Author Topic: Related to current blog post: CNN article on healthcare  (Read 5124 times)

AliInKY

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Related to current blog post: CNN article on healthcare
« on: November 09, 2017, 05:45:49 AM »
This (and pre-existing condition not influenced by lifestyle) is exactly why I can't retire right now:  Rising Obamacare costs frighten some early retirees
http://money.cnn.com/2017/11/09/news/economy/obamacare-early-retirees/index.html

startingsmall

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Re: Related to current blog post: CNN article on healthcare
« Reply #1 on: November 09, 2017, 09:41:00 AM »
I'm less worried about the rising costs than about the pre-existing condition thing. My husband has Ulcerative Colitis.... was diagnosed when he was a college student and he has only had a couple of flare-ups over the last 12 years (none requiring any more than outpatient treatment), but it still frequently keeps him from obtaining insurance. His current employer is a church.... apparently they will overlook pre-existing conditions if you apply for insurance when you first start working there, but if you don't apply for insurance immediately they won't accept pre-existing conditions. When he started the job, we were happy with the coverage we were receiving through my employer.... when I changed jobs, we learned that he will NEVER be able to get insurance at this job because of the fact that the didn't elect it when he first started. GRR.

Monkey Uncle

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Re: Related to current blog post: CNN article on healthcare
« Reply #2 on: November 10, 2017, 04:20:39 AM »
This (and pre-existing condition not influenced by lifestyle) is exactly why I can't retire right now:  Rising Obamacare costs frighten some early retirees
http://money.cnn.com/2017/11/09/news/economy/obamacare-early-retirees/index.html

Not an issue for MMMers who are funding their modest spending from stash withdrawals.  If you spend 30 - 40k a year, only a part of that will be capital gains and dividends that contribute to your AGI.  At that level, a couple or small family will be subsidized to the point that their ACA insurance is far cheaper than the employee contribution on employer-provided insurance.  The bigger issue is making sure their AGI is high enough to keep them off of Medicaid.

Also, because of the ACA, insurers cannot deny you coverage because of pre-existing conditions.  That goes for all health insurance, not just ACA exchange policies (with rare exceptions for certain non-insurance arrangements like health sharing ministries, which are exempt from ACA regulations).

aperture

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Re: Related to current blog post: CNN article on healthcare
« Reply #3 on: November 10, 2017, 05:13:32 AM »
I suspect that we are witnessing the death spiral of the ACA. As the pool of people seeking insurance through ACA gets smaller, it is enriched with people that need insurance because they have a pre-existing condition for which they require healthcare.  As a result insurers have to raise rates because there are not enough low utilizers paying in to cover the needs of the high utilizers. The rate increase will have the effect of pushing out more low utilizers.

We could watch the whole hospital system in the US collapse if too many people opt out of ACA.  Hospitals are legally bound to provide care to any patient in an emergency.  They can go broke providing care if too much of that goes unpaid.  This was a pretty routine crisis for city hospitals before ACA and the expansion of Medicaid. 

One of the best answers to the present crisis is a single part payor system with universal health care.  The enemies of such a solution are the numerous profit takers that stand to lose if a single payor can negotiate rates for all Americans (as the VA does for veterans).  It is unclear that the US political system can accomplish such a thing anymore, but if we are unable, we will be a greatly diminished nation going forward.

Monkey Uncle

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Re: Related to current blog post: CNN article on healthcare
« Reply #4 on: November 10, 2017, 07:51:13 AM »
One thing that might work against that death spiral is the move to eliminate the employer mandate.  If that comes to pass, it seems like it would generate a bunch of new, relatively healthy customers for the ACA exchanges.

startingsmall

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Re: Related to current blog post: CNN article on healthcare
« Reply #5 on: November 10, 2017, 08:33:21 AM »
This (and pre-existing condition not influenced by lifestyle) is exactly why I can't retire right now:  Rising Obamacare costs frighten some early retirees
http://money.cnn.com/2017/11/09/news/economy/obamacare-early-retirees/index.html

Also, because of the ACA, insurers cannot deny you coverage because of pre-existing conditions.  That goes for all health insurance, not just ACA exchange policies (with rare exceptions for certain non-insurance arrangements like health sharing ministries, which are exempt from ACA regulations).

See my post above. We were denied coverage through BCBS due to my husband's ulcerative colitis. Apparently the fact that the employer is a church means they can make exceptions.

ACyclist

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Re: Related to current blog post: CNN article on healthcare
« Reply #6 on: November 10, 2017, 08:37:31 AM »
I think the key is to never let insurance lapse.  Getting back on is the issue, I believe.

We have good coverage. My work does offer a retiree plan.  Although, we will pay about 1300 a month.  Ouch.  It is a good plan though.

We will see what happens in 7 years.  That should be our FIRE date.  We may have to work 3 months or so a year just to pay the policies.  My husband is an RN and we wants to maintain his license so that requires a certain amount of hours every year. 

Even with the insurance monkey wrench, it does feel good to be on top of our finances.  Almost debt free, two homes and a plan to build a third in a mountain biker paradise.  Maybe our "retirement" may just have to look a little different by subsidizing.  Being wise has allowed us to be semi fee by our mid our 50's.  I see some people, poor health and still drudging along at work.  This is due to their spending habits.

Monkey Uncle

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Re: Related to current blog post: CNN article on healthcare
« Reply #7 on: November 10, 2017, 09:56:52 AM »
This (and pre-existing condition not influenced by lifestyle) is exactly why I can't retire right now:  Rising Obamacare costs frighten some early retirees
http://money.cnn.com/2017/11/09/news/economy/obamacare-early-retirees/index.html

Also, because of the ACA, insurers cannot deny you coverage because of pre-existing conditions.  That goes for all health insurance, not just ACA exchange policies (with rare exceptions for certain non-insurance arrangements like health sharing ministries, which are exempt from ACA regulations).

See my post above. We were denied coverage through BCBS due to my husband's ulcerative colitis. Apparently the fact that the employer is a church means they can make exceptions.

From the Department of Health and Human Services:

Quote
Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

These rules went into effect for plan years beginning on or after January 1, 2014.
Quote
The pre-existing coverage rule does not apply to “grandfathered” individual health insurance policies. A grandfathered individual health insurance policy is a policy that you bought for yourself or your family on or before March 23, 2010 that has not been changed in certain specific ways that reduce benefits or increase costs to consumers.

https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html


Quote
•Job-based grandfathered plans: Can enroll people after March 23, 2010, and still maintain their grandfathered status if the plans:
◦Haven't been changed to substantially cut benefits or increase costs for plan holders
◦Notify plan holders they have a grandfathered plan
◦Have continuously covered at least one person since March 23, 2010
https://www.healthcare.gov/glossary/grandfathered-health-plan/

Your husband's employer must have a grandfathered plan.  I don't have any specific experience with this situation, but in theory your husband should be able to get an ACA exchange policy.  Of course you will pay full price for it unless your income is low enough to qualify for a subsidy.

Or your husband could look for another employer that doesn't have a grandfathered insurance plan.  I can't imagine grandfathered plans are all that common.
« Last Edit: November 10, 2017, 02:55:25 PM by Monkey Uncle »

startingsmall

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Re: Related to current blog post: CNN article on healthcare
« Reply #8 on: November 11, 2017, 06:35:50 AM »
This (and pre-existing condition not influenced by lifestyle) is exactly why I can't retire right now:  Rising Obamacare costs frighten some early retirees
http://money.cnn.com/2017/11/09/news/economy/obamacare-early-retirees/index.html

Also, because of the ACA, insurers cannot deny you coverage because of pre-existing conditions.  That goes for all health insurance, not just ACA exchange policies (with rare exceptions for certain non-insurance arrangements like health sharing ministries, which are exempt from ACA regulations).

See my post above. We were denied coverage through BCBS due to my husband's ulcerative colitis. Apparently the fact that the employer is a church means they can make exceptions.

From the Department of Health and Human Services:

Quote
Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

These rules went into effect for plan years beginning on or after January 1, 2014.
Quote
The pre-existing coverage rule does not apply to “grandfathered” individual health insurance policies. A grandfathered individual health insurance policy is a policy that you bought for yourself or your family on or before March 23, 2010 that has not been changed in certain specific ways that reduce benefits or increase costs to consumers.

https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html


Quote
•Job-based grandfathered plans: Can enroll people after March 23, 2010, and still maintain their grandfathered status if the plans:
◦Haven't been changed to substantially cut benefits or increase costs for plan holders
◦Notify plan holders they have a grandfathered plan
◦Have continuously covered at least one person since March 23, 2010
https://www.healthcare.gov/glossary/grandfathered-health-plan/

Your husband's employer must have a grandfathered plan.  I don't have any specific experience with this situation, but in theory your husband should be able to get an ACA exchange policy.  Of course you will pay full price for it unless your income is low enough to qualify for a subsidy.

Or your husband could look for another employer that doesn't have a grandfathered insurance plan.  I can't imagine grandfathered plans are all that common.

For now, we're all on my employer plan, at $950/month. Not ideal, but doable.... and slightly less expensive than similar plans on the exchange. Husband isn't willing to change jobs right now (he's a pastor and feels very committed to his congregation), so I'll stick with insurance-providing jobs until a) he changes jobs, or b) the insurance situation feels more stable.

TheWifeHalf

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Re: Related to current blog post: CNN article on healthcare
« Reply #9 on: November 11, 2017, 08:54:20 PM »
I do not work, we get out insurance through my husband's employer. He wants to retire but I need insurance that's guaranteed. We can handle rising premiums.
Until this health insurance thing is guaranteed, he stays working.
That's too bad. It would be one well paying job, starts about $75,000, for a new employee and income tax paid on traditional IRAs. Both things I think would look good on a President's accomplishment list.

WhiteTrashCash

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Re: Related to current blog post: CNN article on healthcare
« Reply #10 on: November 11, 2017, 09:06:45 PM »
The entire healthcare debacle in the United States is evidence to me that the United States is on the decline. What a bass ackwards way of doing things.

toocold

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Re: Related to current blog post: CNN article on healthcare
« Reply #11 on: November 12, 2017, 10:26:17 AM »
I'm curious to what will happen to those who retire projecting approximately 40k ($1M and 4% SWR) and face a situation in which premiums become subsidized based on an asset test, similar to what is happening in education.

In the early retirement forum, a long time poster decided to return to work because health insurance cost was edging up to $20k per year.

bacchi

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Re: Related to current blog post: CNN article on healthcare
« Reply #12 on: November 12, 2017, 11:29:28 AM »
I'm curious to what will happen to those who retire projecting approximately 40k ($1M and 4% SWR) and face a situation in which premiums become subsidized based on an asset test, similar to what is happening in education.

In the early retirement forum, a long time poster decided to return to work because health insurance cost was edging up to $20k per year.

I'm curious what someone with $4M will do if health care premiums rise to $150k/year and only the mega-rich can get health care. Think it's tough to get a job as an unemployed 45 year old? Try it when you're 70.

inline five

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Re: Related to current blog post: CNN article on healthcare
« Reply #13 on: November 12, 2017, 01:53:45 PM »
I'm curious to what will happen to those who retire projecting approximately 40k ($1M and 4% SWR) and face a situation in which premiums become subsidized based on an asset test, similar to what is happening in education.

In the early retirement forum, a long time poster decided to return to work because health insurance cost was edging up to $20k per year.

I'm curious what someone with $4M will do if health care premiums rise to $150k/year and only the mega-rich can get health care. Think it's tough to get a job as an unemployed 45 year old? Try it when you're 70.

Someone I know just flew to Mexico for dental work...$500 there and $5k+ over here...no brainer...

Apparently Belgium will replace your knee for $4k vs $50k in the US. Germany is around $10k.

bacchi

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Re: Related to current blog post: CNN article on healthcare
« Reply #14 on: November 12, 2017, 02:34:59 PM »
I'm curious to what will happen to those who retire projecting approximately 40k ($1M and 4% SWR) and face a situation in which premiums become subsidized based on an asset test, similar to what is happening in education.

In the early retirement forum, a long time poster decided to return to work because health insurance cost was edging up to $20k per year.

I'm curious what someone with $4M will do if health care premiums rise to $150k/year and only the mega-rich can get health care. Think it's tough to get a job as an unemployed 45 year old? Try it when you're 70.

Someone I know just flew to Mexico for dental work...$500 there and $5k+ over here...no brainer...

Apparently Belgium will replace your knee for $4k vs $50k in the US. Germany is around $10k.

Yeah, medical tourism is the way to go.

https://www.forbes.com/forbes/2007/0813/021.html

Quote
Expat doctors who have trained here and in Europe are returning home, where money goes considerably further than in, say, New York or California. More and more these foreign hospitals--currently numbering about 120, and growing--are not just mirroring the best U.S. practices but are emerging as innovators. They are certified by Joint Commission International, a not-for-profit subsidiary of the Joint Commission, which accredits U.S. hospitals. The international accreditation process is as rigorous as it is in the U.S.--but without the unnecessary bureaucratic paperwork.

A liver transplant in India, at an accredited hospital, is <10% of what it costs in the US. Paying $40k out-of-pocket sucks but can be handled by someone with $1M.


frugalecon

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Re: Related to current blog post: CNN article on healthcare
« Reply #15 on: November 12, 2017, 02:57:21 PM »
I'm curious to what will happen to those who retire projecting approximately 40k ($1M and 4% SWR) and face a situation in which premiums become subsidized based on an asset test, similar to what is happening in education.

In the early retirement forum, a long time poster decided to return to work because health insurance cost was edging up to $20k per year.

I'm curious what someone with $4M will do if health care premiums rise to $150k/year and only the mega-rich can get health care. Think it's tough to get a job as an unemployed 45 year old? Try it when you're 70.

Someone I know just flew to Mexico for dental work...$500 there and $5k+ over here...no brainer...

Apparently Belgium will replace your knee for $4k vs $50k in the US. Germany is around $10k.

I would love to see an actual breakdown of the money flows in the US vs these other countries. Exactly into whose pockets are these dollars flowing? Which prices are higher, and to what degree do they reflect costs here that are less relevant there.

Indexer

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Re: Related to current blog post: CNN article on healthcare
« Reply #16 on: November 12, 2017, 04:26:34 PM »
https://youtu.be/CeDOQpfaUc8

That does a good job explaining why health care is so expensive in the US. Adam is also pretty funny in his other videos.