Can we discuss some details of the ACA?

Just wondering if this would be possible without attacking each other? I've had some problems with the overall bill for some time now...specifically the mandate/penalty/tax.

My question is, what is the incentive for anyone who is currently healthy and has the means to keep paying an insurance premium every month? Why would anyone not just pay the yearly tax/penalty and wait until they get sick before they buy insurance? I know that I could have saved at least 200k since I never got sick until I was 47.

And, what assuranced do we have that that this tax won't keep going up and up every year since every other government program ever started has been poorly run and nearly bankrupt? And since this is supposedly a legitimate tax, what assurances do we have that something else won't be mandated as a tax in the future?

I think these are legitimate concerns imo... what do you think?

My biggest concern is the fact that due to the "tax/mandate" being so low, and the fact that nobody can be turned away with a pre-existing condition. Nobody in their right mind would get insurance when young, and they will just pay the tax. Then, if by some unlucky chance they need anything major (cancer, bad accident, etc) they just buy insurance at that time. This will put private insurers out of business, forcing everyone into the public exchanges, paid by taxpayers.

At that point there will be 2 options...raise taxes substantially, or 2, limit care.

My guess is we will end up with 2 levels of healthcare. One, for those of us who won't be able to afford good insurance anymore, we will be stuck with public doctors and public insurance and huge wait times. The "1%" will create a new healthcare system that doesn't accept the govt insurance. This is where the best doctors will go....because they can make what they want.

Duh, that is the plan. Replace bankrupt private insurance with a goverment plan.

The only young people that will buy insurance are the very risk averse. Or if the company requires health insurance like mine.

With the ACA you can't wait until you get sick and then go buy insurance.

It will work kind of like Medicare where you can only purchase insurance during a certain period once a year. If you are "lucky" enough to get sick during the sign-up period, then the idea might work (though I think you'd have to disclose your illness on the insurance application). Otherwise, you'll be without insurance and will have to wait for the next sign-up period.

But if you have an emergency and don't have any money, you can still do what is happening now. Just go to an emergency room and get "free" treatment, plus you might qualify for Medicaid.

I would expect there are going to be many exceptions and variations. You could lose your job outside the sign up period and need a new plan. You could be a "kid" at age 26 dropping off your parents plan needing coverage. No doubt its going to be a typical government nightmare of bureaucratic rules to navigate, will probably read like the income tax instructions.

Another thing to consider is that "means testing" for subsidies is not so simple as it sounds. Many people have irregular income year-year, even month to month. Your official IRS total AGI 2014 income will not be officially documented and added up until as late as April 2015, so I am not sure what is used to document annual income, and what happens if you estimate it wrong. Lots of fun ahead!

Seems like it would have been much simpler and quicker to have a fixed $2K-$5K Individual/Family tax credit and some funding for high risk pools with guaranteed coverage. That could have been a one-page Health care bill with bipartisan support.

LOL, you can't hide a lot of pork in a 2 page bill.

I see it being repealed after taxpayers get a clear understanding how much more they will have to pay in taxes when those who are healthy, not just young people, opt out and choose to pay the penalty.

There isn't any incentive to purchase health insurance unless you currently need it.

I can still see young people choosing to go without. "They can't leave me bleeding in the street, right?"

Plus so many people aren't being offered insurance in their jobs anymore.

Or just not getting around to it, I have been meaning to do my will for 10 years now and it still isn't done.