This is pretty much the way it is now with the employer sponsored plans I have had over the years. It is much improved over the high deductible HSA I have had for two years - and two more. I am not even guaranteed coverage if I want to change to a better plan. (Just when the ACA kicks in, I’ll qualify for a better plan - Medicare…)
That situation is likely to be the most common reason to want to change under the ACA. Plans will be standardized across insurers, but if you choose a economical “catastrophic” plan and later need the better coverage in a “Silver/Gold/Platinum” plan, you might have to wait for open enrollment.
But that isn’t really a fair comparison. Usually employer sponsored plans are heavily subsidized by your employer as part of your salary. You would be hard pressed to want to eschew your employer coverage for a private plan and pay full price.
And if for some strange reason, I did want to ditch the employer plan, I wouldn’t have to wait a year to sign with a private company, or under the current law, I could go without health insurance if I wanted to.
To continue my example, it would be as if you could buy $200 worth of groceries for $20 because your employer chipped in. That would take a lot of nonsense on the part of your grocery store to switch.
Well, that’s only sort of true. If you had a pre-existing condition you likely couldn’t buy individual insurance at all (or at least not for anything approaching a reasonable price). However, many states require individual insurers to have “open enrollment” periods in which they have to accept folks with pre-existing conditions at a “reasonable” rate. This is very similar to the concept of enrollment periods with guaranteed issue.
Still, under the ACA I see the situation as much improved - at least you are guaranteed another plan, just not immediately.
As it is today, you are neither guaranteed private insurance or in my case, the ability to change my existing private insurance coverage or company.
The ACA is far from perfect - but after a hundred years of trying to improve health care we have at least taken a step in a better direction than the status quo,
That remains to be seen. The fact that the uninsured and those with pre-existing conditions are better off is indisputable. What is still unknown is if the 80% of the public that was happy with their insurance will be any better off. According to a Gallup poll taken today, the public seems to understand the tradeoffs pretty well:
Uninsured and sick people better off, taxpayers, businesses, and those already with insurance worse off.
Well, everybody except Republicans understand the tradeoffs, it seems. Amongst them they consider it 50/50 whether the ACA helps or hurts the uninsured. And they think it makes things worse for folks who get sick.
I think they understand just fine, they just won’t concede an inch. Democrats are doing the same thing, they say with a straight face that it’s a good deal for everyone and insist angrily that no one will be worse off.
Did I miss something? Didn’t they rule exactly the opposite, that Congress could compel the purchase of insurance or, more precisely, that they could penalize those who don’t purchase it?
The tax power does not imply a right to regulate, or criminalize. It just means they can impose a tax. Congress sought to mandate the purchase of insurance through the commerce power, which does grant a power to criminalize and regulate.
Since only the tax power can be used to justify the mandate, it’s against the law to not have health insurance in the same way that it’s against the law to buy cigarettes or alcohol or gasoline. Which is to say that it just isn’t.
Right. But just as it is against the law to fail to pay the tax if you buy those products, it is against the law to not pay the penalty if you do not have health insurance.
Do most people blatantly lie on their tax returns?
I think this will be the hidden snake in the debate of this whole law. Many people will still go without insurance because the tax/penalty is so slight (and really non-existent if you simply tweak your deductions so that you don’t get a refund check).
However, since the law’s constitutionality hinges on it being a simple tax, it seems that any attempt to more strictly enforce or increase the tax to the point where it becomes coercive for people to buy insurance will be met with new lawsuits claiming, “See, it really is a penalty!” and back up to SCOTUS we go.
And I think they would have a good case. Roberts’ opinion was crafted so that even though the ACA called it a penalty, it could fairly be construed as a tax because it was so slight. When it becomes not so slight, can it still fairly be called a tax? We shall see.
Millions more in legal fees because of a narrow ruling which doesn’t answer the larger question.
And if President Romney replaces Ginsburg (but doesn’t get a repeal in the Senate) we can all get ready to do this again right after the new justice is sworn in.
Hmm. I complete my tax form and it says I owe X and I pay less than that. Does nothing happen? Or do I get one of those notices to pay up plus an additional penalty plus interest and further action if I fail to comply?
Sure people can choose to pay the penalty/tax rather than buy insurance.
The Supreme’s ruled it is a tax - despite the rhetoric when it was argued that it wasn’t, it is. You aren’t getting very far with the argument that there isn’t an enforcement mechanism - because you have to pay your taxes, not doing so is tax fraud, and there is an enforcement mechanism for dealing with tax fraud and underpayment of taxes. There doesn’t need to be any special rule for it. Arguing otherwise puts you in the category of people who think taxing is illegal because there is fringe on the flag.
It’s not a fringe view. Congress prohibited all collection methods other than taking refunds.
There are a lot of people who would love to be martyrs to the individual mandate. The supporters of the law didn’t need that kind of publicity. If you’re going to insist that your law isn’t damaging to liberty, then you have to not actually take away people’s liberty.
Which is exactly the point. The government has no desire to put liens on people for not having health insurance. Or to send collection agencies after them. Hell, I’m not even sure “the government” (depending on how you define it) cares if well-off people decide not to buy health insurance.
The primary goals (of the parts of the ACA we’rd talking about) are: (a) make sure everybody has access to health insurance and the means to afford it, and (b) make sure we don’t force the private insurance industry into an immediate death spiral.
And (b) was always secondary to (a) - that’s why Obama didn’t even support an individual mandate during the primary. His opinion (then and possibly even now) was that given the opportunity people will buy insurance. All the government needs to do is provide the opportunity by regulating a broken marketplace. If UHC and co. can’t convince folks to buy their plans on the exchange even with the Feds picking up a big chunk of the tab then too bad for them.
I think the President was right the first time. My company offers insurance, but we don’t have to take it. So then how come it’s sustainable? First, because it’s a good deal, so must opt in. Second, because there are enrollment periods. If you don’t choose health insurance for that year, you can’t sign up again until next year. No reason that model can’t work nationally.