Obama administration issues rules for individual mandate, America continues to exist
by Joan McCarter
It might be touch and go right now, but for the moment, the sky has not fallen and the nation has not yet devolved into godless, Supreme Court-sanctioned, freedomless socialism. But be prepared, just in case, because the Obama administration has just issued regulations for the individual mandate to purchase health insurance under Obamacare.
But it's not that scary.
The mandate penalty "applies only to the limited group of taxpayers who choose to spend a substantial period of time without coverage despite having ready access to affordable coverage," HHS said in a fact sheet on the new rules.
The same fact sheet also noted findings from the Congressional Budget Office that less than 2 percent of the American public will have to make a payment under the mandate.
In 2014, people who choose not to buy insurance and don't quality for an exemption from the mandate will have to pay a fine of $95. The penalty increases to $695 by 2016, and then rises annually based on a pre-determined formula.
If you have a short lapse in coverage, you don't need to worry about the long arm of the law tracking you down. If you lose your job and lose coverage, the IRS won't be at your door. If you don't make enough money to be required to file federal income taxes, you're not going to be fined, though subsidized health insurance will be available to you on the exchanges that will be set up next year. If you have an enlightened enough governor, you might also possibly qualify for the expanded Medicaid program. And if you live in a state without an enlightened governor and you would otherwise qualify for the expanded Medicaid, you will not be subject to the fines if you don't get coverage.
If you can't buy insurance for less than nine percent of your annual salary, you won't be subject to the fines. If you turn down coverage at the beginning of the year because you can't afford it, but then your finances change to make it affordable later in the year, you will still be exempt from the mandate.
http://www.dailykos.com/story/2013/01/30/1183377/-Obama-administration-issues-rules-for-individual-mandate-America-continues-to-exist
= new reply since forum marked as read
Okay, I guess I'll make do.
This sounds more like Whistling-Past-the-Graveyard than a reality based prediction of what will happen in 2014.
The best estimates I have seen are that there will be 40 MILLION to 70 MILLION uninsured Americans in 2014.
That is a BUNCH of Americans that will immediately be affected by The Mandate.
How many MILLIONS was the Democratic majority in 2012?
*Some of these MILLIONS will be covered by the Medicaid expansion,
but some of them won't...depending on which state they live in, and whether that state chooses to go along with the Medicaid Expansion which the Supreme Court has deemed as "optional",
and if that particular state chooses NOT to do so, will there be an immediate enrollment in the National Medicaid expansion that has been promised, or will there be a prolonged Limbo?
Have the agencies been funded and staffed?
Have all the forms been printed?
Is the necessary oversight in place?
We ARE talking about 40 - 70 MILLION human beings,
and 2014 is fast approaching.
*Some of these MILLIONS of Americans WILL qualify for a subsidy ranging from 100% to whatever depending on their taxable income from the previous year. They will be able to use this "subsidy" to purchase Health Insurance on "The Exchange".
They may, or may NOT, be able to choose among the 3 plans offered on the exchange:
The Bronze Plan, The Silver Plan, or the Gold Plan.
(The citizens don't actually SEE "The Subsidy". That goes directly to the Health Insurance Corporation, and it would be more correct to say that the Health Insurance Corporations are being subsidized, but THAT is harder to SELL).
The Deductible and Co-Pays for each plan will decrease according to the richness of the plan the mandated buyers can afford.
The Bronze Plan will cover 60% of the actual cost of the delivered Health Care, up to certain limits, but I haven't been unable to determine if the upper limit fluctuates with whatever plan somebody chooses from The Exchange.
Once the upper limit is reached, the Government will cover additional costs,
but I haven't been able to uncover the the mechanism for covering these costs.
Will the patient be billed directly on Delivery of Health Care and laterreimbursed?
Can they Take-It-Off-of-Their-Taxes and receive it as a refund the following year?
Or is the Door to the Public Treasury going to be WIDE OPEN to the Health Insurance Industry to just take whatever they say covers the "additional costs"?
If the upper limit of actual-out-of-pocket-expense for Health Care at the point of delivery is FIXED at a particular dollar amount,
then someone would have to be a damned ignorant fool to buy anything other than the Bronze Coverage,
but, somehow, due to my faith in the Uniquely American System, I can't help but believe that those who can only afford to buy the Bronze Plan won't receive as much coverage as someone who can afford the Gold Plan, AND it will cost the poorest MORE.
Thus, we have created a multi-tiered Caste System of Health Care delivery where those who need it the most, receive less.
Anyway, I don't see things going all that smoothly in 2014.
I see confusion, chaos, and MILLIONS of angry Americans who will blame the Democratic Party,
and rightly so.
They passed a complicated Republican Health Insurance scam
without forcing the Republicans to take ANY responsibility for it.
All the Republicans have to do is say, "Yep. We voted against it."
Every time Bush-the-Lesser got in hot water over Iraq,
all he had to do was say, "..but the Democrats voted for it too!"
(I fucking HATED every time he did that)
The Republicans won't have to accept ANY responsibility.
So, from the Git-Go, over 1/2 of our politicians (Republicans),
and way over 1/2 of our Media have a Vested Interest in making 2014 as confusing, complicated, and difficult as possible,
because the Republicans can say with a Big Smile, "Yep. Not our fault. We voted against it."
Tea Bagger Summer will look like a Sunday School Picnic compared to 2014.
I don't think the creators of the ACA have any concept of the lives of low income Americans,
or they would have NEVER entertained the idea of partial subsidies, with the recipient coming-out-of-his-own-pocket to pay the remainder.
Once that money is IN-their-Pocket, it is THEIR money, and they won't let go of it without pain & anger,
MORE combustible RAGE when they find out that the IRS is The Collection Agency Hammer.
I live in low income America, and don't know anybody that is going to be happy about THAT.
It is much easier to simply take it out of the paycheck where they won't ever see it, or feel it, or own it,
but what does this low income American know about Low Income America? 
Anyway, we will see.
It looks like my wife & I will personally benefit from the Medicaid Expansion.
We currently grow our own food, and live on a laughably low taxable income,
so we got THAT going for us.
Good Luck to ALL in 2014.
but some of them won't...depending on which state they live in, and whether that state chooses to go along with the Medicaid Expansion which the Supreme Court has deemed as "optional",
and if that particular state chooses NOT to do so, will there be an immediate enrollment in the National Medicaid expansion that has been promised, or will there be a prolonged Limbo?
Have the agencies been funded and staffed?
Have all the forms been printed?
Is the necessary oversight in place?
We ARE talking about 40 - 70 MILLION human beings,
and 2014 is fast approaching.
*Some of these MILLIONS of Americans WILL qualify for a subsidy ranging from 100% to whatever depending on their taxable income from the previous year. They will be able to use this "subsidy" to purchase Health Insurance on "The Exchange".
They may, or may NOT, be able to choose among the 3 plans offered on the exchange:
The Bronze Plan, The Silver Plan, or the Gold Plan.
(The citizens don't actually SEE "The Subsidy". That goes directly to the Health Insurance Corporation, and it would be more correct to say that the Health Insurance Corporations are being subsidized, but THAT is harder to SELL).
...the biggest expansion of the safety net, and if states don't cooperate the federal government steps in. "We will find out in 2014"? That's your objection?
The President's health care policies will help tens of millions of Americans. That's a fact.
Before the health care law, the President signed the expansion of CHIP.
By ROBERT PEAR
WASHINGTON — The House gave final approval on Wednesday to a bill extending health insurance to millions of low-income children, and President Obama signed it this afternoon, in the first of what he hopes will be many steps to guarantee coverage for all Americans.
<...>
The roll call ended a two-year odyssey for the child health legislation, which President George W. Bush adamantly opposed on the ground it would lead to “government-run health care for every American.”
<...>
In a major change, the bill allows states to cover certain legal immigrants — namely, children under 21 and pregnant women — as well as citizens.
Until now, legal immigrants have generally been barred from Medicaid and the State Children’s Health Insurance Program for five years after they enter the United States. States will now be able to cover those immigrants without the five-year delay.
- more -
http://www.nytimes.com/2009/02/05/us/politics/05health.html
A key element of the Affordable Care Act (ACA) is the expansion of Medicaid to nearly all individuals with incomes up to 138 percent of the federal poverty level (FPL) ($15,415 for an individual; $26,344 for a family of three in 2012) in 2014. Medicaid currently provides health coverage for over 60 million individuals, including 1 in 4 children, but low parent eligibility levels and restrictions in eligibility for other adults mean that many low income individuals remain uninsured. The ACA expands coverage by setting a national Medicaid eligibility floor for nearly all groups. By 2016, Medicaid, along with the Children’s Health Insurance Program (CHIP), will cover an additional 17 million individuals, mostly low-income adults, leading to a significant reduction in the number of uninsured people.
Medicaid does not cover many low-income adults today. To qualify for Medicaid prior to health reform, individuals had to meet financial eligibility criteria and belong to one of the following specific groups: children, parents, pregnant women, people with severe disability, and seniors. Non-disabled adults without dependent children were generally excluded from Medicaid unless the state obtained a waiver to cover them. The federal government sets minimum eligibility levels for each category, which are up to 133% FPL for pregnant women and children but are much lower for parents (under 50% FPL in most states). States have the option to expand coverage to higher incomes, but Medicaid eligibility levels for adults remain very limited (Figure 1). Seventeen states limit Medicaid coverage to parents earning less than 50 percent of poverty ($9,545 for a family of 3), and only eight states provide full Medicaid coverage to other low-income adults. State-by state Medicaid eligibility levels for parents and other adults are available here.
The ACA expands Medicaid to a national floor of 138% of poverty ($15,415 for an individual; $26,344 for a family of three). The threshold is 133% FPL, but 5% of an individual’s income is disregarded, effectively raising the limit to 138% FPL. The expansion of coverage will make many low-income adults newly eligible for Medicaid and reduce the current variation in eligibility levels across states. To preserve the current base of coverage, states must also maintain minimum eligibility levels in place as of March 2010, when the law was signed. This requirement remains in effect until 2014 for adults and 2019 for children. Under the ACA, states also have the option to expand coverage early to low-income adults prior to 2014. To date, eight states (CA, CT, CO, DC, MN, MO, NJ and WA) have taken up this option to extend Medicaid to adults. Nearly all of these states previously provided solely state- or county-funded coverage to some low-income adults. By moving these adults to Medicaid and obtaining federal financing, these states were able to maintain and, in some cases, expand coverage. Together these early expansions covered over half a million adults as of April 2012.
Eligibility requirements for the elderly and persons with disabilities do not change under reform although some individuals with disabilities may become newly eligible under the adult expansion. Lawfully residing immigrants will be eligible for the Medicaid expansion, although many will continue to be subject to a five-year waiting period before they may enroll in coverage. States have the option to eliminate this five-year waiting period for children and pregnant women but not for other adults. Undocumented immigrants will remain ineligible for Medicaid.
- more -
http://www.kff.org/medicaid/quicktake_aca_medicaid.cfm
16 million: number of Americans who become eligible for Medicaid under the health care law
http://www.democraticunderground.com/1002531684
Posted by Greg Sargent
Republicans failed to block Obamacare in Congress. Their argument to overturn Obamacare as unconstitutional failed before the Supreme Court. They failed to elect a president to repeal the law. The drive to block or kill Obamacare failed in Congress, failed in the courts, and failed at the ballot box. Obamacare is here to stay.
Which leaves Republicans only one remaining way to scuttle the law — do everything they can to ensure that it fails. And so, many Republicans on the state level are refusing to implement it by refusing to set up exchanges — thus ensuring that the federal government sets them up instead.
Today we’ve hit a critical moment in that effort:
The vast majority of Republican-led states, faced with a Friday deadline to submit plans for running the insurance exchanges at the heart of the law, have opted instead to relinquish much or all of their control to the federal government.
Just 18 states and the District say they plan to operate their own exchanges, which are slated to begin enrollment in October. In an additional 32 states, the exchanges will be run either entirely by the federal government or a federal-state partnership.
It’s now official: In well over half of the states, local governments will relinquish all or some control over implementation of a law that will impact untold numbers of their own constituents. In so doing, they are reducing, rather than increasing, control over what happens in their own states — all in the name of states’ rights.
- more -
http://www.washingtonpost.com/blogs/plum-line/wp/2012/12/14/having-failed-to-repeal-obamacare-republicans-refuse-to-implement-it/
And there is room for improvement.
White House might use Medicare reform momentum to push further health care reform
http://www.democraticunderground.com/10022150571
Arizona Gov. Jan Brewer (R) on Monday said the state will join the Medicaid expansion under the new federal health care law, the Associated Press reported.
Her announcement came as a surprise to many observers, and it distinguishes Brewer from other Republican governors. The Supreme Court's ruling last summer on the Affordable Care Act, widely known as "Obamacare," made the Medicaid expansion under the federal law optional and state leaders such as Texas Gov. Rick Perry (R), Louisiana Gov. Bobby Jindal (R) and South Carolina Gov. Nikki Haley (R) have already opted out.
But in her State of the State address on Monday, Brewer rejected the notion that a rejection of the expansion would reduce the federal government's deficit.
http://livewire.talkingpointsmemo.com/entry/arizona-gov-brewer-opts-for-obamacare-medicaid-expansion
Arizona was the last holdout to join Medicaid when it was originally enacted in 1966.
Posted by Sarah Kliff
<...>
While the stakes are high for the White House, the territory is by no means uncharted. Washington has twice faced off with states over federal health care expansions, when Medicaid initially launched in 1965 and with the Children’s Health Insurance Program in 1997. In both cases, all 50 states ultimately signed up – but not without some wrangling.
<...>
Medicaid got a chilly reception when it launched in January 1966. It was up to the states to decide whether to participate and only six initially signed up: Hawaii, Illinois, Minnesota, North Dakota, Oklahoma and Pennsylvania. Twenty-seven followed suit later that year. Across the country, governors weighed the boon of new federal dollars — Washington would foot half of Medicaid’s bill — against the drawback of putting state money into a new program.
Nascent Medicaid programs quickly faced threats: Republican legislators in the New York introduced a bill in 1967 calling for the state to “live within its means” and repeal its Medicaid program.
<...>
Over time, however, the lure of federal dollars proved strong enough to win over resistant states. Eleven joined the program in 1967. Another wave of eight, largely Southern states came on board in 1970. Arizona proved the last holdout, not joining Medicaid until 1982.
- more -
http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/09/six-governors-say-they-will-opt-out-of-medicaid-how-long-will-they-hold-out/
