It has to be offered to you. Did you seriously just ask that question? That’s asinine, bro.
Go easy, he’s not me.
It doesn’t HAVE to be offered to you, they can choose to pay a penalty instead, so Lobohan is only partly right. However, if it’s not offered to you, you are eligible for exchange subsidies. Or Medicaid, depending on your income.
If you are 133% or more over the poverty line, you go to the exchanges. Otherwise, you get Medicaid.
Spousal and family coverage will have fixed premiums - it won’t vary with the number of kids or wives :D.
The good news is that WV is signing on to the Medicaid expansion part of the ACA. If you meet the standards for ‘unaffordable’ under the ACA - you can get Medicaid or a subsidy for insurance. If ‘unaffordable’ just means ‘more than I think I should have to pay’, then you’ll have to pay the fine/tax - and, of course, all your family’s medical costs.
In theory, the medical loss ratio (MLR) of 80-85% (depending on individual or group) of your premiums must go to healthcare or be refunded to you. Which has has already resulted in a $1.1 Billion rebate being issued to consumers for 2011. However, IMO, this somewhat timid ‘cap’ on premiums does not go far enough and is rather indirect. I think on page 1 or 2 of this thread I expressed my big gripe with the ACA was that it did not adequately address the out of control cost of US healthcare, but I guess the MLR is a start. Reimbursement reform is the real issue.
Just to clarify - ‘must go to healthcare or be refunded to you’ is a limit on insurer overhead/profit.
I recently got into a RL discussion where the claim was made that under the ACA MLR rule, you got 80% back if you had no medical claims in a year!
Yes, this does need to be clarified. Since politicians (on both sides) have already tried to exclude all sorts of things from being calculated in the MLR (insurance broker commission, etc), so basically it lacks real “teeth”, IMO. The real issue is the unsustainable cost of US healthcare, which the ACA does not adequately address, nor is any politician willing to touch the issue with a ten foot pole.
Agreed. The only thing ‘exceptional’ about US healthcare is how much we pay for so little. (and perhaps how political it has become)
They use weasel words, citing individuals who pay $1000/month. That would be people who are already sick. Average health insurance premiums for individuals is $357.
http://kff.org/other/state-indicator/individual-premiums/?state=ny
And that’s for an average plan. The Times cites the bronze plan as being $308.
This is not the first time the Times has been busted for promoting ACA disingenously.
Regardless of how you spin the numbers, New York was ‘guaranteed issue’ with no community rating and no individual mandate. About perfect conditions for the highest possible rates and lowest enrollment. With all three, the ACA will be a dramatic improvement.
True. The main rate shock will be in states with less regulated markets.
Although young healthy people are going to see significantly higher rates everywhere. Even in new York.
We pay $965per month for a family of three. It’s somewhere between decent and mediocre; the lowest package available (the equivalent of ‘bronze’ I guess). The corresponding individual’s premium is $345 per month.
I’ve posted here a few times trying to find better rates or determine if I’m overpaying. Nope. Average and I haven’t been able to do better yet.
The site you linked to uses “Healthy New York” premiums when calculating its averages. Healthy New York is only available to low-income residents who make too much to qualify for Medicare yet are below median income.
To put it in context, a family of three only qualifies if they earn less than $49,000 per year (premiums for a plan with pharmacy is $1,790 per month. That’s $21,480 per year, just shy of half the annual maximum allowed.
An individual must make less than $29,000 to qualify and pays $577 per month/ $7,000 per year.
These premiums vary with the county. I used the county I’m in for simplicity.
Actually, I just realized I overstated the rates we’re paying. We just got a letter a couple days ago telling us a portion of our premium will be coming back to us. It didn’t say how much, but thanks Obama!
Anyone else here buy their own insurance?
So **adaher **posted a cite that was not an accurate contrast to the article I posted? Saints forfend! That never happens!
Says the guy who posted an inaccurate article from the country’s most partisan mainstream paper, and a cheerleader for the Obama administration.
No, your source is from 2010, showing the then current status, the New York times is quoting people like Benjamin M. Lawsky, the state’s top financial regulator regarding the new prices that are coming.
The thing that was ¨busted¨ was actually your say so. Or IOW, you really suck at your fallacious attempts at shooting the messenger.
No need. NY Times is partisan, everyone knows it.
So, doubling down on the shooting the messenger fallacy, not surprised that you would like to embrace that fame with your say so´s. Once again, it was really silly to claim the paper was ¨busted¨ when your data point was just good for the past with no changes enacted, and good only to show the contrast on the changes the regulators are reporting on the savings they are seeing coming.
Just my two cents, i don’t think this health care law is anything but an intrusion of my freedom and forcing me once again to spend money i do not have on something i do not want so that the fat cats in government and corporate america get even richer while I have less for my family. Health insurance is just a racket and noise so that a legal scam on people can continue. I spend far less without insurance by paying cash, my annual costs dropped 88% after canceling this crap.
Easy to say until a drunk driver crosses the yellow line and puts you and your loved ones into intensive care. Who pays then?
THe drunk driver’s insurance, duh.
Actually, Anotheruser1 could benefit from a catastrophic plan. Too bad those plans aren’t qualifying anymore.