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Back in September, 2009 I read and provided an Analysis of The House Bill called:  “America’s Affordable Health Choices Act of 2009”

You will find that analysis, and the attached comments which add a great deal of information here:

Detailed Analysis of Affordable Care Act Below:  To BeFunded by $2Billion of "Otherwise Not Used" Treasury Funds

Here's an excellant resource that lists improvements for women:

It’s in the law: Breaking Down What’s In It For You in the New Health Care Law

Washington Post link with interactive questionaire to see

What does the Supreme Court's health-care ruling mean for me?

However, going forward will require Congress to do two things:

Provide HHS with $2,000,000,000 out of any funds in the Treasury not otherwise appropriated; and

Approval of Obama's appointees to run the programs.

You will find the details in the Analysis cited above.

Will the Congress of NO do so?

Based on SCOTUS ruling, it might be a good idea to brush up on what we can expect.

Most of America's uninsured are low-income people that, because they might own a car or home, don't qualify for Medicaid.  This is one of the primary reasons for the Health Care Bill:  To find a way to insure them, which might actually provide a road for these people to get health care that won't further impoverish them.

An analysis of what it will cost these individuals and families is provided below.

SCOTUS shot down the expanded Medicaid enrollment, even though most would/could have been funded by Federal funds which, in my interpretation, will require low income people to join their state's Health Exchange program.  If the analysis is correct, there will be a sliding scale premium requirement limited to a percent of income.

We know that states are cutting back on Medicaid because of deficit issues.

So, what will poor people pay for premiums?

And, will the Affordable Care Act solve this problem?

Health care related bankruptcy is on the rise, study says

And this

Health costs fuel rise in bankruptcy among elderly

Medicare is fairly comprehensive, but it doesn’t cover everything — and the basic coverage doesn’t cap out-of-pocket expense if you become seriously ill or need nursing care. In fact, healthcare expenses can wreck retirement security – a fact underscored by a recent study that found medical expenses are a major contributor to bankruptcy among older Americans.

This is from topdot08, found in the comments:

Missing important information (1+ / 0-)
Granted I got this from the CBO not reading the bill

Federal poverty level (FPL)

Found on page 15.

Premium payment limit  (as a percent of income)
133% or less 1.5%
150% 3.0%    
200% 5.0%  
250% 7.0%  
300% 9.0%  
350% 10.0%  
400% 11.0%  

by topdog08 on Sun Sep 06, 2009 at 11:04:34 PM PDT

Also, from page 15

For example, a family of three at 133% of the federal poverty line ($24,352 in 2009 annual income) would be required to only pay annual premiums of $365 toward a Basic plan in the Exchange. A family of three at 400% of poverty ($73,240), where the premium subsidies end, would be required to pay no more than $8,056 in annual premiums for a Basic Exchange plan.

More specifically, the premium against which credits would be calculated—the “reference premium”—would be the three Basic plans with the lowest premiums in the area (although the Commissioner could exclude plans with extremely limited enrollment). The “affordability premium credit” would be the lesser of (1) how much the enrollee’s premium exceeds the affordable premium amount, or (2) how much the reference premium exceeds the affordable premium amount.

The Commissioner would establish premium percentage limits so that for individuals whose family income is between the income tiers specified in the table above, the percentage limits would increase on a linear sliding scale. The affordable premium credit amount would be calculated on a monthly basis.

Basic Plans cover less and reqire greater out-of-pocket payments, so I wonder if the poor will avoid going to the doctor and/or seeking medical care?  

As we have read, unpaid medical bills can end up in court, and if the debtor misses the court date because they have to work, arrest warrants have been issued.  

Jailed for $280: The Return of Debtors' Prisons

How did breast cancer survivor Lisa Lindsay end up behind bars? She didn't pay a medical bill -- one the Herrin, Ill., teaching assistant was told she didn't owe. "She got a $280 medical bill in error and was told she didn't have to pay it," The Associated Press reports. "But the bill was turned over to a collection agency, and eventually state troopers showed up at her home and took her to jail in handcuffs."

"Too many people have been thrown in jail simply because they're too poor to pay their debts. We cannot allow these illegal abuses to continue."

How will this be addressed, now that the increased enrollment in Medicaid has been squashed by SCOTUS?

The 2009 Poverty Guidelines for the  48 Contiguous States and the District of Columbia

Persons in family    Poverty guideline

1    $10,830
2    14,570
3    18,310
4    22,050
5    25,790
6    29,530
7    33,270
8    37,010

For families with more than 8 persons, add $3,740 for each additional person.

50% of Americans are single.  50% of American earn less than $26,500

So 50% of single Americans, not covered by Employer insurance programs could pay a Pulic Option health insurance premium of:

10% of wage, or $2,650 premiums plus co-pays and out-of-pockets.

40% of American workers earn less than $20,000 a year.

Here's an income chart for American Workers.

Taxes Median Income

75% earn less than $42,000
50% earn less than $26,000
40% earn less than $20,000

Again, the Median Income in the USA is only $26,000 a year.

Lastly, there isn't much tolerance for spending money in Congress these days, to put it mildly.

This clause raises serious funding questions:


(A) IN GENERAL.—In order to provide for
the establishment of the public health insurance
option there is hereby appropriated to the Sec-
retary, out of any funds in the Treasury not
otherwise appropriated, $2,000,000,000.
order to provide for initial claims reserves be
fore the collection of premiums, there is hereby
appropriated to the Secretary, out of any funds
in the Treasury not otherwise appropriated,
such sums as necessary to cover 90 days worth
of claims reserves based on projected enroll-

ING.—The Secretary shall provide for the re-
payment of the startup funding provided under
subparagraph (A) to the Treasury in an amor-
tized manner over the 10-year period beginning
with Y1.

this section shall be construed as authorizing
any additional appropriations to the Account,
other than such amounts as are otherwise pro-

Page 121
vided with respect to other Exchange-partici-
pating health benefits plans.

Does the Treasury have $2,000,000,000 not otherwise appropriated?

Lastly, as most people in the world seem to agree, health care is a human right.

 “America’s Affordable Health Choices Act of 2009" has already helped people.

Let's hope Congress doesn't find some creative ways, like not funding it, delaying/blocking the appoinment of "a Special Inspector General, appointed by the President with Senate approval get in the way of helping the unemployed and most vulnerable.

Originally posted to War on Error on Thu Jun 28, 2012 at 09:03 AM PDT.

Also republished by Single Payer California and Jobs Wages and Community Investment Working Group.

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