To what extent will the Affordable Care Act be a factor in this race?

[2ManyTacos]

I’m sick and tired of hearing GOPers bitch and moan and spew lies about Obamacare and repeatedly calling for repeal. For fuck sake, they’re acting like Mitt Romney is their last hope against this savage “government takeover” of health care, even though, y’know, his actual RECORD makes it absolutely impossible to reconcile such a stupid idea with the reality of Mittens’s past.

But enough of the ranting. Just this past week, we had even more bitching about the ACA from Romney’s running mate. First, Ryan got his idiot ass booed at the AARP for calling for repeal of the law, and then he repeated the universally disproved lie about the law containing death panels.

All of this makes me wonder how much the ACA is going to influence voters in this election. I mean, I’ll give the GOP one thing: by having Ryan as the VP nominee, they’ve successfully managed to put the health law on top as a key issue in this campaign, which is something that they’ve probably been trying to do ever since it passed in 2010.

I’m just curious whether any of that will stick.

[Chimera]

So far nada. Romney pandered to the right by claiming he would repeal it, but we’ve already seen serious hints that he doesn’t actually oppose what is essentially National Romneycare. Frankly, if he opposed it as strongly as he claimed during the primaries, it would already be a major campaign issue, and it is not.

Well, or at least from my position, I’ve seen jack, other than the AARP thing. I’m not in a swing state, so I can’t speak for the carpet bombing of issues in those states.

[Untoward_Parable]

Well if the speech at the AARP is any inclination it’s going to depress Rodney’s old white conservative guy advantage with seniors. (when Paul Ryan talked about repealing it and how bad it was they boo’d him)

[Enkel]

Lets see… all those seniors who no longer have a doughnut hole in their prescription coverage… and their children who no longer have to cover the cost of that hole in their insurance coverage…

All those kids in school who now have decent healthcare coverage on their parent’s plans…

All those people who no longer have pre-existing condition blocks to health care…

All those people who no longer have life-time limits hanging over their heads…

Many got their first rebate checks in August from being over charges and many plans either didn’t increase or decreased very slightly to meet the 20% profit requirements…

Many will find out that they won’t be ‘taxed’ for lack of coverage because it doesn’t really affect anyone under about $200k in earnings…

Hmmm… hard to tell, but I’m guessing that there are literally thousands (millions?) who’ve seen a positive effect from it.

[Linden_Arden]

How many do you know who simply don’t want health insurance? Those are the people with a legitimate gripe about Obamacare.

There are some obscure taxes raised (tanning salon, medical devices, second home capital gains) but they are not a big deal.

Mainly - people don’t want those “other people” to have health insurance.

[adaher]

Given its importance, it should be a top 3 issue, definitely. I don’t know if it will be, but it should be.

[amarone]

@Linden_Arden

There are some obscure taxes raised (tanning salon, medical devices, second home capital gains) but they are not a big deal.

Medicare taxes are also raised - another 0.9% for people earning over $200k ($250k joint) and a further 3.8% on investment income for these high earners. So, not exactly “obscure taxes”, but they do not affect most people.

[adaher]

Then there’s the mandate/tax, that’s 6 million people according to the CBO.

[Enkel]

Where is this 6 million number coming from?

This article describes the cost trade offs ( Buying Insurance vs. Paying a Fine: What’s the Tradeoff? – Mother Jones )

Let’s take a family of four where the policyholder is age 35 and has an income of $40,000. How much would insurance cost them? According to this handy calculator from Kaiser, here’s what that family would have to pay (converted into a monthly premium):

Premium cost: $925
Federal tax credit: $760
Net cost of policy: $165

However, this overstates things because it’s based on the cost of a “silver” policy. But you don’t have to buy a silver policy. You can pay more and get a gold or platinum policy, and more importantly, you can pay less and get a bronze policy. Bronze policies don’t provide great coverage, but they do provide the basics and they also cover health emergencies. It’s a reasonable option for someone who just can’t afford more. By my rough calculation, a bronze policy would cost about $125 less than a silver policy. This means that the net monthly premium for our family of four would be about $40. That’s not much — and it’s half the cost of the fine.

But how about a family of four with an income of $50,000? After subsidies, their cost for a bronze policy would probably come to about $166 per month. That’s more than the fine ($166 vs. $100) but not a lot more. How many families earning $50,000 would forego health insurance for a net cost of $66 per month? Not too many, I’d guess, even if the insurance policy is mediocre.

As for families making more than $50,000, hardly any of them are uninsured in the first place. **This paper estimates only about 1.6 million uninsured **adults with incomes consistently above $50,000. It’s just not a big number.

This is the link to the paper about uninsured high earners (remember you only need insurance for one month in the year to be excluded from the mandate): content.healthaffairs.org/content/26/6/1745.full

Here is the Kaiser calculator so you can figure out what the effect is estimated on your self: http://healthreform.kff.org/SubsidyCalculator.aspx#incomeAgeTables

[adaher]

The CBO just announced it:

CBO: 11 Million Uninsured Americans Will Be Subject to Obamacare's Individual...

[Enkel]

From the CBO Report:

The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have estimated that about 30 million nonelderly residents will be uninsured in 2016, but the majority of them will not be subject to the penalty tax. Unauthorized immigrants, for example, who are prohibited from receiving almost all Medicaid benefits and all subsidies through the insurance exchanges, are exempted from the mandate to obtain health insurance. Others will be subject to the mandate but exempted from the penalty tax—for example, because they will have income low enough that they are not required to file an income tax return, because they are members of Indian tribes, or because the premium they would have to pay would exceed a specified share of their income (initially 8 percent in 2014 and indexed over time). CBO and JCT estimate that between 18 million and 19 million uninsured people in 2016 will qualify for one or more of those exemptions. Of the remaining 11 million to 12 million uninsured people, some individuals will be granted exemptions from the penalty because of hardship, and others will be exempted from the requirement on the basis of their religious beliefs.

After accounting for those who will not be subject to the penalty tax, CBO and JCT now estimate that about 6 million people will pay a penalty because they are uninsured in 2016 (a figure that includes uninsured dependents who have the penalty paid on their behalf)

So, they’re estimating that there will be 6 million people who earn enough to afford insurance but prefer a free ride. I have no problem with them having to pay the penalty. If they wrap their car around a tree, they’d expect to get treatment in an ER wouldn’t they? What if they needed extensive surgery and long term rehabilitation?

I guess the free ride ends in the year 2016 and all I can say is … About F’n Time!

[adaher]

Are those 6 million people actually wealthy enough to afford health insurance? If Congress really thought that, the penalty would have teeth. No one actually has to pay the penalty, there’s no enforcement mechanism other than to dock refunds, a rather easy problem to get around.

Add into that the fact that SCOTUS ruled that the government cannot actually compel people to buy health insurance and the moral underpinning of the concept has been invalidated. It exists only as a technicality.

[Ca3799]

Romney was just on 60 Minutes this weekend claiming the uninsured have ‘free healthcare at the emergency room’.

I thought we already had this discussion. Plus, I thought he was running of his business sense.

Apparently not.

[gamerunknown]

Not to mention pregnancies are not covered by COBRA and home pregnancies have double the rate of infant mortality (10 in 1000 compared to 5 in 1000 births).

[Wesley_Clark]

The ACA is the major reason I’m supporting Obama in 2012. Not that it matters since I don’t live in a swing state.

I don’t expect Obama to pass any meaningful legislation from 2013-2016. If he wouldn’t/couldn’t pass something in 2009-2010, then there is no way he will do it in 2013-2016.

But if the ACA stays the law of the land it moves the overton window to the left. By the end of this decade the debate won’t be ‘repeal or keep’ it’ll be how to update the ACA. Hopefully that’ll open the window for a medicare buy in, Rx negotiations, comparative effectiveness, stronger regulation of private insurance, assistance for overseas medical visits, etc.

[Jas09]

@adaher

Then there’s the mandate/tax, that’s 6 million people according to the CBO.

@adaher

Are those 6 million people actually wealthy enough to afford health insurance? If Congress really thought that, the penalty would have teeth. No one actually has to pay the penalty, there’s no enforcement mechanism other than to dock refunds, a rather easy problem to get around.

Add into that the fact that SCOTUS ruled that the government cannot actually compel people to buy health insurance and the moral underpinning of the concept has been invalidated. It exists only as a technicality.

So which one is it - will 6 million pay the “mandate/tax” or not? You can’t claim that it’s a tax hike on one hand and then say that it exists only as a technicality that no one actually has to pay.

[Enkel]

@Ca3799

Romney was just on 60 Minutes this weekend claiming the uninsured have ‘free healthcare at the emergency room’.

Just like we, taxpayers, pay for the pensions that Romney raided and foisted on the the government… we, taxpayers, pay for uninsured ER visits… so to him it IS free because we, the people who actually pay taxes at higher rates, are paying for it while he’s paying a fleet of attorneys and accountants to stash his money off shore and out of reach. So, yup… those ER visits are practically ‘free’ for a tax dodger like Romney… no so much the rest of us who live in and are invested in the US.

[ElvisL1ves]

@Jas09

You can’t claim that it’s a tax hike on one hand and then say that it exists only as a technicality that no one actually has to pay.

If the Chief Justice can say that, so can adaher.

[Damuri_Ajashi]

@2ManyTacos

I’m sick and tired of hearing GOPers bitch and moan and spew lies about Obamacare and repeatedly calling for repeal. For fuck sake, they’re acting like Mitt Romney is their last hope against this savage “government takeover” of health care, even though, y’know, his actual RECORD makes it absolutely impossible to reconcile such a stupid idea with the reality of Mittens’s past.

But enough of the ranting. Just this past week, we had even more bitching about the ACA from Romney’s running mate. First, Ryan got his idiot ass booed at the AARP for calling for repeal of the law, and then he repeated the universally disproved lie about the law containing death panels.

All of this makes me wonder how much the ACA is going to influence voters in this election. I mean, I’ll give the GOP one thing: by having Ryan as the VP nominee, they’ve successfully managed to put the health law on top as a key issue in this campaign, which is something that they’ve probably been trying to do ever since it passed in 2010.

I’m just curious whether any of that will stick.

I think this election is doing more to change people’s attitudes about ACA than three years of political ads from both sides. People don’t necessarily see it as a bad thing.

@adaher

Are those 6 million people actually wealthy enough to afford health insurance? If Congress really thought that, the penalty would have teeth. No one actually has to pay the penalty, there’s no enforcement mechanism other than to dock refunds, a rather easy problem to get around.

Add into that the fact that SCOTUS ruled that the government cannot actually compel people to buy health insurance and the moral underpinning of the concept has been invalidated. It exists only as a technicality.

You do realize that anything that is not necessary to the conclusion that the ACA is constitutional is called dicta, right? In other words its not an interpretation of the law and has no precedential value. A different supreme court with different justices can simply ignore that part of the opinion without comment.

[JohnT]

As for my wife and I, it’s one of the reasons we’re voting and campaigning for Obama.