Health Insurance rates went up

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dodecahedron
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Re: Health Insurance rates went up

Post by dodecahedron »

fpr4 wrote:
7 states are going up more than 50%. You can't change plans because most are being eliminated (hmo's are basically the only thing left), you have to have a silver plan to get the premium, and as you pointed out, insurance companies are leaving in droves.

This whole thing was a half measure. You can't force demand for a product, put a cost ceiling on that product and then expect companies to keep offering the product.

And I haven't seen anything that has said the subsidies are going up for 2017. Feel free to post a link indicating otherwise.
1) If the second lowest cost silver plan (SLCSP) goes up in price, subsidies AUTOMATICALLY go up. Also, in many places there are lots of good choices left. You really need to check specifics for wherever you happen to be. In our area a couple companies have exited but we have many good choices left. As for HMOs, I am very happy with my nationally top-ranked HMO. Other places have Kaiser (which slightly outranks mine). So it is a very much YMMV situation.

2) You wrote above "You have to have a silver plan to get the premium." That sentence doesn't make sense--all the metal colors have "premiums." I am not sure what you meant to write, but you can get a premium subsidy whether you have bronze, silver, gold, or platinum as long as your MAGI is below 400% of the poverty level.

What you need a silver for is to get cost-sharing subsidies (i.e., reductions in deductibles, copays, and coinsurance) and those only apply if your income is below 250% of poverty level. For anyone above 250% of poverty category, there is nothing special about getting a silver. Many folks would prefer a bronze that qualifies for HSA contributions.
Last edited by dodecahedron on Sun Oct 30, 2016 6:59 pm, edited 1 time in total.
fpr4
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Re: Health Insurance rates went up

Post by fpr4 »

dodecahedron wrote:
fpr4 wrote:
7 states are going up more than 50%. You can't change plans because most are being eliminated (hmo's are basically the only thing left), you have to have a silver plan to get the premium, and as you pointed out, insurance companies are leaving in droves.

This whole thing was a half measure. You can't force demand for a product, put a cost ceiling on that product and then expect companies to keep offering the product.

And I haven't seen anything that has said the subsidies are going up for 2017. Feel free to post a link indicating otherwise.
1) If the second lowest cost silver plan (SLCSP) goes up in price, subsidies AUTOMATICALLY go up.

2) You wrote above "You have to have a silver plan to get the premium." That sentence doesn't make sense--all the metal colors have "premiums." I am not sure what you meant to write, but you can get a premium subsidy whether you have bronze, silver, gold, or platinum as long as your MAGI is below 400% of the poverty level.

What you need a silver for is to get cost-sharing subsidies (i.e., reductions in deductibles, copays, and coinsurance) and those only apply if your income is below 250% of poverty level. For anyone above 250% of poverty category, there is nothing special about getting a silver. Many folks would prefer a bronze that qualifies for HSA contributions.
Ok, well I misunderstood the subsidy qualifiers (I meant subsidy, not premium).
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dodecahedron
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Re: Health Insurance rates went up

Post by dodecahedron »

fpr4 wrote:
dodecahedron wrote:
fpr4 wrote:
7 states are going up more than 50%. You can't change plans because most are being eliminated (hmo's are basically the only thing left), you have to have a silver plan to get the premium, and as you pointed out, insurance companies are leaving in droves.

This whole thing was a half measure. You can't force demand for a product, put a cost ceiling on that product and then expect companies to keep offering the product.

And I haven't seen anything that has said the subsidies are going up for 2017. Feel free to post a link indicating otherwise.
1) If the second lowest cost silver plan (SLCSP) goes up in price, subsidies AUTOMATICALLY go up.

2) You wrote above "You have to have a silver plan to get the premium." That sentence doesn't make sense--all the metal colors have "premiums." I am not sure what you meant to write, but you can get a premium subsidy whether you have bronze, silver, gold, or platinum as long as your MAGI is below 400% of the poverty level.

What you need a silver for is to get cost-sharing subsidies (i.e., reductions in deductibles, copays, and coinsurance) and those only apply if your income is below 250% of poverty level. For anyone above 250% of poverty category, there is nothing special about getting a silver. Many folks would prefer a bronze that qualifies for HSA contributions.
Ok, well I misunderstood the subsidy qualifiers (I meant subsidy, not premium).
As I noted above, you can get subsidies (tax credits) on any color metal policy as long as your income (MAGI) is below 400% of poverty level. (If your income is below 250%, you get more subsidies on a silver than on other colors, but you give up the right to qualify for an HSA.)
mwm158
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Re: Health Insurance rates went up

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magellan
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Re: Health Insurance rates went up

Post by magellan »

fpr4 wrote:...you have to have a silver plan to get the premium, and as you pointed out...
As I understand it, the amount of premium subsidy you get is based on the cost of the second lowest priced silver plan in your area. However, you can choose a plan with a different metal level and apply your subsidy to that plan as well.
bberris
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Re: Health Insurance rates went up

Post by bberris »

Yes, subsidies go up as rates go up. The formula is that the 2nd cheapest silver plan premium is 9.6 % of your magi when you are under 4x federal poverty limit (64,080 for 2 people in 2017). You lose all subsidy over the cliff. The question is, what if there is only one silver plan?

The subsidy does not depend on the color of your plan you actually choose. You can buy a bronze plan (or gold) and qualify for the same $ subsidy, so your premium would be much less (or more) than 9.6 %
DetroitRick
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Re: Health Insurance rates went up

Post by DetroitRick »

bberris wrote:Yes, subsidies go up as rates go up. The formula is that the 2nd cheapest silver plan premium is 9.6 % of your magi when you are under 4x federal poverty limit (64,080 for 2 people in 2017). You lose all subsidy over the cliff. The question is, what if there is only one silver plan?

The subsidy does not depend on the color of your plan you actually choose. You can buy a bronze plan (or gold) and qualify for the same $ subsidy, so your premium would be much less (or more) than 9.6 %
Interesting question on the 2nd lowest plan - according to the IRS that one plan would then be treated as the second lowest silver plan. See point #19 on this premium tax credit Q & A from the IRS:
https://www.irs.gov/affordable-care-act ... tax-credit

You're right on subsidies generally going up as rates go up of course. But one material exception that I do keep seeing is this one in my own market for both 2016 and 2017 -
a new insurer or two comes in and offers a few Silver policies at unusually low rates. Really low-ball and not even close to the rest of the pack. So one of those then becomes the benchmark, and lowers subsidies for that year for the whole local market. They find out the low rate isn't sustainable and drop out of the market for the next year. Often they also have poor networks and relatively unknown or even bad reputations - so little demand. But they serve to (in my own example) reduce the tax credit severely, even when every other insurer has raised rates. I have no idea how often this happens - but here, for us, twice. Our result for 2017 from this resulted in a 38% increase in net premium, when the gross premium was only up around 21%. Since I haven't heard others with this exception, perhaps its rare everywhere else.
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magellan
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Re: Health Insurance rates went up

Post by magellan »

bberris wrote:The question is, what if there is only one silver plan?
There's probably some rule about how that's handled, but I don't think that's likely to ever happen. Each insurer usually offers several plans at each metal level.

In fact, in more competitive markets, there's a thing called 'silver spamming' where the lowest cost insurer offers a bunch of silver plans to be sure that they offer a plan priced around the cost of the benchmark plan. Say two insurers offer plans and one's silver is $200 a month and the other's is $250. The low cost insurer would want to have a second silver plan at $205 that's almost identical to the original plan to assure subsidies are set based on their plan's premium level, not their competitor's. They know that subsidized consumers are very price sensitive about the part they have to kick in. Keeping the subsidy at $205 makes people much less likely to pay the extra $45 a month to get the competitor's plan. OTOH, if the subsidy is $250, consumers have no incentive to choose a plan that's less expensive than the subsidy.

The spamming comes into play because one insurer doesn't know the premiums that the other insurer will charge in advance. Their strategy will be to layer in a bunch of plans starting at their lowest possible cost (say $200) and gradually going up to their guess at their competitors lowest cost (say $250). Then, regardless of whether the competitor comes in at $225 or $250, they'll be sure that they'll have a plan priced at or near the cost of the benchmark plan.
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magellan
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Re: Health Insurance rates went up

Post by magellan »

DetroitRick wrote:I have no idea how often this happens - but here, for us, twice. Our result for 2017 from this resulted in a 38% increase in net premium, when the gross premium was only up around 21%. Since I haven't heard others with this exception, perhaps its rare everywhere else.
I think what's happening is that the marketplace is bifurcating into two very different segments, a medicaid like ultra low-cost segment, and a higher cost segment that behaves more like traditional insurance that has broader networks and better drug formularies. The big question is whether or not this bifurcated market can become stable and thrive, or whether it'll turn into a race to the bottom with only medicaid like plans surviving in the end.

Private insurers with lots of experience in the medicaid market are entering the ACA marketplace and offering plans very similar to medicaid plans. These plans fully meet the ACA coverage requirements but are ultra cheap because of super narrow networks and stingy drug formularies. Some of these insurers have gone bust or pulled back, but most of them know what they're doing because they have a lot of experience running medicaid plans and building ultra low-cost medicaid networks. My guess is that eventually plans from the most successful of these companies will penetrate every market and will become the benchmark plan in every state. So subsidies everywhere will be based on these very cheap no-frills medicaid like plans. The big question is what happens in the upper end of the market.

One theory is that the market will eventually stabilize in a bifurcated state, essentially becoming two distinct markets inside one system. According to this theory, the individual marketplace will consist of two very different types of insurers and two very different types of clients. Low income folks will buy subsidized medicaid plans and high income folks will buy expensive broad network plans (perhaps only offered off-exchange). The super high cost of the broad network plans will mean that only relatively healthier richer people will buy these plans. One underpinning of this theory is that richer people won't go uninsured and are willing to pay a premium to stay out of the no-frills medicaid like system, even if they're healthy. This will keep the high end market from entering a death spiral.

Another other theory says that it'll be impossible for any company to successfully offer broad network plans because these plans will attract the sickest people, which will make them unattractive to healthy people and cause a death spiral in the upper end of the market, leaving only the medicaid like plans.

No one knows how this will play out, but this is the big question getting worked out right now. IMO, there's no chance of Obamacare 'collapsing' due to a death spiral. The subsidies are designed to create a premium ceiling for 70-80% people buying plans. Even if premiums increase by 1000%, these people get subsidies that increase as premiums increase and are capped at a certain percent of their income.

So the question isn't whether Obamacare can survive - it can. The question is whether it will be a blend of medicaid and a high quality private insurance system or will throw everyone into an extension of the no-frills medicaid program.
bberris
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Re: Health Insurance rates went up

Post by bberris »

magellan wrote:
bberris wrote:The question is, what if there is only one silver plan?
There's probably some rule about how that's handled, but I don't think that's likely to ever happen. Each insurer usually offers several plans at each metal level.
....

The spamming comes into play because one insurer doesn't know the premiums that the other insurer will charge in advance. Their strategy will be to layer in a bunch of plans starting at their lowest possible cost (say $200) and gradually going up to their guess at their competitors lowest cost (say $250). Then, regardless of whether the competitor comes in at $225 or $250, they'll be sure that they'll have a plan priced at or near the cost of the benchmark plan.
Minnesota will have only one plan available after the low-cost plans fill their very low enrollment caps. I expect around November 2. I agree about the spam. Those spam low-cost plans have low caps.
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Lieutenant.Columbo
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Re: Health Insurance rates went up

Post by Lieutenant.Columbo »

MN Finance wrote:Alternatives? Don't get Healthcare. That's my plan
I'm really tempted to do this myself too; well, not exactly, just getting $1000/year non-ACA catastrophic plan with like $10K deductible.

I'd like to know first if the penalty for not having ACA insurance is lower than what I'd be paying for insurance. I'm a high earner and know penalty goes up with your income.

The system really seems messed up.
Lt. Columbo: Well, what do you know. Here I am talking with some of the smartest people in the world, and I didn't even notice!
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JDCarpenter
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Re: Health Insurance rates went up

Post by JDCarpenter »

Lieutenant.Columbo wrote:...

I'd like to know first if the penalty for not having ACA insurance is lower than what I'd be paying for insurance. I'm a high earner and know penalty goes up with your income.

....
There is no penalty if you don't overwithhold.
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jim234
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Re: Health Insurance rates went up

Post by jim234 »

bberris wrote:Yes, subsidies go up as rates go up. The formula is that the 2nd cheapest silver plan premium is 9.6 % of your magi when you are under 4x federal poverty limit (64,080 for 2 people in 2017). You lose all subsidy over the cliff. The question is, what if there is only one silver plan?

The subsidy does not depend on the color of your plan you actually choose. You can buy a bronze plan (or gold) and qualify for the same $ subsidy, so your premium would be much less (or more) than 9.6 %
The difference between the SLCSP plan and income (below) determines the subsidy:

Up to 133% of FPL 2.04% of your income
133%-150% of FPL 3.06%-4.08% of your income
150%-200% of FPL 4.08%-6.43% of your income
200%-250% of FPL 6.43%-8.21% of your income
250%-300% of FPL 8.21%-9.69% of your income
300%-400% of FPL 9.69% of your income
soboggled
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Re: Health Insurance rates went up

Post by soboggled »

mwm158 wrote:
fpr4 wrote:$108k (96 percentile individual income) for the federal government with awesome benefits package and you're complaining? What do you do?

Just because your personal premiums only rose 4% doesn't mean that's a market rate.
I work for the Air Force. I'm a lead engineer for a very well known weapons platform with a few dozen engineers under me. From my experience, the government pays unskilled workers too much and skilled workers too little. I have had offers from various contractors for way more than I'm making, but I believe in the mission and money isn't everything. That said, when we get treated the way we have with no COLAs and furloughs and so forth, it really makes me question that decision.

The benefits are nice, but can and are being cut at every opportunity. Also, I tried to explain how the health benefits work. The cost paid by the government and paid by me are public knowledge. Both are increasing by 4%. The total is the market rate. There's no extra magic subsidy, the government pays up to 75%, but is capped using some formula.

If anything, the government helped raise the rates. I am now covered for a gender reassignment surgery if I decide I want to be a woman. I'm sure it wasn't the insurance company's idea to tack that coverage on for next year. But, I get to pay for it.
You make a decent salary. You have very good inexpensive health insurance subsidized by taxpayers. You have job security, leave and other benefits like no one on earth. If you don't like it, you can always quit and get a job in private industry. So maybe you should count your blessings and stop whining about trivia.
LiterallyIronic
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Re: Health Insurance rates went up

Post by LiterallyIronic »

BruDude wrote:Sounds like a grandfathered plan, ACA was signed in March 2010....if she bought it before ACA was signed, she can keep it forever, or at least until the insurance company terminates that block of plans. If it's a "grandmothered" plan it may terminate at the end of 2016 or 2017 automatically. I'd keep it as long as you can because you definitely aren't going to find anything for $78/month now.
We just got our annual increase letter. It's going to be $101. A 29% increase. Way more than has happened in previous years. That's pushing the bounds of affordability.
Barefootgirl
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Re: Health Insurance rates went up

Post by Barefootgirl »

I've been reading about Americans who manage their health care expenses by only obtaining emergency or catastrophic care here in the US and for routine, predictable expenses, they travel out of the US and obtain quality care, on a cash basis - *at steep discounts when compared to US prices*.

I suppose people need to become creative in these times when healthcare costs are rapidly outpacing the economic indices.
How many retired people does it take to screw in a lightbulb? Only one, but he takes all day.
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magellan
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Re: Health Insurance rates went up

Post by magellan »

LiterallyIronic wrote:We just got our annual increase letter. It's going to be $101. A 29% increase. Way more than has happened in previous years.
This varies by state, but in our state, premiums for grandfathered plans are tiered based on 5 yr age brackets. This is just how it worked before Obamacare. So people ages 40-44 all pay the same premium, but folks turning 45 are bumped into the next age rating bracket and in the year that happens, they see a huge increase.

Could that be part of the reason for the large increase? if not, the increase could mean that only very sick people are hanging onto their grandfathered plans in your state and in that case you're probably looking at a death spiral over the next couple of years for that plan.
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Lieutenant.Columbo
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Re: Health Insurance rates went up

Post by Lieutenant.Columbo »

JDCarpenter wrote:
Lieutenant.Columbo wrote:...

I'd like to know first if the penalty for not having ACA insurance is lower than what I'd be paying for insurance. I'm a high earner and know penalty goes up with your income.

....
There is no penalty if you don't overwithhold.
Hmmm... How can that be?
Do you have an IRS source for that statement?
Lt. Columbo: Well, what do you know. Here I am talking with some of the smartest people in the world, and I didn't even notice!
Barefootgirl
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Re: Health Insurance rates went up

Post by Barefootgirl »

So maybe you should count your blessings and stop whining about trivia.
...but it's not trivial. It's not just the lower than market value of salaries above a certain grade level and nil cost of living increases, but also the calculated impact to the benefits that are based on the salary number.

I'm not sure I get the point - is this the analogy? my neighbor's leg was broken and my ankle was broken, but because it was only my ankle, I should be grateful?

Aren't we both in pain?
How many retired people does it take to screw in a lightbulb? Only one, but he takes all day.
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JDCarpenter
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Re: Health Insurance rates went up

Post by JDCarpenter »

Lieutenant.Columbo wrote:
JDCarpenter wrote:
Lieutenant.Columbo wrote:...

I'd like to know first if the penalty for not having ACA insurance is lower than what I'd be paying for insurance. I'm a high earner and know penalty goes up with your income.

....
There is no penalty if you don't overwithhold.
Hmmm... How can that be?
Do you have an IRS source for that statement?
Here is the PPACA Public Law text: https://www.gpo.gov/fdsys/pkg/PLAW-111p ... ubl148.pdf Look at page 131 (124 Stat. 249), which is subpart (g) of "Maintenance of Minimum Essential Coverage," IRC Section 5000a (starting on 124 Stat. 244):
‘‘(g) ADMINISTRATION AND PROCEDURE.—
‘‘(1) IN GENERAL.—The penalty provided by this section
shall be paid upon notice and demand by the Secretary, and
except as provided in paragraph (2), shall be assessed and
collected in the same manner as an assessable penalty under
subchapter B of chapter 68.
‘‘(2) SPECIAL RULES.—Notwithstanding any other provision
of law—
‘‘(A) WAIVER OF CRIMINAL PENALTIES.—In the case of
any failure by a taxpayer to timely pay any penalty imposed
by this section, such taxpayer shall not be subject to any
criminal prosecution or penalty with respect to such failure.
‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretary
shall not—
‘‘(i) file notice of lien with respect to any property
of a taxpayer by reason of any failure to pay the
penalty imposed by this section, or
‘‘(ii) levy on any such property with respect to
such failure.’’.
Of course, you can be hit in any future year in which you overwithhold, so you need to stay on toes. IRS addresses it in informal FAQ # 29 here: https://www.irs.gov/affordable-care-act ... -provision For secondary sources/explanation, just search for ACA penalty enforcement withholding. Here is a decent overview: https://www.healthinsurance.org/faqs/if ... ncome-tax/ and another: https://ttlc.intuit.com/questions/19250 ... ca-penalty

E.T.A.--sorry for the text blob!
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StealthRabbit
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Re: Health Insurance rates went up

Post by StealthRabbit »

Barefootgirl wrote:I've been reading about Americans who manage their health care expenses by only obtaining emergency or catastrophic care here in the US and for routine, predictable expenses, they travel out of the US and obtain quality care, on a cash basis - *at steep discounts when compared to US prices*.

I suppose people need to become creative in these times when healthcare costs are rapidly outpacing the economic indices.
Pre-age 65 retirees in USA that do not have company HC, and who do not qualify for subsidies are being creative.
A(?)CA took away all my affordable options: (retired / left employment @ age 49; 10+ yrs ago)
  • we are self insured (A(?)CA would be $1700/ month)
  • travel overseas for HC, as do 14M WW (Medi-vacations / Medical tourism). http://www.patientsbeyondborders.com/me ... tics-facts Europeans have been doing this for over 50 yrs, Many countries specialize in this as a 'value add economy' (~50-80B$USD ), UAE is a HUGE newcomer http://www.meditravels.org/
  • Took one year away from home - used Travel insurance ~$100/ month, but you can never return home or it cancels (who wants to be in USA during an election yr :wink: )
  • Use a 'Health care sharing network' if in USA (not insurance, but has legal exemption from A(?)CA penalties.http://www.medicalcostshare.com/compari ... tries.html
  • Try to be lucky... (my first broken leg the day AFTER insurance expired...) :(
In the USA, you do-what-you-have-to-do, it is fortunate we still have that option. (Tho A(?)CA has gone FAR in attempting to force NO OPTIONS. They have not 'won' yet.

BTW: our (4) affordable options were $300/ month when we planned early retirement. A(?)CA torpedoed them all. Both spouses have health risk / chronic / pre-existing conditions. Living on borrowed time (per family history).
soboggled
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Re: Health Insurance rates went up

Post by soboggled »

Barefootgirl wrote:
So maybe you should count your blessings and stop whining about trivia.
...but it's not trivial. It's not just the lower than market value of salaries above a certain grade level and nil cost of living increases, but also the calculated impact to the benefits that are based on the salary number.

I'm not sure I get the point - is this the analogy? my neighbor's leg was broken and my ankle was broken, but because it was only my ankle, I should be grateful?

Aren't we both in pain?
It was the poster to whom I responded who was complaining about having to pay for other people's operations. It's called insurance. The point is that ALL those eligible for federal health insurance have nothing to complain about compared to almost all others, so they shouldn't act as if they are being unfairly treated. Too many think if there is even just one person in the world who has better benefits they are being treated unfairly. If they don't like it they can quit and try getting a job that suits them better in the private sector or with a local government.
BTW, I agree, all pain is equal, though apparently that is not how the US insurance market works, but that's another issue. :D
Barefootgirl
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Re: Health Insurance rates went up

Post by Barefootgirl »

I've been paying automobile insurance for 30 years without 1 claim, so I'm pretty sure some of my funds went toward paying the claims of people who don't drive as cautiously as I do or have worse luck than I do....that's why it's called pooling. Applies to healthcare insurance as well.

But I still think we're all getting hosed - public, private, unemployed, retired and we're all feeling the pain, it's not relative (IMO) when the escalation rate far outstrips the economic indices.
How many retired people does it take to screw in a lightbulb? Only one, but he takes all day.
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munemaker
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Re: Health Insurance rates went up

Post by munemaker »

My employer provided health insurance is going up 12% next year. My share for coverage for my wife and I is about $4,000/year. This is for 80/20 plan with $500/person deductible (no co-pay) with $2,500/person max out of pocket.

I think the COBRA price for this plan is about $14,000/year.
Nick341981
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Re: Health Insurance rates went up

Post by Nick341981 »

magellan wrote:

One theory is that the market will eventually stabilize in a bifurcated state, essentially becoming two distinct markets inside one system. According to this theory, the individual marketplace will consist of two very different types of insurers and two very different types of clients. Low income folks will buy subsidized medicaid plans and high income folks will buy expensive broad network plans (perhaps only offered off-exchange). The super high cost of the broad network plans will mean that only relatively healthier richer people will buy these plans. One underpinning of this theory is that richer people won't go uninsured and are willing to pay a premium to stay out of the no-frills medicaid like system, even if they're healthy. This will keep the high end market from entering a death spiral.
Nope. Rich people generally don't become rich without being very clever. Most rich people stick as much money as they can into tax shelters as possible. 401k, Roth, mega back door Roth. All that wil happen is rich people will take just enough out to stay under and get all the subsidy they can. Example: do a 401k Roth conversion for whatever you want your magi to appear to be for the year and then take however much else you want out of your Roth contributions without affecting your MAGI. I'm just learning about this so I'm sure there are many who could come up with even more clever ways to accomplish the same thing.
outdoorsygal
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Re: Health Insurance rates went up

Post by outdoorsygal »

This is a lesser known avenue for Christians if you are interested. Generally much much cheaper and more bang for your buck
It satisfies the individual mandate to have insurance
https://www.chministries.org/

Costs-
https://www.chministries.org/catastrophicbills.aspx

If you spend what equates to $10 more per month for My Brothers Keeper, you’ll get a lot more protection for just a measly $10 month more
outdoorsygal
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Re: Health Insurance rates went up

Post by outdoorsygal »

My employer went to offering ONE Plan at no cost-(KAISER HSA 4500/40%)
They cut out our fully funded 50K Life Insurance Policy.
The Vision Plan is still $2 deducted per paycheck (for myself only)

I chose to pay a little out of each paycheck for health plan...

:arrow: $17.50 DEDUCTED per paycheck (pretax) for myself only
:arrow: $50 Urgent Care/Doc Visits/Specialists
:arrow: $40 lab/xrays/bloodwork
:arrow: 25/50 generic/brand name drugs
:arrow: $15 Chiropractor/Accupuncture visits (limit 20 per yr)
:arrow: $75 ER Visit (Waived if admitted)

Only what Iisted above^^^ is what I can afford to use :sharebeer
Otherwise...all else requires the $1000 yearly deductible be met first

Kaiser Contracts out with my private Chiropractor already so I chose this Particular Kaiser Plan

Image

$4 Per Paycheck DEDUCTED For Dental Plan (MYSELF ONLY)


Image
Last edited by outdoorsygal on Tue Nov 01, 2016 3:58 am, edited 14 times in total.
outdoorsygal
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Re: Health Insurance rates went up

Post by outdoorsygal »

johnny wrote:Oh, no doubt about it. I pay 30% of the premium and my old employer pays 70%. I'm happy now that I stuck it out for all those years...
Just curious if it is ok to ask, but what did you do for a living?
Tanelorn
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Re: Health Insurance rates went up

Post by Tanelorn »

At some point, possibly a few years from now, the subsidies stop growing and basically all the excess health care cost inflation gets passed on to the individual rather getting paid by the taxpayer. At the rate of premium growth we're seeing now, that may come a lot faster than this estimate suggested:

https://www.americanactionforum.org/ins ... /#_ftnref1
outdoorsygal
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Re: Health Insurance rates went up

Post by outdoorsygal »

I am for taxpayer funded Health Care but in the form of $2000 per yr HSA Accounts.

Then people will stop buying what they truly do not need. Demand for healthcare will go down so prices will start being more competitive. It's also an incentive for people to eat healthier. Keeping Medicaid & Medicare in place
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munemaker
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Re: Health Insurance rates went up

Post by munemaker »

Nick341981 wrote:Most rich people stick as much money as they can into tax shelters as possible. 401k, Roth, mega back door Roth. All that wil happen is rich people will take just enough out to stay under and get all the subsidy they can.
You don't have to be rich. With advance planning, anyone can do this. The law is designed to help early retirees. Use it to your advantage!
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Meaty
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Re: Health Insurance rates went up

Post by Meaty »

mwm158 wrote:I work for the federal government and just checked my basic BCBS plan and the premiums are going up 4%, but still no deductible and the co-pays haven't changed. Way better than last year, but still not great considering we haven't gotten a cost of living increase that comes close to matching inflation since 2010.
I've never gotten a COLA in the private sector - ever
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magellan
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Re: Health Insurance rates went up

Post by magellan »

Nick341981 wrote:All that wil happen is rich people will take just enough out to stay under and get all the subsidy they can.
If the market completely bifurcates as many expect, these rich people would have to accept low-quality medicaid-like insurance in exchange for the subsidy, since that will be the only choice on the exchanges. Many experts don't think rich people will make this trade. Instead, they'll give up the subsidy and buy out of the system, purchasing higher quality off-exchange policies that them access to all the top hospitals and doctors in their area.

It seems unlikely to me that rich people will choose a plan that only offers lower quality doctors and hospitals if they have the means to opt out, but at this point, no one knows for sure.
soboggled
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Re: Health Insurance rates went up

Post by soboggled »

fpr4 wrote:
soboggled wrote:
fpr4 wrote:
mwm158 wrote:
fpr4 wrote:You don't think you're getting COL increases in thr form of super cheap healthcare costs when the typical private sector employees are going up 50%+ in premiums and 20%+ in deductibles?
The government pays $450 a month for my insurance (75% of the total cost), and it has increased 4% for next year. That is an extra $216 a year they will pay. That is about a 0.2% COL increase for me. So no, I don't think that makes up for the effects of inflation on my salary.
$108k (96 percentile individual income) for the federal government with awesome benefits package and you're complaining? What do you do?

Just because your personal premiums only rose 4% doesn't mean that's a market rate.
On no other issue are the bogus claims, whining and exaggerations so great.
1.Yes, by any comparative standard, Federal employees have a great deal on health insurance.
2. No, "typical private sector employees" are NOT seeing increases of "50%+ in premiums and 20%+ in deductibles".
Health care cost in the US is a serious ongoing problem. In 2017: Those with insurance through employers are 95% of non-retirees; they will see increases averaging 6%. The other 5% that depends on ACA will see average increases of 25% but in most cases that will be covered by increased subsidies and most can change plans. The longer term problem of ACA in many states in the shrinking number of insurers.
I meant people on the exchange.

7 states are going up more than 50%. You can't change plans because most are being eliminated (hmo's are basically the only thing left), you have to have a silver plan to get the premium, and as you pointed out, insurance companies are leaving in droves.

This whole thing was a half measure. You can't force demand for a product, put a cost ceiling on that product and then expect companies to keep offering the product.

And I haven't seen anything that has said the subsidies are going up for 2017. Feel free to post a link indicating otherwise.

I already posted such a link.
I don't mean to defend the current system or the ACA. No one thinks it is ideal but the problem is political - we can't agree on the best course. Meanwhile, many millions of previously uninsured people are benefiting, albeit with a sub optimal solution. The arguments against it are similar to those against our current insurance system: Not so good but apparently the best we can do so far.
Having said that, on no other issue is there so much exaggeration and intentional ignorance.
If you can't find authoritative sources that explain by shopping around premiums can be reduced below 2016 without sacrificing benefits, you haven't been really looking or don't want to know. Here is one I already posted: http://kff.org/health-reform/issue-brie ... ketplaces/. Only about 17% of all participants don't get subsidies.
If the ACA is so bad, why do 20M people continue to participate and many more are joining? They have no other viable alternative and it is certainly better than nothing.
Insurers are leaving but not in "droves". The typical ACA marketplace has a choice from among 4 insurers; the states with the most limited choices are a handful of rural ones, I think the 7 you referred to.
One could argue the biggest problems are in states most politically hostile to the law at the state level but that is another issue.
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munemaker
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Re: Health Insurance rates went up

Post by munemaker »

magellan wrote:
Nick341981 wrote:All that wil happen is rich people will take just enough out to stay under and get all the subsidy they can.
If the market completely bifurcates as many expect, these rich people would have to accept low-quality medicaid-like insurance in exchange for the subsidy, since that will be the only choice on the exchanges. Many experts don't think rich people will make this trade. Instead, they'll give up the subsidy and buy out of the system, purchasing higher quality off-exchange policies that them access to all the top hospitals and doctors in their area.

It seems unlikely to me that rich people will choose a plan that only offers lower quality doctors and hospitals if they have the means to opt out, but at this point, no one knows for sure.
I guess it depends on how you define "rich." To me, rich would be around $5M and up. I doubt many truly rich people are taking subsidies. Early retirees with maybe $1M to $3M in assets (no pensions) are often eligible for subsidies, but I would not consider someone in that category "rich." Many public employees have pensions worth over a million dollars, but that doesn't make them rich either.
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magellan
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Re: Health Insurance rates went up

Post by magellan »

munemaker wrote:I doubt many truly rich people are taking subsidies. Early retirees with maybe $1M to $3M in assets (no pensions) are often eligible for subsidies, but I would not consider someone in that category "rich."
I'm using vague terminology on purpose because this isn't black and white. I was trying to lay out the ACA landscape as it appears to be developing. In some states, there are still many plans with high quality networks available on the exchange. In other states, you can only get a plan with a high quality network off the exchange. In yet other states, you can't buy a plan with a high quality network at all.

My point was that entry into the exchanges by providers that specialize in servicing the medicaid population is dramatically changing the nature of the exchanges. These low-cost medicaid like plans are dominating the low-end of many exchanges and are determining subsidy levels. Because these plans are forcing subsidy levels down, people who can't afford high premiums are unlikely to choose anything other than one of these low-cost medicaid like plans. This trend appears to be baked in as best as I can tell.

The big unknown for early retiree Bogleheads who can probably afford to pay a much higher premium, is what happens in the high end of the market.
There seem to be three possibilities:

1) High quality providers are available on the exchanges along with the low quality plans that determine subsidy levels. Early retirees can manage their income to get subsidies, then kick in the extra needed to buy a high quality plan.

2) High quality providers are only available off the exchanges. Early retirees have to decide whether they want to opt-out of the subsidies to have access to high quality provider networks.

3) The only choice both on and off the exchanges is medicaid-like insurance with no option for a high quality plan at any price. This could happen if market dynamics make it impossible for an insurer to profitably offer a high quality plan that enough people will buy.

It's possible that markets will stabilize differently in different states, with some states ending up with scenario 1 above, others with scenario 2, and others with scenario 3.

That will give early retirees one more factor to throw into the mix as they're deciding where to live in retirement.
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dm200
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Re: Health Insurance rates went up

Post by dm200 »

Question: How does the requirement to allow adult children to remain on parent's health insurance affect various rates?

For employer plans, it seems that this would, overall, increase what employer plans cover and pay. What about individually purchased plans, either on or off the exchange?

It seems that this requirement would cause an increase in the number of insured folks in their early to mid 20's.
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dm200
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Re: Health Insurance rates went up

Post by dm200 »

From the beginning of the ACA until, at least, last year, when my wife purchased on the Exchange with a credit/subsidy, her plan (without subsidy or credit) was identical whether purchased directly or on the exchange (Federal in Virginia). This was a Kaiser Silver plan.
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Re: Health Insurance rates went up

Post by sawhorse »

dm200 wrote:Question: How does the requirement to allow adult children to remain on parent's health insurance affect various rates?

For employer plans, it seems that this would, overall, increase what employer plans cover and pay. What about individually purchased plans, either on or off the exchange?

It seems that this requirement would cause an increase in the number of insured folks in their early to mid 20's.
I think it certainly it's one contributor to higher exchange market rates and the increasing disparity between employer plans and exchange market plans. The young and presumably healthier (as a group) aren't signing up for exchange market plans and using their parents' plans instead. In addition, while someone age 25 might already have a family, the ones on their parents' plan are unlikely to, so they have low costs even for their age group.
Last edited by sawhorse on Tue Nov 01, 2016 8:51 am, edited 1 time in total.
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magellan
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Re: Health Insurance rates went up

Post by magellan »

dm200 wrote:It seems that this requirement would cause an increase in the number of insured folks in their early to mid 20's.
It does. The downside is that it takes a lot of healthy young people out of the individual insurance market and that causes rates to be higher than they would be without that provision.

This was seen as a part of an equitable trade off for young people. This provision gives you a large subsidy between the ages of 18 and 26, but once you hit 27, the compressed age ratings in the individual market mean you pay a higher rate than you would otherwise. Once you reach age 35 or so, it starts to balance out.

This is similar to the male/female cross subsidies. Women are more expensive to insure when they're younger, but starting around age 38-40, men become more expensive to insure. So men subsidize women when they're younger, but as they age the subsidy reverses and men get a subsidy from women.
Tanelorn
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Re: Health Insurance rates went up

Post by Tanelorn »

soboggled wrote:I don't mean to defend the current system or the ACA. No one thinks it is ideal but the problem is political - we can't agree on the best course. Meanwhile, many millions of previously uninsured people are benefiting, albeit with a sub optimal solution. The arguments against it are similar to those against our current insurance system: Not so good but apparently the best we can do so far.
Having said that, on no other issue is there so much exaggeration and intentional ignorance.
If you can't find authoritative sources that explain by shopping around premiums can be reduced below 2016 without sacrificing benefits, you haven't been really looking or don't want to know. Here is one I already posted: http://kff.org/health-reform/issue-brie ... ketplaces/. Only about 17% of all participants don't get subsidies.
Almost half the people buying in the individual market don't get subsidies. All of them off the exchange, about 1/3, and another 15-20% of those you cite who buy on the exchange but aren't eligible.
If the ACA is so bad, why do 20M people continue to participate and many more are joining? They have no other viable alternative and it is certainly better than nothing.
8-10M people are getting paid to participate in the exchange. Some 20M are choosing to be uninsured, possibly also paying penalty, just to avoid it. Many people are voting with their wallet that "nothing is better".
Insurers are leaving but not in "droves". The typical ACA marketplace has a choice from among 4 insurers; the states with the most limited choices are a handful of rural ones, I think the 7 you referred to.
There were never droves of major insurers in the first place. Of the top 5, there are two mergers proposed which would leave 3 big ones. As for choice, it looks from the 2017 map care of the NYT that about half the country will have 1-2 insurance companies to pick from.

http://www.nytimes.com/2016/08/20/upsho ... emain.html
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munemaker
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Re: Health Insurance rates went up

Post by munemaker »

sawhorse wrote:
dm200 wrote:Question: How does the requirement to allow adult children to remain on parent's health insurance affect various rates?

For employer plans, it seems that this would, overall, increase what employer plans cover and pay. What about individually purchased plans, either on or off the exchange?

It seems that this requirement would cause an increase in the number of insured folks in their early to mid 20's.
I think it certainly it's one contributor to higher exchange market rates and the increasing disparity between employer plans and exchange market plans. The young and presumably healthier (as a group) aren't signing up for exchange market plans and using their parents' plans instead. In addition, while someone age 25 might already have a family, the ones on their parents' plan are unlikely to, so they have low costs even for their age group.
Just a comment. I work for a medium sized company in western PA that is self insured. We only have one site and all our employees (and generally their families) live in the area. My employer's plan started getting medical bills from Florida. Turns out an employee's daughter (early twenties) got married, moved to Florida, had a baby and my employer's self insured plan was on the hook for the billing. Seemed a bit strange to us at the time; not so much now that we are getting used to the ObamaCare rules.
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White Coat Investor
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Re: Health Insurance rates went up

Post by White Coat Investor »

tampaite wrote:So, I get the healthcare enrollment information for 2017 from my employer and I notice the highlights:
  1. * Premiums will increase 3.3%
  • * Annual deductibles will increase 25%
  • * Annual Out Of Pocket(OOP) expense will increase 38%
Is there any other alternative to signing up for cheaper plan other than one through your employer?

So healthcare companies say expenses are going up and inflation is going up and yet IRS says there is insufficient inflation to increase 401K and Roth IRA contributions for 2017.

Who is correct?
Hmmm....my premiums went up 21% and my deductible went up $1250. Several other things got worse too. I guess if my increase was only 3.3% I'd count my blessings.

Healthcare inflation is not overall inflation. Healthcare and educational costs have been increasing at a much higher inflation rate for at least the last decade or two. Maybe we'll eventually decide we don't want to spend as much as we do on those two things, but that doesn't seem to have happened yet.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course
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Lieutenant.Columbo
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Re: Health Insurance rates went up

Post by Lieutenant.Columbo »

JDCarpenter wrote:
Lieutenant.Columbo wrote:
JDCarpenter wrote:
Lieutenant.Columbo wrote:...

I'd like to know first if the penalty for not having ACA insurance is lower than what I'd be paying for insurance. I'm a high earner and know penalty goes up with your income.

....
There is no penalty if you don't overwithhold.
Hmmm... How can that be?
Do you have an IRS source for that statement?
Here is the PPACA Public Law text: https://www.gpo.gov/fdsys/pkg/PLAW-111p ... ubl148.pdf Look at page 131 (124 Stat. 249), which is subpart (g) of "Maintenance of Minimum Essential Coverage," IRC Section 5000a (starting on 124 Stat. 244):
‘‘(g) ADMINISTRATION AND PROCEDURE.—
‘‘(1) IN GENERAL.—The penalty provided by this section
shall be paid upon notice and demand by the Secretary, and
except as provided in paragraph (2), shall be assessed and
collected in the same manner as an assessable penalty under
subchapter B of chapter 68.
‘‘(2) SPECIAL RULES.—Notwithstanding any other provision
of law—
‘‘(A) WAIVER OF CRIMINAL PENALTIES.—In the case of
any failure by a taxpayer to timely pay any penalty imposed
by this section, such taxpayer shall not be subject to any
criminal prosecution or penalty with respect to such failure.
‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretary
shall not—
‘‘(i) file notice of lien with respect to any property
of a taxpayer by reason of any failure to pay the
penalty imposed by this section, or
‘‘(ii) levy on any such property with respect to
such failure.’’.
Of course, you can be hit in any future year in which you overwithhold, so you need to stay on toes. IRS addresses it in informal FAQ # 29 here: https://www.irs.gov/affordable-care-act ... -provision For secondary sources/explanation, just search for ACA penalty enforcement withholding. Here is a decent overview: https://www.healthinsurance.org/faqs/if ... ncome-tax/ and another: https://ttlc.intuit.com/questions/19250 ... ca-penalty

E.T.A.--sorry for the text blob!
Thank you, JDCarpenter.
I wish I could use the not-withholding-more-than-necessary to avoid the penalty, but I doubt it'll work (for me). I receive W-2 wages monthly and quarterly Estimated Tax payments, and these are designed to go a bit over "total tax" for the year, in order to avoid underpayment penalties.
Lt. Columbo: Well, what do you know. Here I am talking with some of the smartest people in the world, and I didn't even notice!
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Re: Health Insurance rates went up

Post by catdude »

outdoorsygal wrote:
johnny wrote:Oh, no doubt about it. I pay 30% of the premium and my old employer pays 70%. I'm happy now that I stuck it out for all those years...
Just curious if it is ok to ask, but what did you do for a living?
I was a CPA and I worked for a local government in the mid-Atlantic region. I was there for 20 years, and spent the last 12 mostly working on bond issues, i.e., debt management.....
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FIREchief
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Re: Health Insurance rates went up

Post by FIREchief »

The public option will bring some sanity to all of this. Until then, well, insanity will reign.
I am not a lawyer, accountant or financial advisor. Any advice or suggestions that I may provide shall be considered for entertainment purposes only.
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zaboomafoozarg
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Re: Health Insurance rates went up

Post by zaboomafoozarg »

Health Insurance rates went up
Yep they sure did. My parents are now up to 20% of their income for the health insurance premium and another 20% for the deductible.

It's sad, but they can't wait until they're old enough to receive Medicare. They avoid doctors visits unless it's an emergency because the costs are so high.
OnTrack
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Re: Health Insurance rates went up

Post by OnTrack »

johnny wrote:
That's the point I was trying to make. My premiums (or my share of them, to be more accurate) basically are staying flat, and meanwhile I keeping hearing about premiums under ACA going up over 100% in some areas. From what I gather, those huge increases are being driven by young healthy people declining to get insurance on the individual market. Evidently that's not a problem in the group market.
At my previous employer, accepting health insurance from the employer was mandatory unless the employee was covered by other health insurance. There wasn't an option to get out of it by paying a penalty.
veena9111
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Re: Health Insurance rates went up

Post by veena9111 »

I got a letter in the mail from our insurance company showing the premiums for the same plan up about 5 times the amount I paid last year this year . I am now shopping for a new plan. The insurance companies have made out like bandits in the last few years. The deductibles are in the range of $6000,no coverage for drugs. Copays are more than $50 per visit. So basically I am paying for a catastrophic insurance. Both the pharmaceutical companies as well as the health care companies have a free rein to not pay out .At the same time the CEO,COO,CFO compensations have increased by at least 5 times. Some regulation is necessary by the government .If the government can interfere in our bodies they can certainly regulate and fine the gougers. It is not the doctors or the staff who benefit ,its the middlemen who have hijacked our healthcare industry dictating to everyone what should or shouldn't be covered while lining their own pockets along with the lobbyists.
Sorry bout the frustrations expressed here
Tanelorn
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Re: Health Insurance rates went up

Post by Tanelorn »

veena9111 wrote:I got a letter in the mail from our insurance company showing the premiums for the same plan up about 5 times the amount I paid last year this year . I am now shopping for a new plan. The insurance companies have made out like bandits in the last few years. The deductibles are in the range of $6000,no coverage for drugs. Copays are more than $50 per visit. So basically I am paying for a catastrophic insurance. Both the pharmaceutical companies as well as the health care companies have a free rein to not pay out .At the same time the CEO,COO,CFO compensations have increased by at least 5 times. Some regulation is necessary by the government .If the government can interfere in our bodies they can certainly regulate and fine the gougers. It is not the doctors or the staff who benefit ,its the middlemen who have hijacked our healthcare industry dictating to everyone what should or shouldn't be covered while lining their own pockets along with the lobbyists.
Sorry bout the frustrations expressed here
I'm sorry about your rising costs. One thing that may help is to get a "catastrophic" plan - it's a technical term and is the level below Bronze. It's restricted for who can buy it, but if the Bronze plan is more than 8%(?) of your income, you can qualify for an affordability hardship. These plans are slightly worse (higher deductibles) but cheaper also and probably a better value.

As for insurance companies, they make a lot of money elsewhere but they've nearly all been losing money hand over fist on these Obamacare markets. That's why so many are pulling out or cutting back their offerings. If they could make money, you can bet they'd be doing more of it rather than less.

http://www.bloomberg.com/news/articles/ ... sing-money

The cause of the rapidly rising prices, as far as I understand it, is the way the law was structured. Basically, the risk pool for the individual market is trying to cover lots of very sick people who couldn't get coverage before, since the law removed pre-existing condition restrictions. However, the politicians didn't include enough of the general population in the market, so the cost sharing / risk pooling of the insurance companies means that the average cost has to be quite high to pay for everyone's expenses.
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