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Ask HN: Bootstrapped US founders, who do you use for health insurance?

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Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#12

Earlier quoted context omitted.

Any income greater than $50,000 a year does not qualify for any California assistance. $50,000 a year is completely unlivable where I live in the bay area. You have to be near poverty (bay area) to get any government assistance.

> You have to be near poverty (equivalent in bay area) to get any government assistance. Assistance is for those who need it, not those who willingly choose to live in a high COI area. It is possible to live in CA on $50k/year. Would you pay that assistance back if you had a liquidity event? Probably not.

I'd prefer to not get into a political discussion, but once I get on a health care plan, my full premiums will be subsidizing others, so where's my money back when I don't use any of my health care benefits?

Also, you think it's fair that somebody who makes $55,000 pays the same amount for health insurance as somebody that makes $500,000 a year?

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#13
post #10
post #4

Earlier quoted context omitted.

http://micheleincalifornia.blogspot.com/2015/12/how-to-fix-a...

> My understanding is that health insurance originated in this country as a means to plump up employee compensation in a situation where paying more wages was not desirable. You could not entice good employees by offering them a pay raise because it bumped them up into another tax bracket and it just wasn't worth it to them. But the way health insurance got handled, if you offered them a benefits package, it increase…

Thanks. I am considering doing a new piece because I get a lot of flack over details like that while people generally seem to miss the point relevant to our lives today that DPC is a legal alternative under the ACA and a genuinely better solution.

I am frustrated and not sure what I need to do differently to get that across effectively.

Edit: Feel free to nitpick this version: http://micheleincalifornia.blogspot.com/2017/01/direct-prima...

Maybe I shall eventually get it right (just in time for the law to change under Trump).

Thank you.

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#14

Earlier quoted context omitted.

Any income greater than $50,000 a year does not qualify for any California assistance. $50,000 a year is completely unlivable where I live in the bay area. You have to be near poverty (bay area) to get any government assistance.

> You have to be near poverty (equivalent in bay area) to get any government assistance. Assistance is for those who need it, not those who willingly choose to live in a high COI area. It is possible to live in CA on $50k/year. Would you pay that assistance back if you had a liquidity event? Probably not.

[deleted]

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#15

Earlier quoted context omitted.

> You have to be near poverty (equivalent in bay area) to get any government assistance. Assistance is for those who need it, not those who willingly choose to live in a high COI area. It is possible to live in CA on $50k/year. Would you pay that assistance back if you had a liquidity event? Probably not.

I'd prefer to not get into a political discussion, but once I get on a health care plan, my full premiums will be subsidizing others, so where's my money back when I don't use any of my health care benefits? Also, you think it's fair that somebody who makes $55,000 pays the same amount for health insurance as somebody that makes $500,000 a year?

Let's not get into politics then.

At your income level, you're not getting subsidies. You can either pay the IRS penalty, around $2k at what I'm estimating your income at, and cash for whatever health expenses come up, or you can seek out a religious organization who will give you a waiver if you join their program (note: the healthcare that can be provided through such a financial program is probably not what you're going to prefer when the time comes for your healthcare needs to be addressed, caveat emptor).

Another option is to move out of the country before the end of the month; you're not required to be insured if you live outside the US at least 330 days/year.

You could also look at a cheaper bronze HDHP plan instead.

EDIT:

> Also, you think it's fair that somebody who makes $55,000 pays the same amount for health insurance as somebody that makes $500,000 a year?

Not at all! I'm just telling you your options. Don't like it? Quit your startup and go into politics. Good people need to grind day and night to fix things like this. Your fight is not with me. The situation in general sucks, and I am genuinely sorry about your frustration with your healthcare insurance costs.

I thought we weren't getting into politics though (re: your edit adding the last line).

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#17
post #11

try Kaiser permanente cheaper and the model is more efficient. yes you give up some choice but there's a reason it is cheaper before you poo poo it I would give it a try with an open mind

I loved Kaiser when I was in SF. they delivered an awesome service. I just wish they were in Florida :[

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#18
post #7

Earlier quoted context omitted.

What happens when you need urgent medical care like the hospital using direct care?

That is what the high deductible insurance or health savings account is for.

i can't contribute to an HSA without subscribing to a high deductible plan.

" basically a membership in a clinic where you pay a monthly fee in order to get cheap access to your doctor... The monthly fee is substantially less than typical health insurance premiums."

But... I still need a high-deductible plan to contribute to an HSA to deal with catastrophic issues anyway. high deductible plans are putting colleagues of mine in to $1000/month premiums already - saying "spend even more $ each month on a membership plan" isn't going to cut it for most people I know.

5 year ago a 'high deductible' plan cost my family <$300/month. Today it's close to triple what I paid just a few years back.

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#19
If you don't qualify for any subsidy, you should definitely just purchase health insurance directly through the carrier.

I initially purchased insurance via CoveredCA (no subsidy) and they just acted as a middleman between my family and Blue Shield without providing any benefit.

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#20
post #10
post #4

Earlier quoted context omitted.

http://micheleincalifornia.blogspot.com/2015/12/how-to-fix-a...

> My understanding is that health insurance originated in this country as a means to plump up employee compensation in a situation where paying more wages was not desirable. You could not entice good employees by offering them a pay raise because it bumped them up into another tax bracket and it just wasn't worth it to them. But the way health insurance got handled, if you offered them a benefits package, it increase…

That statement is too strong and not correct. For examples of when a marginal tax rate can be over 100 percent, see the first answer here: http://money.stackexchange.com/questions/1258/why-would-you-... and here: https://www.epionline.org/wp-content/studies/shaviro_02-1999...
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