OK, the Affordable Care Act makes me feel 100% better about losing my job.....

[Logical]

I would love to hear what I am missing in my analysis. But based on what I see this is amazing. I had no idea that it was so affordable. I was really not paying attention. If I am wrong on something please let me know.

I am using this link as an estimator: http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/

I am 54 and am worried about my company closing down in 2015. I was really worried about Health Care. I assume I could find some job, but probably without benefits. I honestly was really worried about losing what little savings I have because of no health care coverage.

So I estimated my wife and I could earn, worst case together, $30,000 at a minimum wage job in 2015. I plugged that in the calculator and it says this......

Starting in 2014:
You will have the option of buying a health plan through your state's exchange with federal assistance. Based on your income, your annual premiums for that plan would be no more than $1,200 to $1,890. Your maximum out-of-pocket costs for deductibles and co-payments would be capped at 15 percent of the total cost.

Insurers can’t discriminate against you for having a pre-existing condition, and can only vary rates within a narrow range.

OK, this is amazing to me based on the other estimates I have seen for private insurance. If I am right, then Obama has to get the word out on this plan. People will fall i love with this Act when they know how it can help them.

Am I missing some "Catch"? I cannot believe it is this great!

[Schema Thing]

1. sounds about right

That is just for yourself, not you and your wife, correct?


You might double check on KFF.org

[Logical]

3. The KFF site shows a 'Government Tax Credit'. Does that mean I pay that also?

[PoliticAverse]

26. The tax-credit is how the government subsidizes the plans. You receive the credit...

From: http://www.irs.gov/newsroom/article/0,,id=220809,00.html

Health Insurance Premium Tax Credit

Starting in 2014, individuals and families can take a new premium tax credit to help them afford health insurance coverage purchased through an Affordable Insurance Exchange. Exchanges will operate in every state and the District of Columbia. The premium tax credit is refundable so taxpayers who have little or no income tax liability can still benefit. The credit also can be paid in advance to a taxpayer’s insurance company to help cover the cost of premiums. On May 18, 2012, the IRS issued final regulations which provide guidance for individuals who enroll in qualified health plans through Exchanges and claim the premium tax credit, and for Exchanges that make qualified health plans available to individuals and employers.

[quinnox]

2. Fat chance

A lot of people are going to be really pissed off when they see how much they are forced to pay for it. Especially people making low income, because even then it will cost around 100 dollars a month for the premium (that is with the discounts included) or 60 dollars a month for the penalty. Imagine making minimum wage and having to come up with an additional 100 or 60 dollars a month extra, just to pay a premium or the penalty. That is a lot of money for a low income person.

I suspect this will be altered big time or the Democratic party is going to take a bath after this kicks in, and the republicans will have a field day campaigning against this in 2014.

[Logical]

4. But for that $100 a month they get insurance......

Are you saying they would rather have the $100 and no insurance and then hope they don't get sick and if they do use the ER like they do now for free?

[quinnox]

6. yes, exactly

A lot of people just don't understand how much an extra 100 dollars a month is to someone on low income. It is a lot of money for that person. And if they don't want to pay it, well, the penalty averages out to about 60 dollars a month, how do you think many will feel about that new tax,they are going to be pissed off.

Why do you and so many others think people will be overjoyed to pay a new large tax?? People are going to be pissed, and the Democratic party will suffer big time, trust me.

[Logical]

8. I understand your point.....

but the ER deal is not a good solution either. No preventive care, etc.

[Motown_Johnny]

17. unpaid ER visits end up on credit rating reports

and we all know how that goes


It could easily be argued that paying for the insurance would be cheaper in the long run.

[Honeycombe8]

45. You are wrong, Grasshopper. How do we know that? Massachusetts Mandate. Almost 100% coverage.

100% of the children in Massachusetts are now covered, and about 98% of the people in the entire state have insurance.

The ACA plan has an example we can look at for some things....Massachusetts.

It does seem as if someone would choose the $100, and maybe some would. But apparently when given the choice, most choose the insurance. It's that important. A couple earning $30k a year, despite struggling greatly with money, could still pay $100 a month without having to do without another necessity. Insurance is a necessity, itself.

I'm guessing most people want protection from being caught w/o insurance if they get cancer, need a tumor removed, get pneumonia, etc. If they think $100 a month is expensive, wait until they get that $25,000 bill from the hospital and doctors.

[dkf]

52. Most of the increased coverage was achieved through expanding medicaid.

Roberts kicked the teeth out of the Medicaid portion so if Governors decide not to implement, it's not feasible to get the uninsured population down much.

[Honeycombe8]

77. Most of the states will keep the increased Medicaid. A few won't. Wait and see.

Wait until after the election.

[dkf]

115. I wonder if they can keep it til the Fed contribution goes down

Then drop it. Who is to say it is a permanent change?

[TheWraith]

78. And remember that the ACA's terms are even more favorable than in MA.

The ACA has cost controls, whereas Mass. doesn't.

The ACA subsidizes up to 400% of poverty, Mass only does 300%.

The ACA has a lower maximum limit on premiums.

In other words, there's every reason to believe that there will be fewer people who can afford to pay and won't.

[Marrah_G]

85. The MA program has its flaws.

I've been covered under commonwealth care about 6 months of each year, the rest of the time is spent fighting with them over fucked up paperwork.

I haven't had the meds I need for months because they can't seem to get my income right. I just gave notice at my second part time minimum wage job because they keep saying it puts me over the income limits... which it doesnt. This is just the latest in alot of fuck ups that have me on meds for a couple months.. then off..... then on.... meanwhile my health and emotional state are getting worse by the day.

I've had to go to the ER twice in the last 6 weeks.. the last one ended me in the hospital for 4 days. I am sure that bill will ensure I stay impoverished forever.

maybe I'll have insurance Aug first.... maybe not. Only if they get the new paperwork done before the 25th so I can make my first payment that is necessary to have the coverage started on the following 1st. if not then maybe september. until then its just more pain and insomnia.

Screw it, I'll probably die of dental problems before long anyway, only the poorest level of commonwealth care recipiants gets dental care.

We need single payer. We need it yesterday.

[RegieRocker]

51. That is poor people logic

Last edited Mon Jul 2, 2012, 04:59 PM - Edit history (1)

Some poor people have some poor ways that keep them poor. This is one of them.

[Fumesucker]

81. Yes, poor people don't have enough money to go around.

Car's broke, rent's overdue, power just got shut off..

Time to pay that medical insurance..

ETA: Median income in constant dollars has been flat since the early 70's, the average person made up the difference through credit, the credit has just about played out.

[RegieRocker]

84. I lived

in a 790 sq ft home with a family of 5 for many years. Cost to heat with wood and oil $250.00 a year, elec in summer $75 a month. Lived off a combined income of $25,00 for years. Drove used cars and fixed them myself. Actually for the last 9mo's I was putting $800.00 a month in the bank. Income rose. There is a lot more to this story and 99% of the population wouldn't have lived in this situation but we did. It was dangerous at times but we prevailed. It was also very beautiful. I miss it. I was poor but I didn't have poor people ways that kept me poor. Both my wife and I worked two jobs and pulled ourselves out of the situation. Lost my job at a GM plant and she lost her job at a newspaper that went out of business. Late 70's early 80's. I still work an average of 90hrs a week and I am 57. Two businesses, one substantial and one supplemental. I never give up hope. Not for material things but for a better life for my family. That does include medical care.

[Fumesucker]

88. You've already stated that all poor people have "poor people ways"..

Are you trying now to walk that back?

Or is it just those *other* poor people that have "poor people's ways"?

You know, the undeserving ones.

[rrneck]

89. If everyone were just like you there wouldn't be a problem.

That's arrogant bullshit logic.

[RegieRocker]

98. Your reply is arrogant

everyone has to find their own way out of poverty. Obviously you've never been poor or are still poor. Have you ever lived in a area surrounded by poor people? Since I don't know if you're poor. Do you or have you spent an notable amount of time with poor people? Have you ever helped the homeless? Work at shelters, food banks etc? Let me know. According to you, teaching the poor and homeless people new skills to overcome their poverty or homelessness is arrogant bullshit.

[rrneck]

113. Measuring others against your own experience

is arrogant bullshit. Fleeing from ego to sanctimony via ad hominem confrontation is intellectual dishonesty.

Nobody cares about your life story, or mine. All the libertarian chest thumping in the world won't help you make your point. Or it wouldn't if you had one.

[Marrah_G]

92. I guess I just need a 3rd part time job!

Obviously I am just not trying hard enough. Oh wait...nevermind...I just had to quit my second part time job so I can get healthcare.

[RegieRocker]

99. Really

what are your job titles at these jobs? Explain why you had to quit your second part time job to get healthcare?

[Marrah_G]

103. I am an admin asst at job number one.

Hours cut to 24 a week due to our lovely friends in the financial industry destroying the economy. Job number 2 was minimum wage at a major pharmacy. Job number two supposedly put me over the limit for Commonwealth care. I quit my job so I can get the medicine I need that runs 600 a month, which was more then I made at job number 2 anyway.

I've raised three children on my own and have one in college (thank you airforce) and another who just graduated HS and will be going to jobcorp.

[bluedigger]

114. So you work almost 13 hours a day, 7 days a week?

Sounds great! Most people aren't able or willing to do that. I honestly don't know why they should be, either.

[Marrah_G]

82. This poor person finds your comments offensive

I am really biting my tongue here.

[RegieRocker]

86. Not all poor people ways

are bad. Actually some of which helped me rise above poverty. It's the bad ones that can keep you there.

[Starry Messenger]

83. And what's that honey? I force my employer to pay me shit?

News to me. I also didn't know I was responsible for the rising cost of food. Interesting.

[RegieRocker]

87. Over the top

[Fumesucker]

90. Your original comment is the one that's over the top..

A legitimate question given what you said.

[RegieRocker]

91. Nope

Not all poor people were born poor and not all poor people remain poor. Can you explain why not all poor people remain poor? My statement was about those that remain poor. And if you had read the next post completely and grasped the fact that some poor people ways can bring them out of poverty it might shed some light for you.

[Marrah_G]

94. The ones who stay poor obviously just aren't trying hard enough

Those full time jobs with benefits are EVERYWHERE! Sigh... I think you haven't been poor in a while and don't understand how things have changed.

[RegieRocker]

106. You could do the work I do but you won't

almost anyone can do it, but it takes a sacrifice most are unwilling to do.

[Marrah_G]

108. I've spent a lifetime sacrificing

What job do you do that you think I wouldn't?

[Fumesucker]

100. The poor people that don't remain poor start making more money..

And there are a lot of reasons for that with the biggest one being sheer dumb luck which goes all the way back to the luck of the genetic draw, if you're ugly and stupid you're far more likely to be poor than if you are good looking and bright, things over which you have no control at all.

I've been struck by good fortune right out of the blue enough times to know it happens and I've been struck with bad fortune enough times to know that happens too.

[RegieRocker]

102. Not at all

Many people are in over there heads on mortgages, medical bills etc. Many times it's changing the lifestyle to a less costlier mode of living.

As for as the genetics you're correct. That might be overcomed by working very hard.

Those reasons are why I am and will remain for healthcare (AHCA) and unions.

[Fumesucker]

110. Medical bills aren't due to sheer random chance?

I suppose some aren't (hold muh beer 'n watch this) but a great many are..

[2ndAmForComputers]

123. That worldview is very common and has a name.

It begins with the hand that the majority of people use to write, and ends with the appendage birds use to fly.

[Skittles]

107. another factor is timing

people in the right place at the right time are better able to "pull themselves out"

luck and timing and genetics play as much into success as does hard work

[Marrah_G]

93. Nope

[Starry Messenger]

95. Can't refute it, I see.

[RegieRocker]

104. Ok

I recommend that you reverse your thinking. Don't try to get employers to pay you less (shit) but try getting them to pay you more.

[Marrah_G]

105. LOL

THAT is a thing of the past. I think you just do not understand how things are out there right now. You might have been poor in the 70-80's but that was a very different time.

[RegieRocker]

109. I watched the Grapes of Wrath

many many years ago. That was enough to get me going. I knew 2008 was coming. How? Not sure really. Actually things started to get nuts in the 80's with Ronnie and his minions.

[Marrah_G]

111. You should consider yourself fortunate

You had the opportunity to get in a better place financially. You just need to realize that alot of people don't, especially single mothers.

I just applied to an apartment near my sons college so I can have him and two of his friends move in with me to save on money- dorms at their state college run 10.5 a year now. i'm hoping to find a way to take some courses at the community college at night so maybe I can have the american dream of a fulltime job and health insurance.

It gets really fucking old when people assume I am poor because I just don't try hard enough. I haven't had a vacation in ten years that hasn't involved a hospital stay.

[RegieRocker]

116. i understand

I probably should've worded the title differently. It's a phrase I learned from my mother. Her family was very poor. Some poor people have ways that keep them poor. I know many that fit this.

[Marrah_G]

117. Thank you

I'm sure we probably agree on most things.

[Starry Messenger]

112. Should I rob them?

Seriously, I'm an officer in my union, I don't need to be told to reverse my thinking. You're an outlier with your "live in a cave and save money" lifestyle. This is the 21st century. The yeoman bootstraps era is truly over. Reverse your thinking, more to the left and less like a teabagger.

[RegieRocker]

118. You make no sense

You need to do your job and get your union members more money. Quit getting them Shit wages. Calling me a teabagger eh? Resorting to name calling and labeling is the mark of a teabagger. Yep dream the American dream and keep up with the Jones you are. Real smart.

[Starry Messenger]

119. LOL.

You told the entire subthread we aren't willing to work as hard as you. Sanctimonious smugness generates snark everytime. Enjoy.

[lumberjack_jeff]

121. Not all.

Poor spending habits can create poverty, but the reverse is not always true.

Some (if not most) low income people are clever, improvisational and frugal.

Foregoing health coverage when 80% of it is covered by the government is poor logic, though.

[SoCalDem]

42. "ER for free"

Not really.

When you are poor & you use it for "free", the unpaid charges are kept track of somewhere..like credit agencies and on your "permanent record", so someday when you are working again and making some money, you still "owe" someone the charges you did not pay for.

I suspect that many people who cannot afford the $100 a month, might be able to juggle things a bit, and come up with it.

Maybe a lower cost phone plan per month, or a roommate, or even a part time job a few days a week would cover it...or a family member who could help with the cost for a while.

It's better than nothing.

[Marrah_G]

96. It's not free- it's just another bill that you can't pay

So your credit stays shitty, ensuring you pay loan shark prices if you ever make the mistake of looking for credit.

I had 2 ER visits in the last 6 weeks. one resulted in a 4 day stay so I wouldn't die. I haven't gotten those bills yet...but I will!

[ProSense]

5. A lot of

"A lot of people are going to be really pissed off when they see how much they are forced to pay for it."

...people are going to realize they aren't "forced" to do a damn thing.

You're uninsured? You have a choice to maintain that status.

[ScruffyTheJanitor]

12. Hmmmm...depends on your definition of "forced" Haha

Consider that their choices are either:

1. Pay money to a private corporation, or

2. Pay money to the government.

It is fairly reasonable, and quite understandable, to consider that as a forceful removal of money. The individual is forced to either give their money to the government or give their money to a private corporation.

I don't see how it could be said that they aren't "forced to do something."

[Motown_Johnny]

13. then every tax is forcing people to do something

I don't have kids, but if I did I would get a tax break for them. Is the government forcing me to have kids?




P.S. I hate the mandate but your point isn't valid.

[ScruffyTheJanitor]

18. The basis of all governmental entities is power derived from force and threats of violence.

You are required to pay taxes under the threat that if you don't, you will face consequences (financial, criminal, etc.). But, unlike other taxes, this one involves the concept that if you do not purchase a product from a private corporation, you will be "taxed" by the government.

Thus you are forced to relinquish money, either to a corporation or to the government.

There is no out involved. Both pathways available require you to pay "someone." That is where the force lies.

[freshwest]

23. And if you don't pay your rent or mortgage goverment may be employed with LEOs to force you...

But it's just the middle man in all those situations. There are sources of wealth that back governments and back banks, landowners or whatever analogy one wishes to use. It doesn't matter where that money came from, fraud, conquest, work or inheritance. All goes back to land and resources ownership.

The difference between paying as I do for electrical service, which is city owned and very cheap, is I get a say so in how they will use the money. In effect, I am a shareholder as a citizen. When we pay private corporations, we are not the shareholders, we are a resource for their revenue.

Something like that. Gotta go.

[PoliticAverse]

31. There are Mutual insurance companies which are owned by the policy holders...

( for example: http://en.wikipedia.org/wiki/Health_Care_Service_Corporation ) in addition to different types of non-profit
insurance organizations.

[freshwest]

39. Yes, my auto insurance is that way. They used to give us a rebate. We generally have a few of these

In our lives already, if we can get them. The ACA has already hit a blow on the for-profit by forcing them to give rebates early next year for attemps to hide their advertising in 'direct patient care costs.' The ACA said that and profits had to fit within their administrative fees.

Medicare had or has 10-20% set to cover administrative costs, always lower than for-profits. The failure to provide for real health care, pre-existing conditions, denial of claims, etc. kept the profits up.

Providers, that is, hospitals and doctors suffered and spent many months begging for their payments and were going down. It made their costs go up and kept them from doing what they were educated to do for their patients. This will force more dollars to them, and those are the ones we really care about.

As soon as the Constitutionality of the ACA was approved, there were drops in the value of the two competing forces, the for-profits and the provders. They should not be in competition, they are not in other countries.

Oh, I got to go again. Anyway thanks for your example and that gave me a second to express my opinion again.

[Motown_Johnny]

43. Did I mention that I also hate the mandate?

Why yes... I do believe I did.



The truth is that this can be turned on it's head very easily. Having insurance qualifies you for a $695.00 a year tax break, or 2.5% of adjusted income.


It isn't that you are forced to pay a tax, you just don't qualify for the tax break.

[Spitfire of ATJ]

58. I suppose it never occurred to you

that more employers can now offer health care to their employees as a result of the ACA.

And even if what you say about the minimum wage employee having to shell out and extra $25 a week is true that can be made up for by increasing the minimum wage by 70¢ an hour but if we want to really go for it we could go with Nixon's plan. He wanted to require all businesses to offer health care to their employees. If you work you would have health care, period.

Hell, I'm old enough to remember house calls. Some companies would even send a doctor to your home if you called in sick.

[girl gone mad]

22. But why cheer such a hugely regressive tax?

Especially in the middle of an ongoing unemployment crisis and recession.

[ProSense]

14. Or

Consider that their choices are either:

1. Pay money to a private corporation, or

2. Pay money to the government.

...remain a freeloader: http://www.democraticunderground.com/1002881604

I think most progressives who opt out would rather pay the government than the insurance companies. Most teabaggers will do everything to remain freeloaders while railing against "illegal aliens."

[ScruffyTheJanitor]

21. "...remain a freeloader"

lol

Yea, I guess that could work too.

[girl gone mad]

24. What an ugly post, Prosense.

Disgusting. You truly should be ashamed.

[ProSense]

25. Why?

Nothing ugly about it. It's a fact: People can remain freeloaders, and teabaggers are who they are.

Sorry if that bothers you.

[girl gone mad]

27. You are adopting industry approved hate language.

Don't think it hasn't passed unnoticed to the rest of us that those who oppose this broad expansion of corporate power and mandated individual subservience to the imperial market state are now labeled "freeloaders", despite the fact that most have paid far more than their fair share into the system. While cheering this regressive taxation, you defend the bank bailouts and Obama's adamant refusal to prosecute transparent bank fraud. In other words, you shill for corporate freeloaders while attacking your struggling fellow citizens. Shameful.

[SickOfTheOnePct]

49. Take it up with Nancy Pelosi

I heard an interview with her on the radio, and she used the term "freeloaders" in relation to the tax. I think it was on NPR.

***edited for correction: She said "free riders", not "freeloaders".

[Honeycombe8]

46. Yes, they are forced to contribute to their medical care costs, just like they are forced to

contribute towards their food bill, their car gas, and the other necessities of life.

[treestar]

57. Is paying $$ to a private corporation always bad?

I guess you don't have a car, as that involves paying money to a private corporation?

Or why even pay the doctor/hospital/medical provider? Whether out of pocket, via insurance, or even single payer, that involves "paying a private corporation."

Why do you have to be forced to pay for health insurance? If you had it through an employer, didn't you feel entitled to it, or did you turn it down, saying you didn't want part of your pay being paid to a private corporation?

[Motown_Johnny]

11. Imagine making minimum wage and being sick/injured without any insurance

I would love to see your math on what the premiums are.

If we go with $7.50 an hour, 40 hours a week, 50 weeks a year you get a nice round 15,000/yr (federal minimum is only $7.25, but what the hell).


Now go use this calculator: http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/?hpid=z2


I used 15,000 as the adjusted gross income instead of the net income, but again, what the hell!


For someone who does not now have insurance and is over 26 years old, single and only one person in household it gives me this result.

^snip^

Starting in 2014:
You will have the option of buying a health plan through your state's exchange with federal assistance. Based on your income, your annual premiums for that plan would be no more than $450 to $600. Your maximum out-of-pocket costs for deductibles and co-payments would be capped at 6 percent of the total cost.




So that is more like $50.00 a month (or less) even if we slant the numbers. I don't know how you get anywhere near $100.00/mo.

[PoliticAverse]

28. Note that for such a person buying insurance would cost less than the $695 penalty

that eventually kicks in ($95 in 2014, i$325 in 2015, $695 in 2016).

[dionysus]

16. you will be proven wrong, thankfully.

[nadinbrzezinski]

37. You of course realize that if you are at the lowest threshold of poverty

Medicaid is free, or nearly free, right?

And yes, an extra 100 is a big deal

[Live and Learn]

53. This might help

What if I can't afford insurance under health care reform?
A guide to hardship exemptions

Read more: http://www.netquote.com/health-insurance/news/health-care-reform-hardship-exemptions.aspx

<snip>
When the cheapest option is still too expensive, you can ask for an economic hardship exemption to avoid a tax penalty. According to the nonprofit education group OpenCongress.org, if the cheapest health care plan available on your state's insurance exchange would cost more than 8 percent of your annual income, you would be exempt from the penalty for not having coverage.
<snip>

Hardship exemptions tie into other aspects of the health care reform law. You may have already heard about the subsidies that some Americans will get to help pay for coverage. These subsidies, which will come in the form of tax credits, will be granted to those whose income is between 133 percent and 400 percent of the federal poverty level, according to Kaiser.
<snip>


Details about many aspects of the health care reform law still are being worked out. Massachusetts, the only state that already has a health insurance mandate, has a variety of ways to qualify for a hardship exemption. According to the state's health care laws, residents may qualify for hardship waivers if, during the year, they:

•Were homelessness, had than 30 days of overdue rent or mortgage payments, or received an eviction or foreclosure notice.
•Received a shut-off notice for utilities or had utilities shut off.
•Had non-cosmetic medical or dental out-of-pocket expenses, excluding premium payments, totaling more than 7.5 percent of income.
•Experienced domestic violence, the death of a spouse, or an aging parent or ill child who required full-time care.
•Experienced a flood, fire or other major natural disaster.
•Were unable to buy food or clothing because of the requirement to buy health insurance.


I heard Randi Rhodes claim that in order to be forced to pay the penalty, a family of 4 would need to make over 90 something thousand a year. Not sure where she got that from but I think the point is that very few will actually have to pay the penalty. This article also suggests just getting catastrophic insurance which is much cheaper to avoid a penalty.


In addition, per Opencongress.org (april, 2010)

http://www.opencongress.org/articles/view/1789-Health-Care-Affordability-and-the-Individual-Mandate-

But, if the cost of health care in a state is similar to what it is in Massachusetts right now, the subsidies levels would look like this:

◦An individual earning $15,000 would receive $4,188 from the government, which more than covers the full cost of all bronze plans an the cheapest silver plan.
◦An individual earning $23,000 would receive $3,039 from the government, which would cover cover all but $110 of the annual cost of the cheapest bronze plan, meaning that they could have monthly premiums as low as $10.
◦An individual earning $33,000 would receive $1,353 from the government, which means they would be required to pay $1,803 for the cheapest bronze coverage, or a monthly premium of $150.25.

[Puzzledtraveller]

72. Very good point, many Americans cannot afford any additional out of pocket expenses

and many families will be above the income limit for the full subsidy, these are my clients that are employed, usually with a small families who's job may offer health insurance at a high premium that they already cant afford, or not at all, in this scenario nothing changes for them. These same families can count on their children being covered under present family medicaid programs all states have but under many guidelines, they themselves are not eligible. In my state, many of the single adults between 18 and 59 who seek medicaid are not eligible, they of course do not have dependent children, and are not at least 65, blind and disabled. Because we only have family medicaid(children under 19, pregnancy) , and adult medicaid (65+ and or disabled), those fall in between will still have a tough time gaining coverage, as many won't be able to afford it. The families I see are struggling for every dollar.

[Skittles]

101. more pissed when they find out what they actually GET for it

[freshwest]

7. From the title, I thought you were blaming the ACA for job loss, but...

Aapparently not, so I'm kicking and recommending your informative thread.

Many people here are worried since the corporate media has done such a great job of informing the public.

Thanks for the thread, Logical, and hope you can find a good job if this one goes away in 2015 as you think it might.

[flamingdem]

9. I fully agree the media has created massive confusion about this by

covering republican lies without countering them.

It's so simple once you get the hang of it, and TRULY AFFORDABLE!

[freshwest]

73. It's been a load off my soul to know that so many others will get help now.

I have been breathing a sigh of relief for them and feeling freer myself, yet don't see how this impacts me personally. But I have never objected to taxes that would be used to help others. Despite life's unexpected turns and ups and downs, what goes around comes around.

[robinlynne]

10. My guess is the catch is going to be the healthcare we can receive. I pay 500 a

month, and it is very difficult to see a doctor. Probably at that price, you will only get to see interns, student doctors.

None of the currently existing companies will provide healthcare for that price.
Even kaiser, which is a non-profit, supposedly, costs 500 a month. plus copays. I am in your age range.
My earnings are below the poverty level.

[Motown_Johnny]

15. This is still a free market system

You can pick what ever company you want and you can't be turned down due to a preexisting condition (once that kicks in). So you can choose whatever policy is best for you, even if your needs change.


If you are below 133% of the poverty level you would qualify for Medicaid (depending on how the state challenges go and what state you are in).

[Schema Thing]

19. Let me fix that sentence for you:

"All of the currently existing companies will provide healthcare for that price."



Life is better with facts.

[PoliticAverse]

29. Insurance companies don't 'provide healthcare'. n/t

[robinlynne]

33. great point.

[cherokeeprogressive]

64. Talk about life being better with FACTS lol. Why do people insist on mingling those two terms?

It amazes me.

It's almost like someone needs to remind people that HEALTH INSURANCE isn't HEALTH CARE

[robinlynne]

30. No they will not. they are going to raise current rates 9.9% this year and

each year after. A 10% rate increase triggers checking byt eh feds. Anything under 10% increase per year is acceptable.

[dionysus]

20. "Probably at that price, you will only get to see interns, student doctors. "

i'd like some proof of that. You're claiming discrimination on scheduling visits based upon what kind of payment method you use.

[robinlynne]

32. I ahve been shipping for ehalth insuracne for my Mom, 78 yeras old. Experienced doctors will

not accept the insurance I have found for her. You only get to see interns. That is already quite common now.
I'm talking blue cross, expensive insurance.

So you believe they are going to lower their rates and provide better care?

Good luck with that.

[robinlynne]

34. that is how it is right now. Unless you have insurance through an employer, or an HMO.

[pnwmom]

35. The insurance could go to any provider, except for closed systems like Kaiser.

And the insurer will pay the provider based on a previously agreed upon set-fee schedule, not based on whatever the individual has paid the insurer.

In other words, the costs of all patients seeing a provider would be paid by the insurer on the same basis, no matter what the individual patients were paying to the insurer.

[robinlynne]

50. and you think the insurance company is going to give great health care for less profit? good luck.

[pnwmom]

54. Insurance companies don't give care; doctors do.

And the radiologist, for example, will exactly receive the same payment from the insurer, whether the insured is a 30 year old who needs an MRI, or a 50 year old who needs an MRI -- even though the 50 year old has to pay more to the insurer every month.

Also, many insurance companies are non-profit. Our local blue cross/blue shield is non-profit.

[Ruby the Liberal]

59. Yes, from a cost standpoint, but not from a likelyhood one.

Someone 50+ is more likely to need care than someone who is 30, even though the care is the same.

Another way of looking at this is that if the insurance companies could have figured out a way of being profitable while covering preexisting conditions at the same rate as no-preexisting conditions, they would have already marketed that plan and cornered the market in areas where other companies didn't offer the same.

[pnwmom]

70. Again, health insurers don't have to make a profit. The best tend to be non-profit.

Why haven't health insurance companies already marketed a plan that would cover everyone with preexisting conditions? Because no insurance company could make a profit (or just break even) if they covered preexisting conditions -- unless everyone, healthy and sick, was included in the pool. That is the whole point of the mandate.

[Ikonoklast]

61. I have Kaiser, aged 57, $418 a month, have no problem seeing my doctor.

In fact, his office is pestering me to get in to see him over an issue he wants to discuss with me.

Co-pay is $20 bucks for the office visit.

I have never seen an intern or 'student doctor', but have seen Nurse Practitioners for minor ailments.

You need to find a better plan.

[The Jungle 1]

36. same boat different story

It is called freedom.
I am 55. I am stuck in my present position. Without ACA I can't retire early because no one will sell me insurance. With ACA I am free.This bill really is about freedom. I will now be able to retire early. Yo that is a big deal.

We need to scream this fact at every opportunity.

[Logical]

38. Congrats! I love hearing stories like yours! n-t

[likesmountains 52]

40. I just checked and I will be able to retire before i am eligible for Medicare

and worst case scenario premiums are < $200 per month. You can't imagine how happy this makes me.

[Logical]

41. Great news! Congrats!

[joshcryer]

44. This is quite a heartwarming thread. Being able to retire with a good conscious...

...and not being afraid. That's freedom.

[Honeycombe8]

47. You are lucky you live in a state that will have exchanges. TX won't, I think (where I am).

But I can hope.

[Zalatix]

48. Wait, woah. 15% copay? My heart, my failing heart.

15% of some things in medical care could amount to one really ugly up front co-pay.

[Roselma]

55. There will be an annual maximum out-of-pocket.

Once you have reached that, then you no longer pay more in that year. This is true of most PPO and indemnity policies currently provided by employers. You have a deductible (which counts against maximum annual out-of-pocket), sometimes a copay (which counts against maximum annual out-of-pocket), and then coinsurance (mine is 80/20 which counts against maximum annual out-of-pocket). Once you reach maximum annual out-of-pocket you don't pay 15% of anything. You've spent out of pocket all that you are required to in that year. Insurance picks up the rest.

[cherokeeprogressive]

66. So what is the maximum out-of-pocket? Hasn't the bill been written and passed already?

Everyone keeps making claims, but not giving actual facts.

[Roselma]

80. Annual max out of pocket is tiered. One way to

determine it per tier is to use the KFF subsidy calculator and see the premiums (sometimes with subsidies) and then look on that very same page (in lighter print) and read the verbiage explaining the annual maximum out of pocket for the income that was placed in the calculator:

http://healthreform.kff.org/SubsidyCalculator.aspx

Also, additional explanation is here (it is a pdf):

http://cs.infospace.com/ClickHandler.ashx?du=http%3a%2f%2fwww.kff.org%2fhealthreform%2fupload%2f8177.pdf&ru=http%3a%2f%2fwww.kff.org%2fhealthreform%2fupload%2f8177.pdf&ld=20120702&ap=1&app=1&c=info.metac&s=metacrawler&coi=239138&cop=main-title&euip=74.103.126.73&npp=1&p=0&pp=0&pvaid=8aebd2ae68214295a1a9f12c66458600&sid=1108563648.3177602116641.1341191251&vid=1108563648.3177602116641.1321655616.1801&fcoi=417&fcop=topnav&fpid=27&ep=1&mid=9&hash=6916ACBC81DBDC623DFB3D1A4A474972

[former9thward]

74. According to the OP the maximum out of pocket is 15% of total cost.

Depending on your problems that could be a huge number.

[treestar]

56. It will help a lot of people when we can finally break this employer-provided custom

I've always heard people keep jobs they hate to keep the coverage.

[RAlgarJr]

60. The catch...

The catch is exactly this:

What Government program has ever been created that was cost effective or actually worked?

Let's see... Social Security:
You're forced to pay for it your whole life. If you die before age 65, they pay your family $256, less then your first couple of payments.
If you become disabled, you application is denied until you hire some high priced attorney.. Then it's approved the first time.

It's a shell game, that's it. Some jerk politician who wants to make a name for himself, pastes this as the greatest thing since sliced bread. When it's nothing more then a get rich scheme for the people the Democrats are supposed to despise!

[cyberswede]

62. Medicare seems to work...

Do you think government is the problem, or that government can help with solutions?

[Chan790]

63. Here's two: SCHIP and NFIP. n/t

[physioex]

65. Sort of true.....

Last edited Sun Jul 1, 2012, 07:40 PM - Edit history (1)

We had an friend die around his fifties who also paid into SS. However he had two young children under 18 where SS helped a lot in their lives. I would say, what he put in he got back out. There are may people who benefited from similar situations like this including Paul Ryan. No the system is not perfect but as citizens we need to lobby our politicians to make it better.

[NRaleighLiberal]

67. Seems to me that Social Security is a real success.

I know that I will be valuing it highly when I become eligible.

[cherokeeprogressive]

69. Dude... you stepped in it now. And on your first post even.

Let me give you a clue. One NEVER disses the US Government when there is a Democrat in its highest office.

I'm sure you've just made it onto all kinds of lists kept by all kinds of DUers. Lists that are constantly rearranged and re-prioritized. Lists of posters who simply must go.

[pinto]

71. As a recipient of both Soc Sec and Medicare, I'd say "the catch" is they both work really well...

Really well. My benefits have kept a roof over my head and provided me essential health care.

[NYC_SKP]

79. Enjoy your PPR....

I miss pizza.

[Kablooie]

68. The difference for me would be $4000 under ACA in 2014 vs $16,800 today.

Luckily I found a job so my union insurance kicked in again and I didn't have to pay the $16,000 but that is what it would have cost if I hadn't been able to find work much longer.

[rbnyc]

75. I used this tool for my situation...

...and this is part of what it said:

"If the plan offered by your employer doesn’t meet the law’s standards of affordability or comprehensiveness, you can buy a different plan through your state’s exchange. Based on your income, you probably would not qualify for federal assistance to offset the cost of that plan."

So I set about trying to find out what these standards of affordability are and found this:

What This Means for You

Your insurance company can’t raise rates by 10% or more without first explaining its reasons to your state or federal Rate Review program. All explanations will be posted on Health Care.gov and your Rate Review program will give you a chance to comment on them.
Your Rate Review program will determine if the rate increase is unreasonable. A rate hike is unreasonable if, for example:
It is based on faulty assumptions or unsubstantiated trends.
It charges different prices to people who pose similar risks to the insurer.
Your state regulator can approve or reject an unreasonable or excessive rate increase, if your state laws give the regulator this authority.

Some Important Details

The Rate Review rules apply to new plans in the individual and small group markets. (If you are in a health plan that existed on March 23, 2010, your plan may be a grandfathered plan, which is exempt from the Rate Review rules.)
Starting September 1, 2012, each state may have its own minimum premium increase that requires a review, based on the state’s unique premium trends, health care cost trends, and other factors.
If your state doesn’t have a Rate Review program, or has a Rate Review program that is ineffective, the federal government will conduct Rate Reviews in your state.

So right now, my monthly premium (for a total piece of shit HMO) is about $1,500. My employer pays PART of this - and because they do, they can't afford to pay me anything close to what I'm worth. The big benefit for me and my employer is that our rates shouldn't go up more that 10% every year. Wow.

The first thing I thought of was my "rent controlled" apartment when I first moved to New York City in the mid 90s. Rent control means the landlord can only raise the rent a certain percentage under certain circumstances, so every time they have the opportunity, they surely do that. My TINY 3-room apartment with no bathtub was $1,200 a month. I know that some folks who had been in their rent controlled apartments for decades, did have very low rents - but for folks coming into the system, indeed for most folks, rent control did not affordable housing make.

I admit, I don't understand everything about this convoluted Affordable Care Act, but it seems really clear that it doesn't do what it needs to do - divorce health care from employment and from profiteering insurance companies.

EDIT: typo and just to clarify, I do not make that much money. Just enough so that I don't qualify for any type of help, but not so much that I can actually afford my co-pay to actually see a doctor, or to have prevented us from having had boiled chicken bones and pureed broccoli stems for dinner a couple nights this month.

[patrice]

76. Check out also the Patient Protection part of the Patient Protection & Affordable Care Act too

This is your, your care givers', and your doctors' tool for getting insurance companies to cover the services you need at the appropriate rates:

http://www.pcori.org/

[Yavin4]

97. If You Can Afford An iPhone or iPad or Netflix or Video Game Consoles....

then you will be able to afford health insurance under the ACA.

[cbdo2007]

120. How much extra in taxes would you have to pay in a country with single payer??

Everyone here assumes it's free.

[Yavin4]

122. Precisely. Most Nations with Single Payer Have National Sales Taxes

which are highly regressive, but that's how they fund their soical programs. Everyone pays in, and everyone benefits.

I too want Single Payer, and I would pay for it by adding a new payroll tax and a national sales tax. Single payer only works when everyone contributes to it.