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I'm curious to see how this affects the startup community, especially since I'd imagine cost-wise, this affects the startup community disproportionately (20-40

I'm curious to see how this affects the startup community, especially since I'd imagine cost-wise, this affects the startup community disproportionately (20-40 year olds who fall into the "In many states, premiums are expected to increase by 15-50% for people under 40 years of age" category). Either salaries will have to rise to compensate for that, or startups will have to pay for those higher costs themselves.

vivekajayshah 13y ago
The other potential effect is that startups continue to spend the same amount of money - but purchase lower benefit levels e.g., move to $5-10K maximums from $2-3K maximums.
- dangrossman 13y ago
  The ACA also sets new maximums on maximum deductibles. My $3000 deductible Aetna plan won't be legal any more; no individual plan can have a deductible above $2500, or so I've read.
xnickp 13y ago
Startups and companies with younger employees will (should) early renew in December of this year, extending their current coverage til late 2013, avoiding the price increases in the short term. For the long term, partnering with a good broker and making sure you're on the right insurance plan can wring out some savings to make up for the increases.
- eli 13y ago
  Yup, I think that's what we're doing. I find it strange, though, that the insurance companies are allowing us to renew early and lock in a rate for another year if they're so sure rates would otherwise skyrocket in January.
  - Aloisius 13y ago
    Well insurance rates have been going up for years and insurance companies really have no idea how things are going to shake up. If they overcharge, they have to return the money anyway because of the Obamacare stipulation on the minimum percentage that must be paid to health care providers. Heck, the only reason Obamacare passed was because Blue Shield of California announced it was raising rates upwards of 40% which reignited the fight after everyone thought it was over.
  - dangrossman 13y ago
    You have a low rate in the first place because they've decided there's a low chance they'll have to pay out a lot of money for you. Most likely, your premium is all or nearly all profit. Better to keep your profitable premiums than to lose you to a cheaper state exchange. It'd only make sense to force you into the newer rate immediately if you had no other option -- but the exchanges are all about giving you more options.
    - JonFish85 13y ago
      It'll be interesting to see how this plays out. I imagine that a big percentage (maybe majority / plurality) of people jumping into the insurance markets are going to be people who otherwise couldn't get insurance (pre-existing conditions, whatever--high-cost clients, essentially). The only way to balance the books is to make the healthy people pay more. I expect the young-and-healthy category to pay even more than the 15-50% extra in the article. It's going to be ugly, from a dollar perspective.
      - dangrossman 13y ago
        About 17% of the US workforce is officially "underemployed"; that's a very large number. I would think a large chunk of that are young, healthy people who work one or more part-time jobs without benefits. They're to be forced into the health insurance marketplace as well, with government assistance if they can't afford it -- essentially, there will be a tax dollar transfer to insurers that could absorb much of the extra cost of also insuring people with pre-existing conditions. It really is hard to predict how it will play out.
_delirium 13y ago
Depends mainly on your health history. Startup founders are generally young and male, but not all are free of preexisting conditions. For those who had elevated rates due to health histories previously, the new rates will likely be lower. For those with no negative health history, the rates will likely be higher. The new rates will be roughly a weighted average of the old ones, modulo noise. There are a number of people in both categories on HN, so it would seem to depend on the specific startup.

vivekajayshah 13y ago

The other potential effect is that startups continue to spend the same amount of money - but purchase lower benefit levels e.g., move to $5-10K maximums from $2-3K maximums.

dangrossman 13y ago
The ACA also sets new maximums on maximum deductibles. My $3000 deductible Aetna plan won't be legal any more; no individual plan can have a deductible above $2500, or so I've read.

xnickp 13y ago

Startups and companies with younger employees will (should) early renew in December of this year, extending their current coverage til late 2013, avoiding the price increases in the short term. For the long term, partnering with a good broker and making sure you're on the right insurance plan can wring out some savings to make up for the increases.

eli 13y ago
Yup, I think that's what we're doing. I find it strange, though, that the insurance companies are allowing us to renew early and lock in a rate for another year if they're so sure rates would otherwise skyrocket in January.
- Aloisius 13y ago
  Well insurance rates have been going up for years and insurance companies really have no idea how things are going to shake up. If they overcharge, they have to return the money anyway because of the Obamacare stipulation on the minimum percentage that must be paid to health care providers. Heck, the only reason Obamacare passed was because Blue Shield of California announced it was raising rates upwards of 40% which reignited the fight after everyone thought it was over.
- dangrossman 13y ago
  You have a low rate in the first place because they've decided there's a low chance they'll have to pay out a lot of money for you. Most likely, your premium is all or nearly all profit. Better to keep your profitable premiums than to lose you to a cheaper state exchange. It'd only make sense to force you into the newer rate immediately if you had no other option -- but the exchanges are all about giving you more options.
  - JonFish85 13y ago
    It'll be interesting to see how this plays out. I imagine that a big percentage (maybe majority / plurality) of people jumping into the insurance markets are going to be people who otherwise couldn't get insurance (pre-existing conditions, whatever--high-cost clients, essentially). The only way to balance the books is to make the healthy people pay more. I expect the young-and-healthy category to pay even more than the 15-50% extra in the article. It's going to be ugly, from a dollar perspective.
    - dangrossman 13y ago
      About 17% of the US workforce is officially "underemployed"; that's a very large number. I would think a large chunk of that are young, healthy people who work one or more part-time jobs without benefits. They're to be forced into the health insurance marketplace as well, with government assistance if they can't afford it -- essentially, there will be a tax dollar transfer to insurers that could absorb much of the extra cost of also insuring people with pre-existing conditions. It really is hard to predict how it will play out.

_delirium 13y ago

Depends mainly on your health history. Startup founders are generally young and male, but not all are free of preexisting conditions. For those who had elevated rates due to health histories previously, the new rates will likely be lower. For those with no negative health history, the rates will likely be higher. The new rates will be roughly a weighted average of the old ones, modulo noise. There are a number of people in both categories on HN, so it would seem to depend on the specific startup.