Poll

How has the ACA (obamacare) affected your health insurance costs so far?

I've seen an increase in costs
77 (36.7%)
I've seen a decrease in costs
40 (19%)
I've seen no change in costs
65 (31%)
I don't know.
28 (13.3%)

Total Members Voted: 202

Author Topic: How has the ACA affected your current healthcare costs?  (Read 46818 times)

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #50 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.

Beric01

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Re: How has the ACA affected your current healthcare costs?
« Reply #51 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.
« Last Edit: August 28, 2014, 12:21:34 PM by Beric01 »

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #52 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.

Dicey

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Re: How has the ACA affected your current healthcare costs?
« Reply #53 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.

Spartana

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Re: How has the ACA affected your current healthcare costs?
« Reply #54 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 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 :-)!

Cheddar Stacker

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Re: How has the ACA affected your current healthcare costs?
« Reply #55 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.

Spartana

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Re: How has the ACA affected your current healthcare costs?
« Reply #56 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/
« Last Edit: August 28, 2014, 02:29:14 PM by Spartana »

johnhenry

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Re: How has the ACA affected your current healthcare costs?
« Reply #57 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 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.

Cheddar Stacker

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Re: How has the ACA affected your current healthcare costs?
« Reply #58 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.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #59 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 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.

msilenus

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Re: How has the ACA affected your current healthcare costs?
« Reply #60 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.

Chuck

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Re: How has the ACA affected your current healthcare costs?
« Reply #61 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.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #62 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.

Daleth

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Re: How has the ACA affected your current healthcare costs?
« Reply #63 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).

Daleth

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Re: How has the ACA affected your current healthcare costs?
« Reply #64 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.

Beric01

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Re: How has the ACA affected your current healthcare costs?
« Reply #65 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.

Spartana

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Re: How has the ACA affected your current healthcare costs?
« Reply #66 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 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.

Beric01

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Re: How has the ACA affected your current healthcare costs?
« Reply #67 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.

iris lily

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Re: How has the ACA affected your current healthcare costs?
« Reply #68 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.

« Last Edit: August 28, 2014, 07:29:50 PM by iris lily »

historienne

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Re: How has the ACA affected your current healthcare costs?
« Reply #69 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?

iris lily

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Re: How has the ACA affected your current healthcare costs?
« Reply #70 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


iris lily

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Re: How has the ACA affected your current healthcare costs?
« Reply #71 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?

Tetsuya Hondo

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Re: How has the ACA affected your current healthcare costs?
« Reply #72 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?
« Last Edit: August 28, 2014, 07:56:10 PM by Tetsuya Hondo »

bacchi

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Re: How has the ACA affected your current healthcare costs?
« Reply #73 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?

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #74 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. 

BlueHouse

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Re: How has the ACA affected your current healthcare costs?
« Reply #75 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.

iris lily

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Re: How has the ACA affected your current healthcare costs?
« Reply #76 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.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #77 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. 

beltim

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Re: How has the ACA affected your current healthcare costs?
« Reply #78 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.

iris lily

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Re: How has the ACA affected your current healthcare costs?
« Reply #79 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.
« Last Edit: August 28, 2014, 10:14:28 PM by iris lily »

iris lily

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Re: How has the ACA affected your current healthcare costs?
« Reply #80 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.

CanuckExpat

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Re: How has the ACA affected your current healthcare costs?
« Reply #81 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
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..

Heart of Tin

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Re: How has the ACA affected your current healthcare costs?
« Reply #82 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.

beltim

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Re: How has the ACA affected your current healthcare costs?
« Reply #83 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.

Sparafusile

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Re: How has the ACA affected your current healthcare costs?
« Reply #84 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.

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #85 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. 
« Last Edit: August 29, 2014, 06:51:21 AM by usmarine1975 »

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #86 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.

Heart of Tin

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Re: How has the ACA affected your current healthcare costs?
« Reply #87 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.

iris lily

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Re: How has the ACA affected your current healthcare costs?
« Reply #88 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
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.

historienne

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Re: How has the ACA affected your current healthcare costs?
« Reply #89 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.



historienne

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Re: How has the ACA affected your current healthcare costs?
« Reply #90 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.

historienne

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Re: How has the ACA affected your current healthcare costs?
« Reply #91 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?

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #92 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.

Beric01

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Re: How has the ACA affected your current healthcare costs?
« Reply #93 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.

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #94 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.

historienne

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Re: How has the ACA affected your current healthcare costs?
« Reply #95 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.
« Last Edit: August 29, 2014, 11:45:00 AM by historienne »

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #96 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.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #97 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. 

Chuck

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Re: How has the ACA affected your current healthcare costs?
« Reply #98 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.
« Last Edit: August 29, 2014, 02:05:08 PM by Chuck »

CanuckExpat

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Re: How has the ACA affected your current healthcare costs?
« Reply #99 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..