Obamacare premiums will be down an average of 1.5 percent next year

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dm200
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Obamacare premiums will be down an average of 1.5 percent next year

Post by dm200 » Thu Oct 11, 2018 3:26 pm

"Much of the drop is due to companies raising premiums too much in 2018, experts say, "

https://www.nbcnews.com/politics/politi ... d_nn_fb_ma

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Hayden
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by Hayden » Thu Oct 11, 2018 3:29 pm

With big variability.... mine are going up substantially

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bottlecap
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by bottlecap » Thu Oct 11, 2018 4:04 pm

A welcome relief from the 400% increase since it's enactment, no doubt.

JT

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dm200
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by dm200 » Thu Oct 11, 2018 5:07 pm

it is important to separate overall premium changes with increases due to being a year older. In most states, under Obamacare, there are age brackets where premiums increase as you get older. So, in most states, if overall premiums remained the same, a certain number of folks will have increases in their premiums.

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dm200
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by dm200 » Thu Oct 11, 2018 5:27 pm

This (as best I understand) is the federal rate factor table - used by most states.

Did not format perfectly - but you get the idea. So, for example a 64 year old would pay 3 times the premium as a 21 year old. For the 21 year old, then, his/her premium would go up every year - even if the ACA premiums did not go up overall. In fact, overall premiums could go down and an individual could pay more.

Code: Select all

Age Premium
ratio* Age Premium
ratio Age Premium
ratio
0–20 0.635 35 1.222 50 1.786
21 1.000 36 1.230 51 1.865
22 1.000 37 1.238 52 1.952
23 1.000 38 1.246 53 2.040
24 1.000 39 1.262 54 2.135
25 1.004 40 1.278 55 2.230
26 1.024 41 1.302 56 2.333
27 1.048 42 1.325 57 2.437
28 1.087 43 1.357 58 2.548
29 1.119 44 1.397 59 2.603
30 1.135 45 1.444 60 2.714
31 1.159 46 1.500 61 2.810
32 1.183 47 1.563 62 2.873
33 1.198 48 1.635 63 2.952
34 1.214 49 1.706 64
and
older
3.000

Tanelorn
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by Tanelorn » Thu Oct 11, 2018 6:14 pm

This guy has been tracking all the ACA rates basically as his part time job for years and he's got a 3-4% premium increase with the current laws as they stand.

http://acasignups.net/rate-hikes/2019

My rates are up much more, of course.

2015
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by 2015 » Thu Oct 11, 2018 8:43 pm

Hayden wrote:
Thu Oct 11, 2018 3:29 pm
With big variability.... mine are going up substantially
Yup. Mine decreased but only because I shopped and went with a new insurer, otherwise they would have been higher.

vmsx
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by vmsx » Thu Oct 11, 2018 9:07 pm

bottlecap wrote:
Thu Oct 11, 2018 4:04 pm
A welcome relief from the 400% increase since it's enactment, no doubt.

JT
In states that used to allow pre-existing condition denials, to keep the sickest people uninsured, premiums are now much higher (more like 150% higher since 2014), but in other states, that had must-issue insurance but no state mandate like MA had, rates are lower post-ACA, such as NY and WA.

Massachusetts and RI have the lowest insurance premiums because almost everyone has insurance and thus the risk pool is medically and financially balanced. Insurance premiums are more expensive when those who most need it purchase it and others just get "free" treatment that has to indirectly be paid by everyone else who does pay premiums.

Source:
https://www.kff.org/health-reform/state ... 2asc%22%7D

CRTR
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by CRTR » Thu Oct 11, 2018 9:09 pm

dm200 wrote:
Thu Oct 11, 2018 3:26 pm
"Much of the drop is due to companies raising premiums too much in 2018, experts say, "

https://www.nbcnews.com/politics/politi ... d_nn_fb_ma
If it weren't so ridiculous, it would be funny. I just received a letter from HealthNet. My ACA compliant plan will go up 25.1% next year. Gotta love California.

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MP123
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by MP123 » Thu Oct 11, 2018 10:11 pm

Kaiser in WA just got approved for a 18% increase, they asked for 29%.

Someone must be getting a heck of a deal if the so called "average" is down 1.5%

madbrain
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by madbrain » Fri Oct 12, 2018 5:00 am

CRTR wrote:
Thu Oct 11, 2018 9:09 pm
dm200 wrote:
Thu Oct 11, 2018 3:26 pm
"Much of the drop is due to companies raising premiums too much in 2018, experts say, "

https://www.nbcnews.com/politics/politi ... d_nn_fb_ma
If it weren't so ridiculous, it would be funny. I just received a letter from HealthNet. My ACA compliant plan will go up 25.1% next year. Gotta love California.
Is that the pre-subsidy cost going up by that much ? Or the net of the total cost less subsidy ?

The nice thing about coveredca.org is that you can go back to check rates for previous years.
I have been recording projected rates for future years annually for projection purposes, but looks like this wasn't necessary.
Anyway, for the last year we would both not eligible for Medicare, we would be be 59 and 64, so that would be the worst case premium. I put my zipcode in San Jose and selected Kaiser Platinum. Set income at $100k to make sure to get the total cost (ie. assume no subsidy).
Year 2014 cost for the Kaiser Platinum HMO was $2218/month
Year 2019 cost for the Kaiser Platinum HMO is $2392/month .
That's a 7.8% increase over 5 years, or about 1.5% annual increase on average.
So, I'm very surprised you are getting a 25% increase in one year.

Admittedly, I didn't compare the other plans (silver, bronze), only Platinum.

madbrain
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by madbrain » Fri Oct 12, 2018 5:02 am

MP123 wrote:
Thu Oct 11, 2018 10:11 pm
Kaiser in WA just got approved for a 18% increase, they asked for 29%.

Someone must be getting a heck of a deal if the so called "average" is down 1.5%
Well, Kaiser in CA certainly isn't increasing by that much. I don't think we are getting that great of a deal in California, but ACA at least seems to be working here.

MikeG62
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by MikeG62 » Fri Oct 12, 2018 7:12 am

Tanelorn wrote:
Thu Oct 11, 2018 6:14 pm
This guy has been tracking all the ACA rates basically as his part time job for years and he's got a 3-4% premium increase with the current laws as they stand.

http://acasignups.net/rate-hikes/2019

My rates are up much more, of course.
Assuming this is accurate for my state (NJ) - no reason to believe it is not - our rates are dropping ~7% in 2019. About 2/3rds of the increase is offset by our being one year older. Still a net decrease of 2%-3%. I’m thrilled by that given the massive increase we got hit with in 2018 (and also because I was budgeting for only a 5% increase).

Nice piece of good news this Friday morning.

Edited to add: We do not qualify for any subsidies.
Last edited by MikeG62 on Fri Oct 12, 2018 12:04 pm, edited 1 time in total.
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CRTR
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by CRTR » Fri Oct 12, 2018 10:20 am

madbrain wrote:
Fri Oct 12, 2018 5:00 am
CRTR wrote:
Thu Oct 11, 2018 9:09 pm
dm200 wrote:
Thu Oct 11, 2018 3:26 pm
"Much of the drop is due to companies raising premiums too much in 2018, experts say, "

https://www.nbcnews.com/politics/politi ... d_nn_fb_ma
If it weren't so ridiculous, it would be funny. I just received a letter from HealthNet. My ACA compliant plan will go up 25.1% next year. Gotta love California.
Is that the pre-subsidy cost going up by that much ? Or the net of the total cost less subsidy ?

The nice thing about coveredca.org is that you can go back to check rates for previous years.
I have been recording projected rates for future years annually for projection purposes, but looks like this wasn't necessary.
Anyway, for the last year we would both not eligible for Medicare, we would be be 59 and 64, so that would be the worst case premium. I put my zipcode in San Jose and selected Kaiser Platinum. Set income at $100k to make sure to get the total cost (ie. assume no subsidy).
Year 2014 cost for the Kaiser Platinum HMO was $2218/month
Year 2019 cost for the Kaiser Platinum HMO is $2392/month .
That's a 7.8% increase over 5 years, or about 1.5% annual increase on average.
So, I'm very surprised you are getting a 25% increase in one year.

Admittedly, I didn't compare the other plans (silver, bronze), only Platinum.
No subsidy. I'm 57. It is for a Bronze plan with a $7500 deductible. The new monthly premium will be $887. It's a rough ride, for sure. I paid $303 with a $3300 deductible in 2013, before the ACA kicked in. In fairness, I did turn 55 in 2016.

We'll be moving to Idaho in 2020. Out of curiosity, I checked Bronze plan prices in Boise. They're ~$300 cheaper. Like I said . . . .gotta love California . . . .

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Cyclesafe
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by Cyclesafe » Fri Oct 12, 2018 10:31 am

My unsubsidized private Cali HDHP PPO bronze plan for 2019 is going up 11.47%.

Tanelorn
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by Tanelorn » Fri Oct 12, 2018 10:36 am

It may be down after all, or at least depending on how you measure it.

https://www.wsj.com/articles/price-of-o ... 1539257400
Average rates for popular health plans sold under the Affordable Care Act will fall 1.5% next year, according to the Trump administration, the first such drop and a sign that the insurance markets are gaining firmer traction despite tumult in the past two years.

The decrease will affect average premiums for the second-cheapest plans in the “silver” tier, a middle-cost option, after years of double-digit increases. In contrast, the average rate for those plans increased by 37% between 2017 and 2018, the administration said.
...
Still, the news is a surprise. Many health analysts had predicted significant price increases next year because of the actions taken by the administration and the GOP Congress, especially an end to the penalty for not having insurance and the bolstering of non-ACA-compliant plans.
...
“The population that stayed in the ACA was healthier than we expected,” Mr. Bartsh said. Medica is also expanding into two new states next year.
...
In 2019, 23 more insurers will be participating and 29 current insurers are expanding their footprint, meaning consumers will have more options. Last year, consumers in 56% of counties had only one carrier participating, CMS officials said, and next year that will drop to 39%.

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dm200
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by dm200 » Fri Oct 12, 2018 10:44 am

MikeG62 wrote:
Fri Oct 12, 2018 7:12 am
Tanelorn wrote:
Thu Oct 11, 2018 6:14 pm
This guy has been tracking all the ACA rates basically as his part time job for years and he's got a 3-4% premium increase with the current laws as they stand.

http://acasignups.net/rate-hikes/2019

My rates are up much more, of course.
Assuming this is accurate for my state (NJ) - no reason to believe it is not - our rates are dropping ~7% in 2019. About 2/3rds of the increase is offset by our being one year older. Still a net decrease of 2%-3%. I’m thrilled by that given the massive increase we got hit with in 2018 (and also because I was budgeting for only a 5% increase).

Nice piece of good news this Friday morning.
Yes - I believe different states have very different changes.

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munemaker
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by munemaker » Fri Oct 12, 2018 10:53 am

If you are subsidized, the amount you pay goes up and/or down with your MAGI and has absolutely nothing to do with the premium; whether the premium goes up or down is irrelevant.

HoosierJim
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by HoosierJim » Fri Oct 12, 2018 11:24 am

They should post more stats like median increase, standard deviation - average is well, just average. Is the average the weighted averages per state , per zip code, per covered person?

MikeG62
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by MikeG62 » Fri Oct 12, 2018 12:06 pm

HoosierJim wrote:
Fri Oct 12, 2018 11:24 am
They should post more stats like median increase, standard deviation - average is well, just average. Is the average the weighted averages per state , per zip code, per covered person?
Jim, did you check the details for your state contained here?

http://acasignups.net/rate-hikes/2019

Lot's of specifics by state.
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by curmudgeon » Fri Oct 12, 2018 2:45 pm

If I hold ages the same for both years, my Kaiser bronze HSA plan (one of the lowest cost options) in CA has an 11% increase for 2019. We do actually have more overall plan options available next year, but most are much more expensive. Managing our income to stay under the ACA cliff makes the net premium cost minimal, though with HSA plan we pay most medical expenses out of pocket until hitting the max OOP limit.

gilgamesh
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by gilgamesh » Fri Oct 12, 2018 4:55 pm

I wish I know what my 2019 premium is...the website says I won’t know until a few days prior to Nov 1st.

Carefreeap
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by Carefreeap » Fri Oct 12, 2018 5:47 pm

CRTR wrote:
Fri Oct 12, 2018 10:20 am
madbrain wrote:
Fri Oct 12, 2018 5:00 am
CRTR wrote:
Thu Oct 11, 2018 9:09 pm
dm200 wrote:
Thu Oct 11, 2018 3:26 pm
"Much of the drop is due to companies raising premiums too much in 2018, experts say, "

https://www.nbcnews.com/politics/politi ... d_nn_fb_ma
If it weren't so ridiculous, it would be funny. I just received a letter from HealthNet. My ACA compliant plan will go up 25.1% next year. Gotta love California.
Is that the pre-subsidy cost going up by that much ? Or the net of the total cost less subsidy ?

The nice thing about coveredca.org is that you can go back to check rates for previous years.
I have been recording projected rates for future years annually for projection purposes, but looks like this wasn't necessary.
Anyway, for the last year we would both not eligible for Medicare, we would be be 59 and 64, so that would be the worst case premium. I put my zipcode in San Jose and selected Kaiser Platinum. Set income at $100k to make sure to get the total cost (ie. assume no subsidy).
Year 2014 cost for the Kaiser Platinum HMO was $2218/month
Year 2019 cost for the Kaiser Platinum HMO is $2392/month .
That's a 7.8% increase over 5 years, or about 1.5% annual increase on average.
So, I'm very surprised you are getting a 25% increase in one year.

Admittedly, I didn't compare the other plans (silver, bronze), only Platinum.
No subsidy. I'm 57. It is for a Bronze plan with a $7500 deductible. The new monthly premium will be $887. It's a rough ride, for sure. I paid $303 with a $3300 deductible in 2013, before the ACA kicked in. In fairness, I did turn 55 in 2016.

We'll be moving to Idaho in 2020. Out of curiosity, I checked Bronze plan prices in Boise. They're ~$300 cheaper. Like I said . . . .gotta love California . . . .
Interesting. We are also in the Bay Area but have a Bronze 60 HDHP HMO Plan. I'm the same age as you and my premium goes up to $744.33 (18.3% increase over last year).
t
We (Californian's) pay more because everything costs more here from real estate to wages. But I still love it here and I won't be giving up my ocean view until I have to. :wink:

madbrain
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by madbrain » Sat Oct 13, 2018 2:10 am

CRTR wrote:
Fri Oct 12, 2018 10:20 am

No subsidy. I'm 57. It is for a Bronze plan with a $7500 deductible. The new monthly premium will be $887. It's a rough ride, for sure. I paid $303 with a $3300 deductible in 2013, before the ACA kicked in. In fairness, I did turn 55 in 2016.

We'll be moving to Idaho in 2020. Out of curiosity, I checked Bronze plan prices in Boise. They're ~$300 cheaper. Like I said . . . .gotta love California . . . .
In my zip code in CA in the south SF bay area, for age 57, the cheapest Bronze plans for 2019 are Valley health at $524/month . Kaiser is next at $671/month. Healthnet is not available in our market. The most expensive is Anthem blue cross at $699. There are 5 total bronze plans, and all have between $6000 and $6300 deductibles. I have never heard of a $7500 deductible for an individual plan.
Are you maybe mixing up the deductible with the maximum out-of-pocket costs ? The max OOP on these plans is $7550.

madbrain
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by madbrain » Sat Oct 13, 2018 4:00 pm

WanderingDoc wrote:
Sat Oct 13, 2018 2:40 am
Take this distribution. Bottom 1/3 are below average health, middle 1/3 average, and top 1/3 above average. I stand by my statement that the top 2/3 should self ensure. Paying for insurance for these folks is a terrible financial decision.
I'm not really sure how the distribution helps an individual, until they know where they stand.
0.1-0.9% I consider common . 0.01-0.09% unusual but still NOT RARE. Sure, anybody can contract HIV or Hepatitis, but there are things you can do to mitigate such things (to an extent). If you are in that bottom 1/3 (you have propensity to get sick or already have a chronic illness), then by all means buy insurance.
HIV has 0.3% prevalence in the US, which would make it common rather than unusual according to your classification. It's certainly avoidable, but much harder to do so when you are LGBT and you regularly are in contact with a population that has much higher prevalence than average (I think 5-6% if you assume 5% of the population are LGBT, and most of the HIV+ population is LGBT). Would you recommend all LGBT insure on that basis ?

Things like diabetes, obesity, and hypertension - all above the 1% incidence - I don't even count since they can all be cured quite easily with a lifestyle change. Even breast and prostate cancer can be mitigated. The top 2/3 in this distribution would do best by educating yourself, focus on barbell strength training, maintain a healthy weight and eating habits, the right social conditions, and you are good to go.
Just that easy, hey ? I wonder why 2/3 of the population don't spontaneously choose to be uninsured. Are you uninsured yourself ? And are all your physician colleagues uninsured ?

Carefreeap
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by Carefreeap » Sat Oct 13, 2018 4:22 pm

madbrain wrote:
Sat Oct 13, 2018 4:00 pm
WanderingDoc wrote:
Sat Oct 13, 2018 2:40 am
Take this distribution. Bottom 1/3 are below average health, middle 1/3 average, and top 1/3 above average. I stand by my statement that the top 2/3 should self ensure. Paying for insurance for these folks is a terrible financial decision.
I'm not really sure how the distribution helps an individual, until they know where they stand.
0.1-0.9% I consider common . 0.01-0.09% unusual but still NOT RARE. Sure, anybody can contract HIV or Hepatitis, but there are things you can do to mitigate such things (to an extent). If you are in that bottom 1/3 (you have propensity to get sick or already have a chronic illness), then by all means buy insurance.
HIV has 0.3% prevalence in the US, which would make it common rather than unusual according to your classification. It's certainly avoidable, but much harder to do so when you are LGBT and you regularly are in contact with a population that has much higher prevalence than average (I think 5-6% if you assume 5% of the population are LGBT, and most of the HIV+ population is LGBT). Would you recommend all LGBT insure on that basis ?

Things like diabetes, obesity, and hypertension - all above the 1% incidence - I don't even count since they can all be cured quite easily with a lifestyle change. Even breast and prostate cancer can be mitigated. The top 2/3 in this distribution would do best by educating yourself, focus on barbell strength training, maintain a healthy weight and eating habits, the right social conditions, and you are good to go.
Just that easy, hey ? I wonder why 2/3 of the population don't spontaneously choose to be uninsured. Are you uninsured yourself ? And are all your physician colleagues uninsured ?
Lol, sounds like the arrogance of youth...It won't happen to me! Until something DOES happen and then you find out something you never knew about runs in the family.

CRTR
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by CRTR » Sat Oct 13, 2018 4:56 pm

madbrain wrote:
Sat Oct 13, 2018 2:10 am
CRTR wrote:
Fri Oct 12, 2018 10:20 am

No subsidy. I'm 57. It is for a Bronze plan with a $7500 deductible. The new monthly premium will be $887. It's a rough ride, for sure. I paid $303 with a $3300 deductible in 2013, before the ACA kicked in. In fairness, I did turn 55 in 2016.

We'll be moving to Idaho in 2020. Out of curiosity, I checked Bronze plan prices in Boise. They're ~$300 cheaper. Like I said . . . .gotta love California . . . .
In my zip code in CA in the south SF bay area, for age 57, the cheapest Bronze plans for 2019 are Valley health at $524/month . Kaiser is next at $671/month. Healthnet is not available in our market. The most expensive is Anthem blue cross at $699. There are 5 total bronze plans, and all have between $6000 and $6300 deductibles. I have never heard of a $7500 deductible for an individual plan.
Are you maybe mixing up the deductible with the maximum out-of-pocket costs ? The max OOP on these plans is $7550.
No, unfortunately, I'm not mixing anything up. The wording I. The letter from HealthNet was very clear. In 2018, there was not a single bronze plan available for under $650 (just pulled up my old sign up sheet) in San Diego with the exception of the Medical based plans (Molina, CHG, Care First). Last year, interestingly, Kaiser, Scripps and Sharp HMOs were not a lot cheaper than the Bronze PPOs.

WanderingDoc
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by WanderingDoc » Sat Oct 13, 2018 5:00 pm

madbrain wrote:
Sat Oct 13, 2018 4:00 pm
WanderingDoc wrote:
Sat Oct 13, 2018 2:40 am
Take this distribution. Bottom 1/3 are below average health, middle 1/3 average, and top 1/3 above average. I stand by my statement that the top 2/3 should self ensure. Paying for insurance for these folks is a terrible financial decision.
I'm not really sure how the distribution helps an individual, until they know where they stand.
0.1-0.9% I consider common . 0.01-0.09% unusual but still NOT RARE. Sure, anybody can contract HIV or Hepatitis, but there are things you can do to mitigate such things (to an extent). If you are in that bottom 1/3 (you have propensity to get sick or already have a chronic illness), then by all means buy insurance.
HIV has 0.3% prevalence in the US, which would make it common rather than unusual according to your classification. It's certainly avoidable, but much harder to do so when you are LGBT and you regularly are in contact with a population that has much higher prevalence than average (I think 5-6% if you assume 5% of the population are LGBT, and most of the HIV+ population is LGBT). Would you recommend all LGBT insure on that basis ?

Things like diabetes, obesity, and hypertension - all above the 1% incidence - I don't even count since they can all be cured quite easily with a lifestyle change. Even breast and prostate cancer can be mitigated. The top 2/3 in this distribution would do best by educating yourself, focus on barbell strength training, maintain a healthy weight and eating habits, the right social conditions, and you are good to go.
Just that easy, hey ? I wonder why 2/3 of the population don't spontaneously choose to be uninsured. Are you uninsured yourself ? And are all your physician colleagues uninsured ?
I think generally healthy (protoplasic/genetic-wise) people, and people informed about things they can do to significantly reduce their chance of a negative health event, absolutely should self-ensure - IN THE U.S.

In Japan, where all employers require the same health insurance - dirt cheap around $40-50 per month - no brainier that everyone will have health insurance.

If your statistics are correct, then in makes sense for LGBT to carry insurance even in the U.S. - due to inherent increased risk of HIV/Hepatitis, as you mentioned. Just like someone with significant obesity or metabolic syndrome who refuses to do the simple things to cure it, should also probably carry health insurance.

I'm insured due to my position/employer.. but I don't pay for it. If I had to choose, the criteria I have stated still applies.

Just because a lot of "smart" people do something, doesn't mean it's the right thing to do or even in their best interest.
Don't wait to buy real estate. Buy real estate, and wait. | Rent where you live, buy where others pay your mortgage for you.

madbrain
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by madbrain » Sat Oct 13, 2018 5:52 pm

WanderingDoc wrote: In Japan, where all employers require the same health insurance - dirt cheap around $40-50 per month - no brainier that everyone will have health insurance.
Japan spends $4519 per capita on healthcare according to https://en.wikipedia.org/wiki/List_of_c ... per_capita.

$50 health insurance would only be $600/year, so clearly there are some other sources of funding for healthcare in Japan. I'm not familiar with Japan, but I will guess that some sort of taxation is involved, and perhaps out-of-pocket costs.

That or the insurance system is running some serious deficit.
OK, so I had to do research on my own :

https://www.japantimes.co.jp/news/2017/ ... -premiums/
In 2014, the breakdown of health care expenditures was 48.7 percent from premiums, 38.8 percent from national and local taxes and 12.5 percent out of patients’ pockets. Expenditures will continue to grow, and in 2025 the huge boomer cohort turns 75, after which their contributions to the system go down considerably, even though they will account for the bulk of expenses.
And for HIV patients specifically, an older article :

https://www.japantimes.co.jp/news/2011/ ... -too-late/
How much does it cost to get medication for HIV?

HIV-positive people don’t have to take drugs until their immune system weakens below a certain level.

Until reaching that state, HIV carriers only have to visit a hospital once every two to three months to monitor their immune system.

Roughly speaking, on average, such medication costs about ¥200,000 a month, meaning about ¥2.4 million per year, explained Honda. However, 70 percent of the cost will be covered by national health insurance and additional financial support will be provided to those issued a physical disability certificate, Honda said.
This amounts to $21,000 a year cost, paid at 70%. Still $6400 responsibility for the patient, which is huge. No wonder the premiums can be low, if they leave the patient with so much to pay on their own. A bronze plan would leave a patient with about the same cost. But yes, bronze plans cost more. However, the article is 7 years old, and the cost of HIV medications is much higher now.
If your statistics are correct, then in makes sense for LGBT to carry insurance even in the U.S. - due to inherent increased risk of HIV/Hepatitis, as you mentioned. Just like someone with significant obesity or metabolic syndrome who refuses to do the simple things to cure it, should also probably carry health insurance.
Yes, I'm afraid my stats are correct. I can provide all the links if one wishes, but mostly CDC has that data.
I'm insured due to my position/employer.. but I don't pay for it. If I had to choose, the criteria I have stated still applies.
So, seems like a case of, do as I say, not as I do. Do you know anyone who actually follows your advice and has been successful with it ?
Just because a lot of "smart" people do something, doesn't mean it's the right thing to do or even in their best interest.
Agree, but I think in this case your arguments are much less than compelling.

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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by desafinado » Sat Oct 13, 2018 6:09 pm

Anyone who can afford to self-insure can afford to buy insurance. There are many conditions where the cost is virtually unbounded - it's possible to consume $10m or more in healthcare costs. If you had the $20m where you could truly feel comfortable self-insuring, 30k in ACA premiums would be trivial.

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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by madbrain » Sat Oct 13, 2018 6:12 pm

CRTR wrote:
Sat Oct 13, 2018 4:56 pm
No, unfortunately, I'm not mixing anything up. The wording I. The letter from HealthNet was very clear. In 2018, there was not a single bronze plan available for under $650 (just pulled up my old sign up sheet) in San Diego with the exception of the Medical based plans (Molina, CHG, Care First). Last year, interestingly, Kaiser, Scripps and Sharp HMOs were not a lot cheaper than the Bronze PPOs.
I'm looking at coveredca.com . Not sure what exact zip code in San Diego you are in, so I picked a random one - 92128 . Selected 1 adult age 57, income $100,000 . It found 10 bronze plans for 2019. I just took screenshots and uploaded them to imgur, but bogleheads won't allow me to link to embed them due to pixel dimensions. So here are the links :

https://i.imgur.com/JwDIS9m.png
https://i.imgur.com/ccVmGpK.png
https://i.imgur.com/PuGp4KI.png

All have deductibles between $6000 and $6300 - not $7500.
There is a Kaiser Bronze 60 HDHP HMO plan for $591.53/month . And Healthnet Bronze HMO for $657.27/month.
That seems quite a bit lower than your numbers. So I wonder why the data on coveredca.com differs so much from yours.

Zip code could explain some premium difference, but we are talking 40% higher here, so that seems like too much. Generally, the plan structure remain the same, in terms of deductibles, also.

Are you maybe on an off-exchange marketplace plan ? Those could have different terms than on-exchange, and might explain why the terms in your letter from Healthnet are different.

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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by cutehumor » Sat Oct 13, 2018 6:26 pm

Medicare for all is scaring the insurance companies. The mid term elections are next month. Go raise Obamacare premium and watch more voters come out.

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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by WanderingDoc » Sat Oct 13, 2018 6:59 pm

madbrain wrote:
Sat Oct 13, 2018 5:52 pm
WanderingDoc wrote: In Japan, where all employers require the same health insurance - dirt cheap around $40-50 per month - no brainier that everyone will have health insurance.
Japan spends $4519 per capita on healthcare according to https://en.wikipedia.org/wiki/List_of_c ... per_capita.

$50 health insurance would only be $600/year, so clearly there are some other sources of funding for healthcare in Japan. I'm not familiar with Japan, but I will guess that some sort of taxation is involved, and perhaps out-of-pocket costs.

That or the insurance system is running some serious deficit.
OK, so I had to do research on my own :

https://www.japantimes.co.jp/news/2017/ ... -premiums/
In 2014, the breakdown of health care expenditures was 48.7 percent from premiums, 38.8 percent from national and local taxes and 12.5 percent out of patients’ pockets. Expenditures will continue to grow, and in 2025 the huge boomer cohort turns 75, after which their contributions to the system go down considerably, even though they will account for the bulk of expenses.
And for HIV patients specifically, an older article :

https://www.japantimes.co.jp/news/2011/ ... -too-late/
How much does it cost to get medication for HIV?

HIV-positive people don’t have to take drugs until their immune system weakens below a certain level.

Until reaching that state, HIV carriers only have to visit a hospital once every two to three months to monitor their immune system.

Roughly speaking, on average, such medication costs about ¥200,000 a month, meaning about ¥2.4 million per year, explained Honda. However, 70 percent of the cost will be covered by national health insurance and additional financial support will be provided to those issued a physical disability certificate, Honda said.
This amounts to $21,000 a year cost, paid at 70%. Still $6400 responsibility for the patient, which is huge. No wonder the premiums can be low, if they leave the patient with so much to pay on their own. A bronze plan would leave a patient with about the same cost. But yes, bronze plans cost more. However, the article is 7 years old, and the cost of HIV medications is much higher now.
If your statistics are correct, then in makes sense for LGBT to carry insurance even in the U.S. - due to inherent increased risk of HIV/Hepatitis, as you mentioned. Just like someone with significant obesity or metabolic syndrome who refuses to do the simple things to cure it, should also probably carry health insurance.
Yes, I'm afraid my stats are correct. I can provide all the links if one wishes, but mostly CDC has that data.
I'm insured due to my position/employer.. but I don't pay for it. If I had to choose, the criteria I have stated still applies.
So, seems like a case of, do as I say, not as I do. Do you know anyone who actually follows your advice and has been successful with it ?
Just because a lot of "smart" people do something, doesn't mean it's the right thing to do or even in their best interest.
Agree, but I think in this case your arguments are much less than compelling.
I am simply starting that in Japan their health insurance premiums are super cheap, mandatory, and easy to afford for even below average wage workers. It may be subsided or not, but the fact is, it is WAY cheaper for the individual than in America.

Its do as I do. I don't pay for health insurance - and I'm telling other healthy and informed folks who are willing to take control and responsibly for their health that they shouldn't, either.

Since you asked, Ido know a bunch of guys that have done this successfully. For decades.

Life is about doing a cost-benefit analysis on every major decision you have to make. It's not about thinking "nothing will ever happened to me". If you took that money, saved it and invested it you would have 7 figures instead of throwing that money down the drain to greedy insurance companies. Then if you have an emergency, you will be able to easily cover it, with money to spare.

Paying $20,000-$30,000 for health insurance per year is criminal. Its analogous to a line of sheep nodding their head and saying "yes government I will pay whatever you ask, no problem." Out of pure fear, not rational thought.
Last edited by WanderingDoc on Sat Oct 13, 2018 7:04 pm, edited 1 time in total.
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by WanderingDoc » Sat Oct 13, 2018 7:03 pm

desafinado wrote:
Sat Oct 13, 2018 6:09 pm
Anyone who can afford to self-insure can afford to buy insurance. There are many conditions where the cost is virtually unbounded - it's possible to consume $10m or more in healthcare costs. If you had the $20m where you could truly feel comfortable self-insuring, 30k in ACA premiums would be trivial.
$10m or more? Sit down and think about this before just thinking of huge round numbers. My entire family of 4 has spent less than $100,000 in 63 years (two countries). $10M? What planet is this on. I am not talking about the last 6 months of one's life (end of life care) - you can get a different insurance for this when (if) the time comes.

If health care actually costs $10M for an American, everyone would be dead (because they can't afford this). That number is absurd and dishonest. Think about how much your own health care cost throughout your life.
Don't wait to buy real estate. Buy real estate, and wait. | Rent where you live, buy where others pay your mortgage for you.

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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by desafinado » Sat Oct 13, 2018 7:14 pm

WanderingDoc wrote:
Sat Oct 13, 2018 7:03 pm
desafinado wrote:
Sat Oct 13, 2018 6:09 pm
Anyone who can afford to self-insure can afford to buy insurance. There are many conditions where the cost is virtually unbounded - it's possible to consume $10m or more in healthcare costs. If you had the $20m where you could truly feel comfortable self-insuring, 30k in ACA premiums would be trivial.
$10m or more? Sit down and think about this before just thinking of huge round numbers. My entire family of 4 has spent less than $100,000 in 63 years (two countries). $10M? What planet is this on. I am not talking about the last 6 months of one's life (end of life care) - you can get a different insurance for this when (if) the time comes.

If health care actually costs $10M for an American, everyone would be dead (because they can't afford this). That number is absurd and dishonest. Think about how much your own health care cost throughout your life.
My family member had cancer and their treatment exceeded the pre aca plan lifetime maximum of $2m, and cancer treatment is a lot more expensive than it was 20 years ago. Obviously not every person's lifetime care costs $10m. Congratulations on your fine health.

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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by MikeG62 » Sun Oct 14, 2018 9:37 am

dm200 wrote:
Thu Oct 11, 2018 5:27 pm
This (as best I understand) is the federal rate factor table - used by most states.

Did not format perfectly - but you get the idea. So, for example a 64 year old would pay 3 times the premium as a 21 year old. For the 21 year old, then, his/her premium would go up every year - even if the ACA premiums did not go up overall. In fact, overall premiums could go down and an individual could pay more.

Code: Select all

Age Premium
ratio* Age Premium
ratio Age Premium
ratio
0–20 0.635 35 1.222 50 1.786
21 1.000 36 1.230 51 1.865
22 1.000 37 1.238 52 1.952
23 1.000 38 1.246 53 2.040
24 1.000 39 1.262 54 2.135
25 1.004 40 1.278 55 2.230
26 1.024 41 1.302 56 2.333
27 1.048 42 1.325 57 2.437
28 1.087 43 1.357 58 2.548
29 1.119 44 1.397 59 2.603
30 1.135 45 1.444 60 2.714
31 1.159 46 1.500 61 2.810
32 1.183 47 1.563 62 2.873
33 1.198 48 1.635 63 2.952
34 1.214 49 1.706 64
and
older
3.000
dm200,

Do you have a source (link) for the age factors above? I'd like to have it for future reference.

Thanks,
Real Knowledge Comes Only From Experience

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dm200
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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by dm200 » Sun Oct 14, 2018 10:53 am

MikeG62 wrote:
Sun Oct 14, 2018 9:37 am
dm200 wrote:
Thu Oct 11, 2018 5:27 pm
This (as best I understand) is the federal rate factor table - used by most states.

Did not format perfectly - but you get the idea. So, for example a 64 year old would pay 3 times the premium as a 21 year old. For the 21 year old, then, his/her premium would go up every year - even if the ACA premiums did not go up overall. In fact, overall premiums could go down and an individual could pay more.

Code: Select all

Age Premium
ratio* Age Premium
ratio Age Premium
ratio
0–20 0.635 35 1.222 50 1.786
21 1.000 36 1.230 51 1.865
22 1.000 37 1.238 52 1.952
23 1.000 38 1.246 53 2.040
24 1.000 39 1.262 54 2.135
25 1.004 40 1.278 55 2.230
26 1.024 41 1.302 56 2.333
27 1.048 42 1.325 57 2.437
28 1.087 43 1.357 58 2.548
29 1.119 44 1.397 59 2.603
30 1.135 45 1.444 60 2.714
31 1.159 46 1.500 61 2.810
32 1.183 47 1.563 62 2.873
33 1.198 48 1.635 63 2.952
34 1.214 49 1.706 64
and
older
3.000
dm200,

Do you have a source (link) for the age factors above? I'd like to have it for future reference.

Thanks,
This is where I got it. Not 100% sure is is complete. Also, some states have adopted a different schedule (within the allowable ranges)
http://coventryhealthcare.com/web/group ... 084481.pdf

MikeG62
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Location: New Jersey

Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by MikeG62 » Sun Oct 14, 2018 12:13 pm

dm200 wrote:
Sun Oct 14, 2018 10:53 am
MikeG62 wrote:
Sun Oct 14, 2018 9:37 am
dm200 wrote:
Thu Oct 11, 2018 5:27 pm
This (as best I understand) is the federal rate factor table - used by most states.

Did not format perfectly - but you get the idea. So, for example a 64 year old would pay 3 times the premium as a 21 year old. For the 21 year old, then, his/her premium would go up every year - even if the ACA premiums did not go up overall. In fact, overall premiums could go down and an individual could pay more.

Code: Select all

Age Premium
ratio* Age Premium
ratio Age Premium
ratio
0–20 0.635 35 1.222 50 1.786
21 1.000 36 1.230 51 1.865
22 1.000 37 1.238 52 1.952
23 1.000 38 1.246 53 2.040
24 1.000 39 1.262 54 2.135
25 1.004 40 1.278 55 2.230
26 1.024 41 1.302 56 2.333
27 1.048 42 1.325 57 2.437
28 1.087 43 1.357 58 2.548
29 1.119 44 1.397 59 2.603
30 1.135 45 1.444 60 2.714
31 1.159 46 1.500 61 2.810
32 1.183 47 1.563 62 2.873
33 1.198 48 1.635 63 2.952
34 1.214 49 1.706 64
and
older
3.000
dm200,

Do you have a source (link) for the age factors above? I'd like to have it for future reference.

Thanks,
This is where I got it. Not 100% sure is is complete. Also, some states have adopted a different schedule (within the allowable ranges)
http://coventryhealthcare.com/web/group ... 084481.pdf
Thanks for this. Just saved it to my computer.

Between these age factors and the costs I obtained from the link provided by Tanelorn, I was able to tie into our 2018 premium amounts to within pennies of what I am actually being charged. So I think the age factors are correct (at least currently). Whether they change in the future I have no idea. Still good to have as a reference.
Real Knowledge Comes Only From Experience

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dm200
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Location: Washington DC area

Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by dm200 » Sun Oct 14, 2018 2:28 pm

jibantik wrote:
Sun Oct 14, 2018 2:25 pm
cutehumor wrote:
Sun Oct 14, 2018 11:02 am
jibantik wrote:
Sat Oct 13, 2018 7:43 pm
WanderingDoc wrote:
Fri Oct 12, 2018 3:03 pm
Does ANYONE who doesn't have health insurance pay $30K per year for doctors and dentists?
If I count all of the illnesses my mom, dad, brother, and I have had in the last 30 years, add up what it would cost if paying cash, it wouldn't even come to $100K. In 30 years! Can't believe people are actually paying into this scam :oops:
WanderingDoc wrote:
Fri Oct 12, 2018 5:36 pm
Believe me, I'm a physician so I hear you.
Are you sure you are a physician?
I was in the ICU for three weeks on a ventilator and trach. I had three surgeries. My total bill for 25 total days was over 700k dollars in 10/2010. My insurance paid 350k of it and in network wrote off the rest. I paid 4800 out of pocket max. I'm glad I had insurance.
Yep, I bet nearly everyone knows someone who has had or requires significant medical costs, and I would especially expect a physician would...
A similar situation happened in my circle recently. Unexpected medical issue that ended up costing several hundred thousands of dollars. Although the person did not have insurance for some time, they were luckily convinced to get it shortly before this incident, fortunately preventing complete financial ruin.
Glad for the person, however -- being uninsured (and not paying into the insurance system) hurts the regulars by large claims vs. low (for that person) premiums.

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Re: Obamacare premiums will be down an average of 1.5 percent next year

Post by LadyGeek » Sun Oct 14, 2018 7:09 pm

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