General Discussion
In reply to the discussion: Here's my ACA rate INCREASE for those who doubt... [View all]Yo_Mama
(8,303 posts)I'm sorry, but it is. This plan is one of the qualifying plans sold on the exchange in his state for people his age, and yes, premiums will be very similar, because every company is basically working off the same tables.
ACA's individual mandate means that he has to buy all that extra coverage or pay a fine, which in his case would be very close to the amount of his extra premium. And those are the policies on the exchange.
He doesn't qualify for the subsidies so he doesn't qualify for the cost-sharing, so he is stuck with something like this. And it is not even the increased premium that is bothering him - it is the out of pocket costs. His maximum under the old plan for premiums and deductible (no copays after deductible) was $3,349.32. His maximum under the new ACA-qualifying plan is $9,192.08. With a 50% copay after his deductible, he can hit that maximum if he spends two days in the hospital or has a bad bone break.
So, he's not really insured any more. He has to start saving a lot. If he ever develops a significant medical condition, he may hit those out of pocket maximums several years running. There goes the house!
Look, I am amazed that people don't know this. ACA was written to impose MORE, not less, cost-sharing on people as a way to drive down costs. And some people will pay much higher premiums, because the cost is being shifted around. So it's true that some people (esp. older) are being offered much lower premiums than they had before, because their costs are being shifted onto the young ones like the OP. And people with pre-existing conditions get a break in most states, but that's because he pays more.
Medical bankruptcy rates are going to go up, not down, because of ACA.
The paper he posted is the SBC, which is a disclosure mandated by ACA. The company is terminating his old plan, because otherwise he'd still buy it and pay the fine, and that would mean that they would get a more expensive pool of people from the exchange, which they can't afford. They need him in there, because he's healthy.
He's still better off than if he were some poor guy his age making 30K, because even though that person would get a little help with the premium costs, the out-of-pocket is just hopeless at that income level. And cost-sharing breaks cut out a lot quicker than subsidies, so yes, that poor guy wouldn't be paying quite as much for his premium, but he's stuck with another $6,350 if he gets appendicitis.
Under ACA, both insurance and health care are affordable for very low income people. At rather low levels of income (in the 23-28K range), in many states the premiums are affordable but health care is not.
The benefit to this poster comes 25 years later, when he will be paying lower health insurance costs than he otherwise would have. But right now, it's all negative. It's a much worse insurance policy than he had, it costs more, and his costs if he has to obtain significant medical treatment take all his savings for a couple of years.
What the OP needs to do is pay another $150 or $200 a month to get real insurance. This plan's not insurance.