How does "affordable" figure in the Affordable Care Act

Entitlement Whore wrote:

pineinthegrass wrote:
[snip]

So in summary, most people have group insurance and will not be affected by the ACA, low income people will get very low premiums, and healthy self employed people with middle class incomes can see their premiums double. Less healthy people will generally benefit with the savings very good for the low income, and less good for higher income (depending on state). Also, if all works as planned, there should be less uninsured than today.

Bottom line, it's pretty complicated. Maybe that's the only answer needed.

So the bottom line is that the ACA will benefit a small sector of the population and will not effect the rise or fall of current health insurance policy holders. This doesn't sound like health care reform to me. What have they fixed? The cost of my policy will probably still rise. My level of care will be the same. The prices of drugs will still increase and somewhere in all this there are penalties and taxes designed to pay for all these new rules, regulations and bureaucracy. The ACA doesn't sound like it has much to do with affordability at all.

How in the heck do you think your level of care will stay the same? Maybe in the short run yes, but over time there will be less incentives for people to become doctors and with millions more getting "free" health care, we know what will happen right? If Walmart was to announce that they will be giving away free boxes of pencils, people would be beating down the doors to get them even though they most likely would never use them. JMO

Arlen wrote: You forgot to mention the tens of millions of people who are on government assistance (welfare). They will now have full coverage health insurance. How will this be paid? No new taxes?

This is the elephant in the room.

I did mention that those making less than 139% of the FPL do not get tax credit subsidies, but could qualify for Medicaid, just as they do now. I'd guess most on welfare (not all) would be in that group.

The ACA had provisions to expand Medicaid and require states to join in, but the Supreme Court over-ruled that. So I'm not sure what will happen. I assmume the funding would be from the general fund (income taxes), but I'm not sure on that one. It could also be funded by other taxes and fees added to the ACA, or some mix of all.

Ryt_Rick wrote:
[snip]

How in the heck do you think your level of care will stay the same? Maybe in the short run yes, but over time there will be less incentives for people to become doctors and with millions more getting "free" health care, we know what will happen right? If Walmart was to announce that they will be giving away free boxes of pencils, people would be beating down the doors to get them even though they most likely would never use them. JMO

That's my point. I want answers to these questions, but there doesn't seem to be one source, one list or one government publication that lays out what the ACA consists of.

To paraphrase Pelosi... "You'll know what the bill does or doesn't accomplish when you need it."

Entitlement Whore wrote:

pineinthegrass wrote:
[snip]

So in summary, most people have group insurance and will not be affected by the ACA, low income people will get very low premiums, and healthy self employed people with middle class incomes can see their premiums double. Less healthy people will generally benefit with the savings very good for the low income, and less good for higher income (depending on state). Also, if all works as planned, there should be less uninsured than today.

Bottom line, it's pretty complicated. Maybe that's the only answer needed.

So the bottom line is that the ACA will benefit a small sector of the population and will not effect the rise or fall of current health insurance policy holders. This doesn't sound like health care reform to me. What have they fixed? The cost of my policy will probably still rise. My level of care will be the same. The prices of drugs will still increase and somewhere in all this there are penalties and taxes designed to pay for all these new rules, regulations and bureaucracy. The ACA doesn't sound like it has much to do with affordability at all.

For your example, $700 a month for a family policy isn't too bad. If you are on a group policy, that number should not change due to the ACA, though it will keep going up each year as it does now.

If you are in good health, self employed, and make over 400% of the FPL (over $90K for a family of four), then your premiums under the ACA will probably about double.

It's interesting how the federal government seems to punish the self employed. They already have to pay double the Social Security tax the employed do (though they get a fraction of it back if they owe income tax). And now with the ACA they are going to get a huge hit (if healthy) on their health insurance premiums if they are just moderately successful (we aren't talking anything close to 1%'ers here). At some point the self employed are going to stop working (if they can), or go back to finding a regular job working for the Man. Self employed do get to deduct the cost of their health insurance, but it's just a deduction and not a refundable credit like the ACA offers which means it will only reduce taxes owed by a fraction of what they actually paid.

So far as who the ACA helps or hurts goes, since the majority of people under 65 are covered by a group policy and shouldn't be affected by the ACA, then it follows that only a minority of people will be helped or hurt by the ACA.

I never did cover those over 65. Most have Medicare. As I recall, the ACA isn't supposed to affect regular Medicare, but it had about a $500 million cut in support of Medicare Advantage plans.

Okay so let's start to REALLY look at the numbers.

'Affordable' Care Act? Not so much for Sacramento
Obama's healthcare overhaul is one more costly program for a red-ink state.

http://www.latimes.com/health/la-me-cap ... 736.column

But Finocchio acknowledges that the federal act will result in a heavier state financial load. "We almost certainly will be adding Medi-Cal enrollees, and that will be a cost," he notes.

The additional burden on the states is a negative aspect of the healthcare overhaul that seldom gets discussed, especially in Obama-rooting, liberal-dominated Sacramento.

It's as if somehow it would be contradictory — even Democratic heresy — to support a laudable expansion of healthcare coverage and to also acknowledge that it was going to require more California tax dollars. To ignore the cost is to be intellectually dishonest.
There's a lot of emphasis on the additional federal funds — up to $15 billion annually — expected to be spent in California because of the healthcare law.

But there will be an added state cost for the expansion of Medi-Cal, the California version of the federal Medicaid program for the poor. Finocchio estimates that up to 1.6 million more Californians will enroll in Medi-Cal. But it's really anybody's guess. Each person will cost the state more money.

But the big cost to the state will be for the generous expansion of Medi-Cal, a Medicare offshoot.

And it's ironic because California can't even afford its current Medi-Cal program. It has been cutting back on poor people's care in recent years to staunch budget bleeding.

The state budget passed by the Legislature and signed by Gov. Jerry Brown last month included more than $1 billion in cuts to Medi-Cal and other health programs.


Some of those enrollees will be people currently eligible for Medi-Cal but for whatever reason — perhaps stigma — haven't signed up. Under the new law, it will be easier and more beneficial to enroll.

So it appears that at the state level the devil really is in the details of the "Affordable" Care Act. We will see how affordable it is for states like California.

While I agree with the part about saving money by people not going to the emergency room, but, like above, if people are not even having to pay co-pays to see thier primary, are they more likely to go to the doctor for unneccesary reasons? Hypochondriacs, etc? And since the doctors are still earning from these "patients", they won't discourage it.

One of the reasons Medicare is costing much more than expected.

The "affordable" is a misnomer, just like penalty/fine. The care is not more affordable, the government just picks up the tab for the unaffordable part of the cost for some people.

Pine- your summary of the ACA was pretty thorough, but you missed one part- the doughnut hole. If your income is above the subsidy/credit thresholds, you may be stuck buying mandated expensive insurance and be unable to take a tax deduction. You have to be self employed with a schedule C to deduct health insurance. If you get W2 wages of any kind from an employer, you are not self-employed, and out of luck. No deduction for you! And if you are self employed, its only an income tax deduction, not payroll taxes too like group plans get.

So is this a new group of one percenters for the Occupy folks to go after?

Top 10% of Hospitalized Medicare Users in 2009 Received 64% of the Funds

http://live.wsj.com/video/the-surprisin ... 48B14E8B88

I have to wonder how a Medicare program that spends 64% of it's funds on 10% of its customers can possibly be sustainable or affordable?

If the other 90% of the customers need more than 35% of the funds then who picks up that tab?

Also, if the other 90% actually need a doctor...is there a doctor out there that can give them quality health care?

What if the entire population of Medicare recipients becomes larger? I wonder how proportionate that equation is?

If other 90% needs more than 36% of the funds available in the Medicare coffers and there are no more funds to give....who decides who isn't going to get funding or medical attention?

Lets' talk about affordability along these lines.

Lion, I'm not sure those numbers are unreasonable. The insurance industry is like alot of things, the 80/20 rule is a good estimate. Approx 20% get 80% of the claims money. That's the nature of insurance against risk. IMO a definition of a good insurance plan is where you pay a very small premium and get 0 back if you are a lucky one. Big payout if you are unlucky. I'd rather be the former.

Probably the only way to make Medicare solvent is to move it toward an insurance model, instead of a health care model paying every little $25 bill. Use savings accounts and low income subsidies for routine care, and insurance payments for big items. Makes too much sense though, never mind.