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View Diary: Alan Grayson Offers a Progressive Fix for the ACA: Medicare Buy-In (163 comments)

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  •  Not to mention but I will, those workers (4+ / 0-)
    Recommended by:
    ozsea1, sidnora, divineorder, blueoasis

    over 65 years of age have been paying Medicare premiums all their working life.

    •  Those premiums are only for Part A. (0+ / 0-)

      Parts B and D are funded by premiums (25% from beneficiaries and the other 75% from the general funds).

      For someone in their 60's to pay premiums at cost, that would mean that each person pays around $600 for parts B and D. I have no idea what they would pay for Part A but it would have to be added to the $600/month. They would each also have a $1216 deductible for Part A, a separate $147 deductible for Part B, and another $310 deductible for Part D.

      In addition, there is a 20% co-pay after the deductible for Part B. There is also co-insurance for Part A after 60 days in the hospital ($304/day for days 61-90, $608/day for days 91+ up to a lifetime reserve of 60 days, all costs after lifetime reserve days.) Part D drug costs are also considerable.

      A supplemental policy to cover those costs of Parts A and B would add another couple of hundred dollars per month per person.

      Obviously, younger people would have lower premiums but I am not sure what they would be.

      Using value penquin to see what a family policy under the ACA in TN for a family of 4 (2 - 40 year old adults, 1 - 15 year old child, 1 - 5 year old child) without subsidies - $728 will get you a silver plan with a good network with a $2500 deductible (individual) $5000 for the family, with a maximum OOP of $4500 for the individual or $9000 for the family and 20% co-insurance. That includes the drug plan with better prices than my Part D and dental insurance for the children. Which is quite frankly generally a better plan than each being on Medicare.

      The same policy for a family of 2 - 62 year old people would be  a little less than $1100/ month without subsidies so that would be $550 each.

      Now obviously, if one were to expand Medicare for everyone, then some adjustments would have to be made for family plans, rather than each being insured individually as Grayson is apparently proposing. But his proposal, at least as presented above, needs much filling out to see what the costs would actually be.

      You can't scare me, I'm sticking to the Union - Woody Guthrie

      by sewaneepat on Sun Dec 01, 2013 at 06:52:03 AM PST

      [ Parent ]

      •  I found the figures for a person buying into (0+ / 0-)

        Part A. $426/month per person. That is, of course, for people 65 so it would be less for those younger, but Mr. Grayson's $500 per month per person in their 60's would basically just cover Part A. Total costs for premiums for A, B, and D would be $1100 per month per person in their 60's.

        You can't scare me, I'm sticking to the Union - Woody Guthrie

        by sewaneepat on Sun Dec 01, 2013 at 07:39:00 AM PST

        [ Parent ]

      •  And people working from age 16 straight through to (0+ / 0-)

        their 50s or 60s and die before reaching age 65, their estate gets no refund for the contributions paid, or do they?  

        •  No, they don't get a refund. (0+ / 0-)

          But that has nothing to do with the fact that those payments go to pay the premiums for only Part A. Nor with the fact that if you have not paid into the Medicare fund, it costs you $426/month to buy into part A.

          You can't scare me, I'm sticking to the Union - Woody Guthrie

          by sewaneepat on Sun Dec 01, 2013 at 10:36:41 AM PST

          [ Parent ]

          •  They should. It's actually a pre-paid (0+ / 0-)

            premium.

            No, they don't get a refund.
            •  Do you get a refund when you don't use your (0+ / 0-)

              insurance, be it home, health, or car?

              How would you propose that Part A should be paid for if people get a refund for their taxes if they die without using it?

              You can't scare me, I'm sticking to the Union - Woody Guthrie

              by sewaneepat on Sun Dec 01, 2013 at 12:46:18 PM PST

              [ Parent ]

              •  I propose that dead people's Part A be applied (0+ / 0-)

                to B and D of their survivors.  

                •  What would you do to make up the shortfall in (0+ / 0-)

                  Part A premiums?

                  To my thinking, it is basically a tax and like all taxes, people pay it whether or not they use the service it pays for.

                  But if you want it to be insurance, it is like perhaps a term life insurance policy which you do not get any return on if you do not die during the term. Or any other insurance you have which you do not use. You say it is not a policy, but it goes into effect for you if you meet certain criteria. For most people, that is turning 65, but for others, it is having a certain disease or meeting disability requirements.

                  This is like all insurance, you do not get a refund if you don't use it. Same with Social Security. That is how insurance works. Everyone pays, some get nothing, some get a decent return on their premiums, and some get a lot. Premiums for everyone would have to be much higher if you gave back the money to those who do not use it.

                  What do you think the Medicare portion of the FICA tax would be if those who die before 65 somehow got their money returned (or passed on to their heirs for other parts of Medicare)?

                  You can't scare me, I'm sticking to the Union - Woody Guthrie

                  by sewaneepat on Sun Dec 01, 2013 at 01:31:00 PM PST

                  [ Parent ]

              •  By the way, no. (0+ / 0-)
                Do you get a refund when you don't use your insurance, be it home, health, or car?
                This isn't an insurance policy, paying for Medicare one's entire working life.

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