The Affordable Care Act will change American life. It is that rarest of programs, one that disproportionately benefits the middle class and working poor. It will comfort those most at risk – cancer survivors and heart patients – as they will have access to affordable treatment, if and as needed. And it will make early retirement much more appealing by disconnecting the workplace from medical care.
For purposes of Obamacare there are two kinds of full-time RV’ers: those under 65, and those on Medicare. Medicare will remain unchanged. If you and yours are on it, you may stop reading here.
For those who are not yet Medicare eligible, you owe it to yourself to learn as much about the Affordable Care Act as possible. Beginning October 1, 2013, all kinds of information will become available on the internet, in person, or over the telephone. You face many choices that determine your cost, your coverage, and where you can receive medical treatment. Among them:
Which state’s program should I choose? (Many of us ‘reside’ in No Income Tax states, but spend more time, or work, or own a home in other states. It may be possible to enroll in a more favorable state than one’s tax home. States hostile to Obamacare could be very attractive as their citizens will be offered a Federally chosen plan.)
What level of coverage – bronze, silver, gold, or platinum – makes sense for me? (The regulations will require each insurer to classify their policies as one of those, for comparison and subsidy purposes.)
My chosen policy is effective where? (There is a four year phase-in period before multi-state insurance is required to be accepted in all 50 states.)
After subsidies, what will my insurance cost me? (If your primary income source is some combination of Social Security, a private pension, work camping jobs, and your savings/IRA, you are very likely to get a reduced rate on your insurance.)
I’m middle class; I won’t get no subsidy. (When you worked full-time you was middle class, Jim. Now that you RV full-time, you’re living on less and enjoying life more. Let’s say you and your spouse collect $30,000 annually in SS, pensions, and IRA withdrawals. The most you will pay for a Silver plan is $150 a month. That’s for the two of you, not each.)
Over the next few days I’m going to research and write on those questions. I will learn a lot, and maybe you’ll learn enough to want to know more.
Life on the Blue Highways 
I’m generally skeptical of the ACA but I’m learning about it and want to learn more. Looking forward to reading about what you’ve learned, especially in regards to the multi-state aspect. Does that mean no more in/out of network issues?
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Every plan has to be reviewed carefully before you buy. I am still trying to get the signup website to accept my electronic signature so I can figure Net Cost to us on the policies in my state. Once I know that it’s time to look into which states the multi-state plan under consideration covers, and which providers in those states are participating. In other words, you’re going to have to be as careful as ever, because one disincentive to providers is How Much Does the Insurance Discount their fees. If you’re a full time RV’er, you will want to consider whether the states you visit have approved providers, or maybe they’re like the top of Idaho (close to other states on both sides) or small, like much of New England.
I’ll know more once we get enrolled, but even then, my knowledge is going to be specific to S Dakota, general to the other 25 or so states that are not running their own exchanges, and less useful to those residing in states that participate.
Kat’s working in Kentucky, so I’ve learned a bit there as well. Of particular interest are the private insuror and non-profit insuror prices plan prices here. Blue Cross in KY is $1,400 for a Silver plan while the non-profit is $900, both before any subsidies. With a price difference like that how can Blue Cross compete?
The answer: by putting sales people in grocery stores to sign ’em up on the spot. I saw that yesterday. Looks like competition, even between just two insurors, is going to eventually drive down prices.
Thanks for reading.
Jackson
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thanks for posting this – I will check back in hopes of more info later. my husband and I have been full-timers since 2004, legal residence Florida, he’s on Medicare and I am not. still waiting to hear what my options supposedly might be. I’ve been without health insurance since 1993, but would be happy to get some if affordable. So far though it looks like they count BOTH of our incomes even though just I need insurance. Not very fair.
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I will be in your situation next May, Susan, when I go onto Medicare. It is odd that the after-subsidy net premium for one (instead of two) cost goes up despite paying $130 extra or so a month for Medicare, when family income remains the same. Maybe that’s a flaw in the subsidy calculators; maybe it’s a flaw in the law.
Either way, I got a feeling that this coverage is going to be affordable for you. Check it out.
Thanks for reading us,
Jackson
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