How to Prepare Your FIRE Plan for Healthcare Costs

What is discussed, and when

1. 0:00 – 5:00: Dave Ramsey, Regina Moore, Bigger Pockets Money podcast, Mr. Money Mustache
2. 40:00 – 45:00: Women's Personal Finance, Regina Moore
3. 50:00 – 50:39: Bigger Pockets Money podcast, Indie Jensen, Scott Trench

Notable quotes from "How to Prepare Your FIRE Plan for Healthcare Costs"

• Today's guest, Regina Moore, hit millionaire status before 35, but not by following the typical FIRE playbook. In fact, as a pharmacist, she was able to earn very high income, keep her expenses.

  about Regina Moore · at 0:00

• Later, guys. We are so excited to be joined by Regina Moore today, co-founder of Women's Personal Finance. She has an amazing five story, which we're going to be talking about today. Without further ado welcome Regina.

  about Women's Personal Finance · at 1:03

• Personal finance blogs. And I remember one of the main ones that I found first was Mr. money mustache. So, I spent a lot of my first year out of pharmacy school when I was…

  about Mr. Money Mustache · at 2:07

• Wrong. That wraps up this episode of the Bigger Pockets Money podcast. He is Scott Trench. I am Indie Jensen saying don't pout sauerkraut.

  about Indie Jensen · at 50:30

Who and what is mentioned in this episode?

People

• Regina Moore — Person · 3 mentions · first at 0:00
• Scott Trench — Person · 2 mentions · first at 0:57
  To the Bigger Pockets Money podcast. My name is Mindy Jensen, and with me as always is my not Slowfi co-host, Scott Trench.
• Indie Jensen — Person · 1 mention · first at 50:34

Books & papers

• Dave Ramsey — Book · 2 mentions · first at 1:43
  Pharmacy school with a story that I think many people will share. someone gave me a copy of Dave Ramsey's book as I was graduating and I was interested and I skimmed through it…
• Mr. Money Mustache — Book · 1 mention · first at 2:11

Companies & orgs

• Women's Personal Finance — Company · 3 mentions · first at 1:06
• Bigger Pockets Money podcast — Company · 2 mentions · first at 0:53
  Hello., Hello,, hello,, hello,, and, welcome to the Bigger Pockets Money podcast. My name is Mindy Jensen, and with me as always is my not Slowfi co-host, Scott Trench.

Concepts & topics

• CHIP — Concept · 3 mentions

Full transcript with timestamps

0:00 Today's guest, Regina Moore, hit millionaire status before 35, but not by following the typical FIRE playbook. In fact, as a pharmacist, she was able to earn very high income, keep her expenses low, pay off her house, and reach a million dollars in net worth before age 35. But those plans were derailed by a diagnosis of cancer with her 2-year-old son. Today's episode is going to talk about her journey to fire and the preposterous situation that she and her family are placed in due to subsidy cliffs. This is a major issue for the fire community and has elements of political discussion around it. We'll try to grapple with those as best we can in a moderate side that presents both sides of the issue while presenting Regina's story and her positions on this.

0:52 Hello., Hello,, hello,, hello,, and, welcome to the Bigger Pockets Money podcast. My name is Mindy Jensen, and with me as always is my not Slowfi co-host, Scott Trench.

1:00 Thanks,, Mindy., You, put, on, a, clinic, with these introductions. You'll get that later, guys. We are so excited to be joined by Regina Moore today, co-founder of Women's Personal Finance. She has an amazing five story, which we're going to be talking about today. Without further ado welcome Regina.

1:13 Glad, to, be, here., I, feel, like, I've, been uh wanting to get together with you all for a long time. We finally made it happen.

1:19 We, did, finally, make, it, happen., Shout, out to uh Fin Con for finally connecting us. Let's go back to the beginning of your FI journey. When did you discover the concept of financial independence and early retirement?

1:34 Probably, at, about, when, I, graduated, from pharmacy school um with a story that I think many people will share. Uh someone gave me a copy of Dave Ramsey's book as I was graduating and I was uh I was interested and I skimmed through it and thought like, oh well, yeah, of course people pay off debt. Um, and that it seemed like a good intro, but like not the full story. And pretty quickly from there, I dived into uh reading personal finance blogs. And I remember one of the main ones that I found first was Mr. money mustache. So, I spent a lot of my first year out of pharmacy school when I uh was sometimes sitting late in the evening um on slow uh hospital pharmacist swing shifts uh diving deep into all that stuff Pete wrote and um kind of branching off from there and deciding that um I would find a way to be able to retire early someday. And I had never dream had a dream job. I did a job that I knew would

2:42 have a decent paycheck. Um, but had never really considered that I wouldn't have to do it forever. So, that was my jumping off point.

2:49 Can, you, tell, us, a, little, bit, about, that journey? Like, how how did things go? What did you what did you do to pursue fire and how how did uh can you give us like a couple of key milestones along that journey?

2:58 Yeah,, so, um, I, uh, graduated, as, a pharmacist pretty early. I was the youngest in my class. I graduated at 23. Um, and I, uh, was pretty low debt to begin with. I had about $30,000 in loans. Um, I had some, um, help from my father with tuition and scholarships. So, I came into things doing pretty pretty well. And, um, actually, my first year out of uh, out of school as a pharmacist was my highest earning year in my career. Um, or I should say like my first full year uh, working. I made about $180,000 that year, which seemed like such a huge amount of money to someone who, you know, had just been kind of a broke college student prior.

3:47 And um decided really quickly to pay off all the debts that I had. I ended up having to buy a new used car that year. Um paid that off and um just really kind of grasped that if I started saving, I would be saving a lot of my um my income. I would be in a really good spot. Um, initially I was focused more on um because I had some of that kind of Dave Ramsey influence on not having any debt and being able to potentially pay off a home that I bought at some point. So, I funneled a lot of that um that income into uh home purchase savings uh and uh in 2013 um moved to another state and ended up um buying a house with I think we put about 50% down on the house and ended up paying that off in under two years. Um, so I own my home outright and uh let's see that would have been I think early 2014 that I uh had the house paid off. Um, and I had been investing like in my 401k. I had opened up a uh an

5:02 account with a robo advisor because I didn't really feel comfortable with investing on my own. I didn't really trust myself that much. But once the house was paid off, I realized that I needed to um kind of step it up. And that's when I started to read uh read a lot more personal finance um content. Uh dive in again with a lot of the blogs. Shortly thereafter, started my own blog. And uh I'd say that was really when when I started to get going on the kind of pursuit of fire versus just kind of a I'm going to try to not have debt and um yeah, I've stayed heavily involved since then and have a whole a whole timeline of events.

5:53 So, why, did, you, pay, off, your, house, so quickly? A really quick Google search says that mortgage rates in 2013 were like 3 or 4%.

6:01 Yeah., So, I, I, don't, actually, remember what the interest rate was. Um but uh it was not high. Nothing like it is now. And um if I was to do things over again knowing what I do now, I probably would have um chosen a different path and probably would not have paid off the house. But, uh, it felt like something that bought me a lot of peace of mind at the time. Um a a sense of comfort in knowing that I wouldn't ever have to worry about making a house payment. I'd only have to worry about, uh, you know, covering my property taxes and maintaining a home.

6:47 And that decision was made a lot earlier on in my personal finance journey. So I did not know all the things that I do know now. And I still um I'm still happy with the decision. Um you know, you can't know what the future's going to look like and it's possible that um you know, the markets would have taken a a different turn. Um but uh we had some big struggles with my family um where uh I was not able to to have consistent income for a while due to some um uh major medical issues. My son was diagnosed with cancer in 2018.

7:28 And I think one of the um one of the saving graces for my sanity through that process is that um I didn't have to worry about liquidating money for my 401k or something to keep paying uh paying the mortgage while we went through that process. So the math says it's not ideal. Um, but it it really did work out for peace of mind for me and my family and was the jump start to the rest of the process for us.

8:00 Okay., So,, a, jump, start, to, the, rest, of the process. How long did you it take you to become financially independent?

8:07 I, still, feel, like, I'm, really, working, on what that number means for me. And um if I if I want to say I'm financially independent largely depends on my mood that month. Um I'm pretty comfortable saying that I'm leani. I would say I've been there about two years. So wait, let me do the math. I'm 30. Yes. Um so about 2 years. Uh actually two years this month in December. So, um my initial number that I had aimed for um for considering myself financially dep independent um because the house was paid off and that wasn't part of the calculation anymore um was a million dollar net worth and um I hit that in 2023 in December. money nerd stuff and the 4% rule. Um I had worked out that our basic needs for the family were um at that point about $40,000 a year. Um so nothing extravagant, but you know, we could eat and we could stay in our house and um that's kind of been I'm like a I'm a worstcase scenario type of

9:14 planner. Um so that was my uh initial goal that I wanted to achieve. Now that we've hit that, I'm a little more uh flexible in in how I think about financial independence numbers because once once I knew I had those basic needs met I allowed myself to start thinking more about what I want, not just what I need.

9:38 You, live, in, Oregon., Which, part, of, Oregon do you live in? Yeah,, I, live, out, on, the, Oregon, coast,, so pretty pretty small communities. I'm about 3 hours from Portland. And would you say this is a high cost, medium cost, or a lowc cost living area given that you spend 40 grand and have a paidoff house?

9:54 This, is, such, a, hard, question, to, answer anymore because everywhere feels like a high cost of living area. Um, I I would say it probably is in the medium to high cost. If I had to pay for housing, that would uh that would be a different discussion for me. There's like a three-bedroom apartment. uh in the town next for me renting right now um for $2,800 a month. So I I think that's on the high end of things, but um I admit to being a little bit out of the loop on that and that the the housing part of that equation is really skewing things for a lot of people and because uh because I bought my house in 2013, I'm a little bit protected from that. And so you earned this, you know, this this very high income in your first year and this kind of $60 to $70 equivalent, you know, inflation adjusted equivalent over the ensuing years. What what did you invest in in order to build this million

10:54 dollars in in wealth outside of your your primary residence? Sounds like you bought a primary residence, put a lot down, paid it off. Where did the rest go?

11:01 Let's, see., So, when, I, was, working,, I, um was always it it from from the minute I was eligible for my 401k, I was using my 401k and um and investing at least up to the match on there, often quite a bit more. Um and then at multiple times in my working career, I also had access to an HSA account. Um, so my my HSA has about $100,000 in it, which is um invested in whatever the the closest to a total stock market fund was. Um, so I did I tried to I tried to spread things out. Um, and uh, so I have my HSA 401ks, and IRA and was typically investing in those every year. Um, I usually maxed out my HSA account and uh have have been trying to track my expenses in a way where I can potentially reimburse myself later um or have access to that money if I need it uh you know for healthcare spending. And um with my 401k for the first um few years at least probably the first three to five years it was probably in a

12:17 target date fund. I didn't really start to change things around until I started to dig into um the the personal finance sphere uh around 2017 or so. Um, and uh, at that point I think I've transitioned I've transitioned some of my investments into things like BTSAX. Um, and most of my new investments um, when I had income to put into those uh, went into things like that as well. Um, and uh, with my my older accounts, um, uh, the things that are in the 401ks, some of that is just, um, whatever it was in when I rolled them over from the employer funds, they've been performing pretty well, and I haven't really wanted to uh, dig into sorting out um, strategies around um, transitioning those into more uh, simple simple investments.

13:18 as long as it stays within the 401k I've just kind of left it alone. Um, but yeah, mostly mostly for things that I've uh had my own hand in, it's mostly been like VTSAX or VTI. Um, I can't even explain why one versus the other. That was back when I was reading all those great blogs of the people who really like to get granular and dig into things and it made more sense at the time. And right now I just know they perform pretty well and keep growing and that's a solid strategy for me.

13:52 I, have, several, questions, regarding health care and your HSA. You you really glossed over this cancer diagnosis in 2018 when you were telling your story and I want to come back to that because this healthc care is a big hot topic right now and specifically that's like in the middle of your FI journey. Your son got diagnosed with cancer. Um, how old was he when he was diagnosed?

14:18 He, was, two,, almost, three, years, old. A, child's, cancer, diagnosis, is, traumatic, but he's a baby getting this diagnosis. How did that affect your FI journey?

14:31 Well,, I, thought, the, FI, journey, was, over um when we first got the news. Um, and you know, we you hear so much about financial toxicity with major medical um, issues in families and especially with cancer diagnoses that um, I I just assumed, you know, if he survives, I'm sure this is going to drain us and we'll be starting over from from square one. Um, I believe at the time he was diagnosed, I had a net worth, not including the house. And just to be clear, like when I talk about my my net worth, I generally don't include the value of the house in that. Um it's easier for my brain to think about um numbers of money that I can work with.

15:18 So when he was diagnosed, my my net worth outside of the house was about $400,000. Um and that was at the end of 2018. Actually, we were admitted to the to the hospital um with um suspicion that it was cancer on Christmas Eve 2018. So, December is an interesting month for me emotionally. But um I remember uh cuz that was also like right at the height of when I was I was starting to to blog and um really get invested in this community. Um, I think it was in January of 2019 that there was a a very small dip, a a little micro crash, and I definitely uh thought thought it was all over for us financially.

16:06 Um, what ended up happening was I already had a very strong frugal streak. You know, my my blog back then was that frugal pharmacist. Um, and it's um a a skill or habit that me and my husband both share. And we just really shut down spending as much as possible while my son was sick. Um, we mostly lived at Ronald McDonald House. We didn't spend much of anything if we could avoid it. Um, I ended up being able to work a little bit as a pharmacist. Um uh I think maybe maybe 3 or 4 days a month I would find a shift uh about 2 hours away, maybe not two hours, maybe an hour away. So I'd drive and I'd work a pharmacist shift and then I'd come back to the hospital and and share the bed with my son. And by whatever luck and um you navigating on our part, we didn't end up any worse off by the end of his cancer treatment. Um if anything, the markets had started to pick up and um we were doing better off by the time he was

17:25 done, even though I had worked significantly less. And that was pretty eye openening for me. Um, and definitely inspired me to uh shift gears a little bit um with an intention to not go back to work full-time.

17:44 Did, you, have, an, HSA, during, your, son's cancer treatments or did you have traditional health insurance? I had um I had an HSA uh so a high deductible plan um and uh if I remember right the um the out-ofpocket maximum was about $12,000 um which is not nothing but um but if you've budgeted and saved for that it was something that was manageable especially because we had been saving money in the HSA count already. Um so the the when he was initially initially diagnosed that was in December. Um we hit our maximum out of pocket um for that year based on on the process leading up to him being diagnosed. And then we also hit the maximum out of pocket in like January of uh the first uh full year he was sick of 2019 just due to the expense of cancer treatment. um partway through 2019, I think it was probably in like July or August, um based on that I wasn't working much, um he was able to qualify

19:06 for Medicaid under the CHIP program, the the I forget the acronym, but um it allows children to access Medicaid um although the parents don't themselves qualify, so at a higher uh AGI I the kids can get it and he's been on CHIP since then.

19:25 What, is, the, requirement?, How, do, you, how does one um become eligible for CHIP?

19:30 CHIP, eligibility, is, it's, uh, it's, based on your adjusted gross income and I believe for a family of three. It was around $70,000 a year AGI. Um, so we have stayed underneath that every year since 2019 and he's been able to to, you know effectively have free free healthcare. There's some extra hurdles to navigate with that because uh specific providers aren't accessible and things like that or take more effort to get to, but um for his all of his main needs, it's been um been fine for us. that covers 100% of health care costs for him

20:14 pretty, much., I, mean,, there, there, are certain things that um would be qualified as not, you know, if it's not considered medically necessary, like if if he went to the dermatologist and had a a wart that wasn't bothering him or something like they might say that it's not medically necessary to remove that um and it he might not be able to get that done. There's that type of thing can come up from time to time, but as a kid um who doesn't really have any cosmetic concerns, um we haven't run into anything like that.

20:46 I, was, going, to, ask,, how, long, was, he, in treatment? He, So,, my, son, was, in, cancer, treatment from um the end of December 2018 until mid January of 2020. So, we went home right as COVID started

21:02 and, he, is, now, in, remission., Yes, and, no. Different types of cancers have different um ways that they qualify it. He's um he his does not have something they call remission. They just say no evidence of disease, but he's um officially 5 years off of treatment as of this summer. So more or less considered um cured and it's assumed that the this cancer wouldn't come back. um cancer treatment does make you more susceptible to other forms of cancer like leukemia. Um so that's something we'll have to monitor for and then you know long-term um health effects from that treatment which is very intense. Um but yeah, I think we're I think we're in the clear with um his specific cancer diagnosis.

21:49 It's, just, awful, that, you, guys, had, to, go through this. I'm glad that uh we're in a great spot now, it sounds like and and and uh doing much better. Um can you can you just let us know from the the story around around finances? It sounds like this treatment did several things. Um this diagnosis and the treatment did several things. One is it um it for it had you stop working or stop working a considerable amount reducing those hours a considerable amount for a very extended period um at least the next year probably presumably up until 2020 and then and then thereafter as well. Is that correct? Yeah. Um I I worked between like one and four days a month um through his treatment and I think even the first three or four months I didn't work at all. Um and then I uh I went back part-time um when we were able to come home uh because I needed time off for ongoing appointments. He still had a lot of visits that we had to go to

22:50 3 hours away and overnight stays. So, um I tried to work part-time for a while. Uh so I would have went back to work in I in in January or February of 2020. Um I ended up taking a leave of absence by May of 2020. um with everything going on with COVID and being a pharmacist in a retail pharmacy kind of front lines there um I uh I was very very stressed out like it was not working out well for my health. I was having migraines sometimes daily. Um, super stressed. Uh and also none of the the the restrictions with things like mask mandates or anything like that had come into effect yet. And I had already been masking before the pandemic because he had had a bone marrow transplant. Um, so some of the things that I had already been doing to kind of protect the health of my son became extremely politicized and um, luckily I was able to um, to get unemployment. Um, which was not a lot of money, but it was a little bit. Um, and

24:04 I took three months off uh, kind of at the height of COVID um, as a caregiver. So I I got I got approved for it. um because of being a caregiver of someone who was high- risk. And um I tried to go back to work after that and this is when uh everything was very much a mess with the the healthc care industry. Um a lot of underst staffing. Um pharmacies were closing. We had lines of, you know patients out the front door of the building. Um, and they were scheduling everybody uh at least at 40 hours a week and most people were getting significant overtime just trying to to cover all of the needs at the time. Um, and because of that I ended up leaving altogether.

24:59 They they had told me that I didn't have a choice in choosing to work less while they needed me to work more. Um, and I said that didn't work and I am now a pdeium employee. So, um, I work just a little bit. Um, they'll ask me if I can help out from time to time and if I'm available, uh, I can go and choose to take a shift, but I don't have any obligation to come in.

25:27 In, 2018,, we, get, the, diagnosis, in December. In 2019, we step back and have a greatly diminished hours. This extends through 2020 when when we get good news that that things are are in a much better place for your for your son. But we also have health risks from CO that are particularly acute for your family and that continues to disrupt your ability to generate income uh in various ways due to your your very reasonable lack of comfort with returning to work in these in that in that environment. And so this is a multi-year six five six sevenyear disruption to your income flows this this healthc care event. um and it's and it ramifications downstream on the income side. What were the costs?

26:08 How how do you think about the costs? And one of the things I think that's particularly top of mind for people right now is is fire and healthcare is a particularly um um acute challenge for people to grapple with here in 2025, especially in the context of ACA subsidies going away um or or you know uncertainty around ACA subsidies. How does one think about that if you're giving advice to somebody else who's thinking about fire has young children and this could happen to them um in there this you know god forbid but how do how does one think about that in the context of of this risk this healthcare risk that is so clearly delaying and damaging to your fire journey how do they think about it in the context of of today

26:51 unfortunately, I, think, healthc, care, is the number one factor that's the wild card for anybody planning to potentially retire early. Um factoring in how we are going to manage that is is definitely my biggest ongoing struggle. Um I think one one thing to keep in mind if you're wanting to potentially retire early is being really cognizant of what you feel like you need to live a good quality life. um and how how expensive that really needs to be. Um so I I come at a lot of this from that frugality angle. Um thinking about what my minimal needs are and then just building on that as I reach certain goals. Um, and for for a lot of people, if you have a hope of retiring early, if if health care spending for individuals and family doesn't change very soon with some sort of major healthc care reform, it's making it feel less and less achievable and accessible.

28:04 Um, that being said, if you decide to uh be content and live a lifestyle that um can be had at a lower income, you do potentially open up some of those uh subsidized channels for yourself. So, um like I said with my son, um he's been on the state uh Medicaid program with CHIP um since 2019. Um that's definitely made things a little bit easier. [snorts] Um and we have been uh on a marketplace plan with the ACA subsidies for uh what would that have been 2022 probably. I don't remember the exact year but that's when I finally got kicked off of my employer health plan. And then um actually just this last year uh mid2024 um we in my state of Oregon they expanded the state Medicaid program. So they increased um uh eligibility levels and when we uh applied for our um ACA plan where you go in and plug everything in um planning for it for 2025 um we actually got kicked over to the uh to the state Medicaid program too. So for

29:23 2025 we haven't um paid anything for healthcare. However, it puts me in a really unique situation now as someone who is still earning some income. Um which obviously is nice to have in that I have to be really really thoughtful um about uh if increasing my income is actually paying off for my family because we'll hit that subsidy cliff and um you know potentially be out 15 to 20,000 minimal. um between uh deductibles and premiums for insurance for me and my husband at the very least.

30:05 So,, this, is, like, this, is, a, central issue, right? Like like if your fire number is, you know, uh uh 1.5 million bucks, $60,000 a year in annual spend for example. And this number is either zero or it is $20,000 a year. That's the difference, right? that this cliff effect is is is so real and so acute. What what what is is is that literally the difference here? If you go over the $70,000 limit in household income and that that incentive, you literally drop your your your coverage and have to spend this amount more starting next year in 2026 if subsidies expire or or how does that work in your situation here? because it seems it seems so preposterous the situation that that you are in right now based on the rules of of healthcare in this country.

30:56 Yeah,, it's, a, completely, ridiculous situation. So um for the family of three um in Oregon to qualify for this um extended um Medicaid program, the AGI is right about $50,000 a year. Um, and then for children or a child to qualify, um in my family of three, it was about 70,000. I don't know exactly because it's been a few years since I looked at that number. So, um, my household AGI is under 50,000. Um, and some of that is um, is achieved by, uh, moving money from my brokerage accounts into um traditional IRA savings. um you know so that our AGI stays at a certain level.

31:44 Uh but but yeah, I mean between the premiums and then you know my my husband has chronic health needs and I I figure with medications that he needs that would probably be $500 to $1,000 a month. Um between the medications and doctor's visits and co-pays and all the deductibles and everything. Um, yeah, I estimate that it would probably be about $20,000 a year. So, I'm I'm forced to make decisions uh around working less um because it wouldn't just be $20,000 that I would need to to earn to offset that. You know, you it's it's additional because there's taxes and and whatnot.

32:32 and um to consider if earning that additional income um provides any benefit to my family because I'm also not home as much. I'm not available for child care, etc., etc. Um and and it's unfortunate because like with the the career that I have being a pharmacist um there's another developing pharmacist shortage and I have capacity and interest in potentially working a little bit more. I don't ever want to go back full-time or even at a steady part-time rate. Um, but you know, if there's a couple weeks here and there where there's something going on and uh I can go in and work, I'm not opposed um to to helping helping um my my colleagues out um so that things aren't as chaotic uh at the pharmacy. But um I really can't make that decision uh and and maintain things where they need to be um for my household.

33:33 This, is, this, is, so, freaking, stupid., This is so dumb. Like what you just like like what you just said here about the system. What you're doing is is perfectly smart. But but what like the situation that you're in is preposterous. This is ridiculous. You you are this let's let's lay out what what is happening here. You went on a fire journey. Your goal was literally to become a multi-millionaire, financially independent retiree in your 30s or 40s. You did pretty good on that journey. You paid off a house. You built a lean fire barista fire portfolio. Then tragedy struck and your kid got a horrible illness that took years to treat. Was very expensive and it forced you to basically live on a poverty level income or realize poverty level level income uh across your portfolio so that you could qualify for Medicaid CHIP um in your state across that plan. You also uh uh it sounds like have have a your husband

34:29 I think has some chronic health issues that require treatment um uh to a lesser degree on an ongoing basis as well. Is that right?

34:35 Yep., That's, accurate. You, are, you, are, a, highly, qualified capable worker who could make command a very high wage. But you can't do that because the choice is either uh work full-time and go throughout the year pay full taxes um but you're pay taxes in a much higher tax bracket and pay for an insurance and health care cost, you know, overall health care costs that would cost you $20,000 more overall which is just not worth it. You might even come out, you know, might come out worse off by working 40 to 50 hours a week across a year at your highly paid profession than by just staying at home and not doing that. That that's the effect of this cliff situation in the health care system. And it's not like you want this. This is not like something you're you you like. This is this is what you are stuck in because of the preposterous uh absurdities of of health care in this country in your

35:32 situation in in that requires that requires really complete coverage for really devastating health health situations that are not your fault that are not that are not that are that are completely just bad luck. Is is this is this the correct way to frame the situation? Am I doing right my my rant here Regina?

35:50 Yeah,, more more, or, less., I, mean,, I, don't know exactly what the full repercussions would be. I haven't quantified that. Um but you know, the the thing you didn't add into that is also that then I lose my time and my time with my family and probably come out somewhat on uh, you know, in a worse situation financially right now. Um, that might mean that I have significantly more money in my retirement years. Um, but I'm not really concerned about that at this point. I've I've dialed in um my preloading on my investments um in a way that um I'm not concerned with my retirement income or retirement savings. Everything that I'm doing right now is um just navigating living over the next, you know, 5 to 10 years. And uh yeah, I don't um I don't feel like I have the flexibility I would like to be able to go out and earn more money. Um and it's it's not just about the money, right? Like I'm okay with

36:55 where I'm at, but if I'm going to do work, I want to be compensated for it obviously. Um, and I I don't have the flexibility to make decisions about working a little bit more um without having major financial ramifications.

37:12 You're, in, in, a, crazy, situation, here because, like, like like, we, said,, this cliff has to be front and center and there's no there's no real world where you'd work the full-time because that was never your plan. you're you you're already you you you pursued fire so that you would have flexibility, but you would work more possibly above this cliff if it didn't have such immediate and devastating consequences for your ability to qualify for for healthare um from from the state essentially. I can hear Regina some people let's acknowledge that you had a son with cancer at 2 years old. Terrible tragedy.

37:47 Nothing you can do. Not not your fault. Okay. But I I can I can hear some people, you know, they're shouting at the their podcast feed on their their car player or their phone or or watching here on YouTube and and they're saying "Hey, this this this is not how the system was supposed to be designed. You know, why is this why is this multi-millionaire paidoff homeowner receiving Medicaid CHIP for their family? And how does that work? And and and how do you think about that? How how would you answer that challenge from somebody you know who who who maybe doesn't like that that situation is unfolding to a certain extent?

38:23 I, mean, for, one, I, would, say, none, of, this system is how it was supposed to be functioning. I think if you ask most average people um I don't think any of us expected that you know 20 to 30% of our planned spending should be going towards maintaining healthcare. So, the system's not working um for anybody really. Uh you know, I I paid um fairly significant taxes for a good portion of my career when I my short career when I was working full-time. Um you know, I didn't have a child then. It was just two two adults earning. Um, so I've paid into these systems and um I am um using them fully as they're designed based on the income limits and and all of those things. Um, and I'm a proponent for things like universal health care. Um, I am not opposed to paying more taxes on what I do earn so that more people myself included, have access to more affordable health care. Uh, I wouldn't mind having a system where um my annual

39:46 taxes were higher and I didn't have to do so much long-term planning about budgeting and planning to afford healthcare. um I would prefer to just have that taken as some percentage of my income and know that the bulk of our medically necessary health care um is going to be covered perhaps with some low co-pays or things like that. Um, and based on the way I've had to set up my situation, I continue to put money into my tax deferred accounts, um, which, uh I will likely realize some pretty high taxes on by the time I do retire and start to tap into those because I won't um, have a child uh, that I is factored in to my um, to my annual taxes owed.

40:39 Um, my husband's a bit older than me, so it's it's possible that I'll be a multi-millionaire with [snorts] um RMDs uh that are pretty significant when I'm in my 70s and I'll be taxed at a pretty high high rate then. And if that high rate means that people are having access to health care and I still have a pretty good income um that makes me comfortable enough to live off of, I'm okay with that. like taxes aren't necessarily the worst thing. Um I just want to make sure they're going towards actually helping people who pay them to live better lives.

41:17 Yeah,, I, I, think, it's, a, really, tough subject here and and this we tried to debate this uh we tried to not debate this. We tried to frame it with a representative from KFF um I think last week. When did that come out? That came out on uh on Tuesday, November 25th. And it's a really it's a it's a really hard and interesting and dis you know debate and discussion for America at large and particularly acute in the fire community because uh the healthc care strategy in the fire community is so heavily dependent on on on realized income right? whether that qualifies you for Medicaid CHIP or whether that it qualifies you for sub subsidies for ACA plans and how much um how how many how much in the form of those subsidies that you're getting and I think that's a really challenging political issue for this country right now and your situation is it brings it to to just such stark reality because of the

42:20 tragedy that struck your family and how you were forced to navigate it based on the the way the current system is set up. And so, thank you for sharing it and and and taking on some some hard questions about that um about that situation here today.

42:35 Yeah,, I, hope, most, more, people, are willing to be outspoken in some of these things and um dig into those conversations a little bit more deeply. Um definitely definitely is an area that uh maybe a lot of people haven't put much thought into um and should think about a little bit more. Hopefully this conversation will will spark debate and thought about it inside of the fire community as well because I think it's it's just such a it's such a challenging issue and and I just admire and appreciate you sharing your story and how you've handled things and and I'm glad that the system was there for you in the in this really challenging time personally. Regina, thank you so much for your time today and thank you for sharing the story about your journey with this this navigating the the horrible healthcare landscape that we find ourselves in right now. Where would one find Women's Personal Finance?

43:26 Because you used to be a Facebook group and that has since closed. So,, Women's, Personal, Finance, um, we, have a website uh we don't do a whole lot with it, but women's personal finance.org um or women's personal finance.org/socials /socials um has links to pretty much everything. We are most active on threads, which is like Meta's version of Twitter. Um but we're also on Instagram and uh on Facebook and Tik Tok. We're on all those things. Uh we did have a very large Facebook group. We closed it in December of 2024. So, just now coming up on a one-year anniversary of closing that 82,000 member Facebook group. [snorts] Um, so that we we had more time to dedicate to our uh to our private communities and just we're feeling a little bit of burnout with the Facebook thing. So, it it's a little bit more fun being able to just manage um social media instead of such a large Facebook group. But yeah, if you're interested in

44:31 any of this, come check that out. We also have a weekly newsletter that goes out and um you can find a link to that on that women's personal finance.org/socials link as well.

44:43 All, right,, Scott,, that, was, Regina, Moore and that was quite the wild ride that she had. Um I just want to take a moment and say that I don't think that healthcare should be a political issue. Literally, everybody needs health care. For exactly Regina's story, you can be fined. They were in Hawaii before he got his diagnosis. All of a sudden Christmas Eve, you have a childhood cancer diagnosis and a 14-month treatment plan ahead of you, and your life completely changes in the blink of an eye. That's not political. That's a basic human right to be able to take care of your children. So, for this like she is faced with a bunch of really bad options and she has chosen the option that is like the least bad for her.

45:27 Yeah., I, I, think, it's, a, really, tough situation and I think that folks with different political views will view this situation differently. Right? Some folks um who lean left will view the situation as healthcare is a right and this is this this should not be a burden unfairly placed on this family that just had bad luck and tragedy strike for a 2-year-old getting cancer. And I think other folks in the other political side will say this is a person who's capable of working and commanding a high income and they should pay taxes into that system or pay for their own healthcare if they're capable of doing it since she has a million dollar net worth. And I think that that's the crux of the political debate around healthcare in America today. And I don't know what the right answer is. I just think that this story highlights that problem really acutely here. and the challenge um that those confus conflicting viewpoints will

46:20 have in in in agreeing on a way forward um in a situation like this. I also think that it's really instructive in the fire community in particular because the fire community right now has a lot of particularly good options that may not be available to the rest of the public. Right? Option one, go back to work and get a health insurance plan if tragedy strikes. Option two, control your income and qualify for Medicaid or CHIP or uh or or get heavily heavy subsidies from an ACA plan. Um and option three, um being to do some sort of alternative to health insurance either pay the premiums or get some alternative to health insurance like health shares. And I think that those options are excellent for the fire community, potentially going to be controversial as the debate around healthcare continues in this country.

47:06 And I think that um um that that the challenge for the fire community will be thinking, you know, planning around that. What are health care costs going to look like once you hit early retirement and have the option to control to control your income? What can you actually count on in the future in the decades into the future as you approach traditional retirement age? That's going to be the challenge. I don't, think, we, have a, good, answer, for that right now. And I think the only real answer is be conservative with it and be ready for those costs to go up.

47:36 Whether that forces you to go back to work or whether that forces you to build a more conservative portfolio to potentially cover those healthcare costs in early retirement or medical tourism. Uh alternative options for insurance include the, you know, the health shares, self-insuring, doing the concierge doctors. There's a lot of different options. But when you have a catastrophe like this, you need a catastrophic plan that helps you helps cover the the costs. And yeah, I I am looking forward to a really great alternative program to health insurance but, I'm, not, hopeful, that, I'm, going to see it anytime soon.

48:14 Yeah,, health, insurance, will, always suffer from this problem, right? Because because again, it's it's it capitalism is the allocation of scarce resources right? That's all it is in there. and and and it's it it works in a lot of different categories. The debate about whether it works in healthcare is again a very polit political issue um because healthcare can often mean you know the allocation of resources that mean life or death for people and so it's a really challenging uh concept here and the again I think the two schools of thought are we're all in this together and everybody's insured and then who pays for it and how do we encourage more um more responsible behavior more cost conscious behavior inside the healthare system in the singlepayer system and the other alternative is allowing the free market to work and the free market working will pull together people with lower risk profiles like for example

49:02 potentially my family and pull together people with higher risk profiles like Regina's family and shift those costs potentially unfairly into people that have pre-existing conditions um and away from people who don't and that's that's that's the challenge with healthcare right and I don't again I don't know what the solution is all I know is that for me in the fire journey that means be conservative right make sure that there are these other options available. Um and that you're planning on the worst case scenario or ready to handle the worst case scenario if it comes up with plan B or plan C.

49:35 All, right,, Scott,, should, we, give, out, our email addresses in case anybody wants to send us emails?

49:39 O,, not, on, this, one., U,, you want my our email addresses, go listen to other episodes of the podcast where we put them out there pretty frequently. But, uh, this one's so political that I I feel like we're going to get some uh some interesting ones um from from folks who actually want to go hunting them down. I would encourage respectful emails, but I know that that's not what's gonna happen. So, uh yeah, I'll be in my inbox.

50:00 Let, us, know, in, the, comments., Um,, you know, assuming that you're not a hardcore cheerleader for the left or the right, how how do we do today uh on this? Do we present it with with a reasonable uh neutrality of really hard issue? Or do you have any coaching points for us that are that are helpful and not um not provocative or trashing um things because we won't we won't tolerate extreme political views.

50:18 That, wraps, up, this, episode, of, the, Bigger Pockets Money podcast. He is Scott Trench. I am indeens. Oops. Did I just mess up my name? See, I don't just get my husband's name wrong. I sometimes get my own name wrong. That wraps up this episode of the Bigger Pockets Money podcast. He is Scott Trench. I am Indie Jensen saying don't pout sauerkraut.

Questions about this episode

What is discussed in "How to Prepare Your FIRE Plan for Healthcare Costs"?

In order: 0:00 Dave Ramsey, Regina Moore, Bigger Pockets Money podcast, Mr. Money Mustache; 40:00 Women's Personal Finance, Regina Moore; 50:00 Bigger Pockets Money podcast, Indie Jensen, Scott Trench.

What is mentioned in this BiggerPockets Money episode?

8 people, works and ideas are mentioned, including Regina Moore, Women's Personal Finance, CHIP, Bigger Pockets Money podcast, Scott Trench, Dave Ramsey. Each one on this page links to its own page with every episode that mentions it.

How long is "How to Prepare Your FIRE Plan for Healthcare Costs"?

The episode runs 51 min; the transcript is about 8,320 words in 77 timestamped sections.

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