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.
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.
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.