However, if he really, REALLY can't afford it, and his state has a Teabagger governor who opted-out of the "free" money from the federal government, he can still get a compassionate need waiver, and not have to pay the penalty.

didn't know about that.

for the Medicaid expansion but his state isn't participating he automatically gets a waiver (he doesn't
specifically have to apply for one).

More on the Tax penalty and who doesn't have to pay it can be found here...
http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision

You haven't been banned yet?
Anyway, you could say that he'd probably get good coverage with a subsidy. Or, he could risk having an accident or an illness, wind up in the ER and be in debt -- for years. And you could add that apparently, he's had no experience with a hospital collection agency.

this was a freeper/randian type who I'm friends with on Facebook.

There are many problems and many people hurt by ACA but also much good it does. The parties need to work together to fix the problems.

There are some who do not get a better deal with ACA than with their current insurance. There are some who are currently uninsured who fall into donut holes and who will have to continue to be uninsured, but by all reports, the vast majority of penalties will be waived and it's only a matter of time before donut holes are closed and voters demand that states that didn't expand Medicaid do so.

So who is "hurt?"

Good on you for your optimism though, I guess.

But honestly, "buy (slightly cheaper) insurance or else" is a poor solution to having an uninsured populace, which is probably why Obama ran against the individual mandate in the primaries.

And you're trying to sell to a group of people that fear the IRS more than cancer the idea that the government fee will just be waived? Even if that's true in 100% of cases it wouldn't be believed.

Your post doesn't address that.

It's really hard to argue against that. Why is there a fee at all if it is just going to be waived?

Maybe people reading this conversation later will think you've made a point. From here it looks like you're ignoring my question and are not actually interested in having a discussion. So I won't. Happy Friday.

Edit: and I'm not ignoring YOUR question. I'm trying to determine what assumptions you're asking that question under so that I can answer it.

Some people will end up paying more to help those who cannot. That was the whole idea. Those people (the haves) will pay more to subsidize the "have nots." Are the "haves" being hurt? Depends.

Serious question.

Mitch the Turtle says millions will "lose their insurance and jobs due to the ACA" - We know that is complete bullshit.

Now we have someone posting on DU "many will be hurt" - I'm wondering who?

As near as I can figure. If that is true then they have wasted their time writing penalties into the law for no reason.

If that is not true, there are lots of people who will see less of their paycheck due to ACA. These people are:

-Those whose plans have been cancelled due to lack of maternity or other newly required types of coverage. Nobody will argue that the plan is better, but it will cost more.
-Young people like myself who are uninsured and who will now be subsidizing those who use healthcare more. I plan to pay the penalty (maybe I should just ignore it?) because the plans I can afford don't actually cover me for anything (except protection against complete bankruptcy) due to copays and deductibles.
-People in the new ACA donut hole - who should have been eligible for expanded medicaid but their state opted out. The ACA requires that these people become insured even though there is no way they can afford it. But then again, the penalties are a figment of my imagination so the ACA doesn't actually require anything.
-People who are employed by right-wing nutbags who will use any excuse to steal from their employees. Not ACA's fault.
-People who are employed by large corporations who will use any excuse to steal from their employees, downgrade them from full time, etc. Can be argued that this is partially due to the ACA, since these effects were foreseeable.

In summary, few of these categories are serious problems with the ACA (just points 2 and 3.) Nobody will lose their job directly due to the ACA. Someone who loses their insurance due to the ACA might have to pay more for a similar plan. But there are indeed losers.

"Young people like myself who are uninsured and who will now be subsidizing those who use healthcare more. I plan to pay the penalty (maybe I should just ignore it?) because the plans I can afford don't actually cover me for anything (except protection against complete bankruptcy) due to copays and deductibles."

I don't know why people are so cavalier about this scenario.

The only reasons I have to do so are 1) to avoid the penalties, 2) ideology. I've been posting on DU for 10 years, and ideology isn't enough for me to pay THAT much. It's quite ominous, really.

Add the severe issues with the website and it's actually quite scary.

Is an uninsured by choice 20-30 year old, who really isn't motivated to enroll in the first place, going to put up with the problems being reported with the website? Will he fill out countless applications, log on multiple times each day trying to get through and follow up with phone calls to a helpline that can't help? If he finally gets through and sees his costs, will he sign up?

He will not.

... about "subsidizing" someone else ignoring they are being subsidized by society in their own state of un-insuredness.

They can afford a plan that would cover them against bankruptcy that ALSO covers society against paying for THEIR catastrophic medical incident but prefer to roll the dice and pay a fine.

That's OK - just don't bitch about subsidizing someone else when you are being subsidized. Because, as it stands, you get care paid for by everyone else if you split your head open on the pavement, have a brain hemorrhage, stroke or any countless number of things that CAN happen to young people who think they don't need health care.

there is a significant segment of society that is unisured by choice. They are the 'young invicibles'...young workers who are healthy who just don't see the need for the expense of insurance at this point in their lives. A lot of them pay cash for doctor's visits. And this is the segment the ACA is counting on to help fund the program.

This segment currently has the option for low cost, low coverage plans. They don't anymore. If they weren't willing to pay then, what makes us think they will now for more expensive ones? Many of them will opt for the $95 annual tax.

I don't like it any better than you, but that's the unfortunate reality.

Those people need to be made aware they are ultimately insured and subsidized by tax payers and other people who pay for insurance.

They think just because they don't get hurt or suffer a major illness they are not being subsidized. That's no the way "insurance" works. The system is in place if the should suffer a traumatic brain injury on their skateboard.

First, it isn't a $95 annual tax. It's $95 in 2014. It's $600 in 2015. It goes up from there. It very, very quickly passes the cost of actually buying insurance. Especially when you factor in the subsidies.

Second, you and the other poster are claiming deductibles and copays mean no health care, so might as well pay the penalty. That's wrong. The basic health care that a 'young invincible' would require has no deductible and a low co-pay - $20 checkups, for example. Deductibles kick in for those of us having to deal with more 'unusual' situations. Like the $2500 bill I just got for kid #2's birth.

I've heard something about "preventive care" being free under the ACA. Is this the only thing that doesn't use deductibles? Basically, checkups? In the first year, it is far cheaper to pay out of pocket for a checkup than to pay for the cheapest plan I can get on the exchange.

Yes, in the second year it will be a much better choice for me to get bankruptcy insurance than to pay the penalty.

I haven't been able to get into the system to see specifics.

Most of that is stuff I can pay for out of pocket (until the penalty rises), or don't qualify for.

People like me who have to pay more are hurt financially. Previously we were subsidized, as you say, through emergency room care.

I'm also not objecting to younger people subsidizing elders. There's no other way to run a healthcare system (though as B2G is saying, this can be a very hard sell in America today.)

I'm objecting to the poor subsidizing anyone. A detail I left out of this particular conversation is that my income is $20-25k. Exactly where it falls will determine whether I get an affordable anti-bankruptcy plan (under 22k, I think?) or whether I pay the penalty. Right now it's looking like I'm making slightly more than the lowest subsidy cutoff. I really can't imagine how a household with a median income can even come close to affording those plans, if these are the subsidies I'm getting at the lowest end of the spectrum!

The ACA does not do much to lower costs. Some people are complaining that rates will in fact skyrocket next year. That remains to be seen. Instead, it seeks additional funding for medical care from all users, including those who can't afford it.

I should point out that there is no way in this scheme that I get affordable healthcare. What I get in a best case scenario is anti-bankruptcy insurance. Even if I take out a plan, it doesn't provide me with a normal care due to deductibles and co-pays. In fact it ONLY helps if I accumulate absurdly high medical bills. (I've heard something about "preventive care" being free, but I don't know what that means or if it's true. And if it were, it's probably still cheaper to pay out of pocket.)

There are those for who strict party allegiance prevents them from hearing legitimate criticism and there are those who will not accept criticism because to do so puts them in company of republicans even though our motives for being concerned are nowhere near the same. I do Medicaid eligibility and have had training on our states HBE's, expanded Medicaid and the ACA law. Many of my co-workers, seasoned and dedicated social service caseworkers have serious concerns with the overall impact of the ACA.

I know you are too.

I'll just continue to take the arrows because that's intellectually honest.

60 years old no income, living on savings. Own small condo free and clear. Live in OH. Currently uninsured.

If OH takes expanded Medicaid and I sign up, a lien attaches to my home. If I don't sign up I won't have to pay the fine b/c I don't have to file taxes due to lack of income. To keep my property title clear, I have to remain uninsured.

Still, I'm glad it exists to help those it helps.

That is very unfortunate, and that needs to be fixed. But you are not hurt by Obamacare. You are not in a worse position due to its existence. Your position has unfortunately not improved, but it has not worsened.

send him this:

Subsidies are not available to everybody, and there are plenty of circumstances that make insurance unaffordable to those who don't qualify for subsidies.

I had insurance before the ACA. I have it now. I still can't afford actual health CARE, and I don't qualify for subsidies.

The problem is with the definition of, and the assumptions about what is, "affordable."

"The problem is with the definition of, and the assumptions about what is, "affordable."

The people making these determinations both Dems and repugs, don't have clue how little money is actually worth now adays
My Hubby and I have cut back as far as we can and every time we do a new bill goes up by 4 or 5% so any savings gets taken away immediately

They have this informercial mentally, just 49.95 a month and you get blah blah blah

Um There is no "Just" anything in our budget. We have to account for every penny

But this goes hand and hand with the idea that people living on welfare are somehow living a life of Luxury with no wants or cares in the world.

I qualify for an enormous subsidy, but I can still only pay the premium by using the last of my IRA to buy through the exchange for 15 months, until I get Medicare. The problem, on closer look, is that I would not be able to afford to use the insurance 'cause I couldn't pay my share. A number of the plans require me to pay 30% of surgery. I have not made my final decision yet, I want to speak with someone who can better explain the plans.

that attitude is becoming more prevalent among Democrats as well as Republicans. I just ran into a post this morning on that thread about the Swiss idea for a guaranteed income that is telling.

There also seems to be a concerted determination to pretend that insurance and care are the same thing; they're not. Even if the insurance premium is "affordable," there are still deductibles and copays to pay. That's why having insurance doesn't guarantee care; having insurance doesn't mean we can PAY FOR the actual care, which still costs money AFTER paying for the insurance.

The premium that my employer pays for me (mostly; I pay for some of it) is MORE than my youngest son is paying on his first mortgage, taxes, and insurance for his first house purchased last year. I still have a deductible high enough that I can't afford to get enough care to have "met" it, so that I could keep paying 20% for more care after that. I just do without unless I can't function at all without help; that's happened twice in the last couple of years. Once for shingles, once for an abscess. Other than that, I don't get care. The only other thing I've used my insurance for in the last 10 years is a free flu shot every fall.

things that make you go hmmmmm

Tell him that if he advocates or Single Payer Healthcare, he wouldn't have that problem

that I know are paying 30% of more of an increase.
That does not make the ACA bad nor does it make those people Republican.
It is a fact.

There was another thread that said if the whiner won't provide his state, income, family size, then he probably hasn't actually checked out the exchanges.

I personally expected the rollout problems, primarily due to the use of contractors with ties to questionable Repubs. I've also been shaking my head at the number of people who say they don't need the exchanges but they checked them out anyway, further slamming the sites. Plus FreepTeas trying to bring all the sites down, it is remarkable things are going as well as they are.

We don't have Vision and our dental sucks. So I was checking to see if we could get a supplement insurance just for Our Children for Dental and Vision
I found out about a program called CHIP. but I am not sure if we can use it. we meet the income requirements, however being military might keep us from qualifying I just don't know.


I do know that the dentist wants to put braces on both my boys and they say it will cost almost $6,000 each. but Out dental only covers $1500.00

Anyway, that's why I tried to look. but I will wait until the excitement dies down I am not in any rush like some people are, understandably so.

I've been through several over the years and most seem to have a maximum annual payment of somewhere between $1,000 and $2,000.
I consider it "good" dental insurance if they pay 100% for the standard twice a year cleaning. For more serious dental problems like root canals, you'll get 50% coverage. My wife has had a host of dental issues over the years (probably due to growing up overseas.)

Not sure if the ACA changed maximum coverage on dental benefits, though.

There might be some sort of coverage coordinator with CHIP and S-CHIP, maybe they can help you?

My plan is closing.

I will be OK - union is helping me. But there are many middle-class folks in this scenario (costs increasing under ACA) and this needs to be factored into an evaluation of ACA, and those on the boards here who are either deniers, or dismissive of this fact, are not helping improve ACA.

Health insurance companies have been increasing premiums forever, that's nothing new. Suggest they take a look at their health insurance bills over the past 5 years and see see how much the premiums increased before the ACA went into effect. All premium cost increases can't be blamed on the ACA.

But even if they purchase HI on their own, not thru the exchanges, they still benefit from the ACA.

http://www.whitehouse.gov/healthreform/healthcare-overview

Free Prevention Benefits: Insurers are now required to cover a number of recommended preventive services, such as cancer, diabetes and blood pressure screenings, without additional cost sharing such as copays or deductibles. Already, 54 million Americans with private health coverage have gotten better preventive services coverage as a result.

Coverage for Young Adults: Under the law, most young adults who can’t get coverage through their jobs can stay on their parents’ plans until age 26 – a change that has already allowed 3.1 million young adults to get health coverage and given their families peace of mind.

Coverage for Americans with Pre-Existing Conditions: Before the law, many Americans with pre-existing conditions were locked or priced out of the health insurance market. More than 50,000 Americans with pre-existing conditions have gained coverage through the new Pre-Existing Condition Insurance Plan. This temporary program makes health coverage available and more affordable for individuals who are uninsured and have been denied health insurance because of a pre-existing condition. In 2014, insurance discriminating against anyone with a pre-existing condition will be illegal.

In many cases their existing plans have become unaffordable due to changes in coverage requirements. They must enroll in new, more expensive, ACA compliant plans.

That's the problem.

running to the healthcare website to see what they can get. Which is it, either Government is evil and useless, or they need it. it can not be both

presumably because they don't include the 10 essentials.

Yes, they are paying $2300 per month on their plan. They do not qualify for subsidies. They have been informed by Blue the reason for increase was mandatory coverage required by the ACA (autism, pre-existing, etc.). Some people are being hit with large increases. This is a fact, not a complaint.

Why on earth it was decided (and accepted) that "affordability" doesn't apply to families is beyond me.

What really pisses me off is the decision to allow affected dependents exempt from the mandate, rather than figuring out a way to get them covered. These are kids they've written off, for chrissakes.

but not vote on them. Remember this plan was born in bowels of the Heritage foundations. There will be problems by design.

That is such a BS provision.

My spouse pays less than 9.5% of his AGI (the cutoff) for his premium, with his employer picking up the rest.

To cover the family (daughter and self) would be well in excess of 9.5%. But, because the part for him, alone, is less than 9.5%, we can't use the exchange and aren't eligible for a subsidy.

Is that your understanding?

This must have been a tradeoff to the insurance industry. They should NEVER have been allowed into the negotiation, though I'm not naive enough not to understand why (prescription drug industry as well).

I hope Pres. Obama and Sibelius have a grand scheme up their sleeves to quickly transition to single payer. I have a secret hope they've sabatoged the system in order to go there sooner rather than later. Pres. Obama should have never trusted the right to begin with, keeping single payer off the table in initial negotiations.

A question on single payer: what would this actually mean in terms of individual costs? I mean, perhaps or presumably it would work as a tax that would also be progressive, e.g., one would pay more based on income.

Move, if needed!

Take out $100k or more in student loans!

Get those bootstraps!

borrow the money from your parents if that still doesn't work!

I hope?

of course the poster is being sarcastic

...all the shit they spew at, say unemployed urban non-whites.

In countries with single payer, you can still get private insurance, too, which successful people like most Republicans must be since they are so virtuous, will get anyway. The ACA is a minimum. Can't these people afford much better anyway!

Last edited Fri Oct 18, 2013, 10:15 AM - Edit history (1)

however, there is debate on what level the waiver kicks in.

or is he just spewing RW talking points.
He should have (and you should have) posted some relevant data.

The character Nero Wolfe is told he's an amazing incredible man. The woman asks if there is anything he can't do.

"Yes Madam, I can't pour sense into the mind of a fool. I've tried."

Responding to Freepers is perhaps entertaining to you, but you are in essence trying to pour sense into the mind of a fool, and that has never worked.

there are a few of them that listen to reason. Not many, but a few.

Guess what, even if you come up with some witty retort the ahole still won't learn a thing so YOU ARE WASTING YOUR TIME

if he dont have, or cant afford healthcare insurance, why in the fuck is he a republican!

That toothless yokel should be on Medicaid if he can't afford ACA. Probably is. Or else he's just a greedy rich asshole that simply hates liberals. Did I say liberals? I mean people. In any case, he's a liar. ACA is ONLY for people too rich for Medicaid who can't afford insurance.

probably have a laundry list of unnecessary expenses they can get rid of to afford a basic insurance plan.

qualifies for Medicaid

However, the ACA also indicates that if the premium of the bronze plan is 8% of his income, he can have an exception from the mandate.

In other words, to make a decision of the validity of his statements, you need more information from him