CDZ Analysis of the ACHA and ACA at the individual level

[usmbguest5318]

Preface:
In reading the American Health Care Act of 2017 (ACHA) (O-care is the ACA), I discovered that Congress wrote the damn thing in straightforward enough language, but not at all in a straightforward way. The vast majority of the bill requires one to have a copy of the ACA (in some instances the IRS Code) and refer to it because time and time again, our Congressional representatives have written the revisions by stating "'such and such' a section of the ACA (or IRS Code) is modified to say "XYZ." That's of no use until one knows what the original code section says! Would it have been so hard to have simply copied and pasted the ACA text and then written "the preceding section of the ACA the same thing, emboldening or in some other way calling attention to the altered verbiage?


Introduction:
Of late, the news and politicians has prattled on and on about how and whether the ACHA will pass.[4] Whether it will or won't pass in the House is interesting politically, but I don't think that matters much. I think substance is what matters, and IMHO, the news has not nearly enough addressed what matters -- how individuals can tell what specific impact the bill will have on them -- in any way other than to pontificate and proselytize about what the bill will do; however, I don't find that they've done so in ways that matter to individuals.

Maybe they have, and I've missed it? That is what it is if they have. From what I have read, though, the news and our elected leaders have been very "big picture." I love big picture discussions; I'm a business owner. I happen to think that on the matter of health insurance, however, the big picture is irrelevant if individuals do not have health insurance.

I was primarily interested in discovering how the bill proposes to keep health insurance purchasable/affordable for low to modest income people [1]. The questions I sought to answer are these:

1. What is the process by which low to modest income people would buy insurance under the ACA versus under the ACHA?
2. What is the impact on individual taxpayers of removing the individual mandate and its corresponding penalty and replacing it with the 30% surcharge?

I wanted the answers to those questions because, quite frankly, I don't care about the politics of the bill and getting it passed, yet the politics and contrivances involved in getting the thing passed is a large share of what I've seen discussed in the news and news commentary shows. What I care about is how the bill affects people who need health insurance. And my concern is purely intellectual -- that is, I want to know what the bill will do to the noted classes of people -- because whatever they do isn't going to affect whether I have, can afford or can obtain high quality health insurance.

What I wanted to discern was whether the ACHA materially alters the practical realities faced by modest to low income people who seek health insurance for I suspected my support for or advocacy against the ACHA would derive from what I think in that regard. If I found there to be no material difference, I'd have looked elsewhere in the bill -- likely overall national economic impact -- to determine what I think of it. Quite simply, on a matter such as health insurance and health care, people matter more to me than do profits or political gains and losses, thus the prioritization I assigned to my inquiry into the ACHA.


Findings:
So here's what I found, and please note that this discussion pertains to people who purchase insurance directly, not to people who obtain it via their employer...

Reference Information/Materials:​

• Price of insurance policies -- In some of the sources below, the sums are "buried" articles, so you'll have to scan for the figures. Don't forget, if you're equating the figures to your own situation, to add to the premium cost the amount of your actual historic average co-pay amounts and the share of your deductible that your co-pays don't count toward. (You should do that because regardless of to whom you pay the money, it's still money coming out of your pocket for healthcare/health insurance.)
  • Rising Premiums Rankle People Paying Full Price For Health Insurance -- ~$800/month for the lady mentioned at the start of the article.
    
  • Individual Mandate Penalty You Pay If You Don't Have Health Insurance Coverage
    
  • The Satisfied Unsubsidized: Obamacare’s Hidden Winners
    
  • How Much Does Health Insurance Cost Without a Subsidy? eHealth Price Index Report Shows What Off-Exchange Consumers Paid During the 2015 Obamacare Enrollment Period
    
  • 2017 Obamacare Average Premiums and Average Deductibles - HealthPocket.com
• Text of the ACA -- attached
• Text of the ACHA -- attached

Detailed Answers to My Questions:
The process for individuals obtaining health insurance under the ACHA is as follows:

1. Identify the insurance you want to purchase.
2. Pay for the policy however the insurer allows you to do so.
3. Receive a tax credit on your income taxes.
   • If you don't buy health insurance, you don't get the credit.
   • If you don't file a federal income tax return -- people with low enough incomes, or who are entitled to a refund, and whose income tax liability can be calculated accurately using only W2s and 1099s, and who are willing to forgo their refund, don't need to -- you don't get the credit.[2]

The process for obtaining health insurance under the ADA is as follows:

1. Identify the insurance you want to purchase.
2. Receive a subsidy that reduces the amount of your out of pocket payments for the policy. The subsidy is provided by the government and paid directly to the insurer.
3. Pay to your insurer your share of the premium for the policy. Your share = (Premium price) - (Subsidy amount).

For now, let's assume that the sum of the tax credit and the sum of the subsidy is the same $2500.

(The ACA subsidy and ACHA tax credit will not for most people be the same or similar amounts -- that it's not has been well discussed in the news, but one can tell as much from reading the ACHA, assuming one makes the effort to do so; it's a PITA to do so, but having strong reading comprehension skills one can, and one need not be an attorney to do so....I'm not a lawyer -- the credit is generally less than would be the corresponding subsidy under the ACA, but I'll get to that later in this post.)
​

For individuals:​

• Premiums:
  • Under the ACHA, if the premium is $10,000/year, you need to have $10K of your own money to pay for the insurance policy. You also have to have the money to pay your co-pays, deductibles, etc. Assuming you do have $10K you can pay to the insurer, your "losses" in connection with the ACHA are limited to the interest you forgo by having had to pay that money to the insurance company rather than earning interest on it as it sits in your own bank account.
    • One must calculate the specific interest impact for oneself as whether one pays monthly, quarterly, semi-annually, or annually affects the interest you pay....don't forget that you pay some interest to the insurer if you opt for a periodic payment plan rather than paying annually; thus one must net the interest gains and losses to determine the precise interest-loss sum applicable to one's own situation. (I'm not going to repeat the interest impact after this. Just be aware it's still there but it will be germane to a smaller sum of principal.)
  • Under the ACA, if the premium is $10,000/year, you need to have $7500 of your own money to pay for the insurance policy. You also have to have the money to pay your co-pays, deductibles, etc. In this scenario, the interest effect applies to $7500, not $10K.
• Penalties:
  • Under the ACHA, if you let your health insurance coverage lapse for more than 60 days the insurer will charge you (the language of the ACHA is "insurer shall charge," so it's illegal for them to not charge it) a 30% surcharge for one year after which they can't assess the surcharge until you have another qualified lapse. The surcharge amount goes to the insurer, not the government and into a pool of money used to offset the cost of the tax credit. The insurer gets to keep the money (see Sec. 133 on page 63ff of the ACHA). The surcharge sum depends on the price of the insurance policy you purchase.
    
    If you cannot pay for your insurance and lose it (even for just a day past 60), you'll pay 30% more (~$1100/month in the scenario we're using here) when you "get back on your feet." (Let's hope that "getting back on your feet" entails making a tidy bit more than you did before.)
  • Under the ACA, if you don't get insurance, you will have to pay a penalty for not doing so, and the penalty is assessed as a reduction to your refund, assuming you get one. If you aren't due a refund, it's a sum you must remit to the government, and no matter how you effect payment of the penalty (if you owe it), it's used to offset the subsidies.
    
    The "no insurance" penalty in the ACA is the higher of:
    1. $695/adult and $347.50/child, up to a household maximum of $2,085, or
    2. 2.5% of household income up to the a maximum of the total yearly premium for the national average subsidized price of a Bronze plan sold through the Marketplace. In 2015, the penalty amount using this calculation method was $2,484.

If you earn, $83,500, the most you'll pay as a "no insurance" penalty is $2,085. If you earn more than $83,500, you'll pay, at most, $2,484.​

As you can see, for a given low to modest income individual, and assuming the subsidy and the credit are the same amount, whether one can buy or cannot buy health insurance comes down to whether one can muster $10K or $7.5K or the related periodic, say monthly, payment amounts -- ~$850/month or ~$625/month, respectively.

For insurance companies:
For insurers and in terms of the premium amount they'd receive from any given individual and using the scenario above, there's no real difference. Neither bill defines what insurers can charge for insurance. Under both bills, the insurance company receives the full amount of the premium it charges for a health insurance policy.

What's different for insurers is that under the ACA, insurers must insure everyone, thus their premium amounts reflect a pooling of insurance risk. Under the ACHA, insurers likely will not find themselves insuring as many high risk individuals, namely the ones who are poor (poor enough) and who simply cannot afford the premium payment(s), thus just don't buy health insurance.

Insurers could, in theory, lower the market price of the policies they offer because of the change in their observed risk profiles if their owners' profit demands/expectations allow that to happen. Given where we are right now and the way businesses operate, what's more likely is that prices will be held constant at what they are now, or they will increase more slowly over time, the latter being the most likely of the two.[3]​

Notes:

1. Modest to low income being defined as gross income less than or equal to 300% of the poverty level, given one's household size.
2. I have no idea how many people don't need to file federal (or state, for that matter) income tax returns. I just know that the overwhelming majority of them who are adults are very poor. There are about 1M people who have chosen to forgo tax refunds they are due from a government. Strictly speaking there is a simple filing requirement; however, the federal government won't enforce that requirement if the IRS determines that it owes the taxpayer money.
3. Just what insurers opt to do with their policy prices depends on far more factors than are in scope for this post or thread.
4. Though I have mentioned the media in my introduction, they are not the topic of this thread. Do not discuss whatever you think about the media here. Create your own thread for that. I will request your post be deleted if you make a point of discussing the media and media coverage of the ACA/ACHA.

 

[usmbguest5318]

Supplemental information:

• LA Times' comparison of the ACA and ACHA -- There are some good high level charts, pictures and graphs here. You need to carefully read the "lower 48" chart, but it's a good one if you take the time to make sense of it. The information it portrays is in the ACHA as a table....The table's no clearer or less clear; it just takes up less space on the page.
• The Post's comparison of the ACA and ACHA -- This discussion includes the ACA tax credits as well as the subsidies. My OP discussion does not address the ACA's tax credits.

The tax credits in the Affordable Care Act are based on income and the cost of insurance premiums in a state marketplace. In general, the lower an individual’s income the larger the tax credit. Also, the more expensive the premium, the larger the credit.​

Here is how ACA works:​

• You’re 30 years old and single, making $23,000 a year. The average benchmark premium for a 30-year-old is $3,844 a year, according to the nonpartisan Kaiser Family Foundation.
  
  Your Obamacare tax credit would be $2,426. You would pay $118 a month in premiums, or $1,418 for the year.
• You’re 60 years old and single, making $23,000. The average benchmark premium for a 60-year-old is $9,191 a year.
  
  Your Obamacare tax credit would be $7,773. You, too, would pay $118 a month in premiums.

There’s more.

Obamacare also provides subsidies that can reduce out-of-pocket expenses such as annual deductibles and copayments. Obamacare tax credits are available to people making as much as 400 percent of the poverty level. For an individual, that’s $46,680. For a family of two, that’s $62,920, and for a family of four, it’s $95,400.

Here's how the ACHA works:

• The credits range from $2,000 to $4,000 depending on age. Older consumers get larger credits. The tax credits are capped at $14,000 for a family.
• Income is not a factor in the size of the tax credit, though they are phased out for individuals making more than $75,000 and for married couples making more than $150,000.
  
  
• Using the previous examples:
  • The 30-year-old making $23,000 would be eligible for a $2,500 tax credit — slightly more than under Obamacare. That would lower the cost of the annual premium to $1,344. Also, lower premiums could be available for even younger people under the Republican plan because it makes changes in current insurance rules that favor older customers.
    
    
  • The 60-year-old making $23,000 would get a $4,000 credit — less than under Obamacare. That would increase the annual premium to $5,191. Also, premiums could go up for older adults because the GOP bill allows insurers to charge more as people age and become more susceptible to health problems.

As you can see, O-care is oriented around the principle of providing health care insurance to people, without regard to their health status/health insurance risk profile. It's far closer to the notion of considering actually having health care as a right to which Americans are entitled. The ACHA approach treats health insurance essentially as a non-discretionary service purchase with insurance companies benefitting (sooner or later) from individuals opting not to buy insurance.

 

[Penelope]

People didn't realize what they had with the ACA and how the GOP fought it tooth and nails since inception, by bringing cases to the supreme court , bad mouthing it, and also by not expanding Medicaid in those 19 states. The ACA never had a chance to make any improvements, but now the GOP says they will need to revise and tweak it over years, something they never allowed the Democrats to do.

The GOP is just a tax cut for the wealthy, its not insurance for the needy and median income, which the subsidies were dependent on age , income and no. of people insured.

I have read the pre-existing part and ifs pretty much left up to the states how they want to handle it.

With the GOP plan it will be an individual having to work with the insurance company again, and the insurance company will get the fine (by charging a 30% increase in premiums) , not the government.

With the cap on Medicaid it, many will lose health insurance. A single person making min wage will not be able to afford insurance, which now they would qualify for expanded Medicaid.

Thanks for all the work you did, most will not read it.

The GOP goal, exp the 40 members of the Freedom Caucus are pushing for repeal of the New Deal, away with SS as we know it, away with Medicare as we know it, away with Medicaid except for childbirth, taking away meals on wheels, and probably if they had their way , they would rather kick a homeless man than feed him, or treat him. I never hear Trump talking about the opiate epidemic anymore, he is anti vaccines, and FDA .


Like you said reading the GOP plan I had to keep referring to links, if they added the wording in the links to it, it'd be 3000 pages, that is where I found it would be up to the individual states if they enforced the pre existing conditions. Which I posted here,
1: Guaranteed availability of coverageText contains those laws in effect on March 9, 20

it says 2017 in the article.

We are basically going back to the pre ACA days, with insurance companies at the reign.

 

[usmbguest5318]

People didn't realize what they had with the ACA and how the GOP fought it tooth and nails since inception, by bringing cases to the supreme court , bad mouthing it, and also by not expanding Medicaid in those 19 states. The ACA never had a chance to make any improvements, but now the GOP says they will need to revise and tweak it over years, something they never allowed the Democrats to do.

The GOP is just a tax cut for the wealthy, its not insurance for the needy and median income, which the subsidies were dependent on age , income and no. of people insured.

I have read the pre-existing part and ifs pretty much left up to the states how they want to handle it.

With the GOP plan it will be an individual having to work with the insurance company again, and the insurance company will get the fine (by charging a 30% increase in premiums) , not the government.

With the cap on Medicaid it, many will lose health insurance. A single person making min wage will not be able to afford insurance, which now they would qualify for expanded Medicaid.

Thanks for all the work you did, most will not read it.

The GOP goal, exp the 40 members of the Freedom Caucus are pushing for repeal of the New Deal, away with SS as we know it, away with Medicare as we know it, away with Medicaid except for childbirth, taking away meals on wheels, and probably if they had their way , they would rather kick a homeless man than feed him, or treat him. I never hear Trump talking about the opiate epidemic anymore, he is anti vaccines, and FDA .


Like you said reading the GOP plan I had to keep referring to links, if they added the wording in the links to it, it'd be 3000 pages, that is where I found it would be up to the individual states if they enforced the pre existing conditions. Which I posted here,
1: Guaranteed availability of coverageText contains those laws in effect on March 9, 20

it says 2017 in the article.

We are basically going back to the pre ACA days, with insurance companies at the reign.

Simplified clarification re: Pre-existing Conditions:

• If you have a pre-existing condition but haven't had a recent gap in your health coverage, insurers could not discriminate against you. If you've had a gap, they can.

 

[mudwhistle]

Preface:
In reading the American Health Care Act of 2017 (ACHA) (O-care is the ACA), I discovered that Congress wrote the damn thing in straightforward enough language, but not at all in a straightforward way. The vast majority of the bill requires one to have a copy of the ACA (in some instances the IRS Code) and refer to it because time and time again, our Congressional representatives have written the revisions by stating "'such and such' a section of the ACA (or IRS Code) is modified to say "XYZ." That's of no use until one knows what the original code section says! Would it have been so hard to have simply copied and pasted the ACA text and then written "the preceding section of the ACA the same thing, emboldening or in some other way calling attention to the altered verbiage?


Introduction:
Of late, the news and politicians has prattled on and on about how and whether the ACHA will pass.[4] Whether it will or won't pass in the House is interesting politically, but I don't think that matters much. I think substance is what matters, and IMHO, the news has not nearly enough addressed what matters -- how individuals can tell what specific impact the bill will have on them -- in any way other than to pontificate and proselytize about what the bill will do; however, I don't find that they've done so in ways that matter to individuals.

Maybe they have, and I've missed it? That is what it is if they have. From what I have read, though, the news and our elected leaders have been very "big picture." I love big picture discussions; I'm a business owner. I happen to think that on the matter of health insurance, however, the big picture is irrelevant if individuals do not have health insurance.

I was primarily interested in discovering how the bill proposes to keep health insurance purchasable/affordable for low to modest income people [1]. The questions I sought to answer are these:

1. What is the process by which low to modest income people would buy insurance under the ACA versus under the ACHA?
2. What is the impact on individual taxpayers of removing the individual mandate and its corresponding penalty and replacing it with the 30% surcharge?

I wanted the answers to those questions because, quite frankly, I don't care about the politics of the bill and getting it passed, yet the politics and contrivances involved in getting the thing passed is a large share of what I've seen discussed in the news and news commentary shows. What I care about is how the bill affects people who need health insurance. And my concern is purely intellectual -- that is, I want to know what the bill will do to the noted classes of people -- because whatever they do isn't going to affect whether I have, can afford or can obtain high quality health insurance.

What I wanted to discern was whether the ACHA materially alters the practical realities faced by modest to low income people who seek health insurance for I suspected my support for or advocacy against the ACHA would derive from what I think in that regard. If I found there to be no material difference, I'd have looked elsewhere in the bill -- likely overall national economic impact -- to determine what I think of it. Quite simply, on a matter such as health insurance and health care, people matter more to me than do profits or political gains and losses, thus the prioritization I assigned to my inquiry into the ACHA.


Findings:
So here's what I found, and please note that this discussion pertains to people who purchase insurance directly, not to people who obtain it via their employer...

Reference Information/Materials:​

• Price of insurance policies -- In some of the sources below, the sums are "buried" articles, so you'll have to scan for the figures. Don't forget, if you're equating the figures to your own situation, to add to the premium cost the amount of your actual historic average co-pay amounts and the share of your deductible that your co-pays don't count toward. (You should do that because regardless of to whom you pay the money, it's still money coming out of your pocket for healthcare/health insurance.)
  • Rising Premiums Rankle People Paying Full Price For Health Insurance -- ~$800/month for the lady mentioned at the start of the article.
    
  • Individual Mandate Penalty You Pay If You Don't Have Health Insurance Coverage
    
  • The Satisfied Unsubsidized: Obamacare’s Hidden Winners
    
  • How Much Does Health Insurance Cost Without a Subsidy? eHealth Price Index Report Shows What Off-Exchange Consumers Paid During the 2015 Obamacare Enrollment Period
    
  • 2017 Obamacare Average Premiums and Average Deductibles - HealthPocket.com
• Text of the ACA -- attached
• Text of the ACHA -- attached

Detailed Answers to My Questions:
The process for individuals obtaining health insurance under the ACHA is as follows:

1. Identify the insurance you want to purchase.
2. Pay for the policy however the insurer allows you to do so.
3. Receive a tax credit on your income taxes.
   • If you don't buy health insurance, you don't get the credit.
   • If you don't file a federal income tax return -- people with low enough incomes, or who are entitled to a refund, and whose income tax liability can be calculated accurately using only W2s and 1099s, and who are willing to forgo their refund, don't need to -- you don't get the credit.[2]

The process for obtaining health insurance under the ADA is as follows:

1. Identify the insurance you want to purchase.
2. Receive a subsidy that reduces the amount of your out of pocket payments for the policy. The subsidy is provided by the government and paid directly to the insurer.
3. Pay to your insurer your share of the premium for the policy. Your share = (Premium price) - (Subsidy amount).

For now, let's assume that the sum of the tax credit and the sum of the subsidy is the same $2500.

(The ACA subsidy and ACHA tax credit will not for most people be the same or similar amounts -- that it's not has been well discussed in the news, but one can tell as much from reading the ACHA, assuming one makes the effort to do so; it's a PITA to do so, but having strong reading comprehension skills one can, and one need not be an attorney to do so....I'm not a lawyer -- the credit is generally less than would be the corresponding subsidy under the ACA, but I'll get to that later in this post.)
​

For individuals:​

• Premiums:
  • Under the ACHA, if the premium is $10,000/year, you need to have $10K of your own money to pay for the insurance policy. You also have to have the money to pay your co-pays, deductibles, etc. Assuming you do have $10K you can pay to the insurer, your "losses" in connection with the ACHA are limited to the interest you forgo by having had to pay that money to the insurance company rather than earning interest on it as it sits in your own bank account.
    • One must calculate the specific interest impact for oneself as whether one pays monthly, quarterly, semi-annually, or annually affects the interest you pay....don't forget that you pay some interest to the insurer if you opt for a periodic payment plan rather than paying annually; thus one must net the interest gains and losses to determine the precise interest-loss sum applicable to one's own situation. (I'm not going to repeat the interest impact after this. Just be aware it's still there but it will be germane to a smaller sum of principal.)
  • Under the ACA, if the premium is $10,000/year, you need to have $7500 of your own money to pay for the insurance policy. You also have to have the money to pay your co-pays, deductibles, etc. In this scenario, the interest effect applies to $7500, not $10K.
• Penalties:
  • Under the ACHA, if you let your health insurance coverage lapse for more than 60 days the insurer will charge you (the language of the ACHA is "insurer shall charge," so it's illegal for them to not charge it) a 30% surcharge for one year after which they can't assess the surcharge until you have another qualified lapse. The surcharge amount goes to the insurer, not the government and into a pool of money used to offset the cost of the tax credit. The insurer gets to keep the money (see Sec. 133 on page 63ff of the ACHA). The surcharge sum depends on the price of the insurance policy you purchase.
    
    If you cannot pay for your insurance and lose it (even for just a day past 60), you'll pay 30% more (~$1100/month in the scenario we're using here) when you "get back on your feet." (Let's hope that "getting back on your feet" entails making a tidy bit more than you did before.)
  • Under the ACA, if you don't get insurance, you will have to pay a penalty for not doing so, and the penalty is assessed as a reduction to your refund, assuming you get one. If you aren't due a refund, it's a sum you must remit to the government, and no matter how you effect payment of the penalty (if you owe it), it's used to offset the subsidies.
    
    The "no insurance" penalty in the ACA is the higher of:
    1. $695/adult and $347.50/child, up to a household maximum of $2,085, or
    2. 2.5% of household income up to the a maximum of the total yearly premium for the national average subsidized price of a Bronze plan sold through the Marketplace. In 2015, the penalty amount using this calculation method was $2,484.

If you earn, $83,500, the most you'll pay as a "no insurance" penalty is $2,085. If you earn more than $83,500, you'll pay, at most, $2,484.​

As you can see, for a given low to modest income individual, and assuming the subsidy and the credit are the same amount, whether one can buy or cannot buy health insurance comes down to whether one can muster $10K or $7.5K or the related periodic, say monthly, payment amounts -- ~$850/month or ~$625/month, respectively.

For insurance companies:
For insurers and in terms of the premium amount they'd receive from any given individual and using the scenario above, there's no real difference. Neither bill defines what insurers can charge for insurance. Under both bills, the insurance company receives the full amount of the premium it charges for a health insurance policy.

What's different for insurers is that under the ACA, insurers must insure everyone, thus their premium amounts reflect a pooling of insurance risk. Under the ACHA, insurers likely will not find themselves insuring as many high risk individuals, namely the ones who are poor (poor enough) and who simply cannot afford the premium payment(s), thus just don't buy health insurance.

Insurers could, in theory, lower the market price of the policies they offer because of the change in their observed risk profiles if their owners' profit demands/expectations allow that to happen. Given where we are right now and the way businesses operate, what's more likely is that prices will be held constant at what they are now, or they will increase more slowly over time, the latter being the most likely of the two.[3]​

Notes:

1. Modest to low income being defined as gross income less than or equal to 300% of the poverty level, given one's household size.
2. I have no idea how many people don't need to file federal (or state, for that matter) income tax returns. I just know that the overwhelming majority of them who are adults are very poor. There are about 1M people who have chosen to forgo tax refunds they are due from a government. Strictly speaking there is a simple filing requirement; however, the federal government won't enforce that requirement if the IRS determines that it owes the taxpayer money.
3. Just what insurers opt to do with their policy prices depends on far more factors than are in scope for this post or thread.
4. Though I have mentioned the media in my introduction, they are not the topic of this thread. Do not discuss whatever you think about the media here. Create your own thread for that. I will request your post be deleted if you make a point of discussing the media and media coverage of the ACA/ACHA.

Excuse me, but isn't it dishonest to evaluate a bill before it's completed and ready to be signed?

 

[OldLady]

I saw in the paper this morning that more Americans are considering healthcare a "right." In my granddaughter's lifetime, I believe she will see universal healthcare in this country. Obamacare did not go far enough and it has royally screwed with the insurance company market. The Republicans' plan is not going to fix the problem. This entire half one thing and half another is not going to work, ever. But people are slowly realizing that medical care for all, without consideration for how much money they have, is the only answer in this day and age when medicine can do so much to make lives healthier, happier, and longer.
I think we should repeal Obamacare, keep Medicaid extended coverage and leave the private market to do what it will without government interference. When the time is right, we will do the right thing and get universal healthcare.

 

[usmbguest5318]

Thanks for all the work you did, most will not read it.

YW.

I would not typically have bothered to share the information, but since I did all that work to get myself informed on the key thing I cared about, I figured I'd share it.

 

[usmbguest5318]

This entire half one thing and half another is not going to work, ever.

I could not agree more.

It's nothing but a fancy way of doing what I call "half-assing." I don't care if there are two different "asses" involved or just one half-ass, either approach is still half-assed.

The truly sad thing is that what Trump "sold" re: health insurance/healthcare and what this bill contains aren't at all the same things. The vision Trump promulgated wasn't such a bad thing. The reality of what Congress is about to try passing is not at all a good thing for a lot of people, and not just the 24M who are projected to lose coverage. (Nevermind that O-care provided insurance to some 22M who previously couldn't get it or didn't have it.) Just looking at the calculus I figured out for my OP, it seems to me that lots of middle income people are going to end up not covered.

I think we should repeal Obamacare, keep Medicaid extended coverage and leave the private market to do what it will without government interference.

I don't know what I think about that idea. I haven't thought that specific program design.

I will say that I've been giving more consideration to the question of whether health insurance is another service, like water and electricity, that is best provided in the natural monopoly market structure rather than the monopolistically competitive market structure.

When the time is right, we will do the right thing and get universal healthcare.

As goes what I think for "average" Americans, "now" isn't too soon to deem it "the right time."

 

[Penelope]

H.R. 1628—American Health Care Act of 2017 | House Committee on Rules

Here is the bill so far.

 

[Penelope]

I think we need to cap insurance increases to 3% a years, or the rate of inflation, and also tell them to get on the marketplace or face a hefty fine.

 

[usmbguest5318]

I think we need to cap insurance increases to 3% a years, or the rate of inflation, and also tell them to get on the marketplace or face a hefty fine.

For all my humanitarianism, however much or little that be, I'm not fond of price caps, the exception being usury, but I'm hard pressed to see insurance premium costs as being comparable enough to the price of money that I would define premium increases at or above a certain rate as usurious.

 

[OldLady]

This entire half one thing and half another is not going to work, ever.

I could not agree more.

It's nothing but a fancy way of doing what I call "half-assing." I don't care if there are two different "asses" involved or just one half-ass, either approach is still half-assed.

The truly sad thing is that what Trump "sold" re: health insurance/healthcare and what this bill contains aren't at all the same things. The vision Trump promulgated wasn't such a bad thing. The reality of what Congress is about to try passing is not at all a good thing for a lot of people, and not just the 24M who are projected to lose coverage. (Nevermind that O-care provided insurance to some 22M who previously couldn't get it or didn't have it.) Just looking at the calculus I figured out for my OP, it seems to me that lots of middle income people are going to end up not covered.

I think we should repeal Obamacare, keep Medicaid extended coverage and leave the private market to do what it will without government interference.

I don't know what I think about that idea. I haven't thought that specific program design.

I will say that I've been giving more consideration to the question of whether health insurance is another service, like water and electricity, that is best provided in the natural monopoly market structure rather than the monopolistically competitive market structure.

When the time is right, we will do the right thing and get universal healthcare.

As goes what I think for "average" Americans, "now" isn't too soon to deem it "the right time."

As goes what I think for "average" Americans, "now" isn't too soon to deem it "the right time."
I agree wholeheartedly, have for a long time, but we obviously do not have over half the country behind us on this one. Yet.

People (with some good reason) distrust the government's ability to administer its way out of a paper bag, let alone a complex medical care program that would cover all 320 million of us. That could be improved though, once we get done barking at the Russians hanging around our property line.

It would require more money coming out of our paycheck. People never like that idea, but I think after our experiences with ACA, it's pretty clear that it wouldn't cost as much as it is now. There are many, many ways to reduce healthcare costs. It is time to start looking at them.

If we had universal healthcare, businesses would be freed of an enormous burden to buy insurance for its employees and could spend that money on building more business. Healthcare costs would be contained by what the government program would agree to pay, since it would be the only payee in town. I worked closely with the insurance industry back in the 80's, and they all said that medical insurance is never a money making venture. They make enough to stay afloat, but it is their other lines that turn a profit. What always happens though, is that we look at insurance companies as "deep pockets." I believe that if the market couldn't expect an insurance company to pay whatever ridiculous fees it wants to charge for a new drug or a new MRI machine or a fee for an appendectomy, costs would look very different.

Bernie Sanders scared me to death, but universal healthcare is a great idea.

 

[Penelope]

I think we need to cap insurance increases to 3% a years, or the rate of inflation, and also tell them to get on the marketplace or face a hefty fine.

For all my humanitarianism, however much or little that be, I'm not fond of price caps, the exception being usury, but I'm hard pressed to see insurance premium costs as being comparable enough to the price of money that I would define premium increases at or above a certain rate as usurious.

Well maybe we should get rid of insurance companies completely, that is anther option. See the issue with state lines, which is in effect, is that the network of providers would be unreal unless of course there were fewer insurance companies, which the big ones have been gobbling up the smaller ones. So universal coverage would include all providers in the US. With most insurances , if one is traveling, one can get emergency care as well for the network price, must be an emergency.

 

[usmbguest5318]

isn't it dishonest to evaluate a bill before it's completed and ready to be signed?

Not if one wants to know what one thinks of the proposed bill in time to contact one's Representative and Senators to tell them what one thinks of the thing. What would you do? Call or email them and not know in detail what you're talking about when get them on the phone?

After the bill is passed, it's too late to do anything about it, except complain. I don't operate that way. I'd rather do what I can before it's too late, so that if I'm left with no alternative but to complain later, I at least I know I did the most and best I could not to find myself in such an emasculated position.

 

[mudwhistle]

I saw in the paper this morning that more Americans are considering healthcare a "right." In my granddaughter's lifetime, I believe she will see universal healthcare in this country. Obamacare did not go far enough and it has royally screwed with the insurance company market. The Republicans' plan is not going to fix the problem. This entire half one thing and half another is not going to work, ever. But people are slowly realizing that medical care for all, without consideration for how much money they have, is the only answer in this day and age when medicine can do so much to make lives healthier, happier, and longer.
I think we should repeal Obamacare, keep Medicaid extended coverage and leave the private market to do what it will without government interference. When the time is right, we will do the right thing and get universal healthcare.

I think something that the op doesn't point out is this funding is intended to be catastrophic insurance for the uninsurable. It's only affordable to someone who needs to pay massive health care expenses and cannot find coverage elsewhere. Let's remember what the word "insurance" means.

"Insurance is a means of protection from financial loss. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss."​

 

[mudwhistle]

isn't it dishonest to evaluate a bill before it's completed and ready to be signed?

Not if one wants to know what one thinks of the proposed bill in time to contact one's Representative and Senators to tell them what one thinks of the thing. What would you do? Call or email them and not know in detail what you're talking about when get them on the phone?

After the bill is passed, it's too late do do anything about it, except complain. I don't operate that way. I'd rather do what I can before it's too late, so that if I'm left with no alternative but to complain later, I at least I know I did the most and best I could not to find myself in such an emasculated position.

Excuse me but didn't the ACA change several times after it was signed. Didn't it go through numerous changes after the bill left the House and went to the Senate? Are you assuming that once it's voted on nobody is allowed to amend it, it's literally written in stone like the Ten Commandments? Even the constitution allows for amendments.

 

[usmbguest5318]

People didn't realize what they had with the ACA and how the GOP fought it tooth and nails since inception, by bringing cases to the supreme court , bad mouthing it, and also by not expanding Medicaid in those 19 states. The ACA never had a chance to make any improvements, but now the GOP says they will need to revise and tweak it over years, something they never allowed the Democrats to do.

The GOP is just a tax cut for the wealthy, its not insurance for the needy and median income, which the subsidies were dependent on age , income and no. of people insured.

I have read the pre-existing part and ifs pretty much left up to the states how they want to handle it.

With the GOP plan it will be an individual having to work with the insurance company again, and the insurance company will get the fine (by charging a 30% increase in premiums) , not the government.

With the cap on Medicaid it, many will lose health insurance. A single person making min wage will not be able to afford insurance, which now they would qualify for expanded Medicaid.

Thanks for all the work you did, most will not read it.

The GOP goal, exp the 40 members of the Freedom Caucus are pushing for repeal of the New Deal, away with SS as we know it, away with Medicare as we know it, away with Medicaid except for childbirth, taking away meals on wheels, and probably if they had their way , they would rather kick a homeless man than feed him, or treat him. I never hear Trump talking about the opiate epidemic anymore, he is anti vaccines, and FDA .


Like you said reading the GOP plan I had to keep referring to links, if they added the wording in the links to it, it'd be 3000 pages, that is where I found it would be up to the individual states if they enforced the pre existing conditions. Which I posted here,
1: Guaranteed availability of coverageText contains those laws in effect on March 9, 20

it says 2017 in the article.

We are basically going back to the pre ACA days, with insurance companies at the reign.

Simplified clarification re: Pre-existing Conditions:

• If you have a pre-existing condition but haven't had a recent gap in your health coverage, insurers could not discriminate against you. If you've had a gap, they can.

Link correction: The GOP's Plan for Pre-Existing Conditions Has a Huge Loophole

 

[usmbguest5318]

I saw in the paper this morning that more Americans are considering healthcare a "right." In my granddaughter's lifetime, I believe she will see universal healthcare in this country. Obamacare did not go far enough and it has royally screwed with the insurance company market. The Republicans' plan is not going to fix the problem. This entire half one thing and half another is not going to work, ever. But people are slowly realizing that medical care for all, without consideration for how much money they have, is the only answer in this day and age when medicine can do so much to make lives healthier, happier, and longer.
I think we should repeal Obamacare, keep Medicaid extended coverage and leave the private market to do what it will without government interference. When the time is right, we will do the right thing and get universal healthcare.

I think something that the op doesn't point out is this funding is intended to be catastrophic insurance for the uninsurable. It's only affordable to someone who needs to pay massive health care expenses and cannot find coverage elsewhere. Let's remember what the word "insurance" means.

"Insurance is a means of protection from financial loss. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss."​

What "funding?" What I wrote about is what people who must purchase insurance on their own rather than through an employer's plan have to pay to obtain insurance. Such individuals fund their health insurance purchase, i.e, pay the premium, from whatever sources of money they have.

 

[mudwhistle]

I saw in the paper this morning that more Americans are considering healthcare a "right." In my granddaughter's lifetime, I believe she will see universal healthcare in this country. Obamacare did not go far enough and it has royally screwed with the insurance company market. The Republicans' plan is not going to fix the problem. This entire half one thing and half another is not going to work, ever. But people are slowly realizing that medical care for all, without consideration for how much money they have, is the only answer in this day and age when medicine can do so much to make lives healthier, happier, and longer.
I think we should repeal Obamacare, keep Medicaid extended coverage and leave the private market to do what it will without government interference. When the time is right, we will do the right thing and get universal healthcare.

I think something that the op doesn't point out is this funding is intended to be catastrophic insurance for the uninsurable. It's only affordable to someone who needs to pay massive health care expenses and cannot find coverage elsewhere. Let's remember what the word "insurance" means.

"Insurance is a means of protection from financial loss. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss."​

What "funding?" What I wrote about is what people who must purchase insurance on their own rather than through an employer's plan have to pay to obtain insurance. Such individuals fund their health insurance purchase, i.e, pay the premium, from whatever sources of money they have.

So what’s your point?
Isn’t that the way insurance works?

 

[mudwhistle]

I saw in the paper this morning that more Americans are considering healthcare a "right." In my granddaughter's lifetime, I believe she will see universal healthcare in this country. Obamacare did not go far enough and it has royally screwed with the insurance company market. The Republicans' plan is not going to fix the problem. This entire half one thing and half another is not going to work, ever. But people are slowly realizing that medical care for all, without consideration for how much money they have, is the only answer in this day and age when medicine can do so much to make lives healthier, happier, and longer.
I think we should repeal Obamacare, keep Medicaid extended coverage and leave the private market to do what it will without government interference. When the time is right, we will do the right thing and get universal healthcare.

I think something that the op doesn't point out is this funding is intended to be catastrophic insurance for the uninsurable. It's only affordable to someone who needs to pay massive health care expenses and cannot find coverage elsewhere. Let's remember what the word "insurance" means.

"Insurance is a means of protection from financial loss. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss."​

What "funding?" What I wrote about is what people who must purchase insurance on their own rather than through an employer's plan have to pay to obtain insurance. Such individuals fund their health insurance purchase, i.e, pay the premium, from whatever sources of money they have.

Aren't you confusing the word fund with benefits???