The ACA sees record enrollments his year!

[Lisa558]

The Affordable Care Act does not provide access to health care. It provides access to health insurance. Just because you have insurance doesn't mean you can afford health care.

The ACA allows plans to have a deductibles/co-pays of up to $8,700 and required them to have deductibles of at least $2,800. With those kind of deductibles, a worker at McDonald's is not going to be able to access much health care. Not unless he tell the hospital to bill him with a plan to declare bankruptcy. But we were told that the ACA was needed to prevent such financial ruin.

View attachment 743980

Even if you have a subsidy, you are in bad shape under the ACA:

Here is what the healthinsurance.org calculator says the subsidy would be for a working-class family in a small Texas city:

View attachment 743982

Will you receive an ACA premium subsidy? | healthinsurance.org

See who's eligible for the Affordable Care Act's premium tax credits (premium subsidies), how subsidies are calculated, and why they are more robust in 2023.

www.healthinsurance.org

Here is a little math:

17,244 (the average yearly premium for a family of four stated above)
Divided by
12 (the number of months in a year)
=
1,437 (the monthly premiums before subsidy is applied)
Minus 458 (estimated monthly subsidy as stated above)
=
979 (the monthly premium the family above would have to pay. Monthly. As in every month.

Nine hundred and seventy-nine dollars for a family of four earning $$3,500 per month before taxes and other deductions is the exact opposite of affordable.

Those are the exact type of people for whom the phrase "it is expensive to be poor" applies. It's not expensive to be a lifelong welfare dolee with no desire to break the dependancy cycle. Everything is free then. It is expensive to try and play by the rules and work hard to achieve the American dream. Those are exactly the people that Democratic policies seem designed to harm.

Suppose that somehow the family is able to afford $979 per month on a gross income of only $3,500 per month. Somehow. Now their daughter has a burst appendix and is rushed to the emergency room for treatment which is an emergency surgery. That treatment will cost well over the $7,767 deductable, leaving the family with that debt.

Again, financial ruin due to medical debt is what the ACA promoters promised to stop.

Exactly. The whole thing was about being able to brag about how many people had insurance - or, more realistically, insurance CARDS.

Obamacare was so bad for me that in some cases, I was better off pretending I had NO insurance and paying the “cash price” rather than the ”discounted insurance price”. One time I needed PT, and the cost per session was $99 for cash payers and $130 for those with the Obamacare plan. So….I was paying $800 a month for insurance for the privilege of having to pay more for medical care than people without insurance at all!

 

[Greenbeard]

The Affordable Care Act does not provide access to health care. It provides access to health insurance. Just because you have insurance doesn't mean you can afford health care.

The ACA allows plans to have a deductibles/co-pays of up to $8,700 and required them to have deductibles of at least $2,800. With those kind of deductibles, a worker at McDonald's is not going to be able to access much health care. Not unless he tell the hospital to bill him with a plan to declare bankruptcy. But we were told that the ACA was needed to prevent such financial ruin.

The ACA subsidizes cost-sharing for anyone under 250% FPL. In fact, the median deductible of purchased plans is somewhere around $750. As in half of buyers have plans with medians below that amount. Certainly your McDonalds worker will be below that median.

Now if you want to lower the legal maximum for cost-sharing and/or deductibles, I'm interested in hearing that out. But let's not pretend most people are choosing plans with the legal maximum.

Here is what the healthinsurance.org calculator says the subsidy would be for a working-class family in a small Texas city:

Gonna stop you right there. The link you actually want is: Health insurance plans & prices | HealthCare.gov

Using the info you provided:

Subsidy: $918/month for buyer and spouse, children covered by CHIP.

38 bronze plans available, average premium $8/month
54 silver plans available, average premium $190/month
33 gold plans available, average premium $85/month

Both zero premium and zero deductible plans are available (though obviously those are not the same plans).

Why you would waste the time posting what you did without taking the 5 minutes required to look at what's actually being sold in the marketplace right and what financial assistance is available I have no idea.

 

[Seymour Flops]

The ACA subsidizes cost-sharing for anyone under 250% FPL. In fact, the median deductible of purchased plans is somewhere around $750. As in half of buyers have plans with medians below that amount. Certainly your McDonalds worker will be below that median.

Now if you want to lower the legal maximum for cost-sharing and/or deductibles, I'm interested in hearing that out. But let's not pretend most people are choosing plans with the legal maximum.

If they don't choose the legal maximum for deductable, they will pay more in premiums. You sound like a used car salesman.

Gonna stop you right there. The link you actually want is: Health insurance plans & prices | HealthCare.gov

Using the info you provided:

Subsidy: $918/month for buyer and spouse, children covered by CHIP.

Why are children covered by CHIP? One, we're talking about the ACA, not CHIP and two, you have no way of knowing that the hypothetical family is covered by CHIP.

Here is what I go when went through the steps. Notice that one of the children is male and pregnant. Remember, that is a thing now.

Actually, the ACA website won't show you any plans for cases in which children are not eligible for CHIP. What a scam.

Here was the first plan on the list:

$15,000 out of pocket for a family of four earning 42K before taxes. Where do you propose they get that money?

38 bronze plans available, average premium $8/month
54 silver plans available, average premium $190/month
33 gold plans available, average premium $85/month

Both zero premium and zero deductible plans are available (though obviously those are not the same plans).

Yes, obviously you will have either a zero premium but a high deductable (incredibly high, as above) or a zero deductable and a high premium.

Even if you have "zero deductible," you can still have Yuge out of pocket expenses.

Again, this is the used car dealer's trick. If the customer complains about the monthly payment, increase the down payment and show them the new numbers. If the customer complains about the interest, add on the sticker price and decrease the interest rate.

No matter what, it amounts to an overpriced product that the poor customers they serve cannot afford.

Why you would waste the time posting what you did without taking the 5 minutes required to look at what's actually being sold in the marketplace right and what financial assistance is available I have no idea.

Because the Obamacare site is designed to be deceptive, as in its false assumption that the children will automatically be eligible for CHIP. All of those numbers above are based on a false assumption that everyone with that income's children will be eligible for CHIP. What happens when you get a policy, find out your kids aren't eligible for CHIP and have to add them. Calling Mr. Otis!

You've been had, Greenbeard. Unless you aren't lying also, which I give you the benefit of the doubt. This was all explained by Jonathan Gruber, the architect of Obamacare. I suggest you search Youtube for that name.

 

[Greenbeard]

Why are children covered by CHIP?

Because they are.

Here is what I go when went through the steps.

Pause to note that the reality is radically fucking different than what you posted above.

Even if you have "zero deductible," you can still have Yuge out of pocket expenses.

View attachment 744003

Let's see, zero cost-sharing for primary care and $25 co-pays for specialty care. Which is all most people might need in a given year, particularly shoppers looking for plans with deductibles far below the OOP max.

But let's imagine some health misfortune befalls at least one of them and they have that plan (of course, there are dozens of other options, but we'll go with this particular one for illustrative purposes). 20% coinsurance for a hospital stay so one of the parents hitting their individual out-of-pocket maximum of $2,900 for the year would require incurring costs of at least $14,500. In other words, the individual needs to incur health care expenses at least 35% of the household's annual income to hit its OOP max, which is under 7% of the household's income. Depending on how bad that health misfortune is, they may incur costs well over 35% of the household's income--say, $50K in medical expenses, exceeding their entire income. Doesn't matter, their out-of-pocket liability is capped at less than 7% of the household's income.

No matter what, it amounts to an overpriced product that the poor customers they serve cannot afford.

Overpriced relative to what? It provides substantial financial protection at an affordable price, which is what it's supposed to do.

 

[Seymour Flops]

Because they are.

How do you know? Even the website you have so much faith in says that they "may be eligible." You are being deliberately gullible.

Pause to note that the reality is radically fucking different than what you posted above.

I got it directly from the website that you directed me to.

Let's see, zero cost-sharing for primary care and $25 co-pays for specialty care. Which is all most people might need in a given year, particularly shoppers looking for plans with deductibles far below the OOP max.

Well, sure, it is all they "might" need. That sounds like a pretty healthy family that you're describing. Like four of the kinds of people that used to not even want to pay for health insurance. That is certainly not typical. Have you ever been married to a woman? They go to the doctor way more than guys do.

But let's imagine some health misfortune befalls at least one of them and they have that plan (of course, there are dozens of other options, but we'll go with this particular one for illustrative purposes). 20% coinsurance for a hospital stay so one of the parents hitting their individual out-of-pocket maximum of $2,900 for the year would require incurring costs of at least $14,500.

Yes, which can easily happen. How old are you? Have you ever been hospitalized? It is expensive.

The smallest out-of-pocket maximum I saw on healthcare.gov was $5,800, so I'm not sure where you're getting your figures.

In other words, the individual needs to incur health care expenses at least 35% of the household's annual income to hit its OOP max, which is under 7% of the household's income. Depending on how bad that health misfortune is, they may incur costs well over 35% of the household's income--say, $50K in medical expenses, exceeding their entire income. Doesn't matter, their out-of-pocket liability is capped at less than 7% of the household's income.

You'll have to show me those figures, since you've gotten it so wrong before.

Overpriced relative to what? It provides substantial financial protection at an affordable price, which is what it's supposed to do.

Again, it provides insurance which is not the same as financial protection.

 

[Greenbeard]

How do you know? Even the website you have so much faith in says that they "may be eligible." You are being deliberately gullible.

I know because the CHIP income eligibility threshold for this family is $4,649/month and they're well below it.

Children’s Medicaid and CHIP | Texas Health and Human Services

Children's Medicaid is a health care program for children in low-income families. CHIP is a health care program for children whose families earn too much to get Medicaid but cannot afford health insurance.

www.hhs.texas.gov

I got it directly from the website that you directed me to.

I'm talking about the wrong numbers you used to begin this conversation. As you've now seen, the premiums and OOP maximums for plans available to this family are much lower than the numbers you made up to make your point.

The smallest out-of-pocket maximum I saw on healthcare.gov was $5,800, so I'm not sure where you're getting your figures.

Deductibles and OOP maximums on the marketplace are embedded, meaning any individual within the family is subject to an individual deductible or OOP maximum that is half the family value. Hitting the family deductible or OOP maximum requires at least two members of the family to hit their deductible or OOP max.

The parents in your hypothetical family each have an individual OOP maximum of $2,900, which would require one of them getting sick enough to incur $14,500 in health care expenses. Hitting the family OOP max would require both of them independently incurring that much in health expenses. And if either one--or both!--is that sick, it's not even debatable that they're getting a good deal by having insurance.

Again, it provides insurance which is not the same as financial protection.

It is the same. You buy insurance because it provides financial protection.

What are you arguing for? It should be zero premium, zero deductible, and zero out-of-pocket exposure and anything less is a bad deal?

 

[debbiedowner]

The Affordable Care Act does not provide access to health care. It provides access to health insurance. Just because you have insurance doesn't mean you can afford health care.

The ACA allows plans to have a deductibles/co-pays of up to $8,700 and required them to have deductibles of at least $2,800. With those kind of deductibles, a worker at McDonald's is not going to be able to access much health care. Not unless he tell the hospital to bill him with a plan to declare bankruptcy. But we were told that the ACA was needed to prevent such financial ruin.

View attachment 743980

Even if you have a subsidy, you are in bad shape under the ACA:

Here is what the healthinsurance.org calculator says the subsidy would be for a working-class family in a small Texas city:

View attachment 743982

Will you receive an ACA premium subsidy? | healthinsurance.org

See who's eligible for the Affordable Care Act's premium tax credits (premium subsidies), how subsidies are calculated, and why they are more robust in 2023.

www.healthinsurance.org

Here is a little math:

17,244 (the average yearly premium for a family of four stated above)
Divided by
12 (the number of months in a year)
=
1,437 (the monthly premiums before subsidy is applied)
Minus 458 (estimated monthly subsidy as stated above)
=
979 (the monthly premium the family above would have to pay. Monthly. As in every month.

Nine hundred and seventy-nine dollars for a family of four earning $$3,500 per month before taxes and other deductions is the exact opposite of affordable.

Those are the exact type of people for whom the phrase "it is expensive to be poor" applies. It's not expensive to be a lifelong welfare dolee with no desire to break the dependancy cycle. Everything is free then. It is expensive to try and play by the rules and work hard to achieve the American dream. Those are exactly the people that Democratic policies seem designed to harm.

Suppose that somehow the family is able to afford $979 per month on a gross income of only $3,500 per month. Somehow. Now their daughter has a burst appendix and is rushed to the emergency room for treatment which is an emergency surgery. That treatment will cost well over the $7,767 deductable, leaving the family with that debt.

Again, financial ruin due to medical debt is what the ACA promoters promised to stop.

​

Now try a reliable calculator with both parents as 42 and 2 kids both 13 in your zip at $42000 MAGI and you will see you would qualify for $1449 per month in advanced tax credit and in the end may end up paying somewhere around $2 to $10 a month in premiums for your family of 4.

Health Insurance Marketplace Calculator | KFF

The Health Insurance Marketplace Calculator, updated with 2024 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

www.kff.org

 

[Lisa558]

​

Now try a reliable calculator with both parents as 42 and 2 kids both 13 in your zip at $42000 MAGI and you will see you would qualify for $1449 per month in advanced tax credit and in the end may end up paying somewhere around $2 to $10 a month in premiums for your family of 4.

Health Insurance Marketplace Calculator | KFF

The Health Insurance Marketplace Calculator, updated with 2024 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

www.kff.org

Giving free health insurance out like that costs other people a fortune. Our country can’t afford it.

 

[debbiedowner]

If they don't choose the legal maximum for deductable, they will pay more in premiums. You sound like a used car salesman.

Why are children covered by CHIP? One, we're talking about the ACA, not CHIP and two, you have no way of knowing that the hypothetical family is covered by CHIP.

Here is what I go when went through the steps. Notice that one of the children is male and pregnant. Remember, that is a thing now.

View attachment 743993

View attachment 743994

Actually, the ACA website won't show you any plans for cases in which children are not eligible for CHIP. What a scam.

Here was the first plan on the list:

View attachment 743996


$15,000 out of pocket for a family of four earning 42K before taxes. Where do you propose they get that money?




Yes, obviously you will have either a zero premium but a high deductable (incredibly high, as above) or a zero deductable and a high premium.

Even if you have "zero deductible," you can still have Yuge out of pocket expenses.

View attachment 744003


Again, this is the used car dealer's trick. If the customer complains about the monthly payment, increase the down payment and show them the new numbers. If the customer complains about the interest, add on the sticker price and decrease the interest rate.

No matter what, it amounts to an overpriced product that the poor customers they serve cannot afford.


Because the Obamacare site is designed to be deceptive, as in its false assumption that the children will automatically be eligible for CHIP. All of those numbers above are based on a false assumption that everyone with that income's children will be eligible for CHIP. What happens when you get a policy, find out your kids aren't eligible for CHIP and have to add them. Calling Mr. Otis!

You've been had, Greenbeard. Unless you aren't lying also, which I give you the benefit of the doubt. This was all explained by Jonathan Gruber, the architect of Obamacare. I suggest you search Youtube for that name.

The federal marketplace automatically sends kids to CHIP if at 250% or lower of FPL. Don't know at what percentage non federal marketplace uses. Texas is federal.

 

[Care4all]

No shit, Sherlock.

2.7 million people streamed across our border in 2022

We'll see record setting enrollment in public school (unless their numbers are offset by parents who homeschool in disgust), record welfare, record crime, record drug overdoses, etc.

You forgot the Rapists sent....

 

[C_Clayton_Jones]

It’s no accident that ACA enrollments are reaching record highs

As ACA enrollments reach all-time highs, it's important to remember that these victories aren't accidental: They're the result of competent governing.

www.msnbc.com

This is a very good thing. The more people enrolled, the more people stay our of the ER and stay alive.

Very good.

 

[Seymour Flops]

I know because the CHIP income eligibility threshold for this family is $4,649/month and they're well below it.

Children’s Medicaid and CHIP | Texas Health and Human Services

Children's Medicaid is a health care program for children in low-income families. CHIP is a health care program for children whose families earn too much to get Medicaid but cannot afford health insurance.

www.hhs.texas.gov

Then you know more than the healthcare.gov website which states that such a family "may" be eligible?

But, let's say you're right for the sake of argument, since I see that it is one of those non-factual "facts," that Democrats need to make their arguments plausible. How is that a benefit of Obamacare that kids can get on CHIPS? I could start a "FlopsIncome.com" website and claim it will make sure everyone has a Universal Basic Income.

Then all the site has to do is refer everyone to the welfare offices in their county. Yeah. I implemented UBI. Send me a hundred billion.

CHIPS long predated Obamacare, so for Obamacare supporters to taut it as a benefit of Obamacare is absurd.

I'm talking about the wrong numbers you used to begin this conversation. As you've now seen, the premiums and OOP maximums for plans available to this family are much lower than the numbers you made up to make your point.

No, I saw that the Obamacare website claims that they are much lower than the numbers I got from an independent website.

Deductibles and OOP maximums on the marketplace are embedded, meaning any individual within the family is subject to an individual deductible or OOP maximum that is half the family value. Hitting the family deductible or OOP maximum requires at least two members of the family to hit their deductible or OOP max.

The parents in your hypothetical family each have an individual OOP maximum of $2,900, which would require one of them getting sick enough to incur $14,500 in health care expenses. Hitting the family OOP max would require both of them independently incurring that much in health expenses. And if either one--or both!--is that sick, it's not even debatable that they're getting a good deal by having insurance.

Yes, but the "good deal" will not be affordable for low-income patients. They will have to choose between food and paying off their OOP expenses. Exactly what Obamacare promised to stop.

It is the same. You buy insurance because it provides financial protection.

What are you arguing for? It should be zero premium, zero deductible, and zero out-of-pocket exposure and anything less is a bad deal?

Anything else is not the government making sure everyone has access to healthcare, which was the claim that I refuted. It may be a good deal for some, of course.

Remember that Jonathan Gruber, the architect of Obamacare, said that the most important thing was to not be transparent about the fact that Obamacare shifts the burden of healthcare from the sick to the healthy. So of course, that will sometimes be a good deal for the sick.

In case you don't remember:



"If you made it explicit that healthy people pay and sick people get money, it would not have passed." - Jonathan Gruber

Gullible Democrats pictured the Donald Trumps of the world paying for healthcare for self-imagined starving artists like themselves so they could use student loan to major in video game design or gender studies. It turns out that - once again - it is the working class and the middle class who must bear the burden of Democrats idea of "generosity."

 

[Seymour Flops]

You forgot the Rapists sent....

The women and children that they raped won't forget them.

 

[Greenbeard]

Then you know more than the healthcare.gov website which states that such a family "may" be eligible.

But, let's say you're right for the sake of argument, since I see that it is one of those non-factual "facts," that Democrats need to make their arguments plausible. How is that a benefit of Obamacare that kids can get on CHIPS?

The ACA extended CHIP funding so that children would continue to have access to low-cost coverage. They still do today. Including the hypothetical kids you've been talking about.

No, I saw that the Obamacare website claims that they are much lower than the numbers I got from an independent website.

Those aren't claims, they're price tags. You were window-shopping in the actual marketplace. And yes, the prices are significantly lower than you thought.

Yes, but the "good deal" will not be affordable for low-income patients. They will have to choose between food and paying off their OOP expenses. Exactly what Obamacare promised to stop.

Obamacare promised to put affordable health care within reach of American families, which it has. If you want to attack it for not making health care free for everyone, there's plenty of lefties whose train you catch latch onto.

 

[Seymour Flops]

The ACA extended CHIP funding so that children would continue to have access to low-cost coverage. They still do today. Including the hypothetical kids you've been talking about.

So the ACA was completely unneeded for children.

Those aren't claims, they're price tags. You were window-shopping in the actual marketplace. And yes, the prices are significantly lower than you thought.

Those are not price tags, they are estimates. Yes, the actual marketplace is where the actual price tags are, and they are exactly as I stated.

Obamacare promised to put affordable health care within reach of American families, which it has. If you want to attack it for not making health care free for everyone, there's plenty of lefties whose train you catch latch onto.

It does not make it affordable for everyone, so its very name is a lie. Just as the righties said it would be to howls of derisive laughter from the left.

Feel free to ignore the actual words of Jonathan Gruber, the Architect of Obamacare, since they seem to be triggering for you.

"You know, call it the stupidity of the American voter, or whatever." - Jonathan Gruber

 

[C_Clayton_Jones]

The right’s unwarranted opposition the ACA is purely partisan, devoid of fact and merit, motivated solely by conservatives’ baseless contempt for President Obama.

 

[Greenbeard]

So the ACA was completely unneeded for children.

Incorrect.

Report Finds Medicaid Expansion Associated with Lower Child Uninsured Rates

Introduction Since its passage in 2010, the Affordable Care Act (ACA) has played a critical role in lowering the rate of uninsured children in America. A key part of the ACA’s success in this area …

ccf.georgetown.edu

It does not make it affordable for everyone, so its very name is a lie. Just as the righties said it would be to howls of derisive laughter from the left.

The reality that you BernieBros will need to reckon with at some point is that zero premium, zero cost-sharing coverage for everyone is unlikely to ever come to pass.

 

[debbiedowner]

Giving free health insurance out like that costs other people a fortune. Our country can’t afford it.

It’s no accident that ACA enrollments are reaching record highs

As ACA enrollments reach all-time highs, it's important to remember that these victories aren't accidental: They're the result of competent governing.

www.msnbc.com

This is a very good thing. The more people enrolled, the more people stay our of the ER and stay alive.

I question this article and if they were new enrollments because someone had no insurance or went from off exchange to on exchange to see if they could receive a tax credit. If many of these are just re enrolls then they have not gained that much. The author uses "signed up for ACA", well the author needs to learn if you had insurance off exchange that is also ACA.

 

[JimH52]

Yea it's so useful. Nothing like a plan with a 6000 dollar deductible for someone who is unemployed.

But but but DEY GOTZ DUH OBUMMERCARE!!!! AND IT BE CHEAP TOO!!!

Where is that repub plan.....UP trump's BUTT?

 

[Burgermeister]

A buddy in PA just went on unemployment for the first time and he signed up for Obamacare for him and his wife. He was expecting to pay 2K/mo. or so, maybe more. Nope. No monthly premium, no deductible. Had his choice of three plans - all big names. Keeps his primary doctor, ridiculously low co-pays for everything, free eyeglasses and dental, gym membership, yoga classes, chiropractor, and yes, a free phone as part of the health plan.

He's talked to numerous Obamacare people during the process. Said they are not like DMV workers. Articulate, polite, knew what they were talking about.

He's still trying to figure out how it's possible, but he has the cards and is all set.

Once he is employed and makes above a certain amount, the premiums kick in. Now we understand why so many people are in no hurry to get back to work.