Monday, July 15, 2013

Portland Obamacare Rates and Penalty

MaxRedline links to a chart of approved healthcare rates for the Portland area.

If you want to find out the penalty for not buying insurance depending on your individual/family case, there is an easy calculator at

The initial flat penalty for those earning less than $37,000 will be $95 per individual for 2014 rising to $695 per individual in 2016.  For higher income non-insured the penalty is 1% of adjusted gross income in 2014 rising to 2.5% in 2016.

Under Obamacare you will be able to use hospital emergency rooms for care if you don't have insurance and will be able to get full coverage for any serious conditions that arise by signing up for healthcare coverage after the condition becomes known.  However, there may be a wait to the next calendar year before coverage kicks in.
“It’s going to be important at the end of open enrollment to convey a sense of urgency and now is the time [to get covered],” Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, told a recent Washington forum on the health law. “You can make the decision not to buy and wait until you get sick, but you will have to have until the next year and whatever costs you have in that intervening period are yours to bear.”
Though you may not save as much as Gary Cohen indicates. The bronze level can require the patient to bear 40% of the cost along with prescriptions and medical appointment/exam co-pays. Even 50 somethings might come out ahead in paying the fine and getting health care just when they need it and relying on hospital emergency room services for the unexpected.

H/T Byron York


MAX Redline said...

Thanks for the linky.

I pay $5208 presently for a bronze plane that "covers" both my Bride and me. Plus all the other expenses you mention, here. So yes, even if you're 50+ you can save a ton of cash (as long as you're really healthy) by just going without and paying the penalty to the IRS.

Nice catch, too, on the fact that plans are annual, so there's going to be a wait period before you actually get coverage.

T. D. said...

Thanks for bringing the Portland area rates to my attention. Your site is a must read. And this post and the next rely on your spade work. :-)

Your experience shows just how limited the healthcare coverage can be under the plans if you really need major surgery/treatment. Basically, you saved two years of premiums ($10,000) by paying how many years of premiums before last year's need hit?

Unless one has a family with medical needs, paying the penalty, using the emergency room and signing up later seems the best use of funds. You've been saying that for a long time, Max, and the data is proving you right.

MAX Redline said...

TD - great followup post, just read that.

On the costs: everyone's mileage may vary; in my case, I've been incredibly healthy all my life (as the doctors themselves commented), so if you're healthy and pay 5 years of premiums and then something major hits, if you're on the bronze plan with your significant other, you've paid about $27,000; saving $10,000 when the big one hits. Oh, and of course, you're still paying the $434 monthly premium while undergoing the treatment/surgery, so there's that, too. Which is always nice.

As you note in the last paragraph above, if you and your family are healthy, it's better to pay the penalty, etc.

T. D. said...

Max, thanks for bringing up the problems with bronze (and by extension silver and gold) plans for those struggling economically.

I'm falling into line about your long time advice on the penalty. :-)