
'How Much Will Obamacare Cost Me?' Try Our Calculator - alphakappa
http://www.npr.org/blogs/health/2013/09/26/226456791/how-much-will-obamacare-cost-me-try-our-calculator
======
ck2
So apparently through age 50 each person is supposed to give the health
insurance corporations nearly a quarter million dollars.

I consider myself progressive and this is the most asinine solution I've ever
seen.

Instead of fixing health care costs we are going to make more billionaire
CEOs.

~~~
skwirl
There is a provision in Obamacare that went into effect a couple of years ago
that forces smaller insurance companies to spend at least 80% of their costs
on actual healthcare costs and for larger insurance companies that number is
85%. That means that for insurance companies only 15-20% of revenue can go to
employee salaries, building rent, other administrative costs, advertising, CEO
pay, profits, etc. So I'm not sure if this is actually going to make more
billionaire CEOs. While more people will be buying health insurance, at the
same time, CEOs are now limited in what they can pay themselves. The only way
they can pay themselves more is to reduce administrative costs or cover more
customers, which means making their own health insurance company more
lucrative than their competitors to consumers, which is a good thing.

~~~
epa
Yikes, a nightmare from an accounting perspective. Unfortunately there are
many ways to get around expense proportion limits.

~~~
toomuchtodo
A nightmare? Not at all. My car insurance (State Farm) is considered a mutual
company, and when payouts are less than premiums, I get a refund check.

------
benjohnson
As I understand it, the true costs will be when employers potentially drop
your heath-care coverage and make you temp worker.

Given that most people reading HN are employed in areas with high demand, this
will probably not happen to you, but it could happen to those that are
employed in jobs where there is a more ample pool of workers to draw from.

Sadly, it's hard to calculate the chances of this situation happening - so
we'll all probably just have to wait and see.

~~~
abraham_s
I find it weird that you don't blame the employers for dumping an employee, to
avoid paying 2000$ penalty.

~~~
enraged_camel
As we all know, employers are the "job creators" and whatever they do is for
the good of the economy. If they are dumping employees to maintain their
current profit levels, it's the government's fault for making them do that.

/s

~~~
briandear
Government doesn't create jobs. Every job they 'create' is paid for by someone
else's 'job.' Basic economics. Government creating jobs is as mythological as
Al Gore inventing the Internet.

~~~
maxerickson
It's at least logically possible for a government employee to create value
greater than the taxes necessary to employ them.

------
jdlshore
The most important thing to note about this calculator is that it's based on
CBO _estimates_ , not actual insurance plans:

"Premiums in the calculator are illustrative examples in 2014 dollars derived
from estimates of average premiums for 2016 from the Congressional Budget
Office." [1]

And apparently, 94% of uninsured Americans will have premiums that are less
than projected [2].

Even with those caveats, my costs are estimated to go down. This is very good
news for me, as someone with individual insurance, because health costs are
the dominating factor in my budget.

[1] Second paragraph of the "Notes" section under the calculator's results.

[2]
[http://www.slate.com/blogs/moneybox/2013/09/25/obamacare_pre...](http://www.slate.com/blogs/moneybox/2013/09/25/obamacare_premiums_will_be_cheaper_than_the_cbo_projected.html?wpisrc=burger_bar)

~~~
daguar
The federal premiums will be available on Oct 1.

California's premiums are already available here:
[http://www.coveredca.com/](http://www.coveredca.com/)

------
seldo
Those in the bay area can try the Covered California calculator, which gives
more details on the actual plans that will be available:

[http://www.coveredca.com/shopandcompare/#calculator](http://www.coveredca.com/shopandcompare/#calculator)

As I am currently self-employed, these plans make insurance a LOT more
affordable for me.

------
drakaal
Obama Care "costs" more than their calculator because the "$100 a month plan
for those making under $50k" cost $1,200 but doesn't give the plan holder
anything until they incur $10k in expenses.

Basically you Lose $1,200 that you could have spent on healthcare. That $1,200
is a lot when you consider that many of the people with out healthcare end up
at the Emergency Room for simple things like Strep Throat and end up paying
$500 instead of $80 for a doctor's visit.

The best analogy I can think is like the Poor who opt to be unbanked. Many of
the unbanked do so because the fees in banking are greater than what the fees
are at the Check cashing places because a single overdraft charge.

Obama care is really just bankruptcy insurance, and that is kind of what
bankruptcy is a way to not lose everything if you can't afford it.

~~~
clavalle
Yeah, that is how high deductible plans work.

But if you are in a car accident and need to be airlifted, have a heart
attack, etc etc, it is much better for you to at least have some cap on your
out of pocket.

~~~
briandear
Then an easier law that even republicans would have supported is to have the
government subsidize HDHPs and be done with it. Instead they needed 1200+
pages that the lawmakers didn't even read. Government wasn't after protecting
the 'uninsured'\-- they wanted to control an industry that makes up 5% of GDP.

~~~
nknighthb
Republicans supported the ACA until Obama did. It's based on their own
blueprints from the 1990s fight and Massachusetts.

And if you're going to whine about the length of the bill, get it right. It's
906 pages with legislative formatting (huge margins, lots of other
whitespace). The PDF is trivially googleable.

------
polymathist
Either there's a bug in the calculator or the pricing tier is completely
senseless. (sorry for the long link, it has all the parameters included)

[http://kff.org/interactive/subsidy-
calculator/#state=nc&zip=...](http://kff.org/interactive/subsidy-
calculator/#state=nc&zip=27705&locale=Durham&income-
type=dollars&income=5000&employer-coverage=0&people=1&adult-
count=2&adults%5B0%5D%5Bage%5D=42&adults%5B0%5D%5Btobacco%5D=0&adults%5B1%5D%5Bage%5D=44&adults%5B1%5D%5Btobacco%5D=0&child-
count=0&child-tobacco=0)

Two adults living in NC and making $5,000/yr are expected to pay an annual
premium of $6,901, which is 138.02% of their annual income! What!?

~~~
daguar
TL;DR: In states where Republican governors are choosing not to accept federal
money to expand Medicaid, the very poor are getting screwed.

From the calculator: "If your state does not expand Medicaid You will not be
eligible for subsidies in the exchanges because your income is below 100% of
the federal poverty level."

The reason for this is that the law provided federal dollars to states to
expand Medicaid coverage (pretty much free coverage for enrollees) to all
people making < 138% of the federal poverty level (FPL), and so the EXCHANGE
SUBSIDIES were only written to apply to folks above 138% FPL.

Problem is, the law didn't say that these (very poor) people could receive
subsidies for the Exchanges if the Governor refused to accept federal dollars
to expand Medicaid -- basically because no one thought governors would be so
brash as to refuse free money to pay for the health care of the very poor.

So, yeah. Kinda sucks to live in a Republican state right now if you're poor
and uninsured.

~~~
briandear
I really think that the 'free money' is part of the $2000+ per month withheld
from my paychecks. It's hardly free. It's very easy to spend other people's
money. I'm willing to bet not a single person reading this voluntarily sent
the government and extra payment last year. The interesting thing is that the
majority of economic growth has been in republican states,, specifically
Texas. and North Dakota. So perhaps the poor are worse off, but at least there
are more jobs that can provide the opportunity for them to not remain poor.
This article compares Texas and California economically:
[http://thehill.com/blogs/congress-blog/economy-a-
budget/3071...](http://thehill.com/blogs/congress-blog/economy-a-
budget/307111-economic-growth-texas-california-and-revisions)

------
pjbrunet
This is what I think will happen: 1% of uninsured will jump through all the
hoops and apply for a subsidy (which is more complicated and more expensive
than just picking up the phone and calling BCBS for a high-deductible plan.)
9% of uninsured will finally get insurance to avoid the $500 IRS fine. 90%
will do nothing and get a $500 fine from the IRS. 5% of those people will pay
the $500 fine which is cheaper than buying insurance. 45% of them will throw
the bill in the trash, assuming the IRS knows where they live/work. The other
50% will raise hell they are not paying $500 to the IRS, Obama will feel like
a bully and Obamacare will be history.

If I have it totally wrong, don't just downvote, please explain why. I really
don't know if the IRS fine will be $500, that's just a number I heard thrown
around last year. A $500 fine is less than half the cost a cheap insurance
plan for one person, and much cheaper if you have a family. If you're living
paycheck to paycheck, a possible $500 fine (that's not even a reality yet) is
much less pain than buying insurance right now. My percentage estimates are
off the top of my head (not scientific) but I heard 1/3 Americans don't file
tax returns so that figured into my estimates. And remember we're talking
about uninsured people, I'm thinking a large percentage of them are just
getting by.

~~~
clavalle
>(which is more complicated and more expensive than just picking up the phone
and calling BCBS.

Source?

>The other 50% will raise hell they are not paying $500 to the IRS, Obama will
feel like a bully and Obamacare will be history.

I am not sure how you make that leap.

I think a lot of people will go for the subsidy. Especially people with kids.
Two people who together make $30000 with three kids will pay $600/yr for
coverage while the fine would be $1000. It only makes sense.

~~~
pjbrunet
At this point the fine is still imaginary. Nobody has a $1000 fine in their
mailbox yet. People are used to getting money _back_ from the IRS. Most people
don't understand what a bill from the IRS means. How many people even know
there will be a fine? Has Obama talked about the fine yet?

Also, even if you apply for the subsidy, you'll be paying full price for an
expensive plan in the meantime. A family that's just getting by (that's _why_
they are uninsured) it's going to be much more affordable to get a high-
deductible plan and forget Obamacare altogether. If you're just getting by,
you're not planning your finances a year in advance for when the subsidy check
_might_ come in the mail. The uninsured are thinking about next month, not a
year from now. What percentage of people are sure they will get that
government subsidy check? You're assuming uninsured people have extra money
saved to pay for a full-price insurance plan right now.

~~~
MaysonL
Take a look at what happened with the individual mandate in Massachusetts.
About 1% of the population (48,000 in 2009) paid the penalty, set at 50% of
the minimum insurance premium. Even assuming that the rest of the country has
people stupider than Massachusetts, and more ornery, it's really not going to
be anywhere near as bad as you're predicting.

~~~
pjbrunet
I predicted 5% of uninsured who don't want insurance will pay the fine. About
15% don't have health insurance. If it turns out 1% of the population pays an
IRS fine, that's even more people than I predicted.

[http://en.wikipedia.org/wiki/Health_insurance_coverage_in_th...](http://en.wikipedia.org/wiki/Health_insurance_coverage_in_the_United_States)

~~~
MaysonL
No, you said, and I copy-paste quote _" 90% will do nothing and get a $500
fine from the IRS."_

~~~
pjbrunet
1\. I said 90% of uninsured. That would be 90% of 15% of the population.
Clearly I'm not saying 90% of the population will get fined. But my estimate
will be way off, see #2.

2\. Getting fined (what I said) and paying a fine (what you said) are totally
different. Only 41% of people file tax returns. You can bet that percentage is
much higher among the uninsured. So right off the bat, over half the uninsured
should be fined. Those people were in my 90% estimate but there's really no
way to fine them. I just did some searching and it apprears you are "exempt
from the requirement to obtain minimum essential coverage...if you are not a
U.S. citizen, a U.S. national or an alien lawfully present in the U.S."
[http://www.irs.gov/uac/Questions-and-Answers-on-the-
Individu...](http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-
Shared-Responsibility-Provision)

This is also interesting:

"44% of (people who file taxes) were unaware that they would face a penalty
for not purchasing coverage."

[http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/15/h...](http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/15/how-
hr-block-plans-to-capitalize-on-obamacare/)

------
crazygringo
What legally counts as "tobacco usage"?

Sure, if you smoke a pack a day. What if you just have a couple of cigarettes
when you go out, a couple nights a week? What about once a month? If you smoke
a cigar when your baby's born?

Unlike the other categories, "tobacco use" doesn't make a lot of sense... and
out of all the dangerous, life-threatening activities you can partake in, why
is only this one singled out? Why not change premiums based on BMI too? It's
kind of bizarre.

~~~
daguar
Per the CMS regulations:

"Under the final rule, “tobacco use” is defined as the use of a tobacco
product or products four or more times per week within no longer than the past
6 months by legal users of tobacco products (generally those 18 years and
older) and includes all tobacco products."

Source: [http://www.cms.gov/CCIIO/Resources/Files/Downloads/market-
ru...](http://www.cms.gov/CCIIO/Resources/Files/Downloads/market-rules-
technical-summary-2-27-2013.pdf) (page 3)

~~~
crazygringo
Wow, thanks... I'd googled it and couldn't find it anywhere. HN delivers! That
actually seems like a pretty common-sense cutoff point.

------
patja
It is interesting that the subsidies are based on your Modified Adjusted Gross
Income (MAGI). A nice example of tax code naming conventions: it is both
Modified and Adjusted! One of the items you deduct from your income to get
your MAGI is self employed insurance premiums.

I am curious how this will work in practice for the self employed...it seems a
bit recursive. My premiums paid will be influenced by how big of a subsidy I
get, and the subsidy calculation depends on MAGI which is influenced by the
total of my health insurance premium payments.

Is there a class of the donut hole problem where you forecast that you will
pay enough in premiums to get your MAGI down to qualify for a subsidy, but
that subsidy reduces your actual paid premiums and now you no longer have a
MAGI low enough to get the subsidy? Maybe I need to spreadsheet this and it
isn't such a trap, or maybe the MAGI deduction is based on the gross premium
with the subsidy being a separate credit. Also bear in mind that the whole
thing gets trued up when you file your 2014 taxes with your actual (rather
than projected) MAGI.

------
DennisP
Something I've been wondering: I've got a pretty fair amount of savings.
Suppose I go on sabbatical for a year to do a startup, spruce up my github,
whatever. For the sake of argument say I don't have COBRA.

Everything I've read talks about income, not net worth. If I'm not making
income, am I stuck with Medicaid, even though I have a decent net worth? Or if
I do a little consulting and make $20K, do I get subsidies on the exchange,
even though I really don't need them?

~~~
daguar
Yes -- subsidies are tied to income, not assets (specifically, modified
adjusted gross income [MAGI]).

There are reasonable arguments around the equity of this, but, as you
describe, it actually opens a big door for wishing to try a more
entrepreneurial venture -- especially for those with health conditions.

~~~
DennisP
Interesting. What about medicaid though? From what I've seen there's a minimum
income to get the regular plans on the exchange, and below that you have to go
with medicaid (assuming there aren't net worth qualifications for that).

~~~
daguar
Medicaid _does_ have some asset tests.

Below 138% of the federal poverty level, you would qualify for Medicaid. [1]

If you had ethical qualms about it (or couldn't pass the asset tests) you can
absolutely purchase a plan on the Exchange -- you just wouldn't receive a
subsidy.

[1] In states that have opted to expand it, see my other comment.

~~~
DennisP
Ah good. One last question, if you don't mind: how does the subsidy work for a
freelancer, who doesn't know his annual income until the year's over?

~~~
nknighthb
It's structured as part of your taxes. If you got too much subsidy during the
year, you'd pay the difference next April, if you got too little, you'd get
the difference back as part of your refund (or use it to offset the rest of
your bill).

You're supposed to be able to elect to take a lower subsidy than you expect to
qualify for, if you want to make sure you don't end up with an oversized tax
bill next April. Presumably this will be part of some form when buying
coverage on the exchanges. We'll know what it looks like in a couple days...

------
joelhaasnoot
As a European (Dutch to be exact) that has put up with a very similar
universal healthcare, the numbers are actually about the same for me - based
on income, I get about the same amount of tax credit here. I'm guessing the
conditions of said insurance will be different - no deductible is mentioned
for example, while the Netherlands has a 350 euro required deductible.

~~~
maxerickson
The deductible is sort of smeared into the out of pocket maximum and actuarial
value (but for lots of people it would amount to quite some more than $500).

------
001sky
_The premium is adjusted for family size, tobacco usage, and age of the
user..._

Funny, that one term is not in the questionaire

~~~
taeric
Which one? As soon as you pick "adult or child" then it asks if you use
tobacco.

~~~
gee_totes
I actually think their tobacco section is a little buggy. On Chrome on Fedora
17, I wasn't able to get the tool top to pop up to see how "tobacco usage" is
defined (some states define it as use within the last 12 months, some states
define it as use right now).

------
gweinberg
According to the calculator, I'll be paying about the same as what I'm paying
now with COBRA.

~~~
debacle
If your MAGI is above a certain level, that's kind of the point.

------
Kequc
The number that came up is the cheapest health insurance ever, man. Who could
possibly complain about that. It is like 5% of my income unless something went
wrong in the calculation.

~~~
dangrossman
My estimate was 3 times what I'm paying now, for my own non-subsidized plan.

~~~
jdlshore
Are you young, with no history of health problems? Under the ACA, older people
pay less and younger people pay more (because "old people" premiums are
limited to 3x "young people" premiums), and people with a poor health pay less
and people with good health pay more (because health history is no longer
considered in premiums).

If not, do you have a very high deductible and max out-of-pocket? The ACA puts
limits on the maximum out-of-pocket.

If not, are you on a group plan of some sort? Individual rates tend to be more
expensive than group rates.

If not, can you sign me up? 'Cause I'd love to cut my healthcare premiums by
3x. :-D

