ObamaCares works!

Until you can give us some reliable source for your fairy tales Fred, your posts are meaningless.

Something the Dog Said wrote:

pineinthegrass wrote: On page 4 of the Kaiser article they quote a $250/mo premium for a 40 yr old in Denver. They don't mention the deductible, but the max out of pocket expense appears to be a very high $6350. And has been discussed before, there is a problem with the law in that $6350 could in some cases apply to medical care and prescriptions separately, raising the out of pocket expense to as much as $12,700 in 2014. The $250/mo is for a policy with a 30% copay.

I checked what you can currently get for around $250 at Rocky Mountain Health. For a 40 yr old male in Park county I found a $2500 HSA with drug coverage for $251/mo. The maximum out of pocket expense is $2500 unlike the Obamacare's $6350/$12700. The plan pays 100% of expenses above $2500 while the Obamacare plan just pays 70%.

In addition, you can put up to $3250 tax free into your HSA account which would save you hundreds in taxes ($812 savings if in the 25% tax bracket). If it were me, it would be a no-brainer to take the $2500 HSA which is offered now (though you need to be in decent health to qualify, unlike Obamacare).

I'm still not clear if Obamacare will offer HSA accounts. If they do, I'm worried it would be a $6350 HSA which is too high an out of pocket expense, IMO. Hopefully there will be plans available with lower out of pocket expense, but I'm not sure.

If you are low income the Obamacare premiums do get subsidized and are even less. But if you are single and make over about $45K, you have to pay the full amount and a $6350/$12,700 out of pocket expense is just not very good coverage, IMO.

What is your reference for your claim that the out of pocket would be $12,700. You mention that "in some cases", then go on to generalize that applies in the example. Which is it, in "some cases" or in all cases? You also claim that you do not know what the deductible is, then go onto claim that it would be $12,700 with no basis except for your speculation. Also, you state that you do not know whether or not there will be HSA accounts under Obamacare, then go on to claim that the HSA would be $6350 for your example. It appears that your example is fictional and not based on the facts. Why not use facts unless you are simply fabricating examples for purposes of scare tactics?

Currently you have to pay the full amount regardless of your income level.

The $6350 out of pocket is from the Kaiser article in Figure 6, page 7. It's the same number I've seen in all the articles I've read.

The $12,700 is due to a "glitch" in the law which allows insurance companies to have a $6350 deductible for medical care, and another $6350 deductible for prescriptions in 2014. I can't tell from the Kaiser article if they are quoting one of those policies or not, hence I said it could be either $6350 or $12700. Either way it's much too high, IMO.

http://www.nytimes.com/2013/08/13/us/a-limit-on-consumer-costs-is-delayed-in-health-care-law.html?pagewanted=all&_r=0

edited to add...

I got the $2500 HSA quote for Rocky Mountain Health's website...

https://accessrmhp.org/SOLOApplication/SOLOQuote.aspx?utm_campaign=(organic)&utm_source=organic&utm_medium=organic&utm_term=(not%20provided)

That link may stop working, but you can go to...

http://www.rmhp.org/

Under "Individuals" click "Get a Quote".

I entered Zip 80470, Park county, Male, nonsmoker, birthdate 06/01/1973 (40 yr old).

Their HSA 2500 plan has a premium of $238/mo with generic prescriptions. I upgraded it to brand name prescriptions and the premium was $251.

I also tried examples with a 25 yr old and 60 yr old. The premiums were still close to those mentioned for Denver in the Kaiser article, but the coverage much better, IMO ($2500 out of pocket vs. $6350 or up to $12,700 plus tax savings).

archer wrote: Until you can give us some reliable source for your fairy tales Fred, your posts are meaningless.

And even then the'yre usually meaningless Archer

FredHayek wrote: VL,
I know you aren't this stupid, ACA is not free goverment healthcare. Taxpayer paid healthcare would have made sense, instead it is still the current system with 20,000 pages of new stupid rules and additions to make private healthcare insurance a lot more expensive. Like eliminating limits on maximum benefits.
Your car insurance has limits on payouts, why shouldn't your healthcare insurance?

Yeah..Lets have medicare for all and cut the defense and security budgets in half to pay for it cause I'm more likely to die of Cancer than at the hands of "The Terrorists!" More healthcare jobs, less weapons manufacturing..It all works out, and the money and jobs ares spread out over the entire nation....



1.6 Billion Rounds Of Ammo For Homeland Security? It's Time For A National Conversation
http://www.forbes.com/sites/ralphbenko/ ... versation/

pineinthegrass wrote:

Something the Dog Said wrote:

pineinthegrass wrote: On page 4 of the Kaiser article they quote a $250/mo premium for a 40 yr old in Denver. They don't mention the deductible, but the max out of pocket expense appears to be a very high $6350. And has been discussed before, there is a problem with the law in that $6350 could in some cases apply to medical care and prescriptions separately, raising the out of pocket expense to as much as $12,700 in 2014. The $250/mo is for a policy with a 30% copay.

I checked what you can currently get for around $250 at Rocky Mountain Health. For a 40 yr old male in Park county I found a $2500 HSA with drug coverage for $251/mo. The maximum out of pocket expense is $2500 unlike the Obamacare's $6350/$12700. The plan pays 100% of expenses above $2500 while the Obamacare plan just pays 70%.

In addition, you can put up to $3250 tax free into your HSA account which would save you hundreds in taxes ($812 savings if in the 25% tax bracket). If it were me, it would be a no-brainer to take the $2500 HSA which is offered now (though you need to be in decent health to qualify, unlike Obamacare).

I'm still not clear if Obamacare will offer HSA accounts. If they do, I'm worried it would be a $6350 HSA which is too high an out of pocket expense, IMO. Hopefully there will be plans available with lower out of pocket expense, but I'm not sure.

If you are low income the Obamacare premiums do get subsidized and are even less. But if you are single and make over about $45K, you have to pay the full amount and a $6350/$12,700 out of pocket expense is just not very good coverage, IMO.

What is your reference for your claim that the out of pocket would be $12,700. You mention that "in some cases", then go on to generalize that applies in the example. Which is it, in "some cases" or in all cases? You also claim that you do not know what the deductible is, then go onto claim that it would be $12,700 with no basis except for your speculation. Also, you state that you do not know whether or not there will be HSA accounts under Obamacare, then go on to claim that the HSA would be $6350 for your example. It appears that your example is fictional and not based on the facts. Why not use facts unless you are simply fabricating examples for purposes of scare tactics?

Currently you have to pay the full amount regardless of your income level.

The $6350 out of pocket is from the Kaiser article in Figure 6, page 7. It's the same number I've seen in all the articles I've read.

The $12,700 is due to a "glitch" in the law which allows insurance companies to have a $6350 deductible for medical care, and another $6350 deductible for prescriptions in 2014. I can't tell from the Kaiser article if they are quoting one of those policies or not, hence I said it could be either $6350 or $12700. Either way it's much too high, IMO.

http://www.nytimes.com/2013/08/13/us/a-limit-on-consumer-costs-is-delayed-in-health-care-law.html?pagewanted=all&_r=0

edited to add...

I got the $2500 HSA quote for Rocky Mountain Health's website...

https://accessrmhp.org/SOLOApplication/SOLOQuote.aspx?utm_campaign=(organic)&utm_source=organic&utm_medium=organic&utm_term=(not%20provided)

That link may stop working, but you can go to...

http://www.rmhp.org/

Under "Individuals" click "Get a Quote".

I entered Zip 80470, Park county, Male, nonsmoker, birthdate 06/01/1973 (40 yr old).

Their HSA 2500 plan has a premium of $238/mo with generic prescriptions. I upgraded it to brand name prescriptions and the premium was $251.

I also tried examples with a 25 yr old and 60 yr old. The premiums were still close to those mentioned for Denver in the Kaiser article, but the coverage much better, IMO ($2500 out of pocket vs. $6350 or up to $12,700 plus tax savings).

The $6750 is the cap on cost sharing not the deductible of the plan. It includes not only the deductible but the coinsurance and copays.
I used the Rocky Mt Health Plan site but with Denver since that was the locale cited in the Kaiser report. The premium was $260 for a single 40 year old male. This was with the $2500 deductible. However there was a 30% coinsurance on this policy and copays up to a $3000 in network cap and $6000 out of network cap. So the comparable cap in the Rocky Mt plan is $5500 for in network services and $8500 out of network cap.

The different levels of categories are arranged primarily according to the percentage of cost sharing that the insuree chooses. For example under the silver plan, the insuree shares in up to 30% of the cost up to the $6750 cap. That cap is NOT the deductible. The cap includes the deductible, coinsurance, and copayments. You can select a policy within the silver category to balance the amount of deductible with the amount of coinsurance. For example, you can choose a plan with a $2500 deductible but with a 40% coinsurance (don't know the specifics but just making an example) or a plan with a $5000 deductible but with 20% coinsurance. Regardless of the choice, once you hit the $6750 cap with a combination of deductible, coinsurance and/or copays, you have no additional costs.

http://kaiserfamilyfoundation.files.wor ... 1/8303.pdf

So according to the Rocky Mt Health Plan, a policy for a single 40 year old male in Denver with a cost-sharing cap of $5500/$8500 is $260.37 per month regardless of income while a silver plan under the ACA is $250 (if you are making 400% of poverty level or more) with a cost-sharing cap of $6750. Less if you are below 400% of the poverty level. Pretty much comparable and not the outrage that you posited.

Edited to add: I checked for your information and under ObamaCares, there is a $2500 FSA.
Further edited to add: Your claim about the "glitch" on the additional $6750 cap on prescriptions is misleading. This "glitch" applies only for 2014, only applies in certain cases. It only applies to those individuals who plan to use their current health plans in 2014, not for those selecting new plans under ObamaCares. So to claim that this is the fault of ObamaCares is quite misleading. For someone who keeps attacking my veracity, perhaps you should look at your own.

Millions of Americans worked 30-50years and paid into Medicare and Social Security to the tune of Trillions $$. Now those that did not and illegals want a FREE RIDE.......this is the issue.....for millions nothing more. Because the feds continue to take from us, we pay Medicare Part B (call it anything- still a tax to pay for freeloaders)

---

in our home we pay almost $3000 a year for Part B and Dental.

Radical Socialist entitlement culture is the enemy.....it is wrong, unfair and we will fight this forever.

FOOTNOTE:

The European model works because they have QUALITY healthcare and they do not carry a massive underbelly that America does......and we are trying to import up to 100 million more freeloaders from the South.....these Radical movements feed the Socalist voter pool but destroy our way of life for all others......it is a disaster in the making.

deltamrey wrote: Millions of Americans worked 30-50years and paid into Medicare and Social Security to the tune of Trillions $$. Now those that did not and illegals want a FREE RIDE.......this is the issue.....for millions nothing more. Because the feds continue to take from us, we pay Medicare Part B (call it anything- still a tax to pay for freeloaders)

---

in our home we pay almost $3000 a year for Part B and Dental.

Radical Socialist entitlement culture is the enemy.....it is wrong, unfair and we will fight this forever.

That's a lie...But you knew that...

(4) whether to grant a certification under section
1311(d)(4)(H) attesting that, for purposes of the individual
responsibility requirement under section 5000A of the Internal
Revenue Code of 1986, an individual is entitled to an exemption
from either the individual responsibility requirement or the
penalty imposed by such section.
(b) INFORMATION REQUIRED TO BE PROVIDED BY APPLICANTS.—
(1) IN GENERAL.—An applicant for enrollment in a qualified
health plan offered through an Exchange in the individual
market shall provide—
(A) the name, address, and date of birth of each individual
who is to be covered by the plan (in this subsection
referred to as an ‘‘enrollee’’); and
( the information required by any of the following
paragraphs that is applicable to an enrollee.
(2) CITIZENSHIP OR IMMIGRATION STATUS.—The following
information shall be provided with respect to every enrollee:
(A) In the case of an enrollee whose eligibility is based
on an attestation of citizenship of the enrollee, the enrollee’s
social security number.
( In the case of an individual whose eligibility is
based on an attestation of the enrollee’s immigration status,
the enrollee’s social security number (if applicable) and
such identifying information with respect to the enrollee’s
immigration status as the Secretary, after consultation
with the Secretary of Homeland Security, determines
appropriate.

(c) VERIFICATION OF INFORMATION CONTAINED IN RECORDS OF
SPECIFIC FEDERAL OFFICIALS.—
(1) INFORMATION TRANSFERRED TO SECRETARY.—An
Exchange shall submit the information provided by an applicant
under subsection (b) to the Secretary for verification in accordance
with the requirements of this subsection and subsection
(d).
(2) CITIZENSHIP OR IMMIGRATION STATUS.—
(A) COMMISSIONER OF SOCIAL SECURITY.—The Secretary
shall submit to the Commissioner of Social Security
the following information for a determination as to whether
the information provided is consistent with the information
in the records of the Commissioner:
(i) The name, date of birth, and social security
number of each individual for whom such information
was provided under subsection (b)(2).
(ii) The attestation of an individual that the individual
is a citizen.



(3) INCONSISTENCIES INVOLVING ATTESTATION OF CITIZENSHIP
OR LAWFUL PRESENCE.—If the information provided by
any applicant under subsection (b)(2) is inconsistent with
information in the records maintained by the Commissioner
of Social Security or Secretary of Homeland Security, whichever
is applicable, the applicant’s eligibility will be determined in
the same manner as an individual’s eligibility under the medicaid
program is determined under section 1902(ee) of the Social
Security Act (as in effect on January 1, 2010).
(4) INCONSISTENCIES INVOLVING OTHER INFORMATION.—
(A) IN GENERAL.—If the information provided by an
applicant under subsection (b) (other than subsection (b)(2))
is inconsistent with information in the records maintained
by persons under subsection (c) or is not verified under
subsection (d), the Secretary shall notify the Exchange
and the Exchange shall take the following actions:
(i) REASONABLE EFFORT.—The Exchange shall
make a reasonable effort to identify and address the
causes of such inconsistency, including through typographical
or other clerical errors, by contacting the
applicant to confirm the accuracy of the information,
and by taking such additional actions as the Secretary,
through regulation or other guidance, may identify.
(ii) NOTICE AND OPPORTUNITY TO CORRECT.—In the
case the inconsistency or inability to verify is not
resolved under subparagraph (A), the Exchange shall—
(I) notify the applicant of such fact;
(II) provide the applicant an opportunity to
either present satisfactory documentary evidence
or resolve the inconsistency with the person
verifying the information under subsection (c) or



(h) PENALTIES.—
(1) FALSE OR FRAUDULENT INFORMATION.—
(A) CIVIL PENALTY.—
(i) IN GENERAL.—If—
(I) any person fails to provides correct information
under subsection (b); and
(II) such failure is attributable to negligence
or disregard of any rules or regulations of the
Secretary,
such person shall be subject, in addition to any other
penalties that may be prescribed by law, to a civil
penalty of not more than $25,000 with respect to any
failures involving an application for a plan year. For
purposes of this subparagraph, the terms ‘‘negligence’’
and ‘‘disregard’’ shall have the same meanings as when
used in section 6662 of the Internal Revenue Code
of 1986.
(ii) REASONABLE CAUSE EXCEPTION.—No penalty
shall be imposed under clause (i) if the Secretary determines
that there was a reasonable cause for the failure
and that the person acted in good faith.
( KNOWING AND WILLFUL VIOLATIONS.—Any person
who knowingly and willfully provides false or fraudulent
information under subsection (b) shall be subject, in addition
to any other penalties that may be prescribed by
law, to a civil penalty of not more than $250,000.

But, hey, he/she/it got to use "Radical Socialist entitlement" in a sentence...

:Snooze

By the way, LOVE the nuclear-powered phallic-symbol in the pic... It's soooo "Dark Helmet"...

[youtube:le2d4pql][/youtube:le2d4pql]

Your helmet is sooooooo big.....

How's it workin' out for ya Delta-Cakes? Wanna try something besides LIES next time?...




“Republicanism is just a political justification for being greedy, selfish and mean."

"Remember when Republicans cared about ALL Americans?....... Me neither."

Something the Dog Said wrote: The $6750 is the cap on cost sharing not the deductible of the plan. It includes not only the deductible but the coinsurance and copays.

Sorry, that was a typo on my part. I called it out of pocket expense in the paragraph before, and also consistently called it max out of pocket expense in my previous post. I do know the difference between a deductible and a max out of pocket expense. And I assume your $6750 is also a typo because I think it should be $6350?

Something the Dog Said wrote: So according to the Rocky Mt Health Plan, a policy for a single 40 year old male in Denver with a cost-sharing cap of $5500/$8500 is $260.37 per month regardless of income while a silver plan under the ACA is $250 (if you are making 400% of poverty level or more) with a cost-sharing cap of $6750. Less if you are below 400% of the poverty level. Pretty much comparable and not the outrage that you posited.

I was very clear that I was comparing it to the Rocky Mountain HSA 2500. In that plan the deductible and max out of pocket expense are the same at $2500 (in network). I'd much rather have that plan than a PPO with a $2500 deductible and $3000 max out of pocket. And I'd much rather have a $2500 max out of pocket than Obamacare's $6350. But there are many factors to consider based on your own health.

The HSA plan does cover physicals and cancer screening with no deductible, just as Obamacare does. It doesn't cover office visits for illness or injury until you reach $2500, nor does it cover prescriptions until you reach $2500. But for me, I'd trade that for the much lower $2500 out of pocket expense.

Something the Dog Said wrote: Edited to add: I checked for your information and under ObamaCares, there is a $2500 FSA.
Further edited to add: Your claim about the "glitch" on the additional $6750 cap on prescriptions is misleading. This "glitch" applies only for 2014, only applies in certain cases. It only applies to those individuals who plan to use their current health plans in 2014, not for those selecting new plans under ObamaCares. So to claim that this is the fault of ObamaCares is quite misleading.

You mention a $2500 FSA, but I was talking about an HSA. An FSA is just a health savings account while and HSA combines a health savings account with a health insurance program. So unless your "FSA" was a typo, I'm still not clear what Obamacare will offer so far as HSA's go.

I was clear we were talking about 2014. But yes, the "glitch" only applies to some group plans, which I missed (I missed the "group" part, not the part that it only applies to some plans). Most people have group plans so it could affect many people, but I think we are talking mainly about individual plans in this discussion. So I'll stand corrected there, even though this "glitch" wasn't supposed to happen. I certainly did mention the $6350 max out of pocket, which I said was also way too high, IMO, especially compared to a $2500 HSA.

Bottom line is I'm not trying to mislead, things regarding Obamacare premiums are just are not very clear at this point so far as I can see. And it is pretty complicated too. The good news is we should be able to see the actual policies available after Oct 1st at the exchanges. Then things should be much clearer regarding premiums and learning the details.

pineinthegrass wrote:

Something the Dog Said wrote: The $6750 is the cap on cost sharing not the deductible of the plan. It includes not only the deductible but the coinsurance and copays.

Sorry, that was a typo on my part. I called it out of pocket expense in the paragraph before, and also consistently called it max out of pocket expense in my previous post. I do know the difference between a deductible and a max out of pocket expense. And I assume your $6750 is also a typo because I think it should be $6350?

Something the Dog Said wrote: So according to the Rocky Mt Health Plan, a policy for a single 40 year old male in Denver with a cost-sharing cap of $5500/$8500 is $260.37 per month regardless of income while a silver plan under the ACA is $250 (if you are making 400% of poverty level or more) with a cost-sharing cap of $6750. Less if you are below 400% of the poverty level. Pretty much comparable and not the outrage that you posited.

I was very clear that I was comparing it to the Rocky Mountain HSA 2500. In that plan the deductible and max out of pocket expense are the same at $2500 (in network). I'd much rather have that plan than a PPO with a $2500 deductible and $3000 max out of pocket. And I'd much rather have a $2500 max out of pocket than Obamacare's $6350. But there are many factors to consider based on your own health.

The HSA plan does cover physicals and cancer screening with no deductible, just as Obamacare does. It doesn't cover office visits for illness or injury until you reach $2500, nor does it cover prescriptions until you reach $2500. But for me, I'd trade that for the much lower $2500 out of pocket expense.

Something the Dog Said wrote: Edited to add: I checked for your information and under ObamaCares, there is a $2500 FSA.
Further edited to add: Your claim about the "glitch" on the additional $6750 cap on prescriptions is misleading. This "glitch" applies only for 2014, only applies in certain cases. It only applies to those individuals who plan to use their current health plans in 2014, not for those selecting new plans under ObamaCares. So to claim that this is the fault of ObamaCares is quite misleading.

You mention a $2500 FSA, but I was talking about an HSA. An FSA is just a health savings account while and HSA combines a health savings account with a health insurance program. So unless your "FSA" was a typo, I'm still not clear what Obamacare will offer so far as HSA's go.

I was clear we were talking about 2014. But yes, the "glitch" only applies to some group plans, which I missed (I missed the "group" part, not the part that it only applies to some plans). Most people have group plans so it could affect many people, but I think we are talking mainly about individual plans in this discussion. So I'll stand corrected there, even though this "glitch" wasn't supposed to happen. I certainly did mention the $6350 max out of pocket, which I said was also way too high, IMO, especially compared to a $2500 HSA.

Bottom line is I'm not trying to mislead, things regarding Obamacare premiums are just are not very clear at this point so far as I can see. And it is pretty complicated too. The good news is we should be able to see the actual policies available after Oct 1st at the exchanges. Then things should be much clearer regarding premiums and learning the details.

But you are misleading. You are comparing an HSA with PPO and claiming the differences are due to ObamaCares when in reality you are comparing apples to oranges. The polices described in the Kaiser study are PPO policies and are coming in less expensive than comparable PPO polices currently being offered. If you are satisfied with bureaucratically managed health care then by all means an HSA policy may be the way to go. But why bring an HSA policy into the discussion to compare against a PPO policy other than to mislead? Start your own thread about the benefits of managed health care vs. PPO health care and the cost differentials. Don't try to pretend that the current HSA policy you used as an example is comparable to the silver policies under the ACA as those are two separate animals. Of course you can claim that too is a "typo". And under the ACA, you can certainly select an HSA policy, but the Kaiser study was direct to PPO policies under the ACA. I personally prefer pay a bit more not to have a bureaucrat managing my health care, but that is a discussion for a different thread.

Hmm, when you take my statements out of context, they are considered misleading, but your misleading statements are simply "typos".

Edited to add: And under ObamaCares, HSAs are still in effect. The only change is that OTC medications are not covered and there is a higher penalty for use of funds on non qualified purchases. But if you had simply googled that, you would know that.