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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsWhy is nothing being done about the family glitch?
So much is being done for people who lost their worthless insurance policies, but absolutely nothing is being done about the family glitch. Anyone who has access to health insurance through an employer is ineligible for subsidies, regardless of income. This includes spouses and children of workers as well. But the 9.5% affordability test doesn't count the premiums of spouses and children. It only counts the premium of the worker. It also does not count co-pays and deductibles. As a result, many low income workers are paying for family health coverage they can't afford to use and are ineligible for the subsidies and cost-sharing they desperately need. Families making 139% FPL can't afford the $5,000 deductibles and $10,000 annual out of pocket maximums for family coverage that many employers offer. What are people in those low income families that have expensive chronic conditions like diabetes or cancer supposed to do? Both of these conditions are fairly common and most if not all of these people end up owing a huge chunk if not all of their deductible every year. Another thing that's fairly common in the US is low paying service jobs. How many people working at low income service jobs have families? The government is doing everything to help the people whose worthless insurance policies got cancelled, but nothing for low income families caught in the family glitch. If I'm wrong and something is being done, someone please tell me what. I really want to be wrong.
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progressoid
(50,786 posts)That would be me.
loudsue
(14,087 posts)ours.
Our deductible is $10,000, our co-pays really high, and our coverage sucks. They won't pay for sleep apnea equipment (CPAP machines, masks, hoses, etc), or any other type of hardware, and United Health care tells my doctor what she can and cannot prescribe for me, if they are going to cover the cost of it. All for $500 per month for one person under a group policy. We'd be much better off if the company dropped this awful policy, and let everyone go out on the marketplace.
Of course, North Carolina was Koched in 2012, and we now have republican house, senate and governor for the first time in over 100 years, so we are 100% screwed.
freebrew
(1,917 posts)spouse makes almost poverty level wages. Her insurance is $0. For me, it's $385/mo. That's 25% of her income. No co-pays, can't chose our doctor, no dental or vision. I'm on fixed income.
Yeah, some of us are getting the butt end of this deal.
loudsue
(14,087 posts)get covered that wants or needs to.
I actually blame it on the republicans that certain details couldn't be worked out to help folks in our situation...they were so hostile to the entire program, that we were lucky to get anything passed at all.
The fact that Obama NEVER floated single payer also makes me disappointed, because he might have gotten a better compromise if he hadn't started negotiating to the right of the middle.
We, as a people, are still better off than we were, and I'm REALLY glad for my fellow citizens who are getting great health care at (often) reduced prices.
It will probably take time to fix the glitches for the rest of us who are caught in the corporate insurance squeeze.
freebrew
(1,917 posts)make no mistake, I wholly blame the publicans and dinos for the problems.
Single payer, ala Britain is the way to go.
Kennedy told us we could accomplish anything as a nation.
Reagan told us the rich didn't care to participate.
Barack_America
(28,876 posts)...which demonstrates that legislators clearly foresaw that the "glitch" would leave many families unable to afford insurance.
So, no, under the ACA not "everyone can get covered that wants or needs to". In fact, millions of people were intentionally excluded.
aroach
(212 posts)I've just had it. I was so hopeful that things would finally get better for us when we could get subsidies for our insurance that we can't afford to use. My kids will not have anything under the tree this Christmas -- not even a chocolate Santa. I don't even have enough groceries to make it to payday on the 31st. One of my kids is on the autism spectrum and we still can't get any help. I am so sick of everyone but us getting help that I'm about to turn in my liberal card. I probably shouldn't be spending the money for gas to go vote anyway.
SharonAnn
(13,906 posts)Don't turn in your Liberal card yet! What we need is more "Liberal", not less.
I'm expecting that it will be addressed through various proposed bills in Congress and we have to fight the GOP to get them passed.
If there are no Liberals fighting for this, it won't get addressed.
I'm so sorry that this has affected your family so badly and I'm going to keep fighting to get these issues addressed for you and all the others who are hurt by them.
MrsKirkley
(180 posts)The Republicans are even worse with their get sick die quickly mentality, but the president should be doing something about the family glitch instead of only those whose policies got cancelled. I'm so sorry to hear about your lack of presents for Christmas. Does your area have a toys for tots type program where the public donates new toys and parents go to a room full of toys and pick out toys for their children?
Yes, they do have such programs here but I did not apply for them because I thought I would be able to figure something out. And I might have if the car hadn't broken down on Tuesday. We never qualify for anything though so it probably would have been an exercise in frustration.
The family glitch is awful. My husband's employer pays a large share of his portion of the premium but the part that costs a fortune is adding me and the kids. Our deductible is high and we pay 20% co-insurance rather than a co-pay. We still owe for my son's OT, PT and other therapies from two years ago and none of his doctors will even make him an appointment until we pay it so I'm not sure why we even kept the insurance. We literally can't use it if no one will make us appointments because of last year and the year before deductibles and co-insurance not being paid. His OT was $800 a month after insurance. That was our 20%. Who can pay that?
stocksthatgoup
(28 posts)I don't get to choose my own doctor but hell it is free!!!
MrsKirkley
(180 posts)yet bending over backwards to help those who lost worthless policies. It makes no sense to me. Since so many Democrats are low income Americans, isn't it in the best interests of our party to focus on fixing the family glitch instead of keeping worthless insurance policies active? I sure would like to ask President Obama that question.
Yo_Mama
(8,303 posts)So you are in the same boat. It's not a good one, though.
Jim Lane
(11,175 posts)He's made some fixes through executive order -- some of which, candidly, were a little dubious in terms of his authority to do so unilaterally.
As to the family glitch, I don't see the vaguest shred of an argument that would justify his addressing it by executive order. It's just too fundamental of a problem, and fixing it would require increasing the government's expenditures. He really needs an "ACA fix" bill to address that and a few other things.
Has he sounded out any House Republicans about getting such a bill passed? I don't know. It wouldn't surprise me if he raised the subject and they laughed in his face. No Republican who fears a Tea Party primary (which is pretty much all of them) is going to support a bill that does anything to Obamacare other than defund it.
Still, I agree with you to the extent of saying that Obama should at least try, publicly -- but more to create a 2014 campaign issue than in the expectation of getting anything done. A "fix" bill could address the family glitch and the problems caused by the refusal of many states to expand Medicaid. (The result of that is some people are too poor to get subsidies, truly a silly result. IIRC, it arose because the Supreme Court set aside the portion of the ACA that required Medicaid expansion. Thus, the bill as passed envisioned that everyone below the poverty line would be on Medicaid, and therefore wouldn't need subsidies.)
The RW likes to make a lot of noise about Congress supposedly "exempting itself" from Obamacare. It's nonsense, and to the extent that Congressmembers are treated differently from other federal employees it's because of the Grassley Amendment, pushed and support by Republicans. Nevertheless, a "fix" bill could also provide that members of Congress and their staffs are to be treated exactly the same way as other nonunionized civilian employees of the federal government. Then when they vote against it, their hypocrisy is obvious.
logosoco
(3,209 posts)Last edited Sat Dec 21, 2013, 02:32 PM - Edit history (1)
Well, we may come within a hair's breath of qualifying for subsidies. We won't know for a while because I had to mail a paper application (I was crashing the healthcare.gov site and decided to use the old fashioned way).
Luckily my family does not have chronic health issues (well, i have some but don't see a doctor because I am not interested in pain pills that tear up my stomach and make me sleep my life away).
It makes me angry, but I am trying to look at this as getting the ball rolling in the right direction. It will be hard on the budget if we have to get this health insurance and then not even use it, but maybe someday it will pay off. I joked to my adult kids who will be on the policy with us that if they are going to get sick, make it something big because it is kind of in for a penny, in for a pound!
I heard a rumor there will be no penalty for those who can't afford a plan because of not being able to afford what is offered.
Another thing that I noticed about the application, it is all about income, not medical history. I would like for there to be an option for those who don't need the health care so much, but can pay for a lesser policy in the off chance an appendix goes out or a leg gets broken. A cheap plan just for that I could probably afford. Kind of like with car insurance, I have the policy that covers any damage to other cars, or I can pay more and get the kind that covers my car, too.
They need more options for folks like us. And we need to get closer to a public option.
EDIT to add...
We may only get a subsidy this year because the open enrollment from the insurance at my husband's work closed by the time I tried applying on the marketplace. Next year is a whole new ball of wax! Hopefully they have this glitch fixed by then!
TheKentuckian
(26,314 posts)The seed was planted by the wrongheaded nature of the essential "worldview" baked into the plan that sees much and perhaps most of the problems in our health care system are born of a lack of individual responsibility, including even the worst excesses of the insurance cartel seem to be framed as a response to consumer irresponsibility.
When you start from this jaundiced perspective the first priority is more likely to be to make sure no one is getting over and not living up to their obligations to the cartel rather than making sure folks have affordable care. Hell, when did we have anything resembling a substantive debate on the definition of affordable at all?
This isn't a surprise, it was just another item thrown onto the "we'll fix it later pile" with underhanded knowledge that the idea was subsidy shaving and a way to push "individual responsibly" by encouraging via code for everyone to carry their own policy because the cartel wrote the bill.
stocksthatgoup
(28 posts)Nancy Pelosi!
stymerson
(4 posts)
Demo_Chris
(6,234 posts)Trying to pretend otherwise doesn't help anyone. The goal here is to make healthcare affordable for everyone, not to score political points.
stymerson
(4 posts)Nowhere does the OP criticize the ACA.
This is what the OP said:
"It's funny how before the 2012 election, every DU thread about Obamacare was in favor of it. But soon after the 2012 election, and especially starting around October 2013, there have been soooooo many threads where the DUers are bashing Obamacare."
"Why did they all of a sudden change their minds? The Obamacare that they are bashing now is the same Obamacare that they supported for five years. Why are they now, all of a sudden, changing their minds about it? "
As a lurker at both Free Republic and DU, and who is too young to vote anyway, I think the writer's question is legitimate and deserves to be answered.
The ACA that is being so heavily criticized by so many on the left today today is the same ACA that was being praised so heavily by the left in 2010. The poll numbers show a huge drop in support for the ACA over the past few months. Why is this? It's the same law now that it was then. Since it's the same law now that it was, why are so many people who praised it then, criticizing it now?
The Freepers may be inbred, scientifically illiterate imbeciles, but at least they are consistent in their opinions of the ACA.
My social studies teacher says France has the world's best health care at only half the cost of our system. So why can't we just copy what they do?
Demo_Chris
(6,234 posts)In any case, some of us -- perhaps many of us -- remain as critical of the ACA today as we were when it was under debate. The criticisms and concerns we had then remain just as valid today, and seeing how poorly the thing has been implemented more concerns have been added to the list. But done is done. The Obama administration and their pals in the Insurance Industry got what they wanted, the cheerleaders are out front waving their pom poms and flashing their knickers, and the only thing left is to see how bad the score ultimately gets.
Why didn't we do something better? Because there is money to be made doing it this way, and the people in Washington don't care about the health of the people, they care about the health of their wallets.
stymerson
(4 posts)I don't even understand exactly what this "glitch" is - but whatever it is, it must have been part of the ACA that the President signed nearly four years ago.
I don't understand why they are even calling it a "glitch" because that word is usually reserved for something that is an accident. I would assume that the ACA was discussed, written, debated, etc. very carefully before it was passed. Whatever it is that this "glitch" is doing, it must have been intentional.
Barack_America
(28,876 posts)That's why the Dems accepted it.
And the ACA screwing over families is political gold for Republicans, which is why they won't fight it.
stymerson
(4 posts)The New York Times just published this article.
I'm not disputing the content of this article, but what I am wondering is this: given that the President signed the ACA almost four years ago, why did the New York Times wait until now to report this information?
19% of your income is way too much to be spending on premiums, and is not what I would consider "affordable." This must have been in the ACA when the President signed it nearly four years ago, so why did the New York Times wait until now to report on it? I wouldn't call this a "glitch" either, because whatever it is, it must have been put into the ACA deliberately.
http://www.nytimes.com/2013/12/21/business/new-health-law-frustrates-many-in-middle-class.html?_r=1&hp=&adxnnl=1&adxnnlx=1387635873-yBpAminoYvQy2F4QPm6jLQ&pagewanted=all&
New Health Law Frustrates Many in Middle Class
A 60-year-old living in Polk County, in northwestern Wisconsin, and earning $50,000 a year, for example, would have to spend more than 19 percent of his income, or $9,801 annually, to buy one of the cheapest plans available there.
LibDemAlways
(15,139 posts)affects the unemployed who are getting expensive coverage under COBRA. My brother has been paying over $600.00 a month for COBRA coverage which he can't afford, and was looking forward to signing up for insurance under the ACA. However, he was told becuse he qualifes for COBRA, he is not eligible for a subsidy, even though his only income now is his modest unemployment check. He did get coverage under ACA for close to $500 a month, so some savings but not enough given the circumstances.
TheKentuckian
(26,314 posts)order than helping anyone at all.
This thing isn't going to lead to single payer anymore than the previous system, the CBO will tell you that after 20 years only about 5% of Americans will be in the exchanges.
The exchanges aren't going to drive down costs, they will always have too few to move the needle by willful design. If we were actually in the business of helping folks, Medicaid eligibility would be automatic with unemployment but instead the law is set up to fleece the unemployed as their world is crashing down and is laser focused on keeping as many people as possible from being helped.
Response to MrsKirkley (Original post)
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