The Non-ACA Compliant Boogey Man

Hi all! Understandably, many people are highly skeptical of non-ACA (affordable care act) compliant plans, or private health insurance.

Longer post because this topic requires more nuance than private health insurance = risky, which I see a lot of around here.

Further, this is not a solicitation post. As a broker on both ACA and private plans, I want to give some honest insight because I’ve worked with both for years.

Let’s all start by agreeing on one thing: The BAD insurance is short term, discount, Christian medshare, and other unregulated products. Those have not and will never be considered private health insurance, at least in 2024 broker lingo.

Private health insurance are tailored “plans” (the government has copyrighted ‘policies’) that very much are regulated, legitimate, and reliable. They have traditional deductibles, max out of pockets, and unlimited benefit limits.

There are about 5 or 6 major players in the private health insurance scene right now. Most blue states completely ban them in favor of idealizing universal health care, most red or purple states have them.

Before ACA in early 2010s, healthcare was awful. If you had preexisting conditions, and didn’t already have a solution in place, it was either pay thousands annually or be completely denied from all carriers due to risk profile.

ACA made it where carriers could not deny based off medical history, and also created a way for lower income households to afford healthcare.

ACA is amazing for those with preexisting conditions, lower incomes eligible for premium assistance, or if you don’t mind paying thousands extra to do it on your own.

Here’s the problem: ACA rates are age / zip / income based, and your individual health is not factored in at all. If you’re above the threshold for premium assistance, it’s still stupid expensive in 2024.

Essentially, private health insurance was created to make health insurance more affordable for those paying full price ACA, by factoring in your individual health.

Think of the Geico good driver discount. The insurance carriers want to cherry pick you away from the marketplace since you’re less risky if you’re healthy.

The result is you get better coverage, better prices, and a personal advisor.

The ACA agents on this sub love to stress that all essential requirements for health insurance are met. What they don’t tell you- this is both a good and a bad thing.

If you are never planning on having kids for instance, why would you pay for maternity coverage for 40+ years before Medicare kicks in? If you’re actively pregnant though, ACA is amazing because you can still enroll.

Anyone saying private health insurance is bad is lying. The coverage is reliable, night and day stronger than ACA, and rate-locked for life. It’s not even close.

The problem is not everyone should be, or can be, on true private insurance. You need to work with a broker you trust and one that will help you with an actual healthcare plan.

I promise- if you’re paying full price ACA, or are very healthy, reach out to a broker in your area to explore options and decide for yourself. It’s usually a very easy decision if you qualify.

The boogeyman is alive and well here. Hope this helps demystify the invisible monster that we’ve all created.

submitted by /u/Health-Inusrance
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