How much will medical costs be under the AFA for those earning slightly over 400% of the FPL

[Wesley_Clark]

http://www.spotlightonpoverty.org/exclusivecommentary.aspx?id=ba21673c-b1ac-44b7-8f76-50e856cdb9b5

The Affordable Care Act, which should go into effect on Jan 1st 2014 (assuming the SCOTUS doesn’t overturn it and a GOP president doesn’t redact it) has reimbursement rates and out of pocket maximums.

For those who earn over 400% of the federal poverty level (about 44k for a single person) it says there is no cap on premiums as a % of income like there is with lower incomes.

There is also a $5,950 annual out of pocket maximum under the plans that should be on the exchanges.

I think insurance with a $1000 deductible that is part of a group plan (so no excluding those with pre-existing conditions) can cost about $5000 a year for a single person.

So for people earning about 50k a year medical costs will be about 5k a year in premiums, then up to $6000 a year in deductibles, copays and other fees. So a person earning 45k a year could pay $11,000 a year in health costs. Plus whatever isn’t covered (alternative treatments, etc).

However that is assuming a plan that costs $5000 a year for a single person would have $5,950 a year in out of pocket expenses.

Is anything wrong with my math? Because for people earning 400-600% of the federal poverty level, that is cutting it pretty close.

The ACA is still a good idea, but people barely earning 400% above the FPL will still have trouble affording care.

how does this compare to the reimbursement rates, insurance premiums and out of pocket costs of the MA plan, which the ACA was heavily based on?

[Bloodless_Turnip]

I’m interested also. Anyone have any idea?

[Harmonix]

@from article

Sliding-scale premium credits will be available to people with incomes up to 400 percent of poverty who purchase health plans through the exchanges. The credits will be tied to the silver plan and will cap premium contributions for individuals and families to about 3 percent of income at just over 133 percent of poverty ($14,404 for a single adult or $29,327 for a family of four) and gradually increase to 9.5 percent at 300 percent to 400 percent of poverty ($43,320 for a single person and $88,200 for a family of four) (Exhibit 1).

It makes no sense that someone earning 43321 would pay significantly more then someone earning 43320. The market would balk at something like that.

So I predict that this silver level plan or whatever will cost 43321*0.095=4115.495