# Health care law question (no political jabs allowed)

**URL:** <https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595>\
**Category:** Factual Questions\
**Created:** [June 28, 2012, 4:12pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595 "2012-06-28T16:12:06Z")\
**Posts on this page:** 20\
**Page:** 1

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**Author:** ![Sigene](https://avatars.discourse-cdn.com/v4/letter/s/df788c/32.png) [@Sigene](https://boards.straightdope.com/u/Sigene)\
**Post date:** [June 28, 2012, 4:12pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/1 "2012-06-28T16:12:06Z")

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I’m totally confused about the health care deal, that we’ve been fighting over.

The one thing I want to know is: Can I quit my $100k a year crap job, take up subsistence organic farming for very little income and get excellent quality health care when or if I get sick?

Basically can I quit my job that I’m not that into, and do something I like though it doesn’t pay much or anything, and still get health care without question or (high?) cost should anything happen (heart attack, cut off an arm, cold, flu, cancer, etc.)

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**Author:** ![silenus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/silenus/32/166_2.png) [@silenus](https://boards.straightdope.com/u/silenus)\
**Post date:** [June 28, 2012, 4:15pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/2 "2012-06-28T16:15:01Z")

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By my initial reading of the ruling…it depends. “Does your state participate in the expansion of Medicare?” is the first key question. The court upheld the states challenge on that, so it looks like those states that don’t want to expand Medicare to the poor won’t have to.

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**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\
**Post date:** [June 28, 2012, 4:15pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/3 "2012-06-28T16:15:25Z")

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IIRC, if your income was pretty close to zero, you could always get medicare coverage.

(Or was that limited to those actually on social assistance / welfare?)

the law is for the ones who make a little or a lot but have no coverage.  
If you make a little, there is medicare and then premium subsidies.  
If you make enough, you must buy coverage.

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**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\
**Post date:** [June 28, 2012, 4:24pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/4 "2012-06-28T16:24:48Z")

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[http://news.yahoo.com/medicaid-expansion-key-part-affordable-care-act-130207220.html](http://news.yahoo.com/medicaid-expansion-key-part-affordable-care-act-130207220.html)

> [@](#):
>
> The Medicaid expansion opens eligibility to all people with household incomes up to 133 percent of the federal poverty level – whether unemployed or the so-called working poor – starting in January 2014. That translated into an annual income of approximately $14,850 for an individual and $30,650 for a family of four in 2012, according to the U.S. Department of Health and Human Services.
> 
> Until now, the main groups of people served by the Medicaid program have been low-income parents and children, the frail elderly and the disabled.
> 
> _The Medicaid expansion provision is considered more likely to survive the legal challenge than the Affordable Care Act’s most controversial provision: the individual mandate_, which requires most adults to have health insurance or pay a fine.

Ah the irony of predictions in hindsight.

“Until now … low income parents and children”… so are you dragging the wife and kids out this farm if your state declines to expand Medicare?

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**Author:** ![lazybratsche](https://avatars.discourse-cdn.com/v4/letter/l/ba8739/32.png) [@lazybratsche](https://boards.straightdope.com/u/lazybratsche)\
**Post date:** [June 28, 2012, 4:44pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/5 "2012-06-28T16:44:03Z")

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You would probably qualify for a subsidy that would help you purchase health care from the private market. I think that’s supposed to get you an adequate health care plan at a reasonably affordable price ([this chart](http://en.wikipedia.org/wiki/File:PPACA_Premium_CRS.jpg) lays out what it should cost you, dependent on your income and family size). Basically you’ll pay 2% of your income if you’re at the poverty line, increasing to 9.5% at 4x the poverty line, and the gubmint will cover the rest.

ETA: That will cover some minimum level of plan, but if you want a better quality plan you’d have to cover the rest.

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**Author:** ![Sigene](https://avatars.discourse-cdn.com/v4/letter/s/df788c/32.png) [@Sigene](https://boards.straightdope.com/u/Sigene)\
**Post date:** [June 28, 2012, 4:50pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/6 "2012-06-28T16:50:28Z")

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Im in Missouri, but lets consider Iowa and Wisconsin too.

Lets assume no wife and kids, it’ll just be me.  
I didn’t realize I could get Medicare coverage already if I was not making any or very little money.  
Does this mean I already could have been getting excellent health care, for very little money or essentially free all along through Medicare?

I was under the impression that hospitals and doctors offices could refuse treatement if you couldn’t pay for it, which I would assume meant I wouldn’t be eligible for Medicare unless I was old or something.  
I’m still confused by it all. This is all hypothetical (for now at least); but one of the reasons I work is for health care, and if I don’t need to work to maintain health care, I may be more motivated to take up something much more enjoyable but pays little or nothing. From a health care point of view only…is there any reason why I need to work and make decent money?

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**Author:** ![lazybratsche](https://avatars.discourse-cdn.com/v4/letter/l/ba8739/32.png) [@lazybratsche](https://boards.straightdope.com/u/lazybratsche)\
**Post date:** [June 28, 2012, 5:14pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/7 "2012-06-28T17:14:43Z")

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Medicaid is far from “excellent”. From what I know, it’s better than nothing, and it aspires to be “adequate”. A lot of physicians won’t accept it, and I believe it won’t pay for some more expensive procedures. And depending on your particular state, I think you still can end up with co-pays and deductibles. Still, it’s better than relying on free walk-in clinics and ER visits.

(Also, Medicare and Medicaid are different programs. Medicare is for the elderly, Medicaid for the poor.)

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**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\
**Post date:** [June 28, 2012, 5:31pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/8 "2012-06-28T17:31:54Z")

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Yes to everything **lazybratsche** said. Plus, I’m fairly sure you have to be **brutally** poor to qualify. The Affordable Care Act - assuming it still stands by then - will in 2014 allow people at 133% of the poverty line to qualify. The poverty line is currently a little over $11k for one person.

And currently just being poor isn’t enough - there are factors taken into consideration that include age, disability, having kids, assets/resources, etc.

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**Author:** ![Mdcastle](https://avatars.discourse-cdn.com/v4/letter/m/958977/32.png) [@Mdcastle](https://boards.straightdope.com/u/Mdcastle)\
**Post date:** [June 28, 2012, 5:32pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/9 "2012-06-28T17:32:06Z")

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In Minnesota PMAP and MinnesotaCare (basically medicaid adminstered by commerical health insurance providers) covers all kinds of stuff other insurance won’t, say adult diapers and condoms. But is stingy on some other items, glasses can’t cost more than $65.00 for the frames and the lenses must be cheap polycarbonate. And things like spinal fusion, hysterectomies, chiro care and such have all kinds of red tape to get authorized. And no out-of-country coverage.

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**Author:** ![Chimera](https://avatars.discourse-cdn.com/v4/letter/c/8e8cbc/32.png) [@Chimera](https://boards.straightdope.com/u/Chimera)\
**Post date:** [June 28, 2012, 5:33pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/10 "2012-06-28T17:33:53Z")

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Here’s the wikipedia page that also lays out the parts of the bill and when they take effect.

> **[Affordable Care Act](https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act)**
>
> The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare ...

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**Author:** ![Morgenstern](https://avatars.discourse-cdn.com/v4/letter/m/f9ae1b/32.png) [@Morgenstern](https://boards.straightdope.com/u/Morgenstern)\
**Post date:** [June 28, 2012, 5:35pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/11 "2012-06-28T17:35:23Z")

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> [@silenus](#):
>
> By my initial reading of the ruling…it depends. “Does your state participate in the expansion of Medicare?” is the first key question. The court upheld the states challenge on that, so it looks like those states that don’t want to expand Medicare to the poor won’t have to.

I’m confused on this too. Are people referring to Medi_cade_ here and not Medicare?

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**Author:** ![Sigene](https://avatars.discourse-cdn.com/v4/letter/s/df788c/32.png) [@Sigene](https://boards.straightdope.com/u/Sigene)\
**Post date:** [June 28, 2012, 5:56pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/12 "2012-06-28T17:56:29Z")

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> [@Chimera](#):
>
> Here’s the wikipedia page that also lays out the parts of the bill and when they take effect.
> 
> [Affordable Care Act - Wikipedia](http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act)

So this part of your link interests me.

> [@](#):
>
> Low income persons and families above the Medicaid level and up to 400% of the federal poverty level will receive federal subsidies[28] on a sliding scale if they choose to purchase insurance via an exchange (persons at 150% of the poverty level would be subsidized such that their premium cost would be of 2% of income or $50 a month for a family of 4).[29]

Lets say I make $16,500 a year selling my extra corn, watermelon, and doing odd jobs here and there. Will my insurance costs really be only $400 a year? And this will be real insurance, not just the barely ‘adequate’ available from Medicaid?

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**Author:** ![Green\_Cymbeline](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/green_cymbeline/32/9244_2.png) [@Green\_Cymbeline](https://boards.straightdope.com/u/Green_Cymbeline)\
**Post date:** [June 28, 2012, 6:06pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/13 "2012-06-28T18:06:05Z")

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> [@md2000](#):
>
> IIRC, if your income was pretty close to zero, you could always get medicare coverage.

I think you mean Medicaid… Medicare is for the elderly and disabled.

[QUOTE=Sigene]  
I didn’t realize I could get Medicare coverage already if I was not making any or very little money.

Does this mean I already could have been getting excellent health care, for very little money or essentially free all along through Medicare?  
[/quote]  
Again, I think you mean Medicaid. And generally no, if you are a single adult without kids you probably will not qualify for Medicaid as it currently stands. Like mentioned before, it’s mainly for poor women with kids.

> [@Ferret Herder](#):
>
> Yes to everything lazybratsche said. Plus, I’m fairly sure you have to be brutally poor to qualify. The Affordable Care Act - assuming it still stands by then - will in 2014 allow people at 133% of the poverty line to qualify. The poverty line is currently a little over $11k for one person.
> 
> And currently just being poor isn’t enough - there are factors taken into consideration that include age, disability, having kids, assets/resources, etc.

**Ferret Herder** is right, you do have to be BRUTALLY poor, plus with a disability or kids, to get Medicaid currently. And 133% of FPL is still pretty brutally poor.

So basically, lower income people above the poverty line are still going to have to shell out a decent amount of money for health insurance, as far as I can tell.

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**Author:** ![lazybratsche](https://avatars.discourse-cdn.com/v4/letter/l/ba8739/32.png) [@lazybratsche](https://boards.straightdope.com/u/lazybratsche)\
**Post date:** [June 28, 2012, 6:18pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/14 "2012-06-28T18:18:04Z")

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> [@Sigene](#):
>
> So this part of your link interests me.
> 
> Lets say I make $16,500 a year selling my extra corn, watermelon, and doing odd jobs here and there. Will my insurance costs really be only $400 a year? And this will be real insurance, not just the barely ‘adequate’ available from Medicaid?

That’s for the [government-defined](http://en.wikisource.org/wiki/Patient_Protection_and_Affordable_Care_Act/Title_I/Subtitle_D/Part_I#silver) “silver” plan, which will “provide a level of coverage that is designed to provide benefits that are actuarially equivalent to 70 percent of the full actuarial value of the benefits provided under the plan.” Whatever that means. Basically it will meet some minimum standard defined by the act, and I have to assume that it will have some significant co-pays and deductibles.

So your insurance costs will only be $400, but you’ll still have other health care costs. My WAG is that you’ll have to pay a few hundred more per year in ordinary circumstances, and maybe a few thousand if you get seriously ill or injured.

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**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\
**Post date:** [June 28, 2012, 6:19pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/15 "2012-06-28T18:19:56Z")

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> [@Green\_Cymbeline](#):
>
> ISo basically, lower income people above the poverty line are still going to have to shell out a decent amount of money for health insurance, as far as I can tell.

Single people making up $44,000 a year, and families of four making up to $88,000 are eligible for subsidized premiums. Those at the high end of those threshholds will get a smaller subsidy, with those making less getting a larger subsidy. About 20 million American households will qualify for subsidized insurance of some kind.

> **[Health care reform bill 101: Who gets subsidized insurance?](https://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance)**
>
> Most people will be required to buy health coverage under the healthcare bill now before the House. About 20 million American households will qualify for subsidized insurance, according to the Congressional Budget Office.

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**Author:** ![Simplicio](https://avatars.discourse-cdn.com/v4/letter/s/c37758/32.png) [@Simplicio](https://boards.straightdope.com/u/Simplicio)\
**Post date:** [June 28, 2012, 6:50pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/16 "2012-06-28T18:50:16Z")

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> [@Green\_Cymbeline](#):
>
> **Ferret Herder** is right, you do have to be BRUTALLY poor, plus with a disability or kids, to get Medicaid currently. And 133% of FPL is still pretty brutally poor.
> 
> So basically, lower income people above the poverty line are still going to have to shell out a decent amount of money for health insurance, as far as I can tell.

“Decent amount of money” is obviously in the eye of the beholder. But the subsides are pretty large at the lower end. A single person making twice poverty level would have to pay about 3% of their income to cover their share.

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**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\
**Post date:** [June 28, 2012, 9:56pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/17 "2012-06-28T21:56:43Z")

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> [@Fear\_Itself](#):
>
> Single people making up $44,000 a year, and families of four making up to $88,000 are eligible for subsidized premiums. Those at the high end of those threshholds will get a smaller subsidy, with those making less getting a larger subsidy. About 20 million American households will qualify for subsidized insurance of some kind.
> 
> [Health care reform bill 101: Who gets subsidized insurance? - CSMonitor.com](http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance)

So how would that work if my employer covers some of my health care? Say I’m single and make $40k per year. My premiums are $600/month, but my employer pays them all. Nothing out of pocket for me.

Does the government send me a check for part of that $600? I didn’t pay it, but really I did as that was part of my compensation for work.

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**Author:** ![Simplicio](https://avatars.discourse-cdn.com/v4/letter/s/c37758/32.png) [@Simplicio](https://boards.straightdope.com/u/Simplicio)\
**Post date:** [June 28, 2012, 10:06pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/18 "2012-06-28T22:06:12Z")

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> [@jtgain](#):
>
> So how would that work if my employer covers some of my health care? Say I’m single and make $40k per year. My premiums are $600/month, but my employer pays them all. Nothing out of pocket for me.
> 
> Does the government send me a check for part of that $600? I didn’t pay it, but really I did as that was part of my compensation for work.

The subsidies are just for insurance bought on the individual market. (employer plans already get a tax subsidy)

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**Author:** ![boytyperanma](https://avatars.discourse-cdn.com/v4/letter/b/4491bb/32.png) [@boytyperanma](https://boards.straightdope.com/u/boytyperanma)\
**Post date:** [June 28, 2012, 10:17pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/19 "2012-06-28T22:17:47Z")

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> [@Fear\_Itself](#):
>
> Single people making up $44,000 a year, and families of four making up to $88,000 are eligible for subsidized premiums. Those at the high end of those threshholds will get a smaller subsidy, with those making less getting a larger subsidy. About 20 million American households will qualify for subsidized insurance of some kind.
> 
> [Health care reform bill 101: Who gets subsidized insurance? - CSMonitor.com](http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance)

These numbers don’t make sense to me that would imply that only 20 million people in the US make less then 44k or 88k per household.

Is it an additional 20 million people would be eligible for subsidies?

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**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\
**Post date:** [June 28, 2012, 10:42pm UTC](https://boards.straightdope.com/t/health-care-law-question-no-political-jabs-allowed/626595/20 "2012-06-28T22:42:14Z")

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See **Simplicio** ’s post. The subsidies are only for individual insurance bought on the exchanges. A decent chunk of people making less than $44k/$88k get insurance through their employer or will be eligible for Medicaid (or are old enough to be on Medicaid, have VA coverage, etc…).

The rough numbers kicked around were slightly less than 20k added to Medicaid and roughly the same number buying subsidized policies on the exchanges.

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