Obamacare: What happens when you can't afford to pay?

[Politico]

Premiums cannot exceed 9.5% of income.

You call that affordable?

Let's take someone making $9/hr, single and no dependents

$9 * 2080 hrs = $18,720 yearly income.

18,720 * .85 = $15,912 est. after tax income

$15,912 / 12 = $1326 monthly after tax income


Rent -- $500
Utilities -- $100
Food -- $200
Phone -- $50
Misc toiletries -- $50
Car Ins -- $50
Gas -- $200
Obamacare -- $148

Total monthly expenses = $1298
Total monthly useable income = $28

Are you suggesting that these people should remain uninsured?

I'm not suggesting that anyone should do anything, and the question does not address the point. Obamacare is an assault on the poor and low income people in our country.

I've posted similar calculations over and over. The difference is I included they also don't get subsidies according to the calculator. They cannot afford the insurance.

 

[jon_berzerk]

Premiums cannot exceed 9.5% of income.

You call that affordable?

Let's take someone making $9/hr, single and no dependents

$9 * 2080 hrs = $18,720 yearly income.

18,720 * .85 = $15,912 est. after tax income

$15,912 / 12 = $1326 monthly after tax income


Rent -- $500
Utilities -- $100
Food -- $200
Phone -- $50
Misc toiletries -- $50
Car Ins -- $50
Gas -- $200
Obamacare -- $148

Total monthly expenses = $1298
Total monthly useable income = $28

Are you suggesting that these people should remain uninsured?

I'm not suggesting that anyone should do anything, and the question does not address the point. Obamacare is an assault on the poor and low income people in our country.

Total monthly useable income = $28

not even the co pay amount on one office visit

 

[jon_berzerk]

You call that affordable?

Let's take someone making $9/hr, single and no dependents

$9 * 2080 hrs = $18,720 yearly income.

18,720 * .85 = $15,912 est. after tax income

$15,912 / 12 = $1326 monthly after tax income


Rent -- $500
Utilities -- $100
Food -- $200
Phone -- $50
Misc toiletries -- $50
Car Ins -- $50
Gas -- $200
Obamacare -- $148

Total monthly expenses = $1298
Total monthly useable income = $28



I'm not suggesting that anyone should do anything, and the question does not address the point. Obamacare is an assault on the poor and low income people in our country.

That person would get a subsidy and help with paying the out if pocket expenses.

Are you of the opinion that it us better to remain uninsured?

LOL...

so they will not pay a dime...and get it for free..



nothing new here.

perhaps

but that does nothing for the young and healthy covering

the costs of the old and sickly signing up in droves

 

[Claudette]

What happens if they can't afford to pay??

Easy.

The taxpayers of America will be picking up the tab.

 

[jon_berzerk]

ran the numbers $18,720 yearly income

Based on a household size of one and income of $18,700, you may qualify for a $339/month tax credit you can choose to apply to your premium for these plans. This tax credit has been applied to the premiums below.

Simplicity $5,000
HMO | Bronze
Sanford Health Plan

Monthly premium

$27/mo
One enrollee
Premium before tax credit: $366/mo
Deductible

$5,000/yr

Per individual

Out-of-pocket Maximum
$6,350/yr

Per individual

Copayments/Coinsurance:

Primary Doctor: 40% Coinsurance after deductible
Specialist Doctor: 40% Coinsurance after deductible
Generic Prescription: 40% Coinsurance after deductible
ER Visit: 40% Coinsurance after deductible

---------------------------

Health plans for one individual, age 27

Based on a household size of one and income of $18,700, you may qualify for a $145/month tax credit you can choose to apply to your premium for these plans. This tax credit has been applied to the premiums below.

Simplicity $5,000
HMO | Bronze
Sanford Health Plan
APPLYDETAILS
Monthly premium

$52/mo
One enrollee
Premium before tax credit: $197/mo
Deductible

$5,000/yr

Per individual

Out-of-pocket Maximum
$6,350/yr

Per individual

Copayments/Coinsurance:

Primary Doctor: 40% Coinsurance after deductible
Specialist Doctor: 40% Coinsurance after deductible
Generic Prescription: 40% Coinsurance after deductible
ER Visit: 40% Coinsurance after deductible

 

[Claudette]

Yeah. Come up with that 5 or 6 thousand dollar deductable.

Yup. The Affordable Care Act. Gotta wonder just who the hell its affordable for outside of those we taxpayers will be subsidizing.

The poor will pay little or nothing.

The rich can afford whatever they want.

The middle class will get fucked as usual.

 

[Freewill]

Sure, if you live in Pub Propaganda World...

Z, don't worry, you won't have those free preventive care tests, so by the time you find out you have cancer or many other things, it'll be too late anyway. Ah, life with Pubcare...

Oh gosh another liberal fallacy and I don't think you meant it. FREE? In his example he would be paying 13000/year doesn't seem like anything would be FREE. I guess in Dem world everything coming from the government is FREE, to them.

 

[Freewill]

That person would get a subsidy and help with paying the out if pocket expenses.

Are you of the opinion that it us better to remain uninsured?

LOL...

so they will not pay a dime...and get it for free..



nothing new here.

perhaps

but that does nothing for the young and healthy covering

the costs of the old and sickly signing up in droves

You too some day will be old and maybe, hopefully not, become sickly. The price for the insurance isn't cheap just because you are sickly or old. Of course it depends on what you consider "old."

 

[Luddly Neddite]

You call that affordable?

Let's take someone making $9/hr, single and no dependents

$9 * 2080 hrs = $18,720 yearly income.

18,720 * .85 = $15,912 est. after tax income

$15,912 / 12 = $1326 monthly after tax income


Rent -- $500
Utilities -- $100
Food -- $200
Phone -- $50
Misc toiletries -- $50
Car Ins -- $50
Gas -- $200
Obamacare -- $148

Total monthly expenses = $1298
Total monthly useable income = $28

I'm not suggesting that anyone should do anything, and the question does not address the point. Obamacare is an assault on the poor and low income people in our country.

That person would get a subsidy and help with paying the out if pocket expenses.

Are you of the opinion that it us better to remain uninsured?


By the way....you make a good argument for raising the minimum wage.

Pay attention people.

That is YOU and ME paying for this persons healthcare insurance. Not their health care. But their insurance.

This is called 'redistribution'.

No its not. For the five thousandth time, all insurance depends on the premiums of the healthy to pay for the care of the sick/injured.

And, why don't the rw's mind paying for 100% of the unpaid medical bills under reagan's socialist EMTALA?

 

[francoHFW]

Sure, if you live in Pub Propaganda World...

Z, don't worry, you won't have those free preventive care tests, so by the time you find out you have cancer or many other things, it'll be too late anyway. Ah, life with Pubcare...

Oh gosh another liberal fallacy and I don't think you meant it. FREE? In his example he would be paying 13000/year doesn't seem like anything would be FREE. I guess in Dem world everything coming from the government is FREE, to them.

At no cost then, hater dupe. And there's more you get than that. He should actually SEE what's involved, just like all the other chumps of the greedy idiot rich. Real competitition hasn't even started yet. Good things take time- especially with Pubs and insurers messing things up, just like bad things, like the Pub/Voodoo ruin of the nonrich and the country 1982-2009- Even before the SECOND pub cronyism and corruption 2008 Meltdown, or the total incompetence of 9/11 and the two longest and stupidest wars EVER.

 

[Katzndogz]

What happens when someone goes to the hospital and can't afford to pay is that the hospital signs them up for obamacare and pays the initial premium, no one can be denied for a pre existing condition. Then the hospital submits the bills under the newly minted policy. For an initial payment of a couple of hundred dollars, the hospital can submit tens of thousands of dollars in bills.

 

[baker001]

What happens when someone goes to the hospital and can't afford to pay is that the hospital signs them up for obamacare and pays the initial premium, no one can be denied for a pre existing condition. Then the hospital submits the bills under the newly minted policy. For an initial payment of a couple of hundred dollars, the hospital can submit tens of thousands of dollars in bills.

Still doesn't work. Insurance doesn't pay retroactively. Open enrollment periods aside, if a person incurs a bill on April. 15 and the hospital signs that person up on the same day, coverage doesn't start until May 1 at the earliest. So only medical claims May 1 or later would be paid, the hospital is still out any care they provided in the month of April. Add in the fact that open enrollment is only during the 4th quarter of the year, your scenario is impossible.

 

[baker001]

So what? Life is full of risk. You could die crossing the street.

But let's assume your scenario happens. We can fly to Mexico, Costa Rica, or any of dozens of other countries that have excellent medical facilities and doctors. We would receive the medical treatment needed at a fraction of the inflated US cost.

then a few months later (assuming we still wanted to live in the US) , we could sign up for Obamacare.

Either way, we're WAY ahead of the game.

THANKS OBAMACARE!!

PS- Here is an article about medical tourism" in Costa Rica

You going to "Fly to mexico" when you get in to a car accident? "Nah, I don't need an ambulance....get me on a plane!"

Do you actually think any of this shit through before you say it?

Car accident? BFD. We'll dip into our savings. We're willing to "self insure'. Why does that scare you?

Nothing wrong with self insuring, but that only works if you can afford to do so. You're betting you won't get sick/injured between now and when you hit the amounts in savings where it would cover major medical issues, based on your numbers that's a good 10 years away (and even then $130k is not an amount I would consider being self insured, I'd put that closer to $500k). And that very well may happen, you stay healthy and save and you come out ahead of the game. Or you could get hit with massive medical bills before you get to that point and you're wiped out.

And just because you haven't been sick yet doesn't mean you won't be tomorrow. My boss's husband was the pillar of health. One day he felt horribly ill and was rushed to the hospital. 24 hours later he was dead (some form of leukemia, shows no real symptoms until it gets to the point where you basically drop dead). My boss has insurance and it covered everything ,but she said the medical bills topped $800,000. For only 24 hours of care!

What you do with your life is up to you, no skin off my nose either way, but your plan carries a certain amount of risk.

 

[Zander]

You going to "Fly to mexico" when you get in to a car accident? "Nah, I don't need an ambulance....get me on a plane!"

Do you actually think any of this shit through before you say it?

Car accident? BFD. We'll dip into our savings. We're willing to "self insure'. Why does that scare you?

Nothing wrong with self insuring, but that only works if you can afford to do so. You're betting you won't get sick/injured between now and when you hit the amounts in savings where it would cover major medical issues, based on your numbers that's a good 10 years away (and even then $130k is not an amount I would consider being self insured, I'd put that closer to $500k). And that very well may happen, you stay healthy and save and you come out ahead of the game. Or you could get hit with massive medical bills before you get to that point and you're wiped out.

And just because you haven't been sick yet doesn't mean you won't be tomorrow. My boss's husband was the pillar of health. One day he felt horribly ill and was rushed to the hospital. 24 hours later he was dead (some form of leukemia, shows no real symptoms until it gets to the point where you basically drop dead). My boss has insurance and it covered everything ,but she said the medical bills topped $800,000. For only 24 hours of care!

What you do with your life is up to you, no skin off my nose either way, but your plan carries a certain amount of risk.

Dead in 24 hours and $800K in medical bills? Sounds like a bullshit story to me.

Did they gold-plate the body?

But for sake of argument let's pretend your anecdote is true- So what? I'd be dead!!!! and my medical debt would die with me

I only keep 6 months of living expenses in the bank. The rest of my assets are protected in trusts, Corporations, IRA's and LLC's. My heirs would get their full inheritance unencumbered.

As for $130K being enough to self insure- that's just the amount of premium I will save in the first 10 years. In 15 years I will have saved over $200,000 assuming the money earns ZERO interest. If I invest the $1085 per month in an investment that averages 5% over the next 10 years I will have $ 171,952.00 / over 15 years it grows to $295,000.

Obamacare only works if you are broke (or math challenged!) OR are an insurance company.

 

[baker001]

Car accident? BFD. We'll dip into our savings. We're willing to "self insure'. Why does that scare you?

Nothing wrong with self insuring, but that only works if you can afford to do so. You're betting you won't get sick/injured between now and when you hit the amounts in savings where it would cover major medical issues, based on your numbers that's a good 10 years away (and even then $130k is not an amount I would consider being self insured, I'd put that closer to $500k). And that very well may happen, you stay healthy and save and you come out ahead of the game. Or you could get hit with massive medical bills before you get to that point and you're wiped out.

And just because you haven't been sick yet doesn't mean you won't be tomorrow. My boss's husband was the pillar of health. One day he felt horribly ill and was rushed to the hospital. 24 hours later he was dead (some form of leukemia, shows no real symptoms until it gets to the point where you basically drop dead). My boss has insurance and it covered everything ,but she said the medical bills topped $800,000. For only 24 hours of care!

What you do with your life is up to you, no skin off my nose either way, but your plan carries a certain amount of risk.

Dead in 24 hours and $800K in medical bills? Sounds like a bullshit story to me.

Did they gold-plate the body?

But for sake of argument let's pretend your anecdote is true- So what? I'd be dead!!!! and my medical debt would die with me

I only keep 6 months of living expenses in the bank. The rest of my assets are protected in trusts, Corporations, IRA's and LLC's. My heirs would get their full inheritance unencumbered.

As for $130K being enough to self insure- that's just the amount of premium I will save in the first 10 years. In 15 years I will have saved over $200,000 assuming the money earns ZERO interest. If I invest the $1085 per month in an investment that averages 5% over the next 10 years I will have $ 171,952.00 / over 15 years it grows to $295,000.

Obamacare only works if you are broke (or math challenged!) OR are an insurance company.

Believe what you want, like I said no skin off my nose.

 

[Jarhead]

Nothing wrong with self insuring, but that only works if you can afford to do so. You're betting you won't get sick/injured between now and when you hit the amounts in savings where it would cover major medical issues, based on your numbers that's a good 10 years away (and even then $130k is not an amount I would consider being self insured, I'd put that closer to $500k). And that very well may happen, you stay healthy and save and you come out ahead of the game. Or you could get hit with massive medical bills before you get to that point and you're wiped out.

And just because you haven't been sick yet doesn't mean you won't be tomorrow. My boss's husband was the pillar of health. One day he felt horribly ill and was rushed to the hospital. 24 hours later he was dead (some form of leukemia, shows no real symptoms until it gets to the point where you basically drop dead). My boss has insurance and it covered everything ,but she said the medical bills topped $800,000. For only 24 hours of care!

What you do with your life is up to you, no skin off my nose either way, but your plan carries a certain amount of risk.

Dead in 24 hours and $800K in medical bills? Sounds like a bullshit story to me.

Did they gold-plate the body?

But for sake of argument let's pretend your anecdote is true- So what? I'd be dead!!!! and my medical debt would die with me

I only keep 6 months of living expenses in the bank. The rest of my assets are protected in trusts, Corporations, IRA's and LLC's. My heirs would get their full inheritance unencumbered.

As for $130K being enough to self insure- that's just the amount of premium I will save in the first 10 years. In 15 years I will have saved over $200,000 assuming the money earns ZERO interest. If I invest the $1085 per month in an investment that averages 5% over the next 10 years I will have $ 171,952.00 / over 15 years it grows to $295,000.

Obamacare only works if you are broke (or math challenged!) OR are an insurance company.

Believe what you want, like I said no skin off my nose.

Sorry. But lets be real.....800K for 24 hours of care?

If you are going to make crap up, at least make it believable.

 

[william the wie]

With medevac fixed and rotary wing aircraft and being in a very remote location when help is needed that kind of bill does happen. But unless the incident happened in say Africa highly unlikely. Given bloodbank contamination in Africa and standard leukemia treatments then yeah it is possible.

 

[baker001]

Dead in 24 hours and $800K in medical bills? Sounds like a bullshit story to me.

Did they gold-plate the body?

But for sake of argument let's pretend your anecdote is true- So what? I'd be dead!!!! and my medical debt would die with me

I only keep 6 months of living expenses in the bank. The rest of my assets are protected in trusts, Corporations, IRA's and LLC's. My heirs would get their full inheritance unencumbered.

As for $130K being enough to self insure- that's just the amount of premium I will save in the first 10 years. In 15 years I will have saved over $200,000 assuming the money earns ZERO interest. If I invest the $1085 per month in an investment that averages 5% over the next 10 years I will have $ 171,952.00 / over 15 years it grows to $295,000.

Obamacare only works if you are broke (or math challenged!) OR are an insurance company.

Believe what you want, like I said no skin off my nose.

Sorry. But lets be real.....800K for 24 hours of care?

If you are going to make crap up, at least make it believable.

Why would I make it up? I'm trying to point out something could help a person make a less risky financial choice.

If you're curious, he was transferred between two hospitals by life flight, that alone was billed at $30k (my boss was so taken aback by the amount she mentioned it specifically). An ICU bed at two hospitals, specialists, tests out the wazoo, I could see it getting that high that fast. If you haven't been hospitalized in the last 10 years you may not be aware of how much all this stuff costs these days. A normal run-of-the-mill medical emergency, even a serious one, wouldn't be nearly as much I agree. But this wasn't a typical case.

The point was, that this healthy person that never used his health insurance outside of routine check-ups for almost 60 years of his life, went from healthy to dead in very short order and without insurance would have bankrupted his widow (and these are not people without means). Trying to sign up for health insurance after that fact wouldn't have worked/helped (which is what Zander stated was his/her grand plan in his/her original post) and no time for medical tourism to get cheaper care (not to mention he wouldn't have been stable enough to leave the country, they barely got him stable enough to move him 10 miles to a hospital with more resources to try and help him).

Are the odds a long shot of something similar happening to you? Possibly, maybe even probably . One I'd be willing to take? Not in a million years.

Anyway, like I said, believe what you want. You want to take a chance that a medical disaster won't befall you, or if it does you'll have scraped up enough money to cover it, knock yourself out. You might get lucky and it all works out. You might not and go bankrupt. Your life, your choice.

 

[Zander]

Believe what you want, like I said no skin off my nose.

Sorry. But lets be real.....800K for 24 hours of care?

If you are going to make crap up, at least make it believable.

Why would I make it up? I'm trying to point out something could help a person make a less risky financial choice.

If you're curious, he was transferred between two hospitals by life flight, that alone was billed at $30k (my boss was so taken aback by the amount she mentioned it specifically). An ICU bed at two hospitals, specialists, tests out the wazoo, I could see it getting that high that fast. If you haven't been hospitalized in the last 10 years you may not be aware of how much all this stuff costs these days. A normal run-of-the-mill medical emergency, even a serious one, wouldn't be nearly as much I agree. But this wasn't a typical case.

The point was, that this healthy person that never used his health insurance outside of routine check-ups for almost 60 years of his life, went from healthy to dead in very short order and without insurance would have bankrupted his widow (and these are not people without means). Trying to sign up for health insurance after that fact wouldn't have worked/helped (which is what Zander stated was his/her grand plan in his/her original post) and no time for medical tourism to get cheaper care (not to mention he wouldn't have been stable enough to leave the country, they barely got him stable enough to move him 10 miles to a hospital with more resources to try and help him).

Are the odds a long shot of something similar happening to you? Possibly, maybe even probably . One I'd be willing to take? Not in a million years.

Anyway, like I said, believe what you want. You want to take a chance that a medical disaster won't befall you, or if it does you'll have scraped up enough money to cover it, knock yourself out. You might get lucky and it all works out. You might not and go bankrupt. Your life, your choice.

Good for you. I hope you live a long and healthy life. When and if you get sick, I hope the insurance you are counting on is there for you. Hopefully there will be Doctors in the US that can get you the care you need.

I am not worried about a catastrophic event or illness that kills me quickly. I have a very large, low cost, life insurance policy that will provide for my loved ones if that happens

Meanwhile I will be enjoying my extra $13,000/year that I didn't waste trying to insure against a very unlikely actuarial risk.

 

[william the wie]

Zander, you might also want to disinvest, a lot. The damage to the economy from ACA is likely to be extreme and much more so in LA due to the MediCal reimbursement scheme CA is using. As in you may have to move to another state to find a doctor if you can't afford Concierge Care.