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A God Damned Separate Thread For Your Argument About Obamacare
Is it the biggest piece of legislation since Medicare?
Is it the worst atrocity since the Trail of Tears?
Is it both?
Discuss it here.
EDIT - Also, for people who want information on the exchanges, www.healthcare.gov is the place you need to go to apply and find out how much insurance off the exchange would cost you, what kind of subsidies you would receive, etc.
Note that this is a very popular site and has the typical first few days technical issues, so don't be surprised if it responds about like you would expect from a government website getting hit by millions of people during a government shutdown.
There are better arguments - but it's the closest thing a layman can associate with, so it's always going to be the go-to comparison.
Someone threw the auto insurance thing at me a couple of days ago as well. He was a young guy, and didn't want health coverage. It didn't compute that he could get deathly ill, or break something, and would have to seek medical treatment. No one plans on getting sick, much like no one plans to get into a serious car accident.
The problem is a car is a tangible piece of capital. Adequate supply can replace it, as a commodity if you will. Someone's health is an orange to that apple. If someone shows up to an emergency room on deaths door, and they've willfully opted out of health coverage "Because I don't need it", what is our role as a society there? Mercy killing? Roll'em into a ditch and let nature take it's course? Of course that won't happen - we'll provide competent and compassionate care first, and then heap bills onto them they can't pay, or...we the taxpayers pick it up.
The only way I think to compare them with that bad analogy: Auto insurance protects the owner of the capital, and the aggrieved if at fault. Basically, the stakeholders (bank, insured, legal liabilities). In modern healthcare, society is a stakeholder, and they need to make sure their interests are being protected with uninsured folks using medical services.
Okay, that was kinda weak. I was stretching there. Eh.
The GOP talking point for years was "bootstraps" and no free rides.
Dems introduce a plan to eliminate the freerider problem re: ER care in health care and the GOP goes "Wharbbbbgl"
I have a face book friend crying about the ACA in her statuses. My literal response to her was "we took poli sci 201 with prof x. at the same time. Remember covering the tragedy of the commons / free riders for like 3 weeks?"
I can see how joe average can get scared into it. But someone with even just 2-3 classes in poli sci and economics and a 101 stats class should be able to understand...
Mobile browsing so i don't have a quote / the poster but he was right - it's just fucking racism by some, and blind adherence to racist party elites by others.
Racism makes a convenient excuse, and certainly contributes a bit to some wharble-garble...but let's be clear. If Hillary Clinton was in office right now and passed the ACA, the right would be bitching just as loudly. If Kerry was in office right now and passed the ACA, the right would be bitching just as loudly.
Most of the rhetoric would be the same - different or less dog whistles, but the same rhetoric. Writing it off as simple ignorant racism is giving the right too much credit.
They don't want the Federal government to mandate anything. They don't want their lobbies to make less profit. They don't want the increased taxes in a few specific areas. They don't want health care decoupled in any way from employment.
Health care is / was the new version of the company store. Obamacare breaks that control.
Not denying racism is a factor and an easy crutch for some lazy rhetoric...and it's certainly got some people who would be apathetic if this was Bill Clinton or John Kerry up in arms. But saying it's a lot more than racism.
The racist opposition isn't about the President. It's amplified by him being in office, but fundamentally it's about the same thing that's been the root of opposition to all safety net laws. Black people getting white people's stuff. Social Security was created with a ton of holes to limit the ability of blacks to benefit from it, because that was the only way for FDR to get Dixiecrat votes, for example.
And god damn have they succeeded in doing much the same thing, at least the way I understand things: How it works:
1) Medicaid expansion means more poor people who do not currently qualify for Medicaid do. Hooray!
2) Republican Governors/legislatures refuse money to implement Medicaid expansion.
3) People who qualify for Medicaid don't qualify for subsides, because they should just be on the far superior Medicaid system.
4) People just north of the poverty line, which includes a large proportion of the nation's black people, are utterly fucked and still have shit access to health care unless they live in one of the states that have accepted the free money from the federal government.
5) Mission accomplished.
The idea that your vote is a moral statement about you or who you vote for is some backwards ass libertarian nonsense. Your vote is about society. Vote to protect the vulnerable.
I have a question... I'm watching that video above on ACA 101 and looking at this infographic, and both mention the 30 million people who still won't get covered with the ACA. What combination of circumstances would need to exist so that a person has no access to healthcare at all, either through the exchanges or through Medicaid? Is it when someone just barely makes more than the upper limit of Medicaid? Wouldn't the subsidized exchange prices still apply to make it affordable, or is this person somehow not eligible for the exchanges at all?
I have a question... I'm watching that video above on ACA 101 and looking at this infographic, and both mention the 30 million people who still won't get covered with the ACA. What combination of circumstances would need to exist so that a person has no access to healthcare at all, either through the exchanges or through Medicaid? Is it when someone just barely makes more than the upper limit of Medicaid? Wouldn't the subsidized exchange prices still apply to make it affordable, or is this person somehow not eligible for the exchanges at all?
A huge factor is states that refused the Medicaid expansion, leaving a lot of people in the gap between Medicaid coverage and the 8% maximum cost of insurance premiums compared to income.
For example, a family of three that makes about $4,500$4,900 per year is too rich to qualify for Medicaid in Texas.
But in that case, that family of 3 that makes $4,900 can get subsidized insurance through the exchange for $392/year if the exchange prices are capped at 8% of a family's income (or is it 9.5%?), right? So the "30 million still uninsured" is referring to the 30 million people who cannot afford to spend 8% of their income on health insurance?
I have a question... I'm watching that video above on ACA 101 and looking at this infographic, and both mention the 30 million people who still won't get covered with the ACA. What combination of circumstances would need to exist so that a person has no access to healthcare at all, either through the exchanges or through Medicaid? Is it when someone just barely makes more than the upper limit of Medicaid? Wouldn't the subsidized exchange prices still apply to make it affordable, or is this person somehow not eligible for the exchanges at all?
A huge factor is states that refused the Medicaid expansion, leaving a lot of people in the gap between Medicaid coverage and the 8% maximum cost of insurance premiums compared to income.
For example, a family of three that makes about $4,500$4,900 per year is too rich to qualify for Medicaid in Texas.
There are better arguments - but it's the closest thing a layman can associate with, so it's always going to be the go-to comparison.
Someone threw the auto insurance thing at me a couple of days ago as well. He was a young guy, and didn't want health coverage. It didn't compute that he could get deathly ill, or break something, and would have to seek medical treatment. No one plans on getting sick, much like no one plans to get into a serious car accident.
The problem is a car is a tangible piece of capital. Adequate supply can replace it, as a commodity if you will. Someone's health is an orange to that apple. If someone shows up to an emergency room on deaths door, and they've willfully opted out of health coverage "Because I don't need it", what is our role as a society there? Mercy killing? Roll'em into a ditch and let nature take it's course? Of course that won't happen - we'll provide competent and compassionate care first, and then heap bills onto them they can't pay, or...we the taxpayers pick it up.
The only way I think to compare them with that bad analogy: Auto insurance protects the owner of the capital, and the aggrieved if at fault. Basically, the stakeholders (bank, insured, legal liabilities). In modern healthcare, society is a stakeholder, and they need to make sure their interests are being protected with uninsured folks using medical services.
Okay, that was kinda weak. I was stretching there. Eh.
I mean, insurance is like other insurance. Yes.
The justification for the requirement is completely different, which is why the auto comparison is so bad.
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ChanusHarbinger of the Spicy Rooster ApocalypseThe Flames of a Thousand Collapsed StarsRegistered User, Moderatormod
8% is whether or not you are required to buy insurance and 9.5% is how much of your income your employer is allowed to make you chip in for.
But yeah, a large part of that 30 million is people who can't find plans for less than 8% of their income and/or don't qualify for Medicaid.
I'm not sure if it includes an estimate on people opting to pay the individual fine.
Allegedly a voice of reason.
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ChanusHarbinger of the Spicy Rooster ApocalypseThe Flames of a Thousand Collapsed StarsRegistered User, Moderatormod
I have a question... I'm watching that video above on ACA 101 and looking at this infographic, and both mention the 30 million people who still won't get covered with the ACA. What combination of circumstances would need to exist so that a person has no access to healthcare at all, either through the exchanges or through Medicaid? Is it when someone just barely makes more than the upper limit of Medicaid? Wouldn't the subsidized exchange prices still apply to make it affordable, or is this person somehow not eligible for the exchanges at all?
A huge factor is states that refused the Medicaid expansion, leaving a lot of people in the gap between Medicaid coverage and the 8% maximum cost of insurance premiums compared to income.
For example, a family of three that makes about $4,500$4,900 per year is too rich to qualify for Medicaid in Texas.
Alright, was trying to play around with NY's exchange and it's been getting hammered and it's taken this long to even get to entering real information into it. Now I found something that makes me want to join Team @Spool32.
The list of health care providers you have to select your current policy includes every company doing business in NY....and isn't alphabetized. It's not organized in any fashion that I can tell. With some 200 entries. Fuckers.
Best part? It verifies your plan number...so this theoretically should be able to just happen from entering that number.
Alright, was trying to play around with NY's exchange and it's been getting hammered and it's taken this long to even get to entering real information into it. Now I found something that makes me want to join Team @Spool32.
The list of health care providers you have to select your current policy includes every company doing business in NY....and isn't alphabetized. It's not organized in any fashion that I can tell. With some 200 entries. Fuckers.
Best part? It verifies your plan number...so this theoretically should be able to just happen from entering that number.
Bah.
When I was looking around you could sort by name, premium, deductible, and catastrophic coverage percentage.
Alright, was trying to play around with NY's exchange and it's been getting hammered and it's taken this long to even get to entering real information into it. Now I found something that makes me want to join Team @Spool32.
The list of health care providers you have to select your current policy includes every company doing business in NY....and isn't alphabetized. It's not organized in any fashion that I can tell. With some 200 entries. Fuckers.
Best part? It verifies your plan number...so this theoretically should be able to just happen from entering that number.
Bah.
When I was looking around you could sort by name, premium, deductible, and catastrophic coverage percentage.
This was just in the info gathering stage. I have insurance currently and it asked me to enter it. This was a simple dropdown with like 200 entries.
That every citizen so enrolled and notified, shall, within six months thereafter, provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch with a box therein to contain not less than twenty-four cartridges, suited to the bore of his musket or firelock, each cartridge to contain a proper quantity of powder and ball: or with a good rifle, knapsack, shot-pouch and powder-horn, twenty balls suited to the bore of his rifle, and a quarter of a pound of powder;
You have to sign up for the militia and buy a gun/bayonette/ammo/etc at your own expense. It was passed by the 2nd Congress(which was choked full of constitutional delegates) and signed by George Washington.
That every citizen so enrolled and notified, shall, within six months thereafter, provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch with a box therein to contain not less than twenty-four cartridges, suited to the bore of his musket or firelock, each cartridge to contain a proper quantity of powder and ball: or with a good rifle, knapsack, shot-pouch and powder-horn, twenty balls suited to the bore of his rifle, and a quarter of a pound of powder;
You have to sign up for the militia and buy a gun/bayonette/ammo/etc at your own expense. It was passed by the 2nd Congress(which was choked full of constitutional delegates) and signed by George Washington.
and at the time they were state miltias so there's even less of a interstate commerce argument there than for health insurance
So I was just talking to my parents on the phone, and they're very uninspired by this whole thing. According to their calculations they can't afford even the most basic of plans, and so will have to defer and pay a fine.
Is that actually how it works? I'm more than a little unhappy that they will have to pay money because they can't afford to pay for insurance.
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ChanusHarbinger of the Spicy Rooster ApocalypseThe Flames of a Thousand Collapsed StarsRegistered User, Moderatormod
So I was just talking to my parents on the phone, and they're very uninspired by this whole thing. According to their calculations they can't afford even the most basic of plans, and so will have to defer and pay a fine.
Is that actually how it works? I'm more than a little unhappy that they will have to pay money because they can't afford to pay for insurance.
If the most basic plan is less than 8% of their income, they would have to pay the fine, yes.
There are other factors about the cost than just the premium, though. Are they eligible for subsidies?
There are better arguments - but it's the closest thing a layman can associate with, so it's always going to be the go-to comparison.
Someone threw the auto insurance thing at me a couple of days ago as well. He was a young guy, and didn't want health coverage. It didn't compute that he could get deathly ill, or break something, and would have to seek medical treatment. No one plans on getting sick, much like no one plans to get into a serious car accident.
The problem is a car is a tangible piece of capital. Adequate supply can replace it, as a commodity if you will. Someone's health is an orange to that apple. If someone shows up to an emergency room on deaths door, and they've willfully opted out of health coverage "Because I don't need it", what is our role as a society there? Mercy killing? Roll'em into a ditch and let nature take it's course? Of course that won't happen - we'll provide competent and compassionate care first, and then heap bills onto them they can't pay, or...we the taxpayers pick it up.
The only way I think to compare them with that bad analogy: Auto insurance protects the owner of the capital, and the aggrieved if at fault. Basically, the stakeholders (bank, insured, legal liabilities). In modern healthcare, society is a stakeholder, and they need to make sure their interests are being protected with uninsured folks using medical services.
Okay, that was kinda weak. I was stretching there. Eh.
I mean, insurance is like other insurance. Yes.
The justification for the requirement is completely different, which is why the auto comparison is so bad.
The whole thing breaks down with "you aren't required to own a car". It's just oversimplification, like most of these arguments. See, the "household budget should be same as govt budget" nonsense.
This isnt to mention that your car insurance is so when you accidentally do something awful to someone else, you are covered for it and they aren't fucked.
So I was just talking to my parents on the phone, and they're very uninspired by this whole thing. According to their calculations they can't afford even the most basic of plans, and so will have to defer and pay a fine.
Is that actually how it works? I'm more than a little unhappy that they will have to pay money because they can't afford to pay for insurance.
If the most basic plan is less than 8% of their income, they would have to pay the fine, yes.
There are other factors about the cost than just the premium, though. Are they eligible for subsidies?
Not as far as I know, no. If 8% is the mark, then yeah, they're fucked. I know the ACA isn't and can't be tailored to outliers, but that still sucks. Blargh.
Still, I should probably go over their stuff and look for outs they might have missed.
So I was just talking to my parents on the phone, and they're very uninspired by this whole thing. According to their calculations they can't afford even the most basic of plans, and so will have to defer and pay a fine.
Is that actually how it works? I'm more than a little unhappy that they will have to pay money because they can't afford to pay for insurance.
"Can't afford" means different things to different people. Here are the numbers:
If the cheapest bronze plan available costs more than 8% of your income, then you are exempt from the mandate.
Yeah, I mean there are plenty of exemptions out there for people who truly 'can't afford' insurance.
I'd be very interested to see the specifics of anyone who claims their specific circumstances make them unable to afford insurance, but also not qualify for any of those exemptions. Especially someone the age of anyone on here's parents, who likely have at least some moderate medical bills / prescription costs to begin with.
EDIT - more likely than not, someone who believes that has a fundamental misunderstanding or is making a miscalculation in determining their ability to pay. Especially when taking the fine into consideration.
So I was just talking to my parents on the phone, and they're very uninspired by this whole thing. According to their calculations they can't afford even the most basic of plans, and so will have to defer and pay a fine.
Is that actually how it works? I'm more than a little unhappy that they will have to pay money because they can't afford to pay for insurance.
"Can't afford" means different things to different people. Here are the numbers:
If the cheapest bronze plan available costs more than 8% of your income, then you are exempt from the mandate.
If they make less than $62k a year (the cutoff for a family of 2), they'll qualify for a subsidy.
A few other categories of people are exempt (reservation residents and so forth) but I'm guessing those probably don't apply here.
Thanks for the details. But yeah, that lines up with what I was looking at.
The fine thankfully isn't killer, just annoying and unfair from their perspective. But I think they do get the outlier thing, so at least there's that. I'm just hopeful they overlooked something
So I was just talking to my parents on the phone, and they're very uninspired by this whole thing. According to their calculations they can't afford even the most basic of plans, and so will have to defer and pay a fine.
Is that actually how it works? I'm more than a little unhappy that they will have to pay money because they can't afford to pay for insurance.
Have they entered thier info into the system and checked? Cause it's not exactly the most straight forward of calculations-nor should it be really.
I would imagine <8% of their income for insurance would be a worthwhile expenditure
Yeah they're getting up there.
Not having lived in the states most of their lives, they're pretty much buried with expenses that don't earn them tax credit. They make a decent living by the numbers, but there's literally no money. I know that's not a normal circumstance so I'm not sure if they calculated wrong or if their situation just isn't something you build nation-wide laws around.
If I wanted to seriously go over the options, is the government ACA website the best option? or are there any known third party sites that have a better breakdown? If they have to pay a fine I figure there has to be at least a reasonable plan to spend the fine money on
I would imagine <8% of their income for insurance would be a worthwhile expenditure
Yeah they're getting up there.
Not having lived in the states most of their lives, they're pretty much buried with expenses that don't earn them tax credit. They make a decent living by the numbers, but there's literally no money. I know that's not a normal circumstance so I'm not sure if they calculated wrong or if their situation just isn't something you build nation-wide laws around.
If I wanted to seriously go over the options, is the government ACA website the best option? or are there any known third party sites that have a better breakdown? If they have to pay a fine I figure there has to be at least a reasonable plan to spend the fine money on
If they go to www.healthcare.gov and apply, they should be able to calculate their costs and look at available plans. This is the place to go, although some people (Spool for example) have had some issues with the page.
Some states also provide their own exchange, but since I don't know what state your parents live in the www.healthcare.gov site is probably the best bet.
I really would be shocked to see the fine + their out of pocket medical expenses be substantially less than honest to god insurance.
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ChanusHarbinger of the Spicy Rooster ApocalypseThe Flames of a Thousand Collapsed StarsRegistered User, Moderatormod
Yeah, I mean there are plenty of exemptions out there for people who truly 'can't afford' insurance.
I'd be very interested to see the specifics of anyone who claims their specific circumstances make them unable to afford insurance, but also not qualify for any of those exemptions. Especially someone the age of anyone on here's parents, who likely have at least some moderate medical bills / prescription costs to begin with.
EDIT - more likely than not, someone who believes that has a fundamental misunderstanding or is making a miscalculation in determining their ability to pay. Especially when taking the fine into consideration.
@spool32 fell into a pretty serious gap from what he was saying in another thread, if he would be so kind to explain again. It was agreed that it was a pretty big miss at the time by the thread, and it seemed like a pretty big miss on covering families. I dont know if he falls into "unable to afford" afterwards though.
Here is an article I just stumbled upon that goes a little bit into the ACA coverage gaps. Apparently there's a minimum amount you must make in order to qualify for the subsidized prices, which seems really odd. I guess because they're supposed to flow right into Medicaid, except for people who live in states that didn't expand Medicare? God that sucks.
Here is an article I just stumbled upon that goes a little bit into the ACA coverage gaps. Apparently there's a minimum amount you must make in order to qualify for the subsidized prices, which seems really odd. I guess because they're supposed to flow right into Medicaid, except for people who live in states that didn't expand Medicare? God that sucks.
I think the idea was people under a certain income level would go on Medicaid and States wouldn't be such bullshit partisans as to refuse free money to expand Medicaid and leave the working poor on the hook, right?
Yeah, I mean there are plenty of exemptions out there for people who truly 'can't afford' insurance.
I'd be very interested to see the specifics of anyone who claims their specific circumstances make them unable to afford insurance, but also not qualify for any of those exemptions. Especially someone the age of anyone on here's parents, who likely have at least some moderate medical bills / prescription costs to begin with.
EDIT - more likely than not, someone who believes that has a fundamental misunderstanding or is making a miscalculation in determining their ability to pay. Especially when taking the fine into consideration.
@spool32 fell into a pretty serious gap from what he was saying in another thread, if he would be so kind to explain again. It was agreed that it was a pretty big miss at the time by the thread, and it seemed like a pretty big miss on covering families. I dont know if he falls into "unable to afford" afterwards though.
My situation:
I have a minimum value plan offered to me at work, for which I pay zero for myself. I pay about $500/month for my family, and still have copays and deductibles. A pretty decent plan all things considered.
I want to shop on the exchanges to see if I can get a better deal but because my employer offers a plan, I won't get a subsidy even though I qualify for one otherwise. Furthermore, if I wanted to ditch my plan I would need to negotiate with my boss to capture the $815 employer contribution as cash in my paycheck. This is of course non-trivial.
I also have a problem with the enrollment window, which forced me to elect my employer's plan because the window for the year closed on the Friday before the Exchanges opened, and there was no price info to compare against. If I want to buy a plan on the exchange now, I will have to either get divorced, suffer a death in my immediate family, or quit my job.
----
There exists a larger hole to fall into. If I were unable to afford the $500/month to cover my family, I would still not qualify for the subsidy because my employer offers me personally a free plan. So I would be left in a situation where I could not buy insurance for my family through my employer, and I could not afford it on the Exchange either, because the subsidy is disallowed. My wife and kids would be left without insurance regardless of the ACA. If I were only a little bit poorer than I am, this would be a situation I'd have to deal with.
Now, it appears that the wife and kids could apply independently, but to do that I would need to file a separate IRS return from her in 2014, and that would dramatically raise my tax liability due to no longer having dependents to claim. So it's a wash either way (though this is sort of an open question on the exact figured and I don't think the tax law is very clear on this at all yet).
Here is an article I just stumbled upon that goes a little bit into the ACA coverage gaps. Apparently there's a minimum amount you must make in order to qualify for the subsidized prices, which seems really odd. I guess because they're supposed to flow right into Medicaid, except for people who live in states that didn't expand Medicare? God that sucks.
I think the idea was people under a certain income level would go on Medicaid and States wouldn't be such bullshit partisans as to refuse free money to expand Medicaid and leave the working poor on the hook, right?
There is a legitimate concern that, having taken the money, the States would be subjected to what amounts to blackmail by the federal government in areas unrelated to healthcare. This is a thing that already occurs with federal highway and education funding. For example, the reason the speed limits were once 55mph and the drinking age is 21 is that the federal government threatened to withhold federal highway dollars unless the States all enacted laws to that effect.
Here is an article I just stumbled upon that goes a little bit into the ACA coverage gaps. Apparently there's a minimum amount you must make in order to qualify for the subsidized prices, which seems really odd. I guess because they're supposed to flow right into Medicaid, except for people who live in states that didn't expand Medicare? God that sucks.
I think the idea was people under a certain income level would go on Medicaid and States wouldn't be such bullshit partisans as to refuse free money to expand Medicaid and leave the working poor on the hook, right?
See what you're missing here is that those states are being more efficient than the federal government at providing medical care because...
Nah I can't even finish it. You want to champion state's rights for vital shit and this is what it gets you.
Here is an article I just stumbled upon that goes a little bit into the ACA coverage gaps. Apparently there's a minimum amount you must make in order to qualify for the subsidized prices, which seems really odd. I guess because they're supposed to flow right into Medicaid, except for people who live in states that didn't expand Medicare? God that sucks.
I think the idea was people under a certain income level would go on Medicaid and States wouldn't be such bullshit partisans as to refuse free money to expand Medicaid and leave the working poor on the hook, right?
There is a legitimate concern that, having taken the money, the States would be subjected to what amounts to blackmail by the federal government in areas unrelated to healthcare. This is a thing that already occurs with federal highway and education funding. For example, the reason the speed limits were once 55mph and the drinking age is 21 is that the federal government threatened to withhold federal highway dollars unless the States all enacted laws to that effect.
This is not a legitimate concern! The supreme court has said so!
There is no reason to do it beyond sheer malice and hatred of the Democratic Party/The Poor. These governors are literally leaving poor citizens who need healthcare to go without out of spite, many of whom die of otherwise treatable conditions
they are monsters
override367 on
+11
ChanusHarbinger of the Spicy Rooster ApocalypseThe Flames of a Thousand Collapsed StarsRegistered User, Moderatormod
Here is an article I just stumbled upon that goes a little bit into the ACA coverage gaps. Apparently there's a minimum amount you must make in order to qualify for the subsidized prices, which seems really odd. I guess because they're supposed to flow right into Medicaid, except for people who live in states that didn't expand Medicare? God that sucks.
I think the idea was people under a certain income level would go on Medicaid and States wouldn't be such bullshit partisans as to refuse free money to expand Medicaid and leave the working poor on the hook, right?
There is a legitimate concern that, having taken the money, the States would be subjected to what amounts to blackmail by the federal government in areas unrelated to healthcare. This is a thing that already occurs with federal highway and education funding. For example, the reason the speed limits were once 55mph and the drinking age is 21 is that the federal government threatened to withhold federal highway dollars unless the States all enacted laws to that effect.
As we covered last time we argued about this, this has not been a legitimate concern since after the Supreme Court decision barring that.
No, I still have my employer coverage (though the price went up $50/month). My situation isn't one that can be tl;dr to "ACA is bad". It's just not going to work for me unless I can do a tricky salary negotiation and good plans exist for fewer dollars.
However, as I said, if I couldn't afford the $500 I would be screwed for family coverage regardless of the ACA, because my employer plan prevents me from getting a subsidy even if I otherwise made little enough to get almost all of it covered on the Exchange.
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Rand Paul 2016
There are better arguments - but it's the closest thing a layman can associate with, so it's always going to be the go-to comparison.
Someone threw the auto insurance thing at me a couple of days ago as well. He was a young guy, and didn't want health coverage. It didn't compute that he could get deathly ill, or break something, and would have to seek medical treatment. No one plans on getting sick, much like no one plans to get into a serious car accident.
The problem is a car is a tangible piece of capital. Adequate supply can replace it, as a commodity if you will. Someone's health is an orange to that apple. If someone shows up to an emergency room on deaths door, and they've willfully opted out of health coverage "Because I don't need it", what is our role as a society there? Mercy killing? Roll'em into a ditch and let nature take it's course? Of course that won't happen - we'll provide competent and compassionate care first, and then heap bills onto them they can't pay, or...we the taxpayers pick it up.
The only way I think to compare them with that bad analogy: Auto insurance protects the owner of the capital, and the aggrieved if at fault. Basically, the stakeholders (bank, insured, legal liabilities). In modern healthcare, society is a stakeholder, and they need to make sure their interests are being protected with uninsured folks using medical services.
Okay, that was kinda weak. I was stretching there. Eh.
The racist opposition isn't about the President. It's amplified by him being in office, but fundamentally it's about the same thing that's been the root of opposition to all safety net laws. Black people getting white people's stuff. Social Security was created with a ton of holes to limit the ability of blacks to benefit from it, because that was the only way for FDR to get Dixiecrat votes, for example.
And god damn have they succeeded in doing much the same thing, at least the way I understand things: How it works:
1) Medicaid expansion means more poor people who do not currently qualify for Medicaid do. Hooray!
2) Republican Governors/legislatures refuse money to implement Medicaid expansion.
3) People who qualify for Medicaid don't qualify for subsides, because they should just be on the far superior Medicaid system.
4) People just north of the poverty line, which includes a large proportion of the nation's black people, are utterly fucked and still have shit access to health care unless they live in one of the states that have accepted the free money from the federal government.
5) Mission accomplished.
A huge factor is states that refused the Medicaid expansion, leaving a lot of people in the gap between Medicaid coverage and the 8% maximum cost of insurance premiums compared to income.
For example, a family of three that makes about $4,500$4,900 per year is too rich to qualify for Medicaid in Texas.
E: Fixed:
But in that case, that family of 3 that makes $4,900 can get subsidized insurance through the exchange for $392/year if the exchange prices are capped at 8% of a family's income (or is it 9.5%?), right? So the "30 million still uninsured" is referring to the 30 million people who cannot afford to spend 8% of their income on health insurance?
Holy fuck I thought you missed a zero.
I mean, insurance is like other insurance. Yes.
The justification for the requirement is completely different, which is why the auto comparison is so bad.
But yeah, a large part of that 30 million is people who can't find plans for less than 8% of their income and/or don't qualify for Medicaid.
I'm not sure if it includes an estimate on people opting to pay the individual fine.
NEWP
The list of health care providers you have to select your current policy includes every company doing business in NY....and isn't alphabetized. It's not organized in any fashion that I can tell. With some 200 entries. Fuckers.
Best part? It verifies your plan number...so this theoretically should be able to just happen from entering that number.
Bah.
When I was looking around you could sort by name, premium, deductible, and catastrophic coverage percentage.
This was just in the info gathering stage. I have insurance currently and it asked me to enter it. This was a simple dropdown with like 200 entries.
E: WAS. I WAS shopping plans
http://en.wikipedia.org/wiki/Militia_Acts_of_1792#Second_Militia_Act_of_1792
You have to sign up for the militia and buy a gun/bayonette/ammo/etc at your own expense. It was passed by the 2nd Congress(which was choked full of constitutional delegates) and signed by George Washington.
and at the time they were state miltias so there's even less of a interstate commerce argument there than for health insurance
Is that actually how it works? I'm more than a little unhappy that they will have to pay money because they can't afford to pay for insurance.
If the most basic plan is less than 8% of their income, they would have to pay the fine, yes.
There are other factors about the cost than just the premium, though. Are they eligible for subsidies?
The whole thing breaks down with "you aren't required to own a car". It's just oversimplification, like most of these arguments. See, the "household budget should be same as govt budget" nonsense.
This isnt to mention that your car insurance is so when you accidentally do something awful to someone else, you are covered for it and they aren't fucked.
Not as far as I know, no. If 8% is the mark, then yeah, they're fucked. I know the ACA isn't and can't be tailored to outliers, but that still sucks. Blargh.
Still, I should probably go over their stuff and look for outs they might have missed.
"Can't afford" means different things to different people. Here are the numbers:
If the cheapest bronze plan available costs more than 8% of your income, then you are exempt from the mandate.
If you have bona fide economic hardship, then you are exempt from the mandate.
If they make less than $62k a year (the cutoff for a family of 2), they'll qualify for a subsidy.
A few other categories of people are exempt (reservation residents and so forth) but I'm guessing those probably don't apply here.
the "no true scotch man" fallacy.
if they make less than $62k they probably can afford a plan because subsidy
I'd be very interested to see the specifics of anyone who claims their specific circumstances make them unable to afford insurance, but also not qualify for any of those exemptions. Especially someone the age of anyone on here's parents, who likely have at least some moderate medical bills / prescription costs to begin with.
EDIT - more likely than not, someone who believes that has a fundamental misunderstanding or is making a miscalculation in determining their ability to pay. Especially when taking the fine into consideration.
Thanks for the details. But yeah, that lines up with what I was looking at.
The fine thankfully isn't killer, just annoying and unfair from their perspective. But I think they do get the outlier thing, so at least there's that. I'm just hopeful they overlooked something
I would imagine <8% of their income for insurance would be a worthwhile expenditure
Have they entered thier info into the system and checked? Cause it's not exactly the most straight forward of calculations-nor should it be really.
Yeah they're getting up there.
Not having lived in the states most of their lives, they're pretty much buried with expenses that don't earn them tax credit. They make a decent living by the numbers, but there's literally no money. I know that's not a normal circumstance so I'm not sure if they calculated wrong or if their situation just isn't something you build nation-wide laws around.
If I wanted to seriously go over the options, is the government ACA website the best option? or are there any known third party sites that have a better breakdown? If they have to pay a fine I figure there has to be at least a reasonable plan to spend the fine money on
If they go to www.healthcare.gov and apply, they should be able to calculate their costs and look at available plans. This is the place to go, although some people (Spool for example) have had some issues with the page.
Some states also provide their own exchange, but since I don't know what state your parents live in the www.healthcare.gov site is probably the best bet.
I really would be shocked to see the fine + their out of pocket medical expenses be substantially less than honest to god insurance.
@spool32 fell into a pretty serious gap from what he was saying in another thread, if he would be so kind to explain again. It was agreed that it was a pretty big miss at the time by the thread, and it seemed like a pretty big miss on covering families. I dont know if he falls into "unable to afford" afterwards though.
I think the idea was people under a certain income level would go on Medicaid and States wouldn't be such bullshit partisans as to refuse free money to expand Medicaid and leave the working poor on the hook, right?
My situation:
I have a minimum value plan offered to me at work, for which I pay zero for myself. I pay about $500/month for my family, and still have copays and deductibles. A pretty decent plan all things considered.
I want to shop on the exchanges to see if I can get a better deal but because my employer offers a plan, I won't get a subsidy even though I qualify for one otherwise. Furthermore, if I wanted to ditch my plan I would need to negotiate with my boss to capture the $815 employer contribution as cash in my paycheck. This is of course non-trivial.
I also have a problem with the enrollment window, which forced me to elect my employer's plan because the window for the year closed on the Friday before the Exchanges opened, and there was no price info to compare against. If I want to buy a plan on the exchange now, I will have to either get divorced, suffer a death in my immediate family, or quit my job.
----
There exists a larger hole to fall into. If I were unable to afford the $500/month to cover my family, I would still not qualify for the subsidy because my employer offers me personally a free plan. So I would be left in a situation where I could not buy insurance for my family through my employer, and I could not afford it on the Exchange either, because the subsidy is disallowed. My wife and kids would be left without insurance regardless of the ACA. If I were only a little bit poorer than I am, this would be a situation I'd have to deal with.
Now, it appears that the wife and kids could apply independently, but to do that I would need to file a separate IRS return from her in 2014, and that would dramatically raise my tax liability due to no longer having dependents to claim. So it's a wash either way (though this is sort of an open question on the exact figured and I don't think the tax law is very clear on this at all yet).
so you're losing your employer coverage? or ?
There is a legitimate concern that, having taken the money, the States would be subjected to what amounts to blackmail by the federal government in areas unrelated to healthcare. This is a thing that already occurs with federal highway and education funding. For example, the reason the speed limits were once 55mph and the drinking age is 21 is that the federal government threatened to withhold federal highway dollars unless the States all enacted laws to that effect.
See what you're missing here is that those states are being more efficient than the federal government at providing medical care because...
Nah I can't even finish it. You want to champion state's rights for vital shit and this is what it gets you.
This is not a legitimate concern! The supreme court has said so!
There is no reason to do it beyond sheer malice and hatred of the Democratic Party/The Poor. These governors are literally leaving poor citizens who need healthcare to go without out of spite, many of whom die of otherwise treatable conditions
they are monsters
As we covered last time we argued about this, this has not been a legitimate concern since after the Supreme Court decision barring that.
No, I still have my employer coverage (though the price went up $50/month). My situation isn't one that can be tl;dr to "ACA is bad". It's just not going to work for me unless I can do a tricky salary negotiation and good plans exist for fewer dollars.
However, as I said, if I couldn't afford the $500 I would be screwed for family coverage regardless of the ACA, because my employer plan prevents me from getting a subsidy even if I otherwise made little enough to get almost all of it covered on the Exchange.