2018 ACA costs arrived

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indexfundfan
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Re: 2018 ACA costs arrived

Post by indexfundfan » Sat Oct 14, 2017 7:23 am

BarbK wrote:
Sat Oct 14, 2017 7:13 am
For option #1: Also got some quotes on the short term policies and cheap, cheap..... <$300 per month. Of course they are quoted for just 3 months at a time.
Last night, I saw on eHealthInsurance the option to automatically extend the short term policies to a year.
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westrichj312
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Re: 2018 ACA costs arrived

Post by westrichj312 » Sat Oct 14, 2017 7:36 am

most priemiums went up last year between 20 and 100% so 2018 should look pretty good for most of you complainers with the 10 to 20% range.

DavidRoseMountain
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Re: 2018 ACA costs arrived

Post by DavidRoseMountain » Sat Oct 14, 2017 8:05 am

BarbK wrote:
Sat Oct 14, 2017 7:13 am
indexfundfan wrote:
Sat Oct 14, 2017 6:31 am
Some other options to investigate:

1) Look at short term insurance which can be purchased up to a year at the time with the new EO. These plans are non-ACA compliant, but probably there will be no tax penalty with the guidance under the new EO.
2) See if you can join some trade association's plan. Might only be available earliest from 2019.
3) Reduce your income to at least get below 400% FPL.
4) Go naked without insurance.

I plan to work on 3) once the rates in my state are finalized. The last I read, the rate hike proposed by my insurer is 57%.
I just checked and the only plan in my area that has 2018 prices is B/C B/S - Florida Blue. This is what we currently have now for insurance. Their 2018 Bronze plan price has not changed since Thursday; it is still up 18%.

For option #3: Early retirees; no subsidy so far but a possibility for 2018. Have been doing $75K Roth conversions per year and staying in the 15% tax bracket. Unless my thinking is off, these Roth conversions are worth $7.5K saved in future taxes from RMDs (assuming tax rate stays the same). $75K*15% vs $75K*25%

Checked the possible 2018 subsidy and since it is just my husband getting insurance, the subsidy was between $2K-$3K. Seems we're better off with the Roth conversions.

For option #1: Also got some quotes on the short term policies and cheap, cheap..... <$300 per month. Of course they are quoted for just 3 months at a time.
Why don't you wait til your on Medicare to start doing those Roth conversions? That way you can get your subsidies on the ACA exchange.

michaeljc70
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Re: 2018 ACA costs arrived

Post by michaeljc70 » Sat Oct 14, 2017 9:00 am

madbrain wrote:
Sat Oct 14, 2017 6:08 am
michaeljc70 wrote:
Sat Oct 14, 2017 4:26 am
rrppve wrote:
Sat Oct 14, 2017 1:26 am
Well with the elimination of the CSRs by the Feds, my unsubsidized Blue Shield Silver PPO plan in California is going up a full 50%!!!
This happened on Thursday. How can you possibly have new premiums to reflect that on Friday?
My understanding is because the cost sharing reductions payments were "up in the air" for a while (months) due to the stance of the current administration, many insurance companies pre-emptively raised their overall premiums due to the uncertainty. I believe it's too late for them to change their 2018 premiums now. Companies that didn't raise them will have to eat it up as a loss. This is definitely a case of the ACA being sabotaged.
A Federal court ruled that those CSR payments were illegal. So who sabotaged it?

http://www.latimes.com/nation/la-na-oba ... story.html

"Federal judge rules Obamacare is being funded unconstitutionally"

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Re: 2018 ACA costs arrived

Post by LadyGeek » Sat Oct 14, 2017 9:08 am

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Seasonal
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Re: 2018 ACA costs arrived

Post by Seasonal » Sat Oct 14, 2017 9:14 am

michaeljc70 wrote:
Sat Oct 14, 2017 9:00 am
A Federal court ruled that those CSR payments were illegal. So who sabotaged it?

http://www.latimes.com/nation/la-na-oba ... story.html

"Federal judge rules Obamacare is being funded unconstitutionally"
The case is on appeal and the ruling is stayed pending that appeal. Payments have been made to date, including under the current administration. The decision to stop payments was not based on any new action by the courts.

finite_difference
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Re: 2018 ACA costs arrived

Post by finite_difference » Sat Oct 14, 2017 11:02 am

Tanelorn wrote:
Fri Oct 13, 2017 12:06 pm
Valuethinker wrote:
Fri Oct 13, 2017 11:07 am
2013 $5,884* $16,351*
2014 $6,025 $16,834*
2015 $6,251* $17,545*
2016 $6,435 $18,142*
Your quoting average health insurance costs through an employer. For the 2013-2016 period, the total increase for either individual or family shown above is 10% in total (not per year). In contrast, the unsubsidized individual market has seen skyrocketing costs under Obamacare, increasing 100%+ in just 4 years.

https://news.ehealthinsurance.com/news/ ... pping-data
In 2013, the year before major Obamacare provisions came into effect, the average family’s premium was $426 per month
Between the end of 2013 and the first two months of the 2017 open enrollment period, average family premiums have increased 140%
Between 2013 and the first two months of the 2017 open enrollment period, average individual premiums have increased 99%
My understanding is that it depends on which state you’re in. If your state did not expand Medicaid, then you lose access to federal funding which brings the prices significantly.

Before I ACA I was paying $6k+ per year as a healthy young person each year for private coverage. My insurance rate went up 25% year over year. Before/after ACA I was working so can’t compare the effect there — but seems to be negligible for my state.

There was an executive order signed on Thursday which could destabilize the entire market. Or not. We’ll see I guess.
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Re: 2018 ACA costs arrived

Post by mac808 » Sat Oct 14, 2017 11:25 am

Bigbonds wrote:
Sat Oct 14, 2017 7:18 am
It's not going to have an affect on people who receive subsidies. You are limited in the amount they can charge you, say 10% of your income for example. The people who are going to feel the pain on this one are the ones who don't receive subsidies and therefore are not limited to a percentage of their income in how much they can be charged. If this doesn't encourage people to pay off their houses and become minimalist I don't know what will.
I find the incentives the law creates interesting: encouraging eliminating debt (including mortgage) and reducing expenses (minimalism) as you mentioned, discouraging the exchange of time and energy for money. I did some back of the envelope math and a family of 4 reporting income of $60k/year is capped at spending around $3,600/year (6%) on health insurance premiums. Subsidies take care of the rest. Imagine a couple in their late 40s or early 50s who had kids in their mid 30s, retired early, and have a paid off $1m home, $1m in IRAs, and $3m in VTI in a brokerage account yielding $60k/year. They would be paying ~ $3,600 a year for health insurance premiums. Same couple making $100k/year no longer qualifies for subsidies and would be on the open market paying something closer to $15k - $20k (depending on their state, of course). Is this an effective 15-20% "tax" (phase out of subsidies) on that extra $40k in income?

SpaceCowboy
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Re: 2018 ACA costs arrived

Post by SpaceCowboy » Sat Oct 14, 2017 12:07 pm

To answer some questions.
California had insurers file rates with and without CSRs. Since they were unsettled at the beginning of the month, CA used non CSR rates. This resulted in a surcharge being applied to all Silver plans being sold on exchange.
Association plans likely won't be available for a year or more.
Short term plans don't cover pre-existing conditions frequently and importantly usually have caps removing their value for covering major medical.
Bronze plans are not cheap. The bronze PPO is a little more than last year's Silver. Give me a true major medical plan with a $25k-$100k deductible for $5k and I'll buy it.
What I'm looking at strongly is to find a way to get covered under a friend's employer plan or adding a nominal employee to my business who is in a similar situation. Not sure what has happened to rates on small business market.
ACA was one of the things that allowed me to pull the trigger on semi-retirement.

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Re: 2018 ACA costs arrived

Post by hicabob » Sat Oct 14, 2017 12:12 pm

rrppve wrote:
Sat Oct 14, 2017 12:07 pm
Give me a true major medical plan with a $25k-$100k deductible for $5k and I'll buy it.


That would be my ideal too! Pay for routine care out of pocket and if my deboxilator goes on the fritz requiring expensive care the insurance kicks in.

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dm200
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Re: 2018 ACA costs arrived

Post by dm200 » Sat Oct 14, 2017 12:15 pm

hicabob wrote:
Sat Oct 14, 2017 12:12 pm
rrppve wrote:
Sat Oct 14, 2017 12:07 pm
Give me a true major medical plan with a $25k-$100k deductible for $5k and I'll buy it.
That would be my ideal too! Pay for routine care out of pocket and if my deboxilator goes on the fritz requiring expensive care the insurance kicks in.
Of course, I assume that such a plan for the amounts paid directly up to the annual deductible would need to be charged/billed at the insurance company's negotiated rates and not the "list price" commonly used by providers.

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munemaker
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Re: 2018 ACA costs arrived

Post by munemaker » Sat Oct 14, 2017 6:59 pm

DavidRoseMountain wrote:
Sat Oct 14, 2017 8:05 am

Why don't you wait til your on Medicare to start doing those Roth conversions? That way you can get your subsidies on the ACA exchange.
That is exactly what I am doing... To qualify for the ObamaCare subsidies, I am planning Roth conversions starting at age 66, and limiting Roth conversions to an AGI of $170,000 to avoid the IRMAA.

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Re: 2018 ACA costs arrived

Post by michaeljc70 » Sat Oct 14, 2017 7:18 pm

indexfundfan wrote:
Sat Oct 14, 2017 7:23 am
BarbK wrote:
Sat Oct 14, 2017 7:13 am
For option #1: Also got some quotes on the short term policies and cheap, cheap..... <$300 per month. Of course they are quoted for just 3 months at a time.
Last night, I saw on eHealthInsurance the option to automatically extend the short term policies to a year.
I looked on eHealthinsurace.com for short-term policies. It said there were none available. Only "GAP" policies. These had ridiculously low payouts. Like a max of $7k. Which you could exceed with a broken limb. I am in a big city. Not sure why none were showing.

BarbK
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Re: 2018 ACA costs arrived

Post by BarbK » Sat Oct 14, 2017 7:36 pm

michaeljc70 wrote:
Sat Oct 14, 2017 7:18 pm
indexfundfan wrote:
Sat Oct 14, 2017 7:23 am
BarbK wrote:
Sat Oct 14, 2017 7:13 am
For option #1: Also got some quotes on the short term policies and cheap, cheap..... <$300 per month. Of course they are quoted for just 3 months at a time.
Last night, I saw on eHealthInsurance the option to automatically extend the short term policies to a year.
I looked on eHealthinsurace.com for short-term policies. It said there were none available. Only "GAP" policies. These had ridiculously low payouts. Like a max of $7k. Which you could exceed with a broken limb. I am in a big city. Not sure why none were showing.
A quote: was 1M Policy Max,5K deduct, 7K Max OOP, Coinsurance 20%, Monthly Cost $294.29 for 61 YO Male

I didn't see where you could over ride the 3 month limit.

michaeljc70
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Re: 2018 ACA costs arrived

Post by michaeljc70 » Sat Oct 14, 2017 7:39 pm

BarbK wrote:
Sat Oct 14, 2017 7:36 pm
michaeljc70 wrote:
Sat Oct 14, 2017 7:18 pm
indexfundfan wrote:
Sat Oct 14, 2017 7:23 am
BarbK wrote:
Sat Oct 14, 2017 7:13 am
For option #1: Also got some quotes on the short term policies and cheap, cheap..... <$300 per month. Of course they are quoted for just 3 months at a time.
Last night, I saw on eHealthInsurance the option to automatically extend the short term policies to a year.
I looked on eHealthinsurace.com for short-term policies. It said there were none available. Only "GAP" policies. These had ridiculously low payouts. Like a max of $7k. Which you could exceed with a broken limb. I am in a big city. Not sure why none were showing.
A quote: was 1M Policy Max,5K deduct, 7K Max OOP, Coinsurance 20%, Monthly Cost $294.29 for 61 YO Male

I didn't see where you could over ride the 3 month limit.
I get this message:

"Sorry, we have no short-term health plans for your area.
A GAP plan may be a suitable alternative for you, so we are showing you these plans instead."

I live in the 3rd biggest city in the country. What dates did you use? Maybe that is the issue? I used 11/1-1/31.

EDIT: When I use 1/1/2018 as the start date, I see options.

EDIT2: None of the 4 plans cover any kind of prescriptions. That is a deal breaker. I take none regularly, but if something serious happens that could bankrupt you.

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Re: 2018 ACA costs arrived

Post by ERISA Stone » Sat Oct 14, 2017 7:45 pm

michaeljc70 wrote:
Sat Oct 14, 2017 4:26 am
rrppve wrote:
Sat Oct 14, 2017 1:26 am
Well with the elimination of the CSRs by the Feds, my unsubsidized Blue Shield Silver PPO plan in California is going up a full 50%!!!
This happened on Thursday. How can you possibly have new premiums to reflect that on Friday?
I haven't gotten a quote from my insurance company for 2018, but this article indicates that BCBSGA and KP are increasing rates approximately 57% based on the assumption that the subsidies won't be paid by the federal govt. http://www.georgiahealthnews.com/2017/0 ... nges-feds/

I'll admit that I don't know exactly how insurance calculations work but it would seem to me that subsidies not being paid affects everyone, not just the people eligible, as that is revenue the insurance companies won't be able to collect.

michaeljc70
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Re: 2018 ACA costs arrived

Post by michaeljc70 » Sat Oct 14, 2017 7:50 pm

ERISA Stone wrote:
Sat Oct 14, 2017 7:45 pm
michaeljc70 wrote:
Sat Oct 14, 2017 4:26 am
rrppve wrote:
Sat Oct 14, 2017 1:26 am
Well with the elimination of the CSRs by the Feds, my unsubsidized Blue Shield Silver PPO plan in California is going up a full 50%!!!
This happened on Thursday. How can you possibly have new premiums to reflect that on Friday?
I haven't gotten a quote from my insurance company for 2018, but this article indicates that BCBSGA and KP are increasing rates approximately 57% based on the assumption that the subsidies won't be paid by the federal govt. http://www.georgiahealthnews.com/2017/0 ... nges-feds/

I'll admit that I don't know exactly how insurance calculations work but it would seem to me that subsidies not being paid affects everyone, not just the people eligible, as that is revenue the insurance companies won't be able to collect.
These CSRs only cover Silver plans. But that doesn't mean the insurance companies cannot spread that cost across all plans.

Mine went up 40% last year, so I am not optimistic for 2018. I read in the newspaper they are expecting a 5%-43% increase in my state. Which tells you little since the range is so big. In the past, I've scoured the exchange looking at every option, only to be bewildered. The cheap plans have terrible networks here. That is something I don't read a lot about. To keep my doctor for 2017, I would have had to pay almost $100 more per month. Since I rarely go to the doctor, I didn't do it.

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Re: 2018 ACA costs arrived

Post by indexfundfan » Sat Oct 14, 2017 7:57 pm

BarbK wrote:
Sat Oct 14, 2017 7:36 pm
michaeljc70 wrote:
Sat Oct 14, 2017 7:18 pm
indexfundfan wrote:
Sat Oct 14, 2017 7:23 am
BarbK wrote:
Sat Oct 14, 2017 7:13 am
For option #1: Also got some quotes on the short term policies and cheap, cheap..... <$300 per month. Of course they are quoted for just 3 months at a time.
Last night, I saw on eHealthInsurance the option to automatically extend the short term policies to a year.
I looked on eHealthinsurace.com for short-term policies. It said there were none available. Only "GAP" policies. These had ridiculously low payouts. Like a max of $7k. Which you could exceed with a broken limb. I am in a big city. Not sure why none were showing.
A quote: was 1M Policy Max,5K deduct, 7K Max OOP, Coinsurance 20%, Monthly Cost $294.29 for 61 YO Male

I didn't see where you could over ride the 3 month limit.
I just went back to eHealthInsurance. If you want more than 3 months, what they do is to "Apply for multiple policy terms to conveniently lock in your rate with one application process and get covered longer than 90 days." So I stand corrected. In effect, it is still 3 months at a time.

See screenshot:

Image
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ERISA Stone
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Re: 2018 ACA costs arrived

Post by ERISA Stone » Sat Oct 14, 2017 7:59 pm

michaeljc70 wrote:
Sat Oct 14, 2017 7:50 pm
ERISA Stone wrote:
Sat Oct 14, 2017 7:45 pm
michaeljc70 wrote:
Sat Oct 14, 2017 4:26 am
rrppve wrote:
Sat Oct 14, 2017 1:26 am
Well with the elimination of the CSRs by the Feds, my unsubsidized Blue Shield Silver PPO plan in California is going up a full 50%!!!
This happened on Thursday. How can you possibly have new premiums to reflect that on Friday?
I haven't gotten a quote from my insurance company for 2018, but this article indicates that BCBSGA and KP are increasing rates approximately 57% based on the assumption that the subsidies won't be paid by the federal govt. http://www.georgiahealthnews.com/2017/0 ... nges-feds/

I'll admit that I don't know exactly how insurance calculations work but it would seem to me that subsidies not being paid affects everyone, not just the people eligible, as that is revenue the insurance companies won't be able to collect.
These CSRs only cover Silver plans. But that doesn't mean the insurance companies cannot spread that cost across all plans.

Mine went up 40% last year, so I am not optimistic for 2018. I read in the newspaper they are expecting a 5%-43% increase in my state. Which tells you little since the range is so big. In the past, I've scoured the exchange looking at every option, only to be bewildered. The cheap plans have terrible networks here. That is something I don't read a lot about. To keep my doctor for 2017, I would have had to pay almost $100 more per month. Since I rarely go to the doctor, I didn't do it.
I mentioned in another thread - but I am looking at offering health insurance to my employees effective 11/1. The rates for 11/1 are all at least $300 more than what I pay on the marketplace. To be fair, the deductibles and OOP maxes are slightly lower, but I've always been under the impression that employer plans have lower premiums.

Based on some stories I read like yours, I was lucky in 2017. Mine only went up 20%. If it goes up another 50%, this will likely be the first year I have to seriously start looking at cutting expenses in other areas. I guess it's been a while since I've had to do that so it's a little depressing. I know others have it worse though.

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dm200
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Re: 2018 ACA costs arrived

Post by dm200 » Sun Oct 15, 2017 6:42 am

The rates for 11/1 are all at least $300 more than what I pay on the marketplace. To be fair, the deductibles and OOP maxes are slightly lower, but I've always been under the impression that employer plans have lower premiums.
Are yours and the employer plan from same insurer?

The renewal options may be different as well.

Did you get several bids/options for the employer plan?

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magellan
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Re: 2018 ACA costs arrived

Post by magellan » Sun Oct 15, 2017 7:10 am

Here's a map showing how regulators in each state instructed insurers to handle the costs of unreimbursed CSR subsidies:
https://www.balloon-juice.com/2017/10/1 ... t-be-paid/

Most state regulators are telling insurers to recover the costs by increasing silver plan premiums only. One odd side effect is that people in these states who earn between 250% and 400% of the poverty level may see a 20% increase in the size of their premium tax credit that they can use to buy a non-silver plan that won't be subject to a premium increase. It's basically a 20% windfall to them.

The reason is that premium tax credits for everyone are tied to the cost of the second cheapest silver plan. Since silver plan premiums are increasing across the board to cover the unreimbursed subsidies in most states, the size of the premium tax credit will increase by roughly 20% for everyone eligible in those states.

To get cost-sharing-reductions, you have to buy a silver plan, but premium tax credits are available to everyone eligible regardless of which metal level plan they buy. Hence the windfall.

People who don't get subsidies can avoid the increases by buying a non-silver plan, or in some states, even an off exchange silver plan.

So in most states, the net result of Trump's action is that the CSR's still get paid, but in the form of increased premium tax credits, plus the feds generously increase everyone else's subsidies by 20% as long as they don't buy a silver plan.

The added windfall of extra subsidies for folks earning between 250% and 400% of FPL is why the CBO projects a several billion dollar increase in the deficit.

Tanelorn
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Re: 2018 ACA costs arrived

Post by Tanelorn » Sun Oct 15, 2017 7:22 am

michaeljc70 wrote:
Sat Oct 14, 2017 7:18 pm
I looked on eHealthinsurace.com for short-term policies. It said there were none available. Only "GAP" policies. These had ridiculously low payouts. Like a max of $7k. Which you could exceed with a broken limb. I am in a big city. Not sure why none were showing.
Some states have banned the sale of short term insurance so you don't have an alternative to their ACA plans. I see no short term insurance and no GAP plans. I was not able to find a good list of states however.

Hopefully the new guidance will re-allow 12 month instead of only 3 month short term plans. If they all cross state issuance, perhaps this will offer people like us this option.

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magellan
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Re: 2018 ACA costs arrived

Post by magellan » Sun Oct 15, 2017 7:53 am

michaeljc70 wrote:
Sat Oct 14, 2017 9:00 am
A Federal court ruled that those CSR payments were illegal. So who sabotaged it?

http://www.latimes.com/nation/la-na-oba ... story.html

"Federal judge rules Obamacare is being funded unconstitutionally"
The reimbursement issue is much more complicated than that. There is almost no doubt in anyone's mind that these payments are an obligation of the US government. The law seems to be 100% clear on that. The issue is that congress refused to allocate the funds to pay this obligation.

The legal case is sort of like if you refused to write a check to pay your mortgage and your friend, thinking you were being unwise, wrote the check for you and signed your name. If you sued over the illegal check, a court would likely force your bank to return the money to your checking account, but that wouldn't remove your obligation to the mortgage company.

I have yet to read any analysis from any legal expert who doesn't believe these reimbursements will ultimately get paid.

This article has a pretty good explanation of how it's likely to play out.
http://nymag.com/daily/intelligencer/20 ... forts.html
... last year, U.S. District Court Judge Rosemary Collyer ruled in agreement, declaring the payments illegal but keeping them flowing pending an Obama administration appeal. In August, with the administration out of power, the U.S. Court of Appeals for the District of Columbia Circuit ruled that Democratic attorneys general could instead defend the subsidies in court. New York attorney general Eric Schneiderman has indicated that he will continue to pursue that litigation, but that Friday’s filing, seeking the injunction, will take precedence. Given that Collyer’s punitive ruling came as a surprise to many legal observers, it’s likely that other judges will disagree with her interpretation of the law.

Insurers could also sue the government to get their money, a legal route that appears to carry a high chance of success. As Slate’s Mark Joseph Stern explains, the government maintains a permanent appropriation called the Judgment Fund, which covers miscellaneous payments that have not been issued. When insurers have previously taken Republicans to the Court of Federal Claims over a different section of the Affordable Care Act — this one involving “risk corridor” payments — they’ve won repeatedly, receiving their money through the Judgment Fund.

Stern cites University of Michigan law professor Nicolas Bagley, who has written that, in the event of an insurance-company lawsuit over CSRs, “The question is thus not whether the government will pay, but when.”

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magellan
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Re: 2018 ACA costs arrived

Post by magellan » Sun Oct 15, 2017 10:30 am

indexfundfan wrote:
Sat Oct 14, 2017 6:31 am
1) Look at short term insurance which can be purchased up to a year at the time with the new EO. These plans are non-ACA compliant, but probably there will be no tax penalty with the guidance under the new EO.
I'd be careful assuming they'll be no tax penalty. The tax penalty provision is part of the law and can't be waived by the executive branch. The executive branch can temporarily tell the IRS to suspend enforcement of the penalty, but I don't think they can eliminate the tax obligation. Also, the IRS currently tracks cumulative penalties owed for each taxpayer and will withhold all future tax refunds until the penalty is cleared.

The second issue to be aware of with short term policies is that you have to really read the fine print carefully, especially in states with lax insurance regs. These plans are excluded from the ACA protections on insurance company trickery that was so common before the ACA.

Here are 3 common tricks, often spelled out only in the plan's fine print, that insurers use on these policies to trip people up:
1) Deny claims if anything was incorrect or omitted on the application, even if the error is not intentional or material.
2) Limit max payout per year, or exclude certain types of coverage (eg hospital, outpatient, drugs)
3) Exclude coverage of some outpatient procedures or some prescription drugs.

The last one is particularly pernicious because you have to basically be a medical expert and read the policy's fine print and drug formulary to learn what's covered. Some plans cover some prescription drugs, but exclude all or most chemotherapy drugs. This can leave a 6 figure hole in your coverage even if everything else checks out.

michaeljc70
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Re: 2018 ACA costs arrived

Post by michaeljc70 » Sun Oct 15, 2017 10:48 am

magellan wrote:
Sun Oct 15, 2017 10:30 am
indexfundfan wrote:
Sat Oct 14, 2017 6:31 am
1) Look at short term insurance which can be purchased up to a year at the time with the new EO. These plans are non-ACA compliant, but probably there will be no tax penalty with the guidance under the new EO.
I'd be careful assuming they'll be no tax penalty. The tax penalty provision is part of the law and can't be waived by the executive branch. The executive branch can temporarily tell the IRS to suspend enforcement of the penalty, but I don't think they can eliminate the tax obligation. Also, the IRS currently tracks cumulative penalties owed for each taxpayer and will withhold all future tax refunds until the penalty is cleared.

The second issue to be aware of with short term policies is that you have to really read the fine print carefully, especially in states with lax insurance regs. These plans are excluded from the ACA protections on insurance company trickery that was so common before the ACA.

Here are 3 common tricks, often spelled out only in the plan's fine print, that insurers use on these policies to trip people up:
1) Deny claims if anything was incorrect or omitted on the application, even if the error is not intentional or material.
2) Limit max payout per year, or exclude certain types of coverage (eg hospital, outpatient, drugs)
3) Exclude coverage of some outpatient procedures or some prescription drugs.

The last one is particularly pernicious because you have to basically be a medical expert and read the policy's fine print and drug formulary to learn what's covered. Some plans cover some prescription drugs, but exclude all or most chemotherapy drugs. This can leave a 6 figure hole in your coverage even if everything else checks out.
As I understand it, you no longer have to specify on your tax return if you have insurance. The IRS will accept your return without it so there is no way they can figure out if you owe a penalty or not. I suppose, in the future they could come back and ask you if things change, but that seems pretty unlikely.

BarbK
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Re: 2018 ACA costs arrived

Post by BarbK » Sun Oct 15, 2017 12:53 pm

michaeljc70 wrote:
Sat Oct 14, 2017 7:39 pm

I looked on eHealthinsurace.com for short-term policies. It said there were none available. Only "GAP" policies. These had ridiculously low payouts. Like a max of $7k. Which you could exceed with a broken limb. I am in a big city. Not sure why none were showing.

I get this message:

"Sorry, we have no short-term health plans for your area.
A GAP plan may be a suitable alternative for you, so we are showing you these plans instead."

I live in the 3rd biggest city in the country. What dates did you use? Maybe that is the issue? I used 11/1-1/31.

EDIT: When I use 1/1/2018 as the start date, I see options.

EDIT2: None of the 4 plans cover any kind of prescriptions. That is a deal breaker. I take none regularly, but if something serious happens that could bankrupt you.
I put in a start date of 1/1/2018 and pay monthly. When I put in pay all at once, I got a message similar to yours for GAP plans.
Providers such as United Health Care will not quote more than 60 days in the future, so didn't see their rates.

I experimented with starting earlier, and got the message about extending the 3 month plans for 360 days.

Today went on United Health Care.com and of course only 3 months and starting in 2017, but rates for a 2M policy for 61 YO male was $255 per month, 10K deductible, 10K OOP. On UNH ST policies, the Deductible is not the MAX OOP. Single Payment for 3 months was $619.

Experimented with 5K Max OOP, with 70/30 and premium was $284, Single payment for 3 months was $653.

Lowering the deductible to 5K, 5K Max OOP, and 70/30, premium was $350. Single payment for the 3 months was $805; (about $10 more than one month of Bronze unsubsidized plan).

Lowering the deductible to 1K made the policy comparable to 2015 ACA Bronze plan rates.

On UNH does not look like prescription drugs are covered.

I wouldn't think it would take long for the short term policies to get extended for longer terms once they are permitted to do so.

michaeljc70
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Re: 2018 ACA costs arrived

Post by michaeljc70 » Sun Oct 15, 2017 2:11 pm

BarbK wrote:
Sun Oct 15, 2017 12:53 pm
michaeljc70 wrote:
Sat Oct 14, 2017 7:39 pm

I looked on eHealthinsurace.com for short-term policies. It said there were none available. Only "GAP" policies. These had ridiculously low payouts. Like a max of $7k. Which you could exceed with a broken limb. I am in a big city. Not sure why none were showing.

I get this message:

"Sorry, we have no short-term health plans for your area.
A GAP plan may be a suitable alternative for you, so we are showing you these plans instead."

I live in the 3rd biggest city in the country. What dates did you use? Maybe that is the issue? I used 11/1-1/31.

EDIT: When I use 1/1/2018 as the start date, I see options.

EDIT2: None of the 4 plans cover any kind of prescriptions. That is a deal breaker. I take none regularly, but if something serious happens that could bankrupt you.
I put in a start date of 1/1/2018 and pay monthly. When I put in pay all at once, I got a message similar to yours for GAP plans.
Providers such as United Health Care will not quote more than 60 days in the future, so didn't see their rates.

I experimented with starting earlier, and got the message about extending the 3 month plans for 360 days.

Today went on United Health Care.com and of course only 3 months and starting in 2017, but rates for a 2M policy for 61 YO male was $255 per month, 10K deductible, 10K OOP. On UNH ST policies, the Deductible is not the MAX OOP. Single Payment for 3 months was $619.

Experimented with 5K Max OOP, with 70/30 and premium was $284, Single payment for 3 months was $653.

Lowering the deductible to 5K, 5K Max OOP, and 70/30, premium was $350. Single payment for the 3 months was $805; (about $10 more than one month of Bronze unsubsidized plan).

Lowering the deductible to 1K made the policy comparable to 2015 ACA Bronze plan rates.

On UNH does not look like prescription drugs are covered.

I wouldn't think it would take long for the short term policies to get extended for longer terms once they are permitted to do so.
Isn't not having drug coverage a major risk? Does that include drugs if you are hospitalized or not? I can imagine several (unlikely) scenarios where not having drug coverage could cost tens of thousands of dollars.

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magellan
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Re: 2018 ACA costs arrived

Post by magellan » Sun Oct 15, 2017 3:26 pm

michaeljc70 wrote:
Sun Oct 15, 2017 10:48 am
As I understand it, you no longer have to specify on your tax return if you have insurance. The IRS will accept your return without it so there is no way they can figure out if you owe a penalty or not.
Maybe I'm paranoid, but as I understand it, willfully misrepresenting the refund you're entitled to get is a felony and I personally wouldn't want that hanging over my head.

We're living in unusual times right now and the current administration may be willing to look the other way, however, if the IRS can somehow prove you left that box unchecked so you could claim a refund you weren't entitled to get, you could find yourself in a lot of trouble.

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indexfundfan
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Re: 2018 ACA costs arrived

Post by indexfundfan » Sun Oct 15, 2017 3:56 pm

magellan wrote:
Sun Oct 15, 2017 3:26 pm
michaeljc70 wrote:
Sun Oct 15, 2017 10:48 am
As I understand it, you no longer have to specify on your tax return if you have insurance. The IRS will accept your return without it so there is no way they can figure out if you owe a penalty or not.
Maybe I'm paranoid, but as I understand it, willfully misrepresenting the refund you're entitled to get is a felony and I personally wouldn't want that hanging over my head.

We're living in unusual times right now and the current administration may be willing to look the other way, however, if the IRS can somehow prove you left that box unchecked so you could claim a refund you weren't entitled to get, you could find yourself in a lot of trouble.
This article discusses paying the individual mandate penalty: https://www.healthinsurance.org/faqs/iv ... this-true/

Here's the text in the ACA :

(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.

https://www.law.cornell.edu/uscode/text/26/5000A
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mac808
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Re: 2018 ACA costs arrived

Post by mac808 » Sun Oct 15, 2017 4:08 pm

My understanding is that for about $500/person/year you can sign up for one of the medi-share companies which totally exempts you from any ACA penalties. It might be worth $500 to certain people to have that peace of mind that they did it totally by the book.

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magellan
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Re: 2018 ACA costs arrived

Post by magellan » Sun Oct 15, 2017 4:24 pm

indexfundfan wrote:
Sun Oct 15, 2017 3:56 pm
This article discusses paying the individual mandate penalty: https://www.healthinsurance.org/faqs/iv ... this-true/
Thanks for the extra info. You got me to do some googling and surprisingly, the IRS's current position is that they will not process returns in 2018 if that information isn't provided.

Also, it looks like people who didn't supply that information on their 2016 tax returns will receive a letter from the IRS asking them to provide that information.

Here's a link:
https://www.irs.gov/tax-professionals/a ... fessionals
For the upcoming 2018 filing season, the IRS‎ will not accept electronically filed tax returns where the taxpayer does not address the health coverage requirements of the Affordable Care Act.‎ The IRS will not accept the electronic tax return until the taxpayer indicates whether they had coverage, had an exemption or will make a shared responsibility payment. In addition, returns filed on paper that do not address the health coverage requirements may be suspended pending the receipt of additional information and any refunds may be delayed.

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indexfundfan
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Re: 2018 ACA costs arrived

Post by indexfundfan » Sun Oct 15, 2017 4:29 pm

magellan wrote:
Sun Oct 15, 2017 4:24 pm
indexfundfan wrote:
Sun Oct 15, 2017 3:56 pm
This article discusses paying the individual mandate penalty: https://www.healthinsurance.org/faqs/iv ... this-true/
Thanks for the extra info. You got me to do some googling and surprisingly, the IRS's current position is that they will not process returns in 2018 if that information isn't provided.

Also, it looks like people who didn't supply that information on their 2016 tax returns will receive a letter from the IRS asking them to provide that information.

Here's a link:
https://www.irs.gov/tax-professionals/a ... fessionals
For the upcoming 2018 filing season, the IRS‎ will not accept electronically filed tax returns where the taxpayer does not address the health coverage requirements of the Affordable Care Act.‎ The IRS will not accept the electronic tax return until the taxpayer indicates whether they had coverage, had an exemption or will make a shared responsibility payment. In addition, returns filed on paper that do not address the health coverage requirements may be suspended pending the receipt of additional information and any refunds may be delayed.
That is surprising. And I am also confused by this statement

The 2018 filing season will be the first time the IRS will not accept tax returns that omit this information.

I thought this was the requirement for all these past years?
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DavidRoseMountain
Posts: 121
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Re: 2018 ACA costs arrived

Post by DavidRoseMountain » Mon Oct 16, 2017 6:42 am

magellan wrote:
Sun Oct 15, 2017 7:10 am
Here's a map showing how regulators in each state instructed insurers to handle the costs of unreimbursed CSR subsidies:
https://www.balloon-juice.com/2017/10/1 ... t-be-paid/

Most state regulators are telling insurers to recover the costs by increasing silver plan premiums only. One odd side effect is that people in these states who earn between 250% and 400% of the poverty level may see a 20% increase in the size of their premium tax credit that they can use to buy a non-silver plan that won't be subject to a premium increase. It's basically a 20% windfall to them.

The reason is that premium tax credits for everyone are tied to the cost of the second cheapest silver plan. Since silver plan premiums are increasing across the board to cover the unreimbursed subsidies in most states, the size of the premium tax credit will increase by roughly 20% for everyone eligible in those states.

To get cost-sharing-reductions, you have to buy a silver plan, but premium tax credits are available to everyone eligible regardless of which metal level plan they buy. Hence the windfall.

People who don't get subsidies can avoid the increases by buying a non-silver plan, or in some states, even an off exchange silver plan.

So in most states, the net result of Trump's action is that the CSR's still get paid, but in the form of increased premium tax credits, plus the feds generously increase everyone else's subsidies by 20% as long as they don't buy a silver plan.

The added windfall of extra subsidies for folks earning between 250% and 400% of FPL is why the CBO projects a several billion dollar increase in the deficit.
Wow that would be exactly my situation.

rkhusky
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Re: 2018 ACA costs arrived

Post by rkhusky » Mon Oct 16, 2017 7:08 am

indexfundfan wrote:
Sun Oct 15, 2017 4:29 pm
That is surprising. And I am also confused by this statement

The 2018 filing season will be the first time the IRS will not accept tax returns that omit this information.

I thought this was the requirement for all these past years?
I forgot to check the box 2 years ago and never heard anything from the IRS about it. I plan to owe money every year, just so ID theft or any mistake I make does not delay a refund.

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LadyGeek
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Re: 2018 ACA costs arrived

Post by LadyGeek » Mon Oct 16, 2017 3:29 pm

I removed several posts and replies which speculated on future cost sharing reduction (CSR) subsides, which require a change in US law (proposed legislation).

As noted in Re: Tax exempt muni bond funds & proposed lower rates on taxable investment interest, discussions about proposed legislation (what will happen to implement the changes) is off-topic to "keep investors from making bad decisions. Proposed regulations change many times between the time they're introduced and signed into law."

Health care is no exception. Acting now because of what "might" happen can be worse than doing nothing at all. Let's wait until things settle out and have clear intent (formal changes to law / regulations).

Based on past experience, discussions without clear direction will soon devolve into contentious disagreements. Please stay on-topic.
Wiki To some, the glass is half full. To others, the glass is half empty. To an engineer, it's twice the size it needs to be.

SpaceCowboy
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Re: 2018 ACA costs arrived

Post by SpaceCowboy » Tue Oct 17, 2017 1:01 pm

Well got some "good news" if I buy my California Silver PPO plan off exchange it is "only" up 30% versus buying it on exchange where it would be up 50% due to the CSR decision.
Certainly some of the increase is due to aging as we're in our 50s where rates increase rapidly, but it's still pretty high. Glad to save >$5k off the first shocking quote.

DavidRoseMountain
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Re: 2018 ACA costs arrived

Post by DavidRoseMountain » Tue Oct 17, 2017 1:21 pm

I'm seeing a preview here in Michigan for my Blue Care Network Blue Cross® Select HMO Bronze Saver HSA, and it looks like the price is going up by a 1/3. I'll see what happens when premium tax credits are taken into account.

Da5id
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Re: 2018 ACA costs arrived

Post by Da5id » Thu Oct 19, 2017 12:35 pm

538 blog has an interesting list of how each state is handling it:

https://fivethirtyeight.com/features/a- ... ing-about/

2015
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Re: 2018 ACA costs arrived

Post by 2015 » Thu Oct 19, 2017 8:02 pm

Bigbonds wrote:
Sat Oct 14, 2017 7:18 am
munemaker wrote:
Fri Oct 13, 2017 10:19 pm
DavidRoseMountain wrote:
Thu Oct 12, 2017 9:51 pm
Cost sharing reductions for low income (between 125% - 250% of federal poverty limit) was supposed to be provided by the federal government to the insurance companies.
Depends on who you listen to. The judicial branch has ruled that reimbursement of these cost sharing reductions was not part of the ObamaCare legislation. This was apparently just made up by the executive branch to make the system work smoother.

I am on ObamaCare and will be under the 250% number for 2018, so believe me, I wish it was so.
It's not going to have an affect on people who receive subsidies. You are limited in the amount they can charge you, say 10% of your income for example. The people who are going to feel the pain on this one are the ones who don't receive subsidies and therefore are not limited to a percentage of their income in how much they can be charged. If this doesn't encourage people to pay off their houses and become minimalist I don't know what will.
Why would one have to become minimalist? As my income next year is sourced from taxable, I am in the 15% tax bracket, and LTCG's are taxed at 0%, I will have to do Roth conversions to keep out of Medi-Cal. Because I'll be eligible for subsidies in a Silver HMO plan, my costs will be the same as I estimated them to be earlier this year and when deciding to leave COBRA for an ACA plan. I'm happy.
The majority of states are planning to ask insurers to apply all of the additional cost from the lost reimbursements to silver plans. But some loaded them only on the silver plans sold in the ACA marketplace — those eligible for subsidies — and some are spreading it across all of the silver plans, both on and off the ACA market. In either case, these approaches keep the cost of other plans at the prices set before Trump’s announcement.

People who receive subsidies won’t pay anything extra: Because they pay only a percentage of their income toward the cost of their insurance, their contribution won’t really go up even when prices increase (the federal government makes up the difference through the subsidies it provides).

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