One of the big variables in the health care equation is who will you buy it from and what will be the cost. Will we have a single-payer system where health insurers are out of the picture? Or will there be many health insurers that effectively compete for your business with the government paying for some or all of your premiums? And what about Universal health care that is popular in Europe?
Pennsylvania Marketplace
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Another question mark is the current Pa Health Exchange. Will it be operational in 2016 or will election results in 2014 put the Exchange ideas to an end. That's a big variable and Pa consumers will have to keep a close watch on the developments. The election in 2016 plays a big role in the makeup of the Exchange. We do feel, however, regardless of the results, a repeal is not going to occur. Perhaps some additional changes and tweaks though.
Although President Obama was re-elected, details about the inner workings are still being worked out. The Marketplace is up and running, but there are many issues that are unanswered. Cost overrun is always a major concern. One of the variables is which carriers will continue to offer plans. Not all companies participate, which ultimately hurts consumers. And the shrinking size of Networks is always a concern.
More than likely, in Pennsylvania and the rest of the US, we will see a blend of these two concepts. If you are at or near the poverty level, there should be some type of assistance that will help pay for some, most or all of your premiums. But where will the bar be set? $20,000 of household income? $40,000? This will be a very contentious topic. And perhaps it will be a rolling amount...slightly increasing every year.
Your Income And The Federal Poverty Level
Currently, if you make over $96,000 (family income), there will not be a tax subsidy. However, if you fall under that amount, you will be eligible for financial aid from the federal government. These subsidies will be badly needed since prices may be high without them. Purchasing coverage outside the Exchange may also be an attractive option to be considered.
The Federal Poverty Level guidelines greatly dictate how much financial aid you will receive from the government. That, along with the number of dependents you have, can mean the difference of receiving $10,000 in aid or none at all. This Subsidy Calculator will help you determine your financial aid.
Over Age-65 Market
But as people are able to be treated for more diseases and conditions, and thus live longer, the big burden may not be on health insurance for folks under 65. Medicare may bear the brunt of many current and future problems. Invariably, copays will have to rise and mismanagement, fraud and waste will have to be brought to a grinding halt. OK. I know. Maybe not to a grinding halt, but perhaps a bit better controlled. There's a lot of money that can be saved by simply managing our own house better.
The usage and availability of Medicare Supplement plans may change. Of course, currently, there are plenty of options available and the rates are reasonably priced since it just needs to cover "gaps" in coverage. But as these gaps get larger and seniors become older, rates may go up. And the makeup of policy coverages may change if Medicare changes its basic coverage. I can only say "stay tuned" and let's see what happens.
Another variable is if the Medicare-eligibility age changes. Currently it is age 65. For instance, if it were to change to 67, that could put some pressure on individual health insurance rates since the health of older persons is not as good (generally) as younger persons. Someone would have to pay for that and it may be us! We believe that the Medicare eligibility age will remain at 65.
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But the Social Security retirement age could increase. In fact, it may have to so it can remain solvent. One possibility is an increase of three months every other year. This nominal jump should placate both Democrats and Republicans, and allow Social Security to continue to safely provide retirement income to millions of senior citizens.
Health insurance won't be free in 10 years or 50 years. So yes, you will still have to buy it. But the double digit increases in premiums will be long-gone with various subsidies keeping premiums to a somewhat reasonable level. Non-generic prescriptions will still be expensive, but hopefully the multitude of generic drugs will allow consumers to cheaply purchase the medications they need. And if major diseases such as cancer and heart disease become less costly to treat, it could have a major impact on long term health care costs.
