So What's Really Going to Happen to the Group Market

[Ann H]

Any way you slice it, more people will qualify for some level of subsidy than those who don't.

Actually not. It's true that more than half of the people meet the first test, which is the income test of 400% of FPL or below. Next comes the test of premium being 9.5% of income or less. Singles under age 40 will be knocked out by this provision alone, even if their income is between 301% and 400% of FPL. Then there are some other tests, like availability of group health insurance, coverage on a parents plan, etc. Actually, the CBO estimates that 20 million will get some sort of subsidy through meeting these tests.

 

[Crabcake Johnny]

Who's willing to enter into a discussion about the over 400% FLP crowd?

What happens? For purely illustrative purposes, for a family that just misses the subsidy.

Health Reform Subsidy Calculator - Kaiser Health Reform

If you just miss it, the unsubsidized premium projection is just over $14,000. Over $1,000 per month for coverage. That family is better off with a slight pay cut.

Even for family earning $100,000 - paying over $1,000 a month is gonna put quite a dent in their budget. Personally, I'm hoping for an ultra-high deductible plan outside of the exchange - and I'll gladly eat the fine.

 

[Ann H]

I've heard it said that those earning above 400% of FPL, but not in the "rich" category will feel the biggest pinch. The problem is that you must keep your grandfathered plan or else pick a "certified" plan offered by insurers who offer plans inside and outside the exchange. Unless I'm wrong (please correct me if I am), those plans still must meet essential benefit and still must pay an acturial value of at least 60% (the bronze level). That's a higher level than 80% of what's being sold in the IFP market today. So buying a catastrophic plan won't work, if I understand the rules correctly.

For small groups still in the group market, the addition of employees onto the census of their insured group will be more costly than the penalty, which is one reason for an "implosion" that you discussed at the inception of this thread. If an employer's contribution is not allowed (because the ER no longer has a group plan in force), and these people above 400% of FPL are sent to the IFP market to use after-tax dollars to purchase their own insurance, we may have a new crisis. When the Unions and large employers analyzed dropping coverage, one of the things they analyzed was the effect of a bonus paid to employees above 400% of FPL (taxable) to purchase their own coverage. Stunning.

Prediction? The new "uninsured class" is the middle to upper middle class!

Another problem is the uninsured younger group of people. You can have income between 301% and 400% of FPL and still not get a subsidy if the cost of "the most affordable plan" is less than 9.5% of your income. That means that single people under age 40 are automatically kicked out of a subsidy. What is the largest section of the uninsured class? Single people under age 35.

 

[Crabcake Johnny]

Yep. The 401% to 500% FLP crowd is due to get crushed. I can already tell you what the Democratic response will be; "take your two new cars and go cry us a river."

This is gonna sound odd from from a health insurance agent, but all insurance has a maximum price. Would I pay, for example, $600 a month for auto insurance? I would not. I'd have to think of something else.

At $1,000 a month for health insurance, I'm not sure if that amount of month is worth offsetting potential risk.

 

[Ann H]

I talked to a couple yesterday who are paying $1561 monthly for an NASE plan with a $5,000 deductible that accumulates every 180 days, instead of calendar year. I put then into a $3,000 deductible 100% HSA for $516, they are max contributing to their family's new HSA account and still have $500 a month left over. I used to pay $1300 a month for my family's health insurance until I was able to resolve a pre-existing condition and move into an HSA for $600 a month. I have a feeling I will longingly look back to these premiums... The 9.5% of income test is indexed to move up with the price of premiums, so I guess that means I'll be in the "gonna get crushed" income level where there's no subsidy. Well, unless my insurance business implodes (which is a very real scenario!).

Okay, I'm ready for that relaxation. This time... I'm over and out for a few hours. Gonna go home and play with my kids!

 

[HealthGuy]

Yea, John...Maybe you are right..Exchange plans will be too damn expensive, people take the penalty, and WHAM ASSURANT HEALTH ACCESS PLANS are selling like hotcakes man...We are back in business selling limited benefit indemnity plans. Bring on Obamacare baby, I want to sell Assurant Health Access!

 

[GoCubsGo]

If you looking for sites try _____healthplanexchange.com
Put your state in front.

 

[Crabcake Johnny]

Lots of fun looking for health insurance domains with your state and exchange in the name. I think the only thing left in maryland is marylandhealthexchangeforllamas.com

 

[STIBROKER]

Lots of fun looking for health insurance domains with your state and exchange in the name.

no need to go through all that.....can still be done off of existing website.......

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[Crabcake Johnny]

To me, this is an example of not thinking like a real person. I don't see too many people typing in the words "maryland" with "exchange."

The exact phrase "Massachusetts insurance exchange" gets 36 searches per month.

Go broad and it's only 320. Much heavier traffic is "health insurance in massachusetts" with over 40,000.

Even "massachusetts insurance connector" is only 420. IMHO, "exchange" keywords are not going to get a lot of traffic.