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View Diary: Obama administration issues rules for individual mandate, America continues to exist (94 comments)

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  •  I'm not sure, (4+ / 0-)

    I know they can't deny you, but they probably will still find a way to charge you a much higher rate. Also, if you make less than $88,000 per year you'll get subsidies to purchase insurance, which you (obviously) wouldn't get if you went with the penalty, and many preventative services are also covered.

    If too many people choose to pay the penalty, premiums will skyrocket for all of us, and then all the new regulations on preexisting conditions will become impracticable. Obamacare will collapse, and the Republicans will say I told you so. The real goal of this is to get people signed up.

    "It is, it seems, politically impossible to organize expenditure on the scale necessary to prove my case -- except in war conditions."--JM Keynes, 1940

    by randomfacts on Wed Jan 30, 2013 at 11:42:39 AM PST

    [ Parent ]

    •  Yes, I agree (2+ / 0-)
      Recommended by:
      tofumagoo, arealniceguy

      That people should get signed up. I just not sure how a someone in their mid twenties, who's healthy and doesn't need regular doctor care would benefit from purchasing a policy and paying a monthly premium(even a subsidized one) when the yearly penalty is 95 bucks.

      It's seems counter intuitive to tell someone they should maintain insurance 'just in case' when they can save money and buy it if they need it.

      Perhaps the number of people that fall into that category will be small. I suspect that a large group of people will still continue to utilize their employer provided healthcare.

      Look, I tried to be reasonable...

      by campionrules on Wed Jan 30, 2013 at 12:04:17 PM PST

      [ Parent ]

      •  The penalty is only (2+ / 0-)
        Recommended by:
        tapu dali, LOrion

        95 bucks for the first year. There are a lot of people out there who don't even know what choices they have. I think that's the main impediment to getting people signed up. It's not that people don't want insurance, it's that a lot of people who would buy insurance don't even know about the penalty and subsidy, and in some cases don't even know what the benefits of having insurance would be.

        "It is, it seems, politically impossible to organize expenditure on the scale necessary to prove my case -- except in war conditions."--JM Keynes, 1940

        by randomfacts on Wed Jan 30, 2013 at 12:23:28 PM PST

        [ Parent ]

        •  This has always been my concern. (3+ / 0-)
          Recommended by:
          Odysseus, randomfacts, GayHillbilly

          The beauty of (ahem) single-payer is that everybody is paret of the pool, ill and well alike, reducing overall individual insurance costs.

          It is, indeed, the PPACA's fatal flaw. If enough 20 and 30 somerhings decide to opt out, the program is in trouble.

          I know you believe you understood what you think I said, but I'm not sure you realize that what you heard is not what I meant. -- S.I. Hayakawa

          by tapu dali on Wed Jan 30, 2013 at 04:19:00 PM PST

          [ Parent ]

          •  I'll opt out (0+ / 0-)

            I see no reason why I should pay for it when I'm healthy rather than just buy it if I happen to get sick.

            •  Playing with fire, but I see your point (2+ / 0-)
              Recommended by:
              elginblt, GayHillbilly

              Trouble is, something like an emergency appendix removal, a car crash, really any emergency situation and you won't have time to "buy it" when you need it.  Your emergency room bills will bankrupt you if you aren't independently wealthy and you don't have insurance.  

              I understand your point but you're really toeing the line on your financial health by trying to game the system to save yourself a thousand dollars or so a year...

              With that said, a single payer system where everyone is enrolled is the solution to this but... yeah.  We're not there yet.

              [Terrorists] are a dime a dozen, they are all over the world and for every one we lock up there will be three to take his place. --Digby

              by rabel on Wed Jan 30, 2013 at 06:58:21 PM PST

              [ Parent ]

              •  correct (0+ / 0-)

                but then it's not "health insurance", it's "anti-bankruptcy insurance". I don't have much to lose in bankruptcy anyways.

                it's not financially worth it for me to buy a plan that covers normal checkups, because those cost so much even though I'm young and healthy.  if I get catastrophic coverage, then that' snot really health insurance, it's bankruptcy protection.

              •  further (0+ / 0-)

                part of the point is that if I DID get sick, then I can just sign up for insurance then - they will have to take me.

                •  not if it's sudden (1+ / 0-)
                  Recommended by:

                  You won't get coverage for bills you've already run up, and while you momentarily don't have anything to lose in bankruptcy, that won't always be the case.  If you apply for insurance after you're sick, the insurer could just take it's time processing your application. Also, don't assume bankruptcy will get you out of all bills. Remember how upset a lot of us were about the bankruptcy law back in I think it was 2005? There are personal debts that can't be discharged in bankruptcy. I don't know the details, but I know I don't want to learn the hard way.

                  •  Correct (0+ / 0-)

                    But when we are talking about the calculation of premiums vs. chance if needing lots and lots of medical care, the fact that you can still get insurance for expensive but not sudden ailments makes it even less of a risk than it would otherwise be.

      •  because accidents happen (3+ / 0-)
        Recommended by:
        ozoozol, elginblt, lurkyloo

        and not everyone lives happily ever after.

        Jesus died to save you from Yahweh.

        by nolagrl on Wed Jan 30, 2013 at 06:19:23 PM PST

        [ Parent ]

      •  I would think some one in that group would still (0+ / 0-)

        have a benefit because they might want to get a flu shot (Any one with school age children will probably get the flu if they have not had the flu shot.) or get a STD check up after a hot one night stand they never planned on.

        Our money system is not what we have been led to believe. The creation of money has been "privatized," or taken over by private money lenders. Thomas Jefferson called them “bold and bankrupt adventurers just pretending to have money.” webofdebt

        by arealniceguy on Wed Jan 30, 2013 at 07:13:20 PM PST

        [ Parent ]

    •  For clarification--the $88,000 is now (3+ / 0-)
      Recommended by:
      Odysseus, Willa Rogers, randomfacts

      $92,200 annual income, and applies only to a "Family of Four."

      For an "Individual," the annual income is MUCH lower.  

      It is $44,680 from July1, 2012 through June 30, 2013.

      Here's a link to the FPL Table for 2012.  [I believe that this runs from July 1 of one year, through June 30 of the subsequent year.  So a new table may be the forthcoming by July 1, 2013.]


      “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

      by musiccitymollie on Wed Jan 30, 2013 at 03:53:29 PM PST

      [ Parent ]

      •  $44,680 for an individual (2+ / 0-)
        Recommended by:
        AoT, Odysseus

        Is still a decent sum of money, depending where you live. obviously its going to go a hell of a lot farther in Alabama than in a major metropolitan area.

        If you are making $45K a year, you're not exactly destitute and you should be required to carry insurance.

        •  a few points: (2+ / 0-)
          Recommended by:
          Odysseus, Willa Rogers

          a) you are correct that $44k is not poor. it's a lot higher than the median wage, in fact.

          b) still, because insurance can be incredibly expensive, it can still eat up a very large share of the income of somebody making that much money.

          c) you state that "you should be required to carry insurance" as a matter of fact.  You didn't offer any reasons why you think that.  I disagree, since such a huge portion of insurance payments is basically wasted, especially on things like executive's 4th vacation homes.  

          •  It is a matter of fact (1+ / 0-)
            Recommended by:

            It is the law. And as far as wasted premiums, the medical loss ratio greatly reduces that.

            •  well (2+ / 0-)
              Recommended by:
              Odysseus, Willa Rogers

              as for it being the law, that's not a good answer in a discussion of the value of that being the law.

              Further, even with the medical loss ratio, it's still a large % going into private pockets (and the return is a lot less than something like Medicare).

              And that's if the medical loss ratio holds - which it won't (it often hasn't in places where it was already law, such as California). There is a provision for insurance companies to request exemption from it in the ACA, and it comes down to one executive brance person (a position created by the ACA, but I forget the title of the position) to say yes or no. There's a good chance of regulatory capture.

        •  Hey, I was just trying to clear up the (0+ / 0-)

          "misinformation" above.  It have often heard folks mistakenly quote the amount of $88,000, though it applies to individuals.

          Yes, depending upon where you live, it isn't destitute.  But it's also not a great sum of money in many localities, especially if you're keeping up your own household (i.e., not sharing housing expenses with someone else).

          Personally, we've lived in both D.C. and Alaska (and Alaska has its own FPL because the cost of living there is so high), and I wouldn't envy anyone in either place that was keeping a household up by themselves on that annual income.

          I heard a couple of Brookings economists say during a congressional committee hearing last year, that in today's money (this was in 2012) "middle class" begins at somewhere between $60,000 and $65,000 annual "household" income.

          So, my biggest concern with the ACA is that the subsidies stop at the working class, not the middle class income levels.  For those folks in that income range with a mortgage and two car payments, it will be tough, if not impossible.  And I worry about the "age rating" 3:1 ratio.  I don't think that it's appropriate since group health insurance plans don't rate for age, just lifestyle (smoking).

          But for upper income folks, it will work out well since they will have access to much lower premiums, than before the ACA was enacted.  And for young people up to age 26 (or is it up to, and including?).   :-)


          “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

          by musiccitymollie on Wed Jan 30, 2013 at 05:43:57 PM PST

          [ Parent ]

        •  Oh, and actually, it can get people making less (1+ / 0-)
          Recommended by:

          WASHINGTON — Some families could get priced out of health insurance due to what's being called a glitch in President Barack Obama's overhaul law. IRS regulations issued Wednesday failed to fix the problem as liberal backers of the president's plan had hoped.

          As a result, some families that can't afford the employer coverage that they are offered on the job will not be able to get financial assistance from the government to buy private health insurance on their own. How many people will be affected is unclear.

          The Obama administration says its hands were tied by the way Congress wrote the law. Officials said the administration tried to mitigate the impact. Families that can't get coverage because of the glitch will not face a tax penalty for remaining uninsured, the IRS rules said.....

          Bruce Lesley, president of First Focus, an advocacy group for children, cited estimates that close to 500,000 children could remain uninsured because of the glitch. "The children's community is disappointed by the administration's decision to deny access to coverage for children based on a bogus definition of affordability," Lesley said in a statement.

          The problem seems to be the way the law defined affordable.

          Congress said affordable coverage can't cost more than 9.5 percent of family income. People with coverage the law considers affordable cannot get subsidies to go into the new insurance markets. The purpose of that restriction was to prevent a stampede away from employer coverage.

          Congress went on to say that what counts as affordable is keyed to the cost of self-only coverage offered to an individual worker, not his or her family. A typical workplace plan costs about $5,600 for an individual worker. But the cost of family coverage is nearly three times higher, about $15,700, according to the Kaiser Family Foundation.

          So if the employer isn't willing to chip in for family premiums – as most big companies already do – some families will be out of luck. They may not be able to afford the full premium on their own, and they'd be locked out of the subsidies in the health care overhaul law.

          Employers are relieved that the Obama administration didn't try to put the cost of providing family coverage on them.

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