PPACA premiums are borderline opaque and incomprehensible
If you go to the Kaiser PPACA subsidy calculator and type in the following
Family income: $80,000
3 adults and one child (age 20)
state of IL
the calculator will tell you that your premium will be around $420 a month
But that isn't what you will pay in IL. The real premium is $1200+, which 18% of income (well above the current 10% threshold)
how can this be?
Because the subsidies and rates are not based on income levels--they are based on the lowest cost plan available in the state (benchmark). In Illinois and 29 other states, there is this shady insurance outfit called Ambetter which offers high deductible disaster plans (mini-meds) at a much lower cost to Blue Cross, United, etc.
While Ambetter offers insurance in Illinois, virtually no doctors, clinics, or hospitals accept it If you do manage to get a plan through Ambetter, they might not pay your claims. They have a 1 star rating on the BBB site and have been party to many lawsuits for not paying claims.
So the state uses this bogus insurance as a "benchmark" to set rates and subsidy levels
In my first year of early retirement I paid $1200 a month for my BCBS silver plan for a family of 4 on an income of 75k --that wasn't supposed to happen. It will get worse next year
If you go to the Kaiser PPACA subsidy calculator and type in the following
Family income: $80,000
3 adults and one child (age 20)
state of IL
the calculator will tell you that your premium will be around $420 a month
But that isn't what you will pay in IL. The real premium is $1200+, which 18% of income (well above the current 10% threshold)
how can this be?
Because the subsidies and rates are not based on income levels--they are based on the lowest cost plan available in the state (benchmark). In Illinois and 29 other states, there is this shady insurance outfit called Ambetter which offers high deductible disaster plans (mini-meds) at a much lower cost to Blue Cross, United, etc.
While Ambetter offers insurance in Illinois, virtually no doctors, clinics, or hospitals accept it If you do manage to get a plan through Ambetter, they might not pay your claims. They have a 1 star rating on the BBB site and have been party to many lawsuits for not paying claims.
So the state uses this bogus insurance as a "benchmark" to set rates and subsidy levels
In my first year of early retirement I paid $1200 a month for my BCBS silver plan for a family of 4 on an income of 75k --that wasn't supposed to happen. It will get worse next year
Statistics: Posted by Manny1066 — Wed Aug 27, 2025 9:20 am — Replies 168 — Views 16531