Ask HN: Health insurance for California freelancers? | Hacker News Reader

Ask HN: Health insurance for California freelancers?

13 pointsgcv7 comments

Thanks to the ACA, my cheap catastrophic-coverage-only health plan is going away, and I need to replace it.

On the California exchange, the cheapest alternative costs nearly twice as much per month as my current plan, and will cost way more out-of-pocket (over $6000, instead of $0) if I end up in a hospital. It also has a sky-high deductible. In practice, I'll be paying twice as much money for (1) continuing to pay for basic care out-of-pocket, and (2) I'll still be on the hook for a hefty chunk of change if something bad happens. This feels like a pretty raw deal.

I looked on the web sites of some major insurance companies, and they don't seem to offer any non-exchange plans starting in 2014.

Has anyone here come up with a reasonable workaround, or is everyone planning to just suck it up and pay? A "California Hackers" group health plan, perhaps? I would be interested in hearing the price options of such a thing, if anyone has set it up.

Fellow California freelancer. I'm also get raked over the coals on insurance cost. Previously, my wife and I had great coverage (for us) for ~$220/month. After looking at our options on the California exchange, our costs are going to jump to $4-650/month, depending on the plan.

I haven't found any work arounds yet. But being a freelancer in California, you already know we are hit pretty hard by the tax man. This is unfortunately not unexpected.

The good news is that while costs have jumped, it only takes 3-5 hours per month to cover insurance costs rather than 1-2.

However, if you're not happy with the extra costs, you could try getting a hassle free job as a remote employee and use their insurance policy to come out ahead.

Pay the fine (tax, redefined by SCOTUS) and if you need urgent care go to the emergency room. Declare bankruptcy if it is too much otherwise pay the fees yourself. That is my plan of action. It is easier for me since I don't have a family.

Careful. Right now, under the ACA, insurance companies must sell you coverage no matter what. If the rules change, they may use your gap in coverage as an excuse not to sell you insurance in the future.

If you are making decisions on "if the rules change", that is a very hard game to predict. I'm making the decision on what is the law now. Impossible to predict how it will change if it ever will.

have you tried: http://www.thehealthsherpa.com/insurance_plans?zip_code=9410...

As I understand it, Obama has Executive Ordered a delay in the necessity for your catastrophic plan to go away -- you should call them and see if it can be extended.

It's possible that they can't, and it's also possible that the state of California wouldn't allow them to even if they would (rumor is California was opting out of the delay).

Aside from that, I don't know that there are any great alternatives. The highest-risk gamble is to change your withholdings so that you won't get a refund, and then just take the penalty, which the IRS won't be able to collect as they're only authorized to take it from payouts -- no payouts = no penalty (though if you ever do qualify for a return, it would certainly be withheld then.

The lowest risk alternative is obviously to sign up for ACA, and just really, really hope that you don't need to engage it for services.

Lastly, if it's a serious concern (and it probably ought to be), you could look at getting a job that offers health care as a benefit.

The "delay" isn't going to help anyone quickly.

First it's merely a promise to not prosecute companies for offering soon to be illegal insurance. That provides no protection from civil liabilities, the insurance polices will still be illegal and that has consequences, see a former Federal prosecutor of some note on this subject: http://www.nationalreview.com/article/364117/lawlessness-fix...).

Second, as noted in bmelton's second paragraph, the state insurance commission has to approve the plan. Not only is this sort of thing horrible for Obamacare's economics---there's a reason you're subsidizing others, particularly those 50-64---if they were to allow this anyway, given the best of will by all parties concerned, its highly unlikely they can turn on a dime and get this done in 25 calendar days minus processing time to avoid a lapse in coverage.

Among other things, the insurance company can't afford to offer you exactly the same terms, costs have gone up at least a bit. So the company has to figure out terms that'll likely result in a profit, and the commission has to determine if it's appropriate.

Per Obama's promise not to prosecute, the company also has to have someone smart sit down and detail in every respect how this plan is deems deficient compared to the Obamacare floor. That's more than a tiny amount of work, with potentially severe liability for getting it wrong.

But, yeah, call them and ask them if they're trying to renew your plan and if they think there's any chance they'll be able to do it in time.

Reply on news.ycombinator.com