Cost of Obamacare in the USA

[gk10002000]

I have read some posts about people returning to the USA and asking about medical insurance.  I thought I would add my two cents.  I am 59.  I live in Florida.  I am still working and I make too much money to qualify for subsidies.   I just went to the health gov site and entered all the relevant information and the absolute cheapest plan available would cost $483/month.  California is slightly cheaper I think, but not by much.  So those of you that are independently working (have real estate income, dividend, interest or pensions, etc. this is what you have to look forward to in the USA. 

 

 My previous Florida Blue Cross Blue Shield plan was "grandfathered" albeit with rate increases of 28% a year and I now pay $324 a month.   I don't have to go through the Obamacare website morass.    My plan used to be a fine catastrophic plan which was all I needed or wanted.  

[amykat]

Hi GK,

 

I am just wondering if you could expand on what you wrote a bit?  For example, when you say your catastrophic plan was all you need or want ...do you mean that at 59 until 65? you expect to not use medical care to any significant degree?  Or that you don't mind if you have to pay yourself  $200K, $400K or some other large amount if needed?  Can you give us an outline of what that policy offers?

 

I think your plan sounds very cheap ...but I think it doesn't offer much ...are you saying you think it is cheap also, or expensive?  Good or bad?

[gk10002000]

6 hours ago, amykat said:

Hi GK,

 

I am just wondering if you could expand on what you wrote a bit?  For example, when you say your catastrophic plan was all you need or want ...do you mean that at 59 until 65? you expect to not use medical care to any significant degree?  Or that you don't mind if you have to pay yourself  $200K, $400K or some other large amount if needed?  Can you give us an outline of what that policy offers?

 

I think your plan sounds very cheap ...but I think it doesn't offer much ...are you saying you think it is cheap also, or expensive?  Good or bad?

i think you are misunderstanding what a wrote.  The word catastrophic is a bit of a misnomer.  Plans that used to have coverage for hospitalization or surgery but had little coverage for routine doctor visits were called "catastrophic".  Obamacare doesn't allow that.  All obamacare plans now focus a lot more on providing coverage for routine exams, doctor visits, etc. Not a bad idea, but the plan prices are much higher.  I also now get mandatory maternity coverage (hard to see a use for that at 59 and being a man, drug counseling, and some other stuff I don't want or need).  They significantly limit the type of plan you can choose.  And the cost of plans are very much more in almost all cases, certainly is in mine.  In 2006 when I first got my FL BC BS, my plan was $66/mo.  In 2015 it was $343, now because I presume because I moved from N. Palm Beach two miles north to Jupiter, my cost is $324.  And the biggest price increases were right after Obamacare was signed into law.  5 x increase in price in 10 years (66-324).

  My plan always had fine coverage for hospital, surgery etc.  My deductible was like $5,000.  No big deal since I never had any medical issues.  Basically it was better to have a high deductible and pay lower premiums.  Now it just costs more and the deductible is higher!  I don't know what you mean abut 200k

 

  I just wanted to point out how expensive USA medical care can be for any expats returning to the USA.  Too lazy to list my exact plan features today, but I will post it soon after I log in to my florida blue, I will copy and paste the summary values

[ClutchClark]

I am very appreciative that you have posted this topic.

 

Here is a recent article which discusses the problems with the ACA and why your premiums are very likely to go up more IF you can even find an Insurer to offer you coverage since they all seem to be getting out of the business:

 

http://www.weeklystandard.com/article/2003998

[Boon Mee]

3 hours ago, ClutchClark said:

I am very appreciative that you have posted this topic.

 

Here is a recent article which discusses the problems with the ACA and why your premiums are very likely to go up more IF you can even find an Insurer to offer you coverage since they all seem to be getting out of the business:

 

http://www.weeklystandard.com/article/2003998

Obamacare was a major Trainwreck out of the box.  No wonder it's on minimal life support now.

His lasting legacy! 

[amykat]

Hi GK,

 

Thanks for posting again.  What I meant about paying out $200K for example, was that I think many of these cheaper plans only pay a portion of your costs ...like 50%, or 60% along with whatever high deductibles they have.  Therefore, if you have a large expense, one could get hit with a large bill, like $200K or more.  If you have a small net worth, or one that is variously protected,  maybe you don't care ...if you do care, this wouldn't seem like a good insurance choice to me. (I mean some people plan they will just go bankrupt.)

 

Your previous $66 a month policy probably didn't really cover very much either ...you just never had a chance to find out ...lucky you!  It is when you get cancer, have a stroke, or have an expensive "mystery illness" that needs a diagnosis/treatment, that you find out the real holes in your policy and how much it suck(ed) ...hopefully mostly in the past?

 

The average healthy American person has no reason to learn the ins and outs of the medical and insurance industry until and unless disaster strikes and then it is usually too late.  Also because our employers usually took care of the insurance we didn't even care/know how much that cost until maybe this last decade as things have been changing.

[tonray]

8 hours ago, Boon Mee said:

Obamacare was a major Trainwreck out of the box.  No wonder it's on minimal life support now.

His lasting legacy! 

And what about the healthcare insurance system prior to his Presidency ?...yet again a Trainwreck. Please keep your partisan nonsense out of your posts as it shows how little you actually know about the system. Costs were similar and have risen at about the same rate that they had risen prior to the system's implementation but now people can have some protections. The system sucks in whole but Obamacare did not break it.

[Boon Mee]

“Obamacare failed because it flunked Economics 101 and Human Nature 101.”

The Chicago Tribune published a blistering editorial Friday which says Obamacare is not only failing but has already failed because it “flunked Economics 101 and Human Nature 101.”

 

[ClutchClark]

2 hours ago, Boon Mee said:

“Obamacare failed because it flunked Economics 101 and Human Nature 101.”

The Chicago Tribune published a blistering editorial Friday which says Obamacare is not only failing but has already failed because it “flunked Economics 101 and Human Nature 101.”

 

 

Interesting because that is a libersl leaning newspaper and their Mayor Rahm Emmanuel is the brother of one of the leading architects of obamacare. 

 

Obamacare is a failure and the insurance companies are exiting the program at breakneck speed. 

 

So what happens next?

 

It morphs into a single party system like Medicare run by the gov't with no 3rd party entities OR portions of it start getting dismantled OR they start imposing heavier fines and jail times on these millions of healthy Americans who are refusing to take part in a rigged system. 

 

Who ever thought they would see the day that Americans were required by Law to participate in a private corporate-run "for-profit" commercial enterprise? Its the most un-American concept ala obama. 

[Boon Mee]

1 minute ago, ClutchClark said:

Who ever thought they would see the day that Americans were required by Law to participate in a private corporate-run "for-profit" commercial enterprise? Its the most un-American concept ala obama. 

It plays right into the Saul Alinsky plan to make America a failed State....

[ClutchClark]

3 hours ago, tonray said:

And what about the healthcare insurance system prior to his Presidency ?...yet again a Trainwreck. Please keep your partisan nonsense out of your posts as it shows how little you actually know about the system. Costs were similar and have risen at about the same rate that they had risen prior to the system's implementation but now people can have some protections. The system sucks in whole but Obamacare did not break it.

 

It is true that there were problems with our healthcare system in the US...many problems...but you are not correct that "costs have risen about the same". That is not true...obamacare has driven up costs even faster than the old trainwreck and deductables, co-pays and out-of-pocket limits have all increased as well at an exponential rate.

 

The only difference is that now its the hard-working Americans who can't afford health insurance AND the previously uninsured (the low-income) group now has free and/or highly subsidized healthcare. Ironically, its this marginal income group which also makes the very unhealthiest lifestyle choices (alcohol, cigarettes, obesity) and places the greatest burden on the healthcare system. 

 

And its a shame this is such a partisan issue because you will no doubt paint me as a conservative but I supoorted Bill Clinton when Hillary first brought the concept of nationalized healthcare into the national debate. I recognized the problems with the old trainwreck...but it was quite apparent from the outset of the ACA that it was an even larger trainwreck.

 

And now that insurers are dropping like flies  no one can deny that.

[gk10002000]

14 hours ago, amykat said:

Hi GK,

 

Thanks for posting again.  What I meant about paying out $200K for example, was that I think many of these cheaper plans only pay a portion of your costs ...like 50%, or 60% along with whatever high deductibles they have.  Therefore, if you have a large expense, one could get hit with a large bill, like $200K or more.  If you have a small net worth, or one that is variously protected,  maybe you don't care ...if you do care, this wouldn't seem like a good insurance choice to me. (I mean some people plan they will just go bankrupt.)

 

Your previous $66 a month policy probably didn't really cover very much either ...you just never had a chance to find out ...lucky you!  It is when you get cancer, have a stroke, or have an expensive "mystery illness" that needs a diagnosis/treatment, that you find out the real holes in your policy and how much it suck(ed) ...hopefully mostly in the past?

 

The average healthy American person has no reason to learn the ins and outs of the medical and insurance industry until and unless disaster strikes and then it is usually too late.  Also because our employers usually took care of the insurance we didn't even care/know how much that cost until maybe this last decade as things have been changing.

No no and no.  You are 100% wrong.  My policy did and still does cover everything.  I never would have paid more than the 20% of the costs up until I hit the deductible.  The policy was quite clear.  I did use it once for kidney stone and yes, I ended up paying about 1800 because it was an emergency, I was out of network, etc.   But I would never have paid more than the deductible.  That is what catastrophic coverage does.  You pay less per month, you pay more for routine stuff, but if something big happens you are covered.  $200 k was never in the cards now or then.

[gk10002000]

10 hours ago, Boon Mee said:

It plays right into the Saul Alinsky plan to make America a failed State....

It really does stun me that americans can be forced to

 

10 hours ago, ClutchClark said:

 

Interesting because that is a libersl leaning newspaper and their Mayor Rahm Emmanuel is the brother of one of the leading architects of obamacare. 

 

Obamacare is a failure and the insurance companies are exiting the program at breakneck speed. 

 

So what happens next?

 

It morphs into a single party system like Medicare run by the gov't with no 3rd party entities OR portions of it start getting dismantled OR they start imposing heavier fines and jail times on these millions of healthy Americans who are refusing to take part in a rigged system. 

 

Who ever thought they would see the day that Americans were required by Law to participate in a private corporate-run "for-profit" commercial enterprise? Its the most un-American concept ala obama. 

It really does stun me that the American law forces people to buy this. There is nothing in the constitution that allows this.  I can't believe it has survived some court challenges.  It is like saying the state or government can now mandate Pet cat or dog insurance, or that you must carry 20 million dollar car insurance, or that you must buy flood insurance for your high desert house, or hundreds of other things. 

[gk10002000]

Let me get back on point.  The cheapest medical plan on the health gov obamcare ADA site for me a 59 1/2 year old, non smoker single man, no health issues, in Jupiter, Palm Beach County Florida, making enough income to not qualify for any cost subsidies is $483/month.  Some other states are a little cheaper but not by much.  So those of you thinking of coming back to the USA or who are comparing costs of living abroad, keep that medical cost in mind.  I certainly am.

 

And the actual use of applying for, updating tax and income every year, adjusting premiums, etc. is a headache most people don't realize they have to go through.   Coverage, choice of doctors, HMO, PPO etc are all other issues also.  I just wanted to point out the monthly cost.

[thaihome]

In the midst of all, what is often, partisan criticism of the ACA, I have not seen a single mention of the many millions of low income working people and their families that now have affordable health insurance for the first time. 

 

I certainty agree that the ACA that managed to get out of congress is less then ideal. It would be very good if next year Congress can address these shortcomings. Unfortunately that is unlikely as even if the Senate goes Democratic, it is unlikely the House will.  There is no reason to think that the Republican leadership will behave in  a less partisan manner and refuse to consider any proposal from a Democratic president, even if it is for the benefit of the people.

 

A prime example of this is the current proposal for Zitka research funding that cannot get out of congress due to certain republican members insisting on the bill include a complete defunding of Planned Parenthood, a completely unrelated issue they attach to every bill. How many babies will be born with serious birth defects that might have been prevented by a vaccine in order to further the agenda of these so called "right to life" radicals.

TH 

[gk10002000]

10 hours ago, thaihome said:

In the midst of all, what is often, partisan criticism of the ACA, I have not seen a single mention of the many millions of low income working people and their families that now have affordable health insurance for the first time. 

 

I certainty agree that the ACA that managed to get out of congress is less then ideal. It would be very good if next year Congress can address these shortcomings. Unfortunately that is unlikely as even if the Senate goes Democratic, it is unlikely the House will.  There is no reason to think that the Republican leadership will behave in  a less partisan manner and refuse to consider any proposal from a Democratic president, even if it is for the benefit of the people.

 

A prime example of this is the current proposal for Zitka research funding that cannot get out of congress due to certain republican members insisting on the bill include a complete defunding of Planned Parenthood, a completely unrelated issue they attach to every bill. How many babies will be born with serious birth defects that might have been prevented by a vaccine in order to further the agenda of these so called "right to life" radicals.

TH 

the data are so inaccurately and incompletely reported that nobody knows what the real numbers are.  It is in general a fallacy to say that poor or low income families now can get health care.  There were plenty of cheap health care plans out there before and with a lot more choices than people had before.  What is happening now, is the families go through the rigor of applying for the ACA, then for the cheapest plans, they are getting hit with deductibles that they can't pay out of pocket.   I challenge you to name one person that you know that now has cheaper and better medical coverage than they had before. 

[thaihome]

10 hours ago, gk10002000 said:

the data are so inaccurately and incompletely reported that nobody knows what the real numbers are.  It is in general a fallacy to say that poor or low income families now can get health care.  There were plenty of cheap health care plans out there before and with a lot more choices than people had before.  What is happening now, is the families go through the rigor of applying for the ACA, then for the cheapest plans, they are getting hit with deductibles that they can't pay out of pocket.   I challenge you to name one person that you know that now has cheaper and better medical coverage than they had before. 

 

Good way to avoid a fact driven discussion, just dismiss all the facts and request anecdotal data to prove your point. I  have  a pretty good idea where this will go but anyway,

CLAIM: The law has increased the number of people with health insurance coverage.

This is true, no matter what measure you use. The official Census Bureau and polling firmGallup both found substantial drops in the percentage of people without health insurance after the majority of the law’s coverage expansions took effect in 2014.

http://time.com/money/4209465/is-obamacare-working/

 

As the article  says (and many others as well), lots of issues with the ACA in its current form, but the fact remains the US has the worst, most expensive health care system in the developed world  (and worse then many developing countries). Partisanship politics and knee jerk rejection due to source will not solve it. Most of the ACA originated with Republican proposals, but they continue to reject it simply because they cannot agree to anything Obama does. They are not the least bit ashamed to admit it, and in fact brag about it.

 

By the way, I have not lived in US for 20 years, I don't know anyone in the US that is not covered by an employer provided health insurance. 

TH 

 

 

[gk10002000]

11 hours ago, thaihome said:

 

Good way to avoid a fact driven discussion, just dismiss all the facts and request anecdotal data to prove your point. I  have  a pretty good idea where this will go but anyway,

 

 

 

As the article  says (and many others as well), lots of issues with the ACA in its current form, but the fact remains the US has the worst, most expensive health care system in the developed world  (and worse then many developing countries). Partisanship politics and knee jerk rejection due to source will not solve it. Most of the ACA originated with Republican proposals, but they continue to reject it simply because they cannot agree to anything Obama does. They are not the least bit ashamed to admit it, and in fact brag about it.

 

By the way, I have not lived in US for 20 years, I don't know anyone in the US that is not covered by an employer provided health insurance. 

TH 

 

 

haha. What a nit.  read the freaking article and do more research.   Even if some people did get more insurance than they were there before, it does NOT mean it was due to Obamacare, except that many chose now to get it because it is the LAW and they would be subject some fines that are getting pretty stiff if they don't get it. 

[gk10002000]

12 hours ago, thaihome said:

 

Good way to avoid a fact driven discussion, just dismiss all the facts and request anecdotal data to prove your point. I  have  a pretty good idea where this will go but anyway,

 

 

 

As the article  says (and many others as well), lots of issues with the ACA in its current form, but the fact remains the US has the worst, most expensive health care system in the developed world  (and worse then many developing countries). Partisanship politics and knee jerk rejection due to source will not solve it. Most of the ACA originated with Republican proposals, but they continue to reject it simply because they cannot agree to anything Obama does. They are not the least bit ashamed to admit it, and in fact brag about it.

 

By the way, I have not lived in US for 20 years, I don't know anyone in the US that is not covered by an employer provided health insurance. 

TH 

 

 

As you say, you only know people that work for companies and that have employer coverage.  Their costs increased but not a deal breaker.  As you said, you don't know anybody not covered by an employer.  that means you don't know any of the millions of independent business people, small restaurant owners, gas station owners, real estate brokers, investors, technical or other types of contractors such as myself, etc.  Those millions of people are getting screwed pricewise and plan wise. 

[ClutchClark]

This is the same conversation which has played out so many times in my presence.

 

Democrats on employer coverage their entire careers try to tell people all the cheerleading news releases of the wonders of the ACA and they parrot that crap as if it is the gospel to those who have discovered first hand that its incredibly expensive coverage for small businesses and workers who have to sign up on the Exchanges (my state of CO still has a state exchange).

 

The ONLY people who have done well in the ACA are those getting subsidies due to low income. 

 

 

[Jingthing]

The preexisting condition change is HUGE for those that need to purchase their own insurance. 

[gk10002000]

main point was if you are repatriating back to the USA and losing your overseas exemption that lets you not use Obamacare, be prepared for a health care system you now are required by law to pay for or be penalized.  Do your own due diligence.

[vaultdweller0013]

On 9/11/2016 at 1:11 AM, gk10002000 said:

i think you are misunderstanding what a wrote.  The word catastrophic is a bit of a misnomer.  Plans that used to have coverage for hospitalization or surgery but had little coverage for routine doctor visits were called "catastrophic".  Obamacare doesn't allow that.  All obamacare plans now focus a lot more on providing coverage for routine exams, doctor visits, etc. Not a bad idea, but the plan prices are much higher.  I also now get mandatory maternity coverage (hard to see a use for that at 59 and being a man, drug counseling, and some other stuff I don't want or need).  They significantly limit the type of plan you can choose.  And the cost of plans are very much more in almost all cases, certainly is in mine.  In 2006 when I first got my FL BC BS, my plan was $66/mo.  In 2015 it was $343, now because I presume because I moved from N. Palm Beach two miles north to Jupiter, my cost is $324.  And the biggest price increases were right after Obamacare was signed into law.  5 x increase in price in 10 years (66-324).

  My plan always had fine coverage for hospital, surgery etc.  My deductible was like $5,000.  No big deal since I never had any medical issues.  Basically it was better to have a high deductible and pay lower premiums.  Now it just costs more and the deductible is higher!  I don't know what you mean abut 200k

 

  I just wanted to point out how expensive USA medical care can be for any expats returning to the USA.  Too lazy to list my exact plan features today, but I will post it soon after I log in to my florida blue, I will copy and paste the summary values

 

You have hit the crux of the matter: health care costs have been increasing very dramatically in the US since around 2000, give or take. This increase has had little to do with Obamacare (on the flip side, Obamacare hasn't done a whole lot to decrease costs; they have still been rising faster than inflation).

 

As an example, the company I worked for had a $60/month plan with around a $1k deductible in 2007. A couple years later, after the financial crisis,  they still offered a $60/month plan, but this was now a with a much larger deductible and you still had co-pays after the deductible up to a yearly out of pocket cap of several thousand dollars. The prices steadily increased after this, and when I finally left and moved to Thailand in 2012, the plan was at $120/month. All the costs above were just the employee contributions; my employer was paying more on top.

 

The age of 50 is around when health costs, and thus insurance premiums, start increasing significantly, which is right around when you set your baseline of $66/month. So, you really should adjust this upward by more than 50% to take into consideration the expected increase due to age. Factoring this in, you are only seeing less than a 3x increase over 10 years due to increases in the cost of health care, the other portions of your increase are due to getting older. If you factor in inflation as well, the increase is only around 2x. So, yes, health care costs have about doubled relative to other costs since 2006, but aren't 5x as high.

 

As for coverage you don't need: be careful what you wish for. Most 20-30 somethings don't need coverage for heart disease, high blood pressure, or various other ailments, especially those that are treated with prescriptions. However, the insurance companies can't pass on the complete increase health costs to the older people who will use them. In most states, they are allowed to increase the costs somewhat, but always remember, it is the 20 year olds that are subsidizing your care, and if given the opportunity, the insurance companies would jack up your rates much higher.

 

 

 

 

[GinBoy2]

All insurance works, so long as everyone participates. Think of car insurance, what would happen if the 'safe' middle aged driver decided, Nah not for me...and the insurance companies were left with the reckless young and the incontinent old? Rates would skyrocket.

 

For what ever reason, health insurance seems to take on a partisan battleground status, which totally baffles me.

 

Obamacare is flawed for sure, hobbled by the nonsense compromises required to actually get it passed. Make participation mandatory. Make the penalties for the young not participating punitive, and maybe it might work.

 

Or if you prefer, get rid of all insurance requirements...who cares if you get slammed by an uninsured driver, probably works well with your uninsured health coverage as you're being whisked to the hospital

 

 

[ClutchClark]

On September 25, 2016 at 7:29 PM, GinBoy2 said:

All insurance works, so long as everyone participates. Think of car insurance, what would happen if the 'safe' middle aged driver decided, Nah not for me...and the insurance companies were left with the reckless young and the incontinent old? Rates would skyrocket.

 

For what ever reason, health insurance seems to take on a partisan battleground status, which totally baffles me.

 

Obamacare is flawed for sure, hobbled by the nonsense compromises required to actually get it passed. Make participation mandatory. Make the penalties for the young not participating punitive, and maybe it might work.

 

Or if you prefer, get rid of all insurance requirements...who cares if you get slammed by an uninsured driver, probably works well with your uninsured health coverage as you're being whisked to the hospital

 

 

 

The pricepoint was too expensive from the start.

 

The failure was due to the ACA itself failing to take many things into account.

 

And here in  America we don't like being told to be a consumer to a private corporation or be a criminal.

[ClutchClark]

On September 20, 2016 at 11:48 PM, vaultdweller0013 said:

 

You have hit the crux of the matter: health care costs have been increasing very dramatically in the US since around 2000, give or take. This increase has had little to do with Obamacare (on the flip side, Obamacare hasn't done a whole lot to decrease costs; they have still been rising faster than inflation).

 

As an example, the company I worked for had a $60/month plan with around a $1k deductible in 2007. A couple years later, after the financial crisis,  they still offered a $60/month plan, but this was now a with a much larger deductible and you still had co-pays after the deductible up to a yearly out of pocket cap of several thousand dollars. The prices steadily increased after this, and when I finally left and moved to Thailand in 2012, the plan was at $120/month. All the costs above were just the employee contributions; my employer was paying more on top.

 

The age of 50 is around when health costs, and thus insurance premiums, start increasing significantly, which is right around when you set your baseline of $66/month. So, you really should adjust this upward by more than 50% to take into consideration the expected increase due to age. Factoring this in, you are only seeing less than a 3x increase over 10 years due to increases in the cost of health care, the other portions of your increase are due to getting older. If you factor in inflation as well, the increase is only around 2x. So, yes, health care costs have about doubled relative to other costs since 2006, but aren't 5x as high.

 

As for coverage you don't need: be careful what you wish for. Most 20-30 somethings don't need coverage for heart disease, high blood pressure, or various other ailments, especially those that are treated with prescriptions. However, the insurance companies can't pass on the complete increase health costs to the older people who will use them. In most states, they are allowed to increase the costs somewhat, but always remember, it is the 20 year olds that are subsidizing your care, and if given the opportunity, the insurance companies would jack up your rates much higher.

 

 

 

 

 

False assumptions.

 

False Narrative.

 

False Conclusions.

 

Except there are some occasional good points.