5 ms·

Is $85k annual premiums a typo? That's about an order of magnitude higher than my expectations would have been for near retirement age health care.

deleted 4y ago
[deleted]
lotsofpulp 4y ago
No, the Affordable Care Act restricts premiums for the most costly insureds (age 64) to 3x the least costly insureds (age ~21). So the health insurance premiums you see for ACA compliant health plans are very subsidized by younger plan members, but this subsidy ends starting age 65. In other words, expected healthcare costs for old people are massive. Edit: also, annual premiums for age 64 are around $20k to $25k, and that is with the subsidy from younger plan members.
- cmurf 4y ago
  It is not a health care system, it's a sick and dying payment plan system. They definitely don't want you to die because then you stop paying into the system. But they don't care about quality of life, they want to pay out as little as possible.
- JoshTriplett 4y ago
  > this subsidy ends starting age 65 As I understand it, the subsidy ends at 65 because at that point the "affordable care" option is Medicare. Thus, there's less motivation to subsidize private insurance.
- watwut 4y ago
  The whole point of insurance is that sick get paid from money of healthy.
  - lotsofpulp 4y ago
    The problem with health insurance is the healthy know who they are and the unhealthy know who they are, so you have massive adverse selection. Hence, the ACA rule (now defunct per 2017 TCJA) to require everyone to buy health insurance.
    - throw0101c 4y ago
      > Hence, the ACA rule (now defunct per 2017 TCJA) to require everyone to buy health insurance. Technically the rule still exists, but the penalty is now $0. (IANAL.)
- ac29 4y ago
  > No, the Affordable Care Act restricts premiums for the most costly insureds (age 64) to 3x the least costly insureds (age ~21). > Edit: also, annual premiums for age 64 are around $20k to $25k, and that is with the subsidy from younger plan members. This implies premiums for the least costly group are $6500-8000/year, which is substantially more than the price I pay. I dont have employer-provided healthcare, nor a marketplace plan, I pay the cash price for individuals without any subsidy. And I haven't been 21 in decades.
  - lotsofpulp 4y ago
    I was assuming pricing for gold level plans (health plan covers 80% of costs). https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates2023.pdf https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates20... See Omnia BCBS Gold at $731 per month for age 21 to 24. Omnia BCBS Silver HSA would be $423 per month. Silver plans cover 70% of expected costs, but at age 64, I assume most would want the lower deductible and oop max of a gold plan. Even the insurance company is calculating it needs to charge $300 more per month for that extra 10% of expected healthcare costs they would have to pick up with a gold plan versus a silver. As another datapoint, my family of four gold HSA BCBS plan is running around $33k per year in premiums for 2 adults in their 30s and 2 toddlers.

deleted 4y ago

[deleted]

lotsofpulp 4y ago

No, the Affordable Care Act restricts premiums for the most costly insureds (age 64) to 3x the least costly insureds (age ~21). So the health insurance premiums you see for ACA compliant health plans are very subsidized by younger plan members, but this subsidy ends starting age 65. In other words, expected healthcare costs for old people are massive. Edit: also, annual premiums for age 64 are around $20k to $25k, and that is with the subsidy from younger plan members.

cmurf 4y ago
It is not a health care system, it's a sick and dying payment plan system. They definitely don't want you to die because then you stop paying into the system. But they don't care about quality of life, they want to pay out as little as possible.
JoshTriplett 4y ago
> this subsidy ends starting age 65 As I understand it, the subsidy ends at 65 because at that point the "affordable care" option is Medicare. Thus, there's less motivation to subsidize private insurance.
watwut 4y ago
The whole point of insurance is that sick get paid from money of healthy.
- lotsofpulp 4y ago
  The problem with health insurance is the healthy know who they are and the unhealthy know who they are, so you have massive adverse selection. Hence, the ACA rule (now defunct per 2017 TCJA) to require everyone to buy health insurance.
  - throw0101c 4y ago
    > Hence, the ACA rule (now defunct per 2017 TCJA) to require everyone to buy health insurance. Technically the rule still exists, but the penalty is now $0. (IANAL.)
ac29 4y ago
> No, the Affordable Care Act restricts premiums for the most costly insureds (age 64) to 3x the least costly insureds (age ~21). > Edit: also, annual premiums for age 64 are around $20k to $25k, and that is with the subsidy from younger plan members. This implies premiums for the least costly group are $6500-8000/year, which is substantially more than the price I pay. I dont have employer-provided healthcare, nor a marketplace plan, I pay the cash price for individuals without any subsidy. And I haven't been 21 in decades.
- lotsofpulp 4y ago
  I was assuming pricing for gold level plans (health plan covers 80% of costs). https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates2023.pdf https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates20... See Omnia BCBS Gold at $731 per month for age 21 to 24. Omnia BCBS Silver HSA would be $423 per month. Silver plans cover 70% of expected costs, but at age 64, I assume most would want the lower deductible and oop max of a gold plan. Even the insurance company is calculating it needs to charge $300 more per month for that extra 10% of expected healthcare costs they would have to pick up with a gold plan versus a silver. As another datapoint, my family of four gold HSA BCBS plan is running around $33k per year in premiums for 2 adults in their 30s and 2 toddlers.