Today is the start of the enrollment process for plans at Healthcare.gov. The biggest roadblock to reopening the government is that democrats want a continuing resolution to include extending what I would describe as pretty generous subsidies to make health insurance plans in the marketplace affordable. The republicans, I've only heard Mike Johnson say this actually, is that their intention is to negotiate that after they reopen the government.
Part of the argument against subsidies is that plans at Healthcare.gov shouldn't be that expensive, it's proof that Obamacare doesn't work. Obamacare clearly is a failure in terms of the costs excluding subsidies, I don't I've heard an argument taking the other side even from democrats. However, the answer is clearly not, "Obamacare sucks so it is better to end the subsidies and make everyone pay full boat." Making it dramatically more expensive out of pocket doesn't make a lick of sense.
I found an online calculator that shows the following subsidy.
At $85,000 MAGI, the subsidy is zero. Assuming the calculator is correct, at $85,000 two people the same age as my wife and me would have to pay full boat for health insurance from the market place. Here is my full boat from the market place if the subsidy issue isn't solved.
It is clearly and obviously broken but the answer is not telling someone making $7200/mo that they need to pay more than 1/3 of their income for health insurance. Actually fixing it doesn't appear to a priority for either party, Trump said a plan was coming in his first term and that didn't happen. Under Biden, the subsidies were enacted (made more generous) but the program was not fixed and I am not now aware of any plan in the works to fix it by the current administation.
Have you ever gotten a bid for work at your house and the number comes in so high that it's obvious the guy doesn't want to do the work? "If you want to pay me double, then sure I'll do it." This seems like the same thing. How many people are going to pay $3000/mo for health insurance? That seems insane to me.
The firm where I hang my shingle is now offering access to health insurance. They don't pay anything, I'm a 1099 but the range for us based on our age is $1400-$2400. I also got my renewal notice from the insurance we have for 2025 and as best as I can tell, it is actually staying the same at $709/mo which covers both of us. Some sort of broker (I don't know the correct word) found that plan for us a year ago and I'm sure we'll stick with it if I am reading the pricing info correctly.
I can't imagine we're getting great insurance at that price point but tying together all the low carb weightlifting stuff you're probably sick of hearing from me, we are very fortunate to have very little engagement with the healthcare system.
What does someone in their 50's or any age before Medicare kicks in, who is self-employed and has a lot of chronic maladies they have to deal with and manage do about health insurance? I'm not being snarky, what do they do assuming the $709 price point is shitty insurance? I saw a commercial for some medication I'd never seen advertised before and it said the cost per pill is $42 and the internet says you take two per day. Maybe "good" insurance covers that but would my shitty insurance cover it?
If $709 is correct, then we're saving $23,000 versus the bronze plan and $8400 versus the low end plan that my firm is offering. I don't have lucky genetics. I was prediabetic at 50. The day my doctor's office told me, I got online and found out about low carb and started literally that day. My wife calls me a robot and this is one of many examples she has cited. I've been lifting weights since the late 1970's but obviously did not have diet dialed and I got to a point where I could no longer out-exercise a poor diet.
A couple of weeks ago, I went out on a prescribed fire with the Forest Service. I was out on the line all day with a lot of people from the Forest Service, most of whom were in their mid-20's. Being brutal, most of them look out of shape for their poor diets, they actually talk about this (I just listened). They are in great condition, they can hike circles around me because being young they can out-exercise the consequences of their poor diet. At some point we all lose that ability and we either have to make lifestyle changes or we become unhealthy with insulin resistance and the like.
I've made the point countless times about how much money can be saved over the course of middle and old age by taking up good habits. Life is better and less expensive with just a couple of good decisions.
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