Penalties for not buying your mandated insurance...

[Demo_Chris]

According to the Christian Science Monitor:

In 2014, the fine to remain uninsured is $95 per person (up to a family maximum of $285, or 1 percent of family income, whichever is greater).

But the penalty will increase more than sevenfold in the next two years, with the fine running as much as $695 per person by 2016. The family maximum would be as high as $2,085 (or 2.5 percent of family income, whichever is greater).

http://www.csmonitor.com/USA/Politics/2013/1001/Obamacare-101-What-to-know-if-you-opt-out-of-buying-health-insurance

So, if you are one of the tens of millions of families who cannot afford Obamacare because you don't have a couple hundred extra a month, that's what you are going to owe. That's your tax for being poor. Enjoy.

[blkmusclmachine]

1. This is why I rejected RomneyCare for something better. But, alas, there was no political will in DC

for anything better. Sigh.

[kestrel91316]

131. All about exemptions:

http://www.healthcare.gov/exemptions/

[Cerridwen]

2. I loathe the ACA as it stands to date.

I loathe even more, those who lie, yes I said, lie, about what is in it versus what is actually in it.

There are subsidies and exceptions that are intended to take into account those cases in which individuals and their families can't afford out of pocket expenses that have been reduced from the days of the Insurance Monopoly.

There are many justifications to opt-out. If you or the CSM can't or more probably won't, see that, fuck 'em.

If the "Christian Science Monitor" isn't addressing those and is favoring the latest lies, then fuck 'em. No "news" source is immune to catapulting their own propaganda.

Not.one."news".source.is.immune.

[kestrel91316]

132. Stop relying on "news sources". Go straight to the facts:

All about exemptions to the dreaded mandate and fine.....

http://www.healthcare.gov/exemptions/

[IronLionZion]

196. +1 for this. There's way too much BS flying around. nt

[NYC_SKP]

3. "because you don't have a couple hundred extra a month, that's what you are going to owe"

Have you read the law?

Do you realize that if you don't make a lot of money then you get subsidies?

Do you realize that some folks will pay less than $50 a month, and less???

[cash__whatiwant]

28. we wouldn't want facts to come in the way of feeling outraged nt

[HappyMe]

50. Outrage rejects you and your horrible facts!

[Erose999]

59. From what I can tell, my cost would be $103 a month for a crappy "bronze" plan if I can get the

exchange. And thats after the subsidy. The "Bronze" plan would only cover 60% so I would never, ever get to use it because I can barely afford to eat. 40% of a medical bill is a fucking lot of money for someone making $25k with a lot of student debt. Granted that's better than having to pay 100% of a medical bill, but for me care is still unaffordable.

I may not even get the exchange plan because my employer offers a series of plans, the cheapest insurance being $160 a month, and then some of those "savings account" style plans.

[NYC_SKP]

71. The "savings accounts" are a fucking scam and joke.

I was involved in a Section 125 to make any out of pocket expenses tax deductible. They should be without involving a third private party.

Savings accounts are a way to let corporations have your money for a while, sometimes forever.

[TroglodyteScholar]

200. Yep, you're better off with zero coverage. 100% of medical costs is less than 40%.

Thanks for the math lesson.

[Tien1985]

206. They do have a point

If you have a nickel and the guy next to you has nothing, and you both walk by a booth that says "cookies 10 cents" neither one of you will walk away with a cookie.

[Erose999]

212. Couldn't have said it better myself. Unless I get a 100% subsidy, a pay raise without a hike in

premium, or the cost of care comes waaaaaaaay down, I won't be able to have any health care. That $103 I'll be paying in Obamacare premiums goes straight to some 1% fat cat's pocket and I'll get doodley squat out of it.

If I get sick and it can't be cured with Robitussen, neosporin, or asprin, I reckon it'll kill me. lol

[ohheckyeah]

130. What you make doesn't always reflect what you can afford. n/t

[Cali_Democrat]

4. You fail to mention the benefits to those who don't have enough income

Which is no surprise.

[tinrobot]

5. Tax for being poor?

If you're officially poor, your health insurance cost will be close to free.

[elleng]

27. Thanks.

Gotta get outta here.

[dlwickham]

143. the stupid is burning too much?

is this DU or some right wing hate site

[elleng]

186. Sure is/was.

I have no patience for the stupid, and usually just don't participate. Have to thank the sane.

[bunnies]

65. Or you get nothing.

But youre excluded from the penalty.

[kelliekat44]

229. The poor are already taxed and have been for eons. It's called capitalism. nt

[adirondacker]

6. What's a little more regressive tax as long as it benefits those on top. nt

[TroglodyteScholar]

203. Seriously?

As far as I can tell, coverage through an exchange is going to cost less for those under the poverty line than your "regressive tax" would anyway.

[Gravitycollapse]

7. If you can't afford the insurance, you will almost certainly qualify for Medicaid.

And then you won't be fined.

But, you know, that doesn't fit your preconceived narrative.

[PoliticAverse]

14. Except in the 22 states that didn't expand Medicaid. n/t

[Motown_Johnny]

18. That isn't the fault of the ACA. it is the local governments

and there is a pretty good chance they will come around within the next year or two.

The numbers work.

[Ms. Toad]

24. Not only that -

but if you are in one of those states and in the expanded Medicaid range the penalties are waived.

[Zorra]

25. +1 ~ GOP states offer little help on buying insurance

http://www.democraticunderground.com/1014608184

[Voice for Peace]

110. NM's an exception, Republican governor made smart decision

[bunnies]

68. Surely the ACA could have been fixed.

After the SC decision made it clear that millions of people would be left without.

[PoliticAverse]

138. By that time it was too late, as Republicans controlled the House and the Democrats

no longer could muster 60 votes in the Senate.

[bunnies]

145. I still would have like a vote forced.

Make them say where they stand on helping the poorest.

[PoliticAverse]

148. Well they're trying to delay the entire PPACA's implementation right now. n/t

[bunnies]

150. True enough.

"To hell with everybody" seems to be the general R consensus. I spose theres really no guessing how they'd have voted.

[kestrel91316]

136. Blame the legislatures of those states. Stop blaming Obama and the ACA.

[loyalsister]

195. People are exempt from the fines in states that didn't expand

Actually there are a lot of exemptions.

http://healthaffairs.org/blog/2013/06/27/implementing-health-reform-exemptions-from-the-individual-mandate/

to clarify: People who can't find an affordable plan and don't have access to medicaid because their state didn't expand the medicaid rolls are not required to pay a fine.

[JCMach1]

238. Even in those states, the formula for qualifying for Medicaid changes in Jan.

[sabrina 1]

70. You could always get Medicaid if you couldn't afford to pay for your HC.

What is new about that other than the fact that now those Medicaid funds pass through the hands of the Ins Corps whereas before they were distributed at only a 3% overhead, by the Government. Now as they pass through the Private Corps' hands, 20% or more will remain in their hands. If I am wrong, someone please explain.

[Hoyt]

79. Most states Medicaid programs have been running patients through private insurer's plans for years.

That is not new, although the insurers act more as an administrator/coordinator than an insurance company.

Most states do not have the computer system abilities to run a coordinated program of health care. Maybe they should, but they don't.

[sabrina 1]

89. Which is why we need a National HC system where the money designated

for HC goes to HC, not to for profit Private Corporations.

[winter is coming]

92. "You could always get Medicaid if you couldn't afford to pay for your HC." <---- False.

If you're in a state that isn't expanding Medicaid and your income is over that state's cutoff for Medicaid, you're shit out of luck unless you make enough to qualify for a subsidy. And the cutoff in some states is way below 100% FPL. It's only 10% FPL in Alabama if you're unemployed. http://kff.org/medicaid/state-indicator/income-eligibility-low-income-adults/

Those people are so poor they won't be fined, but they're not poor enough to get Medicaid. IMO, we need to amend the ACA to do something about this because pigs will fly before some of these states consider expanding Medicaid.

[duffyduff]

127. For many Medicaid is nothing but a loan with your estate as collateral.

It ain't free.

[GreenPartyVoter]

207. This is true. I wonder if that will ever stop being the case?

[Keefer]

93. I make too much for Medicaid,

but I probably will receive a subsidy to help pay my premium, but nothing mentions a subsidy for deductibles, co-pays, or prescriptions. I am a heart patient and am unable to work anymore. I am taking 12 medications every day. I am on Medicaid until December 3rd, when SSDI starts. When that happens, my Medicare ends and, according to the SS admin. rules, I am not eligible for Medicare until May of 2015. (2 years after I applied for SSDI.) What do I do?

[sabrina 1]

96. I'm sorry. Truly. I don't know the answer. I do know that they have been

chipping away for several years now, at the required earnings in order to qualify for Medicaid, making it necessary to be indigent before someone qualifies. So I understand that many people who SHOULD have qualified, did not.

I do not know how the new law works regarding this. It should not be this complicated, this complex for people to get the HC they need.

Bargaining for your HC is obscene imho, and shameful in a country that can more than afford a real National HC System where people do not have to worry about what 'category' they are in. Older people especially find all this very confusing as I know after taking care of two elderly family members.

Maybe if you talk to someone at SSDI they might be able to answer your question. I wish I could.

[Keefer]

194. Well...

I called the SS admin. They can't tell me what will happen until I start receiving SSDI in December. So I called the state since I am receiving SSI and Medicaid. They can't tell me anything until the SS admin. notifies them that I am no longer eligible for Medicaid. One hand doesn't know what the other is doing. I'm having a defibrillator implanted on Oct. 8th. More stress is what I DON'T need right now.

[sabrina 1]

219. You don't need anymore stress. Seems there is a lot of confusion

which has real impact on people's lives. Your situation answers a question i had about a friend who has cancer and finally got on Medicaid, or the Az version of it. Now that the state has decided to participate in the ACA exchange program, I wonder what will happen to her coverage which will likely be subject to changes also.

I hope you get things sorted out with as little extra stress as possible. My thoughts are with you.

[Kolesar]

226. Ohioans *never* could get Medicaid if they weren't elderly or disabled

There was no "chipping away", as you described.

Waiting for emergency care paid by foundation funds was pretty complicated. It vexed my brother and probably led to his death while he dithered.

[PoliticAverse]

141. Not true, It was rather difficult to get Medicaid before the PPACA expansion. n/t

[sabrina 1]

156. How will it work now?

It became difficult over the past decade or so as states began to lower the income to near indigent levels before someone would qualify. However I've known people who were on medicaid when it became clear they simply could not afford the hospital bills.

So how can people get on medicaid under the ACA?

[PoliticAverse]

163. Well if you are in one of the states that went with the PPACA's expanded Medicaid...

(you can see which states did and didn't here:
http://www.advisory.com/Daily-Briefing/Resources/Primers/MedicaidMap#lightbox/3/ )

you just need to have an income less than 133% of the Federal Poverty Level (see: http://aspe.hhs.gov/poverty/13poverty.cfm ).

[sabrina 1]

187. Thank you. It looks like 22 states are not participating.

Just a few are fully participating.

This is very complex for a person who is sick and very poor and perhaps doesn't have access to a computer or even know how to use one.

I don't understand why this is all so complicated. When people are sick, they should be taken care of, all of them.

I have been helping to take care of two elderly relatives for the past number of years. There is no way they could wade through all of this without someone helping them.

And if someone is already on Medicaid, in the non-participating states, do they remain on it? I will try to find the answer to that. Because it seems to me they are better off if they already have it to remain on it.

[PoliticAverse]

188. Yes they should still remain on Medicaid. What state in particular is this concerning? n/t

[sabrina 1]

189. Arizona where I have a friend who is on their version of Medicaid. She

has terminal cancer and is no longer working.

Eta: I see their Governor, a Republican, has said he will participate. That should help her to continue to get the help she needs.

[PoliticAverse]

191. Yes it surprised some people here but she did...

From June 18. 2013:

Gov. Jan Brewer on Monday signed the largest expansion of Arizona’s Medicaid program since its inception a generation ago, ending a fierce five-month legislative battle that drove a wedge through the Republican Party.

http://www.azcentral.com/news/politics/articles/20130617brewer-signs-law-arizona-medicaid-program.html

[Sgent]

231. Not in many states

The majority of southern states only provide Medicaid to children, pregnant.women, disabled and elderly. That excludes a lot of working poor.

[sabrina 1]

239. And how will those Southern States change in this regard now?

[pugetres]

8. And now, the rest of the story

Exemptions from the payment

Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

You may qualify for an exemption if:

- You’re uninsured for less than 3 months of the year
-The lowest-priced coverage available to you would cost more than 8% of your household income
-You don’t have to file a tax return because your income is too low (Learn about the filing limit.)
-You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
-You’re a member of a recognized health care sharing ministry
-You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
-You’re incarcerated, and not awaiting the disposition of charges against you
-You’re not lawfully present in the U.S.

If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a “hardship” exemption:

-You were homeless.
-You were evicted in the past 6 months or were facing eviction or foreclosure.
-You received a shut-off notice from a utility company.
-You recently experienced domestic violence.
-You recently experienced the death of a close family member.
-You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
-You filed for bankruptcy in the last 6 months.
-You had medical expenses you couldn’t pay in the last 24 months.
-You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
-You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required
by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.

https://www.healthcare.gov/exemptions/

[Motown_Johnny]

19. A shut off notice? Wow.. now THAT is a loophole

Just don't pay your electric bill until you get the notice, then pay it. That way you don't need to buy insurance if you don't want it.

[Trekologer]

197. The keyword there is "may"

I suspect that there would be more than just a shutoff notice to justify a hardship waiver.

[Chan790]

199. Please don't give morons ideas. n/t

[SidDithers]

31. Don't go introductin' actual facts into a good ol' misinformed outrage...nt

Sid

[johnd83]

9. If your state didn't accept the medicaid increase, then yeah, you're screwed

the entire point of the medicaid expansion was to help this problem.

[pnwmom]

53. You wouldn't owe a penalty in that case, however. n/t

[Agschmid]

114. +1

People should follow up with the state legislatures!

[Demo_Chris]

10. I posted the numbers they came up with...

Obviously there are as many variables as there are families. But know this, there are tens of millions of families who are not technically below the poverty line yet struggle desperately. And while there are, in some case, subsidies that can help offset some of the costs, these families will still be on the hook for money that they simply do not have, and for insurance they will be unable to use due to the lack of savings to cover their copays and deductibles.

That's reality for millions and millions of average Americans.

I posted these numbers so that people might understand that these minimal fines, our parties poverty tax, are not going to stay minimal for long. Make of it what you will.

[cilla4progress]

12. I am one who is facing a significant increase in my health

insurance costs under ACA! My current individual plan is closing on 12/31. I was laid off from my job last month, so, loss of 1/3 of amily income. All new available plans in the exchange are much higher than my current one - even using reduced new annual income.

Also, deductibles are much higher in exchange plans.

I don't qualify for a subsidy because our family is almost 400% of federal poverty level. At 58 1/2 y.o., the insurance premiums take a real jump in 1.5 years. Also, any bets on my employability at my age, in this economy?

For a certain segment of the population, ACA not only doesn't offer help...it hurts!

[Live and Learn]

16. You are leaving out some very important factors of the ACA,

i.e., denying insurance or raising rates due to existing health conditions, increased rates due to sex and annual limits on health care. Almost everyone was susceptible to dramatically (and unaffordable for most) increased health care costs if they ever got a serious illness previously. And if you couldn't afford to pay it, the rest of us paid instead.

In addition, you claim the exchanges are much higher than your current plan but you are losing coverage in your current plan anyway. I doubt very much that the ACA plans are higher than what you could have gotten to replace your current plan pre-ACA regardless of your income.

Certainly, single payer would be better but this is a hell of a lot better than what we had before.

[cilla4progress]

60. All true.

Except my plan wouldn't go away without ACA. Perhaps however it was reform efforts back in 2010 that engendered it.

[Hydra]

39. Sorry you're one of the people standing over the cracks

I was standing over a crack myself, but just got lucky and got a job with insurance that pays most of the premium. I mostly can't afford copays though, so still only seen the Dr. once on my plan even though they are getting paid a steep amount every month.

[cilla4progress]

61. I know ... I worked in a bankruptcy law firm

There were folks who HAD insurance, but had to file for bankruptcy due to the 20% of the health costs their policy didn't cover!

And even with my previous good policy, the costs and dealing with our dysfunctional health care system was a disincentive!

[pnwmom]

54. The WA Basic Health plan closed because of severe state budget cutbacks --

not because of the ACA. Before it closed, it had a waiting list of more than 128,000 people when it stopped taking on new people a few years ago.

[cilla4progress]

62. I wasn't on Basic Health

I was on the "Washington Health Program." It's different.

[pnwmom]

64. The Washington Health Program was part of Basic Health.

And it provided very poor maximum coverage -- only $75,000 - $100,000 a year. One stay in the hospital for a car accident could easily blow through that. So you're comparing apples and oranges.

You will need to buy a policy with the Essential Benefits for yourself. But your daughter, who is under 30, will have the option of a much cheaper policy offering only catastrophic coverage. (the opposite of the kind of policies you've had till now, which covered most costs except for catastrophic.)

http://www.wsma.org/Media/PRC-pdfs-Operations/HI_WA_HEALTH_Overview.pdf

Washington Health is part of the state’s popular Basic Health program – both are administered by the Washington State Health Care Authority. Basic Health provides coverage to 68,000 Washington residents, with the state paying a portion of their premiums based on their income level. WHP provides essentially the same benefits as Basic Health, but with no subsidy and no cost to the state. Enrollees pay the full premium, plus a small amount for administrative costs. HCA contracts with Community Health Plan of Washington to provide WHP coverage.

Premiums are as low as $100 per month. A 35 year old person can expect to pay between $125 and $183 depending on their location and the coverage options they choose. This is far less than what is available in the private insurance market. Enrollees also have low deductibles and copayments.

To hold down costs, WHP members have the option of choosing $75,000 or $100,000 in health insurance coverage every year. This is lower than payout maximums in other plans, but in most cases, $75,000 or $100,000 is plenty of coverage throughout the year. By comparison, less than 2% of Basic Health enrollees reached $75,000 total cost in 2009.

[larkrake]

135. simple, keep your own insurance

or be hooked into a family member's insurance, if all but you you are working. Or take yourself off the family insurance plan and file as an unemployed individual.If you are the unemployed head of household, file for hardship in state programs and you are likely getting unemployment. ACA cant help everyone now, but will lead to single payer soon. People will like it so much, they will push for single payer.

[jeff47]

20. Yep, and you carefully ignored the exemptions written in the law

because that would convert those "tens of millions" who have to pay a "poor tax" into....zero.

[Demo_Chris]

21. That's complete nonsense. If so, why have a penalty or mandate at all? nt

[jeff47]

22. Because the exemptions cover the people you are worried about, not everyone.

Go take a gander at pugetres's post in this thread.

[Demo_Chris]

45. There is no point going around on this...

The REALITY is that there will be millions of people who do not qualify for medicaid or an emergency exemption, and yet find paying for Obamacare a significant burden. Tap dancing around that self-evident fact does not change it. For example:

That family of four (two adults, two kids) earning 35K a year might damn well find shelling out an extra hundred and ten a month to be a massive hardship. Or take a family of three, two working adults, one "adult" child living at home because he cannot find a job, might just as easily find paying an extra hundred and fifty a month to be crippling. But hey, who needs heat anyway -- the insurance companies need their cash.

Let's talk about Nancy. She's single, working, and earning 22K a year. Well done Nancy! But as good as that pay might be -- and in today's America that's pretty decent money -- it's hard for her to pay her rent and all that on only 22K a year. And now, thanks to Obamacare, she has just been hammered with yet another bill. This time for an extra hundred a month that she damn well better come up with or she'll face a serious fine.

These people are not unusual. They exist in the millions. In fact, they just happen to earn what America's largest employers pay -- and maybe even a little more. They matter too. And if they somehow do manage to scrape together the extra cash in order to avoid their poverty fines, you know what they get?

Not a damn thing. They still cannot afford health CARE because they cannot afford the copays and deductibles. And their ability to save that money (like they had any extra to save before this) was just eroded further by this law. Their extra cash is now going to offset the rising healthcare costs of the affluent and padding the insurance companies bottom lines.

Now I suspect that you are not going to actually stop with the celebration long enough to actually think about anything I just wrote. But know this: This crap is going to come back and hammer us down the road. Once these people realize that they are getting screwed, when they have to choose between heating their homes or feeding their kids and buying insurance they cannot afford to use, they are going to blame us.

All numbers from:

http://kff.org/interactive/subsidy-calculator/

[pnwmom]

63. Where is your data that, aside from the people who live in the states

that won't expand Medicaid -- people who will be among those exempt from penalties -- there are many millions who simply won't be able to afford it? And who do make enough to file income tax forms (because there is no mechanism for collection for those who don't)?

I know that, as we've discussed, people who smoke cigarettes might have to choose between their habit and health insurance. And there are other people who would rather spend disposable income on things other than health insurance. But health costs aren't something anyone can avoid eventually. How many millions of people are actually going to fall through the cracks, given the LONG list of reasons people will be able to get waivers from the penalty?

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3765163

[Demo_Chris]

151. None of these people would be elegible in ANY state, nor were any of them evil smokers...

If we cannot agree upon basic reality -- for example, that millions of Americans are barely getting by and a hundred bucks is a big deal to them -- then there is no point carrying on. If I want cognitive dissonance I would discuss the issue with a Republican.

It comes down to this: There are millions of poor people in this country. Most of them work at the stores you shop. As incredible as this might sound, most of them are desperately tight on money (as are those who make far more). However, they are not quite so poor as to qualify for the hardship exemption -- they actually have homes or appartments rather than living in dumpsters. And while it was nice of Obama to include the "Living in a Dumpster" exemption from the mandate, that doesn't do these people any good.

It doesn't help Nancy. She's a recently divorced non-smoker who works two jobs, Lowes and the corner Exxon. She's trying to maintain an apartment and rebuild her life on 26K a year, and she's barely hanging on. Now, thanks to the mandate her monthly bill will be ONE-HUNDRED-SIXTY dollars a month. Again, she will now have to -- by LAW -- come up with an extra $160 for her mandate.

So much for saving for that better car Nancy, the insurance companies need your money.

[pnwmom]

158. I'm sure those people exist, and almost all of them could easily get a waiver.

All they would have to do is delay payment on a single power bill, get a shut-off notice, pay the bill with the $25 fine (or whatever), and then they'd qualify for a waiver from Obamacare.

If you'd rather do that than stop smoking -- cutting your premiums and putting the cigarette savings into health insurance -- then that's your choice.

[Demo_Chris]

164. You keep bringing up that I am a smoker, yet none of the numbers I have posted are for smokers...

Why is that?

Do you feel that pointing out that I am a smoker somehow alters anything I have posted, or is this some kind of underhanded means of suggesting that I am personally irresponsible? Regardless of your reasoning, it's a strawman.

[pnwmom]

169. Because you already told me that your smoking is why you can't afford

the premiums. Your family's premium if you weren't smoking would be only about $150 a month, and that's what a pack a day habit costs.

And I don't think you're unusual. Other people who say they can't afford a premium that works out to $50 a month per family member (in your family's case) are spending the equivalent amount on cigarettes or other purchases that are less important than health insurance.

[questionseverything]

209. odd nothing out was singles out as

unhealthy

not hard liquor or being overweight

but for smoking the penalties are huge,for old smokers cost could be as high as 33% of their income

they let the ins companies charge 3 times as much for an older person than a young one then doubled that on smokers

but that same income would be charged 26% even if they werent smokers...both are undo-able

the aca helps a lot of people but things can still be improved

hopefully we get a clean CR and a deal on the debt limit and then we can get back to working out problems

[jeff47]

214. Because smoking causes more, and more expensive health problems

than the alternatives you listed.

Severe alcoholism will eventually destroy your liver, but it takes a lot longer than for smoking to cause it's host of problems. And if the drinking isn't severe, it's probably not going to destroy the liver. Whereas "casual" smoking will still cause health problems.

Overweight is actually not necessarily a problem. Yes, massively overweight is. But they're finding people at "ideal" weight actually die sooner. Being about 20-30lbs overweight seems to result in the longest life (and presumably the least health problems, since it's health problems that kill people). People are just starting to stop blindly following BMI charts and figure out what actually is the "healthiest" weight.

As for the 3x charge, that's because the older people actually see doctors. And have conditions that require long-term and expensive treatment. The average 20-something is unlikely to need health insurance unless they're hit by a bus.

[questionseverything]

221. i understand the smokers are the dems

targeted group...i have known that since we took the house in 06 and pelosi took impeachment off the table but proudly stated the rotunda would be non smoking

i do not even mind sin taxes...taxes on cigs are how we have supported childrens healthcare in illinois but 33% of income is just too dramatic..it basically makes a legal activity criminal

as i said even 26% is undo-able for most families,that is about the same as a house payment,and it is not as if these families can just poof their obligations that already exist

i find it odd when the dems were raising taxes on the rich we went from 250,000 to 450,000 as the cut off but with healthcare it is around 50 grand?

you said,"
As for the 3x charge, that's because the older people actually see doctors."

that cracks me up...isnt that the point of healthcare? that we can see a doctor?

the child born with some problem that cost millions (where they would of capped out before) should not be denied treatment but neither should an old smoker...and the premiums should not be punitive for either

i am especially worried about taking such a high percent of disposable income(plus the non disposable ) out of the economy...since our economy is 70% consumer driven but that is a whole new debate

just to be clear NONE OF THIS SUGGESTS THE REPS SHOULD BE HOLDING THE COUNTRIES ECONOMY HOSTAGE

but i do think there are problems with the aca that can be changed after we get a clean CR and debt ceiling extension

[jeff47]

232. So....the problem is my casual wording

you said,"
As for the 3x charge, that's because the older people actually see doctors."

that cracks me up...isnt that the point of healthcare? that we can see a doctor?

K, so we change it to "older people actually need to see doctors". Because they have conditions that have to be checked and/or managed. The average 20-year-old will only need a doctor if they are in an accident of some sort.

Happy? Or do you want to whine more about how unfair it is that smokers cost more.

the child born with some problem that cost millions (where they would of capped out before) should not be denied treatment but neither should an old smoker...and the premiums should not be punitive for either

Yeah, doing something for enjoyment that makes you consume more medical care is totally the same as being born with birth defects. I clearly remember selecting the "No birth defects" option in the womb.

Or maybe those aren't similar at all.

i am especially worried about taking such a high percent of disposable income(plus the non disposable ) out of the economy...since our economy is 70% consumer driven but that is a whole new debate

Yeah, because smoking is just as required to live as food and medicine.

Look, I understand you don't want to quit smoking. That's fine. But it's gonna cost you. Both in cigarettes and in medical care and in medical insurance.

[questionseverything]

234. it is not about me at all

it is about policy level decisions and civilized discussions

i started out saying i understood the smoker at 33% was not up for discussion

the 26% of income for every1 of that age is what i was TRYING to discuss

i was just on another thread where his costs will be closer to 30% of income for non smokers and he seems thrilled so evidently i have just not budgeted correctly or i would think 26-35% of income gone before ss and income tax, state tax and roof over head is fine

[sabrina 1]

192. So now people have to mess with their credit and bills

and risk losing their electricity in order to avoid yet another bill the working poor cannot afford. You know all this was argued over before this bill passed. Most Democrats wanted a PO, we didn't get it, we 'compromised' and in the end all the compromises came to nothing since Republicans let Democrats pass the bill all by themselves. Given that, we should have had a PO.

This whole thing is so complex most of those struggling to hang on to a job and take care of their children are not going to be able to spend the time trying to figure out the 'devious ways' to avoid paying a fine for not being able to pay another bill on top of all the others they cannot afford right now.

As this President said during his campaign regarding this issue of mandates: 'If we could solve Homelessness by forcing people to buy a home, we would do it'. That was when he, like most Dems opposed Mandates.

[pnwmom]

193. We didn't have enough Democratic votes for a public option.

Lieberman, for one, was against a P.O. (and he wasn't a Democrat by then, anyway, so we never controlled 60 votes.)

So we did what we could -- we compromised with Lieberman and a few blue dogs and passed the ACA without a P.O.

Some of those blue dogs who helped us pass the ACA lost in the next election to tea party types. Are we better off with those blue dogs gone? Clearly not! Their districts have just gotten redder, and now Boehner and Cantor are in charge.

[jeff47]

215. It's not that hard.

First, we didn't get a public option because Lieberman, the Senator from Aetna, would not allow it.

Second, the ACA is not cast in stone. In fact, it gives us fantastic tools to advance health care in blue states. There's no reason blue states can't start offering public options within their state. And the success of those will help us pass public options nationwide that will result in de-facto single-payer.

This whole thing is so complex most of those struggling to hang on to a job and take care of their children are not going to be able to spend the time trying to figure out the 'devious ways' to avoid paying a fine for not being able to pay another bill on top of all the others they cannot afford right now.

Um...no it's really not that hard.

Healthcare.gov will point you towards your options, including Medicaid if you qualify.

If you can't pay the bill because your state government refused federal aid, you'll likely already qualify for an exemption. If you're in the small group that can't, it's not hard nor risky to get it. Don't pay your electric bill for two months, and then pay it when the disconnect notice shows up. The disconnect notice still gives you 30 days to pay, and it'll cost you about $30 in late fees, depending on your utility.

That was when he, like most Dems opposed Mandates.

Unfunded mandates.

The mandate in the ACA is funded. It's Republicans who refused the money. Republican sabotage is not the Democrat's fault.

[questionseverything]

224. no he opposed mandates

he said he trusted the American people to do the right thing...i believe he still does trust us(although putting up gates around open air monuments suggests otherwise)

and i remember the public option debate differently than you,it sailed through the house and the senate refused to use the nuclear option to pass it...we had enough votes for that

on the other hand we had just lost 8 million manufacturing jobs so losing tons of insurance jobs on top of that would probably not have been the right course at the time

we are just 5 year out from the last huge money collapse,peops are still struggling with the new economy so our leaders need to re evaluate were that funding comes from but the last thing we need is another economic slowdown (which the reps seem to be begging for)

[jeff47]

233. And then he bothered to think about it for more than a minute.

Mandates are required for all single-payer systems - you don't get to "opt out" of paying taxes. That makes single-payer horrible, right?

You can't have the requirement to issue insurance without some form of mandate, because then the logical conclusion is to not buy insurance until you are sick.

Example:
1. I don't buy health insurance.
2. I get sick.
3. I buy health insurance. Insurance company has to cover me and can't exclude my illness.
4. I see a doctor.
5. I complete treatment.
6. I cancel health insurance.

Why would I keep paying for insurance? I can just buy it again when I need it. That causes a pricing death-spiral, and we'd all get to pay cash for everything.

and i remember the public option debate differently than you,it sailed through the house and the senate refused to use the nuclear option to pass it...we had enough votes for that

You're memory is faulty. Lieberman went so far as to oppose his own Medicare buy-in proposal. Several other Senators appeared on the fence about it, but did not make definitive statements.

But that's fine. The ACA was designed so that we don't need a Federal "public option" to get a national "public option". What we need is public options in blue states, a much, much easier fight. Their success will let us expand that to "purple" states, and then nationally.

[questionseverything]

235. the snark is why we can not fix stuff

accusations of whining and use of sarcasm are not necessary

i paid for insurance for 30 years before the insurance industry forced me out and i have never had any major treatment

as the child of a share cropper i am actually kind of proud to pay taxes...means i made middle class

as i have said repeatedly i am happy for those this helps,i would like to pull the rest through the cracks,you seem to see no cracks

[jeff47]

236. Doesn't matter that you bought it for 30 years

Those 30 years had the concept of "pre-existing condition" and didn't have community rating for individual policies.

I think we all agree those "fixes" are necessary. The problem is if we put those in and don't have a mandate, then we get the death spiral I outlined.

you seem to see no cracks

Yeah, that's why my post ended with the path we need to take to get public options and national single-payer.

[lumberjack_jeff]

161. I find my phone bill "a significant burden"

The ACA doesn't advertise itself as freeing everyone from significant burdens.

The guy at 140% of FPL working part time at the tire shop will pay 2% of his income in medical insurance. He'll pay 7.5% of his income in Social Security tax. YMMV, but it seems to me that Social Security tax is a bigger burden and that access to health care is a bigger immediate problem.

[jeff47]

213. Ah yes. Reality. :eyes:

That family of four (two adults, two kids) earning 35K a year might damn well find shelling out an extra hundred and ten a month to be a massive hardship.

In which case they'd have a pretty easy time showing hardship - all they need is a past-due utility bill. Once.

My electric company will charge me about $30 in late fees to get to the point where I'd have the letter necessary for an emergency exemption, and then happily take the money and behave as if nothing ever happened.

Yeah, utterly unavoidable penalties.

Is it stupid that they have to work around it? Fuck yes. But put the blame in the right place: Their Republican state government that was handed money to fix the problem, and refused.

you know what they get? Not a damn thing. They still cannot afford health CARE because they cannot afford the copays and deductibles.

Nope, sorry. Standard "check-up" style doctor visits are covered without co-pays. So are a whole bunch of other visits, as well as a lot of maintenance visits for chronic conditions.

Now I suspect that you are not going to actually stop with the celebration long enough to actually think about anything I just wrote.

No, that's just your self-righteousness and ego.

The ACA is a massive improvement on the status quo, and provides the mechanism by which we will get single-payer. We only have to fight the battle for single-payer in the blue states now. When we win there, we'll "Pull a Canada" to get it everywhere else.

So no, I'm not having a "the job is done" party, even though that makes it easier for you to hate me. I'm fully aware that the job is just starting. The thing I'm happy about is it is finally starting.

[pnwmom]

56. It's not nonsense -- you're simply uninformed, even though you've already

been given the facts in this very thread.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3765163

[kestrel91316]

140. You need to do some reading so you can stop sounding so foolish and uninformed.

http://www.healthcare.gov/exemptions/

[SammyWinstonJack]

30. Exactly!

But know this, there are tens of millions of families who are not technically below the poverty line yet struggle desperately. And while there are, in some cases subsidies that can help offset some of the costs, these families will still be on the hook for money that they simply do not have, and for insurance they will be unable to use due to the lack of saving to cover their copays and deductibles.


Not sure why some here either don't understand that or refuse to acknowledge it.

[Hydra]

42. Because it doesn't affect them, so it can't be possible

I was right in the crosshairs, so I know exactly where some of the cracks are and where it can kill you. Pure luck that I'm not going to starve next year from this.

[sabrina 1]

218. Yes, the cavalier attitude towards anyone who legitimately cannot afford

an extra $20.00 a month added on to their already less than adequate incomes is interesting. We need people running these programs that involve life and death for the American people, especially the poor, the elderly and infirm, who have some empathy and understanding of the plight of the least among us.

The arguments FOR this extremely complex system, even when it is pointed out that for some people just operating a computer is a huge challenge, are so dismissive it makes you wonder if they themselves have ever even been close the situation millions of Americans find themselves in. The REALITY of the plight of so many people appears to be of less concern than defending a political issue. The best way to defend any policy is to make it better and that cannot be done if there is so much denial about the flaws that actually do exist in the program.

[Hydra]

220. That's one of the things that annoys me about the cheering for this

While this will certainly help some people, it's going to hurt others in the process.

Add to this, I've seen food costs rise sharply in the last few months, in some cases as much as 20%. The water is rising down here, but I don't think a lot of people will notice until it affects them personally.

[pnwmom]

66. Because there are many waivers available from the fine

for people who can't afford it -- for example, for people who live in a state that didn't expand Medicaid and can't qualify for an Exchange.

And there are subsidies also available not just to lower premiums, but to help people pay for out-of-pocket costs.

[upaloopa]

36. If your are paying attention you will see

poor people can legally avoid paying a penalty.
The ACA is not the reason people can't afford care. It isn't perfect by far. It was stated that millions will remain without care. It is better than what existed before it.
You need to put responsibility where it lies. People in this country do not want single payer. Most of us do but the majority don't understand it.
The ACA has become the whipping boy of even some on the left when it doesn't deserve it.

[Hydra]

43. The ordinary people do want single payer

The people in power do NOT.

[MattBaggins]

48. We won't "make of it what we will"

We will make of it what it is.

A big pile of steaming bullshit lies. But you know that.

[leftstreet]

13. Kiss your tax refund checks goodbye

[pnwmom]

67. Or break a finger and end up at the emergency room and owe $7,000

like one of my kids. Luckily, she had insurance.

[leftstreet]

72. That will still happen

If people can't afford the insurance premiums, or deductibles, or copays...hospitals will still need to write off and/or settle a certain percentage

Unless the ACA is guaranteeing payment, but I haven't heard that

[pnwmom]

74. There will be a lot LESS for the hospitals to write off.

That's why they're strongly supporting it.

[leftstreet]

75. Uh, most writeoffs and settlements are for the insured

People with insurance still face massive out of pocket costs

In fact, you could probably argue the ACA will increase those numbers...more insured seeking care, more people stuck with out of pocket costs. Hmm

[pnwmom]

76. That's because so many people till now had policies with low limits.

And/or high out of pocket costs.

That will be better now, too.

[leftstreet]

77. No. Cost caps have been delayed

Plus (and I would have assumed you already knew this):

• Bronze: Your plan pays 60%. You pay 40%.
• Silver: Your plan pays 70%. You pay 30%.
• Gold: Your plan pays 80%. You pay 20%
• Platinum: Your plan pays 90%. You pay 10%.

Bronze being the cheapest anyone can afford

So hospitals face collecting 40% on a $20k bill? From people who can barely make the monthly premiums?

[missingthebigdog]

144. Most of the policies I have reviewed have out-of-pocket maximums.

There is a point at which you no longer have to pay the co-pays.

Even if that were not the case, the current system has hospitals trying to collect 100% of a $20k bill. . . .

Is this plan perfect- no way. Is it better than what we had- absolutely.

[PoliticAverse]

157. The caps are delayed only for certain plans using multiple-administrators, not for most plans.

See: http://www.dol.gov/ebsa/faqs/faq-aca12.html

[darkangel218]

15. A lot more people will benefit from ACA than not.

[Motown_Johnny]

17. Everyone up to 133% of poverty line now qualifies for Medicaid

Then there are tax credits for individuals making as much as $40,000 a year.



Nice talking point, go bad it is so blatantly false as to be laughable.

[PoliticAverse]

57. Except in the 22 states that didn't expand Medicaid. n/t

[pnwmom]

69. And they will have any penalty waived if they don't make enough

to qualify for the state Exchange.

[Motown_Johnny]

178. as I said om post #18

That isn't the fault of the ACA. That is the local governments making an insane choice. With any luck that is a temporary situation and when the other 28 states have positive results, those 22 will be forced to get on board.

Also, it is going to be bad for the politicians in those 22 states. They bet on the wrong horse.

[ProSense]

23. Wow! Healthcare.gov has answers, including exemptions from fee due to hardship.

Orignially posted here: http://www.democraticunderground.com/10023754838

How do I get an exemption from the fee for not having health coverage?

Starting 2014, most people must have health coverage or pay a fee (the “individual shared responsibility payment”). You can get an exemption in certain cases.

The individual shared responsibility payment

If you can afford health insurance but choose not to buy it, you must pay a fee known as the individual shared responsibility payment.

The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher.

In 2014 the payment for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285.

You make the payment when you file your 2014 taxes, which are due in April 2015.

Exemptions from the payment

Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

You may qualify for an exemption if:

• You’re uninsured for less than 3 months of the year
  
  
• The lowest-priced coverage available to you would cost more than 8% of your household income
  
  
• You don’t have to file a tax return because your income is too low (Learn about the filing limit.)
  
  
• You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
  
  
• You’re a member of a recognized health care sharing ministry
  
  
• You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
  
  
• You’re incarcerated, and not awaiting the disposition of charges against you
  
  
• You’re not lawfully present in the U.S.

Hardship exemptions

If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a “hardship” exemption:

1. You were homeless.
   
   
2. You were evicted in the past 6 months or were facing eviction or foreclosure.
   
   
3. You received a shut-off notice from a utility company.
   
   
4. You recently experienced domestic violence.
   
   
5. You recently experienced the death of a close family member.
   
   
6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
   
   
7. You filed for bankruptcy in the last 6 months.
   
   
8. You had medical expenses you couldn’t pay in the last 24 months.
   
   
9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
   
   
10. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
    
    
11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
    
    
12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.

How to apply for an exemption

If you are applying for an exemption based on: coverage being unaffordable; membership in a health care sharing ministry; membership in a federally-recognized tribe; or being incarcerated:

- more -

https://www.healthcare.gov/exemptions/

Much more information:

All Topics
https://www.healthcare.gov/all-topics/

[ecstatic]

116. +1000 nt

[Puzzledtraveller]

26. Thank you Democrats for supporting the Health Insurance and Healthcare industry bailout

The shareholders or major insurance companies and health care providers thank you. Without your support the entrenchment of for profit health care would not have been certain. Do not despair at remarks claiming this is the step to single-payer, the ACA insures corporate involvement will continue for years and years to come and your bottom line will too.

Correction! Our bottome line

[upaloopa]

40. Millions will receive care that before they couldn't get

Is it perfect? No what is?
I think a lot of this is sour grapes because millions are trying to make it work and you have a nut to get off hoping it will fail.

[Puzzledtraveller]

44. I like the expanded medicaid portion

However giving states money to expand medicaid did not require the rest of the ACA. Or did it? Seriously, the insurance companies needed that mandate to up enrollment and off set other costs savings that were in the ACA. There is the issue that the ACA will basically not be fair. There are people who because they have insurance through their employer cannot get any help with their premiums and other out of pockets costs. They deserve the assistance too. Like you said, it isn't perfect but do you think any of these issues will be fixed?

[upaloopa]

49. The mandate has a couple of purposes. It will add the young

to the pool thus spreading the cost of care over a wider population making it cheaper for all. At some point the young will be old and will pay a lower cost at that time then they would without the mandate.
Everyone becomes a part of the community just like social security. The young pay for the benefits of the old. As I said the young will get old too.
Also it is unfair for people who can afford insurance to not have it and expect that society will take care of them if and when they need care.

[Hippo_Tron]

204. 45,000 people dying every year due to lack of health coverage isn't fair

I get it, the ACA makes things more expensive for some people and helps some people more than others. It also does a lot to stop 45,000 people from dying every year due to lack of coverage. Isn't that tradeoff worth it?

[geek tragedy]

29. Surprise, surprise more anti-ACA lies from a certain crowd, And they are LIES

If you're poor enough to qualify for Medicaid, but there's no Medicaid expansion in your state, the penalty doesn't apply.

[SidDithers]

32. The new set of talking points have gone out, I guess...nt

Sid

[geek tragedy]

34. On Monday it was "hey, why not agree to the Republicans' demand to delay the mandate"

Now, it's "the ACA is evil" plus "Obamacare will CAVE and give up the ACA"

Same people complaining that the ACA will get bargained away also think the ACA should be bargained away or repealed.

[appleannie1]

33. You are not including the subsidies that should be subtracted from the total so that is inaccurate.

[Capt. Obvious]

35. This is a rather poor effort at trolling

[Hydra]

37. You'll get flak for this

And already have, but I've noticed a pattern with the flak. The people doing it are simply pretending there are no cracks for people to fall into on the subsidies.

There will be people who are only partially subsidized that can't afford the portion they'll have to pay(Got 8% of your income sitting around uselessly?) and then after paying that and cutting food or something else out of their budget, they won't be able to use it to get medical treatment because they won't be able to afford the copays.

And what do they say to that? "Tough shit for those people, this is helping other people, so there!"

This wouldn't be an issue if there wasn't the individual mandate. People would still be uninsured, but they wouldn't be having to give handouts to insurance companies in the process.

[pnwmom]

73. Part of it depends on the definition of "can't afford."

The OP has previously acknowledged that his premium is as high as it is because of a cigarette habit. But a pack a day habit costs more than the health insurance premiums of a non-smoking family of three adults. (as in his family)

I'm sceptical that as many truly can't afford the premiums -- and wouldn't qualify for a waiver -- as he insists. I haven't seen the data, have you?

[Hydra]

80. I ran the numbers for my situation

If I was at my old job, no coverage available, $775 per year out of pocket for a silver program. It would be much better if they counted my disabled parent as part of my household, but they only do that for about half the things usually.

We don't have any spare income for something like that. My job provides now, and the plan I had through them is cheaper than the exchange options that came up earlier this year, but I still don't have money for copays unless I get overtime.

If I just said "fuck it" and got a bronze plan and never used it, it would be $133 per year. That would still hurt, but it wouldn't be as bad as penalty after the first year. The bad part is that I would be part of a welfare program for the insurance company, and I'd be paying tax money toward that.

Even though I'm not in that situation anymore, I fee the need to speak out for the people who will be- because there are gaps/holes/cracks all over in this plan, because it was a Republican plan. Sadly, I don't think the most people care as long as they get something out of it.

[Puzzledtraveller]

87. You hit several nails on the head.

I received training on the ACA and HBE's as part of my job and myself and many caseworkers noticed that there are numerous ways in which people will fall through the cracks and in an economic downturn when they can least afford it. If these families get hit on their tax refunds, which many of them rely on that can mean the difference on many things. People will argue that people need the insurance the ACA makes available, as if the working poor do not already know this. The fact that they cannot afford one dime of any of it escapes many of them. I already had some clients come in to apply and even with subsidies applied declined to apply because they do not have anything to spare.

[Hydra]

91. The common thread I've seen on DU

Is that they people who don't see the cracks and are benefiting have a good revenue source but were getting jerked around by the insurance companies.

That's well and good that they're going to be doing better, but already the insurance companies are getting exemptions on offering programs for kids and the for capped out of pocket yearly. How many more exemptions from written law are they going to get from whining? How long until this is no longer a good deal even for the people who benefit now?

But at the core, I think a lot of the people ignoring the cracks simply don't know what it's like to be working poor with nothing left over at the end of every paycheck. Take more from us, so long as a Dem(?) program "succeeds"?

[Hippo_Tron]

208. You're assuming you don't get cancer or some other catastrophic illness

Being covered by a bronze plan would mean you owe a maximum of $6,350 rather than several hundred thousand dollars.

I get it, you don't like paying into a system you feel is corrupt. I don't like it either. Unfortunately, the people who run the system have an absurd amount of control over our government and that isn't changing anytime soon. The only way to stop 45,000 people a year from dying due to lack of coverage, in the short run, was to force everyone to pay into the corrupt system.

I don't personally get much of anything out of the ACA. But I support it, because it's a short term solution that saves lives. Nobody will die because of the ACA. But a lot fewer people who would've died otherwise will not. It's that simple.

[Hydra]

216. Ah, but that's the problem

Some people WILL die specifically because of the ACA. I would have had to pay for it, and I would have had to pay or pay the fine. I didn't have that money, and others won't either.

I would support the ACA 100% as a step in the right direction without the mandate...but with it, it's a disaster. President Obama said the same thing, so I'm not sure where the dissonance is beyond the false idea of "this was the best we could do."

[Hippo_Tron]

222. Who will die because of the ACA and how?

The mandate is the only way that it will work. Obama opposed the mandate as a bullshit campaign promise and the second he defeated Hillary he basically acknowledged the necessity of a mandate.

As a young healthy person, I recognize that I have to subsidize older sicker people or the system just won't work. And in return, when I'm older and sicker, younger healthy people will subsidize me.

[NoOneMan]

38. Take the penalty, save up, and immigrate to a country that cares about its citizens

[Puzzledtraveller]

46. ^^this^^

[hughee99]

41. Don't think of it as a tax for being poor, think of it as poor people

helping other poor people buy health insurance (the money from one person's fine may go toward another person's subsidy). That way, if anyone complains about it, you can call them selfish for not wanting to help someone else get insurance.

[NoOneMan]

47. That's how a lot of this system works and why rates are going down

The new poor people in the pools will never be able to afford the deductibles and copays, so their premiums/subsidies are just going to pay the health care costs of the existing pool members who could already afford their deductibles and copays. Yeah, its a handout to both the middle class and the insurance companies. The guys on the bottom get a nice little insurance card but no ability to use it

[enlightenment]

88. Yep.

Finally got a quick look (before the system went down) at the benefit plans on my state exchange.

Disregarding how much or little the premium might cost, the majority of the plans are ridiculous. There is a catastrophic plan offered by one company - though they call it a "bronze" plan - that has a deductible of $6350 for individuals and $12700 for families (that's the max out of pocket allowed by the law).

Benefits? No coverage for anything until you've paid the deductible.

Putting aside that useless plan, the remaining "bronze" plans offered little more than that. All had deductibles that ranged from the maximum of $6350/$12700 to a low of $4000/$10000. Low benefits were "nothing until deductible paid" for everything except emergency services - there you pay between $200 and $500 up front and then pay co-insurance rates until the deductible is met. Better plans allowed co-pays that averaged about $50 per visit (some as low as $20, others as high as $90, depending on the service) - and co-insurance until the deductible was met.

"Silver" plans lower the deductible - the highest looked like it was $4000 - the lowest $1000 . . . but at least one of those lower deductible plans went back to the "no coverage until deductible met" for almost every service. The others were scarcely better - average $45 copays and/or coinsurance for everything. So a visit to the doctor for a nagging cough and fever might equal a couple hundred in copays after the visit, lab tests, and prescriptions are factored in - and that's not even touching the deductible.

As for cost? Well, if you are unfortunate enough to make a semi-decent wage that amounts to little or no subsidy, the plans ranged from $333 for the catastrophic plan to almost $700 for a "Gold" plan for an individual (I think there were higher ones but the system crashed when I tried to go to the next page - I did have it in premium low/high order, so I'm comfortable with that low figure).

Frankly, what I saw was something that most lower income people will not use. They'll buy it, because they fear the penalty or fear a catastrophic event or fear the derision of others who call them a burden on society - but they won't use it, because they won't be able to afford it.

If you're bringing home $1724 a month (after taxes) and have to pay a rent or mortgage, buy groceries, pay utility bills, most likely pay other debt, well, your subsidized premium of $103 (for a "Bronze" plan) or $144 (for a "Silver" plan) may be doable - or not.
Even if it is doable, what you are able to buy for that premium is not going to do you much good in terms of "health care" - it will afford you some protection for a major event and allow your betters to pat you on the back and tell you what a good citizen you are . . . but it won't really help you manage the regular round of illnesses and minor medical problems that beset most people most of the time.
A $10000 broken arm will still cost you $6350 dollars at the end of the day, and it's doubtful that you'll be all that thankful that it wasn't $3650 dollars more when the dunning calls start coming in from the collection agencies. Still, it's a broken arm, so you'll have it treated. That nagging cough, that fever that won't go away, the worrisome but not yet debilitating bloody stool? Those you'll treat yourself - or ignore them and hope they go away, because you know you don't have the money to cover the deductible and co-pay and co-insurance.

[Demo_Chris]

159. great post nt

[pnwmom]

51. Not necessarily. There is a possible waiver available for people

who actually can't afford the tax, and there is no enforcement mechanism for people who's income doesn't require them to file income tax forms.

And people who live in states that didn't expand Medicaid, and don't make enough to qualify for Exchanges, won't owe penalties for not being able to afford Obamacare.

[Demo_Chris]

55. See this post...

http://www.democraticunderground.com/10023765124#post45

Yes, there are some provisions for those in extreme hardship. The homeless, for example, will not be fined. I guess that's something. But the family of four, trying to raise their kids, one parent working at Walmart and the other at Home Depot, they WILL be fined if they don't buy.

Using the calculator their premiums will be a significant burden.

We are talking here about America's largest employers and a LOT of people in this position. These are families for whom a $300 a year fine would be a huge deal, let alone dropping an extra hundred a month to feed the insurance machine. And when the fine goes up as scheduled we are gonna get hammered.

Thank Cthuhlu the Republicans are so batshit crazy or we would get crucified over this crap.

[pnwmom]

153. All you need is one shut-off notice -- which you can then pay --

and you can submit that for an exemption for Obamacare, based on hardship.

And you won't owe any penalty if you live in a state that hasn't expanded Medicaid and you don't make enough for the exchanges; and you won't owe a penalty if you make too little money to need to file a return.

And there are numerous other groups of people who won't owe a penalty, as you know.

[zipplewrath]

172. Slow down jasper

Yes, the OP is misleading in the sense that there are folks who "fall into the cracks" and they will be "poor" (but not the "poorest" by any stretch). But even if one claimed their were "millions" that could easily be less than 1% of the population. Even of the claimed 25 million or more that ACA will "help", that'd be less than 10% of them.

But let's be a bit honest, it takes more than "one payment" to have a cutoff notice issued. You'll have to not pay for months, and the fallout can be notible for people who rent. Landlords can know of these things and it can be a violation of ones lease to do as such.

The reality is that ACA puts you in one of 4 categories.

1) People who don't need help with their health insurance
2) People who get a subsidy for their health insurance
3) People who don't qualify for health insurance subsidies or medicaid, but aren't subject to the penalty
4) People who qualify for medicaid

Only category 1 and 2 are subject to penalties, and yes there are a host of exemptions. But the end result is that some people in category 2 and virtually all in category 3 will be without health insurance. And some in category 2 will be subject to the penalty, but won't be able to afford the underlying care. And the cost of that care is anticipated by the White House to continue to rise at 6 - 7% each year for the foreseeable future.

It is a regressive system in many ways, even if not in all ways. It is designed to replace a technically less regressive system, but only because the federal government was less involved. For many it is designed to help, it will be an improvement. My problem has always been that it did little for the vast majority of Americans, and as was stated several times, it was designed that way. It was narrowly focused on those without insurance at all, or with extreme difficulty in getting or keeping it. Nice short term focus, but even as far back as Clinton, it was plainly obvious that the system is unsustainable for the vast majority of us, and it is only getting worse, even after the ACA. And it formalized and codified the insurance companies in the system, instead of marginalizing them.

[pnwmom]

175. That must be regional then.

I got a notice when I was on vacation and had just one payment that was late by a couple weeks. They definitely don't wait through multiple cycles in my city.

[zipplewrath]

183. Was it your first?

Most places I live, you'll get a few "passes" first. Once you recieve your first notice cutoff notice, then future notices will come quickly for years to come.

[kestrel91316]

147. Exemptions from the fine:

http://www.healthcare.gov/exemptions/

[snooper2]

52. I have NEVER understood the name of this publication "Christian Science"

Why title your organization with an oxymoron?

[PeaceNikki]

58. Because of its affiliation with the Church of Christian Scientist

http://en.wikipedia.org/wiki/The_Christian_Science_Monitor

[AnotherMcIntosh]

78. Yep. The Obama Administration even argued before the Supreme Court that it was a tax.

[Drunken Irishman]

81. An absolute lie.

What a dishonest post. Of course, I shouldn't expect any less from DU.

There are plenty of exemption that won't force poor people to buy health insurance.

1. They don't make enough income to file federal tax returns (which, I'm guessing, is nearly all of the tens of millions of families you mention).

2. They can't afford to pay for coverage.

3. They qualify for the Medicaid expansion, but their state hasn't expanded their medicaid program.

In all, most people who can't afford health insurance will probably qualify for an exemption. So, no, tens of millions of poor families will not be forced to pay a fee.

[Hydra]

83. Number 2 is dishonest at best

If you can't afford anything extra, how will you shell out 4-8% of your income for something you won't be able to use?

[Drunken Irishman]

84. It's absolutely honest...

If you can't afford what is likely to be a very low premium (probably less than 100 dollars a month) you're probably making too little money anyway to pay taxes, so, you wouldn't be penalized anyway - or you'd make an income that qualifies for the medicaid expansion. So, even if your state hasn't expanded the program you'd be exempt from the penalty.

We're not talking tens of millions of people. We're talking a very small amount of individuals who will fall through the cracks. Most poor, to lower middle class, will either qualify for very low premiums, the medicaid expansion, or be exempt from the fee.

Total dishonesty coming from the OP.

[Hydra]

103. You haven't done the numbers

I pay taxes despite not having $100 per month extra for me and mine (less than 200% poverty level). A fact I had fun shouting at Mitt Romney when he claimed 47% of us don't pay taxes and so can't be counted on to vote Repub. I pay taxes, and fuck you Mitt!

The "small amount" of people who will be forced to buy a product they can't afford and can't afford to use...because Republicans?

[Drunken Irishman]

198. You didn't read my post, then...

If you can't afford potentially less than $100, you probably qualify for the Medicaid expansion. If your state isn't expanding Medicaid, you're exempt. Just not being able to file taxes is only one way to be exempt and I find it highly unlikely you can't afford less than $100 in premiums and won't qualify either for A) the tax exemption or B) the Medicaid expansion.

[Hydra]

202. Well, believe it or not

I pay taxes, am slightly above the 133% mark, and have no extra capital each pay period supporting my disabled parent.

I do not qualify for job training, SNAP or expanded medicaid. I am exactly in the position you never want to be in...but it could always be worse.

There are holes in the ACA all over- just be glad you aren't in one of them.

[Drunken Irishman]

205. I'm not in any hole because I have employer based health insurance.

Have you tried going through the market place to see what you actually qualify for? You might even find premiums that, while have high deductibles, also are less than $50 a month.

[AnotherMcIntosh]

82. Next, we'll have to solve the problem of homelessness.

//

[AnotherMcIntosh]

85. A mandate-solution would not be perfect, but it would help some and we could fix it later.

[Egalitarian Thug]

86. You've definitely struck a chord. It's telling that in all this falderal, no one seems to want to

talk about health care. It's almost as if some people wanted to keep the conversation away from that area altogether.

Making tax credits sound as if they were some kind of benefit to the citizen, rather than a direct subsidy to corporate parasites.

[ProSense]

94. This is such

"Making tax credits sound as if they were some kind of benefit to the citizen, rather than a direct subsidy to corporate parasites."

...a ridiculous accusation. First of all, people who have insurance through their employer, the majority of Americans, use the existing insurance companies.

The vast majority of those currently uninsured will be eligible for Medicaid, with 17 million newly eligible.

Secondly, there will be numerous new co-opts available on the exchange. In Vermont, the co-opt and the exchange are already being structured for conversion to single payer.

The notion that subsidies are a negative is ridiculous. People want health coverage. Those who can't afford and want it will welcome affordable options.

People are so desperate to find something negative about the law, that they're attacking subsidies to make coverage affordable.

Wow! Healthcare.gov has answers, including exemptions from fee due to hardship.
http://www.democraticunderground.com/10023754838

Under Obamacare, Disney World Will Promote Its Part-Time Workers To Full-Time Status
http://www.democraticunderground.com/10023767654

[Egalitarian Thug]

95. See?

You're always a hoot!

[ProSense]

97. "See" what?

Complaining about subsidies and misrepresenting the penalty is anti-Obamacare desperation.

Period.

[Egalitarian Thug]

100. "...no one seems to want to talk about health care.

It's almost as if some people wanted to keep the conversation away from that area altogether."

Enjoy your freak-out.

[ProSense]

102. Oh please.

The health coverage is not health care argument in a debate about extending coverage to millions of people is obfuscation.

For one thing, Medicaid is one of the best health care systems in the country, and 17 million people become eligible.

Improvements can be made in every system, including Medicare, but that has nothing to do with giving people access to coverage.

[ProSense]

99. See reality:

Florida: MSNBC reports that community health care clinics in Orlando are experiencing long lines as low-income people are visiting to learn more about their options under Obamacare. The CEO of a community clinic in Miami that primarily services uninsured Floridians told MSNBC that Tuesday represents a “new day” for low-income patients who can now gain affordable coverage.

http://www.democraticunderground.com/10023761610

[Puzzledtraveller]

101. That, plus why disrupt the touch-down dance?

It's our side, we scored, that's all the matters to most here I firmly believe. There was a Newsweek cover I believe, "We are All Socialists now" Wrong answer, we are all corporatists now.

[Historic NY]

90. If the penalities are so bad then why are most exchanges jambed...

with people applying. Of course some would rather complain then actually check out the real solid facts.

[lumberjack_jeff]

98. a) there is no collection mechanism.

The IRS cannot initiate civil or criminal penalties, file liens or levy (garnish) a taxpayer's bank accounts or wages or otherwise seize property to satisfy any unpaid ACA tax. Also, no interest can accrue on these tax penalties. The only practical way for the IRS to collect on penalties is to capture or withhold tax refunds from year to year until satisfied. So, in summary, you can't go to jail for failure to comply, but you could lose your refund.

http://www.taxhelpok.com/library/affordable-health-care-and-the-irs-role-in-enforcement-in-collection-of-the-tax.cfm

b) If you're truly poor you will qualify for medicaid. If you're sorta poor, you will qualify for a subsidy. If you make 401% of FPL, but choose to buy a new car instead of buying medical insurance because externalizing your risks is how you roll, I have little sympathy.

[Hydra]

106. *lmao*

I'm saving this for later. The IRS won't be able to collect? Don't bet on it...and those poor people who are sort of subsidized and have to pay for something they can't use? Well they're just SOL, huh?

[lumberjack_jeff]

111. You can save it for *now*, if you like.

http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision

25. What happens if I do not have minimum essential coverage or an exemption, and I cannot afford to make the payment with my tax return?
The IRS routinely works with taxpayers who owe amounts they cannot afford to pay. The law prohibits the IRS from using liens or levies to collect any payment you owe related to the individual responsibility provision, if you, your spouse or a dependent included on your tax return does not have minimum essential coverage. However, if you owe a shared responsibility payment, the IRS may offset that liability against any tax refund you may be due.

Laughter is the best medicine, I suppose, even if you're laughing at your own ignorance.

[Hydra]

113. Scotus says it's a legal tax

It will have teeth.

[lumberjack_jeff]

119. Their only "teeth" is deducting the penalty from any refund you may be entitled. n/t

[Hydra]

121. Like I said, I'm saving this

Not that it will bother you to find out otherwise when the real enforcement comes.

[lumberjack_jeff]

124. Okee doke.

It won't bother me to find that your future silence on topic confirms that I am right either.

[leftstreet]

112. They keep your tax return money n/t

[lumberjack_jeff]

129. If you get a refund, but choose not to spend it on medical insurance, then good.

Not a big fan of externalizing ones own risks when you can afford to do otherwise.

[leftstreet]

134. Yeah, working class people buys yachts with their returns

If you actually know any working class / working poor you can study what happens with the tax return monies. Things like eyeglasses, that tooth that needs fixing, new tires for the car, maybe stock up the pantry, get the kids new coats, pay off a bill

[adirondacker]

237. Thanks. nt

[Raine1967]

104. 2% of the total population will be required to pay the penalty.

I wrote this last year. It explains the mandate. It explains an awful lot.

2% -- that's it. 2% of people would be required to purchase insurance. Of that 2%, the poorest and most vulnerable are not included. Religious objectors are not included. Prisoners are not included. Small businesses with less than 50 employees will not face penalties. 2% of the population would have to face this penalty should they choose not to purchase insurance. Statistically, they can afford it. When you think about it, the penalty is a pretty sweet deal compared to the cost of purchasing health insurance. According to Kaiser Health:

So no, this isn't a poverty tax.

[Prism]

105. DU doesn't understand what it's like to be poor

Or even working class. Nor do a lot of people seem to much care.

Whenever anyone explains mandated insurance is a hardship, the answer is, "no, because subsidies!"

They do not get it. Even with subsidies, oftentimes you just don't have that extra $80 a month.

A few years ago, when I started a new job, I was making about $22-25k. My budget was tightly controlled. Food, housing, transportation. Everything was earmarked. I scrounged up side work to make ends meet. Another $80 a month (with subsidy), would've been very difficult to make work.

And actually getting and paying for care? Forget it.

DU is told this again and again and again.

Look at the responses in this thread. Cold, uninformed, unempathetic, indifferent.

There are those occasional DU demographic polls that always come out largely white and affluent.

Yeah, it shows.

Good luck with it all, though. I was there with you. Now, I make significantly more and have a solid union health plan. But I am not so far removed from being working poor to sit here and lecture you on your business because it suits my politics.

The ACA is an improvement, but the mandate is an abomination, and there was a damn good reason I excoriated Sen. Clinton for it in the primaries.

[lumberjack_jeff]

107. I've never been so poor that my life wouldn't have been a top 5 priority.

And yes. At my 300% of FPL, healthcare becomes affordable because subsidies.

[Prism]

128. You're fortunate in that way.

Subsidies will help a certain segment of people. It is not an all or nothing proposition.

But there are millions of working poor about to get the shaft, and too many want to plug their ears and pretend it's not happening.

And I've been in that position where you just pray you don't get sick. Hell, even with insurance, there are times I've ignored an illness because I didn't have the copay or deductible.

That reality is not going away under the mandate for millions of people.

[Hydra]

108. Thanks for laying it out so bluntly

I'm still in the trenches, but at least this ACA thing isn't going to kill me still.

I doubt many DUers would be sad to see me and my relative starve over their "victory" though. Gotta break a few eggs to get a Heritage Foundation plan to "work."

[ProSense]

118. This is insulting, and

"DU doesn't understand what it's like to be poor...A few years ago, when I started a new job, I was making about $22-25k. My budget was tightly controlled. Food, housing, transportation. Everything was earmarked. I scrounged up side work to make ends meet. Another $80 a month (with subsidy), would've been very difficult to make work. "

...there are a lot of people who know what it's like to be poor.

The point is that health care is always going to come at a cost, even single payer. At one point, the suggestion was a 3.5 percent increase in the payroll tax to pay for a single-payer program (which also required an additional 5 percent and 10 percent tax on the top 5 percent and 1 percent, respectively.

That would be mandated. Period.

There are people who will be eligible for hardship exemptions from the fees. The point is that the health care law establishes a way to make obtaining coverage affordable.

Again, more than half of the uninsured (17 million) will be eligible for Medicaid. This bill is a significant help to low-income Americans.

[Prism]

125. Not so insulting that it stops people from lecturing the struggling.

But carry on, please.

[lumberjack_jeff]

133. I don't know anyone 400% or more of FPL who is struggling for any reason other than medical debt.

Because of the ACA, medical bankruptcy will be a thing of the past. And that's good enough reason to support it.

[Prism]

146. We're not discussing the same things

I'm talking about the working poor. People who make more than the FPL, but still struggle with low income as prices and housing rise.

400% of the FPL is firmly middle class.

And I'm not talking about medical bankruptcy. I'm talking about people mandated insurance they cannot afford who will not seek out treatment because they cannot pay.

The ACA does some good things. But what you're referencing has little to do with my area of concern.

[ProSense]

137. You seem to be implying

"Not so insulting that it stops people from lecturing the struggling."

...that some of those who disagree with the point aren't also "struggling."

What about those who are "struggling" and see this as a good thing?

What about those who will now gain access to care under Medicaid?

Are you speaking for them too?

[Prism]

149. It will help some and not others.

I'm discussing those "not others" that some people seem awfully determined to deny even exist.

[kestrel91316]

152. Bull shit. Plenty of DUers have serious financial struggles. Some ongoing, some sporadic.

Stop calling US the elitists (you know that's what you are doing).

I'm going to be able to get insurance again for the first time in years because of the subsidies. Many other small business owners on here are in the exact same boat.

Take your RW talking points and stuff 'em.

And here's the official word on exemptions to the fine/penalty: http://www.healthcare.gov/exemptions/

[Prism]

160. Just stop

I'm not talking about elitism. I'm talking about ignorance.

Which part of this is so difficult to understand? Say you're working poor. The government mandates you cough up $80 a month post-subsidy for insurance you cannot use.

<I>You simply do not have it.</I>

And people keep calling you a liar, or pretending they cannot hear you and reply, "But subsidies!" Which is largely what I see again and again.

I'm glad the ACA is helping you and millions of others. I'm gal people with pre-existing conditions are getting help. But winners and losers were picked here. You're a winner. Good.

Now what about the losers?

And only here is giving a shit about the poor a "right-wing talking point." But I guess politics must be played.

[Demo_Chris]

165. It's astonishing. They are flat refusing to admit that there are millions...

For whom a hundred bucks is a big-fucking-deal, let alone a hundred a month.

[ProSense]

174. Your point is absurd

"It's astonishing. They are flat refusing to admit that there are millions... For whom a hundred bucks is a big-fucking-deal, let alone a hundred a month."

Yes, $100 month is a lot for millions of people, but that doesn't mean that millions of people will opt out of the health care system for that reason. Anyone who believes that $100 a month is too much or they can't afford it likely doesn't have health care at this point.

They can continue to resist participating in the system and will likely be exempt from the penalty. If not, they will be liable for the penalty, which comes out of their tax return, providing they file one.

Silver plans for those who don't qualify for Medicaid will be as low as $40 on average. All the plans are better because the basic benefits are better.

As I said, the point is that health care is always going to come at a cost, even single payer. At one point, the suggestion was a 3.5 percent increase in the payroll tax to pay for a single-payer program (which also required an additional 5 percent and 10 percent tax on the top 5 percent and 1 percent, respectively.

That would be mandated. Period.

There are people who will be eligible for hardship exemptions from the fees. The point is that the health care law establishes a way to make obtaining coverage affordable.

Again, more than half of the uninsured (17 million) will be eligible for Medicaid. This bill is a significant help to low-income Americans.

[lumberjack_jeff]

167. Not indifferent at all.

It is a tragedy for an illness to cause a bankruptcy that would have taken everything you owned.

It is inconvenient that indemnity from that risk carries a cost. In the case above, (assuming the worst-case scenario, that you were single and starting work with an employer with fewer than 50 employees) the medical insurance premium was about 2/3 of what you pay in SS taxes.

Universal = mandatory. It's the way dictionaries work.

[Prism]

170. We seem to be concerned about different population segments n/t

[PoliticAverse]

180. As did the guy who won the election. n/t

[Warren DeMontague]

211. any SPHC system would have likely resulted in across the board tax increases, as well.

Now, one can argue the benefits of paying into a single gov't run pool as opposed to a multitude of private insuance companies, still, fact remains that coverage for everyone was not going to happen without some money coming from somewhere.

And yes, in an ideal world that would be a SPHC system financed mostly by upper income brackets. But even if that had been the case, folks in the low income brackets probably would be paying a bit more. That's simple reality.

[Prism]

217. No system is perfect

I was never a big fan of, "We'll fix it later!" (I often say that about caulking that mysteriously never gets done)

But this is the system we were able to wrassle out of Congress, and that's fine.

However, it's difficult to fix a problem if people won't even recognize that one exists. That's what's steaming my ass to a tea kettle. The refusal to recognize this is a problem area at all.

[Sgent]

240. I just don't get

how earning 200% of poverty level is poor.

When I was single (relatively recently) I lived on $1,400 / month fairly easily -- except I had no health insurance. Earning 19,000 a month and having health care for $40 / month would have been a godsend. Yes I live in a relatively low cost of living area, but I also had didn't have a room mate.

BTW -- poverty level for a single person is $11,490, so you would have medicaid to $23K, and the exchange would pay 100% of your premium for another good bit.

[ecstatic]

109. Wouldn't anyone who couldn't afford Obamacare get a subsidy or qualify for Medicaid?

I'm talking truly can't afford. Not just---I'd prefer not to pay this because I'd rather pay $300/month to comcast.

[lumberjack_jeff]

115. Yes. A childless couple making $62,039 without employer provided ins. qualifies for subsidy. nt

[Hydra]

117. Yes and no

If you're under 133% and your state is doing the expanded medicaid, you're good.

If you're above that, you get varying levels of subsidy(helpful and not), but a lot of us don't have any extra income at that level, and we won't be able to use it...so the insurance company is getting free money.

The mandate is really the problem here.

[Hoyt]

154. There are a number of preventive services with no deductibles and copays. If you get really sick

you will blow through the out-of-pocket caps quickly, and have everything after that covered at 100%.

I really don't see how anyone -- except under some very rare circumstances -- is worse off under ACA than they were before. I get that some folks are going to have a tough time under ACA, but not as tough as before. Hopefully, those gaps will be resolved once we get over the hump of having the program up and running.

[Hydra]

168. It's a matter of scale

Do you have $2,500 sitting around for out of pocket cap or deductible? I sure don't. I'm having trouble going to see my Dr. for $25 + whatever meds he gives me.

And get this- my plan is much better than a silver through the exchanges. Other problem:

http://www.forbes.com/sites/theapothecary/2013/08/13/yet-another-white-house-obamacare-delay-out-of-pocket-caps-waived-until-2015/

Will they be waived forever, like the Bush Tax cuts that never expire?

[Hoyt]

173. If you need a kidney transplant, do you honestly think most hospitals will say no over $2,500.

I know hospitals that will work out a payment plan of $5 a month for ten years.

The delay in your link is for certain group plans. It doesn't increase your previous cap, if any. So you are no worse off, probably better off than before in that respect.

I get that people are having a tough time, but it's not the fault of the ACA.

[Hydra]

176. I'm fine, but there are people who won't be, and I used to be in that category

It would be easy to say: "Not my problem" like a lot of people here are doing, but this isn't going to magically be ok for a certain groups of people that this bill is going to force into the system with basically no benefits to them...but plenty for the insurance companies.

[Hoyt]

177. I believe more people will be helped. And those that aren't should be on short-list for help.

Most of those that don't benefit are in backwards red states that refused to expand Medicaid simply to punish poor people.

[Hydra]

185. Haha

Thank you for clarifying in the way I have continually said in this thread.

"There aren't people this will hurt, and they don't matter if they were."

[winter is coming]

122. Nope. If your state hasn't expanded Medicaid, it's possible to be ineligible for a subsidy

and ineligible for Medicaid. In that case, you should be exempt from paying a fine.

[lumberjack_jeff]

155. I don't think this is true.

Can you please show me where a person at 130% of FPL without employer provided insurance is prohibited from purchasing insurance from the exchange and qualifying for the highest tier of subsidy?

It is my understanding that an applicant at 130% of fpl in a state without expanded medicare will be eligible for a subsidy which keeps the total cost of insurance premiums at 2% of AGI.

[winter is coming]

166. I didn't say anything specific about the % of FPL.

My understanding is that you can be eligible for a subsidy if you're between 100% and 400% FPL. The cutoff for Medicaid eligibility varies from state to state, however, and is lower than 100% in some states, making it possible to fall into a gap between "eligible for Medicaid" and "eligible for subsidy". http://kff.org/medicaid/state-indicator/income-eligibility-low-income-adults/

[lumberjack_jeff]

171. You're right. I stand corrected.

http://kaiserfamilyfoundation.files.wordpress.com/2013/10/8497-medicaid-eligibility-for-adults-as-of-010114.pdf

[PoliticAverse]

181. Yes if you'd be eligible for Medicaid except your state isn't participating you don't have to pay

the tax for not having health insurance.

[kestrel91316]

120. Thank you for conveniently omitting the many EXEMPTIONS from the fine.

http://www.cleveland.com/healthfit/index.ssf/2012/06/affordable_care_acts_mandate_d.html

Who doesn't have to buy insurance?
• American Indians, prisoners and undocumented immigrants.
• Some religious groups. Those that have historically been exempt from the Social Security system, such as the Old Order Amish, are one example. Religious groups whose members pay for one another's health care instead of buying insurance are also exempt.
• Those whose family income is so low they don't have to file a tax return. Those numbers vary depending on several factors, including how old you are, whether you're married and whether you're the head of your household.
• Those who earn so little that health insurance premiums, after federal subsidies and employer contributions, would total more than 8 percent of their income.
• Those who already have insurance through Medicaid, Medicare, an employer or veteran's health program.

~~~~~~~~~~~~~~~~~~~~~

http://www.csmonitor.com/USA/Politics/2013/1001/Obamacare-101-What-to-know-if-you-opt-out-of-buying-health-insurance

Who is eligible for such exemptions?

You can be exempted from the requirement to buy health insurance – and hence, from the penalty – if you meet one of the following requirements:

•You are uninsured for less than three months of the year.

•You live illegally in the United States.

•You’re incarcerated, and not awaiting disposition.

•You’re a member of a recognized Indian tribe.

•Your income is officially deemed too low.

•The lowest-priced converge would cost more than 8 percent of your household income.

•You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare.

•You’re a member of a recognized health-sharing ministry. (Note: Christian Scientists do not currently qualify for the exemption.)

Healthcare.gov also provides a list of hardship exemptions that qualify an individual for exemption.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

https://www.healthcare.gov/exemptions/

Starting 2014, most people must have health coverage or pay a fee (the “individual shared responsibility payment”). You can get an exemption in certain cases.

The individual shared responsibility payment
If you can afford health insurance but choose not to buy it, you must pay a fee known as the individual shared responsibility payment.

The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher.

In 2014 the payment for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285.

You make the payment when you file your 2014 taxes, which are due in April 2015.

Exemptions from the payment
Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

You may qualify for an exemption if:

You’re uninsured for less than 3 months of the year
The lowest-priced coverage available to you would cost more than 8% of your household income
You don’t have to file a tax return because your income is too low (Learn about the filing limit.)
You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
You’re a member of a recognized health care sharing ministry
You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
You’re incarcerated, and not awaiting the disposition of charges against you
You’re not lawfully present in the U.S.
Hardship exemptions
If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a “hardship” exemption:

You were homeless.
You were evicted in the past 6 months or were facing eviction or foreclosure.
You received a shut-off notice from a utility company.
You recently experienced domestic violence.
You recently experienced the death of a close family member.
You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
You filed for bankruptcy in the last 6 months.
You had medical expenses you couldn’t pay in the last 24 months.
You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.
How to apply for an exemption
If you are applying for an exemption based on: coverage being unaffordable; membership in a health care sharing ministry; membership in a federally-recognized tribe; or being incarcerated:

You have two options--

You can claim these exemptions when you fill out your 2014 federal tax return, which is due in April 2015
You can apply for the exemptions in the Health Insurance Marketplace
Note: If you get an exemption because coverage is unaffordable based on your expected income, you may also qualify to buy catastrophic coverage through the Marketplace. This may be more affordable than your other options.

If you’re applying for an exemption based on: membership in a recognized religious sect whose members object to insurance; eligibility for services through an Indian health care provider; or one of the hardships described above:

You fill out an exemption application in the Marketplace
If your income will be low enough that you will not be required to file taxes:

You don’t need to apply for an exemption. This is true even if you file a return in order to get a refund of money withheld from your paycheck. You won’t have to make the shared responsibility payment.
If you have a gap in coverage of less than 3 months, or you are not lawfully present in the U.S.:

You don’t need to apply for an exemption. This will be handled when you file your taxes.

~~~~~~~~~~~~~~~~

You're welcome.

[duffyduff]

126. You still have to pay back Medicaid if you are 55 and older.

They go after your estate when you die, and many poor do have assets, so forget about your survivors seeing a dime of your estate.

[PoliticAverse]

179. You are referring to the Medicaid Estate Recovery program, more info which can be found here...

http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Estate-Recovery.html
http://aspe.hhs.gov/daltcp/reports/estaterec.htm

[duffyduff]

123. They'll just take it out of any refund you may owe.

It's cheaper for many than opting for something they can't afford to pay premiums or the outrageous deductibles.

If you are REALLY low income, then you get to go on Medicaid, which if you are 55 and older has all kinds of strings attached to seize your estate.

I just got mine in the mail today, and it says as much. It includes monthly payments to OHA (Oregon) as well as any bills you rack up.

[virgogal]

139. Astonishing.

[kestrel91316]

162. Exemptions from the fine/penalty:

http://www.healthcare.gov/exemptions/

THAT'S what I'd call astonishing.

[virgogal]

182. Thanks for that link Post in haste,repent in leisure.

[magical thyme]

142. that's what I thought until I read that under a certain income level you are exempt from the penalty

and another DUer wrote that their mother's options ran from $1/month for the lowest end plan to $100 or so for the higher-end one she was choosing.

[zipplewrath]

184. It's a "crack"

It is definitely a "crack" that people fall into. The exemptions are many and the "hole" between qualifying for medicaid and getting subsidies is narrow. But it can and does happen. And in a country of 300+ million people, that means cracks can hold "millions".

To be honest, the person that isn't all that much different is the one getting a subsidy for an insurance policy to which they must still pay, even though they are unlikely to be able to afford the underlying care should they need it. I know people like this pre-ACA. They had insurance, and were paying for it, even with an employer paying most of the cost of the insurance. But the copays and uncovered expenses made actually accessing the care and using the insurance unaffordable. More than one physician will tell you of working out "extended payment plans" for people WITH insurance, but couldn't afford the uncovered costs.

[magical thyme]

190. I expect to fall through the crack

Make too much to be penalty-free, not qualify for Medicaid in my state (thank you Gov 38%), not be able to afford anything for insurance. So I plan on paying the penalty. If I'm wrong, I'll be the first to own up. But I doubt it.

Besides which, to me the whole thing is a rip anyway. 60% coverage is no different from 0% coverage if you get something truly major. Whether stuck paying $1M or $1/2M, we're just as bankrupt.

[TroglodyteScholar]

201. Can anyone familiar with the subject truly take this post seriously?

Please, give me a reason to....

[Demo_Chris]

210. Facts are facts. You can, if you prefer, live in a fox news type fantasy. That's on you. nt

[Sugarcoated]

223. Actually, the fact is

you left out the many exemptions. Many have posted the list of exemptions above. It almost looks like your response is a type of fantasy. Knock it off and be honest.

[Demo_Chris]

225. I have posted the NUMBERS...

Not only the penalties for non-compliance, but a good half dozen typical family situations. So far all anyone has offered are ways to GAME the exemption list in order to avoid a fine or avoid bankrupting your family. As if this were a solution.

How about instead of trying to debate the self-evident, you admit that this law isn't even close to perfect and we still have a great deal more work to do?

[ChisolmTrailDem]

241. WTF is going on lately? Yet another stupid fucking post, re: ACA! n/t

[Demo_Chris]

242. I know, right? Facts and information are always stupid. What matters are FEELINGS! nt