Way to go Obongo!

[kd]

My thanks to those who participated in earlier discussion. I want to follow up with some information from my insurance company and a summation.

1) My existing plan is being terminated because it doesn't meet the requirements of the ACA; most significantly, it does not provide maternity coverage. (Apparently all plans must now include such coverage even for geriatric males and sterile couples.) Except that...

2) Plans that were in effect before March 23, 2010 and have stayed basically the same since then are grandfathered. My plan is either newer than that or changed non-trivially after that (but before 2012 which is when I moved to this state), so it is not grandfathered. However...

3) The company is offering a replacement plan that is identical to the one I have now, except for adding maternity coverage and such. The premium is 77% higher.

The premiums alone would be 48% of my income, so it's not all that attractive.

If I can increase my income to get above the expanded poverty limit then I'd be able to get a subsidized plan on the exchange, which would have a very low premium, but worse deductible, co-pay, and out-of-pocket than my current plan.

If I can't increase my income to that level, then as far as I know the only thing the exchange will offer me is Medicaid. This remains to be confirmed once the exchange website is working.

From what I've seen in the local media, Medicaid in these parts offers sub-standard care and is a choice of last resort.

My first posting on this topic said "I just wanted to keep the plan I already had, which I chose carefully and which fully met my needs. But some farging politician maroons decided they know better, so now I'll be forced to choose from among worse offerings."

I got significant push-back on that, but so far I stand by it. I strongly support health care reform, but wish the design of it had allowed me to keep my current plan. As in "if you like your plan, you can keep your plan". All it would have required is a tweak to the grandfather clause.

[$tevie]

3) The company is offering a replacement plan that is identical to the one I have now, except for adding maternity coverage and such. The premium is 77% higher.

Sounds like your insurance company is taking advantage of the situation to try to screw you big time.

[michaelb]

One more question then, are you young and healthy? Your premiums before may have been individually rated, and now under the ACA premiums are community rated. This is a huge improvement, but it does raise premiums for some, particularly the young and heathly.

If you had a serious adverse event, or were diagnosed with something like diabetes, your individually rated premiums would have skyrocketed, for some even like a 1000x fold. Over the course of a life, everyone has some adverse events, so this catches up with most folks at some point (the alternative, which is considered to be worst, is to die suddenly and young).

I can't see maternity care costing very much. It is relatively cheap overall, and impacts only a small slice of the population, and the acuaries can obviously adjust the risk pool for pregnancy to account for old sterile men.

[DeusxMac]

michaelb wrote:
One more question then, are you young and healthy? Your premiums before may have been individually rated, and now under the ACA premiums are community rated. This is a huge improvement, but it does raise premiums for some, particularly the young and heathly.

I would deduce from kd's comments above that kd is either a "geriatric male" or a "sterile couple".

michaelb wrote: I can't see maternity care costing very much. It is relatively cheap overall, and impacts only a small slice of the population...

I suspect the ramifications and costs of what can go wrong in a pregnancy contribute to this calculation.

[kd]

$tevie wrote:
3) The company is offering a replacement plan that is identical to the one I have now, except for adding maternity coverage and such. The premium is 77% higher.

Sounds like your insurance company is taking advantage of the situation to try to screw you big time.

I wouldn't put it past them. No doubt they're subject to regulation (and new actuarial requirements of the ACA) but they're sure not out to do me any favors.

Got another data point today. Housemate has a different plan, found it is also being canceled, replacement plan premium is 140% higher. Insurer (Blue Cross) claims massive increases are across the board on all their 2014 ACA-compliant plans. Housemate is also low income and so now in the same boat as me.

[kd]

michaelb wrote:
One more question then, are you young and healthy? Your premiums before may have been individually rated, and now under the ACA premiums are community rated.

I'm old and moderately healthy. My current premium is +15% over the young healthy rate. The premium for sicker people ranges up to a max of +40% over the young healthy rate. However, they used to be able to reject applicants entirely and now they won't be able to, so that's got to be a big factor. And of course the community rating.

[kd]

DeusxMac wrote:
I would deduce from kd's comments above that kd is either a "geriatric male" or a "sterile couple".

[quote=michaelb]I can't see maternity care costing very much. It is relatively cheap overall, and impacts only a small slice of the population...

I suspect the ramifications and costs of what can go wrong in a pregnancy contribute to this calculation.
:oldfogey: I resemble that remark. My current plan does, however, cover anything that goes wrong in a pregnancy; it just doesn't cover routine "normal pregnancy" expenses.

[kj]

Fwiw, I appreciate you patiently explaining your situation. If you didn't, we wouldn't know about it. I don't currently have any reason to think we're in the same boat, but since both my wife and I are insured through our work, we do wonder what is going to happen to our coverage (it looks safe afaict) Have a good one. kj.

[kd]

Thanks kj, I wish you and everybody else the best of outcomes in your own circumstances.