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dkf

(37,305 posts)
Fri Oct 4, 2013, 11:57 PM Oct 2013

The individual mandate’s penalty costs more than you think

On Twitter today, the Washington Examiner's Justin Green asked why it was such a big deal to delay the individual mandate. After all, he noted, the penalty is just $95. How much could that possibly matter?

This is a common bit of confusion. The individual mandate's penalty is not $95 in year one. It's $95 or 1 percent of your taxable income, whichever is greater. So if you make $80,000 in taxable income, the penalty is $800.

And it grows each year. In year two, it's $325 or 2 percent of your taxable income. In year three, it's $695 or 2.5 percent of taxable income. After that, it effectively holds steady.

In all cases, the key is that people pay whichever penalty is larger. That means that it's the percentage penalty that will really matter for most people. Someone paying the $95 penalty is making $9,500 or less in 2014. That's a very low income. That $95 floor is there to encourage people to sign up for Medicaid (in states where Medicaid isn't being expanded, people making that little money will be exempted from the mandate on affordability grounds).

So that's the first point: The mandate's penalty is larger than many people think in 2014, and it gets even larger in 2015 and 2016. If you've got $76,000 in taxable income in 2016, you're paying a $1,900 penalty.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/04/the-individual-mandates-penalty-costs-more-than-you-think/?Post+generic=%3Ftid%3Dsm_twitter_washingtonpost

Wow that adds up. And is it per person? So an uninsured wife plus 2 uninsured kids? So 1% x 4 in year one growing to what?

117 replies = new reply since forum marked as read
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The individual mandate’s penalty costs more than you think (Original Post) dkf Oct 2013 OP
If you've got $76,000 in taxable income Lex Oct 2013 #1
+1000 Avalux Oct 2013 #2
Anyone making $80,000 yr has employer healthcare or can easily afford to pay the penalty. JaneyVee Oct 2013 #86
Maybe you overbought your housing? Credit cards up to here? 2 car payments? dkf Oct 2013 #3
There are also exemptions for things like you describe Egnever Oct 2013 #5
Well it's all a calculation that is pretty specific and individualized. dkf Oct 2013 #11
You need a CPA to calculate your mortgage interest deduction? jberryhill Oct 2013 #115
dfk is only here to stir the pot. Ikonoklast Oct 2013 #116
Can you explain? Matariki Oct 2013 #22
Heres some Egnever Oct 2013 #33
none of those Niceguy1 Oct 2013 #66
Its easy enough to get a shut off notice. bunnies Oct 2013 #88
time to restructure your debt or something if that is the case Pretzel_Warrior Oct 2013 #8
You are right there will be some significant budget decisions. dkf Oct 2013 #13
agreed. this is also another reason to NOT GIVE IN on Republican demands BECAUSE Pretzel_Warrior Oct 2013 #14
There are a lot of things that could be fixed. If we are really going to demand the damned law stay dkf Oct 2013 #15
what are you talking about? Going forward with implementation does not preclude future changes Pretzel_Warrior Oct 2013 #16
That's the argument that is being made against the republicans. The law is passed, they can't dkf Oct 2013 #20
they aren't trying to improve it--they are trying to get rid of it. the 1 year delay on individual Pretzel_Warrior Oct 2013 #21
The Republicans have had over 2 years to offer meaningful changes Trekologer Oct 2013 #28
Not DU. Dem lawmakers saying why the mandate can't be delayed a year. dkf Oct 2013 #75
Could you provide a cite and a link for that comment by a Dem? notadmblnd Oct 2013 #107
No one is demading the law stay static and unchangeable. n/t Ms. Toad Oct 2013 #69
Yes. And maybe we can eliminate homelessness. AnotherMcIntosh Oct 2013 #30
Then you can't afford any health costs either -- pnwmom Oct 2013 #35
I had the opportunity... awoke_in_2003 Oct 2013 #38
You don't buy a house if you live there Recursion Oct 2013 #46
Average rent, SF, 1 bedroom is about 3,000 a month currently Bluenorthwest Oct 2013 #77
That is more than twice my mortgage... awoke_in_2003 Oct 2013 #78
The rent is too damn high Recursion Oct 2013 #79
Even if I were single I couldn't do it... awoke_in_2003 Oct 2013 #102
Only $76k in SF? Sanddog42 Oct 2013 #60
That has been debunked quakerboy Oct 2013 #67
In SF, 2K is not enough for a 1 BD apt, which averages at 3K currently. Bluenorthwest Oct 2013 #81
Craigslist says I can easily get a rental for 2k quakerboy Oct 2013 #117
Yes it is. JaneyVee Oct 2013 #83
Then you fucked yourself. tabasco Oct 2013 #90
I'm just giving the reasons others give me when I wonder why people can't save for retirement. dkf Oct 2013 #97
so downsize treestar Oct 2013 #94
Well they also put those things ahead of saving for retirement. dkf Oct 2013 #100
A medical issue can happen at anytime treestar Oct 2013 #103
More to the point… regnaD kciN Oct 2013 #9
thanks for your judgmental attitude although you know nothing about those who make liberal_at_heart Oct 2013 #48
It's well above the median household income in every major metropolitan area Recursion Oct 2013 #52
Is that true, Recursion? I'm surprised because you say you and your wife have high end Bluenorthwest Oct 2013 #80
This message was self-deleted by its author Recursion Oct 2013 #84
Recursion Mon Sep 23, 2013. "I live in India. Mumbai, in fact. I'm here for the Government." Bluenorthwest Oct 2013 #92
This message was self-deleted by its author Recursion Oct 2013 #95
Why do you think I'm pissed? I think you should be paid way, way more. Bluenorthwest Oct 2013 #108
This message was self-deleted by its author Recursion Oct 2013 #109
Just to make my apology public Recursion Oct 2013 #114
I know about people who do a lot more with a lot less money Lex Oct 2013 #112
Or you can, y'know, GET INSURANCE... regnaD kciN Oct 2013 #4
Does that work for a family plan? Because most family plans I've seen exceed $506. dkf Oct 2013 #6
At least in my state… regnaD kciN Oct 2013 #12
I have a family of 4 and even with subsidies I will be paying $550/month in premiums. liberal_at_heart Oct 2013 #44
But ONE major illness or injury would cost a lot more than that SoCalDem Oct 2013 #73
"For a while at least". True and telling statement. dkf Oct 2013 #76
As far as the penalty goes, yes. But there is a screw-up regarding the exchanges they should fix Recursion Oct 2013 #47
They need to provide for dependents, but not spouses. dkf Oct 2013 #68
Good point also. nt Lex Oct 2013 #7
i think it's anything exceeding 10% for individual. not sure about family. Pretzel_Warrior Oct 2013 #10
You and I have read up a lot more than the average American and we don't know. dkf Oct 2013 #17
so what else is new? it is hard to navigate pretty much ANYTHING in life if a person isn't Pretzel_Warrior Oct 2013 #18
I can only hope people like you get on here once in a while busterbrown Oct 2013 #51
thank you for your vote of confidence Pretzel_Warrior Oct 2013 #56
From what I have learned from you guys tonight i have already passed along to friends and relatives. busterbrown Oct 2013 #65
Or they can ProSense Oct 2013 #19
Well maybe they should mirror the site so the info can be read. dkf Oct 2013 #70
Consider it a "teaser rate": it will go up and up- kenny blankenship Oct 2013 #23
No politicians who voted for Obamacare should be allowed to own stock in health insurance cos, AnotherMcIntosh Oct 2013 #31
Well, then you know that after 2016, its adjusted based on COLA. phleshdef Oct 2013 #34
So quit freeloading and buy insurance. It's subsidized if you can't afford it. PSPS Oct 2013 #24
It is not subsidized for all... ScreamingMeemie Oct 2013 #25
That's the "Democratic" party these days kenny blankenship Oct 2013 #26
It is subsidized for households up to $92K. That's most households. n/t pnwmom Oct 2013 #37
That is self serving way to say 'households of 4 or more' Bluenorthwest Oct 2013 #87
There are subsidies for up to $45,960 individual income in 2013, pnwmom Oct 2013 #111
That's a Democratic phrase now, isn't it? "freeloading" LWolf Oct 2013 #89
I think the math is a little off here because they aren't considering the filing threshold. phleshdef Oct 2013 #27
Off topic question Egnever Oct 2013 #39
You'll be sorry you asked. Its pretty boring. phleshdef Oct 2013 #49
Hah! Egnever Oct 2013 #50
LOL, yea same here. phleshdef Oct 2013 #55
The dark ages...seemed so cool! Egnever Oct 2013 #57
Yea, I've never played an MMO that ever felt so "dangerous" really. phleshdef Oct 2013 #59
Standing at the bank wall Egnever Oct 2013 #61
So. WV? Sanddog42 Oct 2013 #62
Haha, just next door pretty much, Logan. phleshdef Oct 2013 #64
SF now but still visit from time to time n/t Sanddog42 Oct 2013 #113
If somebody making $80k can't swing an $800 penalty, they are living too large IMHO. kestrel91316 Oct 2013 #29
My family lives in western WA on $70,000. Most people in this area make $150,000/yr. liberal_at_heart Oct 2013 #45
There really should be adjustments Egnever Oct 2013 #54
This ought to help Democratic candidates get elected. AnotherMcIntosh Oct 2013 #32
hey if mandated insurance turns out to be a dud there's always solarhydrocan Oct 2013 #63
Sell insurance? OK, if it's medical insurance. AnotherMcIntosh Oct 2013 #71
They need to take those "penalties" and make the them PREMIUMS on a Public Option or single payer. yodermon Oct 2013 #36
now you're talking. liberal_at_heart Oct 2013 #41
Even with ACA I am going to be paying $6600/yr in premiums plus copays and deductibles. liberal_at_heart Oct 2013 #40
My daughter spent more than that in one trip to the emergency room pnwmom Oct 2013 #53
Or you may pay less - Ms. Toad Oct 2013 #72
About $8800 for us spinbaby Oct 2013 #74
Justin Green is also whining that the media didn't hail Ted Cruz for his fake filibuster. Spitfire of ATJ Oct 2013 #42
Boo hoo. That's chump change compared to the tax penalty I pay for renting my apartment Recursion Oct 2013 #43
$47.50 per child. This will rise to $695 per adult and $347.50 per child in 2016. Ellipsis Oct 2013 #58
I just got word from the Navy littlewolf Oct 2013 #82
Stop me if I am being too nosy, but if you don't want any GreenPartyVoter Oct 2013 #91
I am retired military littlewolf Oct 2013 #96
I vaguely remember my Dad trying to decide between Tricare and Medicare. He GreenPartyVoter Oct 2013 #98
Now you have Tricare until you are eligible littlewolf Oct 2013 #101
oh, ok. Maybe that's what he was talking about. Thanks for the condolences. It's been GreenPartyVoter Oct 2013 #104
So bottom line we should just bow to the republicans Kingofalldems Oct 2013 #85
If you make 80000 buy the fucking insurance treestar Oct 2013 #93
no shit nt arely staircase Oct 2013 #105
OMG that is terrible arely staircase Oct 2013 #99
For that matter, why should I have to pay ANY taxes? Nine Oct 2013 #106
Free Lancer dem in texas Oct 2013 #110

Lex

(34,108 posts)
1. If you've got $76,000 in taxable income
Sat Oct 5, 2013, 12:00 AM
Oct 2013

why can't you get yourself in a bronze plan?

 

JaneyVee

(19,877 posts)
86. Anyone making $80,000 yr has employer healthcare or can easily afford to pay the penalty.
Sat Oct 5, 2013, 11:25 AM
Oct 2013
 

dkf

(37,305 posts)
3. Maybe you overbought your housing? Credit cards up to here? 2 car payments?
Sat Oct 5, 2013, 12:04 AM
Oct 2013

$76,000 in NY or SF is not adequate.

 

Egnever

(21,506 posts)
5. There are also exemptions for things like you describe
Sat Oct 5, 2013, 12:06 AM
Oct 2013

but of course we don't want to talk about those.

 

dkf

(37,305 posts)
11. Well it's all a calculation that is pretty specific and individualized.
Sat Oct 5, 2013, 12:12 AM
Oct 2013

Pretty soon you will need to hire a health insurance expert in addition to a CPA. I wonder if all those exemptions will be check boxes on the tax forms or if we will have to read the tax book.

How fast will people get info on their medicaid eligibility I wonder. I imagine you need to know that before you can decide whether to go to the exchanges.

Ikonoklast

(23,973 posts)
116. dfk is only here to stir the pot.
Sat Oct 5, 2013, 03:17 PM
Oct 2013

Give a reasonable response, a hundred irrelevant scenarios get brought up.

So precious. So transparent.

Matariki

(18,775 posts)
22. Can you explain?
Sat Oct 5, 2013, 12:36 AM
Oct 2013

I live in an expensive city and half my income goes to my mortgage. While I'm fortunate to have insurance through work now, there have been times I've freelanced and couldn't afford insurance.

What exemptions are in place that you are talking about? More than just the city you live in? Are a person's expenses taken into account, because I haven't heard that.

 

Egnever

(21,506 posts)
33. Heres some
Sat Oct 5, 2013, 01:41 AM
Oct 2013

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

 

Pretzel_Warrior

(8,361 posts)
8. time to restructure your debt or something if that is the case
Sat Oct 5, 2013, 12:08 AM
Oct 2013

or go get employment at a company that does offer insurance coverage. This is the time for people to evaluate their own circumstance and consider their options.

 

dkf

(37,305 posts)
13. You are right there will be some significant budget decisions.
Sat Oct 5, 2013, 12:16 AM
Oct 2013

This is going to be a story of winners and losers. The experience will not be universal.

 

Pretzel_Warrior

(8,361 posts)
14. agreed. this is also another reason to NOT GIVE IN on Republican demands BECAUSE
Sat Oct 5, 2013, 12:19 AM
Oct 2013

if we and the Dem leaders are all unified and break this crazy strangle hold the tea party wing of Republicans has on rational governance, we may see through elections a group of senators and representatives who will work together a bit more to make necessary modifications to Obamacare to fix some of the shortcomings as the country experiences some affects that were anticipated but no political will to address as well as unintended consequences that become apparent with implementation beginning.

 

dkf

(37,305 posts)
15. There are a lot of things that could be fixed. If we are really going to demand the damned law stay
Sat Oct 5, 2013, 12:20 AM
Oct 2013

Static and unchangable so be it. Then we are stuck with it as is.

 

Pretzel_Warrior

(8,361 posts)
16. what are you talking about? Going forward with implementation does not preclude future changes
Sat Oct 5, 2013, 12:23 AM
Oct 2013

I don't think I've heard ANYONE on DU suggest Obamacare should stay static with no changes going forward.

 

dkf

(37,305 posts)
20. That's the argument that is being made against the republicans. The law is passed, they can't
Sat Oct 5, 2013, 12:32 AM
Oct 2013

Change it now. Attitude begets attitude. Cooperation begets cooperation and the same for the lack thereof. Maybe if they can compromise on the debt ceiling that will foster a working partnership. But if it's bloody and an attempt to bludgeon the other guy, there's no happy days ahead.

 

Pretzel_Warrior

(8,361 posts)
21. they aren't trying to improve it--they are trying to get rid of it. the 1 year delay on individual
Sat Oct 5, 2013, 12:35 AM
Oct 2013

mandate was merely the later round of shit they threw out there. the first point was repeal it. THey didn't have the votes (even though they passed repeal around 45 times in the house). Second round was defund it. Senate was never going to go along with that. Now they're saying delay the linch pin aspect of the law that makes other aspects of it feasible.

Don't tell me they are trying to change it and we should cooperate. They are trying to kill it. By any means necessary, apparently. Including the harm to many people in this country and our economic recovery momentum. Anyone negotiating with those bastards under those conditions deserves to fail.

Trekologer

(1,078 posts)
28. The Republicans have had over 2 years to offer meaningful changes
Sat Oct 5, 2013, 01:05 AM
Oct 2013

Their only solution has been scrap it entirely--which isn't a solution. If the choice is the ACA as it currently is or repeal it completely, the obvious choice is keep the ACA as-is.

 

dkf

(37,305 posts)
75. Not DU. Dem lawmakers saying why the mandate can't be delayed a year.
Sat Oct 5, 2013, 09:54 AM
Oct 2013

It goes something like this: you can't change the law once it's been passed. You haven't heard that from any D official?

IMO they boxed themselves out of future fixes with that brilliant argument.

pnwmom

(110,254 posts)
35. Then you can't afford any health costs either --
Sat Oct 5, 2013, 01:46 AM
Oct 2013

but they always will come.

If you can afford two car payments in SF or NY, you can sell one car, take public transport and afford subsidized health insurance.

By the way, the median household income in San Francisco is about $55K.

http://www.bayareacensus.ca.gov/counties/SanFranciscoCounty.htm

The median household income in NYC is about $50K.

 

awoke_in_2003

(34,582 posts)
38. I had the opportunity...
Sat Oct 5, 2013, 02:05 AM
Oct 2013

to have a job in SF starting at $65k a year. I started checking it out, as I would love to live there. My $65k would buy a shack in SF. That same amount here gives me 2000 square foot of house in a nice neighborhood.

Recursion

(56,582 posts)
46. You don't buy a house if you live there
Sat Oct 5, 2013, 03:11 AM
Oct 2013

I think that's a disconnect between people who live in cities like SF or NYC and people who don't: it's perfectly normal to rent an apartment your whole life in one of those cities.

 

Bluenorthwest

(45,319 posts)
77. Average rent, SF, 1 bedroom is about 3,000 a month currently
Sat Oct 5, 2013, 11:04 AM
Oct 2013

Most people have to pay their own housing, they are not given free housing money by the taxpayers as part of excessive compensation packages.

Recursion

(56,582 posts)
79. The rent is too damn high
Sat Oct 5, 2013, 11:09 AM
Oct 2013

I had roommates pretty much the whole time I lived in DC, and that's cheaper than SFO.

 

awoke_in_2003

(34,582 posts)
102. Even if I were single I couldn't do it...
Sat Oct 5, 2013, 11:55 AM
Oct 2013

I prefer solitude. If someone is living with me they better be sleeping with me

quakerboy

(14,857 posts)
67. That has been debunked
Sat Oct 5, 2013, 06:24 AM
Oct 2013

76k is 6,300 per month. Even if you take 2k off the top for taxes, and another 2k for an apartment, that leaves 2,300/month for other things. More than a lot of us have before paying our rent

There are a lot of NY and SF residents who make it by on significantly less than that. It may not leave the margin of our dreams, but that does not mean its not adequate, much less hardship.

 

Bluenorthwest

(45,319 posts)
81. In SF, 2K is not enough for a 1 BD apt, which averages at 3K currently.
Sat Oct 5, 2013, 11:18 AM
Oct 2013

Now I know folks in NY who have rent cheaper than mine in Oregon because they have lived in rent control for decades. A new resident does not get that sort of break.

quakerboy

(14,857 posts)
117. Craigslist says I can easily get a rental for 2k
Sat Oct 5, 2013, 06:24 PM
Oct 2013

A quick search on craigslist for the SF Bay area turns up over 2500 rentals at $2000 or less. Limiting the search to SF proper and 1bedroom or more drops your options to 159.

Even if you jump it up to 2500, which more than doubles your options, that still leaves you with 1800/month after taxes. Which is a) still noticeably more than the total wage of the average Starbucks Barista who works in SFC, before taxes or housing comes out, and B) still a liveable amount.

Im in oregon as well. Most things are fairly affordable here. But even so, when the amount left over AFTER taxes and paying for housing is greater than my total cost of living including those things has ever been, I dont think its fair to characterize it as "inadequate".

 

tabasco

(22,974 posts)
90. Then you fucked yourself.
Sat Oct 5, 2013, 11:43 AM
Oct 2013

Don't blame the ACA.

Imagine your fucked-up situation if you have a serious health crisis and DO NOT HAVE INSURANCE.

 

dkf

(37,305 posts)
97. I'm just giving the reasons others give me when I wonder why people can't save for retirement.
Sat Oct 5, 2013, 11:51 AM
Oct 2013

If they couldn't save then, they have no $ to pay the extra insurance costs now.

treestar

(82,383 posts)
94. so downsize
Sat Oct 5, 2013, 11:48 AM
Oct 2013

that is not excuse. Putting those things before health insurance for you family? Are you kidding?

 

dkf

(37,305 posts)
100. Well they also put those things ahead of saving for retirement.
Sat Oct 5, 2013, 11:54 AM
Oct 2013

Funny how when I am telling people they should save its impossible. But when it's medical insurance (not even medical care!) they should sell their house and give up their cell phones and cars.

regnaD kciN

(27,631 posts)
9. More to the point…
Sat Oct 5, 2013, 12:08 AM
Oct 2013

…most of those with incomes that high will be covered by their employer. It's those in lower-paying jobs that are more likely to be uninsured -- and they will get pretty comprehensive subsidies to pay for most of their premium.

liberal_at_heart

(12,081 posts)
48. thanks for your judgmental attitude although you know nothing about those who make
Sat Oct 5, 2013, 03:16 AM
Oct 2013

$76,000/yr.

Recursion

(56,582 posts)
52. It's well above the median household income in every major metropolitan area
Sat Oct 5, 2013, 03:26 AM
Oct 2013

I've never in my life lived in a household that makes remotely that much money, so, yes, I don't know much about those who make that... (I've also never been responsible for a family or had a debilitating medical condition or anything like that either; I'm just saying honestly I have no idea what any of those things are like.)

 

Bluenorthwest

(45,319 posts)
80. Is that true, Recursion? I'm surprised because you say you and your wife have high end
Sat Oct 5, 2013, 11:15 AM
Oct 2013

government work, you have said she is a Diplomat of some ranking.
I'm honestly saying, I expected that you and Mrs would be in the mid six figs plus many perks like housing allowances and free cars. Are you excluding large items provided, housing for example?
Authentically surprised at that statement.

Response to Bluenorthwest (Reply #80)

 

Bluenorthwest

(45,319 posts)
92. Recursion Mon Sep 23, 2013. "I live in India. Mumbai, in fact. I'm here for the Government."
Sat Oct 5, 2013, 11:47 AM
Oct 2013

" I put up with a lot of shit working for the US Government in foreign countries. Dengue Fever comes to mind. As does the Bubonic Plague. But, putting those aside, the level of hostility from this board has also been kind of depressing.

My wife is a quite accomplished U.S. diplomat. She has been promoted twice ahead of her seniority."
http://www.democraticunderground.com/10023715296

Can't work abroad but you live in India 'I'm here for the government'. Civil servant or 'quite accomplished US diplomat'?

Forgive me, Recursion, for thinking that a 'quite accomplished US diplomat' and her spouse combined might make near 76K a year. You used your diplomatic status to claim informed standing. And international postings for you and your wife. I have never known anyone who gets posted abroad for 'no where near 76K' for two people, ever.

Response to Bluenorthwest (Reply #92)

 

Bluenorthwest

(45,319 posts)
108. Why do you think I'm pissed? I think you should be paid way, way more.
Sat Oct 5, 2013, 12:06 PM
Oct 2013

But you can not leave out large perks like housing and claim that is not income. That is absurd. If I had no housing expenses, I'd be rich.
I'm going to PM you some information, hope it makes you feel less enraged at me.

Response to Bluenorthwest (Reply #108)

regnaD kciN

(27,631 posts)
4. Or you can, y'know, GET INSURANCE...
Sat Oct 5, 2013, 12:05 AM
Oct 2013

Also, if your premiums would cost (I believe) 8% or more of your taxable income under a silver plan, you would be exempt from penalties anyway. So, for that guy with the $76,000 income, if his monthly premium would be more than $506.67, he could choose to go without insurance and not have to pay a penalty.

 

dkf

(37,305 posts)
6. Does that work for a family plan? Because most family plans I've seen exceed $506.
Sat Oct 5, 2013, 12:07 AM
Oct 2013

regnaD kciN

(27,631 posts)
12. At least in my state…
Sat Oct 5, 2013, 12:15 AM
Oct 2013

…if you've got a family, at that income range, you'll be eligible for subsidies.

Example: We have family coverage through my wife's government job. However, I decided to run the numbers if, hypothetically, she didn't have coverage anymore. At an income level right around the hypothetical example, and with a family of three, full coverage for the entire family under a bronze plan from our current HMO would cost $340/month -- with subsidies paying an additional $455/month. And there were cheaper plans around -- I just wanted to give a case where we could stick with our own doctor and hospital care.

SoCalDem

(103,856 posts)
73. But ONE major illness or injury would cost a lot more than that
Sat Oct 5, 2013, 09:39 AM
Oct 2013

I know people who pay hundreds of dollars each month for cell service/internet/satellite tv..

Insurance for the family is MORE important..

and for people in the 75K+, it's HIGHLY likely that they have coverage through work (for a while at least)..

It's all about priorities

 

dkf

(37,305 posts)
76. "For a while at least". True and telling statement.
Sat Oct 5, 2013, 09:58 AM
Oct 2013

$2000 fine... I dunno if that's enough. And maybe they want to dismantle the employer based system. Corporate America may be willing to oblige.

Recursion

(56,582 posts)
47. As far as the penalty goes, yes. But there is a screw-up regarding the exchanges they should fix
Sat Oct 5, 2013, 03:14 AM
Oct 2013

The family/individual screw-up is that if your employer offers you an individual plan that meets the criteria, neither you nor your family can participate in the exchange, even if your employer doesn't offer a family plan.

 

dkf

(37,305 posts)
68. They need to provide for dependents, but not spouses.
Sat Oct 5, 2013, 09:28 AM
Oct 2013

Of course neither spouses or dependents are required to be subsidized or affordable.

Lots of things to fix. I doubt the GOP will.

 

dkf

(37,305 posts)
17. You and I have read up a lot more than the average American and we don't know.
Sat Oct 5, 2013, 12:27 AM
Oct 2013

I feel really bad for anyone who is trying to navigate this. So much to learn, so much data to look at. For a country that hasn't figured out how to save for retirement I do wonder how people are going to do a good job examining their options. There could be some very bad decision making coming.

 

Pretzel_Warrior

(8,361 posts)
18. so what else is new? it is hard to navigate pretty much ANYTHING in life if a person isn't
Sat Oct 5, 2013, 12:31 AM
Oct 2013

capable of doing research, resisting impulse decisions, and planning ahead. Obamacare is just one out of a litany of things in modern American life that will be difficult for people to handle if they don't try to seek out information and resources.

At least, unlike the Payday loan scammers and criminal mortage brokers who fleece the uninformed and poor, Obamacare has people and resources in place to give accurate information free of charge if people will avail themselves of it.

My wife and I are nowhere near the lines where we'd get subsidies, so I didn't put much research into it (and we already have employer insurance). But you can bet I'd be all over it if those things did apply to me.

busterbrown

(8,515 posts)
51. I can only hope people like you get on here once in a while
Sat Oct 5, 2013, 03:25 AM
Oct 2013

to help some of us who are not adept at figuring this stuff out...Getting older and was always poor with numbers however reading your little bits of info calms me down enough so that I can begin navigating through this stuff..

A couple of you guys have responded really well to the naysayers on the thread.
Bottom line for me is.. This is it! The time the middle class or in most cases former middle class has to make a move and if takes a bit of self sacrifice by us to get this country eventually into a single payer system. Then thats what needs to be done...

I am sure that in the next months many will be yapping away describing all the faults with the AHA. I hope you guys make yourselves noticed frequently. Many of us need a push to get us going..

busterbrown

(8,515 posts)
65. From what I have learned from you guys tonight i have already passed along to friends and relatives.
Sat Oct 5, 2013, 03:54 AM
Oct 2013

It would be a good idea for us to set up up a new forum dedicated to the navigation of the AHA and addressing questions and problems... I know one could probably figure this stuff out on the official AHA but it comes together in a better way here because we can also throw in and out the political stuff which is attached to it..

Do you think if I just start a thread stating: The AHA is here and we would like your comments concerning the problems you are experiencing and at the same time comments concerning the positive things which have surfaced to the forefront. Lets get this discussion rolling and keep it kicked..

ProSense

(116,464 posts)
19. Or they can
Sat Oct 5, 2013, 12:31 AM
Oct 2013

go to healthcare.gov for all answers.

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/

 

dkf

(37,305 posts)
70. Well maybe they should mirror the site so the info can be read.
Sat Oct 5, 2013, 09:35 AM
Oct 2013

Second how do you interpret this:

The lowest-priced coverage available to you would cost more than 8% of your household income

So is that 8% for the entire family plan? Or the individual? Who is "you"? Why doesn't it say "you and your family" or "you and your household".

kenny blankenship

(15,689 posts)
23. Consider it a "teaser rate": it will go up and up-
Sat Oct 5, 2013, 12:37 AM
Oct 2013

like the rest of Obamacare. Up and up and up.

"And it grows each year. In year two, it's $325 or 2 percent of your taxable income. In year three, it's $695 or 2.5 percent of taxable income."

I've known that since the shit was signed. I know something else, too:

THIS IS JUST THE BEGINNING.

The penalty for preferring food to Obamacare is the FIRST thing they'll fix when they "fix it later". And none of you are going to like it.

 

AnotherMcIntosh

(11,064 posts)
31. No politicians who voted for Obamacare should be allowed to own stock in health insurance cos,
Sat Oct 5, 2013, 01:18 AM
Oct 2013
either directly or indirectly.
 

phleshdef

(11,936 posts)
34. Well, then you know that after 2016, its adjusted based on COLA.
Sat Oct 5, 2013, 01:43 AM
Oct 2013

Cost of living increases are way below the average rise in health insurance premiums over the past decade. The penalty actually loses teeth over time. Not that it really has any to begin with, they don't give the IRS much authority to do a whole to you if you don't pay it.

ScreamingMeemie

(68,918 posts)
25. It is not subsidized for all...
Sat Oct 5, 2013, 12:47 AM
Oct 2013

...and that is an extremely nasty thing to say. "Quit freeloading?" Really??

kenny blankenship

(15,689 posts)
26. That's the "Democratic" party these days
Sat Oct 5, 2013, 12:57 AM
Oct 2013

the true heirs of Reagan. Ronnie would have hated today's Republicans. They're not driven by the dollars and sense, but by religion. Mammon was his only God, and by God he could come home again to this Democratic Party. Home again at last.

 

Bluenorthwest

(45,319 posts)
87. That is self serving way to say 'households of 4 or more'
Sat Oct 5, 2013, 11:28 AM
Oct 2013

What are the subsidy cut offs for singles? How about for couples with no kids (we can assume they will have kids later if that helps the conservative mind grasp that they are a household even without the kids)?
Leaving out all of the qualifiers is a bogus tactic. Bogus is a nice word for it..

pnwmom

(110,254 posts)
111. There are subsidies for up to $45,960 individual income in 2013,
Sat Oct 5, 2013, 12:29 PM
Oct 2013

Last edited Sat Oct 5, 2013, 01:00 PM - Edit history (1)

which is well above the median individual income.

LWolf

(46,179 posts)
89. That's a Democratic phrase now, isn't it? "freeloading"
Sat Oct 5, 2013, 11:39 AM
Oct 2013

I've already got insurance. I can "afford" it because my employer pays most of the premium. What I cannot afford is to actually USE it, because having insurance doesn't mean one can afford care. Care still costs money AFTER paying the premium.

I know there are some subsidies out there, which I don't qualify for. Part of the problem is with the terms "affordable" and "afford." It's not the individual with financial obligations that is asked to define "affordable" or to determine what they can "afford;" it's some other entity deciding how that is defined, separate from the actual financial circumstances of real people.

If you are a full time student supporting yourself on a part-time job, like one of my sons, it takes every penny you earn to pay the rent, pay the utililties, and buy groceries. There's nothing left for insurance premiums, deductibles, and copays, PERIOD. It doesn't matter what some entity's formula says ought to be "affordable," and it doesn't matter that there are subsidies out there to help some, if you are not one that the subsidies will cover.

If you work full time and make a decent wage, but that wage has been cut repeatedly since you bought your home at the peak of the housing bubble, and you can no longer afford the mortgage, but can't sell the place because it's value has dropped by more than 50% since you bought it, and you are paying fully 50% of your income every month just to make the mortgage and hope you can hang on until the market someday recovers and you can sell the place, you aren't going to qualify for a fucking subsidy, and there is no more money in the budget for premiums, deductibles, and copays.

If you are a single dad making so little that your son qualifies for the state health plan, but you don't, and you are living paycheck to paycheck to pay the rent and utililties and keep food on the table, there isn't anything left for premiums, deductibles, and copays whether or not some formula spits out an amount that is supposedly "affordable," or you get a subsidy for part of that amount.

Of course, all of those working people are "freeloaders" if they don't somehow find a way to buy health insurance. What they are supposed to do is turn off their lights and heat to pay the premium, and just not use the insurance since they can't pay the deductible. Then they won't be "freeloaders." They don't have to actually be able to USE the insurance; they just have to pay for it.

And they are my family.

Don't think we aren't paying attention to supposed Democrats calling us "freeloaders."

 

phleshdef

(11,936 posts)
27. I think the math is a little off here because they aren't considering the filing threshold.
Sat Oct 5, 2013, 12:57 AM
Oct 2013

The overall penalty is capped at the national average premium of a bronze level plan purchased through the exchange. And if only the flat rate applies, its capped at 300%. Also, its 2.5% times your annual income over the federal income tax filing threshold.

Based on 2013s threshold numbers:

Single $9,750, Head of household $12,500, Married filing jointly $19,500, Qualifying widow/widower with dependent child $15,700, Married filing separately $3,800

I imagine these thresholds will be slightly higher in 2016, but that's what we have to go on for now.

I'm not sure the WP article author realized this because the math doesn't seem to consider it. If you made 76,000 as a single person with no dependents:

76,000 - 9,750 = 66,250
66,250 * 0.025 = 1,656 ($138 a month), a little less than 1900, but if I were a single guy making 76k a year, not only would I be reliving my early 20s (only with money this time!), but I'd also not be hurting from that too much financially. I think you'd be bringing home around 5k a month after taxes. For 1 person, you are doing alright.

Now if you are talking about an uninsured 4 person household with 2 kids, if combined household income were 76,000:

76000 - 19,500 = 56,500
56,400 = 1,412 ($117 a month)

But unfortunately, I think the flat rate will be higher, so it would apply in this case, the cap in 2016 is 300% of 695, which is 2,085 or $173 a month. Also, you have to consider SCHIP programs and what various state qualifications for those are. In some states, the kids might be covered already, in which case, only the parent penalties would apply

However, if the lowest cost of a bronze level plan to cover the family is more than 8% of that 56,500 ($4,520 a year or $376 a month) then they are EXEMPT from the penalty. I'm not sure what the cost of a bronze level plan in 2016 is gonna be. But if its the same or higher than that, then this particular family would probably be exempt and if its lower than that, then that's like 94 bucks a person a month to give everyone at least minimum coverage, not a horrible deal for something really important.

I do think that some of the math with the way the main parts of the ACA works do need adjusted to fill in some gaps where people are in certain situations that are unfair regarding the mandate and the subsidy qualifications. And I believe the math will likely be adjusted at a later date. Also though, consider that the growing size of the exchange pools combined with the 80/20 rule has a lot of potential to bring premiums down. I also believe a lot of these states holding out of the Medicaid expansion will eventually sign on.

 

Egnever

(21,506 posts)
39. Off topic question
Sat Oct 5, 2013, 02:43 AM
Oct 2013

Great post!

Now to my question. If it isn't too personal did you just randomly throw letters together for your user name? I have been trying to make sense of it and just cant. Feel free to completely ignore my question

 

phleshdef

(11,936 posts)
49. You'll be sorry you asked. Its pretty boring.
Sat Oct 5, 2013, 03:18 AM
Oct 2013

Teenager, 15-16 years old, 95-96ish, internet is brand new to a lot of people, especially in southern WVa. Me and buddies got computers and dial up from the community college and of course, we are gonna be total hackers so that we can hook up with Angelina Jolie, etc. Anyway, I'm all into this hippie/grunge/cyberpunk mixture of teenager culture and I have to come up with an awesome handle that has some uber-deep, pretentious meaning. So I came up with "Flesh Deaf", which at the time, I defined as existing apart from your physical self and senses... like the existence of your cyber-persona. But to be super l33t and edgie, I spelled it phleshdef. Anyway, even as silly as the whole origin went, I got use to using it over the years and after I had well outgrown that kind of thing, it kind of just was my main handle. A lot of places, I use phlesh (which completely disregards all the super serious teenage thought I put into it) by itself, but whenever I registered for DU, I happened to use the entire phleshdef alias as it were.

 

Egnever

(21,506 posts)
50. Hah!
Sat Oct 5, 2013, 03:24 AM
Oct 2013

Such a familiar story!

Mine is of course revenge spelled backwards for the very similar reasons Multiplayer gamer nerd from the early dial up days. Sometimes I think about changing mine but I have used it so long and it is almost always available.

Thanks for the memories



 

phleshdef

(11,936 posts)
55. LOL, yea same here.
Sat Oct 5, 2013, 03:28 AM
Oct 2013

Though when I played the early multiplayer fantasy games like Ultima Online or Everquest, I didn't use phleshdef, I used alias that were more in line with the fantasy genre. The funny thing is, today, if I'm playing something more sci-fi oriented, I use phlesh or phleshdef, but if I play something more fantasy, I use the same 3 or 4 fantasy character names for all my characters that I've always used. Those are all old favorite D&D characters of mine of course. Those old habits die hard. Its funny talking about those days of the internet like it was the dark ages or something.

 

Egnever

(21,506 posts)
57. The dark ages...seemed so cool!
Sat Oct 5, 2013, 03:34 AM
Oct 2013

Good lord Ultima in the beginning was chaos on such a grand scale! I miss my rune pouch in other games to this day.

 

phleshdef

(11,936 posts)
59. Yea, I've never played an MMO that ever felt so "dangerous" really.
Sat Oct 5, 2013, 03:39 AM
Oct 2013

From what I've read of Eve Online, it might be the only thing that's ever topped it.

 

Egnever

(21,506 posts)
61. Standing at the bank wall
Sat Oct 5, 2013, 03:43 AM
Oct 2013

sifting through peoples bags looking for those keys...makes me want to try it out again.

I don't think anyone has done a sandbox better. Maybe Eve. Loved my little forge.

 

phleshdef

(11,936 posts)
64. Haha, just next door pretty much, Logan.
Sat Oct 5, 2013, 03:53 AM
Oct 2013

I live in Ohio now though, but that's where I grew up.

 

kestrel91316

(51,666 posts)
29. If somebody making $80k can't swing an $800 penalty, they are living too large IMHO.
Sat Oct 5, 2013, 01:16 AM
Oct 2013

Maybe the $80k crowd will just have to learn to live within their means like the Little People have since forever.

liberal_at_heart

(12,081 posts)
45. My family lives in western WA on $70,000. Most people in this area make $150,000/yr.
Sat Oct 5, 2013, 03:11 AM
Oct 2013

We live a very modest life style. We pay for housing which is very expensive for everybody here no matter your income or the size of your house. I clip coupons, and I just cut my own hair today because I didn't want to spend money on a hair cut. Health insurance is our third largest expense behind rent and groceries. So, don't just assume everybody who makes $70,000 or $80,000 is living in a mansion with a BMW.

 

Egnever

(21,506 posts)
54. There really should be adjustments
Sat Oct 5, 2013, 03:27 AM
Oct 2013

Based on the cost of living where you live. 70k a year can provide a very wide living experience in America from comfortable to near poverty.

solarhydrocan

(551 posts)
63. hey if mandated insurance turns out to be a dud there's always
Sat Oct 5, 2013, 03:50 AM
Oct 2013

the drone bombing of suspects at weddings or wall street bailouts to fall back on!

And just think of how popular the Trans Pacific Partnership will be when Hillary starts running...

Jobs? No one even bothers to bring them up anymore. "They're gone" like the wind. Why not sell insurance?

yodermon

(6,153 posts)
36. They need to take those "penalties" and make the them PREMIUMS on a Public Option or single payer.
Sat Oct 5, 2013, 01:51 AM
Oct 2013

Universal coverage.

liberal_at_heart

(12,081 posts)
40. Even with ACA I am going to be paying $6600/yr in premiums plus copays and deductibles.
Sat Oct 5, 2013, 02:48 AM
Oct 2013

So, I can see why some would rather just pay the penalty. I've suffered through paying $11000/yr premiums already, so I guess I can suffer with the $6600/yr in premiums, but I can definitely see why some would rather pay the penalty.

pnwmom

(110,254 posts)
53. My daughter spent more than that in one trip to the emergency room
Sat Oct 5, 2013, 03:27 AM
Oct 2013

for a broken finger, plus follow-up costs.

Or, her insurance did. If she hadn't had insurance, though, she would have been billed even more, since she wouldn't have benefited from the negotiated insurance discount.

Ms. Toad

(38,594 posts)
72. Or you may pay less -
Sat Oct 5, 2013, 09:38 AM
Oct 2013

Depending on your medical need during the year. Copays and deductibles are not guaranteed expenditures; they are limits on how much you can be required to pay.

spinbaby

(15,387 posts)
74. About $8800 for us
Sat Oct 5, 2013, 09:48 AM
Oct 2013

If we didn't have insurance through work, my husband and I would pay about $8800 for health insurance on the exchanges. Our rates are high because we're high income and in our early 60s. That $8800 is a lot, but is still a LOT LESS than we'd have paid for insurance on the open market before ACA. The ACA may make it possible for us to retire before we reach Medicare age and that is a gift to us.

 

Spitfire of ATJ

(32,723 posts)
42. Justin Green is also whining that the media didn't hail Ted Cruz for his fake filibuster.
Sat Oct 5, 2013, 02:57 AM
Oct 2013

Recursion

(56,582 posts)
43. Boo hoo. That's chump change compared to the tax penalty I pay for renting my apartment
Sat Oct 5, 2013, 02:57 AM
Oct 2013

Our home mortgage mandate penalty is much larger, and people line up to defend that.

littlewolf

(3,813 posts)
82. I just got word from the Navy
Sat Oct 5, 2013, 11:21 AM
Oct 2013

that Tricare standard is a qualifying insurance policy.
now on Monday, I will have to get with HR to tell them
I do not want any of the qualified policies that they
are offering.
Hopefully this is not going to be like herding cats.

GreenPartyVoter

(73,393 posts)
91. Stop me if I am being too nosy, but if you don't want any
Sat Oct 5, 2013, 11:47 AM
Oct 2013

of the qualified policies they are offering, then what will you be doing for health insurance and does it qualify?

littlewolf

(3,813 posts)
96. I am retired military
Sat Oct 5, 2013, 11:49 AM
Oct 2013

as such I have Tricare which is a qualifying policy
which I have been using since I got out.

GreenPartyVoter

(73,393 posts)
98. I vaguely remember my Dad trying to decide between Tricare and Medicare. He
Sat Oct 5, 2013, 11:52 AM
Oct 2013

said each had their plusses and minuses, and I think he wound up going with Medicare along with another policy from Anthem. (At least, I saw a lot of paperwork from Anthem on his "bill table" when we cleaned and closed up the house after he passed.)

littlewolf

(3,813 posts)
101. Now you have Tricare until you are eligible
Sat Oct 5, 2013, 11:54 AM
Oct 2013

for Medicare, then you have to switch. I am sorry for your loss.

GreenPartyVoter

(73,393 posts)
104. oh, ok. Maybe that's what he was talking about. Thanks for the condolences. It's been
Sat Oct 5, 2013, 11:58 AM
Oct 2013

a couple of years, but I still miss him very much.

Kingofalldems

(40,264 posts)
85. So bottom line we should just bow to the republicans
Sat Oct 5, 2013, 11:24 AM
Oct 2013

and scrap the ACA? Certainly the vibe I'm getting.

arely staircase

(12,482 posts)
99. OMG that is terrible
Sat Oct 5, 2013, 11:54 AM
Oct 2013

Last edited Sat Oct 5, 2013, 01:21 PM - Edit history (1)

someone making twice what I do might have to pay in fines less than half what I spend on insurance because they are too lazy, stupid, irresponsible, whatever to get some themselves.

That is the least compelling argument against the mandates I have heard.

Nine

(1,741 posts)
106. For that matter, why should I have to pay ANY taxes?
Sat Oct 5, 2013, 11:59 AM
Oct 2013

Schools? Roads? National defense? Let someone else pay for all that stuff because, while I'm not really poor, I'm just not making as much money as I feel I should be.

"Starting in 2014, the individual shared responsibility provision calls for each individual to

* have minimum essential health coverage (known as minimum essential coverage) for each month,
* qualify for an exemption, or
* make a payment when filing his or her federal income tax return."

It's simple. Do one of these three things. If you're not suffering enough hardship to qualify for an exemption, then suck it up and buy insurance or pay the tax. What's the alternative? Let everyone opt out of paying anything but opt in to getting free healthcare?

dem in texas

(2,681 posts)
110. Free Lancer
Sat Oct 5, 2013, 12:13 PM
Oct 2013

I saw a story on TV about a guy who was a freelance welder, doing high tech work. He was flying all over world doing these special welding jobs. He got sick, a infection on the lining of his heart. It ruined his heart and he was waiting for a heart transplant. Guess what - he had no insurance - guess what - the taxpayer was paying for his medical care.

This is what will happen to the big bad boys who think they are losing their freedom if they are required to have insurance. They get sick, hurt, in wreck, shot, something bad and the taxpayer foots the bill.

This dude may think he has a point, but I think he is pointless and clueless.

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