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Re:Show HN: Effects of House and Senate Bill on California R... by kxyvr on Wednesday December 06, 2017 @05:40PM (#15865775)
Nice tool, but a lot of the market is being altered in a way that blows out these savings. For example, I run my business and my overall tax rate last year was 28%. However, when I account for healthcare premiums and hitting my out of pocket max, I was over 40%. According to the calculator, my tax burden is reduced slightly under the plan. That said, my health costs for next year went up 37% and I'm receiving worse coverage. As such, I will be at a net loss for 2018 and it looks like it will become worse in 2019 if the individual mandate is eliminated.

So, no, I don't expect a calculator to be perfect, but I can't help but stress how important the changes in healthcare costs for self-employed are under this plan.

Re:Show HN: Effects of House and Senate Bill on California R... by technotony on Wednesday December 06, 2017 @07:18PM (#15866424)
My view is that if the individual mandate is eliminated then other insurers will come into the market with cheaper plans that don't include everything (Eg mental health) so health costs for healthy self-employed folks will go down. The thing I've always hated about Obamacare was how healthy self employed folks are subsiding the unhealthy people, this happens because most people in their 20's or 30s are covered by work plans which have a better risk pool.
Re:Show HN: Effects of House and Senate Bill on California R... by meritt on Wednesday December 06, 2017 @09:17PM (#15867071)
> My view is that if the individual mandate is eliminated then other insurers will come into the market

That's absolutely incorrect. The individual mandate requires people purchase health insurance or face a penalty. This will do absolutely nothing to introduce additional insurers. The only thing it will achieve is increased premiums.

> The thing I've always hated about Obamacare was how healthy self employed folks are subsiding the unhealthy people

That's the core principle of insurance, taxes, and functional governments. Everyone contributes to the same pool even if they don't directly benefit from nor utilize every aspect.

Re:Show HN: Effects of House and Senate Bill on California R... by technotony on Thursday December 07, 2017 @09:09PM (#15876166)
The issue with this system is how the pools are created. Most people use a work pool, leaving those outside it in a lower quality pool. I'd be fine with it if the risk was spread across everyone, not if it's just certain types of employees.
Re:Show HN: Effects of House and Senate Bill on California R... by EKLM-ZK88 on Wednesday December 06, 2017 @08:05PM (#15866697)
"The thing I've always hated about Obamacare was how healthy self employed folks are subsiding the unhealthy people"

Is that not how this all is supposed to work? the young and healthy help the old and sick, or the rich living in coastal cities help the poor living in rural areas.

Re:Show HN: Effects of House and Senate Bill on California R... by seanmcdirmid on Wednesday December 06, 2017 @09:36PM (#15867172)
The problem is that they didn’t get rid of group plans when introducing the individual mandate, as they did in Switzerland. Group plans siphon off all the lowest risk, leaving the individual market a huge mess.
Re:Show HN: Effects of House and Senate Bill on California R... by maxerickson on Wednesday December 06, 2017 @08:30PM (#15866838)
They are making a subtler claim, that the individual marketplaces are expensive to insure compared to other insurance (and thus people receiving lower subsidies pay a lot for marketplace insurance).
Re:Show HN: Effects of House and Senate Bill on California R... by mnm1 on Wednesday December 06, 2017 @08:45PM (#15866925)
"The thing I've always hated about Obamacare was how healthy self employed folks are subsiding the unhealthy people"

So do you just hate health insurance in general then? Because all health insurance works like this.

Re:Show HN: Effects of House and Senate Bill on California R... by akmiller on Thursday December 07, 2017 @09:56AM (#15870456)
And not just health....all insurance works like this!
Re:Show HN: Effects of House and Senate Bill on California R... by maxerickson on Wednesday December 06, 2017 @08:12PM (#15866729)
Removing the individual mandate won't change the requirements for plans.
Re:Show HN: Effects of House and Senate Bill on California R... by kxyvr on Wednesday December 06, 2017 @07:49PM (#15866607)
I'm sure it will for some people. That said when I was 21, I was diagnosed and treated for stage 3 melanoma and I can assure you the drugs that I took during that year were not cheap. At this point, it's been more than a decade and I'm wonderfully healthy, but I'm considered a high-risk because of my past with cancer.

Now, there's a very valid moral question as to whether or not I'm entitled to have my healthcare subsidized by others in a pool and I'm fine having that conversation. From an economic point of view, I'm just shy of my mid-thirties with an advanced degree, been in the black with a self-funded business for the last 4-5 years, and have the potential to release products in the near future that could return millions in tax dollars. However, I may be robbed of that opportunity if I'm unable to purchase health insurance that covers cancer. Certainly, that's a frustrating proposition given that the only major misstep that I had was being unfortunate enough to become afflicted with a disease not under my control.

And, just in case someone is curious about high-risk pools, I actually currently carry insurance from one because the ACA marketplace in my state does not offer PPOs and I have one regular appointment out of state. Anyway, the coverage and cost of high-risk pools varied wildly from state to state. As an example, since I'm familiar with TX, prior to disbanding the pool, the law allowed high-risk individuals to purchase insurance at twice the prevailing rate from the pool. If I recall correctly, its pool used a PPO, which is no longer found on the exchange, so we'll use a gold plan EPO to approximate. In Harris county, the current premium for that rate is $429/month with an out of pocket max of $6350. If we went back to the old model of twice the prevailing rate, I'd have to budget $16,646/year, which isn't all that far off from what it used to be. Now, that's just TX and different states had different rules. In the state I'm currently in, the 2018 premium will be $514/month with a $5000 out of pocket max. And, to be clear, there is cheaper health insurance available, but my perspective of coverage and costs changed dramatically after my illness. Health insurance doesn't mean much if it doesn't cover the doctors you trust for a price you can afford.

Anyway, my point is that just because someone is in their 30's and healthy doesn't mean that their coverage will become cheaper or even attainable. Further, this has broad economic implications because it will quite simply force many of us out of the self-employed market because it's not responsible to carry an insurance plan that does not provide comprehensive coverage. This tax plan has been touted as helping small businesses, but it may end mine depending on what happens to the market in 2019.

Re:Show HN: Effects of House and Senate Bill on California R... by scarface74 on Wednesday December 06, 2017 @11:23PM (#15867609)
My situation was crazy. I was denied insurance right before the ACA took effect because of a "preexisting condition" that I never thought about. I have what for all intents and purposes is very mild cerebral palsy. As an adult, I've never had any complications, I was in excellent shape - I had been a part time fitness instructor for years and ran two half marathons the year before. The only noticeable effect of my CP is one of my hands.
Re:Show HN: Effects of House and Senate Bill on California R... by pkaye on Wednesday December 06, 2017 @10:17PM (#15867358)
I'm in the same situation. Fairly healthy until 4 years ago when I discovered my kidneys were failing due to a autoimmune condition. Something that is not discovered early because you feel totally fine until things go really bad. Now I've reached the point I need dialysis and a kidney transplant. Yet I continue to work, pay taxes and would like to continue having affordable health care for my family and I.

Also people don't think about two other high risk pools... women of childbearing age and very young children. If the heath care market is broken up many groups of people will be affected.

Re:Show HN: Effects of House and Senate Bill on California R... by hkmurakami on Wednesday December 06, 2017 @10:31PM (#15867422)
Just wanted to say that I appreciate your candidness and well trained and level headed perspective on an issue that many of our peers opt for hysterics over.
Re:Show HN: Effects of House and Senate Bill on California R... by poulsbohemian on Wednesday December 06, 2017 @05:47PM (#15865839)
Wish I had more than one upvote for you, you perfectly summarize the situation for many of us.
Re:Show HN: Effects of House and Senate Bill on California R... by wang_li on Wednesday December 06, 2017 @06:11PM (#15866032)
Concern about the individual mandate's effect on the market is curious. It's was waived by Obama until 2016. Trump waived it for 2016 and now the tax plan will eliminate it permanently. Seems status quo.
Re:Show HN: Effects of House and Senate Bill on California R... by newfoundglory on Wednesday December 06, 2017 @06:13PM (#15866045)
No, expected future events are part of the status quo and they have been changed. Would you expect the market not to react if the government announced social security payments would all stop in 2018?
Re:Show HN: Effects of House and Senate Bill on California R... by brobinson on Wednesday December 06, 2017 @09:18PM (#15867079)
What? I had to pay an individual mandate penalty on my 2015 tax return...

If you're right, then the IRS owes me a refund.

Re:Show HN: Effects of House and Senate Bill on California R... by wang_li on Wednesday December 06, 2017 @09:22PM (#15867092)
Re:Show HN: Effects of House and Senate Bill on California R... by meritt on Wednesday December 06, 2017 @09:25PM (#15867110)
Hardship exemptions [1] are absolutely not the same thing as waiving the penalty.

[1] https://www.healthcare.gov/health-coverage-exemptions/hardsh...

Re:Show HN: Effects of House and Senate Bill on California R... by guelo on Wednesday December 06, 2017 @08:23PM (#15866793)
Obama did not waive it in 2016.