Obamacare To Increase Individual-Market Premiums By 41%

[Deleted]

iammalcolmx, why are spouses more expensive to insure in general? I had no idea!

[y4m]

Nov 18, 2013 16:06:46 GMT -5 @choco said:

iammalcolmx, why are spouses more expensive to insure in general? I had no idea!

I'm seeing one reason is that there are a lot of stay at home wives (women have higher medical costs in general) and sick folks (if they can't work, they can still get benefits through their working spouse) in this category.  I'd never thought about it before, but it makes sense.

[iammalcolmx]

@choco  I wish I knew!! I wonder if the majority of the spouses on the Health Plans are women and since women give birth and that is EXPENSIVE that impacts things. Most of our very large claims have to do with childbirth.

[ESF]

Nov 18, 2013 16:00:49 GMT -5 @choco said:

Nov 18, 2013 15:46:45 GMT -5 iammalcolmx said:

Sorry I ran when boss was coming to my desk, LMAO.

Two working spouses get penalized if you decide to stay on same plan since now employers are charging an extra $100 per month if you work and can join your own plan.  It doesn't even take into account the fact that perhaps the other plan is so much more expensive.  If a spouse doesn't work, then no penalty. 

But this isn't all employers, right? It's not federal law, it's just something employers are doing to keep what they believe to be sicker people off their rolls.

ETA - and I'm assuming if the spouse works but does not have an employer sponsored plan, there is no penalty to joining?

[scout8]

Pre-ACA, a spouse with a pre-existing condition and no employer insurance of their own would have to go on the spouse's plan. Getting an individual plan wouldn't have been possible. So, maybe this pushed those who were more expensive to insure on to the plans too?

[Deleted]

Nov 18, 2013 15:09:18 GMT -5 y4m said:

Nov 18, 2013 13:57:33 GMT -5 y4m said:

Elderly will receive massive subsidies, thanks to younger people

Thanks to community rating, a key feature of Obamacare, insurers are only allowed to charge their oldest customers three times the amount they charge their youngest customers. Because 64-year-olds consume on average six times as much health care as 19-year-olds, this rule has the effect of driving up the cost of insurance for young people.

But there’s a double whammy. Because premiums for those nearing retirement can still be three times higher than those of younger Americans, elderly individuals will disproportionately benefit from Obamacare’s subsidies. The subsidies increase in proportion to the percentage of your income that is tied up in health insurance; for elderly people whose premiums are much higher, the subsidies are higher too.

And when I say young people, I particularly mean young men. A young woman of average income in the average state will experience little net change in premium costs, if you take subsidies into account; 40-year-old women will see an average increase of 9 percent, and 27-year-old women will see an average decrease of 5 percent. (However, as I noted above, women in good health will see meaningfully higher increases than these averages reflect.)

Let’s take the two extremes. If you’re a 27-year-old man, your average premium under our methodology, pre-Obamacare, is $133 a month. Post-Obamacare, that increases to $201. If you add in the subsidies that accrue to someone with the median income of a 27-year-old man, the net cost of Obamacare insurance goes down slightly to $188. That’s a 41 percent increase, despite the impact of subsidies.

If you’re a 64-year-old woman, on the other hand, your average pre-Obamacare premium was $430 a month. Post-Obamacare, the underlying premium increases to $545 a month. But when you factor in subsidies for the average 64-year-old woman, the net cost of Obamacare insurance drops to $292. That’s a 32 percent decrease, inclusive of subsidies, from pre-Obamacare premiums, and a 46 percent discount off of post-Obamacare prices.

Nobody wants to board the old people hate train?

I love to hate on the olds, I'm just too tired today

[SusanBAnthony]

I don't know what exactly to hate on about old people. They are expensive to insure, and we should have death panels. What else is there?

I don't know how much more expensive spouses are to insure than employees. Ther rational I heard was just that adults are much more expensive to insure than children, so it is cheaper to insure a whole slew of Dugger children, than it is to insure Michelle. Because odds are, they won't have any medical expenses other than well visits and vaccines, until the time they get off the plan. Of course you have the occasional broken arm and the like, but the odds of an expensive medical thing like cancer is very very low.

[Deleted]

Nov 18, 2013 16:21:56 GMT -5 ESF said:

Nov 18, 2013 16:00:49 GMT -5 @choco said:

Sorry I ran when boss was coming to my desk, LMAO.

Two working spouses get penalized if you decide to stay on same plan since now employers are charging an extra $100 per month if you work and can join your own plan.  It doesn't even take into account the fact that perhaps the other plan is so much more expensive.  If a spouse doesn't work, then no penalty. 

But this isn't all employers, right? It's not federal law, it's just something employers are doing to keep what they believe to be sicker people off their rolls.

ETA - and I'm assuming if the spouse works but does not have an employer sponsored plan, there is no penalty to joining?

Not federal law as far as I know.  You make a great point about women being more expensive in general especally during the child bearing years.  Yes, no penalty if spouse works and no employer sponsored plan.

[ESF]

Nov 18, 2013 15:09:18 GMT -5 y4m said:

Nov 18, 2013 13:57:33 GMT -5 y4m said:

Elderly will receive massive subsidies, thanks to younger people

Thanks to community rating, a key feature of Obamacare, insurers are only allowed to charge their oldest customers three times the amount they charge their youngest customers. Because 64-year-olds consume on average six times as much health care as 19-year-olds, this rule has the effect of driving up the cost of insurance for young people.

But there’s a double whammy. Because premiums for those nearing retirement can still be three times higher than those of younger Americans, elderly individuals will disproportionately benefit from Obamacare’s subsidies. The subsidies increase in proportion to the percentage of your income that is tied up in health insurance; for elderly people whose premiums are much higher, the subsidies are higher too.

And when I say young people, I particularly mean young men. A young woman of average income in the average state will experience little net change in premium costs, if you take subsidies into account; 40-year-old women will see an average increase of 9 percent, and 27-year-old women will see an average decrease of 5 percent. (However, as I noted above, women in good health will see meaningfully higher increases than these averages reflect.)

Let’s take the two extremes. If you’re a 27-year-old man, your average premium under our methodology, pre-Obamacare, is $133 a month. Post-Obamacare, that increases to $201. If you add in the subsidies that accrue to someone with the median income of a 27-year-old man, the net cost of Obamacare insurance goes down slightly to $188. That’s a 41 percent increase, despite the impact of subsidies.

If you’re a 64-year-old woman, on the other hand, your average pre-Obamacare premium was $430 a month. Post-Obamacare, the underlying premium increases to $545 a month. But when you factor in subsidies for the average 64-year-old woman, the net cost of Obamacare insurance drops to $292. That’s a 32 percent decrease, inclusive of subsidies, from pre-Obamacare premiums, and a 46 percent discount off of post-Obamacare prices.

Nobody wants to board the old people hate train?

I'll bite.

In terms of plan sticker price, I don't see the increase from $133 to $188 as the young guy subsidizing grandma.  That increase could very well be subsidizing the cost of people in that age group.  I know young people who were unable to buy insurance in the individual market due to an irregular pap smear, a history of migranes, ora previous miscarriage.   No way was a $133/month plan ever covering any maternity - maternity riders in the individual market would cost hundreds of dollars more a month, plus include hefty deductibles.  Throw in actually unhealthy people in that age range previously shut out of the individual market, and it's not surprising that a restructuring of plans would result in a cost increase.  

That it's gone up from $133 to $188 tells me that all the Joe 27 Year Olds out there are now subsidizing their brothers' bum knees and their wives' pregnancies, not that AARP has stuck it to the youngins once again.

I'm sure this board is going to have to agree to disagree about whether risk-pooling across an age demographic is fair to Joe 27 Year Old or not, but I'm not convinced that Joe 27 Year Old is picking up an unfair share of grandma's meds (looking at sticker price alone, of course).

Now the subsidies are a different issue, and yes, I'm not wild about the broke millennials further subsidizing the richest generation through tax dollars, as the issue is framed here.  But I'm not up to date on all the specifics of how the subsidies work to articulate any further response to that.

[NitaX]

Nov 18, 2013 16:21:56 GMT -5 ESF said:

Nov 18, 2013 16:00:49 GMT -5 @choco said:

Sorry I ran when boss was coming to my desk, LMAO.

Two working spouses get penalized if you decide to stay on same plan since now employers are charging an extra $100 per month if you work and can join your own plan.  It doesn't even take into account the fact that perhaps the other plan is so much more expensive.  If a spouse doesn't work, then no penalty. 

But this isn't all employers, right? It's not federal law, it's just something employers are doing to keep what they believe to be sicker people off their rolls.

ETA - and I'm assuming if the spouse works but does not have an employer sponsored plan, there is no penalty to joining?

I think it's coming to most employers. It looks like private companies have done this for some time. This year, our plan has a spouse out provision. If your spouse has coverage through their place of employment, they have to take that plan unless it's some ridiculously high percentage of their income. It's so BS if you ask me because we now how to pay too fucking much for insurance. I carry the kids and my H has to pay for himself. That is probably costing us some $300 a month out of his pay where as being on mine didn't cost anything. And we're the healthy people. No one in my family takes any sort of medication or has any illness. So, yeah, I'm bitter. 

[Deleted]

Please remind me to get an answer from our brokers about the spouse insurance. I"m intrigued to discover this answer.

[iammalcolmx]

Nov 18, 2013 14:34:44 GMT -5 ttt said:

Also, this part is confusing me:
Additionally, the average of 5 cheapest plans in Alabama ends up being more expensive than the second-cheapest silver plan (which is used to calculate subsidies). Thus, in Alabama, we assume, for the purposes of developing a net cost of insurance for the median individual, that the individual purchases the second-cheapest silver plan.


Does that mean they're actually NOT using the cheapest Obamacare plans??

ETA source: www.manhattan-institute.org/knowyourrates/about.htm

I have finally gotten some sleep. Ok so they are using the Silver Plan as a comparison? Why??? I would like to see one with the Bronze.

[y4m]

Nov 19, 2013 8:26:56 GMT -5 iammalcolmx said:

Nov 18, 2013 14:34:44 GMT -5 ttt said:

Also, this part is confusing me:
Additionally, the average of 5 cheapest plans in Alabama ends up being more expensive than the second-cheapest silver plan (which is used to calculate subsidies). Thus, in Alabama, we assume, for the purposes of developing a net cost of insurance for the median individual, that the individual purchases the second-cheapest silver plan.


Does that mean they're actually NOT using the cheapest Obamacare plans??

ETA source: www.manhattan-institute.org/knowyourrates/about.htm

I have finally gotten some sleep. Ok so they are using the Silver Plan as a comparison? Why??? I would like to see one with the Bronze.

This is just for Alabama.  I read it as "Alabama didn't have 5 cheap bronze plans for us to average, so we took the 5 cheapest bronze and silver and averaged those, and the average comes out somewhere in the silver plans"  For every other state, there were five cheapest in the bronze tier to use.

[iammalcolmx]

Nov 19, 2013 8:40:51 GMT -5 y4m said:

Nov 19, 2013 8:26:56 GMT -5 iammalcolmx said:

I have finally gotten some sleep. Ok so they are using the Silver Plan as a comparison? Why??? I would like to see one with the Bronze.

This is just for Alabama.  I read it as "Alabama didn't have 5 cheap bronze plans for us to average, so we took the 5 cheapest bronze and silver and averaged those, and the average comes out somewhere in the silver plans"  For every other state, there were five cheapest in the bronze tier to use.

That makes sense but what are they using for Pre-ACA rates? It says they got an average of the 5 cheapest plans which would not be considered Bronze plans because of the ACA requirements.

[y4m]

I'm not sure what the deal is with this finder.healthcare.gov site they are using to find the pre-change policies.

I did it for myself and the cheapest plan it gives me covers pregnancy, has no lifetime maximum, etc. So it does appear that would meet Bronze plan standards.

[y4m]

The more I read, the more I think they did a pretty good job at approximating an apples to apples comparison between old and new. Most of the provisions in terms of requiring no cost preventative care, no lifetime maximums, etc. are already in effect for new policies in 2013, so if you're looking at current policies available for sale, those are fair comparisons.

The difference for 2014 is that insurers have to take pre-existing conditions, but the study goes through how they account for that at length.

[iammalcolmx]

Nov 19, 2013 9:47:25 GMT -5 y4m said:

The more I read, the more I think they did a pretty good job at approximating an apples to apples comparison between old and new. Most of the provisions in terms of requiring no cost preventative care, no lifetime maximums, etc. are already in effect for new policies in 2013, so if you're looking at current policies available for sale, those are fair comparisons.

The difference for 2014 is that insurers have to take pre-existing conditions, but the study goes through how they account for that at length.

It doesn't take into account plans years all start at different times during the year. The requirements are not for the Calendar Year they are for the plan year. I believe this is why people are now getting those notices that their old coverage( THAT OBAMA TOLD PEOPLE THEY COULD KEEP : is no longer available. If your insurance has lapsed longer than 63 days we can still pull the pre-existing conditions clause all the way until October of 2014.

[y4m]

Nov 19, 2013 10:31:18 GMT -5 iammalcolmx said:

Nov 19, 2013 9:47:25 GMT -5 y4m said:

The more I read, the more I think they did a pretty good job at approximating an apples to apples comparison between old and new. Most of the provisions in terms of requiring no cost preventative care, no lifetime maximums, etc. are already in effect for new policies in 2013, so if you're looking at current policies available for sale, those are fair comparisons.

The difference for 2014 is that insurers have to take pre-existing conditions, but the study goes through how they account for that at length.

It doesn't take into account plans years all start at different times during the year. The requirements are not for the Calendar Year they are for the plan year. I believe this is why people are now getting those notices that their old coverage( THAT OBAMA TOLD PEOPLE THEY COULD KEEP : is no longer available. If your insurance has lapsed longer than 63 days we can still pull the pre-existing conditions clause all the way until October of 2014.

All those changes went into effect in 2010, 2011, 2012 though--they would be part of any plan being offered for sale right now, which is what they are comparing to in this study.

The only major change for 2014 is the pre-existing conditions one, which they do account for.

www.hhs.gov/healthcare/facts/timeline/timeline-text.html