GOP "Delay Individual Mandate"

[RayNY]

Everyone (subsidized) should say they smoke and just have the government pay the increased premium subsidy to the insurance carriers. When their actual experience does not meet MLR guidelines, because we're not actually smokers and have not incurred increased expense, they will issue MLR rebates back to us, the policy holders, as the law is written.

FREE MONEY! (Or, at least, some of our tax money refunded to us...)

Too bad my state doesn't have a tobacco surcharge =(

 

[Post Quartermaster]

The article poses an interesting concept, but they missed a key point. The 8% affordability exemption applies to MEC (minimum essential coverage), not the Silver plan. The person who wrote the article used the online calculator (presumably Kaiser's or Berkley's), which show estimated premiums for the benchmark plan (the 2nd lowest cost Silver plan). The affordability law is for people who cannot find a minimum essential coverage (MEC) plan for less than 8% of their household income. So, for instance, the bronze plan, or an employer sponsored skinny MEC, or even the catastrophic plan (if the person is eligible for it) would constitute MEC.

Another point that author missed, is that 50% is the max they can charge - but they can charge less. Or no surcharge at all. Until plans/rates are revealed, we will not know. However one carrier I work with has mentioned the strong possibility of no tobacco surcharges in 2014....

 

[FLM2]

Everyone (subsidized) should say they smoke and just have the government pay the increased premium subsidy to the insurance carriers. When their actual experience does not meet MLR guidelines, because we're not actually smokers and have not incurred increased expense, they will issue MLR rebates back to us, the policy holders, as the law is written.

FREE MONEY! (Or, at least, some of our tax money refunded to us...)

Too bad my state doesn't have a tobacco surcharge =(

It doesn't work like that, subsidies are based on non-tobacco rates-if you smoke, you pay the entire extra premium out of pocket. It's explained on the Kaiser Subsidy/Premium calculator

 

[stuy119]

Another point that author missed, is that 50% is the max they can charge - but they can charge less. Or no surcharge at all. Until plans/rates are revealed, we will not know. However one carrier I work with has mentioned the strong possibility of no tobacco surcharges in 2014....

I'm not an actuary, but that tells me that there will be surcharges, it will just be paid out among everyone - not just smokers.

 

[RayNY]

FLM, thanks for the correction. I never dug into it too much because it doesn't apply here.

Argument's sake, as a smoker, if bronze premium is <8% but the surcharge bumps it up to 11%, is that still "affordable"?

I ask because I'm curious if you could waive out of the mandate due to actual rates being "unaffordable" or if it's only off the base rate.

 

[Dave020]

California will not be imposing any tobacco ratings in Covered CA

 

[AllenChicago]

California will not be imposing any tobacco ratings in Covered CA

It's not up to each insurance carrier to determine whether to rate for tobacco and by how much, like it is now?

A plus for CA health insurers is that the state ranks 2nd in the number of NON-SMOKERS. (Idaho is 1st)
Source: CDC Vital Signs - Adult Smoking in the US
.

 

[Dave020]

Ca it is illegal in 2014 to impose any tobacco rating. State law.

 

[AllenChicago]

Ca it is illegal in 2014 to impose any tobacco rating. State law.

Isn't Tobacco the only ratable health "condition" in the overall ACA? So that means CA will have NO RATINGS WHATSOEVER related to the human body's condition, or habits?

 

[Dave020]

Isn't Tobacco the only ratable health "condition" in the overall ACA? So that means CA will have NO RATINGS WHATSOEVER related to the human body's condition, or habits?

Correct. Community rating no possible rate ups no matter how bad health is.