government program to help families below 133% of the poverty line.
Thanks for the info johnhenry.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 28, 2014, 08:22:34 PM

My mother's (ex-)employer has a Cadillac plan, covered everything with the exception of massage with no copay, no deductible unless you went out of network.  Her employer is picking up the cost of the tax, for the same reason they have the great plan, they want to offer good benefits to attract good employees (and the PR).  And honestly, compared to the over $500/person, the tax is not too huge.  In fact, their cost went down this year (though of course it will go back up after the tax).  And you do realize that many people get these benefits tax free while others (often those who can least afford it) were left without insurance or spent 25-50% of their pay on insurance?  To COBRA my mom's insurance my last year of college cost me over 25% of my pay.

That's nice that you don't mind someone else pays $500 per employee.

I still am not clear of the purpose behind the tax--just to raise money? why would employers continue to offer this Cadillac stuff if they have to pay a tax on it, in addition to actually paying more for it.

The fact that "many people get these benefits free while others..." boo hoo,  yeah, I get it, or rather, I need to internalize this below until I no longer question the great and powerful Oz:

It's important that you do not have more than I have.

We should all have equal stuff.

It is not fair that some have more than others.

You should be happy to spend your money to make certain that we are all equal.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 28, 2014, 08:28:43 PM

My mother's (ex-)employer has a Cadillac plan, covered everything with the exception of massage with no copay, no deductible unless you went out of network.  Her employer is picking up the cost of the tax, for the same reason they have the great plan, they want to offer good benefits to attract good employees (and the PR).  And honestly, compared to the over $500/person, the tax is not too huge.  In fact, their cost went down this year (though of course it will go back up after the tax).  And you do realize that many people get these benefits tax free while others (often those who can least afford it) were left without insurance or spent 25-50% of their pay on insurance?  To COBRA my mom's insurance my last year of college cost me over 25% of my pay.

That's nice that you don't mind someone else pays $500 per employee.

I still am not clear of the purpose behind the tax--just to raise money? why would employers continue to offer this Cadillac stuff if they have to pay a tax on it, in addition to actually paying more for it.

The fact that "many people get these benefits free while others..." boo hoo,  yeah, I get it, or rather, I need to internalize this below until I no longer question the great and powerful Oz:

It's important that you do not have more than I have.

We should all have equal stuff.

It is not fair that some have more than others.

You should be happy to spend your money to make certain that we are all equal.

You do get that I was on that plan right?  So I was the person with "more" in this case?  Your comment make no sense.  Employers who are willing to pay for good plans, will chose to have a good plan, because compensation brings in good employees.  Well, unless they can convince people that OMG, we had to make all these cuts because of obamacare. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: beltim on August 28, 2014, 08:32:16 PM
I still am not clear of the purpose behind the tax--just to raise money? why would employers continue to offer this Cadillac stuff if they have to pay a tax on it, in addition to actually paying more for it.


The point of the tax is twofold:
1) To encourage employers to shop to get the best deal, putting downward pressure on health care costs.
2) To reduce the tax-free benefit of health care for the most generous health care plans.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 28, 2014, 10:00:59 PM


You do get that I was on that plan right?  So I was the person with "more" in this case? 

Ok, so you were on a "Cadillac" plan.  But now you're not. ok.

I am concerned about Chuck here and his additional costs. Guess it's likely his privilege will get kicked to the curb next year, his employer may well choose to end it.
Quote
Your comment make no sense.  Employers who are willing to pay for good plans, will chose to have a good plan...

...until they don't. Because at some point it costs beyond what they are willing to pay, and they are done with the Cadillac.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 28, 2014, 10:08:01 PM

The point of the tax is twofold:
1) To encourage employers to shop to get the best deal, putting downward pressure on health care costs.
2) To reduce the tax-free benefit of health care for the most generous health care plans.

Thanks.  #1 seems practical, I suppose, although a Cadillac plan at $10,200 for single coverage isn't much over the $9,000 average annual premium that someone identified on another thread.   My plan at work is $6,500 annually for single coverage (no dental, no vision) so we are a long way from being taxed and prodded to change our ways.

I think that #2 is stupid, but whatever.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: CanuckExpat on August 28, 2014, 10:51:19 PM
Or would you limit him to the one-size-fits-all that I believe is the Canadian model? If my information is correct (and please let  me know if it is not) no physicians in Canada are allowed to accept private-pay clients.
Well as you specifically wrote it, your information is in-correct, but maybe only in the technical sense. For example, an American visiting Canada who happens to break his foot would be free to pay cash for services.
What might be more specifically true is:
Quote
The Canada Health Act, which sets the conditions with which provincial/territorial health insurance plans must comply if they wish to receive their full transfer payments from the federal government, does not allow charges to insured persons for insured services (defined as medically necessary care provided in hospitals or by physicians). Most provinces have responded through various prohibitions on such payments. This does not constitute a ban on privately funded care; indeed, about 30% of Canadian health expenditures come from private sources, both insurance and out-of-pocket payments. The Canada Health Act does not address delivery. Private clinics are therefore permitted, albeit subject to provincial/territorial regulations, but they cannot charge above the agreed-upon fee schedule unless they are treating non-insured persons (which may include those eligible under automobile insurance or worker's compensation, in addition to those who are not Canadian residents), or providing non-insured services. This provision has been controversial among those seeking a greater role for private funding.
Source (http://en.wikipedia.org/wiki/Health_care_in_Canada#Restrictions_on_privately_funded_health_care)
So it's more complicated and varies by jurisdiction, practice and service, and it's entirely up to the provinces if they participate (but there's a shitload of federal funding attached to participating)
But that is a different topic anyhow..
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Heart of Tin on August 29, 2014, 06:38:30 AM
I'm glad the ACA at least spread out the cost of having babies across both sexes by not allowing different premiums based on gender.

I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.

Just FYI, 70-year-old men have higher health costs than 70-year-old women. The standard rule where women cost more than men is only currently true from about age 18 to about age 60. Male children and male elders both cost more than their same-aged female counterparts. Source (PDF warning) a 2013 study published by the Society of Actuaries: www.healthcostinstitute.org/files/Age-Curve-Study_0.pdf

Also, the whole point of insurance is to pool risk. Paying for just your share of risk is equivelant to self-insuring.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: beltim on August 29, 2014, 06:45:14 AM
I'm glad the ACA at least spread out the cost of having babies across both sexes by not allowing different premiums based on gender.

I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.

Just FYI, 70-year-old men have higher health costs than 70-year-old women. The standard rule where women cost more than men is only currently true from about age 18 to about age 60. Male children and male elders both cost more than their same-aged female counterparts. Source (PDF warning) a 2013 study published by the Society of Actuaries: www.healthcostinstitute.org/files/Age-Curve-Study_0.pdf

This disagrees with my earlier data.  For the elderly population, I think the difference is your data looks at per person numbers while mine looks at population.  I'm not sure why there's disagreement on children.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Sparafusile on August 29, 2014, 06:45:27 AM
My wife went from being completely uninsurable to being able to get insurance when ACA went into effect. In fact, the reason we got married when we did (almost a year earlier than planned) was because her insurance was dropped without warning. So in that regard, our insurance payments have gone up. But that's far superior in my book to not being able to get it at all.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on August 29, 2014, 06:46:59 AM
I think what people mean when they say pay your fair share is to pay your fair share of the pool.  Many want free health insurance or free healthcare.  Which we all know doesn't exist.  Someone is paying for it.  And the Government doesn't make money, they take money from taxpayers.  The argument that someone is selfish because they don't like the ACA is just plain silly.  It's like saying President Obama wrote the bill or that everything is George Bush's fault.  Let's remember we have congressional leaders that play a big role in these decisions or non decisions as they seem to be.

My own opinion is that choice is paramount, and freedom are paramount.  And I agree taking care of others is important, and imagine that I am not a fan of the Affordable Care Act because it's not affordable.  It is a means to an end.  One payer is coming whether we like it or not.

My own opinion is that reform needed to be made and sadly instead we just pushed around the who pays, who doesn't pay etc... and no real reform save the uninsurable being able to get insurance or not be denied.  I know someone that was glad when the ACA went through but then upset because our State didn't accept the Medicaid expansion.  She could get coverage but it was to expensive or rather she wanted it for free.  I talk to and help this lady when I can.  We sadly haven't addressed the COST associated with healthcare. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 29, 2014, 06:59:45 AM
I think what people mean when they say pay your fair share is to pay your fair share of the pool.  Many want free health insurance or free healthcare.  Which we all know doesn't exist.  Someone is paying for it.  And the Government doesn't make money, they take money from taxpayers.  The argument that someone is selfish because they don't like the ACA is just plain silly.  It's like saying President Obama wrote the bill or that everything is George Bush's fault.  Let's remember we have congressional leaders that play a big role in these decisions or non decisions as they seem to be.

My own opinion is that choice is paramount, and freedom are paramount.  And I agree taking care of others is important, and imagine that I am not a fan of the Affordable Care Act because it's not affordable.  It is a means to an end.  One payer is coming whether we like it or not.

My own opinion is that reform needed to be made and sadly instead we just pushed around the who pays, who doesn't pay etc... and no real reform save the uninsurable being able to get insurance or not be denied.  I know someone that was glad when the ACA went through but then upset because our State didn't accept the Medicaid expansion.  She could get coverage but it was to expensive or rather she wanted it for free.  I talk to and help this lady when I can.  We sadly haven't addressed the COST associated with healthcare.
Coming from someone who COBRAed because I was not able to get individual insurance at ANY cost, I felt damn lucky to get COBRA and even luckier than ACA was passed.  Yes, insurance is expensive, I don't think you can get around that without changing our entire medical model (including how research is done), but the ability to get it is SO important when you can't.  My mother was able to retire at 58 because of ACA, because she now could access insurance.  ACA is less about affordability and more about access.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Heart of Tin on August 29, 2014, 07:18:46 AM
ACA is less about affordability and more about access.

Absolutely. There are some really glaring loopholes and unintended consequences of the affordability part of ACA (9.5% of income for health insurance premiums is not affordable in my opinion), but the accessibility parts of ACA are pretty universally praised.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: iris lily on August 29, 2014, 07:33:40 AM

Well as you specifically wrote it, your information is in-correct, but maybe only in the technical sense. For example, an American visiting Canada who happens to break his foot would be free to pay cash for services.
What might be more specifically true is:
Quote
The Canada Health Act, which sets the conditions with which provincial/territorial health insurance plans must comply if they wish to receive their full transfer payments from the federal government, does not allow charges to insured persons for insured services (defined as medically necessary care provided in hospitals or by physicians). Most provinces have responded through various prohibitions on such payments. This does not constitute a ban on privately funded care; indeed, about 30% of Canadian health expenditures come from private sources, both insurance and out-of-pocket payments. The Canada Health Act does not address delivery. Private clinics are therefore permitted, albeit subject to provincial/territorial regulations, but they cannot charge above the agreed-upon fee schedule unless they are treating non-insured persons (which may include those eligible under automobile insurance or worker's compensation, in addition to those who are not Canadian residents), or providing non-insured services. This provision has been controversial among those seeking a greater role for private funding.
Source (http://en.wikipedia.org/wiki/Health_care_in_Canada#Restrictions_on_privately_funded_health_care)
So it's more complicated and varies by jurisdiction, practice and service, and it's entirely up to the provinces if they participate (but there's a shitload of federal funding attached to participating)
But that is a different topic anyhow..

That is interesting, thank you.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on August 29, 2014, 09:49:48 AM

This seems like a pretty big non sequiter.  A progressive taxation system -->  Orwellian socialism?   It's a pretty big leap, maybe you'd care to spell it out?

I mean the form of socialism that Orwell described in Animal Farm, which is the critique I understood iris lilly to be making.  That's the general use of 'Orwellian' - to describe the world of 1984/Animal Farm, not to describe his personal beliefs. So yes, Soviet socialism, as distinct from democratic socialism.


Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on August 29, 2014, 10:02:22 AM


I still am not clear of the purpose behind the tax--just to raise money? why would employers continue to offer this Cadillac stuff if they have to pay a tax on it, in addition to actually paying more for it.


Employer-paid healthcare benefits are compensation to employees.  It's actually an anomaly that they are not generally taxed as income, like almost all other forms of compensation.  Thus, it's a little odd to complain about the very idea that health care benefits might be taxed, unless you believe that there should be no income tax at all.

I do see valid criticism at the idea that instead of a typical progressive taxation system, with increasing marginal tax rates, the "Cadillac plan" tax is an excise tax.  It exists in this form because many health care economists consider these plans inefficient, since they typically include no/very low copays and other forms of cost-sharing.  Many health care economists would prefer that patients have some "skin in the game," believing that this would incentivize patients to choose more cost-effective forms of care.  As a result, the drafters of the ACA chose to tax Cadillac plans in order to encourage employers to offer plans with more cost-sharing.

Personally, I am not persuaded that most health-care decision-making works that way; when someone calls 911, for example, they generally do not have a conversation with the operator about which hospital will provide them with the cheapest care for a heart attack.  So I would prefer a typical progressive taxation system (or, better yet, single-payer care funded through the general income tax).  But that is the logic.  It is really not an attempt to sneak in socialism by the back door.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on August 29, 2014, 10:09:14 AM
My own opinion is that reform needed to be made and sadly instead we just pushed around the who pays, who doesn't pay etc... and no real reform save the uninsurable being able to get insurance or not be denied.  I know someone that was glad when the ACA went through but then upset because our State didn't accept the Medicaid expansion.  She could get coverage but it was to expensive or rather she wanted it for free.  I talk to and help this lady when I can.  We sadly haven't addressed the COST associated with healthcare.

Sorry for the triple post, everyone!  I wanted to say that I agree with your first point, but I'm curious why you are surprised that someone who supports the ACA is upset that their state has not accepted Medicaid money.  The whole point of the Medicaid expansion is to provide insurance for people who cannot afford private insurance, even with a significant subsidy.  If she is eligible for the Medicaid expansion but not for the subsidy, that means she earns less than 138% of the federal poverty level.  At that income, I'm pretty confident that she cannot afford to pay for insurance on the exchanges without a subsidy.  So, the refusal to accept federal funds for the Medicaid expansion means that she will continue to be uninsured.  That sucks for her. Why wouldn't she be upset?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on August 29, 2014, 10:54:11 AM
I wasn't surprised.  My point was she is upset because she won't have FREE healthcare (at least to her)  As stated it's not free someone is footing the bill.  And as stated reform is needed but not in the area of shifting who pays and doesn't but in the overall cost of healthcare.

One should note this individual can afford to do things that I have decided I can not even though I really could. 

I find it interesting that a blog about self sufficiency and self reliance seems to have a large pool of followers that support passing their own expenses on to another.  The expense being their own health insurance premium.  I am not talking about pooling in the sense that my insurance carrier does but in the sense that some should get it free while others should pay through the nose.

And please understand I am not of the thinking that only the rich should have the healthcare.  I just feel that as a country people need to take more responsibility for themselves.  One of the reason's I like this blog and others like it.  We have plenty of people living off of SS and other programs and I have even met with individuals that have decided to spend everything they get so that the government will care for them when they are older.  And some of them were born in another country but became legal US citizens.

And I hesitate to comment on this post because I know it is a highly political discussion with a lot of misinformation on both sides of the aisle.  I am a registered Independent because neither party is dealing with the true issue and that is healthcare cost.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on August 29, 2014, 10:59:08 AM
I wasn't surprised.  My point was she is upset because she won't have FREE healthcare (at least to her)  As stated it's not free someone is footing the bill.  And as stated reform is needed but not in the area of shifting who pays and doesn't but in the overall cost of healthcare.

One should note this individual can afford to do things that I have decided I can not even though I really could. 

I find it interesting that a blog about self sufficiency and self reliance seems to have a large pool of followers that support passing their own expenses on to another.  The expense being their own health insurance premium.  I am not talking about pooling in the sense that my insurance carrier does but in the sense that some should get it free while others should pay through the nose.

And please understand I am not of the thinking that only the rich should have the healthcare.  I just feel that as a country people need to take more responsibility for themselves.  One of the reason's I like this blog and others like it.  We have plenty of people living off of SS and other programs and I have even met with individuals that have decided to spend everything they get so that the government will care for them when they are older.  And some of them were born in another country but became legal US citizens.

And I hesitate to comment on this post because I know it is a highly political discussion with a lot of misinformation on both sides of the aisle.  I am a registered Independent because neither party is dealing with the true issue and that is healthcare cost.

Well stated - every word. I do think a natural consequence of the MMM philosophy is using some of that extra FIRE time to help others in need, but at the same time, people need to take more responsibility for their actions and make positive steps towards self-improvement.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on August 29, 2014, 11:17:44 AM
In my opinion the biggest difference between a Liberal and Conservative is a Liberal thinks people won't help others and the Government should do it for them.  Conservatives believe people will help others and the Government has no business getting involved.  My own opinion is the truth is somewhere in the middle.  Neither side is heartless they just disagree on how to get the job done.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on August 29, 2014, 11:41:45 AM
I find it interesting that a blog about self sufficiency and self reliance seems to have a large pool of followers that support passing their own expenses on to another.  The expense being their own health insurance premium.  I am not talking about pooling in the sense that my insurance carrier does but in the sense that some should get it free while others should pay through the nose.

I would just note that some of us are actually supporting paying for other people's expenses.  My family are way over the income levels for subsidies, plus we do get very good employer-sponsored health care.  We will hopefully continue to be in that position until we are eligible for Medicare.  We also pay fairly high marginal tax rates.  For me, it's not about wanting to get benefits for myself or my family.  I just don't like watching other people die or go bankrupt because they can't afford medical care.

I understand that the person you are talking about may make poor financial decisions in other respects, but that doesn't mean she can afford health insurance.  If she is single and would qualify for the Medicaid expansion, she is earning less than $16,000.  Per the estimator, an exchange plan for a 35 year-old single person in Alabama (I picked a state at random) will cost a minimum of $200/month with a $6,000 deductible.  So, she would have to pay more than 50% of her income in a year before her insurance kicks in.  Even just the premiums would be at least 15% of her income.

If this is someone who could be earning substantially more money and chooses not to, I think you have a point.  But you can work full time at minimum wage and be eligible for the Medicaid expansion.  My opinion is that anyone who is willing to work full time is doing their part for society, and should have meaningful access to medical care.

ETA: Just noticed you are from Pennsylvania.  Your friend should be happy - your governor just agreed to accept the Medicaid expansion.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on August 29, 2014, 11:56:01 AM

ETA: Just noticed you are from Pennsylvania.  Your friend should be happy - your governor just agreed to accept the Medicaid expansion.
[/quote]

Yea I just got done reading more details about the package.  And as always some still are not Happy.  Not sure where so and so will fit into that picture.

Here's the thing I agree people should not be refused healthcare.  But how do we go about getting everyone the care they need while at the same time having everyone contribute.  The problem is you can't.  There are always going to be the lackies that take the benefit and don't contribute.  That's my problem.  I understand fully pooling risk which is not what the ACA is about.  It screws up the pool of risk. 

Say you and I and 8 other people join together to cover our medical expenses.  Every time one of us get's a bill we all pitch in and pay 10% of the bill no matter the cost.  That is pooling.  And essentially what Insurance companies do for us using math that baffles the masses.  The difference between me you and 8 other people and the insurance company is the insurance company add's a component called Profit.  Which they should the question is how much profit.  They take our group of 10 people and pool it with hundred's of thousands of other people to spread the risk, lower our cost and the impact of one illness.

What the ACA has done is forced our group to take on an individual who will have high healthcare cost and guarantee that our out of pocket expenses will increase.  While at the same time taxing us to pay that person's share because they can't "afford" it. 

Again I am not against helping people, I just don't think the ACA was the fix.  Comprehensive reform that includes malpractice suits, income levels in every aspect of healthcare, facility cost etc...  That is just a sampling of all the aspects that need to be reformed.  But I digress and will end here.  I didn't want to go this far.  Politically we have made enemies of our neighbors simply because we disagree on what is or isn't the best way to go about something.  And sadly it will cost us more in the end.  But again it is what it is and life will go on and I will be Happy regardless.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on August 29, 2014, 12:02:07 PM
I find it interesting that a blog about self sufficiency and self reliance seems to have a large pool of followers that support passing their own expenses on to another.  The expense being their own health insurance premium.  I am not talking about pooling in the sense that my insurance carrier does but in the sense that some should get it free while others should pay through the nose.

I would just note that some of us are actually supporting paying for other people's expenses.  My family are way over the income levels for subsidies, plus we do get very good employer-sponsored health care.  We will hopefully continue to be in that position until we are eligible for Medicare.  We also pay fairly high marginal tax rates.  For me, it's not about wanting to get benefits for myself or my family.  I just don't like watching other people die or go bankrupt because they can't afford medical care.

I understand that the person you are talking about may make poor financial decisions in other respects, but that doesn't mean she can afford health insurance.  If she is single and would qualify for the Medicaid expansion, she is earning less than $16,000.  Per the estimator, an exchange plan for a 35 year-old single person in Alabama (I picked a state at random) will cost a minimum of $200/month with a $6,000 deductible.  So, she would have to pay more than 50% of her income in a year before her insurance kicks in.  Even just the premiums would be at least 15% of her income.

If this is someone who could be earning substantially more money and chooses not to, I think you have a point.  But you can work full time at minimum wage and be eligible for the Medicaid expansion.  My opinion is that anyone who is willing to work full time is doing their part for society, and should have meaningful access to medical care.

ETA: Just noticed you are from Pennsylvania.  Your friend should be happy - your governor just agreed to accept the Medicaid expansion.
Same here, my budget for FI includes non-subsidy costs of insurance.  My mother wants to spend more so she is ineligible for subsidies.  I am just happy to be included in getting non-employer insurance, at any reasonable cost.  And given that COBRA for me was over $500, finding a family plan for $700 seemed quite reasonable. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Chuck on August 29, 2014, 02:01:57 PM


You do get that I was on that plan right?  So I was the person with "more" in this case? 

Ok, so you were on a "Cadillac" plan.  But now you're not. ok.

I am concerned about Chuck here and his additional costs. Guess it's likely his privilege will get kicked to the curb next year, his employer may well choose to end it.
Quote
Your comment make no sense.  Employers who are willing to pay for good plans, will chose to have a good plan...

...until they don't. Because at some point it costs beyond what they are willing to pay, and they are done with the Cadillac.
That is looking very likely. A lot of people are talking about opt outs, and the prez is probably going to just downgrade our plan.

For background: I'm in a very competitive field (small biz Gov Contracting) working for a very small company (I am employee number 20) and my boss is an awesome guy. Note that by law he doesn't even have to provide any health coverage at all, however he has for years provided employees with the best he could possibly afford, and paying 100% (for singles) of the premium himself. We aren't going to be profitable this year do to some gov cost saving shenanigans  (basically, they drug their feet long enough to pay us at last years rate, despite the whole company getting a COLA) and frankly he cannot afford to absorb this huge cost increase himself.

My plan was amazing. Now it will not be, and despite the decrease in the quality of service, I'm still likely to pay more both in premium and deductible.

I get that this law is fashionable here, but it is in the process of impacting me in a pretty negative way.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: CanuckExpat on August 29, 2014, 02:32:21 PM
My plan was amazing. Now it will not be, and despite the decrease in the quality of service, I'm still likely to pay more both in premium and deductible.

I get that this law is fashionable here, but it is in the process of impacting me in a pretty negative way.

Not to split hairs, but the "Cadillac Plan Tax" components of the ACA aren't scheduled to come into affect until 2018 (http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=99)

If your employer is changing their plan now, that is at their discretion, or possibly because they are planning ahead to 2018, by which time the law could change for all we know :)

But it's not being mandated or taxed yet..
Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on August 29, 2014, 02:46:10 PM

What the ACA has done is forced our group to take on an individual who will have high healthcare cost and guarantee that our out of pocket expenses will increase.  While at the same time taxing us to pay that person's share because they can't "afford" it. 


The problem is that if higher-risk individuals are going to be able to buy insurance on the open market, they need to be in a risk pool with lower-risk people.   We used to "solve" that problem by just allowing insurance companies to exclude high-risk people, and/or charge them risk-adjusted prices.  As a result,  lots of people were either totally unable to get a policy or only able to get an extremely expensive policy.  The ACA tries to solve the problem through a combination of the individual mandate and requiring insurers to offer roughly the same policy to everyone.   This combination "forces" higher and lower risk individuals into the same risk pool, raising costs for lower-risk folks and lowering costs for higher-risk folks.  I'd prefer to solve it by having a single-payer system, so that there's just one big nation-wide risk pool.  But it is a real problem that does need to be solved.

Also, this is maybe pedantic, but the risk pool issue and subsidies are separate issues.  There are plenty of low-risk folks who still need a subsidy to afford insurance, and there are plenty of high-risk folks who do not get or need subsidies. 



Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cassie on August 29, 2014, 02:53:29 PM
I would definitely prefer single pay-or health care.  NOt only is our premium very expensive but our max out of pocket for a serious illness is also a lot.  So we pay a ton of $ for a so-so plan.  Other countries do it much better then we do and we should follow their examples.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on August 29, 2014, 03:20:28 PM
Here's the thing I agree people should not be refused healthcare.  But how do we go about getting everyone the care they need while at the same time having everyone contribute.

Universal, single-payer coverage.  If other nations can do it, we can do it.  If we can "afford" highways for all of us to drive on and schools to educate our kids, we can afford healthcare for everyone who needs it.

This is an easy problem to solve when you only worry about getting everyone the care they need and not about having everyone contribute.  Because once you agree that everyone must contribute, you have to determine how much they contribute.  And every time you have someone who can't meet their contribution you have a "lackie" (from your quote below).

The problem is you can't.  There are always going to be the lackies that take the benefit and don't contribute.  That's my problem.

Luckily the "problem" at hand is one of perception and not reality.  When you view every transaction as having a winner and a loser and every citizen as either a giver or taker.... you will see this "problem" everywhere you look.

Riddle me this.  When someone buys a big life insurance policy and then dies in accident, who is the winner and who is the loser?  Insurance company or the beneficiary? 

Surely you are not proposing an "insurance" system where we all contribute more than we get back in benefits.  What would be the point?  We can't all be givers, you know.

Who are the "lackies" in the current (medicaid + ACA) system.  Is it anyone on medicaid?  Or is it also those in the lowest income (highest subsidy) pool covered by the ACA?  Or does it include any family getting a subsidy under the ACA (which includes those all the way up to 400% of the poverty line)?  Or are none of those lackies as long as they can actually afford the premiums?  Are they lackies if they fall behind and miss one payment?  Or must they miss multiple payments?

Or is a "lackie" not determined by what income level one is at, but whether he believes that he's deserving of the subsidy towards his premium.  Or to be a lackie does he have to hold the opinion that his subsidy should be even greater than it is?  If merely holding a belief like that isn't sufficient to make one a lackie, surely it is enough if someone takes active steps, planning, precautions so that his income is at a level that gets him the biggest subsidy within his reach.  I just hope there are no "lackies" lurking on this site where they may learn to "game the system" by hearing some of us discuss strategies for maximizing ACA subsidies in ER.  Sometimes we discuss things like that when we aren't talking about maximizing our tax deductions and credits or "minimizing our tax" burden by how we allocate across tax-deferred vs tax free accounts.

I'm just glad to be rich enough that I'm "minimizing my tax burden" rather than "chasing a handout", like a lackie.



Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on August 29, 2014, 08:38:55 PM
As stated initially my family's premium and deductibles have increases and my wife's employers cost has also went up. For us the ACA has been a negative. Sorry OP did not mean to take us so far off topic.

Thanks for the discussion. 

For the record I spent 10 years without health insurance then purchased a major medical policy.  And now have coverage through my wife and the VA.  I donate money to help those in need etc... 

Good luck.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: randymarsh on August 29, 2014, 08:49:31 PM
I think this price comparison is somewhat meaningless because prices aren't the only thing that changed. The benefits changed too. In many cases, I think people who are paying more are getting more. Whether they wanted more is another argument. I also imagine people are comparing what comes out of their paycheck now vs. before. But it's possible your employer simply decided to use the ACA as a scapegoat to cut your benefits/increase prices. Just like some restaurant in Seattle added some bullshit "Minimum Wage" fee as a line item on receipts when they passed the increase. Except it doesn't take effect until 2015...
Title: Re: How has the ACA affected your current healthcare costs?
Post by: CanuckExpat on August 29, 2014, 09:33:01 PM
But it's possible your employer simply decided to use the ACA as a scapegoat to cut your benefits/increase prices.

Yes, we had a notice about increased premiums due to "health care reform", but without specifics of why. I think when you dig further some of it is a convenient excuse for premiums that would have raised anyways, some is related to insurance companies thinking they will be less profitable overall and passing on the cost, and some is related to employers thinking ahead.

Quote
Nearly half of upper-middle-income Americans who have employer-based health insurance say the Affordable Care Act has had a negative effect on their health insurance. This is likely because 46 percent of this demographic reports paying more for insurance and also being hit with higher out-of-pocket expenses, including deductibles and co-payments, than they were a year ago.  But analyst Doug Whiteman said this may be a case of companies passing along more of the health insurance costs to employees and using Obamacare as an excuse
..
Businesses are passing along more of the insurance costs to their covered employees, though this is a trend that has been going on for years, since before Obamacare. One example of the apparent disconnect: Some companies are blaming the ACA's 40 percent tax on higher-cost "Cadillac" health insurance as reason to raise plan costs or curtail coverage. But that aspect of the law doesn't take effect until 2018. It would appear companies are acting very preemptively
http://www.cbsnews.com/news/obamacare-blamed-for-increases-in-insurance-costs/

Quote
Employees' costs are expected to rise 5 to 7 percent next year, according to early estimates. Those annual increases have been a fixture for years. But in some 2014 open enrollment documents companies are specifically citing the law as a factor in next year's pricing.But most of the language in open enrollment guides is not specific about the portion of the increases attributable to the Affordable Care Act, allowing companies and insurers to use the new law as an excuse for increases they might have implemented anyway.
...
But insurance providers say they are already passing on costs that are a direct result of the health care law.The requirement that children be allowed to remain on their parents' plans until age 26 has added millions of people to employer-provided coverage rolls with little corresponding increase in revenues. Another factor in rising premiums: the law's protections for people with pre-existing conditions. The law is designed to offset the cost of covering people with pre-existing conditions by guaranteeing millions of new customers for insurance companies. But with the ultimate number of new customers still unclear, insurers are raising prices pre-emptively
http://www.cnbc.com/id/101158964

So in the end it is complicated :)
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Chuck on September 16, 2014, 06:06:45 PM

My plan was amazing. Now it will not be, and despite the decrease in the quality of service, I'm still likely to pay more both in premium and deductible.

I get that this law is fashionable here, but it is in the process of impacting me in a pretty negative way.

Not to split hairs, but the "Cadillac Plan Tax" components of the ACA aren't scheduled to come into affect until 2018 (http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=99)

If your employer is changing their plan now, that is at their discretion, or possibly because they are planning ahead to 2018, by which time the law could change for all we know :)

But it's not being mandated or taxed yet..
The plan downgrade won't happen until the tax does. However we are all paying more for our premiums already. That started this fiscal year.


Quote from: thefinancialstudent
I think this price comparison is somewhat meaningless because prices aren't the only thing that changed. The benefits changed too. In many cases, I think people who are paying more are getting more. Whether they wanted more is another argument.
Indeed. Why am I suddenly paying for prenatal care? I don't have ovaries.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cheddar Stacker on September 16, 2014, 08:36:02 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on September 16, 2014, 08:45:38 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Wow, very interesting. As mentioned previously I'm opting out of my work's plan (and getting paid to do so) due to being on my parents' plan, but I'm definitely watching my company's prices to predict what they will be like once I hit age 26. I guess this is the first year for the ACA to really affect health costs, so it will be interesting.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on September 17, 2014, 02:54:36 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Have you priced insurance through the exchange?  Even if you don't qualify for a subsidy you may be able to save quite a bit by buying on the exchange.  Especially if you are only 36.  Younger folks are more likely to have this as an option since plans on the exchange do take age into account.  But *most* employer plans throw everyone into the same pool and don't charge younger employees less.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on September 17, 2014, 03:01:24 PM
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: geekette on September 17, 2014, 03:46:35 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (http://online.wsj.com/public/resources/documents/SUN_-A002.pdf) (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: randymarsh on September 17, 2014, 05:57:42 PM
Wow, very interesting. As mentioned previously I'm opting out of my work's plan (and getting paid to do so) due to being on my parents' plan, but I'm definitely watching my company's prices to predict what they will be like once I hit age 26. I guess this is the first year for the ACA to really affect health costs, so it will be interesting.

I did the same thing. When I accepted my job offer a month ago, medical for an employee (no family) was ~$20 per month. At that price, I was going to just use my employer's since it'd be easier for me to manage any paperwork and not have to ask my parents' questions about coverage or anything. Then they announced new plans and my cost would double. It's not a hardship to pay $40 for insurance, but it made me look closer and realize how much better my parents' plan is. Lower copays, lower coinsurance, out of network coverage, etc.

So I'm staying on mine as well. And I'm getting $200 a month from my employer to use for flex spending and Aflac coverage. Contacts and glasses just became free!
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on September 17, 2014, 06:28:45 PM
So I'm staying on mine as well. And I'm getting $200 a month from my employer to use for flex spending and Aflac coverage. Contacts and glasses just became free!

They just give me cash, though it is taxable. I'm doing the math right now and buying a catastrophic plan off the exchange and then getting paid by my company for not enrolling in my health plan may make me come out ahead once I reach 26. Of course, my per-paycheck payment for buying a health plan through my company is pre-tax, so it's pretty close.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cheddar Stacker on September 17, 2014, 07:31:48 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Have you priced insurance through the exchange?  Even if you don't qualify for a subsidy you may be able to save quite a bit by buying on the exchange.  Especially if you are only 36.  Younger folks are more likely to have this as an option since plans on the exchange do take age into account.  But *most* employer plans throw everyone into the same pool and don't charge younger employees less.

I priced it a few months ago. It would've been roughly the same cost as my current plan. Now with the 33% increase I wil revisit once our re-negotiated rates come back. This is for a plan year beginning december 2014 for a company of around 20 people.

Also, it's not just about me, I have to bear a big chunk of the cost of employee coverage as an owner. This will take our annual cost from ~50k to ~67k. Frownyface.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on September 17, 2014, 07:41:30 PM
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages.
It depends on the insurance company and the plan.  Under my mom's Cadillac plan everyone, regardless of age, was charged the same.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Beric01 on September 17, 2014, 07:43:44 PM
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages.
It depends on the insurance company and the plan.  Under my mom's Cadillac plan everyone, regardless of age, was charged the same.

My company's insurance is also the same regardless of age - hence why I'm considering avoiding it completely. It's a bad deal for a very young person, though I'm sure great for almost anyone else.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on September 18, 2014, 01:00:02 PM
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages.
It depends on the insurance company and the plan.  Under my mom's Cadillac plan everyone, regardless of age, was charged the same.

My company's insurance is also the same regardless of age - hence why I'm considering avoiding it completely. It's a bad deal for a very young person, though I'm sure great for almost anyone else.
Depends on your level of health.  I seriously benefited from my mom's plan in ways people who were older, yet healthier did not. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 12:27:01 PM
My husband carries our insurance and works for a large corporation. 
....
Our annual family out of pocket went from $4000 to $25K (this is an issue)

Potentially if I am able to get pregnant again (and the pregnancy spans 2 insurance years) I will be paying 50K. 
....
I'm really not loving the ACA at the moment.

If your employer-provided coverage isn't good, you can buy insurance through the Marketplace. You'd have to pay out of pocket if your employer coverage is "affordable" under the law, but at least you wouldn't have a $25k OOP max. An individual policy can be had for as little as $100 in many states and depending on age with a $6250 annual OOP max.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 12:38:12 PM
My costs increased... or maybe they've decreased depending on how you look at it. I am ER'd on a fairly low taxable income so pay for my own health insurance. My self-funded Blue Cross plan was cancelled as of Jan. 1st, 2014 and the new plan I got had a monthly premium increase three-times the former costs and a greater annual out of pocket costs by about $2,500 (from $4000 to $6500 annually).  It will now cost me over $14,000/year in premiums and deducibles BEFORE my insurance company has to start paying.  I do not qualify for subsidies because I am TOO low income, however I live in a Medicaid expanded state so could get that if I choose now that they no longer require means testing of assets. I don't wish to get Medicaid though. So, being that I have a military service-connected disability, I can use the VA hospital for free or low cost and that's what I intend to do. While I don't like doing that anymore than I would have liked going on Medicaid, I really don't like paying the new much higher private insurance costs I have too either. If I couldn't use the VA like most people, or wasn't in a Medicaid expanded state like many people, and had my same low income (mustachian income!) then I would be SOL and have to pay the increased amount (which is more than I live on per year), do without coverage, or go out a get a job (OH THE HORROR!)

I'm curious what your objection to enrolling in the Medicaid expansion plan is. Technically, it has at least the same minimum coverage requirements of all the private plans in the Marketplace (including free preventive services). Interestingly, the Medicaid expansion benefits are actually different than the benefits people get on traditional Medicaid (i.e. the Medicaid that existed before the ACA, and still continues to exist). And it's currently 100% paid for by the federal government, so it's nearly the same financial cost to the government as if you had the largest possible tax credit (at 139% of the federal poverty level in a state that expands Medicaid). And if you don't actually use any of the services, the cost to the government is nothing. And in some states, the Medicaid agency is just a pass-through to a private plan. Some states literally just enroll the beneficiaries of the Medicaid expansion into private plans on the Marketplace.

It's nice that you can afford to pay the premium out of pocket. But if you can't in the future, it's nice that the Medicaid expansion will be there for you.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 12:46:32 PM
My costs went down because I changed jobs, totally unrelated to ACA. My wife though, has been on private insurance for years (we have VERY different medical needs).

This year the plans changed drastically with ACA but we were able to get what looked like a much better plan for her for only a little bit more money. The problem is that our insurer is now realizing that they underestimated the cost of that plan and got tons more sign ups on the exchange that they didn't expect because the plan was the best value available. So they are slowly, month after month, changing the policies making prescriptions more expensive every month. Its now not so good of a deal (its about as good as we had last year for slightly more cost).

If you got the plan on the Marketplace, then I think it's illegal for plans to change the benefits deleteriously in the middle of the policy year. I believe they have to wait until the next policy year begins (January 1) to increase the costs of services, providing you with the opportunity to pick a different plan. In fact, there's a special provision to insure the insurers in these first few years of the Marketplace to that if some insurers get unlucky (all the sick people join) they get some surplus funds collected by the lucky insurers (with all healthy people) that didn't go to paying for medical care. In other words, it sounds like your insurer may be acting appropriately.

If you got the plan through your employer, then people signing up on the exchange shouldn't affect the cost of your employer-provided benefits, so that sounds like a fishy excuse. Raising costs may also against your employer's contract with the insurer.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 12:54:59 PM
As a health policy analyst, I feel compelled to jump in just to point out one thing --- healthcare costs have been rising an average of 10% for year for ever 20 years, in fact, it was exactly the reason we needed serious health reform (that and the fact that tens of millions of people were uninsured). 

Businesses and insurance companies have done a great job of passing off increases as a result of the ACA but in many cases its misleading, outright lies in some instances.  Health care inflation has been about double regular inflation for a long time, so it's not so easy to disentangle your health care costs going up due to the ACA or just general cost growth. 

There are certainly winners and losers in any sort of reform and there are millions in the U.S. today who have seen premiums and/or deductibles go up as a result of the ACA, but there are also millions who are seeing their rates go down or are obtaining health insurance for the first time.  The real impact of the ACA will not be known for years to come when we can determine, and no longer speculate, whether health care cost growth has slowed down and whether more people have access to care.

100% agree. It's really complicated to compare pre-ACA plans to post-ACA plans, and the monthly dollar amount and copays and deductibles don't get all the way there either. It's really hard to put an accurate value on the additional benefits plans have to provide, the guaranteed issue of insurance to anyone who wants it, not being able to exclude coverage for pre-existing conditions, and not being able to drop you from coverage when you do get sick.

The real problem is that the health care system itself is so terribly broken. The ACA is a patch and some tinkering on a system that needs fundamental reform. I think it's a net positive, but would love to see more being done. If you look at the polls that say the ACA is unpopular (which is silly because it's so complicated that almost no one knows what's in it), half of the people who don't like the bill are opposed to it because it doesn't go far enough. Strangely that's not well reported.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 01:21:25 PM


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf

Women are 3x as likely (http://www.news-medical.net/news/20110609/National-survey-finds-women-more-likely-to-see-doctor-on-regular-basis-than-men.aspx) to visit the doctor regularly. They also live longer, meaning they can die from conditions that men don't even live long enough to experience.
I stand corrected! Of course I wonder if the fact that women visit a doctor more regularly then men is the reason they live longer? That plus not jumping off roofs just for the heck of it :-)!

The biggest reason women are more expensive is that they have a very expensive health condition called pregnancy. And, the last time I checked, men are significantly responsible for the development of that condition.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 01:23:57 PM
I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.

I need more information about this hypothetical 70-year old man to form an opinion.  Was he born of a woman?  Or did he spring fully formed from Zeus' brow?

In the prior case, it seems like he has some vested interest in women having babies, and has benefited personally from the practice.  In the latter case, I agree that this seems unjust.

Plus, why isn't that hypothetical 70-year old man on Medicare?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 01:28:34 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

The "Cadillac tax" doesn't start until 2018. And it's only 40% of the amount of the cost above the threshold ($10,200 for individuals and $27,500 for families, adjusted for inflation). So if your super expensive health plan costs $28k for the family (guessing since you said "we"), your tax would be $200 for the family for the year.

http://www.uhc.com/united_for_reform_resource_center/health_reform_provisions/excise_tax_on_high_cost_coverage.htm
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 01:44:36 PM
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

Chuck, I would like it if an Obamacare apologist would step up here to explain why the employers of Chucks all over the country, employers who go above and beyond for their employees (I thought that was a good thing???) are being taxed this way.

I haven't delved into it, having been busy trying to identify how the POS legislation will benefit me. Because it really is all about me, haha.

But anyway--What's the idea behind this tax on "Cadillac" health plans, other than just another way this beast raises money to pay for itself?

Not an ACA apologist (but an ACA expert), but I believe the idea behind the "Cadillac tax" (which Chuck doesn't accurately characterize--see my previous response) is that it will help reduce healthcare expenses. From an economic perspective, if people have health plans that are that expensive, they are covering "too much" optional and unnecessary care. One of the fundamental problems with insurance is that it hides the cost of the actual services that you are consuming, which economic theory says will lead to overconsumption of those services. So by taxing these diamond studded plans a bit, it will encourage the plans to slim down and provide more of a price signal to beneficiaries and encourage them to make more economically rational decisions about the care they get. The "skin in the game" phrase is used for this. If it's going to save their life, they will still have coverage to get it. If it's not needed, maybe they won't. Not sure how I feel about this idea, but that's my understanding of the reasoning.

And to be clear, this is a very prominent line of thought in conservative Republican arguments around healthcare. Republican elected officials are making that argument today. It's not something that liberal Democrats advocated for (in fact the unions almost fought against the ACA due to its inclusion in the bill). It's one of the many aspects of the bill that makes it a generally conservative approach to healthcare reform. The ACA is essentially the approach Mitt Romney took in Massachusetts. It's similar to the approach that the conservative Heritage Foundation endorsed in the 90's. It's similar to the approach that Republican Senators Bob Dole and Orrin Hatch proposed in the 90's. The opposition is almost entirely disingenuous politics. There are plenty of legitimate arguments against the ACA, but those aren't being made, because almost no one in Congress would support the changes those legitimate arguments would move us towards (i.e. to a system like every other major industrialized nation has).
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 01:53:46 PM
I wasn't surprised.  My point was she is upset because she won't have FREE healthcare (at least to her) 

Medicaid isn't "free". Many states charge premiums to those with incomes above the poverty level (just lower premiums than the cost of the insurance) and there are copays charged for care as well. People on Medicaid tend to be very poor, and research shows that they actually skip getting needed care at times when the copays are as low as $1-$4 because that's such a large part of their budget. I think when things are free, people are probably going to overuse them. But I also don't want people to not get what they need because they can't afford it. Tough policy choices.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 02:13:02 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (http://online.wsj.com/public/resources/documents/SUN_-A002.pdf) (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November.

It sounds like something else is going on with that kind of increase. If it's a small group plan, perhaps some people had some really big expenses and they are passing it along in this next year's premiums. That has happened a lot over the years. Or perhaps they are using the ACA as an excuse to raise premiums dramatically. Or perhaps it's a negotiating tactic. The KFF poll is a national poll, so they should detect any kind of increase of that size in a region as well.

From what I've read (I think it was a KFF or RWJF report), the rates on healthcare.gov in November are going to be about the same as this past year. Some states had single digit % increases and some had single digit % decreases.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on September 19, 2014, 02:21:27 PM
My costs increased... or maybe they've decreased depending on how you look at it. I am ER'd on a fairly low taxable income so pay for my own health insurance. My self-funded Blue Cross plan was cancelled as of Jan. 1st, 2014 and the new plan I got had a monthly premium increase three-times the former costs and a greater annual out of pocket costs by about $2,500 (from $4000 to $6500 annually).  It will now cost me over $14,000/year in premiums and deducibles BEFORE my insurance company has to start paying.  I do not qualify for subsidies because I am TOO low income, however I live in a Medicaid expanded state so could get that if I choose now that they no longer require means testing of assets. I don't wish to get Medicaid though. So, being that I have a military service-connected disability, I can use the VA hospital for free or low cost and that's what I intend to do. While I don't like doing that anymore than I would have liked going on Medicaid, I really don't like paying the new much higher private insurance costs I have too either. If I couldn't use the VA like most people, or wasn't in a Medicaid expanded state like many people, and had my same low income (mustachian income!) then I would be SOL and have to pay the increased amount (which is more than I live on per year), do without coverage, or go out a get a job (OH THE HORROR!)

I'm curious what your objection to enrolling in the Medicaid expansion plan is. Technically, it has at least the same minimum coverage requirements of all the private plans in the Marketplace (including free preventive services). Interestingly, the Medicaid expansion benefits are actually different than the benefits people get on traditional Medicaid (i.e. the Medicaid that existed before the ACA, and still continues to exist). And it's currently 100% paid for by the federal government, so it's nearly the same financial cost to the government as if you had the largest possible tax credit (at 139% of the federal poverty level in a state that expands Medicaid). And if you don't actually use any of the services, the cost to the government is nothing. And in some states, the Medicaid agency is just a pass-through to a private plan. Some states literally just enroll the beneficiaries of the Medicaid expansion into private plans on the Marketplace.

It's nice that you can afford to pay the premium out of pocket. But if you can't in the future, it's nice that the Medicaid expansion will be there for you.
It's an ethical issue for me not a practical Medicaid-related one. I just don't feel that the taxpayers should have to pay 100% of my total healthcare/insurance costs so I can retire at 40 to play beach volleyball all day long. I feel that if I have the money to retire early, it's up to me to fund my own healthcare and insurance unless (until) we have true Universal health insurance/care for all. I know other's here feel differently though so don't want to debate the politics of the ACA. However I do like the availability to all people regardless of pre-existing condition thing about the ACA.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 02:23:03 PM
My personal healthcare costs are about the same as pre-ACA (large employer health plan).

My brother went from not being able to afford coverage for him, his wife, and his 4 children, to being fully insured with a great plan from the Marketplace that they can afford.

My parents are still uninsured but could get affordable coverage if they chose (my dad really wants coverage and hasn't been able to afford it in years but my mom is against the ACA and won't even buy the private insurance plans available).

My uncle, aunt, and cousin went from being uninsured to having good coverage (the cost is one-third what their previous option was).

Another cousin went from being uninsurable to having good coverage.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 02:27:45 PM
It's an ethical issue for me not a practical Medicaid-related one. I just don't feel that the taxpayers should have to pay 100% of my total healthcare/insurance costs so I can retire at 40 to play beach volleyball all day long. I feel that if I have the money to retire early, it's up to me to fund my own healthcare and insurance unless (until) we have true Universal health insurance/care for all. I know other's here feel differently though so don't want to debate the politics of the ACA.

In most states, enrolling in Medicaid doesn't cost the government anything. It only costs something if you actually use the insurance to get care. Nothing stops you from having the coverage (in case something really bad and unaffordable happens) but paying out of pocket. Or even if you use the insurance you could make a donation to the Treasury for the amount you don't need.

My brother was fundamentally opposed to taking CHIP coverage for his 4 kids. If something happened to them he wouldn't have any way of taking care of them. I felt that was irresponsible. He could always not use the coverage or pay it back later if he wanted to, but at least his kids would have the care they needed. Fortunately his income went up a bit and the Marketplace plans are affordable for him.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Spartana on September 19, 2014, 02:35:05 PM
It's an ethical issue for me not a practical Medicaid-related one. I just don't feel that the taxpayers should have to pay 100% of my total healthcare/insurance costs so I can retire at 40 to play beach volleyball all day long. I feel that if I have the money to retire early, it's up to me to fund my own healthcare and insurance unless (until) we have true Universal health insurance/care for all. I know other's here feel differently though so don't want to debate the politics of the ACA.

In most states, enrolling in Medicaid doesn't cost the government anything. It only costs something if you actually use the insurance to get care. Nothing stops you from having the coverage (in case something really bad and unaffordable happens) but paying out of pocket. Or even if you use the insurance you could make a donation to the Treasury for the amount you don't need.

My brother was fundamentally opposed to taking CHIP coverage for his 4 kids. If something happened to them he wouldn't have any way of taking care of them. I felt that was irresponsible. He could always not use the coverage or pay it back later if he wanted to, but at least his kids would have the care they needed. Fortunately his income went up a bit and the Marketplace plans are affordable for him.
Yes I understand it doesn't cost anything (other then paperwork and associated costs to get me on the system) to have Medicaid, and if I didn't have an alternative to affordable care (I do via the VA healthcare system or can afford to buy my own plan if I want) then I would sign up. I am not against Medicaid for those in need (or against any social service for those in need like your brothers family) but technically I am not in need cause I have the big stache, plus a small government pension, plus a tax-free disability benefit from the VA, plus a paid off house, plus...well you get it :-)!  I would rather see less people like me, low taxable income but high asset, be exempt from qualifying for Medicaid so that money can be used to fund programs for the truly needy. However, I was pretty disappointed when my inexpensive catastrophic plan was cancelled.

ETA: I even accidentally got put on Medicaid when I tried to apply for insurance on my state's exchange. I ended up cancelling it but the massive reams of paperwork and all the other stuff involved was pretty over the top.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 06:32:17 PM
Yes I understand it doesn't cost anything (other then paperwork and associated costs to get me on the system) to have Medicaid, and if I didn't have an alternative to affordable care (I do via the VA healthcare system or can afford to buy my own plan if I want) then I would sign up. I am not against Medicaid for those in need (or against any social service for those in need like your brothers family) but technically I am not in need cause I have the big stache, plus a small government pension, plus a tax-free disability benefit from the VA, plus a paid off house, plus...well you get it :-)!  I would rather see less people like me, low taxable income but high asset, be exempt from qualifying for Medicaid so that money can be used to fund programs for the truly needy. However, I was pretty disappointed when my inexpensive catastrophic plan was cancelled.

ETA: I even accidentally got put on Medicaid when I tried to apply for insurance on my state's exchange. I ended up cancelling it but the massive reams of paperwork and all the other stuff involved was pretty over the top.

Understood. I think the attitude of many in this thread--of not taking something meant to help those who are less fortunate when that help is not needed--is very admirable.

Even though it was a pain for you to cancel it, I'm glad the system worked to auto-enroll you in Medicaid. So many people have trouble enrolling and staying enrolled that they have setup the system to help lower the burden to get covered. It's the rare case like yours where people try to keep out. :)
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Heart of Tin on September 19, 2014, 07:43:23 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (http://online.wsj.com/public/resources/documents/SUN_-A002.pdf) (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November.

It sounds like something else is going on with that kind of increase. If it's a small group plan, perhaps some people had some really big expenses and they are passing it along in this next year's premiums. That has happened a lot over the years. Or perhaps they are using the ACA as an excuse to raise premiums dramatically. Or perhaps it's a negotiating tactic. The KFF poll is a national poll, so they should detect any kind of increase of that size in a region as well.

From what I've read (I think it was a KFF or RWJF report), the rates on healthcare.gov in November are going to be about the same as this past year. Some states had single digit % increases and some had single digit % decreases.

I thought that small groups had moved to single risk pool rating, and would therefore be rated with respect to the entire small group market, not the individual group's health status. Have I misunderstood this part of ACA?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: forummm on September 19, 2014, 08:38:02 PM
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (http://online.wsj.com/public/resources/documents/SUN_-A002.pdf) (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November.

It sounds like something else is going on with that kind of increase. If it's a small group plan, perhaps some people had some really big expenses and they are passing it along in this next year's premiums. That has happened a lot over the years. Or perhaps they are using the ACA as an excuse to raise premiums dramatically. Or perhaps it's a negotiating tactic. The KFF poll is a national poll, so they should detect any kind of increase of that size in a region as well.

From what I've read (I think it was a KFF or RWJF report), the rates on healthcare.gov in November are going to be about the same as this past year. Some states had single digit % increases and some had single digit % decreases.

I thought that small groups had moved to single risk pool rating, and would therefore be rated with respect to the entire small group market, not the individual group's health status. Have I misunderstood this part of ACA?

Some small groups have, others haven't. There are still many grandfathered plans out there that are not subject to many of the ACA's requirements. Small employers can move into a single risk pool rating if they want to.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: PeachFuzzInVA on September 20, 2014, 08:19:00 PM
My coverage stayed about the same, but that's because I had to drop my employer-sponsored health plan, as it was no longer affordable, and switch to a non-compliant, short term, private health plan. At work, we suddenly had the choice, pay about the same with a ridiculous deductible or pay 3x as much and keep the same deductible. Neither of which were affordable in my situation. Since there's a provision in the ACA that allows up to 2 years of non-compliant plans, I plan to ride out 2 years worth of short term plans and reevaluate what the current options are when time runs out.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Chuck on November 22, 2014, 09:51:27 PM
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Tyler on November 22, 2014, 10:38:18 PM
So I retired early this month.  :)  That's worthy of a whole 'nother discussion, but for the purpose of this one it allows me to directly compare the full cost of my former employer provided coverage (via the full COBRA rate) with all of the options on the exchange.

Setting aside subsidies, the most similar plan to the old one (which I used for a surgery and was very happy with) with the exact same provider is about 25% cheaper per month (for the two of us) with a slightly lower deductible.  The tradeoffs are that the exchange version does not cover out of network doctors at all while my former one does (with 30% co-insurance), now I have to get referrals to see a specialist where I did not before, and the max OoP is a little higher.  Frankly, those are tradeoffs I'm willing to make.  So for us, having multiple options to choose from vs taking the only one offered by the employer seems to work out well.

Of course one could also compare costs with subsidies and employer contributions, but the base cost to the insurer isn't so bad.

Title: Re: How has the ACA affected your current healthcare costs?
Post by: chucklesmcgee on November 22, 2014, 10:59:13 PM
This law can go fuck it's self.

They're just lubing us up for when the other bills come due for all the other old timers.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cressida on November 22, 2014, 11:36:13 PM
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.

How do you know this is the ACA's fault?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Cheddar Stacker on November 23, 2014, 05:49:14 AM
I mentioned upthread about a 33% increase in premiums on our company renewal. We ended up quoting other carriers and got a 5% reduction in premiums. Not too bad.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Pigeon on November 23, 2014, 06:38:01 AM
The anti health care reform folks like to phase the question this simply. They seem to conveniently forget that health insurance costs weren't exactly flat before the ACA.

We need universal, single payer healthcare like most other developed nations.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Chuck on November 23, 2014, 09:14:14 AM
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.

How do you know this is the ACA's fault?
Because prior to this year certain criteria could be considered, apart from age, when determining pricing. Then, pricing was averaged across the whole company, and that was the rate that each employee paid: The heathier workers subsidizing the sicker.

Now only age and number of family members can be considered. So, rates just went up, up up for almost everyone in the company. We had to get out of our low deductible, high rate plan because we simply can't afford it as a company anymore. So we went to a higher deductible and STILL slightly higher premium plan... and got across the board copay increases as well. I was actually pleased with the amount of detail that HR and our Heath Rep went into in describing exactly why all this is happening. And yes, apologists, it's the ACA.

But my wife's birth control is free now, instead of 10 bucks, so there's that. Heh.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on November 23, 2014, 10:00:43 AM
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.

How do you know this is the ACA's fault?
Because prior to this year certain criteria could be considered, apart from age, when determining pricing. Then, pricing was averaged across the whole company, and that was the rate that each employee paid: The heathier workers subsidizing the sicker.

Now only age and number of family members can be considered. So, rates just went up, up up for almost everyone in the company. We had to get out of our low deductible, high rate plan because we simply can't afford it as a company anymore. So we went to a higher deductible and STILL slightly higher premium plan... and got across the board copay increases as well. I was actually pleased with the amount of detail that HR and our Heath Rep went into in describing exactly why all this is happening. And yes, apologists, it's the ACA.

But my wife's birth control is free now, instead of 10 bucks, so there's that. Heh.
What kind of criteria?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: BEN_BANNED on November 23, 2014, 11:27:24 AM
I just received paperwork from the company benefits coordinator .

My premiums will rise approximately $36/mo. at the beginning of next year. That's after they essentially doubled last year.

So much for the ACA keeping increases from spiraling out of control.(http://www.f169bbs.com/images/smileys/boring.gif)
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on November 23, 2014, 05:08:31 PM
The ACA was designed not to fix the issues but to  spiral us into a one payer system. Those who supported it know it and openly admit it.  Those who oppose it either understand and are in denial or totally misunderstand its intent.  And for those who think one payer is great talk to those that actually have it and get their opinion.  Its not free its paid for using tax dollars. It will increase our taxes and be less efficient. One only needs to examine other government entities books to see how intelligent it is to hand anything to the federal gov. 

I am not anti gov. I realize we need limited gov but also have seen the waste first hand in the military and the mentality that its gov money.  I would kindly remind those individuals that tax payers foot the bill.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on November 23, 2014, 05:35:31 PM
The ACA was designed not to fix the issues but to  spiral us into a one payer system. Those who supported it know it and openly admit it.  Those who oppose it either understand and are in denial or totally misunderstand its intent.  And for those who think one payer is great talk to those that actually have it and get their opinion.  Its not free its paid for using tax dollars. It will increase our taxes and be less efficient. One only needs to examine other government entities books to see how intelligent it is to hand anything to the federal gov. 

I am not anti gov. I realize we need limited gov but also have seen the waste first hand in the military and the mentality that its gov money.  I would kindly remind those individuals that tax payers foot the bill.
Most Canadians I know, (I live in Buffalo and know quite a few) do like their system.  And if you do the math comparing their costs of taxes, and ours plus the cost of medical care (average), we spend just as much.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on November 23, 2014, 05:42:41 PM
Most Canadians I know and have talked to dislike their system.  Most common complaint is long waits especially for children and specialist. I even know a few that carry dual citizenship so they have easy access to American healthcare.  That goes back from a conversation within the last month and over ten years ago.  Maybe my circle is limited or the theme is the same.

I did not do a cost analysis. I prefer the Gov less involved in some of my life not more.

Every trip I make to the VA hospital I get to see the vast amount of money our Gov is spending on veteran healthcare and we have all heard about the quality and efficiency of that system. I have no complaints but have talked to others that do.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on November 23, 2014, 05:47:10 PM
Most Canadians I know and have talked to dislike their system.  Most common complaint is long waits especially for children and specialist. I even know a few that carry dual citizenship so they have easy access to American healthcare.  That goes back from a conversation within the last month and over ten years ago.  Maybe my circle is limited or the theme is the same.

I did not do a cost analysis. I prefer the Gov less involved in some of my life not more.

Every trip I make to the VA hospital I get to see the vast amount of money our Gov is spending on veteran healthcare and we have all heard about the quality and efficiency of that system. I have no complaints but have talked to others that do.
That's weird, you can just buy private insurance there and skip the wait.  Why use the US system?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on November 23, 2014, 07:43:31 PM
I don't know just relaying what has been shared with me. 

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Unfortunately politics has gotten so toxic its no longer OK to disagree because if you do you are miss informed stupid or whatever else decides to label you.  Because of the toxic politics we can't have a good discussion regarding the facts. And it doesn't matter which party a person subscribes too.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on November 23, 2014, 08:14:53 PM
I don't know just relaying what has been shared with me. 

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.


Unfortunately politics has gotten so toxic its no longer OK to disagree because if you do you are miss informed stupid or whatever else decides to label you.  Because of the toxic politics we can't have a good discussion regarding the facts. And it doesn't matter which party a person subscribes too.
I am not sure about that.  Other countries do pay less than we do.  However, the US pays more partly because of additional tests (something I am honestly ok with) and the money that goes into research.  The drugs and treatments we have today would not exist if we spent like the other countries. 
Though I do agree with you on your second paragraph.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: BlueHouse on November 25, 2014, 09:36:56 PM
So far,  I like it. I'm just about to change plans (it's open enrollment period) and this year I'm changing to a different plan   Not sure how this will all work out, but here's my plan.
2015 buy platinum plan. Get all tests and doctors visits that I've been putting off. If clean bill of health, switch to a low premium plan next year Andy void all doctors for one to two years. In third year, switch back to platinum plan. Repeat.
I've never had the freedom to switch plans before and I've always paid much more in than I ever got out of it (except once). I never want to be afraid to go to the doctor again. I love knowing that someone has to cover me regardless of what I may develop.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Exflyboy on November 25, 2014, 10:32:01 PM
I don't know just relaying what has been shared with me. 

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.


Unfortunately politics has gotten so toxic its no longer OK to disagree because if you do you are miss informed stupid or whatever else decides to label you.  Because of the toxic politics we can't have a good discussion regarding the facts. And it doesn't matter which party a person subscribes too.
I am not sure about that.  Other countries do pay less than we do.  However, the US pays more partly because of additional tests (something I am honestly ok with) and the money that goes into research.  The drugs and treatments we have today would not exist if we spent like the other countries. 
Though I do agree with you on your second paragraph.

Many countries spend HALF what we do on a per GDP basis... HALF!!!!!
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on November 26, 2014, 06:59:58 AM
Many countries spend HALF what we do on a per GDP basis... HALF!!!!!

And I Repeat. The American System does NEED REFORM in a BIG WAY.  IT's TOO EXPENSIVE. 

The ACA in my opinion does not fix that, nor does it attempt too.  A One Payer system will not fix that just look at the VA system too expensive and behind on technology I am in Awe every time I visit the VA in my area to see all the money we are spending.

Other Countries spend less for various reasons.  And our cost are so high for many different reasons, equipement, the kind of care provided to all, research, lawsuits, etc....  Simply saying their cost per GDP is half does not mean we should switch how our system is set up.  We need to have a proper in depth cost analysis.  The tiny bit of research that I have done has shown that the area's above are some of the reasons.  One concern with other countries is they do not provide the same amount of care to their elderly as we do. 

Sadly as stated above we Can't have a good discussion among legislators or even American's for that matter because we have over politicized the whole thing.  Again I AGREE we need REFORM




Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on November 26, 2014, 10:03:44 AM

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.


Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: usmarine1975 on November 26, 2014, 10:10:53 AM
Part of the problem yes but not all of it.  One payer doesn't fix all of it.  Again look at the VA system and how expensive it is.


My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.


Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on November 26, 2014, 10:15:06 AM
Part of the problem yes but not all of it.  One payer doesn't fix all of it.  Again look at the VA system and how expensive it is.


My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.


Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.
VA system also includes research not just medical care though.  And do you happen to have #s for the cost for the VA per person compared to the cost in single payer countries?  In addition, would not veterans have a higher incident rate of needing medical care, because their previous positions?
Title: Re: How has the ACA affected your current healthcare costs?
Post by: johnhenry on November 26, 2014, 12:21:47 PM
Part of the problem yes but not all of it.  One payer doesn't fix all of it.  Again look at the VA system and how expensive it is.


My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.


Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.

Scratching my head.  You do understand that the VA is not operating in a "single payer system", right.  It pays for healthcare products and services offered in the only marketplace we have, which has more than one payer.... obviously. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: historienne on November 26, 2014, 12:48:28 PM
usmarine, what data leads you to conclude that VA costs are high?  The articles collected here suggest the opposite, that (quoting from an abstract of one of the research articles) "VA costs do appear to have been significantly lower than fee-for-service charges that the federal government might have to pay if veterans were treated in private sector hospitals for the same diagnoses."
http://www.herc.research.va.gov/resources/faq_b06.asp

It's certainly true that the high cost of health care in the US is a complex issue, and some of it is related to both direct and indirect subsidies for research.  However, a significant portion is also related to the cost of administering health care in the US, which is much higher than it is in other countries, largely because of the greater complexity of our insurance/billing system.  A single-payer system would reduce those costs.  This article has a good summary of the issue: http://www.commonwealthfund.org/publications/in-the-literature/2014/sep/hospital-administrative-costs
Title: Re: How has the ACA affected your current healthcare costs?
Post by: clifp on November 26, 2014, 02:09:50 PM
Last year my grandfathered Kaiser plan went up 13% that is the biggest one year jump I've seen since getting the policy 12 years ago.  This year the increase was much more typical 3.5% to 390/month.  However there was some good news. I am able to switch to a silver plan (which is basically bronze in ACA terminology) for only $160. There is no coverage at all until I hit $5,000 deductible but than most everything is covered completely.  On the other hand I can get a lot of doctor visits at $120 a piece and lab test for the $230/month I'm saving.  In the past if I had switched and I got really sick I would have been stuck with the high deductible plan forever (and there were things like prescription drugs and transplants that it didn't cover at all). But now I can switch to silver or gold ACA  plan next year if I get sick.

I definitely feel like I am gaming the system, heads I win. Tails I get a do over.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on November 26, 2014, 02:14:18 PM
Last year my grandfathered Kaiser plan went up 13% that is the biggest one year jump I've seen since getting the policy 12 years ago.  This year the increase was much more typical 3.5% to 390/month.  However there was some good news. I am able to switch to a silver plan (which is basically bronze in ACA terminology) for only $160. There is no coverage at all until I hit $5,000 deductible but than most everything is covered completely.  On the other hand I can get a lot of doctor visits at $120 a piece and lab test for the $230/month I'm saving.  In the past if I had switched and I got really sick I would have been stuck with the high deductible plan forever (and there were things like prescription drugs and transplants that it didn't cover at all). But now I can switch to silver or gold ACA  plan next year if I get sick.

I definitely feel like I am gaming the system, heads I win. Tails I get a do over.
That is odd, when I was COBRAing a kaiser plan in jumped over 15% both years and that was back in 09. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: clifp on November 27, 2014, 04:24:51 AM

That is odd, when I was COBRAing a kaiser plan in jumped over 15% both years and that was back in 09.

Kaiser region operate  independently. I am guessing you weren't in Hawaii. Also by far the most expensive Health Insurance I ever bought was COBRA.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on November 27, 2014, 07:49:58 AM

That is odd, when I was COBRAing a kaiser plan in jumped over 15% both years and that was back in 09.

Kaiser region operate  independently. I am guessing you weren't in Hawaii. Also by far the most expensive Health Insurance I ever bought was COBRA.
Nah, Ca.  I just find it strange that in one area they'd need to increase inflow by 15% yet not anywhere close in other areas.  I wonder why that is.  And I had no choice at the time, I was not eligible for a private plan. 
Title: Re: How has the ACA affected your current healthcare costs?
Post by: geekette on November 27, 2014, 10:31:12 AM
Also by far the most expensive Health Insurance I ever bought was COBRA.
This probably isn't news to you, but COBRA rates are what your employer pays, plus a 2% admin fee.  Until a couple years ago when employers started including info on their portion of the insurance premium, I don't think many people had a clue how much insurance cost. 

We were on COBRA over 20 years ago, and IIRC, it went from under $300 to over $400 (for 2 adults) between '91 and '92.  Sounds cheap now, but I about cried when we got that letter.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: wberkgal on December 04, 2014, 06:23:00 PM
So I retired Dec. 1 and enrolled in Covered California (ACA, Obamacare) today for my husband and me. Thought these figures might be useful. We're in our early 60s. I had worked for a giant company, self-insuring, where payroll deduction was $259.32/month for the 2 of us. According to the 2013 W-2, the company paid $10964.72 for health insurance. Not sure if that includes my payroll deduction or if it was just the company's part. COBRA, for  Kaiser HMO, is $1013.42/month for the 2 of us.

Covered California is $1598/month for the 2 of us for Kaiser HMO Silver plus. With the $1484/month credit we'll pay $114/month based on our taking $2250/month from our IRAs (not planning to take SS or having other earned income.)

Coverage looks slightly worse (higher deductibles) but the giant company coverage was reduced in the same way next year, so they look about the same in the end. If we had to take COBRA we would have, as my husband has minor health issues and I don't think we would have been able to get coverage any other way. Most likely I would not have been able to retire yet as COBRA coverage would have expired before he was eligible for Medicare.

Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on December 04, 2014, 06:36:36 PM
So I retired Dec. 1 and enrolled in Covered California (ACA, Obamacare) today for my husband and me. Thought these figures might be useful. We're in our early 60s. I had worked for a giant company, self-insuring, where payroll deduction was $259.32/month for the 2 of us. According to the 2013 W-2, the company paid $10964.72 for health insurance. Not sure if that includes my payroll deduction or if it was just the company's part. COBRA, for  Kaiser HMO, is $1013.42/month for the 2 of us.

Covered California is $1598/month for the 2 of us for Kaiser HMO Silver plus. With the $1484/month credit we'll pay $114/month based on our taking $2250/month from our IRAs (not planning to take SS or having other earned income.)

Coverage looks slightly worse (higher deductibles) but the giant company coverage was reduced in the same way next year, so they look about the same in the end. If we had to take COBRA we would have, as my husband has minor health issues and I don't think we would have been able to get coverage any other way. Most likely I would not have been able to retire yet as COBRA coverage would have expired before he was eligible for Medicare.
California allows for COBRA to be extended to 3 years instead of 18 months, so if he is over 62, you should have been ok.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: wberkgal on December 04, 2014, 08:18:17 PM
That's interesting, GIN, my separation paperwork specifically  mentions "up to 18 months following your termination of employment."  I know there are a lot of California-specific benefits rules so I shouldn't be surprised that they got this wrong, although usually they're correct. If I happen to have more contact with the HR dept, I'll let them know their paperwork is wrong for CA. Thanks.
Title: Re: How has the ACA affected your current healthcare costs?
Post by: Gin1984 on December 04, 2014, 08:32:24 PM
That's interesting, GIN, my separation paperwork specifically  mentions "up to 18 months following your termination of employment."  I know there are a lot of California-specific benefits rules so I shouldn't be surprised that they got this wrong, although usually they're correct. If I happen to have more contact with the HR dept, I'll let them know their paperwork is wrong for CA. Thanks.
It is called CAL-COBRA.  I can PM you some info if you need.  My mom is on it now.