Native Americans get UHC (Indian Health Service) from the federal government, so adding them to the insurance exchanges would be counter-productive. Likewise, if you get other federal health care like VA benefits or Military Tri-Care, you are not eligible for the new insurance exchanges.
It is in SEC. 4377. DEFINITIONS AND SPECIAL RULES. if you want to read the details.
They did put up a pretty good fight, in case you didn’t notice. Spent a butt load of our money to convince us to give them more money. Its the American way!
I ask again my recurring question: these awful things they do to people, do they do them because they absolutely must, that they cannot make a profit otherwise and would be forced to give up? Or do they do it out of sheer greed, and are entirely capable of making a modest but sustainable profit without doing these things.
Because, as you may have noticed, these things will no longer be permitted. So: do they have to do it, or no? If they did it out of an urgent need to provide their CEO with a twenty million dollar salary, they are swine and not to be trusted. If they did it because they had no other option, then they are quite possibly boned, no?
Based on the time stamp of my post that you quoted, I think I know why it seems like a non sequitur now…
I guess it depends on how specific the details you want to check out are. But the basic structure of the bill has been pretty much fixed for at least a year, and the text of the Senate bill has been fixed since Christmas. I guess a few people might be thrown if they were expecting a penalty of 750$ and the Reconciliation changes made it 695$, or were interested in the precise balance between funding from the excise tax and the Medicare surtax, they would’ve had to wait to see what the Reconciliation changes were. But I doubt one person in a thousand made up their idea of what the bill would be based on details at that level.
Well, two things. One, your making it like this is some consequence of the last minute changes to the bill, but as the paper you link to says, its a consequence of all the variations of the bill that were being floated. As I said, the basic structure has been pretty consistent for a year plus, so making predictions like this has been possible for at least that long, unless you want to get down to the really fine details.
Second, the move a way from Employer based health care was already happening, before the Obama or even Bush Presidencies. That the government is now providing an alternative for people who have been left without insurance due to this change is a good thing, even if it accelerates the rate at which employer based insurance dies. The only other alternative is to try and prop up the Employer based system, and I don’t think either party wants to move in that direction.
The plan already closes (and funds the closing of) the Medicare donut hole. Hence the ending of the subsidies, there’s no need for the gov’t to provide two different programs to pay for Medicare subscribers medication.
I agree that that’s probably where Health Care in this country will end up, but I seriously doubt it will happen at anywhere close to the rate you predict (and I think we’d be better off if it happened faster). For all the griping, the bill is both fairly timid in the changes it makes and slow to take effect, I’d bet 50% of the under-65 crowd will still be getting their insurance from employers in 2020.
However, any significant “fixing” of the formulas throws the CBO cost estimates right out the window.
From personal experience with the Massachusetts plan, I think that the numbers given in the OP sound reasonably affordable. I used to not have insurance by choice. I’m young and healthy and don’t make all that much more than the $22,000 example. I had to purchase insurance, which is through my employer, and I pay a bit more than the $1386 in the OP out of pocket. It’s not much fun, but it’s doable. On balance, I’m happier with reform than without, even if it does impose rather substantial costs on me.
The thread seems to be winding down, but I still have some questions that I don’t think have been answered (if they have, just point me to the post numbers with my apologies). Rather than start a new thread, I’ll just re-ask them here, but with a bit more detail:
My sister and her husband don’t get insurance through their work at this time. Both work for small (alternative) health care companies. They have 3 small children. My questions are on the timing…when will their companies have to either pick them up for insurance, or be forced to pay a penalty…and how will that penalty work? IIRC, the penalty is $2000 per employee, but is that monthly, yearly, or a one time penalty? Assuming their companies opt to pay the penalty, what will my sister and her husbands options be? Will they have to go out and find health care on their own, when will the governments plans be available to them, and if the governments plans aren’t available and they can’t afford to get coverage on their own, will they have to pay the $695.00 penalty, and if so, starting when? If none of the above is close to how it will be, then explain to me how it will play out for them in the next year…and the next several after that.
My next question has to do with a friend of mine. She is a single mother with a daughter that just turned 18 a few months ago. Currently the daughter is on her fathers health care plan, but he is dropping her and giving legal custody to the mother formally (probably to save himself money, among other slimy reasons). My friend has health insurance that (currently) pays 80/20 for employees, but 50/50 for dependents. She can’t afford that price on her income (the father won’t pay child support after the daughter moves back in with her mother). So…what are their options? With the daughter have to get insurance or pay the $695 penalty? Will my friend be forced to put her daughter on her insurance, even if she can’t afford to? Will there be government assistance for my friend or her daughter? Will there be government group plans available, and when will they be available for people in the above situation. Also, is the personal penalty a one time thing, or do you have to pay it every year…or every month?
I’d appreciate some GQ style answers to the above, since I don’t know the answers to these and I’ve been asked by both my sister and my friend what they think will happen next. If someone could give a time line for how things might work out for both examples I’d be VERY grateful, especially from someone who has had the chance to really dig through the modified bill and understands the sequence of events that have been set in motion by all this, and when things will start happening. I know that some things will start almost immediately, but others won’t happen until much later (like 2014).
-XT
Brilliant observation! Perhaps next we’ll start a thread debating the beauty of 2+2=4.
Because unhealthy people and poor people cannot afford health care, universal care requires that the healthy and the rich subsidize the unhealthy and the poor. This fact also falls in the category of 2+2=4 obviousness. If this is your point, start a new thread “Golden Rule: Good or Bad?”
The present legislation doubtless has many flaws and, unfortunately does little or nothing to address the real problem of American health care: unneccessarily high costs. I will not be at all surprised if flaws in the plan, real or perceived, let the GOP play a game of “Told ya’ so!” for many years. If you’re looking for someone to blame for this, I’d go with the GOP. If 85% of Congress had been working sincerely for a good bill, intelligent compromises could have been made. With the GOP united behind the sole goal of sabotage, those who supported health care had much less room to manoeuvre.
The penalty is 2k$/yr/employee, but only effects employers with more the 50 employees, so depending on how small your small alternative health company is, they might be exempt from the penalty. I think theres also some increased tax benefits for smaller companies to insure their employees, so they still might offer insurance even if they’re under 50 employees.
The exchanges for subsidized insurance will open in 2014 as well, so they’ll have a couple months to find a plan before getting hit with a penalty. The penalty is also just 100$/yr the first year, it ramps up to 695$/yr over, err, a couple years, I forget. Two? Four? Something like that.
There won’t be any penalty for the daughter being uninsured till 2014. Starting in the next few months, children will be able to stay on their parents healthplans till age 26, but obviously that doesn’t do your friend any good if she can’t afford the coverage anyways. Employers are supposed to offer “affordable” coverage to their employees to avoid the penalties, but I’m not sure how “affordable” is defined. Hopefully, will force your friends employer to switch to a more affordable health plan and then her daughter can stay on it till she turns 26 or stops being a dependent. Otherwise, they can still either get subsidized insurance through the state-exchange or (if they’re low income), through the expanded medicaid (both, again, start in 2014 at the same time the fees for not having insurance start).