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> Now that those subsidies are going away for next year, premiums are going to spike. For example, if someone paid $60 a month for their health insurance this y

> Now that those subsidies are going away for next year, premiums are going to spike. For example, if someone paid $60 a month for their health insurance this year, they might be looking at $105 a month next year. I was on the exchanges, unsubsidized, until this year. Last year's premium went from $3,000/month to $3,600/month. I had to buckle and get on a company plan with less coverage this year. Meanwhile, every other piece of spare real estate in town is a new medical facility. Urgent cares, palatial orthopedic facilities… There's a crash coming.

Forgeties79 1y ago
> Meanwhile, every other piece of spare real estate in town is a new medical facility. Urgent cares, palatial orthopedic facilities… There's a crash coming. Consolidation of hospitals/medical facilities/practices and the rapid spread of PE firms is absolutely destroying our already cracking healthcare industry. A crash is definitely coming. And just like with the financial crisis, we’re going to be the ones footing the bill and/or just dying on hospital steps. Combined with so many doctors fleeing states with strict abortion/anti-LGBT laws, as well as the dismantling of programs encouraging doctors to work in under-served (often rural/low income/isolated) areas, it doesn’t take a genius to figure out who’s going to be hit the hardest.
DennisP 1y ago
We're likely to lose a lot of rural hospitals due to Medicaid cuts. We might need those new urban facilities, as those patients who do have insurance travel to the places still open.
- analog31 1y ago
  What I read is that the big beautiful bill includes subsidies to keep those hospitals open, just not for them to treat patients.
- giantg2 1y ago
  The medicaid reimbursement rates are so low that hospitals have been closing anyways. This might speed it up, but the outcome was already in motion.
BugsJustFindMe 1y ago
> I was on the exchanges, unsubsidized, until this year. Last year's premium went from $3,000/month to $3,600/month. I want to know details of your situation, because my exchange premiums are like $300/month.
- ceejayoz 1y ago
  Platinum plan (which winds up most fiscally responsible for us - we max out the low out-of-pocket-max reliably), four people. Something like a bronze plan wouldn't save us any money; lower premiums trade for high deductibles and copays. Good if you're healthy. https://imgur.com/a/SC3DNTf https://imgur.com/a/SC3DNTf
  - deleted 1y ago
    [deleted]
  - BugsJustFindMe 1y ago
    I'm a little confused. At $3660/month vs $1900 for bronze, that's $21200 more per year than the bronze plan just for the privilege of ever being able to send bills to them even before any actual medicine happens. $21200 is already higher than the bronze family max out of pocket of $18400. Does that not mean your minimum possible cost on platinum is worse than your maximum possible cost on bronze? Bronze premium + max OOP is 41200. Platinum premium alone is 43920 before any care. It seems like you could save a bunch of money on bronze? (goddamn, these costs are fucking bonkers no matter what)
- deleted 1y ago
  [deleted]
- bix6 1y ago
  Curious what the details of your situation are and how often you use healthcare?
- bpt3 1y ago
  Either you have a high deductible, or you're just being subsidized by everyone else. The unsubsidized cost of a standard PPO plan for a family can easily reach $3000 a month. This is situation normal, people just don't see it because their employer is responsible for the cost.
hydrogen7800 1y ago
>palatial orthopedic facilities I'll see your anecdote with another anecdote. Around where I live, for the past few years there was a sudden massive ad campaign for a new orthopedist complete with billboards featuring the presumably founding doctor's smiling face, and various other print and sponsored ads. Their main building is a giant gaudy marble, glass and brass clad building, but there are others that have taken up more mundane buildings. I don't know how such a business launches so quickly with so much $$, but it must be PE. They've certainly got a lot of debts to pay off now, and I can imagine the assembly-line level of care with more focus on low-margin patient satisfaction, encouraging reviews about how nice and friendly everyone was, rather than actual effective care. This is of course my cynical uninformed take after seeing mucho $$ spent on advertising. Maybe they are actually great and effective doctors, for all I know.
silisili 1y ago
It's pretty sickening, to be honest. For sobering data, check out the link below and look what happened in just 20 years. Unfortunately it stops at 2013, it's probably a solid orange blob today... https://www.bls.gov/opub/ted/2014/ted_20140728.htm https://www.bls.gov/opub/ted/2014/ted_20140728.htm
xtiansimon 1y ago
> “For example, if someone paid $60 a month for their health insurance this year, they might be looking at $105 a month next year.” This example is meaningless, except to explain how math works. I have NYS Marketplace Bronze (insipid terminology) plan. I’m 55 and in good health (knock). These are no other people on my plan. My plan cost is $600/mo. I pay $300 and get a tax credit for $300 (which I can claim monthly, but which is reconciled on my tax return). This is the only way to discuss the cost. So what is the change? Is the cost going up? Every indication is yes. Is the tax benefit going down? Not clear.

Forgeties79 1y ago

> Meanwhile, every other piece of spare real estate in town is a new medical facility. Urgent cares, palatial orthopedic facilities… There's a crash coming. Consolidation of hospitals/medical facilities/practices and the rapid spread of PE firms is absolutely destroying our already cracking healthcare industry. A crash is definitely coming. And just like with the financial crisis, we’re going to be the ones footing the bill and/or just dying on hospital steps. Combined with so many doctors fleeing states with strict abortion/anti-LGBT laws, as well as the dismantling of programs encouraging doctors to work in under-served (often rural/low income/isolated) areas, it doesn’t take a genius to figure out who’s going to be hit the hardest.

DennisP 1y ago

We're likely to lose a lot of rural hospitals due to Medicaid cuts. We might need those new urban facilities, as those patients who do have insurance travel to the places still open.

analog31 1y ago
What I read is that the big beautiful bill includes subsidies to keep those hospitals open, just not for them to treat patients.
giantg2 1y ago
The medicaid reimbursement rates are so low that hospitals have been closing anyways. This might speed it up, but the outcome was already in motion.

BugsJustFindMe 1y ago

> I was on the exchanges, unsubsidized, until this year. Last year's premium went from $3,000/month to $3,600/month. I want to know details of your situation, because my exchange premiums are like $300/month.

ceejayoz 1y ago
Platinum plan (which winds up most fiscally responsible for us - we max out the low out-of-pocket-max reliably), four people. Something like a bronze plan wouldn't save us any money; lower premiums trade for high deductibles and copays. Good if you're healthy. https://imgur.com/a/SC3DNTf https://imgur.com/a/SC3DNTf
- deleted 1y ago
  [deleted]
- BugsJustFindMe 1y ago
  I'm a little confused. At $3660/month vs $1900 for bronze, that's $21200 more per year than the bronze plan just for the privilege of ever being able to send bills to them even before any actual medicine happens. $21200 is already higher than the bronze family max out of pocket of $18400. Does that not mean your minimum possible cost on platinum is worse than your maximum possible cost on bronze? Bronze premium + max OOP is 41200. Platinum premium alone is 43920 before any care. It seems like you could save a bunch of money on bronze? (goddamn, these costs are fucking bonkers no matter what)
deleted 1y ago
[deleted]
bix6 1y ago
Curious what the details of your situation are and how often you use healthcare?
bpt3 1y ago
Either you have a high deductible, or you're just being subsidized by everyone else. The unsubsidized cost of a standard PPO plan for a family can easily reach $3000 a month. This is situation normal, people just don't see it because their employer is responsible for the cost.

hydrogen7800 1y ago

>palatial orthopedic facilities I'll see your anecdote with another anecdote. Around where I live, for the past few years there was a sudden massive ad campaign for a new orthopedist complete with billboards featuring the presumably founding doctor's smiling face, and various other print and sponsored ads. Their main building is a giant gaudy marble, glass and brass clad building, but there are others that have taken up more mundane buildings. I don't know how such a business launches so quickly with so much $$, but it must be PE. They've certainly got a lot of debts to pay off now, and I can imagine the assembly-line level of care with more focus on low-margin patient satisfaction, encouraging reviews about how nice and friendly everyone was, rather than actual effective care. This is of course my cynical uninformed take after seeing mucho $$ spent on advertising. Maybe they are actually great and effective doctors, for all I know.

silisili 1y ago

It's pretty sickening, to be honest. For sobering data, check out the link below and look what happened in just 20 years. Unfortunately it stops at 2013, it's probably a solid orange blob today... https://www.bls.gov/opub/ted/2014/ted_20140728.htm https://www.bls.gov/opub/ted/2014/ted_20140728.htm

xtiansimon 1y ago

> “For example, if someone paid $60 a month for their health insurance this year, they might be looking at $105 a month next year.” This example is meaningless, except to explain how math works. I have NYS Marketplace Bronze (insipid terminology) plan. I’m 55 and in good health (knock). These are no other people on my plan. My plan cost is $600/mo. I pay $300 and get a tax credit for $300 (which I can claim monthly, but which is reconciled on my tax return). This is the only way to discuss the cost. So what is the change? Is the cost going up? Every indication is yes. Is the tax benefit going down? Not clear.