$0.

I'm a veteran with a disability rating of 40% after several deployments overseas. This means I get free healthcare for life through the VA(although my family is not covered through the VA, instead through my wife's employer).

If I didn't have VA coverage we'd have to spend $800/mo for me to be added to my wife's plan. Incurring an extra $800/mo out of the gates would have likely been a non-starter.

That was a significant factor in my ability to step out on my own.

It feels like America is really hamstringing our entrepreneurs by not having a medicare-for-all or some other public option.

This weirds me out so much about US. It is (was?) touted as a beacon of entrenourship and savvy business thinking, but a lot of things seem to be right downward hostile towards business.

The parent is an indication of this - he wouldn't have considered starting a business unless his health care was taken care of. Other things like taxes, beaurocracy and legal matters seem extremly convoluted and unfriendly to business when compared to Sweden, which is often painted a socialist.

When people say the US is business friendly, I think they’re really observing that the US is big-business friendly.

Convoluted taxes allow big business and the very wealthy to evade them more easily.

Convoluted bureaucracy makes it easy to get ahead by working the loopholes, which you can only do if you’re big enough.

Same thing for other legal matters.

All of this is really a cautionary tale of regulatory capture pushed by vested interests, usually at the expense of working people.

$500/mo/person for ACA (Obamacare) HMO Silver Plan in Illionois. It comes out to $12,000 per year for a family of two adults, no kids. This is fully out of pocket without subsidies.

HMO means you have to go to specific providers, and get referrals for any specialists. Silver plan means the deductible is about $2000 per person before insurance starts paying, then various levels of co-insurance until you hit a spending cap of about $7000 per person. Only family doctor and referral specialist visits are fixed price, at $30 and $60 fixed copay, respectively.

EDIT: comparatively speaking, a PPO silver plan (you get to choose your own doctor) would go up to about $800/person/month. And a gold plan with lower deductibles and lower coinsurance would be $1000/person/month and more. Basically, if you end up going to a doctor for anything serious, you end up paying $thousands out of pocket anyway, whether due to monthly premiums on gold, or deductible on lower plans.

I think it is open enrollment season; log on to your local Obamacare site and check.

In New York, off the top of my head, premiums are something like $250 a month for an individual plan, I think $900 for a family for a high deductible plan that probably won't pay anything next year.

When the subsidies are factored in for a family that earns $50k a year, I think you wind up paying about $70 a month.

If you are not destitute but have a fairly low income (say $35k a year for that family) you qualify for the "Essential Plan" which has a $20 a month premium and a low deductible.

I don't live in the US but asked some colleagues in New York how much it would be for a self employed person with a family (of 4 as an example) and they told me around $20K/year. Your figures are very far off that, what gives, is it because there are so many options it's like choosing anywhere from a low end to a high end restaurant?

In essence, yes. GP quoted figures for a high-deductible health plan. The premiums are low because the deductible is high - you would have to pay thousands of dollars of any medical bill out-of-pocket before the insurance plan would start to cover expenses. Low-deductible plans (insurance covers practically all of any bill) are available, but the premiums are substantially higher, especially for higher-income people ineligible for government subsidies.

$20k p.a. is a low-end estimate for minimal cover and high deductible. Here are the actual plans from Oscar for NYC -> https://assets.ctfassets.net/plyq12u1bv8a/1ffUyjqSleteGxYkSq... Likewise, for a single, min cost in 2020 will be $500/mo.

GP figures might exist in NY if it's a) a very low-income situation or b) a generous employer that covers most of the cost, and the employee's contribution is minimal. Neither applies to a typical self-employed family.

That link is something to behold, tiers within tiers.

It fully depends on your income. The poster above said "with subsidies".

With a family of 4, you would get some for of subsidy all the way up to about $100k mAGI.

One important thing to note about that modified adjusted gross income number is there are a few things you can control about it. Like contributions to retirement accounts and college funds will reduce your agi.

> $250 a month for an individual plan

$375-400 is the lowest I could find for an individual plan in NY.

Unfortunately this completely depends on how the state implements the subsidies. For a family of 4 in my state, $50k will get you a $0/month Bronze plan or $1500-2000/month for the Silver or Gold plans. As far as I can tell the only benefit for the Silver and Gold plans is that you pay for your care ahead of time so it seems like you are paying less for each visit.

From my recent plan shopping in Washington state, the silver and gold plans looked like they might save you money if you were likely to use a lot of services, but not hit the out of pocket max (i seem to recall out of pocket max plus premiums was pretty close for all the plans); it felt like silver and gold might cover a couple things bronze didn't, but it's pretty hard to actually compare these things, because you have to go through so many layers of plan documentation, much of which isn't easily obtainable.

The situation is absurd. healthcare.gov is supposed to help us figure out what's best but you can't export any of their info. I have to hand-create a spreadsheet every year using information from the that website in html form and then for the plans that look promising I have to go into multiple PDFs and pull out information. It's all so opaque.

It's even more difficult in my case because I can decide on my income ahead of time since it's almost all capital gains. The only way to see how the plans change when your income changes is to delete your current application and resubmit it, fortunately the info is all still there. But you still have to repeat the html and pdf -> spreadsheet process.

It's become very helpful to understand cutoffs like 200% FPL and 218% and 400% and concentrate around there.

I'm happy for ACA as it allows me to contribute to the industry outside the confines of a medium or large company, but it’s clear that the whole healthcare system needs to be burnt to the ground eventually.

There is a "compare" function. But I think you can only compare 3 or 4 at a time.

But in many cases, I think silver is the sweetspot for anyone who plans to use a moderate amount of healthcare.

Bronze if you just want catastrophic coverage.

The plans above bronze rarely offer much benefit for the price.

I would focus on comparing all the silver plans.

Now there's a great reason to remain single.

Not sure if you are joking or not. 218% of FPL is $56,135 for a family of four and only $27,228 for a single person. What this means is that you can make up to that amount and get a huge subsidy, basically giving you free insurance.

What is the significance of the 218%?

My understanding is that in non-medicare expansion states, subsidies start at 100% fpl (below that and you have to get on Medicaid) all the way up to 400% of fpl reducing to nothing but the time you hit 400%.

In Medicare expansion states, subsidies start at 134% of fpl.

Exact income is irrelevant here, all you need to know is if you are above or below the ACA subsidy line. Having been self-employed in Washington State both pre-and-post ACA, the actual $$ per family member hasn't shifted greatly, but choice of plans became more limited. Currently paying ~ $375/mo for myself (ACA Bronze equivalent), with minimal (~$10/mo) increase for 2020. When I had the kids on my plan, they were a bit less - last time I paid for a full family plan (two years ago), it came in at approx. $1100/mo.

I've been with all of the major carriers in the state. Cost differences are minimal and any coverage differences are impossible to compare. Health insurance in the US has become exactly like auto insurance - you pay cash out of pocket and just pretend you don't have insurance until something really bad happens.

I hate this country.

Funny, things were substantially different here in the US back around 1999-2004. Cost of living was substantially lower and consumer pricing was actually better in the US than elsewhere. Fast-forward to today and we're all being gouged by the telecoms, food prices, tuition bills, health insurance, real estate prices... well you get the idea. What's the big difference between then and now? Many, many mega-mergers. For example, back in 1999 there were 17 major airlines. Today there are four. The government plays a big role in this, as do the major corporations since they draft their own legislation and have their bought and paid for politicians sponsor the bills. I've heard the situation summed up as: in Europe, the governments work for the people. In the US, the government works for the big corps and that means, it's not working for the people.

Isn't this expected? The capital growth is proportional to its size. Unless there is something that restricts it's growth, it will absorb all smaller players.

As a self-employed person who has lived in Australia, the UK and now Canada this thread is eye-opening.

You are free to leave at anytime

It's...not that easy to just get citizenship elsewhere. So no, I'm not free to leave.

Yes it is. Plenty of countries here in South America make this an easy enough process.

EDIT: Guess you guys didn't want to move after all. We'll still welcome you if you change your mind.

Argentina: You may visit Argentina for up to 90 days on a tourist visa by just showing a valid U.S. passport when you arrive. For a residence visa you must have a passport valid for at least six months longer than your arrival date. You may need a physician's report to ensure you are in good health. You may also need a criminal background check, depending on the consulate where you apply. These documents must be translated into Spanish and notarized. Check with the Argentine consulate where you make your visa application for acceptable translators and notaries.

Brazil: any foreigner looking to work in Brazil must have a work visa or Brazilian residency. In most cases, you should have a job secured before planning to move. The employing company must submit a work permit application to its local Ministry of Labor & Employment – this is the first step to meet the requirements in the work visa application process. After the application is approved, the approval is published in one of the local legal newspapers and sent to the Ministry of Foreign Affairs. After this, the Ministry will contact the Consulate or Embassy, which will then start the visa process.

No. Even South American countries don't have any open-door policies.

Argentina's process sounds easy enough to me, and similar to Uruguay's, which is where I'm from. Of all things you have to do to move to a whole 'nother country, a fair dose of paperwork should be fairly low on your list of worries.

You will do about as much if not more paperwork when trying to rent a place, sign-up for electricity, Internet connection, a smartphone contract, and so on.

So it does seem to me that TurkishPoptart is fairly free to leave if his/her worry is just complying with the law as mentioned in the posted comment.

On COBRA, wife and 2 year old kid. I pay 1900 per month for Anthem Blue Cross plus dental and vision benefits. I’m in California. I’m self employed and COBRA runs out soon, but everything on the exchange is about the same amount.

Have you checked on Health Sherpa? I pretended to be a San Jose, California resident with a spouse and a 2 year old kid, making $100,000/year, and it showed me bronze plans starting at ~$700/month.

Your age, etc. may cause this to be different, but I think there's a good chance you can improve on $1900/month.

Don't know about individuals anymore but in the East Coast area (NY/NJ), a family of 4 would cost you about $2000/Month for an OK plan.

I pay about $475 a month for a HealthShare program through Liberty Health Share (for my entire family). It qualifies as insurance for tax purposes, but they are very clear that it is not insurance. But IMO it's a much better option for people living a healthy lifestyle.

You might want to check Health Sherpa, it does a decent job of sorting through your options for you. I live in Texas, and am in my 50's, and for me and my family it's around $1000/month. I am above the ACA subsidy line.

God help us. How many kids? How's the deductible?

1 kid, plus spouse and I. It's a bronze plan, so deductible is typical for bronze plans. I check on healthcare.gov and Health Sherpa every year to make sure it's about as low as I can get for bronze plans.

It's kind of blowing my mind how different the prices are state to state. $900 for a family plan in New York? I pay $1600 in MN for my family plan in MN.

It’s the same cost in NY. The “$900” figure given elsewhere is either outdated by a decade, or the plan is heavily subsidized by the employer. $1,600/mo is the minimum a self employed family would pay.

Self employed in CA, single, $225 per month, no subsidies.

$1300 per month for two 28 year olds in NYC