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Stethescope in shape of human head.
The "sticker shock" Republican state governments are hyping as they release preliminary premium rates for their state exchanges under Obamacare is overblown and basically cooked in many ways. One of the primary ways they're obfuscating real premium rates is by ignoring the fact that a very large chunk of people participating in the exchanges will be receiving subsidies to help pay. The Kaiser Family Foundation breaks it all down in a new study.

Based on data released from states so far, KFF finds that about 48 percent of families currently buying their insurance on the individual market—they don't have coverage through an employer—will receive subsides averaging $5,548 per family, which is about two-thirds of the average cost of a benchmark "silver" policy offered through the exchanges. A Kaiser official explains.

"About half of the people won't be paying the sticker price," said Gary Claxton, director of the health care marketplace project at Kaiser, an information clearinghouse on the health care system. "The people who get help will get quite a lot of help."

"Many, but certainly not all, of the people who don't get tax credits will pay more," he said. "How much more will be a function of a lot of different things."

As an example, a young, single male who now has a bare-bones, catastrophic health insurance plan that he bought on the individual market could end up paying more, depending on his income and where he lives. But in paying more, he's also receiving comprehensive coverage that will lower his out-of-pocket spending on services. If he's making less than $46,000 a year, he'll receive the subsidy. That subsidy goes directly to the insurance company when he enrolls.

About a million people, KFF estimate, will benefit from being newly eligible for Medicaid. Millions more will continue to get the same coverage they've previously had through their employers. And millions new customers, people who have been uninsured, will get the subsidy and have insurance. Which likely means that the majority of people participating in the exchanges aren't going to be paying the "sticker price" for their insurance, but they "after markdowns" price with the subsidy.

If you want to get an idea of what you might be paying on the exchange, KFF has this subsidy calculator to help.

Originally posted to Joan McCarter on Wed Aug 14, 2013 at 11:39 AM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (31+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Wed Aug 14, 2013 at 11:39:09 AM PDT

  •  They're going to blame all rate hikes on Obamacare (12+ / 0-)

    So part of the push back will have to show trend lines over the years before and after the ACA and show/remind that rates of folks who have health insurance go up yearly regardless of the ACA.  Also they need to make sure to point out that the insurance existing policy holders have has been improved by the ACA and is much more secure.  

    If you're not talking about what billionaire hedgefund bankster Peter G. Peterson is up to you're having the wrong conversations.

    by Jacoby Jonze on Wed Aug 14, 2013 at 11:55:30 AM PDT

  •  Well, I'm not that young but I fit into this (9+ / 0-)


    If he's making less than $46,000 a year, he'll receive the subsidy. That subsidy goes directly to the insurance company when he enrolls.
    I have the same problem with the ADA that I had with "Romneycare" which was the reason I fled Massachusetts for Maine. That problem is that it's not an equitable, single-payer system and while private insurers say they hate it, are in a better position to benefit from it that I am.

    I'll enroll, and it will cost me dearly. And I'll have a huge deductable, and a junky plan.

    I'm getting pretty tired of the corporatisation of the Democratic Party, and I'm a little appalled that that remains a "controversial" position.

    I resent that. I demand snark, and overly so -- Markos Moulitsas.

    by commonmass on Wed Aug 14, 2013 at 11:56:51 AM PDT

    •  2 Conservative Parties. nt (3+ / 0-)

      We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

      by Gooserock on Wed Aug 14, 2013 at 12:29:20 PM PDT

      [ Parent ]

    •  yeah, i don't fare so well. If I continue to be (3+ / 0-)
      Recommended by:
      divineorder, Willa Rogers, smokey545

      unemployed, there would be $0 subsidy and a cost of about $10,000.

      If I take some lousy survival job (like Kmart), and rake in 17000, i'd qualify for a subsidy but my cost would be $3882 (cuz the subsidies will not pay 1 cent of the smoker surcharge).

      so my take home pay on 17k would be about 15.5k and out of that I'm supposed to pay almost 4k for health insurance?  I don't think so.

      bring on the fines. (and untreated illness, i guess)

      "Don't Bet Against Us" - President Barack Obama

      by MRA NY on Wed Aug 14, 2013 at 01:58:31 PM PDT

      [ Parent ]

    •  Let's not let Republican governors skate. (1+ / 0-)
      Recommended by:

      A fair amount of implementation is up to the state.  

      I seem to recall reading that NY is seeing dramatic decreases in rates.  but then they have a democratic governor, and have been doing things to improve the situations.

      A lot of Republican governors have been doing their best to make Obamacare fail.  everything I've read of LePage, i'd put him in this category.  

      The Ds aren't as good as I'd like, but they aren't so bad that I'd vote for R's.  

      Republicans: if they only had a heart.

      by leu2500 on Wed Aug 14, 2013 at 04:45:53 PM PDT

      [ Parent ]

      •  one of the primary reasons that NY will fare (0+ / 0-)

        so well is that they have historically been generous with thier medicaid eligibility and benefits, so they will be enrolling a much smaller percentage with expansion than most places would and their benefit package far surpasses what is required (e.g. NY Medicaid covers dental)

        The fact that they already have included a greater percentage of low-income, high risk individuals is what makes their financials so rosy with the influx of federal $.

        "Don't Bet Against Us" - President Barack Obama

        by MRA NY on Wed Aug 14, 2013 at 05:30:08 PM PDT

        [ Parent ]

        •  Health Plan Cost for New Yorkers Set to Fall 50% (0+ / 0-)
          State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.
          “We’re seeing in New York what we’ve seen in other states like California and Oregon — that competition and transparency in the marketplaces are leading to affordable and new choices for families,” said Joanne Peters, a spokeswoman for the Department of Health and Human Services.

          Republicans: if they only had a heart.

          by leu2500 on Wed Aug 14, 2013 at 06:00:35 PM PDT

          [ Parent ]

          •  asdf (0+ / 0-)
            New York's announcement this week that insurance premiums would drop 50% next year for individuals buying their own coverage in new online marketplaces made good talking points for proponents of the Affordable Care Act, but consumers in most states are unlikely to see similar savings.

            That's because only a handful have New York's rules, which — like the federal law — bar insurers from rejecting people with health problems. Unlike the federal law, however, New York does not require consumers to purchase coverage, so over time, mainly older, sicker people, have purchased coverage. That drove up prices and discouraged younger, healthier people from buying policies, as did a requirement that insurers charge the same rates regardless of age or health status.

            As a result, premium prices listed for individuals often top $1,000 a month for some New Yorkers buying their own coverage, making the state's rates among most expensive in the nation.

            "New York with such extreme rules sets the stage for a larger drop in rates than you'd expect to see in many other states," said Paul Ginsburg, president of the Center for Studying Health System Change, a non-partisan think tank in Washington D.C. "It's clearly in the minority."


            "Don't Bet Against Us" - President Barack Obama

            by MRA NY on Wed Aug 14, 2013 at 06:09:13 PM PDT

            [ Parent ]

  •  the young and healthy with only catastrophic (5+ / 0-)
    Recommended by:
    nextstep, VClib, bobtmn, MRA NY, Willa Rogers

    coverage certainly will economically be worse off.

    As an example, a young, single male who now has a bare-bones, catastrophic health insurance plan that he bought on the individual market could end up paying more, depending on his income and where he lives. But in paying more, he's also receiving comprehensive coverage that will lower his out-of-pocket spending on services.

    The reason it makes sense to have only catastrophic coverage if you are young and healthy is that, in all likelihood, you will spend less on out-of-pocket medical expenses than the cost of comprehensive insurance coverage. In other words, if you have only one or two doctors' visits a year, maybe your out of pocket is $500, and your catastrophic coverage premium is $1500.  That's a total health care spending of, say, $2000.  Compare that to comprehensive health care coverage at, say, $3000 a year, with a $500 deductible and 10% co-pays. I'm making up numbers here to make a point -- if you are young and healthy, and have a really high possibility that your only health care spending will be maybe two doctors' visits, you can do the math to see if you come out better having catastrophic coverage only.  In the past, lots and lots of healthy young people have made that economic decision and have come out economically ahead.  This is especially true if that person also  has access to a health savings account, where the out of pocket payments are made with pre-tax dollars.  In the past, the difference between a catastrophic only policy, and comprehensive coverage, often was significantly more than the savings in out-of-pocket costs.   As an alternative, many healthy people (including many of our employees, who pay a part of their own health insurance premiums and pay more for family coverage) chose high-deductible plans, combined with a health savings plan.  If they did not use a lot of medical services, they came out economically better than by having a far more expensive comprehensive plan with very low deductibles and out of pocket costs.

    Frankly, even though I'm not young, for several years now, since health savings accounts became available, I've opted for a very high deductible policy combined with a health savings account.  Because I'm a part owner of the business, and I pay my own health insurance premiums in full, it has been, economically, the better way to go, especially since the HSA carries over from year to year.  That option, as I understand it, eventually will no longer be available.

    This is almost certainly going to be a significant increase in expenses for young, healthy people who may have opted for high deductible or catastrophic policies in the past.  It has to be that way, because the whole system is based on spreading the cost around, where (generally speaking) the younger and healthy are, through their insurance premiums, going to be subsidizing the older and sicker.  

    •  If the cost savings for (0+ / 0-)

      some people are going to come in the form of the subsidies, that also means that other taxpayers will be paying to subsidize them.

      Will that end up being an invisible cost for people in evaluation how the legislation affects them?

      •  We all subsidize the uninsured already (8+ / 0-)

        Example:  When uninsured people are forced (by whatever circumstance) to use the emergency room as their only available medical care, that care is usually far more expensive than if they'd been able to get care earlier.  <--- This is an understatement.  Often, those bills will go unpaid.  That's a large factor in the cost of emergency room care,  not to even mention the fact that "real" (for lack of a better word) emergency patient care can be delayed / effected when an emergency room is overcrowded, etc.

        other taxpayers will be paying to subsidize them
        We all subsidize the uninsured already and it's nothing new.  The ACA will spread the cost over a larger pool of people and that's one of many reasons why so many states are seeing that the cost of insurance under the ACA is far less than some had predicted.

        It's not a question of whether our founding fathers are rolling in their graves but rather of how many RPM they're clocking.

        by Eyesbright on Wed Aug 14, 2013 at 02:03:33 PM PDT

        [ Parent ]

    •  This is a new rule change under Obama: (1+ / 0-)
      Recommended by:
      denise b
      the HSA carries over from year to year.
      Previously, it was required to spend all HSA monies by year end.  If you're correct, it seems with ACA the rules are changing again.
      •  i know there are different types of these (0+ / 0-)

        accounts.  I think the HSA he is referring to might always have had different regs than the medical savings accts most individuals (versus business owners) have.

        "Don't Bet Against Us" - President Barack Obama

        by MRA NY on Wed Aug 14, 2013 at 05:33:43 PM PDT

        [ Parent ]

      •  No, not a rule change. HSA for all our employees (1+ / 0-)
        Recommended by:

        has always carried over from year to year.  You could put so much in it before taxes, and if you didn't spend it all, it carried over to the next year.  It's an option for all our covered employees, and so many opt for higher deductible and HSA's.  It's a better economic deal for many of them, especially if they are also covering their families, than a comprehensive health insurance plan with a low out-of-pocket.

        HSA's are different from FSA's, which do not carry over.

  •  Should the headline be "Obamacare" not "Obama?" (8+ / 0-)


  •  The "rate shock" will be out-of-pocket costs... (2+ / 0-)
    Recommended by:
    divineorder, judyms9

    ...for deductibles and co-pays, which are not as generously subsidized by income level as the insurance premiums are.

    I was shocked to see, e.g., that single households making the princely sum of $30k/year would have to pay thousands of dollars in out-of-pocket costs before care is fully covered.

    I think this is an underrecognized facet of PPACA (making high out-of-pockets costs the new normal) and I'm considering writing a diary setting forth the ramifications for Americans, and for PPACA.

    The fact that the cap for out-of-pocket costs has been deferred for a year for some plans is an ill omen of what's to come, in my opinion.

  •  Heritage Foundation fingerprints (4+ / 0-)

    "That subsidy goes directly to the insurance company"

    I guess that's why we need to give the insurance cos. special "transition-period" bonuses.  Question:  with those bonuses coming through, will the transition period ever officially end?

    Clap On, Clap Off, The Clapper!

    by ActivistGuy on Wed Aug 14, 2013 at 04:20:12 PM PDT

  •  We're still confused - not enough info yet. (2+ / 0-)
    Recommended by:
    janmtairy, PHScott

    I'm trying to find out if I can get a tax subsidy for my employer-sponsored health insurance.  If I have me and spouse on the employer's health insurance, then we qualify because our household income is under the poverty limit.

    If I'm the only one on the health insurance, then the premiums for the year are well within 9.5% of income level.  Then maybe we can shop for hubby on the federal marketplace.  But I just can't find enough info yet to get this clarified.

    Of course, I'm in Texas, so there's no state marketplace set up - I have to wait until Oct 1st to even see what's going to be available.

    I see you drivin' 'round town with the girl I love / And I'm like / Please proceed, Governor. - Dave Itzkoff

    by Jensequitur on Wed Aug 14, 2013 at 04:27:29 PM PDT

    •  I'm in PA. (2+ / 0-)
      Recommended by:
      judyms9, PHScott

      My partner is 61 and has no or very little income expected for 2014.  Also no state marketplace.  Looks like if she can't get on Medicaid, there will be no subsidy.  

      I think you need to recognize the difference between "subsidies," which help you pay upfront, and tax credits, which you will receive in 2015 after you file your 2014 taxes.  

      I also think there is a HUGE opening for a consulting company or nonprofit to explain the ACA to, well, all the rest of us.  WOW, is this all confusing.  And I'm pretty good at figuring stuff out.

      "The next time I tell you someone from Texas should not be president of the United States, please, pay attention." Molly Ivins

      by janmtairy on Wed Aug 14, 2013 at 04:51:11 PM PDT

      [ Parent ]

  •  Here's what I wrote to my coworkers - (3+ / 0-)
    Recommended by:
    MRA NY, smokey545, GRLionsFan

    We're still trying to figure out whether the Savings Advantage (bronze) or the Classic Choice (silver) plan will be better.  All the examples that my employer ran through both plans came out cheaper on the bronze plan, even with the higher out-of-pocket costs.  They're throwing money into individual HSAs with the bronze plan, which helps out a lot.


    To qualify for a tax subsidy from the federal government, your income must be between 133% and 400% of the federal poverty level.  (Around $29,000-$88,000 for a family of four.)

    If you get insurance through an employer, you qualify for a subsidy if your premiums are more than 9.5 percent of income, or if the plan is inadequate - less than 60% of the cost of covered benefits. The Savings Advantage plan more than qualifies for the bronze plan set by the federal government.  (Four categories of health care - bronze, silver, gold and platinum.  Bronze is bare minimum coverage with high out-of-pocket costs, and silver is similar to the PPO coverage offered by Aetna.)

    You can actually qualify for a tax subsidy - and this is important - if 9.5% of your total household income for the year is less than the yearly premium.

    Let's make up an example of a poor employee.  He makes $24,000 a year, and spouse makes less.  Their total household income for the year is around $25,000.  The premiums for the Savings Advantage plan come out to $2,964 a year for employee and spouse.  9.5% of the household income is $2375, so they qualify for a tax subsidy from the federal government to purchase the insurance provided by the employer.

    Or they can opt to go with the federal marketplace.  If they purchase a Silver plan on the marketplace, their premiums would be $1,129 for the year, and they would receive a tax subsidy of around $7,087.  This means that they could be spending a total of $8,215 on insurance for the household, most of it subsidized by the federal government.  They would need to purchase a silver plan, which would limit out-of-pocket expenses. (also known as coinsurance.)

    This is all I've found out.  I'm nowhere near certain that this is correct. Individual insurance premiums from my employer would be $794 for the year, which means I don't qualify for a subsidy.  With my spouse added, the premiums in the Savings Advantage plan would be too high for the household income, and we would qualify for a tax subsidy.

    Now it's just a waiting game until we can get more information about the federal marketplace.

    I found out a lot of information here:

    Find out what you qualify for at this link:

    Help calculating your tax subsidy here:

    This site is mostly ads, but there are some facts in there:

    Sign up for the Health Insurance Marketplace at this link, but there's no federal marketplace set up yet.

    I see you drivin' 'round town with the girl I love / And I'm like / Please proceed, Governor. - Dave Itzkoff

    by Jensequitur on Wed Aug 14, 2013 at 04:32:00 PM PDT

    •  My income for the year to date is around (5+ / 0-)

      1% of the poverty level.  Not 101%, 1%.  I've earned less than $100 so far this year.  Because Ohio politics is dominated by a 'Let them eat cake' brand of Republican, I'm not eligible for Medicaid or other forms of public assistance, because I'm considered 'an able bodied non-senior adult without children'.

      So I hope those subsidies don't stop at 133% as a lower limit.  Medicaid is not actually covering all of those below 133%, depending on the state in which we reside.

      •  Time to leave Ohio (0+ / 0-)

        Never interrupt your enemy when he is making a mistake.

        by Libertina on Wed Aug 14, 2013 at 05:27:33 PM PDT

        [ Parent ]

      •  I'm pretty sure the expansion requires covering (0+ / 0-)

        single adults.  I said that upthread, and have thought that for a while (which is why I'd been thinking I'd have coverage if PA had opted into the expansion).

        I need to double check this, but am pretty sure that is the case.

        "Don't Bet Against Us" - President Barack Obama

        by MRA NY on Wed Aug 14, 2013 at 05:44:05 PM PDT

        [ Parent ]

        •  Ohio rejected the expansion (1+ / 0-)
          Recommended by:
          MRA NY

          Or at least the Ohio legislature did.  Kasich actually wanted to take it, mainly so he doesn't get booted on his next election.

          So I'm hoping the federal exchange will cover my situation.

          •  yeah, same boat - I'm in PA. though it has (1+ / 0-)
            Recommended by:
            Dr Erich Bloodaxe RN

            become clear that I will not be able to afford insurance on the exchange.

            The only possible way I will end up w ins is if I find a decent job.

            I don't see why the exchange wouldn't meet your needs.

            "Don't Bet Against Us" - President Barack Obama

            by MRA NY on Wed Aug 14, 2013 at 06:11:26 PM PDT

            [ Parent ]

          •  ya know, now i understand your original post. (1+ / 0-)
            Recommended by:
            Dr Erich Bloodaxe RN

            actually, you will be able to get ins on the exchange, but NO subsidy.  that is what I learned a couple weeks ago using the kaiser calculator.

            I guess they made no provision to provide people under 133% with subsidies since the law was written to have all states expand medicaid.  with the supreme court decision they've had a year to deal with it but doesn't seem that anyone has even tried. (not that they could get an obamacare fix through the house anyway)

            someone suggested yesterday that they are asking for your estimated 2014 income to calculate your subsidy, so you can just put in a figure just over the 133%.  that person is doing that for their mom.  

            i checked that approach today, which is when I found out that they will not pay 1 penny of the smoking surcharge, so that would leave me with a premium of about $3900.  That price is based on an annual salary of 17k which after taxes would be about 15.5 k and they would expect me to pay almost 4 k of that to insurance.  yeah, right.

            now i just need to double check on what my penalty will be and give up on the idea that i could see a doctor about some medical issues that may or may not be serious.

            "Don't Bet Against Us" - President Barack Obama

            by MRA NY on Wed Aug 14, 2013 at 06:28:01 PM PDT

            [ Parent ]

            •  Oh hell, that's insane. (1+ / 0-)
              Recommended by:
              MRA NY

              And I already had the IRS ding me for incorrectly figuring my taxes this last year for the first time ever.  I made $330, but since the bulk of it was in cash, without any sort of receipts, for things like tutoring and computer help, they told me I couldn't take the earned income credit.  I had suspected that, and told them I didn't want the $25 I would have gotten for it back, they could just keep it, but because I'd figured it in the first place, I had the rigamarole of having misfiled my taxes.

              I'm still obese, and now have several pre-existing issues, so I can only guess at how expensive even the crappiest insurance will be for me, especially sans any subsidy.  Joy.  I better pray I find a job soon, or else I'll be going uninsured and paying the fine.

              •  well, actually pre-exisitng conditions will not (1+ / 0-)
                Recommended by:
                Dr Erich Bloodaxe RN

                matter.  If I am remembering correctly, the only things that will vary your cost are: location, age and smoking.

                and yeah, for me too - find a job or just pay the penalty.  no  health care, i guess unless i moved to a state with medicaid expansion - but the catch 22 is I can't afford to do that!

                "Don't Bet Against Us" - President Barack Obama

                by MRA NY on Wed Aug 14, 2013 at 07:07:34 PM PDT

                [ Parent ]

    •  There was a question about this (0+ / 0-)
      If you get insurance through an employer, you qualify for a subsidy if your premiums are more than 9.5 percent of income
      Someone was saying a while back that the 9.5% doesn't apply to dependent coverage, only the portion of the premium that covers the employee. Do you know if that's true?

      We decided to move the center farther to the right by starting the whole debate from a far-right position to begin with. - Former House Majority Leader Tom DeLay

      by denise b on Wed Aug 14, 2013 at 05:20:04 PM PDT

      [ Parent ]

      •  That was the question I had - (0+ / 0-)

        I asked it at our company meeting, and the boss lady didn't know. It's important to me directly, because it'll affect whether I go with the federal marketplace for hubby, or put us both on the company plan and try to get a tax subsidy for help with our premiums.

        I see you drivin' 'round town with the girl I love / And I'm like / Please proceed, Governor. - Dave Itzkoff

        by Jensequitur on Wed Aug 14, 2013 at 05:45:09 PM PDT

        [ Parent ]

  •  OK, it's official (1+ / 0-)
    Recommended by:
    Theodore J Pickle

    I'm telling the teabaggers in my life that when a GOP politician or industry shill on corporate payroll tells me that some idea or legislation will cause economic collapse and the next coming of communism overnight....

    I will calmly say that I must automatically assume I am being lied to. This '$20 for a Big Mac if minimum wage goes up' bullshit is another example. I've NEVER eaten a Big Mac anyway.

    After the Iraq invasion boondoogle, how can I do anything but?

  •  And just how do you put a $ figure (5+ / 0-)

    on the ability of someone previously excluded from insurance due to pre-existing conditions to now be able to get coverage, irrespective of price?

  •  It's too bad that the American people are still (2+ / 0-)
    Recommended by:
    leu2500, niemann

    waiting for good medical care for all our people.  I wish we were part of Great Britain because we would have had this decades ago.  Instead, we have the most expensive care by far of any country and the American people live in fear of being cut off of health insurance or in fear because they don't have health insurance.  So very sad.

  •  That very tactic was used, unchallenged, on one of (1+ / 0-)
    Recommended by:

    the MSNBC shows in the last day or two by a Repub Rep on as a guest.    He brought up the example of a late twenties guy in his district whose premiums had jumped from $200 to $800 or so, but completely failed to address the fact that that guy was probably going to end up having even more than the increase subsidized by the government.  And no one called him on that, iirc.

    Now such a rate hike in itself seems pretty dubious, given how many states have been posting that their rates are going down, but completely ignoring subsidies made it seem like his twenty-something was going to be severely harmed by the new rate.

  •  So...taxpayers get the sticker shock. (0+ / 0-)

    This plan is a transfer of wealth from the middle class to the insurance companies jacking up rates. Hooray?

    The first rule of government should be "Do no harm." The urge to act can frustrate the desire to help.

    by Common Cents on Wed Aug 14, 2013 at 04:50:32 PM PDT

  •  Unfortunately, the Xchange is higher for us (0+ / 0-)

    As a small business employee, we're being told that if we are grandfathered into our old plan, but if we opt to do the exchange instead, our group plans would increase by 3%.

    And the group plans of course are going up as they always do this year despite the fact that our usage was significantly low last year. At least initially, the exchange for us is not advantageous.

    Lawrence, KS - From ashes to immortality

    by MisterOpus1 on Wed Aug 14, 2013 at 04:57:01 PM PDT

    •  How does the coverage compare? (0+ / 0-)

      We decided to move the center farther to the right by starting the whole debate from a far-right position to begin with. - Former House Majority Leader Tom DeLay

      by denise b on Wed Aug 14, 2013 at 05:20:45 PM PDT

      [ Parent ]

      •  Don't know yet, but our office manager (0+ / 0-)

        who's in charge of the insurance stuff mentioned the top tier on the exchange will be pretty comparable to our current top tier coverage. We won't know the full details of the exchange until the beginning of October though.  The coverage benefits comparison is definitely something I'll be interested in examining closely.

        Lawrence, KS - From ashes to immortality

        by MisterOpus1 on Wed Aug 14, 2013 at 08:34:22 PM PDT

        [ Parent ]

    •  Only 3%? (0+ / 0-)

      My private insurance went up by 10-15% every year pre-ACA. 3% is inflation, not the fault of the ACA.

      Never interrupt your enemy when he is making a mistake.

      by Libertina on Wed Aug 14, 2013 at 05:30:16 PM PDT

      [ Parent ]

      •  Our private insurance went up 2.2% (0+ / 0-)

        which was pretty "normal" I guess.  Unfortunately the exchange is going to be a little higher.  I'm hopin' it will start beating out the private insurance in the coming years, though.

        Lawrence, KS - From ashes to immortality

        by MisterOpus1 on Wed Aug 14, 2013 at 08:31:38 PM PDT

        [ Parent ]

  •  I would love to hear just one health insurer (0+ / 0-)

    complain about the losses it will sustain because of the ACA.  The best that can come of the ACA is that families will not have to go bust if one of the household earners has a catastrophic illness or injury.
    Medicare for all could have been implemented more easily, but all the folks involved in the insurance racket would have to find new lines of work, and they have fleets of lawyers and lobbyists.

    Building a better America with activism, cooperation, ingenuity and snacks.

    by judyms9 on Wed Aug 14, 2013 at 05:10:34 PM PDT

  •  A key question I've not seen answered is this: (2+ / 0-)
    Recommended by:
    MRA NY, PHScott

    Come October 1st, will we be able to see multiple definitive, binding quotes on the exchange site before committing? Because in the old system the only way to know the rate for sure has been to sign up.

    Ideology is when you have the answers before you know the questions.
    It is what grows into empty spaces where intelligence has died.

    by Alden on Wed Aug 14, 2013 at 05:20:09 PM PDT

  •  Shouldn't the fact that we NEED subsidies to (2+ / 0-)
    Recommended by:
    RobertNiles, niemann

    buy health care, oops, I mean insurance, be a clue that this is not the way to go?? Am I glad some people will now have access to medical care...absolutely! But the system is set up to give the insurance companies the exorbitant prices they fix so that they don't have to foot the bill for real care. Imagine how much more affordable health care would be if we didn't have to keep paying profits to insurance companies.

    •  My thought exactly. (0+ / 0-)

      Especially the part about

      That subsidy goes directly to the insurance company when he enrolls.
      Wow.  How convenient for the insurance company.  A lot of government money going directly to them.

      How about we just get rid of the insurance company middle-men altogether, and just use all that money directly for real HEALTHCARE.

  •  This committee has plenty of substantative (0+ / 0-)

    issues to work on, and they are trying to crucify the Affordable Health Care Act instead. Public pressure to actually do something constructive would help.

  •  A great way to get information is on CSPAN (0+ / 0-)

    During the Washington Journal morning program every Monday, there is a guest who knows the ACA law and its implementation down to the finest details. The information is presented factually and people call in to ask questions about their individual circumstances or to make comments. Some of the issues discussed here have been covered on the program. For example, there are people caught in a coverage gap between  qualifying for Medicaid {Medical Assistance) and qualifying for the federal subsidies. Sadly, poor people in  Republican states where the governor and legislature have refused to expand Medical Assistance, will fall in the gap. There was even a state whose legislature voted for the expansion, but the governor vetoed it anyway (don't know which state).

    I wish the very neutral guest would make a statement with expletives about how those malicious governors are deliberately inflicting  increased morbidity and mortality in poor populations in their states. I wish the guest would tell the truth; those governors don't give a thought to what they are really doing in real peoples' lives. This should be an impeachable offense as I presume such action violates their respective oaths of office.

    What makes me even more incensed is the fact that the Medicaid expansions are funded at 100% by the fed for the first three years, and then at no less than 90% each year after that!!! The states do not have to pay at all for 3 years! I feel like I don't even live in the USA anymore.

    But...based on the Republican callers' remarks, the GOP is doing an A++ job misinforming and lying to their voters. They are succeeding and it is morally wrong.

    •  Yep. (0+ / 0-)

      Single adults with no dependents who earn under 133% of the poverty line are SOL in non-expansion states.  I looked up the data for a friend of mine, a student.  The college they attend does not offer health insurance for students.  This person has minimal income from work-study and part-time jobs.  The calculator said this person would have to pay 65% of their gross income in health insurance, and that doesn't count the out of pocket costs.  Health insurance is completely out of reach - and then they are also penalized?

      How did we manage to construct a system that punishes primarily the working poor?! (I guess that's a rhetorical question.)  I wish we could make the Medicare expansion mandatory.

  •  Ugh (0+ / 0-)

    Family of four. $100K income. Paying $9K annually in premiums now, going up to nearly $13K a year under ACA. I did spend $10K out-of-pocket last year on top of our premiums, thanks to two appendectomies (one for each child). But it looks as though we're keeping the $10K out-of-pocket max under ACA, so no improvement there.

    Between spending 20%+ of our income on health care and 20%+ of our income on federal/state and self-employment taxes (where, again, do I sign up for that tax rate Mitt Romney pays?), I'd gladly exchange this system for a single-payer system with a combined income tax rate of up to 45% on my income. I'd be paying less overall on taxes/health care, and probably get better care, too.

    A system that leaves people spending 20%+ of their incomes on health care -- and that will continue to under the ACA -- is not sustainable. Not if we're hoping for increased consumer spending to fuel the economy.

    Unfortunately, the Democrats own the nation's health care system now. Like it or not, to the general public, all health care is "Obamacare." And unless the Republicans decide to flank Obama from the left (fat chance), that means our only future alternatives for changing the nation's health care system will be ones where insurance companies suck more money from the middle and working classes.

    As I said, ugh.

  •  Subsidies for those already covered (0+ / 0-)

    early retiree with insurance thru the state - $680/mth

    the calculator shows that I am eligible for $5,000 annual subsidy based on income. It says premiums over 9.5% of income are eligible for subsidy.

    "You are what you write, not what you look like."

    by PHScott on Thu Aug 15, 2013 at 04:23:54 AM PDT

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