Tuesday, December 24, 2013

The Procrastinator's Guide To Buying Obamacare and the 15th Unilateral Delay to the Law

This is from Megan McArdle at Bloomberg. The entire post is worth reading:
Today is the last day to sign up for Obamacare if you want your insurance to start on Jan. 1.
Just kidding! The Washington Post just reported that the administration has “quietly” delayed the sign-up date by another 24 hours. As someone I know drily noted, “I want coverage that starts January 1st, but at this rate, I think I'll just wait and sign up in June."  
Still, I imagine that some of you are planning to buy insurance via the exchanges today. If you’re planning to sign up, here are some things to remember: 
Bronze plans have subsidies; Catastrophic plans don’t. This is actually most of the difference between them, which is why Catastrophic plans seem to be, at best, only modestly cheaper. If your household income is under 300 percent to 400 percent of the federal poverty line, you may want the Bronze plan, even if you’re under 30, or had your insurance cancelled by Obamacare. 
People whose income is between 100 percent to 250 percent of the federal poverty line qualify for a special subsidy, but only for Silver plans. This subsidy limits your out-of-pocket expenditures if you buy a qualified Silver plan. If your income falls into this range, regardless of other situations, this is what you should buy. 
Pay attention to doctor networks, not just price. A lot of the new plans kept premiums low -- often at the behest of regulators -- by sharply limiting doctor networks. Yes, corporate health insurance does this too. But these networks seem to be quite narrow. Don’t just check to see that your kids’ pediatrician is covered; make sure that the area’s top hospitals are also included. The most important feature of insurance is not allowing you to prepay your doctor bills; it’s covering you in the event that something goes terribly wrong. And when your kid gets cancer, or your husband is horribly injured in a car wreck, you will want access to the top programs, not the underutilized community hospital that was willing to take the price your low-priced insurer offered. It is much better to pay extra for a good network than it is to pay extra for lower deductibles. 
Better check that prescription drug coverage, too. All Obamacare plans have to offer prescription drug coverage. But that doesn’t mean they have to cover the drugs you’re taking. If the drugs you take are generic, who cares? But if you’ve got AIDS or rheumatoid arthritis, you and your doctor are probably pretty specific about your regime. Make sure that you can stay on it with your new plan; don’t just assume it’s covered. 
The mandate penalty is not $95 unless you are really poor. The administration has been trying to soften the negative image of Obamacare by de-emphasizing the penalty. As a result, a lot of people think that the mandate penalty for the first year is only $95. It’s not; it’s $95 or 1 percent of income, whichever is greater, up to the cost of the cheapest health insurance plan you could have bought. I agree with Yuval Levin that a one-year delay of the entire mandate looks more likely by the day. But understand that if you do not buy insurance by March 31, you at least risk paying much more than $95. I won’t yell at you if you decide you’re better off not buying insurance. But it should be an informed decision. ...