No, because you are not insured throught the state insurance exchanges, you are not eligible for any subsidy.
The poor have always gotten free medical care. Go to any County ER and they will treat you. Mind you, they will send a giant bill, but once they know you can’t pay it, oh well.
This costs Taxpayers a shitload of $$, and it seems like Obamacare will at least fix this, to some extent.
And that seems to be the oft repeated point of contention that some people aren’t getting.
“Why should I be forced to buy insurance? It isn’t right!”
“Of course it’s right. Why should everyone else be forced to pay for you when you don’t?”
No, you don’t have the right to say it’s on your own head if something happens, because we all know that a> When push comes to shove, people decide that they’ll go get that medical assistance, and b> Only a very small number of people think we should leave people to die if they can’t afford care. Society as a whole doesn’t accept that.
My take away from this, is that if I want to quit my job this health care plan is better for me than without the plan. And I’m going to make the assumption that I’ll be able to get ‘decent’ (whatever that is) healthcare for minimal cost.
Based on my understanding of current law and the ACA that is almost certainly true.
It’s not a free lunch, of course - state taxes might go up to cover the Medicaid expansion and there are some tax increases on “Cadillac” plans and payroll tax hikes on high earners (as well as a tax on tanning salons).
But for the mid-to-lower income worker it is (venturing into IMHO here) a net positive economically.
But Medicaid/subsidy for health insurance is paid for by the taxpayers anyways, so if a poor person goes to the ER & their Medicaid/government subsidized insurance pays for, it still costs the same, so this doesn’t actually reduce any health care costs, it just shuffles around how things get paid for.
Now, if one can get the poor to go to regular doctors clinics for routine stuff that could save some money, but many doctors already refuse/highly limit Medicaid patients, and adding millions to the Medicaid won’t help that situation; and the government subsidized insurance is going to need much higher payouts to avoid the situation where doctors start refusing those patients as well.
The bill increased Medicaid payments to combat this problem. Especially for family practice type docs.
I think the problem of doctors not seeing medicaid patients is somewhat over-emphasized in anycase. I used to work for a health practice in a relatively small rural city (the kind of place that should have the worst problems with docs accepting medicaid) and while it was a minor pain in the butt finding docs to take medicaid referrals, that’s all it was: a minor pain in the butt. Patients had to deal with slightly longer waiting times and had to spend a little longer finding a doc that would take them.
The OP points to a very real benefit of the ACA. (“Obamacare”) Post year 2014, when all the provisions become effective, it will be far easier for Joe “I’m tired of working for The Man” Smith to try to start his own business. The currently huge cost of health insurance, even for healthy individuals, is serious impediment to starting any small business. Under the current system, the usual approach is for one spouse to work the business, while the other spouse works a 9-5 job with health coverage for the couple. That only works if the would-be small business owner is married to someone able to find/keep a job with decent benefits. Even then, the employed spouse has limited time to help run the business, which may doom the business from ever achieving critical mass.
The ACA will make it far easier for single people to start small businesses, and help to allow both partners in a marriage to work the businesses.
We’re self employed, make far too much to be eligible for any direct subsidy, but pay our entire insurance premium by ourselves (about $12K per year for basic coverage). Are additional or new tax write-offs included in the Act? Not the subsidy credits per se, but increases to current deductions?
Or, if we were dumb enough to have the income but self-insure, would we suddenly find ourselves with a 12 thousand dollar hit to our income (assuming we went with this plan)?
On that note, are there any figures or estimates out there as to how many people make over the subsidy limit (this site suggests that it’s $93,000 for a family of 4) yet do not already have health insurance?
Most likely it would be more beneficial for you to buy a group plan through the exchange unsubsidized. This sort of risk spreading is one of the primary goals of the law.
And yes, as I understand it, if you were currently self-insuring (i.e. uninsured) you would either need to buy a policy off the exchange or pay the penalty.
It’s not entirely clear to me if you’re talking about a small business that provides insurance or not. There is a new credit for very small businesses - spelled out here: http://www.irs.gov/newsroom/article/0,,id=223666,00.html.
You won’t get a subsidy, but you will get to participate in the state exchanges. In theory that means you will be able to purchase a better plan for less, since such plans will have to compete on the exchanges. Given that the highest-income subsidized family of four will pay $8400, and gets a subsidy of $1480, even without any subsidy you should be able to find $10,000 plans that meet some reasonable standards.
In theory.
I’d like to express my appreciation to everyone for answering my questions without this tumbling into an acrimonious rift of political arguments
No problem. And the big caveat is that nobody really knows how this is finally going to work. A lot of people are hopeful, a lot are fearful, and a lot are a mix of both. It’s a pretty big change to a very big part of the economy. There’s still a ton of regulation and implementation to get through, and that will help define exactly how this works for you and the rest of us.
The idea is that, even lacking a subsidy, insurance for people like you will become cheaper, hopefully by a significant margin. Many people in your situation do not buy insurance if they are youngish and healthy. This increases the cost of health care for all by a not small amount, (because the cost of emergency care for the uninsured has to be paid for) and increases the cost of health insurance for those who do buy it by a large amount, because the people that buy it are more likely than the general population to need to use benefits.
Here’s something I’ve never understood. I know people who have ended up in the ER uninsured. The resulting bills have been huge and the collection calls unrelenting. How does that reality work with the idea that we all pay for the uninsured to go to the ER? I also know that the billed cost for the uninsured is much higher than the costs would be for an insured person, so I assume the actual loss to the hospital is much less than the balance due on the statements sent to these people.
I’m guessing most people in this situation just throw their credit rating down the tubes and don’t pay, and then some tax funded government agency covers the lost income to the hospital, is that it? And if that is actually the way it works in reality, will this new health care law mean that those people never get a bill in the first place? Will the same government agency just cover the cost from the start but just in a different way?
That’s where I’m a bit confused. I can think of two factors that could lower our premiums (if I’m understanding things correctly). One seems to relate to the amount an insurance company can spend on overhead or something like that. The second is that by dramatically increasing the number of people who pay into the insurance risk pool the overall premiums should go down. This could occur, for example, because most (but not all) twenty-year-olds pay more into an insurance plan than they receive in benefits. The two tie together because the extra premiums collected have to somehow reconcile with the overall benefits paid.
But why won’t insurance companies simply sell the whippersnapers cheap coverage for super-catastrophic-expialidocious events with high deductibles for broken toes and the like?
Or will hospitals, who are now getting paid by insurance companies for treating people who could not pay at all yesterday, reduce their fees because they don’t need to make up for those losses?
Can’t. The exchanges have mandatory minimum coverages.
Ideally, yes. ER fees in particular should not be as high without non-payment rates approaching (or even exceeding) 50% in some areas. I wouldn’t expect specialist fees to change as much.
Some of the losses in the old system were covered by gov’t programs. A lot were covered by the hospital just writing off the losses, which in turn meant the actual cost was passed on to other patients and thus to either the gov’t (through Medicaid and medicare) or private insurance companies.
This involves a lot of overhead though. Trying to collect money from people that aren’t going to pay involves extra work for hospital billing, administrators, lawyers, etc. Its a lot cheaper to just bill an insurance company. And there’s also a lot of extra overhead created by the financial uncertainty due to hospitals having to serve people who may or may not actually pay for the services received.
So ideally the new system will save money both by getting people to seek medical care before they get bad enough to need the ER and by getting rid of the overhead and uncertainty created by the hospitals having to chase uninsured people around for months only to eventually write off most of their bill.
(also, it will hopefully keep the ER’s from getting filled up with people whose medical problems aren’t really acute emergencies, but have no where else to go for medical help).
It is perhaps worth noting that in Massachusetts, where a program similar to the ACA has been in place since 2006, ER visits have not fallen since enactment, but rather have continued a previous pattern of rising.
So if you could get healthcare for free, you’re life would be perfect.
Anything else you want handed to you?