4 ms·

One good aspect doesn't make it a boon. In my personal experience, the law has made insurance less affordable. I'm in between jobs and bought an inexpensive sho

One good aspect doesn't make it a boon. In my personal experience, the law has made insurance less affordable. I'm in between jobs and bought an inexpensive short-term, high-deductible plan. However, the plan has been deprecated (no renewals after a certain date) because it does not meet all provisions of the ACA.

rdl 13y ago
My long-term HDHP went from $80/mo to $118/mo, which is high in percentage terms, but still not a big deal IMO. In the process they gave me unlimited lifetime coverage, added free preventive care, etc. -- which IMO seems actuarially impossible, but I'm on the buy side of this transaction.
- gojomo 13y ago
  Can you share the name of your provider (or their peer set)?
  - rdl 13y ago
    It really varies by state. I went to an online insurance comparison app (I should promote Leaky or SimplyInsured here, but at the time in 2010, I used ehealthinsurance), searched for HDHPs, then picked based on reputation. I picked a Blue Shield provider with no lifetime cap (or a $6mm lifetime cap, I forget). The only states I know are WA and CA. In WA, I like Regence Blue Shield; plans seem to be in the $100-150/mo range now. In CA, there are also a lot of HDHPs in the $100-150/mo range. I'd specifically avoid Kaiser as an employer giving coverage, as some people really dislike Kaiser since you must use a Kaiser doctor, hospital, or other facility, but if you're an individual and like a Kaiser doctor, it might be a good choice. Otherwise a lot of people I know use Health Net, Anthem, etc. I'm not a lawyer nor am I a licensed insurance agent so I'm hesitant to recommend specific plans. I think these rates are low due to being HDHPs and the "best" patient group; 26-35 year old single male. Those are exactly the people who don't get individual insurance unless they're cautious people who join AAA, change oil on time, buy fire extinguishers, look both ways before crossing the street, etc. (and thus exceptionally good risks), and even then seek to minimize contact with doctors. I suspect the unhealthy ones are particularly likely to take jobs with insurance, or be on medicaid/prison/etc., in that bracket, or are so irresponsible as to have no insurance (because hey, even $120/mo is better spent on beer). Rates don't seem that much worse for women (which is weird, since I'd assume most women get enough extra covered services covered now by an HSA to destroy the actuarial model for a $100/mo plan). The rates 4x once you add children, though. I tried also plugging in numbers for people born in 1969, 1959, 1950, and rates do go up, but only maybe 4x, too. So the prices are generally within a 10x range per insured, at least for healthy people or in places where there is no medical underwriting, tops, and under ACA, that will converge to 4x (although I'm sure by raising the low end by 50-150% and only lowering the top end by a trivial amount.) I always assumed all insurance was $500+/mo/insured, since that's what the group rates for small businesses seem to be, but that's due to adverse selection and inefficiency I think. The real problem seems to be if you're unhealthy when looking for insurance, or have children (particularly with high medical costs), or have an acute high-cost event, or are poor enough that $100-200/mo is a hardship (even though I think $100-200/mo for health insurance, whether paid by the individual or the government, is pretty reasonable), or are, worst case, so unhealthy that you're also poor and thus doubly screwed.
    - rdl 13y ago
      Wow, this is insanity: I priced some NY (10024) and MA (02139) zip codes on ehealthinsurance and the coverage looked approximately 5x CA or WA rates. I'm not sure if that's specific to the site and their mix of carriers, or if insurance really is that much more expensive on the East Coast.
      - gojomo 13y ago
        Thanks for all your pointers and observations! I will likely be in the market for an HDHP soon and these will give my own search a running start.
300bps 13y ago
>In my personal experience, the law has made insurance less affordable. Last year I had a PPO insurance plan at work that cost $216 per month for a family plan and had very tiny out of pocket expenses. This year my employer dropped the PPO as being unaffordable and switched to a HDHP that costs the same $216 per month for my family plan. Now the plan pays literally nothing for the first $3,000. And then 80/20 up to the first $7,000. The ACA benefited a lot of people. If you're an older student living at home. If you have a pre-existing condition. If you develop a catastrophic illness. But if you're not in one of those benefited groups then you are paying for those benefited groups.
- jws 13y ago
  $216 sounds like only your part of the payment. Do you know how your employer's contribution (the bulk of the total cost) changed? Sounds like they saved a lot of money.
  - MrUnknown 13y ago
    This is exactly it. The company I work for is fairly open, and I know how much they pay every pay period for my health insurance, and it is about 3x as much as I pay for the plan. This guy's company sounds like they changed providers, pushed almost all the cost to the employee (under the mask that it costs the employee the same), is saving a ton of money, but tells the employees to blame the ACA. While I work for a decent company, they even tried to blame some crap on the ACA trying to explain why the premiums went up this year. Except, they went up the same amount the year before, and the one before that also.
    - LekkoscPiwa 13y ago
      yeah, and that's called inflation and is the direct result of the Government actions and not your employers fault.

rdl 13y ago

My long-term HDHP went from $80/mo to $118/mo, which is high in percentage terms, but still not a big deal IMO. In the process they gave me unlimited lifetime coverage, added free preventive care, etc. -- which IMO seems actuarially impossible, but I'm on the buy side of this transaction.

gojomo 13y ago
Can you share the name of your provider (or their peer set)?
- rdl 13y ago
  It really varies by state. I went to an online insurance comparison app (I should promote Leaky or SimplyInsured here, but at the time in 2010, I used ehealthinsurance), searched for HDHPs, then picked based on reputation. I picked a Blue Shield provider with no lifetime cap (or a $6mm lifetime cap, I forget). The only states I know are WA and CA. In WA, I like Regence Blue Shield; plans seem to be in the $100-150/mo range now. In CA, there are also a lot of HDHPs in the $100-150/mo range. I'd specifically avoid Kaiser as an employer giving coverage, as some people really dislike Kaiser since you must use a Kaiser doctor, hospital, or other facility, but if you're an individual and like a Kaiser doctor, it might be a good choice. Otherwise a lot of people I know use Health Net, Anthem, etc. I'm not a lawyer nor am I a licensed insurance agent so I'm hesitant to recommend specific plans. I think these rates are low due to being HDHPs and the "best" patient group; 26-35 year old single male. Those are exactly the people who don't get individual insurance unless they're cautious people who join AAA, change oil on time, buy fire extinguishers, look both ways before crossing the street, etc. (and thus exceptionally good risks), and even then seek to minimize contact with doctors. I suspect the unhealthy ones are particularly likely to take jobs with insurance, or be on medicaid/prison/etc., in that bracket, or are so irresponsible as to have no insurance (because hey, even $120/mo is better spent on beer). Rates don't seem that much worse for women (which is weird, since I'd assume most women get enough extra covered services covered now by an HSA to destroy the actuarial model for a $100/mo plan). The rates 4x once you add children, though. I tried also plugging in numbers for people born in 1969, 1959, 1950, and rates do go up, but only maybe 4x, too. So the prices are generally within a 10x range per insured, at least for healthy people or in places where there is no medical underwriting, tops, and under ACA, that will converge to 4x (although I'm sure by raising the low end by 50-150% and only lowering the top end by a trivial amount.) I always assumed all insurance was $500+/mo/insured, since that's what the group rates for small businesses seem to be, but that's due to adverse selection and inefficiency I think. The real problem seems to be if you're unhealthy when looking for insurance, or have children (particularly with high medical costs), or have an acute high-cost event, or are poor enough that $100-200/mo is a hardship (even though I think $100-200/mo for health insurance, whether paid by the individual or the government, is pretty reasonable), or are, worst case, so unhealthy that you're also poor and thus doubly screwed.
  - rdl 13y ago
    Wow, this is insanity: I priced some NY (10024) and MA (02139) zip codes on ehealthinsurance and the coverage looked approximately 5x CA or WA rates. I'm not sure if that's specific to the site and their mix of carriers, or if insurance really is that much more expensive on the East Coast.
    - gojomo 13y ago
      Thanks for all your pointers and observations! I will likely be in the market for an HDHP soon and these will give my own search a running start.

300bps 13y ago

>In my personal experience, the law has made insurance less affordable. Last year I had a PPO insurance plan at work that cost $216 per month for a family plan and had very tiny out of pocket expenses. This year my employer dropped the PPO as being unaffordable and switched to a HDHP that costs the same $216 per month for my family plan. Now the plan pays literally nothing for the first $3,000. And then 80/20 up to the first $7,000. The ACA benefited a lot of people. If you're an older student living at home. If you have a pre-existing condition. If you develop a catastrophic illness. But if you're not in one of those benefited groups then you are paying for those benefited groups.

jws 13y ago
$216 sounds like only your part of the payment. Do you know how your employer's contribution (the bulk of the total cost) changed? Sounds like they saved a lot of money.
- MrUnknown 13y ago
  This is exactly it. The company I work for is fairly open, and I know how much they pay every pay period for my health insurance, and it is about 3x as much as I pay for the plan. This guy's company sounds like they changed providers, pushed almost all the cost to the employee (under the mask that it costs the employee the same), is saving a ton of money, but tells the employees to blame the ACA. While I work for a decent company, they even tried to blame some crap on the ACA trying to explain why the premiums went up this year. Except, they went up the same amount the year before, and the one before that also.
  - LekkoscPiwa 13y ago
    yeah, and that's called inflation and is the direct result of the Government actions and not your employers fault.