
Ask HN: What are you going to do for health insurance if ACA is repealed? - citizen_concern
...especially freelancers and entrepreneurs, whom ACA enabled.
======
anon_aca
From a practical sense, I'm not sure exactly how the change will impact me.
I'm self employed, and have been for about 15 years. I currently purchase
insurance for my family through the exchange, but my income is above the level
where I'd receive any tax advantage from doing-so. The off-exchange plans
costs were comparable to the on-exchange plans, but there was a minor benefit
to purchasing a plan on the exchange versus a similar plan from the same
provider off-exchange based on the paperwork I reviewed, unless the paperwork
was just wrong. I never got a clear answer. So we went with the exchange plan.
I used to purchase insurance on the open market before exchange plans existed,
so presumably that's where I'd go again.

But the costs are extreme.

I pay close to $20k annually for a generally-healthy family of four. That rose
~17.8% from last year, and presumably it'll rise again this year. If the
increase rate is similar, that'd put it at around $24k in 2018, which
coincidentally is comparable to the federal poverty rate for a family of four.

I'm fortunate that I'm employed. I have no problem paying into a system where
the healthy subsidize the care of the less healthy. That's the whole idea
behind any insurance. But the rate of increase I've seen in my health
insurance costs over the past few years has been unlike any increase I've
experienced for other costs of living, and if the trend continues, I'm not
sure what I'll do for coverage. It'd like push me to re-evaluate whether to
remain self-employed.

------
jstewartmobile
Our premium is $1300/mo for a family of four. In the beginning, the ACA kicked
us in the nuts. Prior to the ACA, it was cheap to insure children. After the
ACA, children cost as much as adults. Pretty rough, and we made too much to
get a subsidy.

Last year was pretty lean, so we did get some money back on the subsidy. The
whole Obamacare thing has been a wash for us.

In spite of that, I wish they'd just leave it alone. Good system or bad
system, if it stays the same, I can factor that into my prices and it will all
come out in the wash. When they just randomly change things in the thoughtless
and adversarial way that lawyers/politicians tend to, I no longer know what to
plan for.

------
waterphone
Same as I do now: no insurance.

------
gt565k
Go outside the US to South/Central America or Eastern Europe. Airfare
included, it's cheaper than paying out of pocket even with ACA.

------
Mz
You might consider Direct Primary Care:

[http://micheleincalifornia.blogspot.com/2017/01/direct-
prima...](http://micheleincalifornia.blogspot.com/2017/01/direct-primary-
care.html)

