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I paid $185 per month for Blue Cross Blue Shield Texas health insurance in 2011.  BCBS notified me my 2017 premium will be $620 per month, a 54% increase over 2016 and a 235% increase (3.35x) over 2011.  I'm a non-smoker with no serious health issues.

Has anyone else seen such a huge increase?  Can anyone explain why this is happening?  Thinking about dropping it for a year and paying the penalty.

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Texas opted out of the Affordable Care Act (ACA). Contact your Governor and Texas Senate and House

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ellory said:   Texas opted out of the Affordable Care Act (ACA). Contact your Governor and Texas Senate and House
gfl

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ellory said:   Texas opted out of the Affordable Care Act (ACA). Contact your Governor and Texas Senate and House
  Incorrect.  Texas declined the ACA option to set up a state exchange, so Texas residents can use the federal exchange to access ACA insurance policies.  All other ACA provisions apply to Texas and every other state; there is no such thing as "opting out" of federal law.  Texas also declined the optional Medicaid expansion under ACA.  Due to my income, I am ineligible for both Medicaid and subsidies under ACA.

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Premiums are increasing dramatically in most states.  The average increase in states covered by ACA federally run exchange is a 25% increase in premium.

As an example:
Arizona - premiums are up more than 100% on the Silver plan
Oklahoma - premiums are up 69%
Illinois - premiums are up 43%
North Carolina - premiums are up 40%
Indiana - premiums are down 3%

As to Ellory's comment above,  I seriously doubt Texas not joining ACA had much impact on your premium increase.  From what I have read, some states such as  Texas opted out of expansion of medicaid subsidies available through ACA because the states would have been required to expand their state medicaid program.  Some states set up their own state run exchange.

The reason some states didn't want to expand medicaid is because ACA only offered "temporary" subsidies to the states for the expanded medicaid program hence states like Texas didn't want to be stuck paying the additional cost of expanded medicaid once those federal temporary ACA subsidies burn off.

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The main drivers are really two things:

1.  Overall healthcare costs are increasing.  More people are now covered by insurance, guess who is paying the higher costs?  Insurance companies
2.  Insurance companies are paying out more.  Previously those that were uninsurable or that would be paying high premiums due to health issues, are now paying much lower premiums than their true risk profile would allow if there weren't caps in place.  As a result, healthy people and those who don't consume much health insurance are paying more to support the unhealthy who are now using more healthchare that is being paid by insurance.  

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I am in a obamacare plan. But I recd a letter from the insurance comp that they are dropping out of My State after 12/31/2016.
I started checking the marketplace exchanges and it's terrible out there.....absolute bloodbath....

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cleanbeat said:   I paid $185 per month for Blue Cross Blue Shield Texas health insurance in 2011.  BCBS notified me my 2017 premium will be $620 per month, a 54% increase over 2016 and a 235% increase (3.35x) over 2011.  I'm a non-smoker with no serious health issues.

Has anyone else seen such a huge increase?  Can anyone explain why this is happening?  Thinking about dropping it for a year and paying the penalty.

  Your premium has tripled because you are comparing it to 2011.  The only thing "affordable" in the ACA is the subsidies and cost sharing plans given to people with low enough income.  All the good that has come from Obamacare could've been attained by just expanding medicaid and leaving everything else alone.  Helping to subsidize someone's $500/month premium does them no good when they still have to come up with a $7,000 deductible before the policy kicks in.

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If your workplace doesn't offer health insurance, are there even any other options out there other than an exchange plan?

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cleanbeat said:   I paid $185 per month for Blue Cross Blue Shield Texas health insurance in 2011.  BCBS notified me my 2017 premium will be $620 per month, a 54% increase over 2016 and a 235% increase (3.35x) over 2011.  I'm a non-smoker with no serious health issues.

Has anyone else seen such a huge increase?  Can anyone explain why this is happening?  Thinking about dropping it for a year and paying the penalty.

  Are you paying 100% of the premium in 2011 and 2016 or is part of it paid by an employer? How do the 2011, 2015 & 2016 plans compare in terms of coverage and deductibles?

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cleanbeat said:   BCBS notified me my 2017 premium will be $620 per month
  You don't get insurance at work? If not, what's your annual income? 

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Have you shopped for cheaper plans? Do you have a low deductible? Are you over 50 years old?

There are a number of reasons WHY you've seen such increases. The ACA made insurers cover a lot more which is more expensive. Health care costs have increased and that cuases your rates to go up. Apparently BCBS is jacking rates ~50-60% average in TX. Clear sign their costs are much higher than they've expected. We spend over $10k per year per person average on healthcare in this nation. The insurers are also now losing a subsidy from the government called 'reinsurance' which was helping offset some of their costs during the initial transition into the ACA.

Tripling in 6 years is not typical.

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cleanbeat said:   Can anyone explain why this is happening? 
  Obamacare made health care costs drop and saved everyone $2500, don't you remember?  It's been a rousing success. 

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pandahouse said:   If your workplace doesn't offer health insurance, are there even any other options out there other than an exchange plan?
In California, at least, you can still purchase off-exchange individual health plans.  The problem is, however,  I was told a couple of weeks ago by Blue Shield that their individual off-exchange plan is virtually identical in premium and coverage as the on-exchange plan through California's state-run ACA exchange.   I suspect that California's Insurance Commissioner "encouraged" insurers to make their off-exchange individual plans mirror the on-exchange plans in order to eliminate competition for the on-exchange plans.    The insurance companies are increasing small business group plan premiums to make up their losses on the exchange plans.... so eventually most of us will be forced to buy insurance through the exchange.  

 

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bighitter said:   their individual off-exchange plan is virtually identical in premium and coverage as the on-exchange plan through California's state-run ACA exchange
 

  
What would you expect to be different?

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jerosen said:   We spend over $10k per year per person average on healthcare in this nation.
 

  
That's really the meat of it. Last number I saw, which was for 2014 was total US health care costs across total population (including children) was $9,800 per person, per year. Considering insurance is designed to spread the total cost of a risk pool amongst the members and since ACA eliminates the ability for insurers to kick off the really sick (which I think is great), you're going to see costs trend towards that average. Granted that is total cost of care and for most, insurance pays some and we pay some at each use of service (copays, deductibles, etc). Insurance is really expensive because health care is really expensive.

As soon as you have to include the really sick in your risk pool, the costs shoot up dramatically. The insurers are still developing actuary models for the new people who are coming onto the plans. They guessed at rates and apparently people are using more services than they expected.

If you want cheaper insurance, focus on controlling the cost of care.

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pandahouse said:   If your workplace doesn't offer health insurance, are there even any other options out there other than an exchange plan?
  

Most big healthcare facilities are affiliated here with an insurance company so you can apply online direct, but I don't think you can qualify for the tax credits, 

I just checked as I had marketplace for a few months this year, my previous silver plan was $273.12/mo without tax credits. The same plan doesn't seem to exist anymore, as there was a county discount of about $30/mo. The closest one to compare now looks like it is $380.17, but I know the deductible is about $1000 less under the new plan. 

If you're really thinking of dropping it is likely more affordable to get some crazy disaster insurance for minimum coverage instead of the penalty, you can get some super cheap plans with like a 15k ded, basically you need to have emergency surgery to max it out.

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doveroftke said:   
bighitter said:   their individual off-exchange plan is virtually identical in premium and coverage as the on-exchange plan through California's state-run ACA exchange
  
What would you expect to be different?

In a competitive market place with a population as large as California, I would have hoped to find a greater number of insurance companies available off-exchange.  Also I would have expected a larger network of available doctors off the exchange given that many doctors stopped accepting ACA insurance due to the low reimbursement rates.

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doveroftke said:   
bighitter said:   their individual off-exchange plan is virtually identical in premium and coverage as the on-exchange plan through California's state-run ACA exchange
What would you expect to be different?

  Especially given that Obamacare requires all plans (on or off exchange) to provide all kinds of minimum and pre-existing condition coverage. Even if there are different off-exchange plan options they are not going to be any cheaper, just maybe different mixes of deductibles, co-pays, co-insurance. and max out-of-pocket.

I don't know why people are surprised with the crazy rate increases. You can't mandate all kinds of minimum required coverage, allow anybody with pre-existing conditions and people who have years of no coverage to not have medical needs far outweighing the previous pool of insured individuals.

My premiums are increasing 35% and that is after the increases in the < 400% PL subsidy.

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cleanbeat said:   I paid $185 per month for Blue Cross Blue Shield Texas health insurance in 2011.  BCBS notified me my 2017 premium will be $620 per month, a 54% increase over 2016 and a 235% increase (3.35x) over 2011.  I'm a non-smoker with no serious health issues.

Has anyone else seen such a huge increase?  Can anyone explain why this is happening?  Thinking about dropping it for a year and paying the penalty.



Welcome to Affordable Care.

Research guaranteed issue and community rating for your answer as to why it's happened.

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btuttle said:   
doveroftke said:   
bighitter said:   their individual off-exchange plan is virtually identical in premium and coverage as the on-exchange plan through California's state-run ACA exchange
What would you expect to be different?

  Especially given that Obamacare requires all plans (on or off exchange) to provide all kinds of minimum and pre-existing condition coverage. Even if there are different off-exchange plan options they are not going to be any cheaper, just maybe different mixes of deductibles, co-pays, co-insurance. and max out-of-pocket.

I don't know why people are surprised with the crazy rate increases. You can't mandate all kinds of minimum required coverage, allow anybody with pre-existing conditions and people who have years of no coverage to not have medical needs far outweighing the previous pool of insured individuals.

My premiums are increasing 35% and that is after the increases in the < 400% PL subsidy.

  What's been lost is how the purpose of individual insurance is for those with similar risk profiles to insure against unusual (for that profile) healthcare expenses.  It isnt so that someone can offload their regular recurring healthcare costs on others.  If society feels there is certain care everyone is entitled to receive, then society needs to provide that care to all it's citizens (a la medicaid, medicare, and an ER's mandate to not to refuse anyone treatment); not force certain citizens to pay for the care of certain other citizens. 

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If you're really thinking of dropping it is likely more affordable to get some crazy disaster insurance for minimum coverage instead of the penalty, you can get some super cheap plans with like a 15k ded, basically you need to have emergency surgery to max it out.
  
That's exactly what I need.  Where can I find a policy like this?  For me, $200 to $300 per month with a $15K deductible is better than $620 per month with a $6.5K deductible.  In a year or two, I can set aside the savings to cover the difference in deductibles.  I can cover minor expenses, I just don't want to be bankrupted by a serious medical issue.

To those asking, I am self-employed with income exceeding the thresholds for ACA subsidies and Medicaid.

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Glitch99 said:     What's been lost is how the purpose of individual insurance is for those with similar risk profiles to insure against unusual (for that profile) healthcare expenses.  It isnt so that someone can offload their regular recurring healthcare costs on others.  If society feels there is certain care everyone is entitled to receive, then society needs to provide that care to all it's citizens (a la medicaid, medicare, and an ER's mandate to not to refuse anyone treatment); not force certain citizens to pay for the care of certain other citizens. 
 

  
The difference is most other insurance risk profiles are based on factors you can control. Don't want to be in a risk pool with DUI offenders? Don't drive drunk. Don't want to be stuck in a risk pool of people with type one diabetes, don't be unlucky enough to be born with it!

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cleanbeat said:   
If you're really thinking of dropping it is likely more affordable to get some crazy disaster insurance for minimum coverage instead of the penalty, you can get some super cheap plans with like a 15k ded, basically you need to have emergency surgery to max it out.
  
That's exactly what I need.  Where can I find a policy like this?  For me, $200 to $300 per month with a $15K deductible is better than $620 per month with a $6K deductible.  In a year or two, I can set aside the savings to cover the difference in deductibles.  I can cover minor expenses, I just don't want to be bankrupted by a serious medical issue.

To those asking, I am self-employed with income exceeding the thresholds for ACA subsidies and Medicaid.

  
The maximum allowed out of pocket maximum for an individual plan is $7,150.

If you're Christian, go to church regularly, agree to forego coverage for any "non-Christian" related diseases (abortion, STD/STI treatment, etc.) you can check out Medishare. It waives the penalty and can provide barebones type coverage.

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Many reasons but some of the ones I predicted would happen around 2010 on this forum.

1) Marginal value of utility. Elderly people can only be charged 3 times the price of a young person even though they tend to use 6 times the health care. This means that a young person is expected to pay for himself and to subsidize the elderly.

The laws of economics state that someone will only buy something for $1 when they expect the utility to be greater than $1 (otherwise they would prefer to keep their dollar). Obamacare by design expects young people to pay Sky high prices but get little in terms of value, and elderly people to pay little for a lot of value and of course it can't work. You end up with adverse selection -- sick and elderly people clamouring to the markets and young and healthy are not interested.

2) Obamacare is not insurance since you can buy a policy after a medical event has happened. You can go without insurance and if you have a serious diagnosis then you sign up for insurance after the fact (there's a list of 15+ reasons to sign up during non enrollment periods). This would be like buying a homeowners policy while your house is burning down. It makes no sense.

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ellory said:   Texas opted out of the Affordable Care Act (ACA). Contact your Governor and Texas Senate and House
  
This comment does not make any sense and is not true.  Texas and Texans must follow U.S. law too.  Texas did not setup a state exchange (consistent with the Affordable Care Act which gives states the option),  but certainly did not opt out of affordable care act. 

Welcome to "Affordable Care."  Folks across the United States are seeing massive increases in premiums/rates due to the ACA.  This is occurring in states using the federal exchange (like Texas) and states who setup their own state exchange. 

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vegas4x4 said:   
Glitch99 said:     What's been lost is how the purpose of individual insurance is for those with similar risk profiles to insure against unusual (for that profile) healthcare expenses.  It isnt so that someone can offload their regular recurring healthcare costs on others.  If society feels there is certain care everyone is entitled to receive, then society needs to provide that care to all it's citizens (a la medicaid, medicare, and an ER's mandate to not to refuse anyone treatment); not force certain citizens to pay for the care of certain other citizens. 
  
The difference is most other insurance risk profiles are based on factors you can control. Don't want to be in a risk pool with DUI offenders? Don't drive drunk. Don't want to be stuck in a risk pool of people with type one diabetes, don't be unlucky enough to be born with it!

  The point is that insurance is to protect against non-regular/non-routine expenses - just like auto insurance doesn't cover oil changes or running out of gas.  It isn't so someone can pay $100/month for their ongoing $1000/month health expenses.  Regular, ongoing healthcare expenses are no different than monthly housing or food costs - and no one is suggesting you should be forced to pay twice as much for your house because you can afford it, just so the guy next door can get an identical one for free; no one is suggesting you should pay more for your dinner just because you can afford it, so a person with less income can sit at the table next to you and pay less for the same meal.  

Its actually no different than 0% credit card offers.  They were offered, and a subset of users figured out how to profit from them.  So the rules were changed to minimize such unintended activity.  Just like insurance was offered to cover unexpected costs, and some people were able to use it to cover their regular day to day expenses - but instead of changing the rules to minimize the unintended usage, the rules were changed to compound the problems, further embellishing the unintended usage to the detriment of everyone.  It's the equivalent of forcing credit card issuers to give FatWalleters higher credit limits to use with those 0% offers.

If society decides to provide medical maintenance assistance, it can provide a medical maintenance assistance program.  But imposing mandates on the individual insurance market is not appropriate nor effective.

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Glitch99 said:   The point is that insurance is to protect against non-regular/non-routine expenses - just like auto insurance doesn't cover oil changes or running out of gas.  It isn't so someone can pay $100/month for their ongoing $1000/month health expenses.  Regular, ongoing healthcare expenses are no different than monthly housing or food costs - and no one is suggesting you should be forced to pay twice as much for your house because you can afford it, just so the guy next door can get an identical one for free; no one is suggesting you should pay more for your dinner just because you can afford it, so a person with less income can sit at the table next to you and pay less for the same meal.  

If society decides to provide medical maintenance assistance, it can provide a medical maintenance assistance program.  But imposing mandates on the individual insurance market is not appropriate nor effective.


I'm not sure what you're suggesting here. The cost of treating most chronic health conditions (would that fall into regular/routine?) would bankrupt the average person. Using the prior example, type one diabetes, the cost of treatment for that disease is around $9,000 per year and increases with age. That's not realistic for the average person to just handle that type of expense with routine budgeting. Yeah if you want to suggest that insurance doesn't need to cover the annual checkup which is realistic for a person to budget for, I can agree with and get behind that.

The reality is most people are not real sick. Most people refuse to believe they could become real sick, because that's not a comfortable thought to entertain. Given that, most people don't care if real sick people are covered because it's not them.

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vegas4x4 said:   

I'm not sure what you're suggesting here. The cost of treating most chronic health conditions (would that fall into regular/routine?) would bankrupt the average person. Using the prior example, type one diabetes, the cost of treatment for that disease is around $9,000 per year and increases with age. That's not realistic for the average person to just handle that type of expense with routine budgeting.

I was rather clear what I was suggesting. It doesn't matter if it's realistic for the average person to handle the cost of a chronic health condition, the individual insurance market is not a solution to that problem. It goes against the entire premise of insurance.
  

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vegas4x4 said:   
I'm not sure what you're suggesting here. The cost of treating most chronic health conditions (would that fall into regular/routine?) would bankrupt the average person. Using the prior example, type one diabetes, the cost of treatment for that disease is around $9,000 per year and increases with age. That's not realistic for the average person to just handle that type of expense with routine budgeting. Yeah if you want to suggest that insurance doesn't need to cover the annual checkup which is realistic for a person to budget for, I can agree with and get behind that.

The reality is most people are not real sick. Most people refuse to believe they could become real sick, because that's not a comfortable thought to entertain. Given that, most people don't care if real sick people are covered because it's not them.
 

  
As long as the focus is on who pays rather than addressing the cost drivers the problem will continue to get worse.

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I see people discussing that "insurance" should not cover regular things (like checkups), and should only be for emergencies or rare events.

However, the point of the preventative care being covered is that (in theory) it is cheaper to pay for an annual checkup or vaccine or mammogram (for $100) that may prevent a $100,000 ER bill down the line. Is this actually happening? Do the benefits take a while to materialize? I haven't seen empirical answers, but would be interested to see them. But the idea seems sound.

As for passing care costs for the old and sick onto the young and healthy, someone above posted that if we think every person deserves a minimal level of care (as opposed to people dying in hospital parking lots with armed guards at the doors), then the question becomes, how do we pay for that? In any scenario, SOMEONE is paying for the sick and elderly and poor. (And if you are young and healthy and not poor, that someone will be you one way or the other.)

The previous system was that people had no insurance, couldn't afford doc visits, waited for a big problem, then went to the ER where it costs 10x as much to treat. They can't pay, so the hospitals jack up all other prices by 2x to cover the 1/2 who can't pay. That gets paid for by (a) cities subsidizing hospitals through taxes that we all pay for, (b) other visitors to the ER paying double, or (c) all of us paying those costs indirectly through insurance premiums.

The question is really, what is the best/fairest way to allocate those costs? Through the government, where we all pay through taxes, through some sort of progressive tax system? Through the complex insurance system we had before where insurance rates just kept going up and nobody understood what anything costs? Through $50,000 ER bills for 4 hours of care? Through the ACA where those who can afford it pay higher premiums and others get subsidies?

There is no "easy" perfect answer or it would have happened already. It is a complex, expensive proposition that will eventually entail some very hard choices, as medical care costs approach 17% of GDP. And without addressing why costs in the U.S. are far higher than any other country, there is no "solution." Certainly repealing the ACA wouldn't make those high costs go away -- they may just be paid a different way (the question is how, and nobody agrees on that).

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Glitch99 said:   
cleanbeat said:   I paid $185 per month for Blue Cross Blue Shield Texas health insurance in 2011.  BCBS notified me my 2017 premium will be $620 per month, a 54% increase over 2016 and a 235% increase (3.35x) over 2011.  I'm a non-smoker with no serious health issues.

Has anyone else seen such a huge increase?  Can anyone explain why this is happening?  Thinking about dropping it for a year and paying the penalty.

  Your premium has tripled because you are comparing it to 2011.  The only thing "affordable" in the ACA is the subsidies and cost sharing plans given to people with low enough income.  All the good that has come from Obamacare could've been attained by just expanding medicaid and leaving everything else alone.  Helping to subsidize someone's $500/month premium does them no good when they still have to come up with a $7,000 deductible before the policy kicks in.

  
You do know that the subsidies apply to the deductibles as well, right?

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IMBoring25 said:   
vegas4x4 said:   
I'm not sure what you're suggesting here. The cost of treating most chronic health conditions (would that fall into regular/routine?) would bankrupt the average person. Using the prior example, type one diabetes, the cost of treatment for that disease is around $9,000 per year and increases with age. That's not realistic for the average person to just handle that type of expense with routine budgeting. Yeah if you want to suggest that insurance doesn't need to cover the annual checkup which is realistic for a person to budget for, I can agree with and get behind that.

The reality is most people are not real sick. Most people refuse to believe they could become real sick, because that's not a comfortable thought to entertain. Given that, most people don't care if real sick people are covered because it's not them.

  
As long as the focus is on who pays rather than addressing the cost drivers the problem will continue to get worse.

  
Well, the cost trends have actually improved somewhat, and who pays is actually pretty closely tied up with the cost drivers.  To control cost growth, we need to control either price or volume.  A single payer structure can do both effectively (it has negotiating clout, and can refuse to pay for services/products that don't provide enough value for the $).  Absent that, putting some degree of control in the hands of consumers can help on volume, but won't do a lot on price (since insurers are often too small to have enough negotiating clout). 

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You do know that the deductible assistance is only on silver plans, and with a much lower income limit than the premium subsidies, right? ($29,700 for a family of one in my state)

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taxmantoo said:   You do know that the deductible assistance is only on silver plans, and with a much lower income limit than the premium subsidies, right? ($29,700 for a family of one in my state)
  
I do.  Not clear what your point is.  

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I just checked a policy I looked at for my son and I back in September.  In September the quote was $621/month for a Bc/Bs Bronze plan (2016), but it had copays for Doc etc., before deductible kicked in.  Same policy now has no copays, everything goes to deductible and its $1149/month for a quote beginning 1/2017.

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robby69 said:   I just checked a policy I looked at for my son and I back in September.  In September the quote was $621/month for a Bc/Bs Bronze plan (2016), but it had copays for Doc etc., before deductible kicked in.  Same policy now has no copays, everything goes to deductible and its $1149/month for a quote beginning 1/2017.
  
How old is he?    $1100 / mo is very high for anyone not in their 60's.      Is this policy covering more than one person?
 

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cestmoi123 said:   
Glitch99 said:   
cleanbeat said:   I paid $185 per month for Blue Cross Blue Shield Texas health insurance in 2011.  BCBS notified me my 2017 premium will be $620 per month, a 54% increase over 2016 and a 235% increase (3.35x) over 2011.  I'm a non-smoker with no serious health issues.

Has anyone else seen such a huge increase?  Can anyone explain why this is happening?  Thinking about dropping it for a year and paying the penalty.

  Your premium has tripled because you are comparing it to 2011.  The only thing "affordable" in the ACA is the subsidies and cost sharing plans given to people with low enough income.  All the good that has come from Obamacare could've been attained by just expanding medicaid and leaving everything else alone.  Helping to subsidize someone's $500/month premium does them no good when they still have to come up with a $7,000 deductible before the policy kicks in.
 

  
You do know that the subsidies apply to the deductibles as well, right?

  You did read my comment saying that "the only thing "affordable" in the ACA is the subsidies and cost sharing plans given to people with low enough income", right?  And expanding Medicaid to cover those people, rather than going through the exercise of charging a premium for a private policy then subsidizing that cost, would've achieved the same benefit at a lower cost to everyone involved.

Skipping 129 Messages...
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Here's an article published today in the New York Times about problems that could occur for those with pre-existing conditions who try to get insurance if the ACA is dismantled, and if only part of the protection for pre-existing conditions is kept:
http://www.nytimes.com/2016/11/15/opinion/what-could-be-worse-th...

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