OK, suppose I'm making payments on my "affordable" mandatory private health insurance

Most of my discretionary income is gone, even with the subsidy, but under normal circumstances I can keep paying. Then the deficit targets aren't met and my subsidy gets slashed. My house suffers storm damage that absolutely must be repaired in order for the house to stay livable. I can't do that and keep paying on the insurance, so I fall behind on payments. When I file a claim, it gets denied because I haven't paid. Now what?

...if you're making up things that aren't happening, you may as well make up good ones...

People winning the LOTTO only happens every once in a while.

I'm guessing you've never had a major financial emergency.

Consider yourself lucky.

I'm always in some kind of financial crisis. My point is we have enough to do dealing with actual things happening in our lives than to freak out about 'What ifs...?' & things that aren't happening.

It's much more of a "when"..

Which was my entire point.

WHEN you have a financial crisis then you will have no leeway, you will be forced to fork over your hard earned cash to an immortal and amoral corporation that would rather see you die than spend a nickel on your care.

...let's just see what the final bill looks like. I don't want to waste my energy on worst-case scenarios. Right now, my job is to keep on Congress to include a public option & try & find a conscience for Joe Lieberman & others to sign on...

"Too late to do anything" in our system is about negative two months.

And *our* job is going to be to do what the fuck we are told by our betters in Congress.

This whole thing has had "worst-case scenario" written all over it almost since the very beginning.

Get the Kucinich amendment back so that states can go for single payer. Maybe convince the Progressive Caucus to strip out and repackage the useful parts of the bill.

If you're curious as to what's in the Congressional healthcare bill &
don't want to wade thru 1000+ pages, here's a link to a "Readers
Digest"-version of it at only 61 pages...

http://energycommerce.house.gov/Press_111/health_care/hr3962_Section_by_Section.pdf

We all know that the Devil is in the details and that the big print giveth while the small print taketh away.

If the "condensed" version is 61 pages, how many Devils are there in the 1000 plus pages of the full bill?

From my point of view the only reason for such a long and complex bill is to make it easier for the powers that be to game the system. Canada's health care legislation is the Canada Health Act, in both English and French it is 14 pages long..

See for yourself at this link..

http://laws.justice.gc.ca/PDF/Statute/C/C-6.pdf

You should always plan for bad situations. If this legislation can't handle typical bad situation, and results in a catastrophic failure of the system when a bad situation happens, then it wasn't well thought out and isn't really helping people.

If people are going to be FORCED to be customers, then situations like the one in the OP should have been considered and there should be answers to that kind of a question. People should know how this mandatory insurance is going to work out for them when things turn bad.

If everyone took your position, that there is no point in ever asking hypothetical questions, then nobody would ever be prepared for disasters or emergencies.

...posting on DU just has the blind leading the blind. It's all guesses. Get real facts & post them... then, we can talk about it.

The only people who are allowed to be concerned about what would happen in bad situations are people who already know the answers?

If they already know then why would they need to ask?

And what about all the people who don't already know? Don't they have a right to ask and see if anyone has any ideas or information?

You are being very dismissive, but it doesn't seem that you have any good reason for it. You're just being a nay-sayer for the sake of being a nay-sayer. If you really don't like this thread that much, then why post here?

You could ignore this thread and leave hypothetical questions to people who aren't so offended by them.

I'm not the Hypothetical Police. I don't care how you use your time/heartbeats. My preference is to not worry about things that aren't happening. You can do it anyway you want...

The only reason I've come back to this board is because people keep replying to what I wrote, so I thought the polite thing to do was answer. If you don't want me to answer, don't respond... it's that simple.

rather than posting back with the first snarky thing they can think of.

n/t

No wonder we Dems have such a lousy reputation.

We won't bring up the topic of Suzanne Somers, but, lol, you and I are on the same page, as you are aware. :D :hi:

then you get sick. You can't work, so your employer lets you go because they need to get somebody who can do the work.

Now you have no health coverage, you're sick, and have no money to pay for private insurance.

FMLA.

I worked for a large, national company which had 53 locations. Not sure how they did it but if you worked at a location with less than 50 employees you were not covered under FMLA. And you are not covered if you have worked at a company less than a year. Try not to get sick the first year.

That is correct, each job site must have at least 50 employees who live within a 75-mile radius of the site. So, if you work for a large company headquartered in New York, but you work at a small branch office in Peoria, IL which employs only 10-15 people, the Peoria office would not be required to comply with FMLA.

if he calls in sick more than 5 times in a six month period, regardless of duration, he has to go before a review board to explain why he is sick so often (he has chronic asthma). Calling in sick more than 5 times in a six month period is grounds for termination.

And without a job, there is no way he can cover the costs of his asthma medications.

For those living paycheck to paycheck, 12 weeks with no income would be catastrophic.

Diabetes and a heart attack and my health insurance runs out next month.

Ever. It should be a right, not a privilege.

So sorry to hear about your situation.

Last month I went to get a script for my daughter filled and the pharmacy says my coverage is no longer good. The Pharmacy company hems and haws about some clerical or computer mistake that they are unsure of. They didn't even know the reason it happened. I know exactly what happened. I am on severance and they hoped I would assume that it had just run out and not call and give them an earful.

So yesterday I open my mail and get full bills from the local hospital as the medical insurance company is trying to pull the same shit that the prescription drug insurance company tried to pull. I am really convinced they have "clerical" and "computer" glitches just hoping the patient is to stupid to fight it.

....it`s the american way!

USA! USA! USA!

relative to insurance. Assuming you like the way things currently are.

but here, you must be very, very wealthy to be able to pay for your own care because the doctors, clinics, and hospitals contract with the insurers for special rates, and if you don't have insurance, you get billed three times what someone with insurance gets charged.

The number of places with really good public transport in the US can be counted without taking your shoes off. A car is a necessity for most Americans these days just to get to work.

A halfway serious car problem can cost thousands these days..

I start out having a job that provides me with insurance. I am compliant with the mandate.

I lose the job and go on unemployment which qualifies me for Medicaid. I have to sign up for it and wait for my eligibility to be determined. I am found to be qualified for Medicaid and enrolled. What about all the time that was uncovered while waiting to have my Medicaid eligibility determined? Do I get penalized for that?

I get hired again, but this time as a 1099 contractor at over 400% FPL pay. My income disqualifies me for both Medicaid and subsidies so I have to pay full price for private coverage.

The contract work dries up and the income from my contract job drops below 400% FPL but not down to 133% FPL Medicaid eligibility. I have to apply for subsidies and wait until my eligibility for them is determined. Meanwhile, I can't afford the full price of premiums on my current income. What do I do? Stop paying and be in violation of the law? Or not pay other bills and ruin my credit so I can be in compliance?

I have asked my Congressman's staff how this mandate works for people who are self-employed or have unstable incomes. They don't have an answer for me, other than, "they'll have to buy insurance".

That's really the point in this hypothetical where everything breaks down. What causes your subsidy based on your FPL position to get slashed? When would they legally be allowed to cut that subsidy?

I guess what I'm asking is what is the in reality basis for this occuring? Could this actually occur under the bills as written?

http://www.cbo.gov/doc.cfm?index=10642&zzz=39653
...exchange subsidies would be automatically adjusted to avoid the estimated increase in the deficit for that year. ... estimates of the deficit impact for the proposal, the failsafe provisions would require a reduction in exchange subsidies averaging about 15 percent during the years 2015 through 2018.

...why don't you work harder so you can save more money for your future misfortunes? I heard Sean Whannity tell his listeners on the radio a couple weeks ago that "there's nothing stopping you from working 16 hours a day", so we should all quit whining.

So, follow the advice of your ideological allies.

If you just forgot the :sarcasm:, erase erase. If not, I just wanted to say the OP is a well-known and well-respected DUer (with whom I've been known to disagree on occasion), but "ideological allies?" :wtf:

...which is pretty scary!

What are they gonna do, imprison me for not playing along? Won't that go over well on Fox News?

If non-compliance is widespread, there may be some kind of welcome public outburst.

the following things will happen:

1) Growth in underground economy (why get paid "on the record" if it only means you'll be forced to buy a plan you can't afford?) If your income shows up much lower, at least you'll get the subsidy

2) Perhaps, if the insurance cos. can still rate people by age, enough pressure from over-50s who're outraged by ridiculous charges, that they'll force an opening up of Medicare to their age group (though this won't be utopia--to avoid "nasty surprises" you still have to pay $300+ a month for "supplemental" insurance.) Remember, these are the people who turn out most faithfully to vote. But there will need to be a campaign to convince them to agitate.

3) A push, by stealth, to get as many additional people as possible qualified for the govt. programs. Hey, if we go from 40% to some over $50, we're that much closer to single payer.

I'm putting these as predictions, but heck....who says it can't happen here?

People with any property that could be seized in a bankrupcy may also get more creative by coming up with "shells" -- ways to make it unreachable. Why should this be an option only for the rich?
If enough people do this, we might get some sort of legislation that makes the extra amount they charge for people who pay out-of-pocket uncollectable/unenforceable. Hell, they can make money by charging the insurance co. $300 for a minor procedure. What's the possible rationale for charging $3000 if you pay in cash. (Actual figures from a recent bill summary received by a family member.)

....hospitals can tell you to f--- off when you show up at the E.R. holding two of your severed fingers in your other hand. (That, and to clean up the mess you made on their sanitized floor from your bleeding).

Doctors can do exactly what Lawyers do...if they don't have a form of guaranteed payment, they are not obligated to provide you with their service.

to keep up with the demands of your government for your money. I believe there would be some kind of penalty for not paying on the insurance. If they put in an exclusion clause like they did in Massachusetts where you can petition to opt out if you can't afford the insurance, then you are back to being uninsured for health care. This is a real slap in the face to the poor, many whom are poor because they are unable to work due to ill health, but they aren't so dirt poor that they can qualify for Medicaid.

This stinks.