Ovarian cancer, lung cancer, diabetes. The list could go on and on for diseases that could possibly be controlled if found early enough.

IMHO, people are much more likely to see doctors on a timely basis if they have adequate insurance.

He'll be saving over $300 a month (he had been paying for COBRA). We're very thankful for this!

He also is one of the coveted younger people that the ACA wanted to get signed up.

where it will be a non-issue. Currently you would be "better off" to not get coverage, pay the minimal fine, and then get horribly sick and buy insurance.

Your rethug friend is correct, you can, right now, game the system this way. The thing is, most people want good health insurance and are willing to pay a fair price for it. Most people are not looking for ways to game the system.

indigent care. You break your arm...and you decided NOT to get insurance...you are on your own you are not going to get much sympathy.

After that date, a person will have to experience a qualifying event to get coverage for that year just like usual. Getting sick isn't a qualifying event.

whatever the bill will still be paid by the taxpayers just like always. The hospital can't put you out on the street with a broken arm or appendicitis.

Your credit rating will also take a major hit if you don't pay.

Yes, hospitals raise their charges for procedures etc to cover the deadbeats, asking the insured to pay more. But that doesn't stop them from hounding the deadbeats.

But the biggest problem if you opt out of insurance is that you're on the hook for all of the expenses you incur before you get insurance. If you're in an accident, you could have major bills. Same thing if you're admitted to the hospital in an emergency situation.

Yes, insurance companies can't deny you insurance for a pre-existing condition, but they also don't retroactively pay your medical bills for any treatments you had before you got the insurance. You pay all of those expenses. The insurance company starts paying once you've secured the policy.

You can roll those dice, but it could cost you hundreds of thousands of dollars.

My income is kind of low now, but I am still hoping to eventually get a full time job.

My question is this. If you can just barely afford a monthly plan, then how do they expect you to pay the high deductibles?
I might have payed for more than I can afford, but the other plans offer very little coverage until you pay off the deductible.
Either way the insurance company makes out good.

I am grateful for something, but hopefully it is what I think it is.

but it is virtually worthless unless you come down with some catastrophic illness. I hear the deductibles are over $5000 a year.

$2500 to $5300, and none had an out-of-pocket maximum greater than $6350 per year. You could easily rack up more than $6350 without having a catastrophic illness, and it would be worth your while. You don't know ahead of time what you'd need in a given year, though. Sort of like auto insurance.

you could be out $10000 before the insurance would pay a penny. I am glad I am on Medicare and don't have to deal with this mess.

so hope it works out. I hardly ever used it for 30+years, so of course I am with out now that
it is more important. Too bad we don't just have accounts that we keep the credit for if we never use it.

For many services, one would pay an office co-pay. Beyond that, the amount one would be responsible would be based on the insurance plan's contracted rate with the provider, not the provider's billed rate. So, even if the deductible wasn't met in the year, the out-of-pocket expenses are lower than not having insurance. This, of course, varies by plan.

Deductibles only apply for illnesses.

Big Insurance is still raking in Big Bucks with this bizarre, poorly executed health care act.

that insurance companies won't do very well with the ACA.

Why? Because Obama needed their buy in to get it passed. If he wouldn't have needed them we might have gotten Single Payer. But they lobby hard and he needed votes from those that they lobby. That is the way it works and until we stop the lobbying, it always will!

lower deductibles and max out-of-pockets. My state didn't expand Medicaid or develop a state exchange so I saw it on the site for another state, but basically I was looking for quotes and depending on my income the deductibles and out-of-pockets varied widely. It had a note on the computer that said my income may qualify me for lower deductibles which it called subsidized deductibles or deductible assistance.
There are higher deductibles and co=pays which is why certain things don't have a deductible at all like physicals, flu shots, mammograms and some other things. So basically the few things one needs every year and make sense policy wise to avoid much larger future costs are required in every policy and then it's a trade-off between higher policy premiums or higher deductibles.

My state has one that pays for the cancer screening tests, mammograms, etc. for people with too much income for Medicaid but below another ceiling.

The ACA web site also links to other community health low cost providers. I found a dentist through that - you can qualify for reasonable charges depending on your income.

Maybe they can eventually get rid of this deductible concept.

The Medicaid income requirements leave people with awfully low incomes, just not low enough for Medicaid, going from full coverage to maybe more affordable premiums, but if something actually needs treatment, 5K to pay for it before the coverage kicks in.

and this is what the Republicans are fighting tooth and nail against. I think they'd really rather that people with low incomes just suffered.

Or 1% of income in 2014, 2% of income in 2015 and 2.5% of income in 2016.

http://money.cnn.com/2013/08/13/news/economy/obamacare-penalty/

So the fine will be convincing. Being uninsured will be still cheaper and the IRS has said it cannot enforce the fine (because if you submit your taxes yourself using an estimated form, 1040-ES, then you don't get a refund).

maximum out of pocket of $1000 a year. Can you get a plan like that with Obamacare?
I am retired and on Medicare myself, just curious. The rethug said you can't even get insurance like that with Obamacare and if your employer has such a plan he will have to pay penalty for a Cadillac insurance plan.

benefits. As you may know, that has become increasingly rare. I'm glad you are on Medicare, too. You can thank LBJ's vision of a Great Society! Many of us wish we had Medicare for all ages.

did I didn't agree with. But we had great health care benefits and we have a fairly good pension now, that alone made the union dues well worth it. Even though our company liquidated our union still negotiates a great group Medicare supplement for us.

...but they're overlooking those three magic words: whichever is greater.

how this will work for my friend and his wife. Both unemployed, being supported by his brother for caring for their mother who has dementia and cancer. My friend, Carlos, hasn't filed taxes in god knows how long. His wife is a community college student. Carlos is 52, wife is 37. Neither has health insurance. Will they be fined?

However, a lot of GOP held states didn't expand Medicaid, so they may in fact be hurt by Obamacare. It sucks but the SCOTUS shot down the mandatory Medicaid expansion.

At worst though they wouldn't have to pay any fine or the fine would be pennies on the dollar, in those states. Fortunately it doesn't get big until 2015 so the states have a year to get on board the Medicaid expansion and I'd encourage you or anyone in states that didn't expand to caucus for an expansion. Fight for it.

That's one reason I think we'll have single payer because once people in GOP states realize they're being screwed over this they'll change sides (particularly the working poor who vote GOP, they'll see that they're getting the short end of the stick in GOP states that didn't expand). Eventually Medicaid should be expanded in all the states and then individuals paying for expensive private insurance will want the cheaper Medicaid option, pow, single payer. Will take many years for this to happen though (which is why I didn't advocate for-private insurance but why I defended it, in principle).

His brother gives them about $2,500 a month, I think.

They should be eligible for CA's Medicaid expansion and not have to pay anything or pay very little for very good coverage. You should have them go check out the rates. CA's exchange is one of the best in the country. I was blown away by one DUer who had to pay a few bucks for very good coverage (and all birth control and general office visits are free).

It may feel like they're paying for something that they don't want to even if it's a few bucks but they won't regret it especially if they use their policy. I know I myself hated the idea but I hadn't even been to a doctor in a decade so it's forcing me to take advantage of the free office visits and getting checked out. Fortunately my cholesterol and overall health is OK but it could've been bad (was overweight for awhile there with no doctor visits or well checkups).

how the govt will find them, if they don't file or pay taxes...if that makes any sense.

I mean, at worst they won't have to pay a fine but they won't be covered. But if they're in such bad economic conditions, they should be able to be covered. So at best they get free health care.

The IRS said they can't enforce it, so if you don't pay taxes or are using an 1040-ES estimated tax return, you can't be forced to pay it. What is 1% of 0% income? 0%!

Please have them look into CA's Medicaid expansion. They may be surprised.

I will mention this once things calm down in their lives. Mom is getting hospice care now, but he is still caring for her 24/7. No time for much else. Wife is Korean, so her English is good, not great.

and, as I myself, still looking for a job, told me she was not going to enroll because she would have to pay $600 . She is not young either. I still have my husband insurance but I can't ever afford the deductible!

so hope you don't get sick that year.

It is ridiculous that a person should get bankrupted if they had a misfortune of spending a few days in a hospital.
And, have you ever dealt with the hospital billing department? They'll squeeze the last drop of blood from you for $0.59.

Insurance is not the answer. Maybe it is an answer at this stage, I dunno.
If they can afford it, they should buy it. It is only prudent.
If they cannot afford it, it is a non-issue.

I just had emergency surgery -- two procedures, in fact. I will have to file for medical bankruptcy, I'm sure.

slowly. Hopefully this initial step will push this country in the correct direction of single payer.

It would make so much more sense to simply expand Medicare or TriCare. Premiums coming out of paycheck just like Social Security (and there already is a deduction for Medicare so this would have been very easy to implement - if politicians weren't bought off by the insurance lobby).

scared off from that, but if they had it, they'd like it. I'll never understand Republicans. They must have excellent coverage, or be sure nothing is ever going to happen to them.

for years I paid a premium and thought I was covered but didn't really think about the deductible and now am at an age where I end up needing things that cost less than the deductible and so I pay out of pocket, but still a whole lot.

And the plan I had only paid 80% once over the deductible. So that insurance didn't stop me from having a whole lot of debt as long as something actually needed to be treated.

...attitudes like that are the perfect illustration of why the mandate is required.


Second, insurance isn't retroactive. Good luck getting in a car accident or something, waking up in the hospital a week later with 50 grand in medical bills, and trying to go buy insurance and file a claim for it.

Yeah you'll still be able to get insurance, for all the good it'll do you with those charges they're not going to pay for.

(And that's a generic "you"... not accusing you specifically of being too irresponsible to buy insurance)

(Main point still applies though).

You could just pay the fine every year I suppose, probably what a lot of poor people will opt to do rather than add another bill every month that they couldn't afford and since they can only buy the cheapest premium they will not be abe to use because the co-pays will be so high.

So their choice will be 'pay a fine' for not buying something you can't afford, or buy something you can't afford and won't be able to use and don't pay some other bill.

I have always been against Mandated Insurance, as was Obama during the campaign, one of the reasons I supported him. I am still outraged as I was when Republicans were demanding that those 'lazy, welfare queens should be forced to pay for their HC' that anyone should be forced to pay a private business for a product they can't afford, or be fined.

What a windfall for those private Corps. But then they wrote the bill so no surprise.

I wonder if we could all get in on this, owning a business that Congress forces people to buy from?

This country is rich enough to pay for the health care of every citizen. All they have to do is to spend a fraction of the money they are paying for the military. I guess it's okay to pay to kill people but not okay to pay to keep their own citizens alive.

and millions more are receiving significant subsidies. Even middle class families are getting good subsidies.

You say that you are against "mandated insurance".

What do you think Social Security and Medicare is?

There was no way to get universal payer through congress and even if they did there was no way that we would have gotten the 5th vote on the Supreme Court.

Your other 'facts' are equally off.

Total health care in the US = $ 2.7 trillion

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf

The Defense budget is $ 525 billion but total defense spending is about $ 900 billion.

http://www.cjr.org/united_states_project/the_true_cost_of_national_secu.php?page=all

Rather than taking a fraction of the defense budget to pay all of the health care costs the reverse is true. If we took all of the money from all of the defense and national security budgets it would amount to only about 30% of the health care costs.

With the exception of, amazingly, Kentucky (might be a few others but I can't think of them).

In states where Medicaid expansion is happening? Free or near free health care for millions of people. Of course, this cannot be acknowledged, because nothing good is coming from the ACA. Nothing.

Three previous topics on the ACA: http://election.democraticunderground.com/10023757103

And: http://www.democraticunderground.com/10024088437

And who benefits the most? The poor: http://www.democraticunderground.com/10023917607

It exposes a problem so it definitely doesn't need more coverage.

They'll cover your next accident maybe. If you get cancer you're on your own if you don't have insurance. If you try to apply while you need treatment your premiums will be through the roof. Which is why you should lock in a good rate BEFORE you get sick.

It exposes a problem so it definitely DOES need more coverage.

which will possibly catch things like cancers at an early, and treatable, stage. If you have no coverage and you don't notice until you're sick? Then it may be too late. Taking care of your body is like taking care of your car; you can just drive it until the engine blows up, or you can do regular maintenance and change the oil and transmission fluid and coolant and such to make it more likely that it'll last longer. Which one is the smart thing to do?

Next year will be an even smaller window to enroll in. This yr it is until March 31st. If a person is not enrolled in a health care plan at the time of their illness will be stuck with the bill. He can not just go out and enroll.
About 50,000 people each year without health insurance will die from lack of treatment. There is a myth that if you have no insurance a hospital must treat you. That is false. All any hospital has to do is provide emergency treatment. Once you are stabilized they will just give you a referral to another doctor or the free clinic.

Only about 1% of those without health insurance will receive charity care. Doctors and clinics in my state are requiring people undergoing procedures to pay a deposit for their treatment before they will treat any major illness.

once you've been in an accident or had a hard attack and those expenses can easily bankrupt you.

uninsured people have been doing before ACA i.e head to the next emergency room for treatment. They will still treat you like before and seek the debt collectors at you when you don't pay. The same ole problem yet again.

and would be willing to pay the insurance premiums to prevent it if they can. Debt collectors can be quite a hassle and having your credit ruined is not a lot of fun.

And that is what the Affordable Care Act is all about making insurance affordable. Not really sure it met the goal but it is a good start.

Of course, getting rid of insurance all together would be much better which is why so many on DU fought so hard for single payer.

before you fall down the stairs, or burn yourself, or need surgery immediately due to an appendix or something.

which actually draws attention to the very use of the word "insurance"

Insurance cover the probability of an event : not a definite occurrence the probability of which is 1.

The Affordable Care Act includes 2 subsidies: premium subsidies and cost sharing subsidies for those with incomes of 100% to 200% FPL. To be eligible for these subsidies, you must not be offered insurance through your own or a family member's employer. If the employer offers insurance, the family is not eligible for subsidies no matter how low their income is. While employers usually subsidize insurance for their employees, they often don't for the families of their employees. They just offer family policies with premiums and/or deductibles so high that low income families can't afford to seek medical care. Low income families end up paying for health insurance they can't afford to use and aren't eligible for any help. The 9.5% affordability test only counts the employee's portion of the premium. I suppose they could try working 2 part-time jobs instead of one full-time to avoid being offered insurance through an employer, but often employers aren't willing to shuffle schedules and most employers seem to require employees be available for long shifts on weekends. Then there's the conflict of interest problem. If a person works in a department store that sells almost everything, they're pretty limited on where else they can work. The reality is, until all states have expanded Medicaid and until the family glitch no longer exists, low income families will continue to get screwed.

So suppose you don't have insurance and you have a car accident in June. It's true you can buy in at the same rates in the next open enrollment period, but I think that means you couldn't possibly get coverage until December 1st, 2014.

Not much help when you are needing the medical care in June, July and August, is it?

an auto accident or some other disastrous thing. You'll find that you'll still be paying for your health care for that issue on your own, even after signing up for insurance.

We buy health insurance because we know that anything can happen to any of us at any time.

If you think you're invulnerable, you just haven't found your vulnerability yet.

Trust me on this.

That you can't "buy Obamacare". "Obamacare" is health insurance REFORM, not something that can be purchased. These imbeciles are so brainwashed into thinking this is some sort of government program that they don't have a fucking clue as to what the ACA really is. It doesn't matter what you tell them, because they will believe what they want, regardless of what are the facts of the matter. I don't think they can even comprehend the idea that health insurance now comes with check-ups that can help prevent a person from getting seriously ill in the first place. Just tell this rethug idiot that if he would rather buy his insurance when his cancer gets to Stage 4, rather than when he can go in for a free check-up that would catch it at Stage 1, then have at it. Enjoy the blank, uncomprehending stare you will likely get when you tell him that.

Start with those three. Rethugs have trouble holding even one idea in their heads at a time. Giving them 3 reasons should be more than enough.

The point is now you can never be denied care when in need no matter your financial status or circumstance- thanks to President Obama and the Democrats.
Nice of him/her to point out a benefit we provided - you're welcome!