Something I don't get about the health insurance, I mean health care reform law.

[raccoon]

It mandates that people carry health insurance, right?

Let's say you have a person who's too young for Medicare, works, but her
workplace doesn't offer health insurance. She makes $10.00 per hour.

She's hypertensive or has high cholesterol or is diabetic.

How the hell is she supposed to afford health insurance? If any company would
insure her to begin with?

(PS is a hypothetical person. I make a little more than that and don't have the
health problems mentioned her.)

Looks to me like there will be a lot of people who just don't have insurance, same as
there are lots of people driving around who don't have car insurance.

Looks like whoever is supposed to enforce this will be working on it 24/7.

[sinkingfeeling]

1. First, the new law requires insurers to accept pre-existing conditions and secondly, there is a

subsidy to assist on costs.

[prairierose]

4. ....And that worked so well when the affordable care act said...

they had to insure children and could not cut off sick children, yet last summer we saw, they just called it something else and threw children off insurance. The murderers in the insurance industry will do anything to increase their profits.

I make about $10/hr, none of my employers offer insurance. I do not have any big health problems but I do have pre-existing conditions. Therefore, insurance would cost me a fortune..no thanks. I want a public option.

[area51]

14. +1

Exactly right, call the insurance mafiosi what they are -- murderers. No other country that claims to be first world would let this continue, unless the end goal was to keep population numbers down.

[bvar22]

16. The law does NOT require them to accept everyone with pre-existing conditions

The LAW requires them to accept ONLY those who are RICH ENOUGH to afford the steep BUY IN.
So far, only 16% of Americans with pre-existing conditions have been able to afford THAT "Pre-Screening".
...MORE "reform" that only benefits The RICH!

WAKE UP!!!


You will know them by their WORKS,
not by their excuses.

Solidarity!
--------------------------------------------------------------------------------------------------------------------------------

[TorchTheWitch]

18. it's a tax credit not a subsidy

You have to come up with the money yourself up front. And the tax credits are shit. Personally, I'm in my 40's, healthy, will have to purchase my own insurance since it's not provided through employment, and even with the tax credit I'll still have to come up with an insurance premium that is MORE than my monthly rent payment. Not only that, but with the high deductibles and copays I wouldn't be able to afford to use it even if by some miracle I could come up with the monthly premium. It's ludicrous to imagine that when most people live paycheck to paycheck they can possibly afford such an extreme additional bill especially when it doesn't even DO anything for them.

Anyone that thinks they'll be safe from such a nightmare because their employer provides health insurance enjoy it while you can because when this bill kicks in employers will dumping your health insurance in favor of the fine for not providing it because it is FAR cheaper. And no way in hell are employers going to be increasing anyone's paycheck because of this just like they didn't when they decided that their employees had to start partially paying for their health benefits that used to be 100% on the company's dime. This bill wasn't just a gift to health insurance companies it was a gift to ALL employers that have despised having to provide health insurance to their employees since it's inception decades ago.

Fuck this corporate welfare bill. It's a damn disaster, and they KNEW it would be, which is why it doesn't take affect until after the presidential election.

[subterranean]

21. The tax credit can be used in advance to pay for the premiums.

This is straight from the IRS web site:

http://www.irs.gov/newsroom/article/0,,id=220809,00.html

Starting in 2014, individuals and families can take a new premium tax credit to help them afford health insurance coverage purchased through an Affordable Insurance Exchange. Exchanges will operate in every state and the District of Columbia. The premium tax credit is refundable so taxpayers who have little or no income tax liability can still benefit. The credit also can be paid in advance to a taxpayer’s insurance company to help cover the cost of premiums. On Aug.12, 2011, the IRS issued proposed regulations that describe who will be eligible to receive the premium tax credit and how to compute the credit. The proposed regulations also describe how to reconcile any advance credit payments for health benefits purchased through an Exchange with the final credit amount.

[Lars39]

2. And she's paying as much as she can on past medical bills she's accumulated.

[Crazy Dave]

3. Just like with car insurance

In my state (FL) the DMV and the insurance companies have very good communication. If you do not renew your policy they send the information to the DMV and you get your license suspended. Since the insurance was made mandatory and computer records more proficient, the rates have tripled over the past 15 years.

Now back to health insurance, Obama and the insurance providers knew what they were doing and just like with car insurance, make it mandatory for all, the higher risk that you are health-wise, the higher the premiums you will pay, or you and/or your employer will pay a fine.

I've heard that under the new laws you can be forced to pay as much as a 300% higher premium for insurance but I don't know where to find that information and cannot confirm it.

[Scuba]

5. HCR: A monstrosity apparently designed to prove that "government can't do healthcare". n/t

[MrsBrady]

6. read this website...

it's very helpful and informative.

http://www.healthcare.gov/law/timeline/index.html

[Uben]

7. Try paying $2100/mo for premiums.....

...for a $5K deductible, and then get back to me. This is what I have to pay for me and my wife, and there are zero subsidies for us. I worked hard and saved for my early retirement only to have the insurance companies take 1/3 of my income away. My wife had a bout of breast cancer eight yrs ago and the premiums have skyrocketed ever since.

[doc03]

10. A friend of mine that is about 60 and has diabetes and other

problems said the cheapest health insurance he could find was $23000 a year. He is unemployed and pays over $1000 a month on medication all he can do is just take a chance on not getting too sick.
If he buys insurance he would eventually be bankrupt and if he doesn't and gets sick he will be bankrupt. Some choice.

[Shagbark Hickory]

8. You had it right the first time.

Health insurance not healthcare.

[doc03]

9. I don't claim to understand it either. I thought if you didn't

chose to buy insurance or didn't have the money to buy insurance you would pay a tax and then the government somehow took care of your health care. Or do you just die like Ron Paul suggested I don't know?

[Schema Thing]

11. The majority of her insurance bill will be subsidized.

And all insurance companies will accept her at the same rate as everyone else.



Why did you not know this?

[alc]

13. subsidies, rates, copays, coverage and many other things still TBD

2700 pages and most of the details are left to the administration and agencies. About the only detail the bill set is the % of premiums that must go to "medical care". But, even "medical care" is not well defined. The administration has said that administrative costs are not part of "care", but that could change.

If there's a republican administration in 5-10 years and costs go over $1 trillion they may cut subsidies to stay under the "magic number". Some versions of the bill even had the clause saying subsidies would be cut to stay under the magic cost. Premiums, copays and coverage are left up to the bureaucrats - they may change yearly, and don't expect the changes to help us.

Things could end up good for the OP example, or could really suck. Why did you not know this?

[subterranean]

12. Can this hypothetical person afford $1,127 a year?

That's about how much she would be required to pay for insurance premiums, according to this subsidy calculator:

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

That's assuming she works full-time at $10 an hour, or $20,800 a year. If she only works part-time, she would pay less. Of course, the figure above is only the cost of premiums. It does not include out-of-pocket expenses for actual health care.

[Yo_Mama]

15. But her out-of-pocket expenses would cost her another $2,083

So it is a help for her, but it is a very large portion of her after-tax income. Her actuarial coverage ratio is supposed to be about 87%, so she would be expected to pay an average 13% of her medical bills.

$20,800
- 1,270 (est. federal inc tax)
- 1,591 (FICA)
- 670 (guesstimated state tax)
-------
$17,269
- 3,210 (Kaiser calculated premium plus out of pocket)
-------
$14,059 She would be paying about 18.5% of her disposable income for medical care, but she would have insurance. How good the insurance would be is another question. Most diabetics without good health coverage have to spend a lot on testing equipment and drugs.

[Selatius]

19. According to your math, her health care would be unaffordable.

It would get to the point where she would have to choose between food and health care costs, and if it's not that, then it's rent and utilities and credit card bills and so forth.

[Yo_Mama]

22. It's Kaiser's math, not mine

But I wouldn't call this precisely affordable either.

She certainly couldn't live alone with what she's got left in almost anyplace I know of. By the time you pay for car insurance and fuel to get to work, rent, food and utilities don't fly, and urban rents are expensive enough that she wouldn't be able to live where public transport was a feasible option in almost all of the country.

I don't think people have sat down to think about this. The theory was that persons should be charged substantial out of pocket costs to restrain "over-utilization" of health care, but I think it is going to end up that lower income persons either let their income drop somewhat lower to get the Medicaid (if she were making 15K she would get Medicaid) or don't buy the insurance. With that level of medical problems, she really needs insurance so I am guessing that she might just drop hours.

I also have been waiting patiently to find out how the regs will handle persons with highly variable income. There are a lot of people who run businesses or are contractors who don't have a very predictable income flow, and since subsidies and copays vary so hugely under this bill, I have no clue how it will be handled so that such persons actually get health care at a price they can afford to pay.

You know what's really sick? If this hypothetical woman, who is certainly out there, were making 16K a year at her job she would only have to pay $537 for medical premiums, but would STILL have an out-of-pocket maximum of $2,083. You tell me how such a person is supposed to actually get treated!

Her only real option would be to work less - if she made 15K a year she would get Medicaid under the bill and have nothing to pay for premiums or testing equipment or medications at all.

I never felt this plan was realistic for lower income individuals.

[bvar22]

17. Even IF she could afford the policy,

...she couldn't afford to USE it due to High Co-Pay/Deductibles.
These policies are called "Junk Insurance" for a reason.

Even with a subsidy, 50+ Million already struggling Working Class Americans are going to be forced to
write a BIG CHECK every year to a RICH Corporation that Manufactures NOTHING, provides NO service, and creates NO Value Added Wealth.

These 50 Million are going to be PISSED,
and they WILL blame the Democrats,
and rightly so.
Democrats will be unelectable for a generation,
and the once in a generation opportunity for REAL reform will have been squandered.

There will be NO Fixing it Later.


You will know them by their WORKS,
not by their excuses.

Solidarity!
--------------------------------------------------------------------------------------------------------------------------------

[subterranean]

20. I'm a little more optimistic than you are

and the reason is the move by certain states (Vermont and possibly Montana, so far) to opt out of the reforms and instead use the Federal money to implement their own systems that will actually cover everyone. If that trend spreads to more states (and I think it might), the Democrats' reform may eventually evolve into REAL reform!