Obamacare no Bargain for Me

[tskeeter]

Although I've been concerned, I've tried to be sort of open minded about Obamacare.  But, I think my mind just closed.

As part of our retirement planning, I have estimated what our medical care premiums would be between the time we retire and the time we qualify for medicare.  Because I have access to medical care in retirement at COBRA rates, we used those COBRA rates for our 2012 estimate.  After allowing for a bit of cushion and inflation, we were looking at $15K a year for the two of us.

For comparison sake, for my 2013 update, I decided to use premiums from our state Obamacare insurance exchange.  So, away I went.  First off, we're not going to be eligible for any subisides.  Well, that wasn't entirely unexpected.  Pull up information on gold plans, which would most closely mirror our current coverage.  Wow, there are only four companies offering gold level medical insurance plans for people approaching retirement age.  A look at the rates showed that three of the companies were pretty close together.  And that their 2014 rates were nearly 32% higher than the last information that I had gotten.  The remaining plan was quite a bit more expensive.  About $4K a year more than the other three companies for the two of us.  Or, about 53% more than I had figured we would pay when I updated our retirement budget the fall of 2012.  Not quite the $2,500 per family savings we have been told to expect.

Now, the more scarey part is that I suspect that the introductory rates are not sustainable.  As insurance companies accumulate actual experience, I expect we will see rate increases of at least 25% over the next three years.  Assuming my projection becomes reality, we'd be looking at medical insurance premiums that are 64% - 92% higher than I had projected just a year ago.  Ouch!  

I guess no unemployed youngster is going to be getting my job for a few more years.  Even if those boneheads in Washington can resist driving us into the ditch and wiping out a good chunk of our retirement savings again.    

  

[Sum Dum Gai]

Health insurance is expensive for old people??? *puts on his shocked face*

And it's really expensive if you ASSume 25% cost increases per year. Now I'm outraged!

[Ombud]

I read that the rates are only sustainable if enough of the healthy 20 somethings sign up and they are electing to take the tax penalty instead

[Rocky Mtn Saver]

In its defence, the exchange is more designed for people who don't have other options and who can't afford to be covered at the moment.  It sounds like you have both, so you're not truly the target demographic the exchanges are trying to fit with 'affordable' coverage options. 

[Rocky Mtn Saver]

Oct 14, 2013 17:00:32 GMT -5 Ombud said:

I read that the rates are only sustainable if enough of the healthy 20 somethings sign up and they are electing to take the tax penalty instead

2014 hasn't even begun yet.  We'll see how it all plays out over the next couple of years. 

[Angel!]

This is why I thought there was a flaw in using the 400% cutoff.  Older people above 400% will often end up paying substancially more than the 9.5% income.

But, no one asked me when they wrote the law.  So, yeah insurance for some people is still going to cost a lot.

[Deleted]

I think most of us are going to be driven to work until we are eligible for Medicare.  Look for the government to raise the Medicare age to match the full SS age.

That assumes employers don't start dumping employer-provided insurance as quickly as they dumped employer-provided retirement plans (pensions).

The big employers have to LOVE it.  They now have a reason to restructure health care benefits . . . we can all get it on the open market.

[tskeeter]

Oct 14, 2013 16:58:47 GMT -5 Sum Dum Gai said:

Health insurance is expensive for old people *puts on his shocked face*

And it's really expensive if you ASSume 25% cost increases per year. Now I'm outraged!

Well, Dark, the part that burns me a bit is that these increases are on top of the increases that insurance companies have passed along in preparation for Obamacare.  Since Obamacare legislation was signed, I experienced a 60% rate increase one year, followed by a 29% rate increase, followed by a 9% rate increase.  Nearly an 85% rate increase just ramping up to the Obamacare implementation.  In my fantasies, I had kind of hoped that the earlier rate increases and caps on insurance premium rates for old farts under Obamacare would keep rates kind of in line with what I was told rates were for people my age (old) just a year ago.  Finding that the old folks rates might easly double from the 2012 old folks rates will probably cramp my style for a few more years.   

[saveinla]

We just got our benefits and other than a 2$ increase in medical and 10$ increase in dental plan (I was paying 4$ per paycheck for the standard metlife dental which was very low) , nothing has changed.

In fact all copays and coinsurance count as part of the deductible for the PPO plans because of the new healthcare law and they are covering a lot more medications at no cost and a number of others are included with a 8$ copay. I like the plan so far.

[Rocky Mtn Saver]

Oct 14, 2013 17:12:16 GMT -5 saveinla said:

We just got our benefits and other than a 2$ increase in medical and 10$ increase in dental plan (I was paying 4$ per paycheck for the standard metlife dental which was very low) , nothing has changed.

In fact all copays and coinsurance count as part of the deductible for the PPO plans because of the new healthcare law and they are covering a lot more medications at no cost and a number of others are included with a 8$ copay. I like the plan so far.

My employer plan actually improved this year to cover the last of the new ACA-required stuff plus a vision option, and there was no increase in premiums. 

[Deleted]

Tskeeter... Those were increases in the totl premium, or your part of the premium?

Are you with a large company or small?

[tskeeter]

Oct 14, 2013 17:03:50 GMT -5 Rocky Mtn Saver said:

In its defence, the exchange is more designed for people who don't have other options and who can't afford to be covered at the moment.  It sounds like you have both, so you're not truly the target demographic the exchanges are trying to fit with 'affordable' coverage options. 

True, we're probably not the exchange target demographic.  However, why would an insurance company charge people who are buying insurance directly from the insurance company less than they would charge someone buying through the exchange?  I can't see that happening.  Could you imagine the uproar in the White House and Congress if insurance companies charged poor uninsured peope buying their insurance through the exchanges more than they do people who are buying their insurance outside the exchanges?  I don't think any insurance company is stupid enough to open that can of worms.  

[Ombud]

The plan is the same but it went up 50% last year. Only up 10% this year

[Miss Tequila]

Oct 14, 2013 17:14:31 GMT -5 Rocky Mtn Saver said:

Oct 14, 2013 17:12:16 GMT -5 saveinla said:

We just got our benefits and other than a 2$ increase in medical and 10$ increase in dental plan (I was paying 4$ per paycheck for the standard metlife dental which was very low) , nothing has changed.

In fact all copays and coinsurance count as part of the deductible for the PPO plans because of the new healthcare law and they are covering a lot more medications at no cost and a number of others are included with a 8$ copay. I like the plan so far.

My employer plan actually improved this year to cover the last of the new ACA-required stuff plus a vision option, and there was no increase in premiums. 

We had our annual meeting with our insurance company. Our premiums are going up 10 percent, 4 percent of that is tied to compliance with ACA

[Deleted]

So 3 years ago you were paying, full premium, apx $6,536 a year? For couple.

[Rocky Mtn Saver]

Oct 14, 2013 17:15:56 GMT -5 tskeeter said:

Oct 14, 2013 17:03:50 GMT -5 Rocky Mtn Saver said:

In its defence, the exchange is more designed for people who don't have other options and who can't afford to be covered at the moment.  It sounds like you have both, so you're not truly the target demographic the exchanges are trying to fit with 'affordable' coverage options. 

True, we're probably not the exchange target demographic.  However, why would an insurance company charge people who are buying insurance directly from the insurance company less than they would charge someone buying through the exchange?  I can't see that happening.  Could you imagine the uproar in the White House and Congress if insurance companies charged poor uninsured peope buying their insurance through the exchanges more than they do people who are buying their insurance outside the exchanges?  I don't think any insurance company is stupid enough to open that can of worms.  

I'm not saying that there are two sets of rates.  I'm saying that if you have employer coverage options and/or you can afford your current insurance options, then you're not the target consumer that the ACA is trying to help locate affordable coverage.  You already have coverage you can apparently afford, and at a 'gold' level of coverage.  The exchanges serve all types of consumers, but their purpose is particularly to try to get people covered who don't have either of those advantages (no access and/or can't afford it now). 

[Angel!]

Oct 14, 2013 17:15:07 GMT -5 oped said:

Tskeeter... Those were increases in the totl premium, or your part of the premium?

Are you with a large company or small?

Good questions.  Those increases are interesting to say the least.  Our premiums have barely budged in 3 years now.

[tskeeter]

Oct 14, 2013 17:33:48 GMT -5 @tbird said:

Oct 14, 2013 17:15:56 GMT -5 tskeeter said:

True, we're probably not the exchange target demographic.  However, why would an insurance company charge people who are buying insurance directly from the insurance company less than they would charge someone buying through the exchange?  I can't see that happening.  Could you imagine the uproar in the White House and Congress if insurance companies charged poor uninsured peope buying their insurance through the exchanges more than they do people who are buying their insurance outside the exchanges?  I don't think any insurance company is stupid enough to open that can of worms.  

I'm not sure I follow this line of reasoning.  The ins companies charges based on pooled risk - and they are not going to be selling insurance at a loss, whether that pool is on the exchanges or not....

so - they are not required to sell at a loss so not sure how this "can't happen" if there is a pool outside the exchanges that is less costly.  Will there still be "private insurance" outside the exchanges?  idk

Also - weren't you talking about cobra - isn't that still available through your employer? Is cobra going to go away now that there are the exchanges? I hadn't heard about that - although - it might be as everyone will be able to get on the exchanges - but - I don't know what the current status of that is.

The point I was trying to make is that it shouldn't matter whether you are buying insurance through the exchange or not, for the same plan, the rates should be the same.  Rocky Mtn Saver's comment seemed to me to imply that because I had access to insurance outside the exchange, I would be able to buy insurance for less than the rates quoted on the exchange.  I can't see that happening.

[Rocky Mtn Saver]

My point was that the purpose of the ACA is to help those who don't have access to employer coverage or can't afford to have insurance as it stands.  You can do both already, so you may not see the touted financial incentives designed to try to help the poor and uncovered.  You're not the person the ACA is most designed to assist, although you still benefit from the OOP caps, lifetime caps, and attempted quality improvements.  So, yes, if COBRA is a better option for you, then take it.  You have more options to get and stay covered, which is one of the key goals for the ACA. 

[Deleted]

tskeeter,

You might want to check out my thread from last week:

notmsnmoney.proboards.com/thread/35390/aca-coverage-cost

In a nutshell we would have to pay $150/mth or a 30% increase to maintain our current level of coverage (basically silver). Kaiser did the typical marketing thing and is going to have us slip to bronze level. We're still pretty healthy at nearly 55 and 52 so will probably take it.

While disappointed, I can't say I'm surprised. I believe there's a reason that so many aren't currently covered.

The one silver lining I see for us is that we can't be rejected due to pre-existing conditions and can shop around in the future.

[tskeeter]

Oct 14, 2013 17:52:26 GMT -5 @bonnap said:

tskeeter,

You might want to check out my thread from last week:

notmsnmoney.proboards.com/thread/35390/aca-coverage-cost

In a nutshell we would have to pay $150/mth or a 30% increase to maintain our current level of coverage (basically silver). Kaiser did the typical marketing thing and is going to have us slip to bronze level. We're still pretty healthy at nearly 55 and 52 so will probably take it.

While disappointed, I can't say I'm surprised. I believe there's a reason that so many aren't currently covered.

The one silver lining I see for us is that we can't be rejected due to pre-existing conditions and can shop around in the future.

Saw your thread last week.  Guess I was hoping that my level of concern was unjustified and that the rate increases you reported were related to being in CA, which has been identified as one of the places experiencing significant rate increases.

Overall, my take is similar to yours.  The pre-existing condition provision is an advantage.  And we might have more flexibility around selcting plan providers.  But, it looks like we're going to experience the cost increases I was hoping we might avoid. 

[Rocky Mtn Saver]

I would also respectfully point out that there's no way to know how much of any increases in premiums or decreases in coverage right now are actually due to the requirements/structure of the ACA, and how much of that is the insurance companies seizing on a gorgeous opportunity to jack up rates knowing that "Obamacare" will take all the blame and not themselves. 

[tskeeter]

Oct 14, 2013 17:56:47 GMT -5 @tbird said:

Oct 14, 2013 17:47:54 GMT -5 @wxyz said:

For those that will be working over the next 10-30 years, enjoy the ride.  Obamacare is going to be the gift that just keeps on giving for your entire life.

I would bet that in 10 years it will be very rare for ANY employer, except of course for government, to offer health insurance.  It will become the norm to simply give the employee some minimum amount, like $2500, and tell them they have to get their own through the exchanges.

If you think not, than you are not old enough to remember how about 15-20 years ago it was the norm for companies to offer defined benefit pensions.  Of course, they are virtually all gone now except of course for government workers.  Once companies saw that they could pay some percentage of earnings and put all the employees into a 401K plan instead of a traditional pension the change took off and became the norm within about ten years.  The same is OBVIOUSLY going to happen with health insurance.

The employers will love it since this will dramatically decrease their financial obligation.  Employees will hate it at first but within about 10-15 years no one will remember the days of employer provided health care.

ENJOY (I will be on medicare in about nine months so...... )

I'm not sure this is a bad thing?

One of McCains issues was the lack of consumers impact on health care costs - consumers are somewhat blind to what they paying either for services OR even the insurance if it is employer subsidized one. The thought was to get it out of the employers and into the consumers hands. Isn't this at least some step towards that?

I've been in situations where I was not happy with the choices offered....crappy HMO or superexpensive PPO, and nothing in between....getting your own- at least you know what it costs, you can make some cost containment decisions, and I don't think that is necessarily a net negative.

Rukh, I don't think that Obamacare does much of anything to put the consumer back into the medical services equation.  Government officials have defined what services are to be covered by insurance plans.  Not the individual consumer.  An insurance company is the party paying for the care, not the consumer.  The fact that the consumer does not pay directly for each service provided means that the consumer doesn't make the same decisions about when to seek medical care, based on their own cost benefit anaysis of the true cost of the services they consume.  Patients make that decision based on the cost of their co-pay.  When discussing which tests the Doctor will order, the patient doesn't decide to decline expensive tests that are unlikely to provide valuable information about their condition.  The immediate out of pocket cost for the patient is limited to their co-pay and has no relationship at all to the cost of the tests being ordered by the Doctor.  If the patient was responsible for paying for every test the Dr. ordered, the patient would probably assume a more active role in determining which tests would be performed, and whether those tests would be performed enmass, or whether the determination of whether or not to do each test would be predicated on the results of the preceeding test.     

My take is that Obamacare simply puts an insurance company in the middle of more Dr./patient relationships than ever before by penalizing people who choose not to purchase medical insurance.  And that it reduces the involvement of consumers in determining what types of services they want to have covered by any medical insurance they may choose to purchase because the Obamacare legislation mandates that a specific menu of services be included in every insurance policy.  Neither of these actions strike me as being particularly consumer centric.  

[Rocky Mtn Saver]

The ACA requires a minimum level of services provided, which is not the same thing as 'a specific menu of items'.  The government also tells my car manufacturer what minimum safety levels, fuel efficiency, and structural items it must put into its product.  This serves me as the consumer because I don't have to try to determine what was included or not included in the car's manufacture.  Having minimum standards provides consumers a place to begin on a level playing field and then purchase above that what they can afford and what they want. 

[Rocky Mtn Saver]

Oct 14, 2013 18:48:18 GMT -5 @tbird said:

Oct 14, 2013 18:36:32 GMT -5 Rocky Mtn Saver said:

I would also respectfully point out that there's no way to know how much of any increases in premiums or decreases in coverage right now are actually due to the requirements/structure of the ACA, and how much of that is the insurance companies seizing on a gorgeous opportunity to jack up rates knowing that "Obamacare" will take all the blame and not themselves. 

That is really worrisome, but I think we have to wait and see?

Also - it may be what the company sees as a necessary safeguard since no one can predict how this is really going to go the next year or two. They had to offer plans and they aren't allowed to consider those pre-existing conditions, there fore - they are unable to estimate their costs going forward so this is all in flux.

Hopefully - if they do overcharge - it will correct downwards the next time rates are set.

We shall see...

But we've already seen this with business pre-emptively striking their health coverage offerings while decrying that 'Obamacare made me do it'.  This is a great opportunity to increase profit and decrease expenses.  I seriously doubt the insurance companies aren't doing exactly the same thing. 

ETA:  How often does any company get a blank-check opportunity to increase rates and/or decrease services without being expected to offer any backup support for their claims that they had no other choice?  All they have to say is "it's Obamacare's fault" and we consumers all go, "right, that lousy government..."  It'd be too hard for most companies to pass up. 

[Rocky Mtn Saver]

Being covered by a crappy plan is part of the problem the ACA is trying to fix.  Many medical-related bankruptcies still involve people who are covered by some kind of coverage.  But without things like OOP caps, with lifetime limits on coverage, etc, those plans still leave their clients high and dry when the poo-poo hits the fan. 

[Deleted]

Well, technically my policy would end too since it doesn't cover maternity care. I'm 52 and post menopausal. And my husband is male and has to be covered too.

Sometimes these articles say nothing important.  

[Rocky Mtn Saver]

Oct 14, 2013 19:04:37 GMT -5 @bonnap said:

Well, technically my policy would end too since it doesn't cover maternity care. I'm 52 and post menopausal. And my husband is male and has to be covered too.

Sometimes these articles say nothing important.  

Technically, I think my policy ended this summer too.  I only know that because our plan had been grandfathered in for a couple of years and didn't cover several new requirements in preventative care.  This summer, we were no longer grandfathered in and so the insurance now covers several new things.  I also just got an informational brochure this week that said I was "receiving this notice because you recently became covered under your employer's group health plan."  I've been covered under this plan for 5 years, so I think it's finally become a 'new' ACA-eligible plan. 

[Rocky Mtn Saver]

Oct 14, 2013 19:05:03 GMT -5 @tbird said:

Oct 14, 2013 18:52:45 GMT -5 Rocky Mtn Saver said:

We shall see...

But we've already seen this with business pre-emptively striking their health coverage offerings while decrying that 'Obamacare made me do it'.  This is a great opportunity to increase profit and decrease expenses.  I seriously doubt the insurance companies aren't doing exactly the same thing. 

ETA:  How often does any company get a blank-check opportunity to increase rates and/or decrease services without being expected to offer any backup support for their claims that they had no other choice?  All they have to say is "it's Obamacare's fault" and we consumers all go, "right, that lousy government..."  It'd be too hard for most companies to pass up. 

I thought there was a profit limit in place for the insurance companies?

But I agree - there is greed motivation for some entities - now with a convenient scapegoat. And worse - there are some entities motivated to make it as painful/expensive as possible to prove a point. So - what we are going to end up with - is a crap shoot. 

Yeah, I do think there's some new rules.  But I'm also sure they'll find a way to milk it for all it's worth! They're insurance companies, after all!

[Deleted]

skeeter, in the op did you mean that when you retire you will have income levels which will put you outside the subsidies level?