Does everyone have to get "mnsure"? (Rochester, Orr: 2013, health insurance)

[Citykid55]

...

[golfgal]

"have to" how? Yes, you need to have health insurance but if you have a plan through an employer you don't get MNSure.

[Glenfield]

If you don't have private insurance or get it through mnsure you'll have to pay a penalty to the government. It will be expensive but perhaps not as much as your insurance.

[golfgal]

Originally Posted by Glenfield

If you don't have private insurance or get it through mnsure you'll have to pay a penalty to the government. It will be expensive but perhaps not as much as your insurance.

Actually, the MN rates are very reasonable, lowest in the country.

[Glenfield]

Originally Posted by golfgal

Actually, the MN rates are very reasonable, lowest in the country.

Let's see how it all looks a year from now before we congratulate ourselves. Private employers are cutting back on employee health benefits, espcially for retires, and foisting them off on the state exchanges, which depend on the participation of young, healthy, and previously uninsured people to keep costs down. This move by IBM, which has a good number of retirees in Rochester, has not been factored into the current cost structure. If there are more moves like this costs will rise, and that will drive the young and healthy out of the program. The healthcare landscape is changing every day and it's too early to claim success.

CORRECTED-IBM to transfer U.S. retirees to healthcare exchanges next year | Reuters

[golfgal]

Originally Posted by Glenfield

Let's see how it all looks a year from now before we congratulate ourselves. Private employers are cutting back on employee health benefits, espcially for retires, and foisting them off on the state exchanges, which depend on the participation of young, healthy, and previously uninsured people to keep costs down. This move by IBM, which has a good number of retirees in Rochester, has not been factored into the current cost structure. If there are more moves like this costs will rise, and that will drive the young and healthy out of the program. The healthcare landscape is changing every day and it's too early to claim success.

CORRECTED-IBM to transfer U.S. retirees to healthcare exchanges next year | Reuters

Given that insurance operates on the law of large numbers, the exchanges should benefit from added participation, however, what's going to kill the rates is if people start running to the doctor every time they sneeze. We will see. Most of the major changes have already happened and you are paying for those now. The biggest change is no pre-existing condition clauses for people over 19, under 19 is already in effect. That might alter rates some, however less than 15% of the country is without health insurance now (and when they started talking about the ACA) so those numbers are not going to be significant. Of those 15%, about 1/2 choose not to take coverage, not because they can't get it but they don't want to pay for it.

UPS announced that they won't cover spouses that have medical coverage options through their own employer. The State of MN has been doing that for YEARS-15 at least. With the laws and reporting issues that will change for businesses, I don't blame them for covering people that can get coverage elsewhere.

[Glenfield]

Originally Posted by golfgal

Given that insurance operates on the law of large numbers, the exchanges should benefit from added participation, however, what's going to kill the rates is if people start running to the doctor every time they sneeze. We will see. Most of the major changes have already happened and you are paying for those now. The biggest change is no pre-existing condition clauses for people over 19, under 19 is already in effect. That might alter rates some, however less than 15% of the country is without health insurance now (and when they started talking about the ACA) so those numbers are not going to be significant. Of those 15%, about 1/2 choose not to take coverage, not because they can't get it but they don't want to pay for it.

UPS announced that they won't cover spouses that have medical coverage options through their own employer. The State of MN has been doing that for YEARS-15 at least. With the laws and reporting issues that will change for businesses, I don't blame them for covering people that can get coverage elsewhere.

My point was that shifting retirees onto the state exchanges may well increase the costs of those plans because retirees go to the doctor more than younger people, and may cost those plans more than they pay in. You are correct that many changes have already been implemented. Our plan here went from $500 out of pocket per year per family to $4,000 per year. Reason given: increased costs due to expanded coverage under Obamacare. Maybe that was just an excuse, but they did it anyway.

[golfgal]

Originally Posted by Glenfield

My point was that shifting retirees onto the state exchanges may well increase the costs of those plans because retirees go to the doctor more than younger people, and may cost those plans more than they pay in. You are correct that many changes have already been implemented. Our plan here went from $500 out of pocket per year per family to $4,000 per year. Reason given: increased costs due to expanded coverage under Obamacare. Maybe that was just an excuse, but they did it anyway.

You have to understand that the $4K is a cost savings for your company and you. Having a $500 out of pocket max is almost unheard of these days, and for many years. It would be considered a Cadillac plan and then your company would be fined an excise tax for that. It sounds silly but, if you knew that your visit to the doctor was only going to cost you $10, would you go..even if you weren't really sick but think you might be? Probably. How about if that same visit was going to cost you $100, would you wait another day or two to see if it was just a cold? Now, if you are coughing up a lung and have a fever of 103, does it matter to you if you pay $10 or $100--you know you are sick and probably have pneumonia so you are going to the doctor. Then, add to that, you know you have pneumonia--do you go to urgent care or to the ER? Urgent care is going to cost you $70, the ER $1500..most people are going to go to urgent care.

Part of the ACA design is to make health care a little less easy on people. They want people to be responsible consumers. They don't want people to run to the doctor every time they sneeze, but they also want a reasonable stop-gap if they are really sick or get hurt or whatever.

Most retirees won't shift to the Exchange, they will go to Medicare. Now they have Medicare and a secondary plan, probably. That secondary plan is what is going away. Those that are not Medicare eligible yet will move to the exchanges, but those numbers aren't all that large and you are talking about people from age 55-65 roughly.

It's not perfect but there are a lot of good things that are happening with this plan and for people like you that still have these "old" plans, yes, it's going to hurt a little more. People like us, we've had $6000 out of pocket max for 10+ years. Our plan costs have not gone up much at all in the past several years. Last year we got a $200/year increase on our family plan. Keep your costs down by using your plan responsibly and you can help keep those hikes under control.

[Glenfield]

Originally Posted by golfgal

You have to understand that the $4K is a cost savings for your company and you.

As I recall, your field is education. Mine is finance. But I don't need to an MBA to know that paying up to $4,000 out of pocket versus $500 at the same premium is NOT a savings for me! Them? Sure. But for me? Hardly.

[golfgal]

Originally Posted by Glenfield

As I recall, your field is education. Mine is finance. But I don't need to an MBA to know that paying up to $4,000 out of pocket versus $500 at the same premium is NOT a savings for me! Them? Sure. But for me? Hardly.

The taxes they would pay on the excise would get passed off to you in either reduced pay, reduced benefits or higher premiums, etc. Depending on the size of your company, that could be millions in taxes. You also have to look at how often you would really spend that $4000 out of pocket. Unless you have a big surgery or maybe a baby, chances of meeting your out of pocket max is small. I am not in education any longer.