Plotting Your Escape From The PPACA

William was damned near ecstatic.   My client had a right to be.  William is a 57 year old self-employed Republican pragmatist.  He is also very unhealthy.  There are no imminent threats.  He just suffers from the kinds of things that causes health insurance companies to run away.  William’s current health insurance, a $5,000 deductible HSA qualified contract, is $1,055 per month.  On January 1, 2014 his premium plummets to $404.

William is now a huge fan of the Patient Protection and Affordable Care Act (PPACA).  And if you, like Bill, are paying a lot of money for your health insurance due to your significant health problems, then the new law may save you a lot of money, too.  Today’s blog is not for you.

Today’s blog is for those Americans who are reasonably healthy, do not need maternity coverage, and have an income above 400% of the federal poverty level.  This is also a post for those people who will not qualify for a federal subsidy for a number of other reasons.  The following will actually be relevant for a lot more people than you might think.


Today’s blog post includes numbers.  Lots and lots of numbers.  Stay with me.  This is your money.

The exchanges opened October 1st.  There have been, predictably, significant computer issues that will be resolved in time.  Some of our insurers are still trying to get their policies and applications approved.  I have been advising my clients to ignore the new system until November 1st.

I finally received Medical Mutual of Ohio’s 2014 rates.  We don’t have applications, just rates.  Here is how the PPACA affects a healthy 58 year old who happens to be fond of a good cigar (ME!). 

Current Policy – $5,000 deductible HSA qualified contract – $310 per month

New 2014 Policy – $6,000 deductible HSA qualified contract – $633 per month

If you will bear with me, I will give you a more complete look at some real numbers.  The following is a Medical Mutual of Ohio policy, $6,000 HSA qualified contract, for a non-smoker.  The 2013 rates assume the insured is healthy.  We no longer care in 2014 as we begin to utilize community rating.

                         2013                                                                                  2014

            Male                Female                                                            Male or Female 

22    $  55.21             $  75.43                                                                 $166.75

42        92.68               135.67                                                                   219.62

62      244.92              254.09                                                                   476.20

Community rating is great if you are the sickest guy on your street.

All of these policies, new in 2013 and new for 2014, cover preventive care at 100%.  The 2014 policies also cover maternity the same as any other medical condition.  But if you don’t have a serious pre-existing condition and you don’t need maternity, you don’t need one of the new 2014 policies.

How do you escape the PPACA if it isn’t going to help you?  Get coverage now!  A policy purchased now, effective now, eludes the PPACA till the end of 2014.  What will we do a year from now?  I don’t know, but I would rather save $3,600 over the next year and see what develops.

The Department of Health and Human Services (HHS) has been forced to create this on the fly.  Let’s give them an extra year to get this right.  If you allow yourself to be victimized by the PPACA, it is your own damn fault.

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