Who will NOT be helped by this reform bill?

[fadedrose]

We've heard who will, but now who won't.

[cutlassmama]

1. Adults with pre-existing conditions

[Name removed]

4. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Cronus Protagonist]

At what price?

And don't you have to have had NO insurance for the last six months to buy in in any case?

[phleshdef]

10. I would answer your questions, but first I'm wondering if YOU know the answers?

Because if you really did, I think you would have stated those answers to back up your point. Instead, I think you are trying to throw some red herrings out there to see if they stick. Its a tactic people typically use when they don't have a real argument to make.

[fadedrose]

19. Aw, go on...

Someone close lost a job due to a factory closing. Hasn't been able to find a job for a year, so he can hardly afford insurance, plus he's lucky if unemployment benefit extension will apply in Michigan, and to whom..

No, I want to know how somebody unemplyed can BUY some kind of insurance.
Not a red herring person.

[Cronus Protagonist]

26. Red herrings?

I'm not the type. See, I know it's not likely to be cheap to be in that highest risk pool, and I also heard, as I stated, that you have to have NOT been insured for the last 6 months AND have to have been turned down for insurance due to pre-existing conditions to get into that expensive pool. I don't know if that's true, which is why I phrased it in the form of a question. I was looking for answers, not for such a shining example of a dime store detective's failure to grasp the obvious.

I was just wondering if you knew the price. Instead you told me way more about yourself than you said about me. I simply asked a question; an argument is not a question, so I wonder how you could have made such a leap as to expect one.

You simply displayed your suspicious nature and rather judgmental, dismissive world view. Life must be hard for you. God bless.

(By the way... http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7946432)

[vaberella]

5. what?! Where did you get that information?

They're the first people to get helped from the bill. Insurance companies cannot deny coverage on pre-existing..that goes into effect once the bill is passed. Oy.

[cutlassmama]

11. Only for CHILDEN, NOT adults.

[phleshdef]

13. No, ADULTS AS WELL. Does anyone around here actually pay attention?

[Name removed]

14. Deleted message

Sub-thread removed by moderator. Click here to review the message board rules.

[robinblue]

32. Robert Gibbs publicly admits a 4-year delay in implementing the adult preexisting condition rule.

Forum Name General Discussion
Topic subject Robert Gibbs publicly admits a 4-year delay in implementing the adult preexisting condition rule.
Topic URL http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7951114#7951114
7951114, Robert Gibbs publicly admits a 4-year delay in implementing the adult preexisting condition rule.
Posted by seafan on Fri Mar-19-10 12:42 AM

WH Press Secretary Robert Gibbs acknowledged today during his press briefing that the rule prohibiting insurance companies from excluding adults for preexisting conditions will not take effect for another four years.


This is the first time I have heard this publicly stated by an official of the administration.


Today. Three days before the purported vote.



Now, the question is, will our media report this to the American people before this debacle of a vote?


Somehow, I don't think most people will take this little piece of shrouded information lightly.


With all the celebration going on about how 'historic' this bill is, the people are finding out that they will not see any benefits for 4 more years for one of the mainstays in how this monstrously flawed Senate health care bill was sold to us.



So, for 4 more years, the lives of adults with preexisting conditions will be destroyed by the backroom deals made between the president and Big Health.


Are they hoping for the ink to dry on this bill before the people find out?


Don't the people of this country deserve better than THIS?




MR. GIBBS: .....

Tom.

Q I have two quick questions.

MR. GIBBS: Yes.

Q First, earlier this week -- sorry, I have two questions. First, earlier this week, both Rush Limbaugh and Michael Moore pointed out that the preexisting condition provision of the legislation doesn’t take effect for another four years, and I’m wondering if you could tell us, was that a concession, and if so, who fought for that and what did they -- what did you get in return?

MR. GIBBS: There is --

Q For adults, that is.

MR. GIBBS: Right. Well, again, the -- as I described earlier and as the President has described, there are certain things that cannot be instituted until you have everyone in the system. Obviously this is a piece of legislation that phases in over the course of many years those changes. And as a result of that phasing in, when that's done, preexisting conditions for adults will be outlawed. But understand this -- when this becomes law, an insurance company will no longer be able to discriminate against a child that has -- that they believe or says that has a preexisting condition.

Q That’s on day one.

MR. GIBBS: Right.

Q Children. And so it’s pegged to the mandate then, is that fair to say?

MR. GIBBS: Yes.

.....





Notice that Gibbs did not answer the question of 'who pushed for this, was it a concession, and what might he have gotten in return.....'



Four more years of greed by insurance companies in the face of hardship and helplessness of sick people?



Oh, it's just because it will take that long 'to get everyone into the system'.


Not at all like expanding Medicare might accomplish right away, you see.




I just cannot describe the sense of betrayal we are enduring.

[Jeff In Milwaukee]

56. Temporary High Risk Pools

The legislation creates High Risk pools for people who are currently excluded. These will remain in effect for the next four years, until the private carrier insurance kicks in.

People with pre-existing conditions WILL be able to obtain insurance coverage.

[Capn Sunshine]

58. No They don't. Hysteria is the prevalent mode for a lot of folks here

The fact that they posted so many screeds about their progressive values being intentionally ground into the dust by an unfeeling (new) President indicates hysteria infected the progressives as well as the Teabaggers. It's almost as if they were one and the same pretending to be progressives online.

Hey, wait a minute.........

[Jakes Progress]

33. Is Robert Gibbs a liar?

Either you are wrong or the WH press secretary is. I'll guess you.

[jenmito]

6. False. n/t

[Jakes Progress]

34. Only if you have four years to wait.

Keep up.

[Name removed]

7. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Name removed]

27. Deleted message

Message removed by moderator. Click here to review the message board rules.

[DevonRex]

15. Not true. And you should know that by now. nt

[Jakes Progress]

35. True. Follow the WH press office on this.

They say it won't take effect until 2014.

[Jeff In Milwaukee]

40. Not True.

Children with pre-existing conditions can get coverage immediately, as can adults who have pre-existing conditions, though a temporary high-risk pool. The temporary pool will be replaced by a permanent insurance exchange in 2014. For consumers, that's really just a change in your insurance carrier and won't have any material effect on your coverage.

[Jakes Progress]

43. I've got some swamp land for sale.

Any guess at what the coverage in the on-again, off-again high risk pool will cost? Any guess at what will happen to premiums in the four years before all the goodies take affect? Just check out what the credit card companies did in the six months the administration gave them to get ready for the "regulation" took effect.

You place a lot more faith in the good will of insurance companies and their executives than I do.

[Jeff In Milwaukee]

44. It's not up to the insurance companies....

This is a government-regulated pool.

Please. I beg you. Before you make yourself look like a damned fool (again). Read the Bill.

[Jakes Progress]

46. Before you make yourself look like a damed fool again

learn how politics works. Learn how this bill has been written and approved by the insurance corporations. Show me where it says that the premiums will be the same for those with preconditions as those without. Show me where it says that the insurance companies will have an independent agency to curtail misuses. Just as it is now, anything the insurance companies do that might step over the very lenient lines already drawn, it will require the wronged party to get themselves a lawyer and sue. The profits that pay for the giant law phalanx that the insurance companies will block you with will be guaranteed with your tax dollars.

This is a bill for the insurance companies. It guarantees them against loss with your tax money. The only sticking point they had was that they wanted stiff penalties for anyone who didn't buy insurance. They don't care how the new people get the money to pay the premiums (which are not regulated) just as long as they get it.

Wisconsin must be a paradise of public minded corporations where CEOs never have any sway with politicians. Here in Texas, the politicians are bought and paid for by the big three (Oil, Real Estate, and Insurance). My best friend's mother just had a doctor cut open the wrong eye in an operation. But at the behest of our insurance lobby the politicians put through tort reform that has made it all but impossible for her to collect damages. You may think that the national congress is so above that kind of thing, but I do not. I think that one year of lies and balking over something as plainly obvious as guaranteed health care is evidence to the contrary. In any land where the elected representatives had the best interest of the people at heart we wouldn't be begging to have this miserable excuse for a bill pass.

I celebrate your blind faith in corporate goodness and the kind hearts of politicians. It's kind of touching.

[Jeff In Milwaukee]

49. Read the Bill

Stop spouting uninformed nonsense.

[Jakes Progress]

52. Stop spouting uninformed and naive nonsense.

Read the bill and study history.

[Jeff In Milwaukee]

53. I HAVE read the bill....

But your posturing, fact-free posts would indicate that you have not.

[Jakes Progress]

54. If you have read the bill,

and understand the language, and see the context of the language, then you would not keep making these erroneous comments. You could even address the requests to help us find the language that puts an independent agency to oversee insurance companies and find the part where there is a limit to their profit margins and the regulations that make sure that those with pre-existing conditions don't pay higher premiums than everyone else. You have argued that those who suggest these are lacking are wrong and haven't read the bill. We can't prove a negative, but you can prove your assertions.

Please avoid wiggle language and vaguely worded legal assurances. Just show us the stuff you say in in the bill that you have read.

Or you could just stop accusing others of that for which you are guilty.

[Jeff In Milwaukee]

55. As I said, "Posturing and Fact-Free"

Why, how could ANYBODY possibly disagree with me? Well, they must not know the facts and must not be as CLEVER AND INSIGHTFUL as I am?

:eyes:

I stand by the statements I made upthread. If you have some pathological distrust of the government's ability to regulate the marketplace -- and I work in healthcare administration so I see their regulatory operations up close and personal on a daily basis -- then that's your problem.

While this legislation is by no means perfect, it's a giant step forward. If you think otherwise, then you're on the same side as Glen Beck and Mitch McConnell. And in that case, I couldn't possibly care less what you think.

[Jakes Progress]

115. What a crock.

Again, your first line accuses me of having the same attitude that you put out.

It is fairly obvious that you haven't read the bill since you cannot find any language that supports your positions. You "stand by the statements" without so much as attempting to provide any evidence that they are correct. You take your own opinion as fact and then seek to belittle those who disagree. Pathetic more than pathological.

If you work in healthcare administration, then you think the regulations are sufficient, you are part of the problem rather than the solution. You "insider's" view of the might be that of the guy who sits in an office rejecting claims and shucking off patients. That doesn't let you see medicine from the viewpoint of those who have to duck and weave through the obstacle course that is set by hospitals and insurance companies. To you they are paperwork that makes your job relevant. To the sick and the suffering, they are impediments to care. Of course you trust the regulation system; you are a part of it.

Then you trot out the tired argument of those who no longer have a leg to stand on when they begin tossing out stupid, inane, and intellectually dishonest comparisons that don't apply. I'm surprised you stopped short of calling me Hitler. Jut how am I on the same side as beck and mcconnell? You are woefully ignorant of politics and current events if you think these two support single payer or the public option. But you knew that. You just couldn't answer any of my questions about your position, so you just jumped into that pit.

If you were a physician, I would tell you to heal yourself. More apropos is the suggestion that you get a pile of forms and start filling them out.

[DailyGrind51]

51. For 4 years, but they can get into a high-risk pool until then.

[totodeinhere]

96. If they were serious about true reform they wouldn't make people wait four years for it.

What a joke. Why couldn't it kick in immediately? This will give the pukes plenty of time to repeal it if they can retake Congress is November, which they well might.

[Skittles]

103. no shit

the things some DUers are excusing is un-fucking-believable

[mkultra]

121. they where clearly just fucking around this whole time.

[quiller4]

113. They (I) will be helped by the high risk pool immediately and by

the ban on discrimination in lateer years.

[Cleita]

2. Doctors and other health care providers who will still have to

make war with the insurance companies to get paid. They still will have to have extra staff to deal with the bloated billing involved in it.

[HughMoran]

3. ??

If you're capable of posting, you're probably capable of researching this question.

Unless you just like to start shit for the sake of starting shit?

[fadedrose]

20. Frankly, I already answered a response something like yours,

but theirs had better language.

[Name removed]

21. Deleted message

Message removed by moderator. Click here to review the message board rules.

[phleshdef]

8. Republican congress critters that have worked to defeat it.

[Clio the Leo]

16. beat me to it. NT

[iamthebandfanman]

9. me. n/t

[Hello_Kitty]

12. People who can't afford the premiums and deductibles even with a subsidy.

Several threads have discussed how a single adult making $10 an hour will have to come up with $100 a month out of her own pocket. As yet, not one supporter has explained where she is supposed to get this extra money considering that $10 an hour is barely subsistence wages even if you pinch every conceivable penny. Yet the PTB have determined that $100 a month + still more out of pockets is "affordable" to someone making $10 an hour.

[fadedrose]

25. Your reply is probably right

Thanks - I was thinking along the same lines. Not a real improvement there.

[woo me with science]

28. We have a winner. nt

[Tailormyst]

100. its not even a real subidy, its a tax credit

everyone pays full price and then get more back at tax time. When it's July and you are broker then shit, the promise of a tax credit next February is not going to pay those premiums.

[Cleobulus]

17. I calculate to to get medical care for my preexisting condition I'll need an additional 200 to 300..

dollars a month to pay for the debt I would accumulate plus premium and this is assuming I qualify for cost-sharing, and the payments for the debt would be stretched out to 20 months. I don't have that kind of money.

[ChicagoSuz219]

22. You're just making up numbers now...

Wait & see what the actual numbers are before you freak yourself out.

[Cleobulus]

29. Best estimate from my employer offered plan...

Which I cannot buy into right now, I will not qualify for a subsidy for that, because it would cost me about 7.5 percent. In addition the plan in question has a maximum out of pocket of 5,000 dollars, up to 2/3rds of which may be paid for through cost sharing with the federal or possibly state governments.

I make 10 dollars an hour.

My plan(if I bought into) is 124 dollars a month.

Getting treated means coming up with 2,000 dollars or having a payment plan worked out with whoever I get treatment from, I'm estimating that 100 dollars a month would be the minimum they accept, so that would be stretched for 20 months.

Assuming, of course, that nothing changes in the prices of the plans offered, and if I have the same job I have now by 2014.

That is at minimum 224 dollars a month I'll have to pay, it may be a lot more, I doubt it will be a lot less.

[ChicagoSuz219]

31. If you can't afford your employer's plan...

...you may be eligible for something better. All I'm saying is let's see how it plays out once it's passed, and then you can see what your options would be...

[Cleobulus]

37. Hmm, that would technically be fair...

However, please bear in mind that I'm being wildly optimistic in my figures. Also, at less than 8% of income for the premiums, that's considered affordable by the federal government.

[ChicagoSuz219]

38. I don't really get what you're saying...

...in any event, I'm just hoping it passes today!!

[Cleobulus]

67. OK, let's see if I can make you understand...

I can theoratically afford my employer's health insurance plan, to be "covered" as it were, I just can't afford to actually USE IT!

[ChicagoSuz219]

94. Because of the deductibles & co-pays? n/t

[Cleobulus]

112. That is correct, even if I qualify for cost sharing...

I'd have to shell out close to 10% of my income on top of paying for premiums to get medical care.

[ChicagoSuz219]

119. I don't think that's correct. n/t

[goclark]

23. And how are you covered now for your preexisting condition?

:shrug:

[Cleobulus]

30. Not at all, but that's part of the point, if I were covered for my preexisting condition...

what would have changed for me? Will I all of the sudden be able to afford treatment just because I can claim I'm insured on some form?

[mkultra]

122. since you make 20K a year

wasn't there a subsidy that went along with this bill?

[Oregone]

18. Poor people stuck with the "bronze" package who cant afford to use their insurance

[Jakes Progress]

36. More stratification of classes.

The divide widens.

[GreenPartyVoter]

50. That's my fear too.

[SoFlaJet]

24. Every Single Republican

politically...

[Jeff In Milwaukee]

39. Don't forget those poor insurance companies...

They may be forced to exist on a reasonable profit.

[elleng]

41. 'Private' insurance companies

and their stockholders.

[craigmatic]

42. People who are too poor to afford to pay for mandatory insurance but aren't eligeable for medicaid.

[Jeff In Milwaukee]

57. Nice Try....

Wrong Website. I believe you're looking for www.freerepublic.com

The plan includes subsidies. A single person making $20,000 per year would pay only $1,119 (after subsidies) for health insurance. That comes to about $90 per month, which is both affordable and not a bad deal at all.

[Cleobulus]

60. And what will the deducts and copays be on such a plan, can they afford that? n/t

[Jeff In Milwaukee]

61. All insurance plans have deductibles and co-pays....

First you're demanding a pony, now you're demanding a unicorn.

Deductibles (which includes co-payments) may not exceed $2,000.

[Cleobulus]

62. Well fuck, I guess I have no choice but still not have medical care then...

how fucking dare I actually ask for medical CARE I can afford? Its not like being in pain is enough, well shit, I guess you got yours so fuck everyone else.

[Jeff In Milwaukee]

64. What are you pissing and moaning about?

This bill provides access to affordable health care.

[Cleobulus]

66. Define "affordable" I bet you anything that we have two different definitions.

ON EDIT: Here, let me illustrate this for you, after paying all my bills(on 10 bucks an hour), and gas, I have approximately 300 dollars to spend on food. If I had my employer's insurance, that would be reduced to about 200 dollars. This is with me making 10 dollars an hour. Now, how the hell am I going to afford health insurance copays and deductibles?

EDIT TWO: Redid my budget.

[Jeff In Milwaukee]

68. Affordable

Meaning that you can get sick without having to declare bankruptcy. A lot of people can't afford to front $2,000 in cash for a deductible (me included), but compared to $50,000 in medical bills and losing your house and your car, it's a pretty good deal.

Want free health care? You're not going to get it. Even in Canada and the UK, while there are no co-payments or deductibles, there are higher taxes. So you're paying for it one way or another. And bear in mind that this proposal increases subsidies as one's income goes down. A single person making the minimum wage would pay the eqivalent of $0.12 per hour for their health insurance.

[Cleobulus]

70. I have a condition that will basically make me use all the available...

insurance I would have for a year, 2,000 dollar deduct plus whatever the out of pocket maximum is. So basically you are saying that I still can't afford medical care, just that I would theoretically be in less debt if I did use it.

ON EDIT: And saying that people in Canada and the UK still pay is a bit dishonest, don't you think, because a person in Canada or the UK, making something around my salary is going to pay a fraction, a tiny fraction, of the cost of their medical care compared to me.
A
We had a guy on DU talk about paying 15 dollars(for parking) to get a nuclear bone scan in Canada, an an American, even with this bill, will be paying a significant fraction of their salary to pay for that, far more than the Canadian did in taxes for that year.

[Jeff In Milwaukee]

72. Not what I'm saying....

$2,000 is the maximum deductible for a single person, so your out-of-pocket would be that + your premium.

Go to http://healthreform.kff.org/SubsidyCalculator.aspx to see what the costs are for you.

Personally, I'd have to take out a loan of some kind to pony up $2,000 (that's if I had to pay it all at once on account of a major illness or injury). But a $2,000 loan beats $50,000 in medical bills, which I couldn't pay no matter what I did.

[Cleobulus]

73. So would I have to take out a loan(assuming I qualify)...

Don't know how I would afford the payments, I guess I could not eat, and the subsidy calculator is for PREMIUMS dammit, stop using it as the end all, be all, for calculating health CARE costs. I don't even qualify, my premiums as of right now, would be below the threshold where subsidies kick in.

[Jeff In Milwaukee]

75. Most hospitals will set up payment plans....

And I'm not confusing premiums and deductibles. I just said that your total cost would be the deductible + your premium. The maximum deductible is $2,000 per single and $4,000 for family coverage.

So you're telling me that you make too much to qualify for subsidies?

[Cleobulus]

76. My employer offers insurance, I would qualify for subsidies for the premiums...

if they didn't, right now the premiums would cost me about 7.5% of my income, before taxes, I make approximately 20,800 dollars a year. My employer, at the moment, offers a plan of 2,000 dollar deduct, 20% copays and a 5,000 dollar maximum out of pocket.

And again, I ask, will I even be able to afford to eat with a payment plan from the hospital?

[Jeff In Milwaukee]

79. Short Answer: Yes

The legislation has premiums capped at just over 5% of your income. Your cost of premiums would be about $1,200 after subsidies. Your deductible would be capped at $2,000. The legislation prohibits companies from making "unreasonable" annual limits on coverage. I don't know the definition of "unreasonable," but even minor surgery anymore costs more than $5,000 -- so I would imagine your annual limit would be more than what you have now.

Payment plans worked out by hospitals are based on your income and ability to pay. They are not interested in giving you unreasonably high payments just to have you default (and they end up eating the costs).

[Cleobulus]

81. So basically I'll have to hope I don't lose my job for years on end...

or have anything else happen so I would be able to pay off the debt? Well, that's something to look forward to worrying about.

[Jeff In Milwaukee]

82. Well....yeah

Is there some reason you'd be HOPING to lose your job?

Dude. Your healthcare cup was empty yesterday and today it's half full. And we're going to keep working to improve what we've got now. The Republicans are glowering that "This isn't over yet" and for once I agree with them. There's more to be done.

[Cleobulus]

84. On one level, actually, yes, at least then I could possibly qualify for medicaid...

or at least get a job with a paycut to qualify for medicaid. That's one advantage of the bill, hell, I'm thinking of ways to game the system to make it affordable for me. One thing is trying to scrape up enough money to get in the high risk pool, use it to get surgery, and then get off it as soon as possible, because I doubt I could afford it long term.

Another possibility is paying for a Platinum plan for a couple of months, after switching to a job that doesn't offer insurance, paying that for a couple of months, get my surgery, and then getting off the plan and down to a bronze level plan, and switch as needed.

I don't like the idea of having to game the system though, but I'll do it if I have to, my preexisting condition is a one time shot thing, I get fixed, its not a long term or recurring condition.

[Jeff In Milwaukee]

85. This legislation expands Medicaid

Right now, it's very difficult for a single male to qualify. The legislation provides additional funding to expand Medicaid, so you might well qualify.

[Cleobulus]

86. I don't qualify at my income level, but if I take a large enough paycut...

or loose my job entirely, then yes I would be able to qualify under this plan, like I said, that's one good thing in this bill.

[Lydia Leftcoast]

88. ALL insurance plans have deductibles? Only since about 10-15 years ago

and not even then, in some cases.

When I left Portland in 2003, my individual Kaiser plan had NO deductibles. It had copays, but no deductibles

In addition, NO other country that I know of has deductibles, even the ones that rely on private insurance.

Deductibles are an EVIL scheme by the insurance companies to avoid payment if their other schemes don't work.

[Jeff In Milwaukee]

91. Then I've been ahead of the curve....

Some plans (really nice ones) have no deductibles or co-payments, but you pay a lot for them.

Blue collar insurance has deductibles, and I oughta know. I've been paying them.

[dflprincess]

108. With many policies a deductible is what you pay before insurance kicks in at all

The "coverage" my employer now offers requires we come up with the $1,200 deductible before anything else is covered and this kind of policy is becoming more common.

The bill passed last night allows maximum out of pockets of nearly $6,000 for a single and between $11,000 and $12,000 for a family. (I'm sorry I don't remember the exact numbers.)

The max out of pockets may increase annually and do not include premiums or expenses your insurance company decides are not covered. The deductible will count toward the out of pocket max.

Out of pocket amounts this high will keep people from accessing care when they need and will still drive people into bankruptcy.

Besides the insurance companies the other big winners in this scam will be the credit card companies as people are still faced with paying for medical care with plastic.

[LisaM]

77. I think $90 a month is a lot for someone earning 20k per year

It might sound affordable on paper, but that's more than 5% of their gross pay! What if they have rent, student loans, transportation, etc.?

[UhOh]

105. IF you're making $20k per year and

and have student loans then soemthing doesnt add up. Why would you pay $10-20k a year to go to school to get a job that only pays $20k?
You can get that with a free high school education.

[Xithras]

87. Actually, no, they'll be paying double that per month.

As was pointed out in a long discussion a few days ago, the subsidies are ONLY a year end tax credit. You will be expected to pay the full premium, and will be refunded the subsidy amount annually.

The only exception are the minority who will qualify for the state exchanges, who MAY have the subsidy taken right off the top, depending on how the state arranges it (and who may have to pay additional taxes and "broker fees" to their state for the privledge).

[Lydia Leftcoast]

89. And tax credits are a RICH PERSON's idea of a good deal

They are NO help when you need the money NOW.

[Jeff In Milwaukee]

92. A huge difference....

Between tax credits and tax deductions. The Republicans have been flogging tax deductions, which don't do poor people any good because the poorer you are, the more likely you are to not have a tax liability anyway.

These subsidies are refundable tax credits. So even if you don't have any tax liability, you'll still get the payment. One option for making the payment is to reduce your federal withholding. If your income is sufficiently low (less than about $40K for a family of four) you're not going to have any tax liability anyway, so drop your withholding to zero. That puts additional cash in hand to help pay the premium.

Bear in mind, this is only an issue during the first year (and I would like to see some "bridge" credits available for that purpose -- sort of like Advance Earned Income Credit). After that, a family of four earning $35,000 pays only about $1,500 per year for premiums. That's about $50 per paycheck.

[Lydia Leftcoast]

95. But there are no "bridge credits," and that STILL leaves the problem

of not being able to pay NOW.

Oh, and $1500 per year is $125 a month, and that's not including the copays and deductibles. Tax credits are irrelevant when the money is being withdrawn from your bank account.

[Jeff In Milwaukee]

98. All that being said...

From the Christian Science Monitor, in an article on Friday regarding subsidies:

"The federal subsidy would go straight to the insurer. It would look like a discount on the policy to the customer."

This seems to be confirmed in the New York Times posted yesterday.

It would appear that your subsidy will be automatic upon enrollment. So if the government is paying 80% of your bill, a premium of $300 per month would be only $60.

The subsidy is not a tax credit, so this discussion appears to be a moot point.

[Lydia Leftcoast]

102. OK, so it's not a tax credit; it's pure corporate welfare

This makes me feel so much better. :sarcasm:

The insurance companies are sucking the life blood out of the economy (second only to the military industrial complex), and we're going to, in essence, REWARD them by 1) giving them a guaranteed customer base, and 2) giving them no incentive to cut prices or add services, because if a customer can't afford what they charge, we'll give them money.

This country is so fucked up.

[Jeff In Milwaukee]

104. Oh for shit's sake, Lydia

Read the Bill. To be allowed to participate, a company must maintain minimum service standards, not exceed proscribed pricing levels, and may allot no more than 15% of the premium costs to overhead and profit. All of which must be done without dropping high-risk enrollees or through denying coverage.

You know what that boils down to? A MASSIVE incentive for these companies to get more efficient and to lay pressure on health-care providers to hold the line on costs.

This bill does the exact opposite of what you're claiming.

[dflprincess]

106. Yes, and past experience tells us how honest and trustworthy these companies are

they won't even try to find ways around the regulations. :sarcasm:

You know the fine for denying coverage is a lousy $100/per month/per denial - in a lot of cases they'll just write it off as the cost of doing business because paying the fine will still be cheaper than "covering" the person.

They don't write all those campaign "donations" for nothing

[Lydia Leftcoast]

107. And dflprincess used to work for one of the biggest and nastiest insurance companies

so she knows what she's talking about.

(I sure wish someone would guarantee me a specific percentage of profit.)

[Jeff In Milwaukee]

110. That's both Overhead and Profit....

85% has to be spent on actual care. EVERYTHING ELSE (billing, advertising, EVERYTHING) needed to run the company has to come from that 15% - there is no gauranteed profit in this.

[Jeff In Milwaukee]

109. The $100 per day figure appears to be an Urban Legend

Something that Mike Moore dropped into a column, but nobody seems to be able to find the exact language in the legislation.

If you have a link to the text, please provide it.

Other healthcare regulations (anti-kickback laws, for example) have fines of $50,000 per violation and triple damages.

[dflprincess]

111. Assuming, of course, that the regulations are enforced

and I'm not holding my breath on that.

I seriously doubt that the politicians are all that anxious to actually make their corporate masters tow the line and there won't be a whole lot of pressure brought to bear on whoever is supposed to be in charge of enforcing the penalties. Wendell Potter, who supported this scam, has made it clear in interviews that the insurance companies will find ways around the regulations - and he's certainly someone who would know how adept they are at that.

As for the $100, you're correct or at least I can't find it - I was quoting Michael Moore. I searched on a number of phrases and it doesn't come up - though I find plenty on what the penalties that individuals and employers will face if they don't purchase insurnace from the crooks. I even found information on how hospitals will be penalized if they have too many readmissions.

The fact is, not a whole lot comes up about what will happen to the insurance companies if they break the rules. I did a quick search for it and I couldn't find anything that backs up your assertions that they'll have fines of $50,000 - do you have a link to that text?

[Jeff In Milwaukee]

114. The figures I quoted were for Stark Amendment violations

The False Claims Act has $50 - $100,000 per violation and triple damanges.

Given that level of damage, a measly $100 per day fine seems to be a lowball figure.

[dflprincess]

117. Doesn't that apply to false claims filed for Medicare & Medicaid reimbursements?

It's not surprising that they'd fine them more for filing a false claim for reimbursement from the government (one of Minnesota's non profits got caught doing just that a few years ago, they're doing quite nicely now so the fines didn't slow them down much). And it would not be surprising if fines for cheating consumers were low balled.

Fines for ignoring environmental protection laws can be low enough that it's cheaper to go on violating the law rather than following it and there's really no reason to think this bill would be different. Especially when you think of all those campaign "donations" the insurance industry makes.

What's interesting about the bill is that it's so much easier to find the penalities for individuals and employers if they don't comply or <God forbid> lie to the insurance company or government. I can't find anything that tells us what happens to the insurers if they falsely DENY claims. One of the tricks they use to save money is to deny a claim, usually on the grounds it's not a covered expense, knowing that most people won't bother to fight them over it.

[Tailormyst]

101. The copays and deductibles on those plans make it unusable

ALSO- it is a tax credit. Which means you pay full cost all year and get a bigger refund in Febuary. Most people getting this tax credit live paycheck to paycheck. This will break alot of budgets. A true subsidy would make this a little more tolerable.

[Mass]

45. People eligible for a waiver because they cannot find an insurance under 8% of their revenue,

but earning too much for Medicaid or subsidies. These are mostly middle class people, with a middle-income, and above 50, given that the bill allows for an age ratio of 1:3.

[Odin2005]

47. Most Americans. the Insurance Companies will profit mightily, though.

[BlueIris]

48. Kick.

[Lyric]

59. Gay and lesbian families with children.

Since the federal government doesn't recognize them as "families", they only get the single-person subsidies--far less than their actual, practical costs require. Add to that the fact that gay families pay more in taxes (on both incomes and benefits) as well, and they are truly the most Screwed of all.

[activa8tr]

63. If one of the gay parents is a biological parent, why wouldn't

that person be treated as a single parent with a child/children?

I'm not sure I follow how they would be excluded.

[Cleobulus]

83. What if the biological parent isn't the one with good insurance...

the other one cannot claim the other parent, nor children as spouse/dependents.

[Lyric]

93. That's similar to our situation.

In four years, my partner will be able to get Medicaid (unless the 'Pukes manage to repeal that part) but for now, she has no insurance while me and my son have Medicaid. In the meantime, after the law kicks in, if she makes even $1000 more than her current $10,000 a year (the equivalent of a 50-cent raise), she'll lose Medicaid eligibility and have to pay a premium for an exchange plan--a premium that will be a lot higher than it would be if the government recognized our family, because they'll be calculating it for a single adult with no dependents. That's not true, of course; she DOES support a family, not just herself. But that doesn't matter to the government. We don't have a dime to spare and wouldn't even if she made a bit more, but we'll have to cough it up if and when she dares to make more than the official Medicaid threshold.

Two of our gay male friends are in a similar position. "Joe" has two kids from his previous straight marriage, and he has custody of them because their Mom is a crackhead who can't take care of them. "Matthew" is the breadwinner of the family, but neither of the kids are his biologically. Matthew will be paying a premium based on a decent middle-class income that works well to support their family, but his subsidy will be tiny because the government doesn't consider Joe and the kids to be dependent on his income, even though they ARE. If their relationship was legally recognized, Matt would be getting a much higher subsidy, based on the actual costs of raising a family. As it is, they get socked with paying more than a straight married couple would have to pay.

We really have to work on getting rid of DOMA and getting marriage equality rolling. Laws like this, laws that continue to ignore our families as if we don't exist, are KILLING us. The strain and stress are unbelievably high. :(

[Hell Hath No Fury]

65. The 20+ million people these bill does not cover --

Granted, many of those are illegal aliens but a third of that number are US citizens.

And I will not be helped by this reform bill. I will techincially be able to purchse insurance with the tax credit but will not be able to afford the care if I should get seriously ill. Paying 15% of a 10k operation is still too much for me. I can't remember that last time I had $1500.

[Jeff In Milwaukee]

69. Go here....

http://healthreform.kff.org/SubsidyCalculator.aspx

See what your costs are.

[Hell Hath No Fury]

71. I did.

Repeatedly. On several calculators. I stand by my post.

[Jeff In Milwaukee]

74. Most hospitals have Financial Counselors

If you can't afford $1,500 for major medical bills, most institutions have alternative resources and payment plans. A lot of people would have a hard time scratching together $1,500 on the spot (me included), but there are alternatives.

And bear in mind, the absence of deductibles means higher costs paid by taxes. You're going to pay it one way or the other. There aren't any freebies out there, even with a Public Option.

[Cleobulus]

78. I would happily take Canada's tax rate if I can afford to use its insurance...

Your comparison between the HCR bill and what is offered under Single Payer or NHS plans is stupid. There is no comparison, people in those countries aren't expected to pay anywhere from 1/10th to 1/4 their income on medical care. Hell Canada's tax rate isn't that much greater than ours and its on a progressive scale.

[Jeff In Milwaukee]

80. Taxes are higher in Canada....

And if you're married with children, taxes in Canada can by up to double what you pay in the United States.

But that being said, I completely agree with you and I would GLADLY pay double what I pay in taxes right now if we could have universal health care provided to every American -- without copayments or dedutibles.

But given the fact that the current legislation passed with just three votes to spare, I think we both know that's not going to happen anytime soon.

[Lydia Leftcoast]

90. People over 50

The insurance companies will be legally allowed (and do you think they won't take the opportunity?) to charge people over 50 up to 3 times more than people under 50.

That is another thing that no other country does.

[Digit]

97. I will be one of those forced to pay the fine

Pre-existing conditions and over 55.....and no job at the moment.
Oh and no, I don't qualify for medicaid.

[frazzled]

120. Currently, insurance companies charge them up to 7 times as much

A limit of 3 times is a vast improvement.

[Tailormyst]

99. People who can afford to use the insurance due to deductibles and copays

Also they are giving tax credits and not subsidies. Anyone who has their refunds garnished for student loans or any other such thing is stuck paying the whole thing. Also people getting tax credits once a year have to use their non existent disposable incomes during the rest of the year. Having to pay out hundred every month, even with the promise of getting it back in the spring will break alot of budgets. Much of the good parts won't be implemented for years.

For some people it will help them. For others, not so much. I am happy for those it helps, but frankly I am not cheering this as some huge win. The only really big winners here are the insurance companies.

[northernlights]

116. I will not be helped. INSURANCE reform does not provide CARE

and dropping student loans to fund Pell Grants does not help the working student replacing an outdated and useless degree with a useful one. it just favors one set of people over a different set.

I'm on the losing side so far with *every* Obama policy to date. x(

[Jeff In Milwaukee]

118. Oh Sweet Jesus....

Do you ever read anything other than the headline?

The Administration isn't "dropping" student loans, it's essentially taking them away from the private sector and saving millions every year, and some of that savings will be put into Pell Grants.

This isn't directed at you personally, but I am appalled by the ignorance and misinformation that I'm seeing on this website in the past few months. We mock Sarah Palin for her "Death Panels" bullshit, but I'm seeing just as bad - and sometimes worse - coming from people at DU.