I’m just curious about this. (Asked generally, not specifically of Whack-a-Mole): What would be the subsidy and the residual cost for people in the following situations or similar ones:
[ol]
[li]Retired and living on $20,000 in pensions/SS[/li][li]As 1, but semi-retired with part-time employment raising income to $25,000[/li][li]Person or couple on SSDI (their sole income)[/li][li]“Working poor” making ca. $25,000 a year[/li][li]Widow with minor children working mnimum wage job but also getting survivors’ payments from SSA[/li][li]Childless couple making around $30,000 a year[/li][/ol]
Obviously my examples are founded on real-life instances now or formerly known to me. I’ve also run into instances where Medicaid has rejected applicants who were unable to afford health insurance – any clue how such situations would be resolved. (We’re talking an income gap where Medicaid cap is below what is available income after (other) necessities are paid for – a range where the household is “making too much for Medicaid” but not making enough to afford insurance.
Doesn’t the retired person on your list qualify for Medicare? If so, I’m not sure much changes under this plan.
A working poor couple making $25,000 Would be liable for somewhere between $1000 and $1575 per year for health care. A single person who is making $25,000 would be liable for $1575 to $2012 for health care. Plus, in both cases they will be required to pick up the deductible or co-payment for any health services used, up to 15% of the total cost.
A childless couple making $30,000 per year total will have to pay between $1890 and $2415 per year for their health coverage, with the government picking up the rest. However, you’ll be responsible for paying the deductible up to 27% of the entire cost of the coverage.
So, let’s say you’re that married couple with the $30K income. You buy the lowest-cost health care available in the exchange, which comes with a high deductible - say $2000.
if you incur a health expense of $2000 or under, you pay 27% of the cost and the government pays the rest. So you’re out another $540.
If you incur a health expense of $10,000 or more, you’ll pay out the full $2000 deductible, and the government won’t help you with a nickel of it.
I’m not saying this is good or bad, but it’s the kind of stuff that very few people who supported this plan actually know about. You can bet that there are a lot more surprises like this in the multi-thousand page bill.
Another important unintended consequence of this bill - the marginal tax rate for low income people just got a lot higher.
For example, let’s say you’re an individual making $14,403 (133% of FPL). You’re of average age and health, so your insurance is $2000/yr. At that income level, the government will require you to pay 2% of your income, or $288 for your health care (plus deductibles). That’s a pretty good deal for you.
Now you get a raise to $16, 245. Your health insurance cost just jumped to $649. That’s increase in cost of $362, out of a gross income gain of $1842. So just your health care benefit alone represents a marginal tax rate of about 20%. Add in the other government benefits you lose, plus any additional tax brackets the new income may be in, and you’re creating a fairly significant disincentive effect for people to work harder or take overtime to make more money or whatever.
And that extra money comes out of post-tax income. If your effective tax rate on the new income is 28%, then your $1862 wage increase represents a take-home increase of $1340, of which you now have to pay an additional $362 in health care, leaving you with $978.
The reason the health care effect is big is because you are now expected to pay 4% of of your TOTAL income instead of 2% for going from 133% of FPL to 150% of FPL. So your health cost doubles, even though your income only increases by 17%.
These things have consequences. They change behavior on the margin. No one knows exactly what the changes will be - how it will change employment patterns and the number of working poor and all that - but the changes will be there. They’re unintended consequences, and probably bad.
Except for the $500 billion-with-a-b that they need to take out of Medicare that will supposedly pay for this bill. Not that Congress has ever kicked that down the road before through overriding the SGR. Or that if they managed to actually do it, it would affect healthcare delivery for seniors at all.
No, that won’t be an issue I’m sure. I’m sure there’s half a trillion in waste fraud and abuse that they will now find in the system (probably right next to the weapons of mass destruction).
**Sam/B], great post #143. I’ve been harping in other threads about the possible retirements of doctors as an unintended consequence (an astounding 45% will consider it, according to this poll).
This article was already quoted, but not the conclusion:
IMHO sure there is a chance to get the courts to go for the option to repeal it, but I see it as very unlikely, at best the courts could only go for making a ruling that would allow states to opt out, but that is as far as I think the Republicans might be able to take this.
The fact that plans like the Massachusetts one were not taken to court tells me that many judges would not be too sympathetic to make a judgment that would eliminate that currently established plan.
To go in another direction, what type of policy are you getting for these percentages of income?
In other words, is it a policy with a $20k deductible, doesn’t cover much and “loses” the claim forms all of the time?
Or is it a nice policy, $5 doctor visits, $5 generic prescriptions, $10 brand name, etc.?
I mean, those percentages of income aren’t bad if that is your total health care cost for a family, but it is terrible if all you are getting is a catastrophic plan and have hundreds or thousands more per year on top of that.
Say, haven’t you been told several times in the last couple of days that Medicare Advantage is being cut. It’s a private plan paid for with government money that costs more and doesn’t do any better than Medicare.
Isn’t it dishonest to keep saying that Medicare is being cut?
I’m assuming that $500 billion is never coming out. As it is, the government has to kick another $362 billion into Medicare to prevent a 21% cut in doctor’s salaries next year - which they removed from this bill to get a good CBO score.
The notion that there is $500 billion in medicare cuts in this bill that will actually be carried out by the government is a fantasy.
It’s an unscientific poll. You might as well cite an internet poll or ask the guys at a line-dancing class what they think.
If that poll is correct, it’s by accident. You are knowingly pointing to a worthless poll to bolster your case. Why don’t you have any real information you can point to?
You are the one asserting that there will be a mass doctor retirement in response to HCR. You are the one required to back that up with more than wishful thinking.
Yes this is unnecessary nitpicking. As a general matter, I agree with your comment, but we are not presently discussing those provisions in the U.S. Constitution. The discussion, thus far, has been confined to Article I, Section 8, or the 16th Amendment. Should those other provisions become germane to the dialogue, at any point, then your statement becomes necessary. It is nitpicking for the sake of nitpicking but does not add anything substantive to the dialogue. It is annoying nitpicking.
No one is ever going to be charged with a fine for not having health insurance. It will not happen. The language is in the bill so that the overall costs would pencil out before the vote. The true costs of the program would have outraged and alienated some supporters. With the threat of a fine, fictional money from fines can be added in to lower the cost of the program.
The fines and penalties will be quietly dropped once the bill becomes law. There will be no court challenge because there will be no fines, only an increase in the cost of the program buried in the federal budget.