Trying to understand the ACA/Obamacare

To provide context, this is the first time I have independently applied for health coverage.

My parents earn above the threshold for the ACA (or around 120k), so they have to pay for their coverage - minus the employer contribution.

Also I found out that I am outside the threshold for the ACA, so I will also have to pay for my own coverage with no subsidies whatsoever.

When I had a look, a basic plan was around $188-191 (before tax) a month, for my own medical needs (like the off chance accident of being run over by a car, and visiting the doctor for a check up every six months).

How can part-time workers (that make up 40%+ of Americans) that work below the $16,000 threshold afford decent healthcare coverage, when they are excluded from the ACA, and Medicaid is so restrictive that the poor can't get access?

Also, what about those earning above the 48-60k threshold (depending on the state) who probably can't afford decent healthcare coverage, given the costs of accommodation, education, and general living expenses, yet are excluded from the ACA simply on the basis they 'earn too much'?

If you don't buy coverage you get a $500-600 fine a year, and if you do get coverage you are having to pay $188+ a month just for basic coverage. There is a subsidy if you earn around 48-60k, but what about the other 60%+ of Americans that get nothing from the ACA but are forced to pay taxes for the 16-60k'ers?

That means that the 16-60k bracket get subsidies from taxes from the poor, the upper middle class, and the rich. We hear about the 1% but who is really taking advantage of the tax system, is it really those earning above 60k or below 16k - or the small percentage of Americans (say 20-30%) that are given subsidies at the expense of everyone else in America that gets nothing?


You're missing the point.

The purpose of the ACA is to enrich Big Insurance companies and to expand Federal government power over our private lives.

For most ACA enrollees, the tiny provider networks combined with enormously high deductibles mean they won't use any health care except for extreme emergencies.
 
To provide context, this is the first time I have independently applied for health coverage.

My parents earn above the threshold for the ACA (or around 120k), so they have to pay for their coverage - minus the employer contribution.

Also I found out that I am outside the threshold for the ACA, so I will also have to pay for my own coverage with no subsidies whatsoever.

When I had a look, a basic plan was around $188-191 (before tax) a month, for my own medical needs (like the off chance accident of being run over by a car, and visiting the doctor for a check up every six months).

How can part-time workers (that make up 40%+ of Americans) that work below the $16,000 threshold afford decent healthcare coverage, when they are excluded from the ACA, and Medicaid is so restrictive that the poor can't get access?

Also, what about those earning above the 48-60k threshold (depending on the state) who probably can't afford decent healthcare coverage, given the costs of accommodation, education, and general living expenses, yet are excluded from the ACA simply on the basis they 'earn too much'?

If you don't buy coverage you get a $500-600 fine a year, and if you do get coverage you are having to pay $188+ a month just for basic coverage. There is a subsidy if you earn around 48-60k, but what about the other 60%+ of Americans that get nothing from the ACA but are forced to pay taxes for the 16-60k'ers?

That means that the 16-60k bracket get subsidies from taxes from the poor, the upper middle class, and the rich. We hear about the 1% but who is really taking advantage of the tax system, is it really those earning above 60k or below 16k - or the small percentage of Americans (say 20-30%) that are given subsidies at the expense of everyone else in America that gets nothing?


You're missing the point.

The purpose of the ACA is to enrich Big Insurance companies and to expand Federal government power over our private lives.

For most ACA enrollees, the tiny provider networks combined with enormously high deductibles mean they won't use any health care except for extreme emergencies.
It's the same with most employer coverage now too. I would have to have a $12,000 emergency to ever see my insurance take over any medical bills. The marketplace is worst with about $14,000 out-of-pocket. It not just the ACA enrollees. Their out-of-pocket wouldn't be as high?? IDK. They should have looked at ridiculous medical costs from doctors and hospitals first. That would have cleaned up much of America's healthcare whoas. Yep.
 
To provide context, this is the first time I have independently applied for health coverage.

My parents earn above the threshold for the ACA (or around 120k), so they have to pay for their coverage - minus the employer contribution.

Also I found out that I am outside the threshold for the ACA, so I will also have to pay for my own coverage with no subsidies whatsoever.

When I had a look, a basic plan was around $188-191 (before tax) a month, for my own medical needs (like the off chance accident of being run over by a car, and visiting the doctor for a check up every six months).

How can part-time workers (that make up 40%+ of Americans) that work below the $16,000 threshold afford decent healthcare coverage, when they are excluded from the ACA, and Medicaid is so restrictive that the poor can't get access?

Also, what about those earning above the 48-60k threshold (depending on the state) who probably can't afford decent healthcare coverage, given the costs of accommodation, education, and general living expenses, yet are excluded from the ACA simply on the basis they 'earn too much'?

If you don't buy coverage you get a $500-600 fine a year, and if you do get coverage you are having to pay $188+ a month just for basic coverage. There is a subsidy if you earn around 48-60k, but what about the other 60%+ of Americans that get nothing from the ACA but are forced to pay taxes for the 16-60k'ers?

That means that the 16-60k bracket get subsidies from taxes from the poor, the upper middle class, and the rich. We hear about the 1% but who is really taking advantage of the tax system, is it really those earning above 60k or below 16k - or the small percentage of Americans (say 20-30%) that are given subsidies at the expense of everyone else in America that gets nothing?


You're missing the point.

The purpose of the ACA is to enrich Big Insurance companies and to expand Federal government power over our private lives.

For most ACA enrollees, the tiny provider networks combined with enormously high deductibles mean they won't use any health care except for extreme emergencies.
It's the same with most employer coverage now too. I would have to have a $12,000 emergency to ever see my insurance take over any medical bills. The marketplace is worst with about $14,000 out-of-pocket. It not just the ACA enrollees. Their out-of-pocket wouldn't be as high?? IDK. They should have looked at ridiculous medical costs from doctors and hospitals first. That would have cleaned up much of America's healthcare whoas. Yep.
Weird.

That's a higher deductible than mine on the private marketplace (which is about $2000 or $6350 max out of pocket), with a total cost of $191 or so per month.

Though I am not required to use the public marketplace.
 
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Actually, my work health coverage has a very high premium each month with a deductible half-as-low as in the marketplace. I have no idea how my employer determines their/my premiums or deductibles. ??

The private marketplace in my area for my income has an even higher (than my employer) premium and twice as high deductible. I have no idea how the private marketplace determines their premiums or deductibles. ??
 
Actually, my work health coverage has a very high premium each month with a deductible half-as-low as in the marketplace. I have no idea how my employer determines their/my premiums or deductibles. ??

The private marketplace in my area for my income has an even higher (than my employer) premium and twice as high deductible. I have no idea how the private marketplace determines their premiums or deductibles. ??
I went with a non-profit provider, which isn't always an option in some states.

That said, deductibles do change by area. In my county the average out of pocket is about $6350 for most providers on the private marketplace.

I wouldn't know how employers do it, but I would guess they are forced to negotiate each year with a health insurance company and try and to not get taken to the cleaners.
 
To provide context, this is the first time I have independently applied for health coverage.

My parents earn above the threshold for the ACA (or around 120k), so they have to pay for their coverage - minus the employer contribution.

Also I found out that I am outside the threshold for the ACA, so I will also have to pay for my own coverage with no subsidies whatsoever.

When I had a look, a basic plan was around $188-191 (before tax) a month, for my own medical needs (like the off chance accident of being run over by a car, and visiting the doctor for a check up every six months).

How can part-time workers (that make up 40%+ of Americans) that work below the $16,000 threshold afford decent healthcare coverage, when they are excluded from the ACA, and Medicaid is so restrictive that the poor can't get access?

Also, what about those earning above the 48-60k threshold (depending on the state) who probably can't afford decent healthcare coverage, given the costs of accommodation, education, and general living expenses, yet are excluded from the ACA simply on the basis they 'earn too much'?

If you don't buy coverage you get a $500-600 fine a year, and if you do get coverage you are having to pay $188+ a month just for basic coverage. There is a subsidy if you earn around 48-60k, but what about the other 60%+ of Americans that get nothing from the ACA but are forced to pay taxes for the 16-60k'ers?

That means that the 16-60k bracket get subsidies from taxes from the poor, the upper middle class, and the rich. We hear about the 1% but who is really taking advantage of the tax system, is it really those earning above 60k or below 16k - or the small percentage of Americans (say 20-30%) that are given subsidies at the expense of everyone else in America that gets nothing?


You're missing the point.

The purpose of the ACA is to enrich Big Insurance companies and to expand Federal government power over our private lives.

For most ACA enrollees, the tiny provider networks combined with enormously high deductibles mean they won't use any health care except for extreme emergencies.
It's the same with most employer coverage now too. I would have to have a $12,000 emergency to ever see my insurance take over any medical bills. The marketplace is worst with about $14,000 out-of-pocket. It not just the ACA enrollees. Their out-of-pocket wouldn't be as high?? IDK. They should have looked at ridiculous medical costs from doctors and hospitals first. That would have cleaned up much of America's healthcare whoas. Yep.


They should get government out of the health care allocation business altogether.


- Health insurance provided by employers is compensation, not health care
- Decouple prepaid health services (routine check ups, tests) from catastrophic care. Having insurance as an intermediary for every health care activity is the biggest driver of costs.
- Get rid of state barriers to competition.
- Tax health care while allowing for tax free Health Savings Accounts to offset the impact. Free individuals to choose the health care that suits them.

I came to the conclusion quite some time ago that all that health insurance does is provide revenue to insurance companies instead of "basic care". The co-pays and deductibles we pay for routine things are likely what those things would cost in the absence of any insurance whatsoever.
 
For most ACA enrollees, the tiny provider networks combined with enormously high deductibles mean they won't use any health care except for extreme emergencies.

- Decouple prepaid health services (routine check ups, tests) from catastrophic care. Having insurance as an intermediary for every health care activity is the biggest driver of costs.

"Under the ACA, people only use health insurance for extreme emergencies. Under my plan, people will only use health insurance for catastrophic medical emer--um, events."

:eusa_shifty:
 
For most ACA enrollees, the tiny provider networks combined with enormously high deductibles mean they won't use any health care except for extreme emergencies.

- Decouple prepaid health services (routine check ups, tests) from catastrophic care. Having insurance as an intermediary for every health care activity is the biggest driver of costs.

"Under the ACA, people only use health insurance for extreme emergencies. Under my plan, people will only use health insurance for catastrophic medical emer--um, events."

:eusa_shifty:

Her point evades you? We're going to be paying the same prices, or more, for insurance that provides us little to no value. The corporate whores in Congress have set the insurance industry up as needless middle-men in every single health care transaction, offering no practical utility - literally bleeding us. It's a shameful sellout and you know it.
 
Her point evades you? We're going to be paying the same prices, or more, for insurance that provides us little to no value. The corporate whores in Congress have set the insurance industry up as needless middle-men in every single health care transaction, offering no practical utility - literally bleeding us. It's a shameful sellout and you know it.

How are they "middle-men in every single health care transaction" if transactions below ~$12,000 are paid out of pocket, say through funds stashed in an HSA? Because they negotiate rates on your behalf? If your issue is with the rates health care providers (e.g., docs and hospitals) command from insurers, then your ire is (at least half) mis-directed.
 
For most ACA enrollees, the tiny provider networks combined with enormously high deductibles mean they won't use any health care except for extreme emergencies.

- Decouple prepaid health services (routine check ups, tests) from catastrophic care. Having insurance as an intermediary for every health care activity is the biggest driver of costs.

"Under the ACA, people only use health insurance for extreme emergencies. Under my plan, people will only use health insurance for catastrophic medical emer--um, events."

:eusa_shifty:


Sorry. I. Should. Have. Said. It. Really. Slow. It's clear you have trouble keeping up.

In my scenario, people aren't paying outrageous amounts for "prepaid" routine health care services via premiums that are worthless. They pay for catastrophic health care insurance, and then have HSA money to spend on routine care, or they can pay for that out of aftertax income.
 
In my scenario, people aren't paying outrageous amounts for "prepaid" routine health care services via premiums that are worthless.

Does "worthless" here mean that your premiums don't entitle you to the services (due to cost-sharing requirements)? That's the opposite of saying they're prepaid by your premiums.

Using funds from an HSA just means that you're covering the cost-sharing requirements of a high-deductible plan--which is exactly how the ACA works. By definition you can't use an HSA unless you have a high deductible plan (nor would there be any reason to use one if you had a low-deductible plan). So why complain about high deductibles if your "solution" is high deductible plans?
 
Her point evades you? We're going to be paying the same prices, or more, for insurance that provides us little to no value. The corporate whores in Congress have set the insurance industry up as needless middle-men in every single health care transaction, offering no practical utility - literally bleeding us. It's a shameful sellout and you know it.

How are they "middle-men in every single health care transaction" if transactions below ~$12,000 are paid out of pocket, say through funds stashed in an HSA? Because they negotiate rates on your behalf? If your issue is with the rates health care providers (e.g., docs and hospitals) command from insurers, then your ire is (at least half) mis-directed.

My "issue" is with the fact that Congress has mandated that we pay insurance companies regardless of whether we value their services or not. My "ire" is directed at every corporatist shill who supports this policy.
 
My "issue" is with the fact that Congress has mandated that we pay insurance companies regardless of whether we value their services or not.

Believe it or not, I get that you don't like the individual mandate.

What I asked is: How are they "middle-men in every single health care transaction" if transactions below ~$12,000 are paid out of pocket, say through funds stashed in an HSA?
 
My "issue" is with the fact that Congress has mandated that we pay insurance companies regardless of whether we value their services or not.

Believe it or not, I get that you don't like the individual mandate.

What I asked is: How are they "middle-men in every single health care transaction" if transactions below ~$12,000 are paid out of pocket, say through funds stashed in an HSA?

They are middlemen because they get a cut regardless of whether they pay out benefits or not. Even if we don't ever use the services they offer, we still have to pay them. They have inserted themselves as permanent fixtures in the healthcare market, regardless of how useless they become.
 
The ACA leaves an out for states. They can have their own Health Care and no big deal. In Colorado, since the state began their health program, the cost has gone down, not up. If you state is playing grabass with the ACA and refusing to set up it's own programs then it's just ripping off the tax payers in that state. And you will see higher premiums.

The ACA is only bad when your state doesn't give a shit about you. Seems there are quite of few of those.
My state did not take the ACA build out because it must be paid back to the government. What's the point of that? Too many strings attached. A state needs to stand on it's own without government. My state's medical costs are high because the medical providers; doctors and hospitals, etc. have taken advantage of the Obamacare situation. A broken ankle costs about $40,000 in my state, from when you break it to when you fix it. They have known for decades how to fix broken bones. How do you explain that, hmmm?

It works like this. Companies that want to gouge and cheat everyone will be forced to either play by the rules or they can move to a state with no rules. The State sets these conditions. IT sounds like there are hundreds of gougers waiting to set up in your state.


Stop with the misinformation.

You have NO idea WHO sets the Rates do you?

The Insurance Companies can ask for whatever increase they want, the State DOI can yea or nea it...if it's higher than 10% then DHS get's involved with the approval process.

The companies cannot just charge whatever they want.

No State, no Company can just "decide" not to abide by the Law, ANY plan sold after Jan 10 MUST comply with the ACA.
 
The ACA leaves an out for states. They can have their own Health Care and no big deal. In Colorado, since the state began their health program, the cost has gone down, not up. If you state is playing grabass with the ACA and refusing to set up it's own programs then it's just ripping off the tax payers in that state. And you will see higher premiums.

The ACA is only bad when your state doesn't give a shit about you. Seems there are quite of few of those.
My state did not take the ACA build out because it must be paid back to the government. What's the point of that? Too many strings attached. A state needs to stand on it's own without government. My state's medical costs are high because the medical providers; doctors and hospitals, etc. have taken advantage of the Obamacare situation. A broken ankle costs about $40,000 in my state, from when you break it to when you fix it. They have known for decades how to fix broken bones. How do you explain that, hmmm?

It works like this. Companies that want to gouge and cheat everyone will be forced to either play by the rules or they can move to a state with no rules. The State sets these conditions. IT sounds like there are hundreds of gougers waiting to set up in your state.


Stop with the misinformation.

You have NO idea WHO sets the Rates do you?

The Insurance Companies can ask for whatever increase they want, the State DOI can yea or nea it...if it's higher than 10% then DHS get's involved with the approval process.

The companies cannot just charge whatever they want.

No State, no Company can just "decide" not to abide by the Law, ANY plan sold after Jan 10 MUST comply with the ACA.

In this state, the STATE determines the maximums in premiums. Not the Feds. The Feds just put a minimum only with exceptions for the State Programs. New twist. It looks like those states that rely on the Feds entirely are in for a huge awaking when the fees for not complying starts to be taken from their taxpayers only to be sent to the premiums to those states that have their own system. And no refunds will happen in those states that are fighting tooth and nail. Sooner or later, the taxpayers will speak out in the form of their votes. The ,more you fight it the more you get your foot deeper in that grave. Stop Digging.

Your misinformation is astounding and get seven more unbelievable as time goes by.
 
The ACA leaves an out for states. They can have their own Health Care and no big deal. In Colorado, since the state began their health program, the cost has gone down, not up. If you state is playing grabass with the ACA and refusing to set up it's own programs then it's just ripping off the tax payers in that state. And you will see higher premiums.

The ACA is only bad when your state doesn't give a shit about you. Seems there are quite of few of those.
My state did not take the ACA build out because it must be paid back to the government. What's the point of that? Too many strings attached. A state needs to stand on it's own without government. My state's medical costs are high because the medical providers; doctors and hospitals, etc. have taken advantage of the Obamacare situation. A broken ankle costs about $40,000 in my state, from when you break it to when you fix it. They have known for decades how to fix broken bones. How do you explain that, hmmm?

It works like this. Companies that want to gouge and cheat everyone will be forced to either play by the rules or they can move to a state with no rules. The State sets these conditions. IT sounds like there are hundreds of gougers waiting to set up in your state.


Stop with the misinformation.

You have NO idea WHO sets the Rates do you?

The Insurance Companies can ask for whatever increase they want, the State DOI can yea or nea it...if it's higher than 10% then DHS get's involved with the approval process.

The companies cannot just charge whatever they want.

No State, no Company can just "decide" not to abide by the Law, ANY plan sold after Jan 10 MUST comply with the ACA.

In this state, the STATE determines the maximums in premiums. Not the Feds. The Feds just put a minimum only with exceptions for the State Programs. New twist. It looks like those states that rely on the Feds entirely are in for a huge awaking when the fees for not complying starts to be taken from their taxpayers only to be sent to the premiums to those states that have their own system. And no refunds will happen in those states that are fighting tooth and nail. Sooner or later, the taxpayers will speak out in the form of their votes. The ,more you fight it the more you get your foot deeper in that grave. Stop Digging.

Your misinformation is astounding and get seven more unbelievable as time goes by.

The DOI HAS to report anything over 10%, then the Feds step in.

You are just wrong, sorry.
 
DOI? Is that a federal Department? The only Federal DOI is Department of Interior that deals in wildlife. If you mean Department of Insurance, each state has one under the Governors Office.
Google
Since you seem to not to be able to utilize Google, just click on the link.

You can learn or you can just keep making it up as you go or repeating what your handler tells you to.
 
DOI? Is that a federal Department? The only Federal DOI is Department of Interior that deals in wildlife. If you mean Department of Insurance, each state has one under the Governors Office.
Google
Since you seem to not to be able to utilize Google, just click on the link.

You can learn or you can just keep making it up as you go or repeating what your handler tells you to.

LOL, every State has it'sown DOI, now state with me and you'll learn something....any rate hike under 10% stays within the State, anything higher than 10 % and it must be submitted to HHS.

Is it your learned opinion that Co is somehow exempt from the ACA?
 
pppppsssst?

DOI is Dept of Insurance ;)

Insurance is what I do kid, no keep going ;)
 

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