"Affordable" Care Act - Yeah, Right.

Emily Cat said:
Being part of the health insurance industry, I've never been able to figure out why so many people have decided ACA is somehow a great thing for us.
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It's a compromise. It's better than no healthcare reform at all, but worse than UHC. I'm with Magyar in that it astounds me conservatives are against the "free market solution" they championed a mere twenty years ago. Less, if you consider Romneycare is same solution as the ACA and the Heritage Foundation's plan, in all the key aspects.
 
Emily Cat said:
If you're making less than 400% FPL, then you do qualify for subsidies - assuming you're purchasing through the individual market. Are you purchasing through the individual market, or is this employer-provided coverage?
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It is dependent upon percentage of your income, the lower your income the lower the percentage of income is and the cost of the insurance. Some people especially those who are near the 400% limit will not qualify depending upon the cost of the plan. (at least that is how I understand it)

For example a family of four with income of 80,000 will only qualify for a credit if the cost of insuranc is greater than 9.5% of 80,000.
 
eeyore1954 said:
It is dependent upon percentage of your income, the lower your income the lower the percentage of income is and the cost of the insurance. Some people especially those who are near the 400% limit will not qualify depending upon the cost of the plan. (at least that is how I understand it)

For example a family of four with income of 80,000 will only qualify for a credit if the cost of insuranc is greater than 9.5% of 80,000.
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I'm not sure if this link will paste through, but I put in the following inputs:

http://kff.org/interactive/subsidy-...s[0][tobacco]=0&child-count=0&child-tobacco=0

Age 30
No kids
1 adult
Income $44,000
Zipcode from Santa Fe, NM.

Results:

Household income in 2014:383% of poverty level

Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy:9.5%

Health Insurance premium in 2014 (for a silver plan, before tax credit):$2,877 per year You could receive a government tax credit subsidy of up to:$0 per year
(which covers 0% of the overall premium)

Amount you pay for the premium:$2,877 per year
(which equals 6.54% of your household income and covers 100% of the overall premium)
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Alright, fine, the Affordable Care Act is bad. Can we move on to Single-Payer now?
 
Unabogie said:
So unless you listed your roommate as a dependent and then named them in your tax return, your roommate doesn't affect your healthcare subsidies and it would be silly to even think otherwise. Wildcat was just retrieving that from an orifice that receives little sunlight.
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No, he was, apparently, citing the Census Bureau's definition of household. In which, it seems, he was mostly correct. That the Census Bureau's definition was (apparently) incorrectly attributed for use in determining subsidies for ACA coverage is a separate matter.

I was only pointing out his definition of household—which some posters seemed to scoff at—is indeed used for some official government purposes.
 
Morrigan said:
lol, I have never heard the term "household" refer to roommates in any financial context...
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Seriously?
The United States Census definition similarly turns on "separate living quarters", i.e. "those in which the occupants live and eat separately from any other persons in the building"[4] A householder in the U.S. census is the "person (or one of the people) in whose name the housing unit is owned or rented (maintained);" if no person qualifies, any adult resident of a housing unit is a householder. The U.S. government formerly used the terms "head of the household" and "head of the family" to describe householders; beginning in 1980, these terms were officially dropped from the census and replaced with "householder".[5]
A household is officially defined as follows:[6]
A household includes all the persons who occupy a housing unit. A housing unit is a house, an apartment, a mobile home, a group of rooms, or a single room that is occupied (or if vacant, is intended for occupancy) as separate living quarters. Separate living quarters are those in which the occupants live and eat separately from any other persons in the building and which have direct access from the outside of the building or through a common hall. The occupants may be a single family, one person living alone, two or more families living together, or any other group of related or unrelated persons who share living arrangements. (People not living in households are classified as living in group quarters.)
​
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http://en.wikipedia.org/wiki/Household
 
Some reasons why your premiums may go up due to the ACA:

  1. Existing health insurance policies often don't cover the same range of medical expenses (i.e. prescription drugs, physical therapy) as an ACA compliant plan. If your existing plan had less extensive coverage, you may see an increase in premiums.
  2. Existing policies may not have a cap on out of pocket expenses. ACA plans cap these at $6,350 per year for an individual. If your plan did not cap out of pocked expenses, you may see an increase in premiums.
  3. Insurance premiums are no longer dependent on pre existing conditions. If you were lucky enough to have none, you may see your costs go up.
  4. Insurance premiums no longer depend on your sex. If you are male, you may see your costs go up.
  5. The ACA limits how much premiums can vary by age. If you are young, you may see your premiums go up.
 
eeyore1954 said:
It is dependent upon percentage of your income, the lower your income the lower the percentage of income is and the cost of the insurance. Some people especially those who are near the 400% limit will not qualify depending upon the cost of the plan. (at least that is how I understand it)

For example a family of four with income of 80,000 will only qualify for a credit if the cost of insuranc is greater than 9.5% of 80,000.
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Please see my long and detailed example of how the calculation works. The most important bit is that it's not any plan - it's a particular plan. Although it's theoretically possible, most of the second lowest silver plans are going to exceed the 9.5% of income requirement.

I suppose there might be cases where someone who is very young might end up with their 2nd lowest silver cost being less than 9.5%.
 
Emily Cat said:
Please see my long and detailed example of how the calculation works. The most important bit is that it's not any plan - it's a particular plan. Although it's theoretically possible, most of the second lowest silver plans are going to exceed the 9.5% of income requirement.

I suppose there might be cases where someone who is very young might end up with their 2nd lowest silver cost being less than 9.5%.
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Did you catch my link to the Kaiser website? Assuming Newton's Bit is in Santa Fe, it looks like he would not qualify for a subsidy based on:

Age 30
No kids
1 adult
Income $44,000
Zipcode from Santa Fe, NM.

That's a pretty good example of what you're talking about.
 
I think the true effect on affordability will be still with the jury until we see the impact on prices of paying customers not having to subsidize emergency care and unpaid bills so much. That's a shoe that still needs to drop.

Another potential cost driver is that more people have multiple options instead of just one (or none) which has a competition element.
 
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Alareth said:
According to the Kaiser site, with my current paltry income of 11,000 a year I don't qualify for subsidy.

The silver plan it uses for the price calculations is nearly 30% of my yearly income, the bronze is close to 20%

http://kff.org/interactive/subsidy-...s[0][tobacco]=0&child-count=0&child-tobacco=0
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Wow, man, you're one of the people stuck with GOP governors who refused to expand Medicaid. This is something that definitely needs a fix but 100% of the blame goes to Gov. Scott.

http://america.aljazeera.com/articl...medicaidkeepsmillionsfromhealthinsurance.html

Sorry about that. I truly suggest you tell your friends about this and call your Congressman.
 
Alareth said:
According to the Kaiser site, with my current paltry income of 11,000 a year I don't qualify for subsidy.

The silver plan it uses for the price calculations is nearly 30% of my yearly income, the bronze is close to 20%

http://kff.org/interactive/subsidy-...s[0][tobacco]=0&child-count=0&child-tobacco=0
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I wonder if you could just lie and claim an income of $12,000? At that income level, a $20 per month premium buys a silver plan that pays 94% of all covered expenses.
 
Hell, it may not even be a lie, are you sure it doesn't creep towards $12K with OT and such?
 
Kestrel said:
I wonder if you could just lie and claim an income of $12,000? At that income level, a $20 per month premium buys a silver plan that pays 94% of all covered expenses.
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$11490 is the lowest to qualify, and then it suddenly pays 98% of the premium (you pay $230 yearly for a $3263 plan). The big blue "Your State Has Not Decided to Expand Medicaid" in the explanation says it all.

Maybe I could pay him $500 for 'Product Testing' and he can repay me $1000 for 'Consulting Fees'. He'll still save $2500.
 
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Ziggurat said:
You need to figure out how to read for comprehension. Here is the entire relevant paragraph:

Aside from the problems the exchange website has been experiencing, at this point there's basically no way to evaluate a lot of the plans because many of them haven't set their reimbursement rates yet and so doctors don't even know if they'll accept those plans. So you can buy a plan (if you're lucky enough to get the website to work), but you can't actually figure out what the plan offers because the providers are unknown.​

Note the highlighted parts, which include qualifiers. These make it explicit that I'm not talking about all plans, but a subset of plans. The second sentence doesn't explicitly include those qualifiers, but since it only logically follows for the subset of plans the previous qualifiers refer to, it should be obvious to any reader with a modicum of sense that the second sentence doesn't refer to all plans either.

So I'm left wondering whether you don't have a modicum of sense, or whether you're deliberately trying to misread my post.



Almost everyone will participate? Why on earth would they? Healthy young people are better off just paying the fine. And the point that cost is no longer dependent on health is exactly what drives the adverse selection problem.
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They're going to participate because the subsidies are unbelievably good:
http://kff.org/interactive/subsidy-...s[1][tobacco]=0&child-count=2&child-tobacco=0
 
Fudbucker said:
They're going to participate because the subsidies are unbelievably good:
http://kff.org/interactive/subsidy-...s[1][tobacco]=0&child-count=2&child-tobacco=0
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Not to mention that healthy young people are better off because even healthy young people want health coverage, even if they're not currently sick. When I was in my twenties my wife was in a union and we got health benefits. I was HUGELY grateful for that coverage, and I almost never went into the doctor's office.
 
Sabretooth said:
Just got my packet for my 2014 health care.

Premiums are increasing by $1,200 for the year.

Co-Pays are also increasing. Well-visits are no longer free.

So much for "affordable". Biggest misnomer in history.


It's a pile of horse crap and Obama is big *********** liar.
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You have my doubts.
 
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