Originally Posted by Bad Dog

Is that $500 monthly (hmmmm), or a one-time yearly check from Trader Joe's? I suspect the latter. $500/12= $41.67/month. Ouch.

I have no doubt that the insurers will attempt to game the system. It will take at least two presidential election cycles to focus the anger on the insurers, and cheap employers. And two more to get a Supreme Court to lay the smack down on greedy bastards. By 2040, a better healthcare system should start to emerge. Just in time to die.

Don't forget the federal subsidies.

There's 6 million people who will not be part of the Medicaid expansion but will still pay less than $100 per month; that $42 cuts that in about half.

Here's a no bullshit calculator to see what subsidies will be applied to your premium -

http://kff.org/interactive/subsidy-calculator/

If your in a state with an exchange, you can figure this out pretty quick. If your governor is GOP, you're probable screwed - at least for a while.

Looks like about $200/month for a silver (70%) plan, since I don't smoke. I'll have to max out my HSA to cover everything until I get my tax credits. In my reduced circumstances, that's still going to hurt.

The 60/70/80/90 structure could be pretty brutal, for those who can only afford the bronze 60% plan.

This was a sweet deal for the insurers. Not bad for the employers, as well. Everybody who wanted a single-payer plan has a reason to bitch. Better than nothing, though.

A government buyout of the health insurance industry by 2050?

Oh, yeah. My out-of-pocket max with the silver plan is over $6000. That's $500/month. Paiiiinnnn...

Originally Posted by Bad Dog

Oh, yeah. My out-of-pocket max with the silver plan is over $6000. That's $500/month. Paiiiinnnn...

Yeah, that does sound painful. Did it explain co-pays? Just curious.

Originally Posted by Bad Dog

Looks like about $200/month for a silver (70%) plan, since I don't smoke. I'll have to max out my HSA to cover everything until I get my tax credits. In my reduced circumstances, that's still going to hurt.

The 60/70/80/90 structure could be pretty brutal, for those who can only afford the bronze 60% plan.

This was a sweet deal for the insurers. Not bad for the employers, as well. Everybody who wanted a single-payer plan has a reason to bitch. Better than nothing, though.

A government buyout of the health insurance industry by 2050?

Ah, I don't know your exact situation nor can I be your tax adviser, but I hope you realize that if you know you will be in for a big tax credit, you can adjust your withholding to keep that money in your pocket. The govt doesn't need your interest-free loan. It fact, the people that sign you up can take care of this for you upfront.

Here's some actual help -

How the subsidy works. The subsidy for health insurance is technically a tax credit, which would normally reflect on a taxpayer’s returns each year. However, since many low- and middle-income families can’t afford to pay insurance premiums without help upfront, this credit works differently.

Instead of applying when they file their taxes, eligible individuals and families can apply for this tax credit when they sign up for insurance. The government will calculate how much is owed in the tax credit, and the amount will be paid directly to the insurance company. Then, the insured person only needs to pay the remaining portion of the premium (normally paid out in monthly installments) to the insurer.

If individuals or families choose to apply for the credit when they file their taxes, this will be a refundable credit. Those who can afford to pay their health insurance premiums throughout the year may take that route, in which case the subsidy will first pay down any taxes the individual has due, and whatever is left over will be distributed as a tax refund.

While the first option – receiving the payout upfront – is more manageable for many families, make sure to calculate your income correctly. If your income increases, and it turns out that your advance payment was too large, you’ll have to repay at least a portion of the overpayment. How much of the overpayment you’ll be required to repay will depend on how far above the FPL you are.

Originally Posted by Bad Dog

Oh, yeah. My out-of-pocket max with the silver plan is over $6000. That's $500/month. Paiiiinnnn...

That $6000 max is the catastrophic part of this insurance. That is the maximum you would have to pay if something real serious like a major injury or illness befalls you. If you max out, you will be having a lot more to worry about than your finances - like staying alive. However, this provision ensures you will never have to worry about going bankrupt over a serious illness or injury.

Oh, just in case this is not know, the $6000 includes your premiums, co-pays and deductibles. If you pay 200 per month, that's 2400. Then let's say your deductible is 500 - that brings you to 2900, leaving, at most, $3100 you might be on the hook for, even if you are having $250,000 brain surgery and recovery from a motorcycle accident (it happens).

That 3100 at the 70% Silver Plan level translates to your insurer paying 10,333 and from there, the insurer pays 100% - you don't even have to make your premium payments any more in that year or subsequent years if that motorcycle accident keeps you down. You will have a lot more on your plate that what your poor insurer is having to pay, but at least going bankrupt will not be one of things you have to worry about.

Oh, and like my mom, wife, sisters, daughter tell me every chance they can - "stay off that F'n motorcycle!"

Originally Posted by Bad Dog

Looks like about $200/month for a silver (70%) plan, since I don't smoke. I'll have to max out my HSA to cover everything until I get my tax credits. In my reduced circumstances, that's still going to hurt.

The 60/70/80/90 structure could be pretty brutal, for those who can only afford the bronze 60% plan.

This was a sweet deal for the insurers. Not bad for the employers, as well. Everybody who wanted a single-payer plan has a reason to bitch. Better than nothing, though.

A government buyout of the health insurance industry by 2050?

But would you be eligible for the silver plan if you smoked marijuana, crack, or black tar heroin instead of tobacco?

Originally Posted by Deb C

Yeah, that does sound painful. Did it explain co-pays? Just curious.

Negative. Don't have that information yet. Waiting on 1 OCT.

Originally Posted by playwrite

That $6000 max is the catastrophic part of this insurance. That is the maximum you would have to pay if something real serious like a major injury or illness befalls you. If you max out, you will be having a lot more to worry about than your finances - like staying alive. However, this provision ensures you will never have to worry about going bankrupt over a serious illness or injury.

Oh, just in case this is not know, the $6000 includes your premiums, co-pays and deductibles. If you pay 200 per month, that's 2400. Then let's say your deductible is 500 - that brings you to 2900, leaving, at most, $3100 you might be on the hook for, even if you are having $250,000 brain surgery and recovery from a motorcycle accident (it happens).

That 3100 at the 70% Silver Plan level translates to your insurer paying 10,333 and from there, the insurer pays 100% - you don't even have to make your premium payments any more in that year or subsequent years if that motorcycle accident keeps you down. You will have a lot more on your plate that what your poor insurer is having to pay, but at least going bankrupt will not be one of things you have to worry about.

Oh, and like my mom, wife, sisters, daughter tell me every chance they can - "stay off that F'n motorcycle!"

Right about the motorcycle. Need more data after the exchanges open on 1 OCT, to have a complete picture. The Kaiser online calculator is interesting. I'll need to see what Missouri offers before making an informed choice.

Deb, look what BJC is doing:

http://www.stltoday.com/business/loc...17a0643a1.html

My mom worked 30+ years for Deaconess, and while I was under 18, I got my coverage there as part of her benefits. That's one of the few reasons many RN's, etc stick around in a soul-grinding environment.

And, BJC is Wash U's teaching hospital. LOTS of potential future candidates are going to get shafted.

http://www.stltoday.com/business/loc...f601cb355.html

We are dying as fast as we can for you.

Originally Posted by Bad Dog

Deb, look what BJC is doing:

http://www.stltoday.com/business/loc...17a0643a1.html

My mom worked 30+ years for Deaconess, and while I was under 18, I got my coverage there as part of her benefits. That's one of the few reasons many RN's, etc stick around in a soul-grinding environment.

And, BJC is Wash U's teaching hospital. LOTS of potential future candidates are going to get shafted.

Yeah, I saw that on the news last evening. This will have a negative impact on the lives of so many. And to think that this sort of thing is happening all over the state and the country.

Some health systems and hospitals are tightening their benefits, Kopp said, because “the health care industry is under a lot of strain right now.”

“Pressures are being put on the hospitals to cut their costs,” he said. “The Affordable Care Act is not just about the public paying more to get health care coverage. Hospitals are getting cuts too. They are struggling to remain viable.”

The insurance industry are the real winners in the ACA. But then, we could have expected as much since the industry was the main creators of the program.

Bad Dog, I forgot to mention how many layoffs the hospital has had earlier this year. Our friends who still have jobs say that the pressure is intense to make up for the work of those who have been laid off.

Not to mention, that requiring more hours for benefits, cuts out the second jobs that many of these employees have to make ends meet. It's just a shame that many have to work under increasing stress just to maintain insurance that mainly serves the corporate interest.

I'm probably one of the few who say this, but I believe in a 2 (or more) tier system of healthcare. This ensures that everyone has basic healthcare, but rewards achievement in a capitalistic society with better service with limited resources. See my following post on a "Baseline Economy" in the Socialist America thread.

Originally Posted by Ghost Echo

I'm probably one of the few who say this, but I believe in a 2 (or more) tier system of healthcare. This ensures that everyone has basic healthcare, but rewards achievement in a capitalistic society with better service with limited resources. See my following post on a "Baseline Economy" in the Socialist America thread.

In reality (all hype aside) wasn't this the premise of "Romney-care" in MA?

Originally Posted by Deb C

Bad Dog, I forgot to mention how many layoffs the hospital has had earlier this year. Our friends who still have jobs say that the pressure is intense to make up for the work of those who have been laid off.

Not to mention, that requiring more hours for benefits, cuts out the second jobs that many of these employees have to make ends meet. It's just a shame that many have to work under increasing stress just to maintain insurance that mainly serves the corporate interest.

Remember that next time you whine about Obamacare not actually cutting medical costs.

Just what do you think cutting medical cost was going to entail - magic ponies pooping out free syringes???

Poor ponies. That sounds painful.

What will be painful is a nursing staff that's increasingly over worked. Quality of care will deteriorate under an already stressful job. Since most part time work done by nurses is on the weekend, more 12 hour shifts will be required. While many nurses already do this, it being mandatory, will make patient care more at risk for mistakes. There's already an abundant number of patients dying or made more ill by human error in hospitals, wait till they add fatigue to the mix.

Originally Posted by Ghost Echo

I'm probably one of the few who say this, but I believe in a 2 (or more) tier system of healthcare. This ensures that everyone has basic healthcare, but rewards achievement in a capitalistic society with better service with limited resources. See my following post on a "Baseline Economy" in the Socialist America thread.

But even that's not good enough for the Social Darwinists - and so long as their political adversaries continue to talk out of their derrieres on virtually every other topic besides the economy, they have an outstanding chance of getting their way.

http://www.washingtonpost.com/blogs/...-even-help-it/

Wonkbook: Shutting down the government won’t stop Obamacare. It might even help it.

There's a cold logic behind the willingness of some conservatives to risk everything to stop Obamacare. But it's not that Obamacare will fail. After all, if the law will just be a debacle, Republicans should let it take effect, ride the catastrophe to overwhelming victory in the 2014 midterms, and then use their massive congressional majorities to repeal it.

Rather, as EJ Dionne writes, the real fear is that the law will succeed. Once Obamacare begins delivering health insurance to millions of Americans it will become effectively impossible to repeal. That's what's happened in every other country that's introduced a national health-care system. That's why the right needs to stop Obamacare before it begins.

The irony of their strategy, though, is that shutting down the federal government won't stop Obamacare. It might even help it.

The Congressional Research Service put it bluntly -- well, bluntly given the cautious, careful language favored by the CRS -- in a July report. "It appears that substantial ACA implementation might continue during a lapse in annual appropriations," they wrote.

There are a few reasons for this. For one thing, the lapse in appropriations only hits so-called "discretionary" funding. But the ACA's core functions are on the "mandatory" side of the budget. So, for instance, the money for tax credits and Medicaid expansion would arrive on schedule. State and federal exchanges would still operate. The individual mandate would still be in place.

So a lot of the law's funding would be unaffected. Meanwhile, the more marginal spending that is affected could be backfilled by the Obama administration moving mandatory money around, and even going beyond that, the White House could argue that crucial positions fall into the bucket of essential personnel who are protected during a government shutdown. So while it wouldn't be ideal, implementation would move forward.

But it gets worse for Republicans from there.

Obamacare's first year will be full of glitches and hiccups and mistakes and misfires. That's true for every big, complicated law (remember when Boehner called Medicare Part D's implementation "horrendous"?). The expectation is that Republicans will be able to take advantage of those problems. But if the early implementation comes in the context of an extended government shutdown, Republicans might well get blamed for implementation glitches as the media and voters ask whether the law wouldn't work more smoothly if the GOP hadn't turned out the lights.

Moreover, if Republicans get blamed for an annoying and unpopular government shutdown -- not to mention for some of Obamacare's problems -- that might blunt the gains they're likely to make in the 2014 midterms. More Democrats in Congress means more protection for Obamacare going forward.

So a government shutdown won't stop Obamacare from being implemented, but it might mean Republicans get blamed for some of the problems of implementation, and lose the ability to benefit politically from the inevitable hitches in the rollout.

The conservatives who won't yield against Obamacare might ultimately prove to be the law's best friends.

More often than not the sheer stupidity of the GOP really puts a hurt on the country. However, there are times when it puts a smile on my face.

...but let's keep this quiet for the next few weeks.

- the stop Obamacare morons must of hired Todd Akin as their media strategist to reach out to women -

http://news.yahoo.com/obamacare-batt...200027191.html

Creepy Obamacare ad hits college campuses and your nightmares

Here's what the ACA offers in just free preventative care to women -

All Marketplace health plans and many other plans must cover the following list of preventive services for women without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

Anemia screening on a routine basis for pregnant women
Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer
Breast Cancer Mammography screenings every 1 to 2 years for women over 40
Breast Cancer Chemoprevention counseling for women at higher risk
Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
Cervical Cancer screening for sexually active women
Chlamydia Infection screening for younger women and other women at higher risk
Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
Domestic and interpersonal violence screening and counseling for all women
Folic Acid supplements for women who may become pregnant
Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
Gonorrhea screening for all women at higher risk
Hepatitis B screening for pregnant women at their first prenatal visit
HIV screening and counseling for sexually active women
Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older
Osteoporosis screening for women over age 60 depending on risk factors
Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
Sexually Transmitted Infections counseling for sexually active women
Syphilis screening for all pregnant women or other women at increased risk
Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
Urinary tract or other infection screening for pregnant women
Well-woman visits to get recommended services for women under 65

Here's what it offers free for the children that women bring into the world -

Coverage for children’s preventive health services

All Marketplace health plans and many other plans must cover the following list of preventive services for children without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

Autism screening for children at 18 and 24 months
Behavioral assessments for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
Blood Pressure screening for children at the following ages: 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years.
Cervical Dysplasia screening for sexually active females
Depression screening for adolescents
Developmental screening for children under age 3
Dyslipidemia screening for children at higher risk of lipid disorders at the following ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
Fluoride Chemoprevention supplements for children without fluoride in their water source
Gonorrhea preventive medication for the eyes of all newborns
Hearing screening for all newborns
Height, Weight and Body Mass Index measurements for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
Hematocrit or Hemoglobin screening for children
Hemoglobinopathies or sickle cell screening for newborns
HIV screening for adolescents at higher risk
**Hypothyroidism screening for newborns
Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:

Diphtheria, Tetanus, Pertussis
Haemophilus influenzae type b
Hepatitis A
Hepatitis B
Human Papillomavirus
Inactivated Poliovirus
Influenza (Flu Shot)
Measles, Mumps, Rubella
Meningococcal
Pneumococcal
Rotavirus
Varicella
Iron supplements for children ages 6 to 12 months at risk for anemia

Lead screening for children at risk of exposure

Medical History for all children throughout development at the following ages: 0 to 11 months, 1 to 4 years , 5 to 10 years , 11 to 14 years , 15 to 17 years.
Obesity screening and counseling
Oral Health risk assessment for young children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
Phenylketonuria (PKU) screening for this genetic disorder in newborns
Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
Tuberculin testing for children at higher risk of tuberculosis at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
Vision screening for all children.

And the morons on the Right want to equate that to a creepy Uncle Sam looking up your crotch???

Just how stupid does the Right think women are?

It's really amazing.

Originally Posted by Ghost Echo

I'm probably one of the few who say this, but I believe in a 2 (or more) tier system of healthcare. This ensures that everyone has basic healthcare, but rewards achievement in a capitalistic society with better service with limited resources. See my following post on a "Baseline Economy" in the Socialist America thread.

In terms of practical politics this may have been easier to sell than Obamacare...and perhaps, thus, have a better chance at enduring.

Last year, I canvassed for Team Obama in the outskirts of Northern VA - highly contentious areas around Manassas. To tell you the truth, I was a little nervous because it was not only obviously Romney country but gun tottin folks a-plenty (I kept mine in the car).

I was amazed, and made less anxious, by how the campaign had me going exactly to homes of Obama supporters/lean'ers that had not the best track records for turnout. It explaine why I never was sent to homes with Obama signs all over the yard - those people were going to get to the voting booths come what may. The folks I went to wanted to vote Obama but to varying degrees may not actually make it to the polling booths. We offered them car rides on voting day, but the big thing was just having someone from the campaign come to their door, thank them for their past voting, and offer whatever help needed to get them out to vote on the big day. That alone really made a difference in Virginia and I imagine everywhere else. It was also obvious that the GOP had nothing like this and their capacity for GOTV was the butt of a lot of jokes. I read an article that the computer geeks that make this all possible are solidly Progressives and that this is going to have an ever increasing impact on election outcomes - think Nate Silver analytics versus the typical Faux News talking head's gut feeling (e.g. Karl Rove).

Now that intelligence is being applied to the ACA rollout -

http://www.washingtonpost.com/blogs/...the-uninsured/

Obama campaign’s data team has a new mission: Mapping the uninsured

Civis Analytics, a data analysis firm based in Chicago, was founded by alumni of the Obama campaign, who spent years figuring out how to find specific voters – and convince them to vote for Barack Obama.
Now, some of their analysts have turned their number-crunching skills to Obamacare and created one of the most detailed maps of where the uninsured live. The idea was to give the people doing enrollment a better sense of where, exactly, to focus their efforts.

"We came to this because it is a big and difficult problem," says Kate Jordan, engagement manager at Civis. "There are a lot of people who want to enroll individuals, but it's a small percentage of the population, about 15 to 16 percent nationally, and you have limited time and resources. How do you decide whose door to knock on, or where is it best to have your community events?"
Civis's map has an uninsured rate for each census tract, which usually includes about 1,000 or so people. This is a pretty granular level of detail: There are over 70,000 census tracts across the country, usually about the size of one neighborhood. The District of Columbia alone is divided into 179 different jurisdictions. And here's what the city looks like, when you break it down by the uninsured rate of each jurisdiction:...

Be sure to check out the detail of the example maps.

Think about that the next time you see in the news some beer-soaked fraternity event put on by the Right with some dressed-up clown in a creepy Uncle Sam running around and insulting the intelligence of the women.

Any doubt how this is going to turn out?

Originally Posted by TimWalker

In terms of practical politics this may have been easier to sell than Obamacare...and perhaps, thus, have a better chance at enduring.

If one can break out of the non-realistic choice of one or the other and look at it as a step in the correct direction, things get a little clearer.

I realize that just adds to the panic and desperation on the Right, but for my friends on the Far Left, maybe, some consolation

The scary thing about the ACA (Obamacare) is the way the subsidies are paid out. If I understand it correctly, one has to pay the monthly premium in full and then gets reimbursed via tax credits when their tax return is processed the following year. I don't know how it is for most people, but I'd be unable to afford to add another $350 monthly bill to my budget. Even after one pays the premium, the coverage is very poor for the two least expensive plans and involves a lot of out of pocket expense and a high deductible. I fear the ACA will be unworkable for many if not most working people.

Bri2k