Yipee-Ki-O wrote:Regardless of the name, I'm personally pretty excited that come October of this year I can choose among health insurance plans which should be vastly superior to my present individual coverage and its $5,000 deductible.
I also have an individual $5k deductible policy, but I'm not as sure that my choices will be better in October. I'm generally supportive of the new law because the old insurance system was so badly broken. Under the old rules, insured people who got sick were very vulnerable to being gamed out of the system by insurance companies. Also, a large chunk of the population didn't have insurance, which left them vulnerable to substandard care and to financial ruin. It also caused major cost shifting onto the folks that did have insurance. PPACA has a good shot at fixing a lot of this. I think that's a really good thing and I'm very hopeful that it succeeds.
OTOH, we shouldn't expect miracles from the Rev 1.0 version of something so complicated. It's nearly certain that there will be some nasty unexpected consequences as the kinks get worked out. For most people that already have employer coverage, the impacts from PPACA will hardly be noticeable, but for folks like us with individual policies, the change and the uncertainty are huge.
Based on the current state of rule-making for the exchanges, I probably won't be able to replace my $5k deductible plan under the new system. Deductibles are likely to be capped at around $2500. All things equal, that'll translate into a big premium increase for me even if nothing else changed.
Healthy young people will almost certainly see large premium increases, because all plans will be required to include maternity coverage and because the premium spread between the youngest policyholders and the oldest is capped, which will result in younger policy holders subsidizing older folks. That's good for me, but bad for younger folks just getting started out. Also, in the majority of states that previously allowed medical underwriting, people without preexisting conditions will likely see big premium increases, since healthy people will pay the same premiums as people with serious medical issues. Again, I personally support this change, but it will come at a cost.
For now I'm watching and waiting. People with existing grandfathered policies can keep them for as long as the insurance company offers them. Of course, this means giving up subsidies from the exchanges. Still, if I can, I may stay put for the first year or two and let things settle out. Once you give up enrollment in a grandfathered plan, you can never go back. The subsidies from the exchanges are enticing, and as an early retiree I could probably do some income gaming to qualify every other year. Still, right now I'm thinking it's best to watch and wait.