If a person making $20K could buy health coverage for $19/week

[cthulu2016]

If a single person making $20K/year could buy good health coverage (equivalent to of better than typical employer provided plans) for $19/week, and was technically required to do so, but with no substantial penalty for not doing so, would that be a good thing?

[JVS]

1. Would the person be able to get meaningful medical treatment from said coverage or is it just a...

means of making sure that the medical industry "gets theirs" in the event that something were to happen to this person?

[cthulu2016]

2. Real coverage, not just a catastrophic policy

Some level of preventative care, perscriptions, etc. At least equivalent to the usual employer health plan.

[B Calm]

11. What would the deductible be?

[robinlynne]

41. How can we get health care for 19.00 a month?

[patrice]

3. The mandate is what drives the premiums down, so I am wondering how that would be possible.nt

[JVS]

8. The mandate doesn't drive the premiums down. The mandate drives down...

the probability of a randomly chosen insurance buyer of being sick. While this increases the ratio of insurance collections to payouts, it does not lower premiums unless the insurance companies decide to lower premiums.

[patrice]

10. Thanks for that clarification. So the environment of competition in the exchanges, between

different kinds of coverage packages, is the ONLY thing that can cause them to choose to lower premiums?

[Earth_First]

4. For $19/wk. with a $7/$8/$10K (or higher) deductable...what's the point?

A lot of variables to consider, this one being top priority.

[cthulu2016]

6. stipulating "good" coverage

[patrice]

13. good coverage, "Ay, there's the rub." What package options will be available in what kinds of

contexts is what the exchanges are all about, right?

[Schema Thing]

15. why are you asking as if this isn't all readily available information?

[patrice]

20. Because "our" governor turned down the federal dollars for the state to form its own

exchanges, so, as I understand it, HEW will setup generic exchanges in this state. Meanwhile, the governor has de-facto privatized Medicaid as something called KanCare and somekind of statewide health-care co-operative, which can go one way or another, has been started in Wichita, one of our major cities.

Won't the exchanges evolve anyway, depending upon what kind of market demands come out of the mandate when it is fully in force in 2014?

[WCGreen]

32. The 85% rule that stipulates that percentage of money coming in has to be spent

toward medical care will force the costs of insurance downward.

It will also stop the inflation of costs on the medical side because they won't have to keep bumping up the price of a procedure or medical care in order to get the insurance companies to cover the true costs.

[Hutzpa]

5. With no penalty?

Yes.

[diabeticman]

7. a few questions: IS the $20,000 before or after taxes? The coverage--is that for actual use or

something my wife had in which she couldn't find a doctor in our area that took her insurance. The company claimed go to our website anyone listed in your area on our website will take our card.

a) The list was for the other card this company offered. Offices said they took insurance card X from the company that they didn't hear of insurance card Y or that "Insurance name".

B) when finally she found a doctor he did nothing but tell her she was fat and go on a diet.

[cthulu2016]

9. It is whatever Obamacare provides

$20K is income level, so presumably before taxes, but the money paid woud be deductible, of course.

Some argue that an $80/month health insurance mandate for a single person with no dependents making $20K/year is a burden that cannot possibly be borne—even with no mechanism for enforcing that mandate.

But it strikes me as a hell of a deal.

And I have been poorer than that... I don't think $19/week is a meaningless thing.

[diabeticman]

22. 19 dollars right now is huge for me. It is either a tank of gas or will provide food for my wife

and I to eat for a week. If she makes her winter soups and we already have some of the items already. If not we live on Peanut butter or baloney sandwiches.

[leftstreet]

12. Why couldn't insurers be competitive without a govt mandate?

If an insurer intended to offer good coverage with low deductibles at $19 per week - why wasn't said insurer already doing it?

[TreasonousBastard]

14. Probably the same reason nobody makes a new car for $8,000, or builds a house for $15,000

[leftstreet]

16. Profit

So, hoping a for-profit insurer will offer good coverage with low deductibles at $19 a week is a joke

[TreasonousBastard]

18. More likely expenses...

Most people don't have the slightest idea how insurance p&e works.

[leftstreet]

19. Does Obamacare put controls on expenses? Great!

That's good news

[TreasonousBastard]

46. It's supposed to. We'll see how that works.

[TreasonousBastard]

17. Well, without a really good sales pitch...

it won't mean a thing without enforcement. Lots of people don't buy car insurance even though they face big fines and losing their licenses, and more wouldn't without those penalties. Life insurance? Wotta laugh...

20 bucks a week is a good deal, and even at that low rate it would be subsidized for that kind of income.

[dkf]

21. What good is having access if you can't pay the co-pays?

If its still too expensive to use the coverage then mandating buying something you can't afford to use is just a tax.

[lumberjack_jeff]

25. The maximum out of pocket for the person in question would be $2083

Inconvenient, but not bankruptcy-causing.

"Can't afford" is a red-herring. No one opts to die rather than get necessary medical care.

[leftstreet]

27. That's a vile statement

"Can't afford" is a red-herring. No one opts to die rather than get necessary medical care.

What an elitist sewage spew

You have no evidence that once a premium is paid to a for-profit corporation the policy holder will be able to access any necessary medical care.

Deductibles, co-pays...the for-profit corporations are not being mandated to give anyone access to necessary medical care.

[lumberjack_jeff]

39. Drop the pearl-clutching act.

What gibberish.

The evidence that the premiums of an insured entitle him or her to coverage of medical expenses is a) common sense b) the law and c) the general experience of anyone who's ever had medical insurance.

The HCR law caps a persons maximum out of pocket expenses, AND allows enrollees to choose a cheaper, catastrophic package of coverage for less than the $20 weekly in the OP example.

No one would rather die than spend 5% of their income on coverage or 10% on care. Faced with the choice, they find that they can afford it after all.

The benefit of HCR is that the person in question isn't faced with bankruptcy, and won't be denied future coverage because of that illness.

[gollygee]

23. Once upon a time I made about $17k a year and had no health insurance

I got sick and ended up having massive debt due to the health care I didn't have insurance for. It isn't like if you go to the hospital and don't have insurance or the ability to pay that they just do what needs to be done and you never hear from them again. You get billed and sent to bill collectors and your credit gets screwed up. It would have been hard to keep up with the $19 a week, but on the other hand it would have kept me out of the financial mess I ended up in.

[dkf]

29. Even Medicare has copays.

Odds are you still would have landed up with debt, just not so much. At some point though, a $3,000 debt is just as bad as $30,000. And the premium gets charged monthly so you get reductions now for the chance that you might have debt later for which you can't manage copays anyway.

[gollygee]

31. $3000 would have been much better

Definitely not as bad as $30,000.

[gollygee]

33. Also $3,000

is an amount my parents might have been able to help with. My parents didn't have a whole lot of money and couldn't help with the situation I ended up in.

The Republican health care program for the poor is "don't get sick." And of course people do get sick. It was maddening. I was so careful to live within my means, with no cable TV or internet, never going out to eat, just waiting until I'd start making a living wage. Which eventually did happen, but by then I had this huge pile of debt because I'd gotten sick once upon a time when I didn't have insurance and couldn't afford it. I wouldn't have been able to purchase insurance for $19 a week. I remember looking into it and even catastrophic insurance, which sounded like I'd have a hard time getting money paid out even if something did happen, cost more than that. It's been a long time but it seems like the cheapest I could find was $125 a month, which seemed like a fortune in those days. If this $19 a week was taken out of my paycheck pre-tax, I would have been able to deal with it, though it might have meant even more austere meals.

[coalition_unwilling]

30. In one short paragraph, you have uttered (perhaps unwittingly) one of the most effective and

eloquent indictments of American capitalism I have ever read. Your misfortune occurred in a society where 1% of the population controls 40% of the wealth (and 10% control 80% of the wealth). There is something obscenely offensive about that state of affairs.

Briefly put, getting sick should not end up causing anyone in this country a "financial mess". Jesus H. Christ.

[lumberjack_jeff]

24. Yes. Period. n/t

[LiberalFighter]

26. Really?

Why would this be considered good coverage?

[DJ13]

28. Not good

If the ACA had been tax based (a payroll tax thats progressive like the income tax) like it should have been, instead of self financed with penalties, that $20k worker would need to pay nothing and have no out of pocket expense like the rest of the civilized world.

[Yavin4]

34. In Europe, The People Pay Huge VAT Taxes to Pay for Their Single-Payer Healthcare

Would that be a better deal? That person making $20K a year would be paying a lot more than $19 a week in sales taxes.

A lot of folks here seem to be under the impression that a Single Payer system is paid entirely by taxes on the rich, but that is not the case. Yes, Europe has very generous social benefits, but they also have very high taxes on EVERYONE. I support how Europe does things.

[XemaSab]

35. $960 a year

for someone making $20,000 is huge.

[Yavin4]

36. Would You Rather Pay Sales Taxes to Pay for Single Payer?

That's how other nations finance their Single Payer programs.

[Comrade_McKenzie]

37. People living paycheck to paycheck shouldn't have to pay anything into the system... nt

[KG]

38. obviously, not many commenters on these threads are making 20k or less

and it's not just the 80 bucks, it's copays and deductibles to consider. ACA - neither affordable, nor care.

[HopeHoops]

40. Frankly, no.

[cherokeeprogressive]

42. What's the deductible, yearly cap, and lifetime cap on "good health coverage"?

How much are prescriptions going to cost?

[Egalitarian Thug]

43. No. $19 p/wk out of a gross pay of $385 is not nothing. Your scenario needs to be more specific.

What's good coverage? What are the deductibles and co-pays? What constitutes an insubstantial penalty? And what happens if said person doesn't buy the insurance becomes sick or injured?

FICA is $28.88 per week and I don't have a current withholding table, but if the person claims single 1 on their W-2 the withholding is also quite significant. That's the problem with subsistence wages, there is no comfort margin, no disposable income. When anything happens, and something always happens, they fall further behind and a perpetual cycle begins.

[SheilaT]

44. A reason to have catastrophic coverage,

that kind with a very high deductible, is so that when you do need medical care, you get billed the far cheaper insurance rate, meaning the one insurance companies pay, rather than the higher amount billed to those without insurance.

That's something most people do not know, and if they did, more people would get the cheapest cost to them catastrophic coverage for that reason.

[JDPriestly]

45. It would be wonderful, but it would not work.

The health insurance companies would never accept providing insurance at low rates without a mandate to buy it and without a penalty for not buying it because the insurance companies would lose too much money. If we did that people who were sick or needed lots of medical care would buy the insurance and the healthy people would not buy it.

I'm assuming that the cost of the insurance would increase as the income increased.

We have the mandate because that's the way you can make sure that the cost of providing low-cost insurance for those who cannot pay for the full cost of the insurance is shared by those who can afford to pay more for their insurance.

The actual insurance costs more than $19 a week or about $60 per month.

Besides, if you earn $20,000 per year and pay your payroll taxes, paying $60 per month or $720 per year is plenty enough. The current insurance policies without the ACA do not cover some of the costs that the ACA requires the policies to pay -- some of the tests, etc.

A lot of people insured through an employer only receive insurance for themselves, not for other family members. A lot of people insured through an employer only have catastrophic insurance. That is no good because ultimately health care costs can be lowered if people regularly visit a primary care physician.

For example, diabetes and high blood pressure can be controlled -- but people need to be tested to find out if they have it. Too many Americans don't get tested.

Also, a lot of back problems can be helped by physical therapy. People without health insurance cannot afford that. Pills are cheaper. So is alcohol. So they self-medicate the cheap way. And then they end up with a problem far bigger than the one that they started with and that could have been treated with physical therapy.

So that's why we have the ACA.