Well, I did it. I drafted a new web page dedicated to the Patient Protection & Affordable Care Act, more commonly known as the Affordable Care Act (ACA) or "Obamacare".
Regardless of where folks stand on it, it is an important piece of legislation that can impact the plans of those contemplating Full-time RVing. Even the basics are a bit complicated, but for those that want to tackle it, you can check out:
I decided to go ahead and do a web page on the subject rather than a Journal entry where my opinions tend to seep in more often. :)
My intent is to go back in and create various examples to help explain many of the provisions but, for now, I just wanted to get the basic information out there.
I have to say I learned a lot about the ACA, and there are a lot of really good things in it. However, I still have huge doubts about the long-term sustainability of the law from a financial perspective given the country's debt and budget deficits.
But, assuming that we don't look at the big picture and focus only on the short term (like politicians), I wanted to see how the ACA worked and how it would affect us personally.
Before you read much further, it might be a good idea to go and read through the "Affordable Care Act & RVers" page. Otherwise, much of what follows may not make any sense. :)
At the beginning of the month, when the healthcare exchanges opened, I learned that sixteen states (and the District of Columbia) were running their own healthcare exchanges while the rest of the states were using the federal exchange called The Marketplace at Healthcare.gov.
Note that you can access the individual state exchanges through Healthcare.gov by using the drop-down box and entering your state of domicile. If your state is one with its own exchange, there will be a link to that exchange.
Well Kentucky, our domicile state, happens to be one of the sixteen states with its own exchange. At the time, I didn't set up an account because there was a horrible warning on the site that basically said by using the website we had no expectation of privacy and our information could be shared everywhere. A week later, the warning had been changed completely.
So, I finally went back, established an account, and plugged in all the required information so I could see the plans available and what premium "subsidy/tax credit" we may be eligible for. To get there, I had to enter our estimated household income (Modified Adjusted Gross Income) that we expected for 2014. Of course, with our current situation, that estimate is a big ol' guess.
The first time through I entered an annual income of $30,000 and found that entitled us to a subsidy of $424 per month. The second time through I entered annual income of $60,000 (which is close to the maximum income eligible for a subsidy for a family of 2) which gave us a subsidy of $96 per month.
Continuing on, there were a total of 24 insurance plans on the Kentucky exchange for us. I had to do a spreadsheet to compare all of them - premiums, deductibles, co-pays, co-insurance, total out-of-pocket limits, "in network" variables, "out of network" variables, national coverage or not, Health Savings Accounts or not, etc, etc. :)
There were three insurance providers: Humana, Anthem Blue Cross/Blue Shield (which we have now) and the Kentucky Health Cooperative (which I'd never heard of).
There were eight plans listed as "Bronze" plans, eight "Silver" plans, five "Gold" plans, and three "Platinum" plans.
The monthly premiums (before subsidies) ranged from $453 per month to $992 per month. You may recall that we are currently paying $263 per month.
All eight of the Humana plans (two in each metal designation) were HMOs with a very limited network, no national coverage, and we would be 100% responsible for all "out of network" costs. Of course the premiums were the cheapest in each category for those plans.
The four Kentucky Health Cooperative plans (one in each metal designtation) were PPOs and the next cheapest, but they had high co-insurance percentages (amounts you pay after the deductible is met), they had no national coverage, and they had no Health Savings Account options.
The remaining plans were all Anthem Blue Cross/Blue Shield. All twelve plans were PPOs with national coverage with varying deductibles, out of pocket maximums, and co-insurance. Three of them had Health Savings Account features. There was one "Bronze" plan that was very similar to our current high deductible plan, and its premium was $590 per month (without the subsidy). With the $453 subsidy, it was $166 per month, and with the $96 subsidy, it was $494 per month.
So, depending on how much we actually make during 2014 (and the related subsidy), the one comparable plan to what we have now might be a good deal or a bad deal. There is certainly incentive, if we buy through the ACA exchange, to keep our income down or at least consistent.
The good news for us is that our current plan is "grandfathered" and we can keep it if we wish. It may not have some of the protections of all the new plans under the ACA, but it's a really good plan. Of course, as premiums increase, we might end up going through the ACA exchange later.
Of course, another factor for us is that we have an aversion to taking a subsidy when we don't really need it. But, I'm sure we'll get over that IF our premiums get so high we can't afford them on our quite variable income.
So, my friends, because Kentucky runs its own exchange which is operational, I was able to get in and gather some information to see what it's all about. We're gonna stick with our current plan for now, but at least I finally have an idea of the options under the ACA.
We hope our new web page is helpful, and that soon everyone will at least have the ability to research and compare options. Good luck! :)