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Many See I.R.S. Penalties as More Affordable Than Health Insurance

nytimes.com

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Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#91

Post by zrail »

mgkimsal wrote: post #76
Frondo wrote: post #67

Earlier quoted context omitted.

When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…

Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available. Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before). App…

We started on a $1500 indv / $3000 fam deductible PPO in 2014 for about $800/mo for two people. In 2015 the premiums went down maybe 0.5%. In 2016 the premiums have gone up 6% and the out of pocket max went up $500 per person to $4k.

ACA has absolutely been a net positive in my life. I had cancer in 2012 and so it would have been literally impossible for me to get health insurance outside of a group plan. With ACA I've been able to go independent, start my own business, choose my own clients, and fully control my destiny.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#92

Post by llamataboot »

teuobk wrote: post #45
tptacek wrote: post #27

Earlier quoted context omitted.

If you don't have preexisting conditions, you can still buy PPOs from the big insurers as non-ACA plans.

Based on my search this year, that isn't necessarily true. Here in Denver, all of the insurers that were offering PPO plans in years past have left the individual market (not just the ACA exchange), save one: Anthem BCBS. Availability appears to vary widely, both from state to state and within states. If I lived in western Colorado instead of on the Front Range, I'd have a couple of PPO insurer options. If I still li…

Don't miss it too much, my BCBS of MN policy just went up 45% year-over-year. It's pretty good coverage, but it's still nearly $10k/year just for the premium for my wife and I.

Still, I was also one of those pre-existing conditions that simply could not buy any insurance before the ACA.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#93

Post by JoBrad »

ghaff wrote: post #57
dibujante wrote: post #53

Earlier quoted context omitted.

No, I factored taxes into my calculation. I am aware that "free" healthcare is not "free" unless you do not pay tax.

According to this [1] which is fairly consistent with other things I've read, US costs are maybe 25% higher than in Canada. What that means is debatable in the context of waiting times, etc. [1] https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_s...

The US government was spending 25% more on healthcare, pre-ACA, and with less comprehensive healthcare than Canada. Actual healthcare cost overall (on average) is roughly double for all of the year's listed in the chart.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#94

Post by iofj »

yetanotherone wrote: post #44
tomohawk wrote: post #32

Inevitable result of thinking that adding even more government intervention would result in better, cheaper plans. If they were really interested in making better, cheaper plans, they would roll back most of the ACA, eliminate the restrictions on buying across state lines (actually allow competition), and transfer the tax incentives for getting insurance from employers to employees. Basically, all they had to do to m…

It's a little offtopic, but this reminds me of Lessig's "the corrupting influence of money is the first problem facing this nation. That unless we solve this problem, we won’t solve anything else." In my opinion the public option wouldn't have cost us much as a nation on the whole, and could have possibly worked out to great advantage, but was not going to happen because health insurance companies are too powerful fo…

> In my opinion the public option wouldn't have cost us much ...

If you look at the margins the insurers are using (the maximum a public option might be cheaper), they're not much. 10% is rare. Given government inefficiency, I'd expect a public option to have been at least as expensive, and probably more expensive.

So why would a public option be cheaper ?

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#95

Post by pmorici »

brewdad wrote: post #23
pmorici wrote: post #10

Earlier quoted context omitted.

My current plan has an has an HSA component but the company that administrates the account, BenefitWallet, has some fine print in the account agreement that they charge an account fee for balances less than several thousand dollars. Realistically I only spend several hundred dollars per year on healthcare stuff so I don't think it is to my advantage to lock up that much money in a non-interest bearing account or pay…

One advantage to consider is that there is no time limit on when you spend the money. As you age, your health care costs will rise. How much interest are you really making on $5000 in today's environment? $50? $100? Meanwhile, you save your marginal tax rate on any dollars contributed towards future medical expenses. That's a pretty good return on your money. $5000 at 28% marginal rate knocks $1400 off your tax bill.

~7% ($350)

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#96

Post by lisper »

mgkimsal wrote: post #76
Frondo wrote: post #67

Earlier quoted context omitted.

When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…

Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available. Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before). App…

> Yeah, it's pretty crappy in NC.

That's because your state is run by people who want desperately for the ACA to fail, and so they are intentionally making it as crappy as they can.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#97

Post by magicalist »

gscott wrote: post #2

I work with someone who has health insurance from the California exchange. His assigned doctor is about a 2 hour drive away. Maybe he has picked the cheapest plan but such a situation shouldn't really happen if this was well run.

FWIW as of 2015 California requires there be "primary care network providers with sufficient capacity to accept covered persons within 30 minutes or 15 miles of each covered person's residence or workplace", specialists within 60 minutes or 30 miles, and that there be sufficient capacity for doctors within those limits to accept new patients[1].

Getting that enforced isn't easy, but that situation not only shouldn't happen but should also be grounds for regulatory action against the insurer.

[1] http://www.insurance.ca.gov/0400-news/0100-press-releases/20...

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#98

Post by mikeash »

lotsofpulp wrote: post #88
mikeash wrote: post #66

Earlier quoted context omitted.

It's mildly terrifying. If you're unlucky enough to break a major bone or get cancer or something like that, you could literally be on the hook for millions of dollars. I lived overseas for a couple of years, and when I got back to the US one of the first things I did was obtain health insurance because of this.

Might be a better option to just declare bankruptcy.

In many cases that's true. Medical debt is the cause of most personal bankruptcies in the US. But it's not a good option either, so better to avoid both if you can. If you have substantial savings then you'd stand to lose those to your creditors in bankruptcy. If you have no savings and don't plan on taking out any loans for a long time then it might be a decent option.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#99

Post by iofj »

clamprecht wrote: post #64
privong wrote: post #39

Earlier quoted context omitted.

> The plans have been a disaster. They got rid of the only plan that makes sense for young people: Catastrophic insurance (deductible of over $10,000). Don't forget, that was by design. The law needs young, healthy people to put money into the system to support the expenses insurance companies would encounter due to the increased coverage for less healthy people.

I am okay with paying more to cover others who can't afford it. What I'm not okay with is losing my plan, my doctor, and my benefits, all while paying more.

When you think about it, the two are really the same thing. A lot of people (some 15 million) got coverage, and they're not paying for it, you are.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#100

Post by ploxiln »

simoncion wrote: post #90
ploxiln wrote: post #50

Earlier quoted context omitted.

Well, that's not traditionally how health insurance works in the US, but it's how all types of "insurance" should work - it should not be for routine costs. Insurance, generally, should be for unlikely unexpected costs. Otherwise, it's just involving an extra middle-man in payment, and that middle-man is going to make a profit. It's unfortunate that in the US, even for completely routine medical costs, you can't skip…

> I think the fixation on "everyone should have good health insurance" is making this dysfunctional situation permanently unfixable. Nah. Every citizen should have good health insurance that requires no out-of-pocket expenditures. There should be one plan, available to every citizen. There should be one payer, the Federal Government. Anything else is a recipe for price-gouging and ballooning costs.

but see, that's not "insurance"
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