The rates are in

Health and Human Services has released the rates for the federally run Exchange marketplaces in 36 states.  They are really good:

http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/ib_marketplace_premiums.cfm

Here are the big take-aways:

  • $145 a month for the cheapest Bronze plan for a 27 year old making $25,000 a year is definately affordable
  • Family coverage at either 2nd cheapest Silver or cheapest Bronze is extraorinarily affordable —
  • Competition does wonders
  • Networks matter, some pricing will be higher in outlier counties compared to core counties.

This thing is going to work.






331 replies
  1. 1
    PaulW says:

    This thing is going to work.

    Until the Republicans sabotage everything with the debt ceiling hostage taking.

    I am wondering if the Republicans’ efforts to kill government like this falls under the legal definition of sedition. Anyone got a copy of the U.S. Code handy?

    EDIT: I’ve got a link right here http://www.law.cornell.edu/uscode/text/18/2384

    If two or more persons in any State or Territory, or in any place subject to the jurisdiction of the United States, conspire to overthrow, put down, or to destroy by force the Government of the United States, or to levy war against them, or to oppose by force the authority thereof, or by force to prevent, hinder, or delay the execution of any law of the United States, or by force to seize, take, or possess any property of the United States contrary to the authority thereof, they shall each be fined under this title or imprisoned not more than twenty years, or both.

    Granted, the GOP Congress won’t be using force, but they are using the power of their office, which can be backed by force if they call for it.

  2. 2
    Zifnab says:

    When you add in what my employer is paying, I think a number of these rates are lower than what I’m paying right now. :-p

  3. 3
    Shakezula says:

    Lies! All lies by evil Democrats and liberals with their numbers and math! And health insurance is un-Christian! If everyone would surrender their money to my talevangical friend’s church souls to Jesus they wouldn’t get sick! Hey, you know who else had health insurance? Hitler! And Darth Vader!

    /Standard RW Denial

    Now if you could … Ahem.

    $145 a month for the cheapest Bronze plan for a 27 year old making $25,000 a year is definately affordable
    Family coverage at either 2nd cheapest Silver or cheapest Bronze is extraorinarily affordable –

  4. 4
    eric says:

    @Zifnab: and THAT is the true goal of Obamacare….stop tying health care to employment and the economy will boom because people will take more chances and risks because they are not exposing themselves to catastrophic health care costs.

  5. 5
    I'mNotSureWhoIWantToBeYet says:

    $145 a month for the cheapest Bronze plan for a 27 year old making $25,000 a year is definately affordable

    With respect, for some people making $25k a year, having $5 a month left over by the end of the month is a great victory. “Affordability” isn’t a universal attribute that can be determined by looking at two numbers.

    Low rates are great, but there are going to be some people who are going to have to really struggle to pay the low rates, and some cases even with subsidies. Let’s not go overboard and say that everyone can afford these rates.

    My $0.02.

    Cheers,
    Scott.

  6. 6
    peach flavored shampoo says:

    •Networks matter, some pricing will be higher in outlier counties compared to core counties.

    So the rural, likely red voters will pay higher than the urban, blah Dem voters? If I’m interpreting this correctly, expect this to become a HUGE talking point.

  7. 7
    Jake Nelson says:

    Minnesota: $192 for the second-lowest Silver plan. Mississippi: $342 for the lowest Bronze.

    Maybe some people in the South should take a look at why they’re getting screwed. (We know why, but, y’know, the South…)

  8. 8
    Violet says:

    $145 a month for the cheapest Bronze plan for a 27 year old making $25,000 a year is definately affordable

    Seriously? Is that with a subsidy? I’m not sure I agree with that assessment.

  9. 9
    Gin & Tonic says:

    Whoever designed the NY State web site for this program should be sent out on an ice floe to die. There is absolutely no way to determine premiums short of downloading an Excel spreadsheet to my computer. What if I don’t have a desktop machine, or don’t have one I control?

  10. 10
    Sister Rail Gun of Warm Humanitarianism says:

    @peach flavored shampoo: Yup. I plan to throw the market back at them.

    “It’s because you’re living in an area that doesn’t have much competition to drive down the costs.”

  11. 11
    FoxinSocks says:

    @I’mNotSureWhoIWantToBeYet:

    Yes, this is one point I don’t think the Democrats understand: $145 a month for health insurance should be affordable, but in this terrible economy, the number is terrifying. I know there will be subsidies, but even if I had to pay $50 extra a month right now, I’d be very stressed. (And yes, when I didn’t have insurance, that was terrifying and stressful too)

    I wholly support Obamacare. It’s already saved one of my friend’s from medical bankruptcy, but I don’t think the Democrats understand how tight things are for ordinary people.

  12. 12
    pamelabrown53 says:

    Living in Florida, there is no exchange info. available til Oct. 1. So yesterday I called my insurance co. (I’m self-insured), BC/BS of FL. to find if they are participating in the exchange. Talked to an Obamacare expert (their term!) and yes they are participating. The really good news is that there will be 10 co. on the exchange. This shocked be because the level of nasty obstructionism from of Tea Party governor has been off the charts. I expected 2 or 3 co., meaning little or no competition.

  13. 13
    Jake Nelson says:

    Violet: With subsidy, at 25K, it’s $0.

  14. 14
    jl says:

    @Jake Nelson: The geographic patterns aren’t what I expected, given historical distribution of per capiita health care expenditure. I wonder if there are any systematic differences between states that set up their own exchanges versus those that did not and are throwing their fates to the Great Satan, the federal government?

    And don’t tell Cole since it may throw him into one of his ‘fits’, but looks like the NYT is going for some misinformed Debbie Downerism on the rates:

    NYT Is Badly Confused on Obamacare, Mistakes Mid-Price Plan for Low-Price Plan
    Dean Baker, Beat the Press
    http://www.cepr.net/index.php/.....price-plan?

  15. 15
    Gordon, the Big Express Engine says:

    http://www.forbes.com/sites/th.....for-women/

    Rich – my glibertarian buddy sent me this. A lot to unpack here. Is the issue mainly that the states that are dragging their feet on setting up the exchanges, the ones seeing the biggest rate increases (at least how these guys late things out)?

  16. 16
    Jake Nelson says:

    @jl: Well here in MN, all insurance companies have to be nonprofits by law. Now, “nonprofits” can still pay their execs an absurd amount (UnitedHealth paid its CEO $1 billion one year (yes, with a B)), so it’s mostly a technicality, but it takes another wedge out of the “where the money goes” chart.

    So state-by-state regulation is likely to play a role.

  17. 17
    Fair Economist says:

    @Zifnab:

    When you add in what my employer is paying, I think a number of these rates are lower than what I’m paying right now. :-p

    Generally speaking, these rates are going to be lower than what a typical business pays because of standardization, competition, and subsidies. There’s going to be a stampede of business trying to get into the exchange system. A poorly anticipated side-effect, and one that’s going to be very harmful to Republicans because now Democrats will soon offer legislation bringing huge cuts to business health insurance costs while Republicans will be trying to deny it.

  18. 18
    Kay says:

    @I’mNotSureWhoIWantToBeYet:

    You really do have to compare it with what an insured 27 year old who makes 25k a year is currently paying out of pocket, though.

    There’s only two groups of 27 year olds who make 25k a year, the uninsured and the insured. There is no third group of “insured, pay nothing”. The intent was to put those two groups in a comparable situation.

    If the insured are currently paying X out of pocket (not even counting their employer share) they couldn’t put the uninsured on a better footing, or the currently insured 27 year old will think it’s unfair. And she’ll be right.

  19. 19
    Jim, Foolish Literalist says:

    @Violet: I don’t think so, this from Think Progress is little more complete

    a 27-year old who does not qualify for tax credits will pay, on average, $163 for a plan that covers approximately 60 percent of health care expenses (a so-called bronze-level plan), while a 27-year-old with an income of $25,000 could pay $83 dollars per-month after subsidies. Individuals up to 30 years old will also have the option of buying cheaper catastrophic coverage outside of the marketplaces, though they will not qualify for subsidies. A family of four in Texas with an income of $50,000 would pay as little as “$57 per month for the lowest bronze plan after tax credits,” the report finds.

    Still seems a bit high to me, I started self-insuring at 35 (non-smoker) for a hundred a month ten years ago (those premiums sky-rocketed when I turned forty, however).

    Just caught the video, Senator No-Second-Tier-Ivies just said that Neville Chamberlain and the British stood by to watch the rise of the Nazis in the 1940s. And is any finger-wagging, chin-stroking Bothsidesist going to notice the comparison of health insurance to the Final Solution?

  20. 20
    Jim, Foolish Literalist says:

    @FoxinSocks: Yes, this is one point I don’t think the Democrats understand:

    Which Democrats? Mary Landrieu and Mark Pryor? Or Al Franken and Barbara Mikulski?

  21. 21
    Fair Economist says:

    @Jake Nelson:

    Minnesota: $192 for the second-lowest Silver plan. Mississippi: $342 for the lowest Bronze.

    Personal cost of having Republicans run your state: Over $2,000/ per year.

    The freight train is coming and the Republican clown car is stuck on the railroad crossing.

  22. 22
    Higgs Boson's Mate says:

    Having been poor enough times to know what it’s like to pray that a tire doesn’t blow, or to chew on aspirins to pack them into the hole in my tooth where a filling came out, I can assure you that anything more than “free” is not remotely affordable for many working Americans. ACA is a good start. Hopefully, the teahadists will destroy themselves la terreur 1793 style so that future Congresses can expand and improve the thing.

  23. 23
    John says:

    For the federal exchange, it looks like $145 is the average cost for the Second Lowest Silver After Tax Credit plan for a 27-Year-Old with an Income of $25,000. The average for a the lowest bronze plan, after tax credit, is $93.

    Also, in states with more expensive plans, the tax credit is greater.

    John

  24. 24
    JPL says:

    @Fair Economist: Republicans will convince their constituents, it’s Obama’s fault. Their no plan would save them money.

  25. 25
    Elizabelle says:

    @Fair Economist:

    The freight train is coming and the Republican clown car is stuck on the railroad crossing.

    Oh, I hope so.

  26. 26
    jl says:

    @Gordon, the Big Express Engine: I skimmed it. Roy is an ideological hack. First he seems to intentionally misunderstand, or misrepresent, what the HHS means by rates being ‘lower than expected’. to paint the HHS as intentionally misleading people.

    The HHS did not say the rates were lower than the cheapest plan a person can buy now. Roy also does not adjust cost for benefits. The cheapest plans you can buy now are very skimpy catastrophic plans that don’t cover much, or little more than scams (like the bogus out-of-state plan one of my relatives had that knew how to collect premiums, but never figured out how to pay a claim).

  27. 27
    fuckwit says:

    I dunno, the California numbers are fucking scary for me. I can’t affort $300/mo, that’s nuts.

    I could maybe afford $50/mo, maybe $100/mo.

    In other words, in order to not destroy me, the rates need to be in the range of a cell phone payment, not a car payment. Though I guess it’s certainly an improvement over rates in the range of apartment rent or mortgage payment.

  28. 28
    Kay says:

    @I’mNotSureWhoIWantToBeYet:

    I say that because that’s what I hear. We have a large group of young people who are insured even with relatively low wages because it’s a manufacturing area, and manufacturers still offer health insurance.

    What they ask is if people “like them” will get “free” insurance, when they don’t. They make about 25-30K, and they pay varying amounts towards employer-provided insurance, but 100 a month isn’t uncommon.

  29. 29
    FoxinSocks says:

    @Jim, Foolish Literalist:

    All of the above AND the Obama administration. Barbara Mikulski is my senator. I think she does a great job, but when I call her office…no, I don’t think she understands how bad the economy is. So many of my friends who have college degrees and used to make good money are just barely surviving. It’s exhausting. I don’t blame the dems, of course, I blame the Republicans, I just wish the dems would fight a bit harder.

  30. 30
    carbon dated says:

    @Gin & Tonic: They will send out hard-copy packets starting on Oct 1 (if you ask for them), or if you’re jonesing to know what’s on that spreadsheet right now you can call and they have a human on hand to walk you through it: 855-355-5777. (I’m waiting until next week)

  31. 31
    maye says:

    I just got off the phone with CIGNA and learned that beginning Jan. 1, no insurance company will be able to deny coverage for PEC, and the only reason to buy insurance on the exchange is if you qualify for government subsidies. CIGNA, not on the exchange in California, will have to sell me a policy for the same rate as one of the companies on the exchange. No more, no less. It will be interesting to see how long these companies will continue their “individual” policies once they have to follow all the ACA rules.

  32. 32
    Belafon says:

    @JPL: Which is exactly thinking down here for a lot of people. Forcing them to pay for something in advance, even if it is cheaper in the long run, is a violation of their right to keep all their money in their mattress. Even if all it’s doing is allowing companies to continue to underpay everyone.

  33. 33
    shelly says:

    If I had my way…..

    The Republicans can badmouth Obamacare all they want but they just can’t use the word ‘trainwreck’ anymore.

  34. 34
    maye says:

    @fuckwit: did you check on the subsidy calculator at Covered California? The numbers being quoted in all the news stories are before the subsidies are calculated.

  35. 35
    jl says:

    @fuckwit: I think you are looking at rates before subsidies. the link in the post says that

    ” After taking tax credits into account, fifty-six percent of uninsured Americans (nearly 6 in 10) may qualify for health coverage in the Marketplace for less than $100 per person per month, including Medicaid and CHIP in states expanding Medicaid. “

  36. 36
    Villago Delenda Est says:

    This thing is going to work.

    Not if Rafael Cruz has anything to say about it!

  37. 37
    jl says:

    @maye: Thanks. I get from Covered California calculator, in SF Bay, single 35 year old with no dependents at 25K per year pays between 60 (bronze) and 90 (Platinum) bucks per month. The cost seems to be about the same in various podunkville areas of CA.

  38. 38
    grape_crush says:

    > This thing is going to work.

    No it won’t.

    I mean, it will, but there’s going to be a ton of glitches and stories of bad experiences, magnified a hundredfold by people who need to find glaring examples of how the PPACA ‘failed’.

    Same thing happened with Social Security and Medicare. Implementation isn’t going to be perfect or flawless in any project of this size. That’s the reality, and our expectations should be reasonable.

  39. 39
    kc says:

    $145 a month for the cheapest Bronze plan for a 27 year old making $25,000 a year is definately affordable

    Spoken like someone who makes a lot more than $25,000.00 a year. No offense.

  40. 40
    Higgs Boson's Mate says:

    @jl:

    Are those tax credits applied to withholding or are they applied to your annual income tax? If it’s the latter then those who are struggling are still screwed. Waiting for payday can be an eternity, waiting for an annual tax credit will be impossible for many.

  41. 41
    liberal says:

    @I’mNotSureWhoIWantToBeYet:

    Let’s not go overboard and say that everyone can afford these rates.

    Spot on.

    I make a lot more money than $25K/yr, but it doesn’t take much imagination and economic awareness to figure out that that’s a lot of money to some people.

  42. 42

    @Jake Nelson: One reaction I’ve already seen to these numbers is “everyone not in Minnesota should be angry at their state government.”

  43. 43
    kc says:

    Where’s the info for people who are older than 28?

  44. 44
    jibeaux says:

    This might be a straightforward question or a difficult one, I don’t know, but I know the exchanges can’t deny you coverage based on a pre-existing condition, but how does it handle rates with pre-existing conditions? My self-pay plan didn’t require a physical, but it did ask about several conditions in particular, and came in higher than the “rack” rate. For one of them, I know there’s a common, very heavily-advertised and very expensive non-generic medication which I have already considered and ruled out. I wanted to put that in an asterisk — “but I promise I will not ask for Xyzelifesiax!”

  45. 45
    Shakezula says:

    @FoxinSocks: Have you tried Cardin’s office?

  46. 46
    liberal says:

    @FoxinSocks:

    I don’t think she understands how bad the economy is.

    I don’t understand this crap—all one has to do is read any one of a zillion bloggers (Krugman, Atrios, perhaps some front pagers here) and realize that the emp to pop ratio hasn’t improved much at all.

    Even if you fetishize GDP, the growth numbers are anemic.

  47. 47
    Elizabelle says:

    @kc:

    Wait until that 27 year old breaks an ankle or an arm with a paying job — so she is not eligible for hospital “charity care” — and gets hit with a $12,000 medical bill.

    $145/month is $4.83/day.

    I would eat peanut butter sandwiches 6 times a week to get medical care when needed, and not worry at night about bankruptcy if I get knocked over by someone on a bicycle.

    No offense.

  48. 48
    Jake Nelson says:

    Bah, didn’t see my typo at #13 in time to edit it. Meant to say $90, but now I see that’s only one possible number depending on stuff anyway. But that neighborhood. I make <$10K/yr and pay about $90/mo for my employer's (super limited) plan, so it fits… wonder if they're going to drop part-timers next time around so we can get a better plan for the same rate off the marketplace (which is the thing that wasn't anticipated enough with this plan, people with employer coverage wishing they didn't have it…)

  49. 49

    Richard, I am trying to find the link to the official site to look at the costs of these plans…..I used it some months back but have lost it. Can you post the link? I am in AZ if that makes any difference at all.

    Also, at that time when I did a quote on the Bronze plan for my family (myself and my three year old son) they wanted to charge me $600 / mo, which I think is insane. I do have a pre-existing condition but that is prohibitively high. Heck that’s half my rent! That has to be wrong. Praying to FSM that it was wrong and why I want to check again. In the meantime I just got a short term major medical plan for my son only. I’m not worried so much for myself, but for him if something catastrophic should happen.

  50. 50
    I'mNotSureWhoIWantToBeYet says:

    @Kay: You make good points, and I agree with them.

    I just wonder if these stories that give pre-subsidy costs are scaring more people than necessary. People with low incomes generally don’t have $145 of disposable income lying around every month. If that $145 is actually closer to $100, and that $100 mostly offsets existing health insurance expenses, then it makes a huge difference. But if someone in that situation only sees a headline that Obamacare is going to cost them $145 a month, then they may just freakout and plan to pay the fine rather than investigating the real cost in their personal situation.

    HHS should be blanketing every available eyeball with this linky: https://www.healthcare.gov/families/ Let’s hope they do that soon.

    Cheers,
    Scott.

  51. 51
    jl says:

    Also, for all those people who whine about it being unfair because they perceive themselves as being young, or healthy or both, I think they have self-servingly and advantageously misinformed themselves about the reality of health care finance in the U.S.

    Due to federal and state regulations, everyone is covered for catastrophic health care. If they unexpectedly get sick or get hit by a bus, they can go to the ER, and if the ER cannot stabilize them, they get admitted to a hospital. Such people can easily rack up bills that they cannot pay. But they are not paying premiums, are they? So, are these people rugged self-sufficiently individuals or shirkers? Depends on how you look at it.

    Someone can say hell no they are healthy and that’s that. But as old Alexander Hamilton said, decisions on public policy are always ‘matters of probabilities’. And probability says, if you got some coverage you should pay some premiums.

    The rugged individuals who are whining should be writing their state and federal representatives to repeal laws and regs that require the health care system to provide care in life threatening situations, if they are serious, and not just shirkers.

  52. 52
    Robert says:

    Around $219-260 a month for a bronze plan in Jersey? My goodness. I can actually afford real insurance again. And it’s better than the crap insurance my substitute teacher hiring firm offers.

  53. 53
    MattR says:

    @jibeaux: I believe that they cannot charge you more based on pre-existing conditions. I think age and smoking status are the only two things they can factor into rates.

  54. 54
    kc says:

    @Elizabelle:

    Spoken like a true capitalist.

  55. 55
    jibeaux says:

    I do want to share the scenario of a woman I know, though. She is self-employed and does not make a lot of money. She has been paying steadily increasing self-pay rates which she can afford, barely, and has two kids who have been covered under her ex-husband’s policy. He unfortunately died this summer and she will have to insure them as well. The subsidies are going to be nothing short of salvation for that family. I mean, this is the situation that Republicans want to go back to — “sorry your dad died, kids, but work hard and maybe when you grow up you can be insured then.”

  56. 56
    jl says:

    @Higgs Boson’s Mate:

    From Covered California website:

    ” When you enroll in a health plan through Covered California, tax credits can be immediately applied to the insurance premium, which reduces the amount you pay each month. ”

    http://www.coveredca.com/coverage_basics.html

  57. 57
    maye says:

    @jibeaux: beginning Jan 1, Pre-existing conditions will not be used in calculating rates. Age and zipcode will.

  58. 58
    Chyron HR says:

    @kc:

    Where’s the info for people who are older than 28?

    Uh, duh, there isn’t any. Haven’t you heard about the Death Panels yet?

  59. 59
    maye says:

    @Ms. D. Ranged in AZ: you might be better off buying two individual plans rather than a family plan.

  60. 60
    MattR says:

    Anyone watching McCain on the Senate floor? As I commented in the “not a fillibuster” thread, he is doing a pretty good job of putting Cruz and others in their place. He is currently pointing out the inaccuracy and offensiveness of the Nazi appeasement comparison

  61. 61
    FoxinSocks says:

    @Shakezula:

    I’m a regular caller to both their offices. I’m surprised they don’t go, “Oh, it’s YOU again.” But in this case, I don’t have a specific constituent problem for them to address, I just want them to be more cognizant that the economy still sucks and can they please stop with austerity-lite. And when I tell their (very kind and patient) staffers that, I don’t get the sense that they really understand.

    Sorry, I’m just in a dour mood because thanks to the shutdown threat, my family is once again being hurt financially, so we’re trying to trim our already tight budget even more.

    Anyways, back to the ACA. I know there’ll be lots of problems with it, but I’m still excited for its roll-out.

  62. 62
    Elizabelle says:

    @kc:

    I am presently uninsured, kc.

    It’s such a relief to see affordable healthcare coming online.

    Do you think we’d be getting this option if it was free to everyone who felt they could not pay a cent for it?

    Why can’t your hypothetical 27-year old pay $145/month, or $36.35/week for medical insurance? Which could save her life, provide her birth control pills, keep her from bankruptcy if she has a terrible illness or accident?

    What do I not understand?

    Elizabelle the capitalist

  63. 63
    Elizabelle says:

    @MattR:

    Ha ha. McCain can see how bad the Cruzathon was for the Republican brand.

    (I personally loved the part where several GOP senators thundered that Obamacare passed without any Republican votes. That will look nice in political ads next fall.)

  64. 64
    Just Some Fuckhead, Thought Leader says:

    So what the hell was Obama talking about when he said health care coverage was cheaper than yer monthly cell phone bill? Is someone really paying that much for their monthly cell phone? If so, isn’t that a problem?

  65. 65
    kc says:

    @Elizabelle:

    Believe it or not, there are people who don’t have an extra $145.00 a month. They. Just. Don’t. Have. It.

    I agree it’s better to have health insurance, but if you can’t afford it, all the preaching in the world won’t change anything.

    Why aren’t you insured?

  66. 66
    Jim, Foolish Literalist says:

    @MattR: He is currently pointing out the inaccuracy and offensiveness of the Nazi appeasement comparison

    If John McCain could get some anger management therapy and be kept away from any and all discussions of foreign policy, he might pass for a decent Republican. And now that their War Hero Surro-Daddy has given them permission, maybe some Gasbags will notice this, too.

  67. 67
    Joel says:

    @grape_crush: Working, and the appearance of working in the eyes of partisans, are two different things. However things appear, we should ultimately be focused on outcomes.

  68. 68
    srv says:

    Obama personally destroys Michelle’s plan:

    Like an estimated 22 million other Americans, I am a self-employed small-business owner who buys health insurance for my family directly on the individual market. We have a high-deductible PPO plan that allows us to choose from a wide range of doctors.

    Or rather, we had such a plan.

    Last week, our family received notice from Anthem BlueCross BlueShield of Colorado that we can no longer keep the plan we like because of “changes from health care reform (also called the Affordable Care Act or ACA).” The letter informed us that “(t)o meet the requirements of the new laws, your current plan can no longer be continued beyond your 2014 renewal date.”

    In short: Obama lied. My health plan died.

  69. 69
    Joel says:

    @kc: This depends. In California or New York, $25k is outrageously pitiful. But health insurance costs are the least of that earner’s worries.

  70. 70
    jl says:

    @Just Some Fuckhead, Thought Leader: Are you snarking?

    You can get a prepaid go-phone and shell out the minimum refill every month I guess. What is that, ten or fifteen bucks? You going to complain if your health insurance is not that cheap?

    You want a contract, you gong to be able to talk for an hour a month on less than 60 bucks?

  71. 71
    Emma says:

    @kc: According to the document, if I am reading it right, the $145 would be the highest premium paid. There are two less expensive plans.

    And yes, you’re right, some people wouldn’t even be able to afford those. But we have to start somewhere.

  72. 72
    Kay says:

    @jl:

    Such people can easily rack up bills that they cannot pay. But they are not paying premiums, are they? So, are these people rugged self-sufficiently individuals or shirkers? Depends on how you look at it.

    They’re deluding themselves there too. They better be uncollectable (unemployed) if they rack up a hospital bill.

    Providers in this county are extremely aggressive on collections. If they’re working, they’re getting garnished. There seems to be this idea they will stroll away from medical bills. They won’t. The provider gets a judgment and then takes a cut of their pay. There’s only three ways to satisfy it outside a judgment. Call the provider and negotiate a reduced rate/payment plan before they sue, discharge it in bankruptcy, if it’s big enough, or quit your job and move home. Bankruptcy is 1500 bucks here, to hire a lawyer and file.

  73. 73
    Elizabelle says:

    @srv:

    And you are quoting Michelle Malkin (via Yahoo “News”) why?

  74. 74
    Higgs Boson's Mate says:

    @Elizabelle:
    “Why can’t your hypothetical 27-year old pay $145/month, or $36.35/week for medical insurance?”

    Because they’ve already sold everything the pawn shop will take so that they can live on Top Ramen? Bankruptcy is only a threat to someone who has something to lose by filing it.

  75. 75
    Jim, Foolish Literalist says:

    @Elizabelle: The enemy of Secret Republican Obama is their hero.

  76. 76
    jl says:

    @Kay: I assumed that low to middle income rugged individualists and small time start-up Galts do not whine over medical bankruptcies that wipe them out. But you are correct.

  77. 77

    @Just Some Fuckhead, Thought Leader:

    Is someone really paying that much for their monthly cell phone? If so, isn’t that a problem?

    The average cell phone bill for an individual in this country is $47/mo. The average per household is about $103. A surprising number of people getting that minimal plan will be paying less than they do for their cell phone after subsidies.

    But then cell phone costs in the US is about as inflated relative to the rest of the world as our health insurance is. They’re both really inefficient here. What’s the point of having four redundant, but incompatible cell networks in a country as large as this? It’s just a monumental waste of money.

  78. 78
    Another Holocene Human says:

    @peach flavored shampoo:

    So the rural, likely red voters will pay higher than the urban, blah Dem voters? If I’m interpreting this correctly, expect this to become a HUGE talking point.

    Nuh-uh, they’re gonna get a bigger government subsidy.

  79. 79
    srv says:

    @Elizabelle:

    What do I not understand?

    That your 27 year old isn’t as responsible as the oppressed Michelle?

  80. 80
    Jeremy says:

    @Elizabelle: because the left wing nuts and right wing nuts are different sides of the same coin. Their hatred for Obama trumps everything so both sides adopt similar strategies and talking points. I just laugh because I really can’t tell the difference between the two.

  81. 81
    grape_crush says:

    @Joel: @Joel: > Working, and the appearance of working in the eyes of partisans, are two different things.

    Agree, but there’s more than just the partisan angle. There will be legitimate issues that need correction. This thing is going to work, yes. Will it ever be without problems? Probably not.

  82. 82
    Another Holocene Human says:

    Why is there a whole thread crying about whether the rates are affordable–they’re subsidized scaled on income, people, so your hypothetical example pays according to that–when it’s clear from some recent studies that interest is very, very high?

    Yes you have some people who buy crisps before milk after Orwell’s example but the penalties the first two years are quite low. Let’s see what a big surge in participation does before we start crying about the holdouts.

  83. 83
    Jeremy says:

    @Another Holocene Human: It seems like people are forgetting about the subsidies. The less money you make the more help you get from the government so we can’t just look at the reported initial price.

  84. 84
    PurpleGirl says:

    @Gin & Tonic: I’ve been looking on the NYS Dept. of Health web site for the exchanges information. Where did you find it? Thanks.

  85. 85
    Elizabelle says:

    kc and Higgs:

    Virginia does not seem to have its plans online yet.

    Per healthcare.gov, if you are a Virginia resident between the ages of 30 and 64, not insured by an employer, and likely to make less than $49,000 in 2014, Medicaid (!) pops up as an option.

    I am self-employed, and likely to stay that way through about March of next year.

    I will let you know what Virginia offers people like me once the plan is up.

  86. 86
    Chris says:

    @Elizabelle:

    Huh. I haven’t started looking for options yet (still on my parents’ plan, which runs out by December 1st) but am also rather hoping that Medicaid pops up as an option for grad students. If not Medicaid, then hopefully something affordable. (And yes, even $145 a month would be pushing it, A LOT).

  87. 87
    Kay says:

    @jl:

    It’s why I sort of hate the “deadbeat” argument. I get it, theoretically, and I also see how it’s politically useful, but I also see tons of people carrying scary letters from collection agencies, and those are the ones who are on the ball! Usually I see people carrying scary letters from a court because they ignored all the prior letters.

    At least twice a year I see a really young adult who is shocked they’re being billed for a ride in an ambulance. I get that too, it seems like it SHOULD be an “emergency service” that is state-provided, to the person it was this profound once-in-a-lifetime event conducted entirely by good samaritans, but it’s not like that at all :)

  88. 88
    John says:

    This looks like a pretty useful tool (http://kff.org/interactive/subsidy-calculator/):

    The Kaiser Family Foundation has updated its health reform subsidy calculator to provide ZIP code-specific estimates of the insurance premiums and tax subsidies available for people who buy coverage for 2014 through the new state health insurance marketplaces.

    By entering their ZIP code, income, age, family size and other factors into the calculator, consumers can get estimates of the tax subsidies and insurance premiums available to them if they were to purchase insurance through the marketplaces, or exchanges, once open enrollment begins Oct. 1.

    John

  89. 89
    jl says:

    Say I am one of those oppressed enterprising hipster single 27 year old hipsters scraping by on $15.7 K per year in SF. The handy dandy Covered California calculator says

    ” Your Annual Income is just below the maximum for Medi-Cal coverage – please be sure you have entered an accurate income.

    Good news! Because your household income is below the Medi-Cal limit, you may qualify for Medi-Cal”

    When I get successful and hit around $20K I can get a Bronze plan for $60 per month, after subsidy.

  90. 90
    Another Holocene Human says:

    @pamelabrown53: I hope “co” means companies and not counties. Anyway, sounds like good news to me, especially since Medicaid won’t be available.

    PSA for Florida: ALL Florida children are eligible for Florida KidCare and the full freight rates (including dental) are VERY affordable. Depending on income you could be subsidized or free. Definitely check it out before you get killed by employer family rates.

  91. 91
    Another Holocene Human says:

    @Jake Nelson: So state-by-state regulation is likely to play a role.

    And in Florida, Rick Scott deregulated any new entrants to the health insurance market and will be sending out letters saying it’s because of ACA. I guess he’s hoping Florida is such a big state nobody will notice that no other state deregulated NEW entrants to the health insurance market–!!

  92. 92
    jl says:

    @Kay:

    I’m not sure what you mean by ” It’s why I sort of hate the “deadbeat” argument.”

    You work in the grass roots political world, so you probably have to think differently than I do.

    As an economists and statistician, I am very willing, and have, called people with certain attitudes deadbeats and shirkers to their faces.

    So, I’ll let you know if I am in your area, so you can apply some duct tape over my mouth.

  93. 93

    I would just like to note that the criticism over the affordability of these plans is exactly what the GOP and their corporate backers want you to do. If we paid a living wage in this country, the need for subsidies and entitlements would be so vanishingly small that it couldn’t survive as a political issue. The answer to everyone’s complaint is: Pay a decent wage. All problems get solved from that solution, including the problem of high cell phone bills.

  94. 94
    Elizabelle says:

    @srv:

    Michelle Malkin:

    Obama lied. My health plan died. But I got a better one through the health exchanges. And my sister was able to leave her job, the one with health insurance and the skeevy employer. Thanks, Barack!

    How likely are we to see that update?

  95. 95
    Another Holocene Human says:

    @Higgs Boson’s Mate:

    Having been poor enough times to know what it’s like to pray that a tire doesn’t blow, or to chew on aspirins to pack them into the hole in my tooth where a filling came out, I can assure you that anything more than “free” is not remotely affordable for many working Americans. ACA is a good start. Hopefully, the teahadists will destroy themselves la terreur 1793 style so that future Congresses can expand and improve the thing.

    Maybe it’s all a scheme to halt the Great Migration and make families decide that the cold, job free North is preferable to the warm, no Medicaid, job free South?

    It’s not Congress, it’s the Supreme Court of the United States who created this absurdity.

    Wasn’t Roberts one of those folks trying to “cage” voters in the 1980s? It’s all about returning white supremacist countrol to the Deep South. Unfortunately the train pulled out of the station for Georgia, and Tejas is vulnerable as well. So what does that leave?!? South frigging Carolina?

    Btw, that family succeeded in keeping the Cherokee baby they trafficked away from her active duty military father with the help of a crooked law firm and “Christian” adoption service. Where? South Carolina. South Carolina basically doesn’t respect paternal rights and is the “friendliest” state for crooked internal adoptions. Funny, all-hail-the-patriarchy spits in fathers’ eyes. If only the MRAs would catch on… but they never will. Too busy being the “betas” online to child molester activists. “Yes, feel your anger.”

  96. 96
    jl says:

    @John: Thanks. I get a different cost for Bronze plan that from covered California. Kaiser calculator says my 27 year old single hipster alter ego in hip SF neighborhood pays zero dollars out of pocket for a Bronze Plan after subsidy, not 60.

  97. 97
    srv says:

    @Elizabelle: Well, this blog is supposed to Monitor and Mock thought leaders like Michelle, so it would be awesome if Mr. Mayhew would run up his calculator for her.

  98. 98

    @maye: Yeah, that occurred to me too. I literally just signed up for one today for my son for 6 months and maybe by then, I’ll have a better idea what is out there for a “family”. Or maybe the boyfriend will marry me so I can go under his insurance. LOL

  99. 99
    Elizabelle says:

    Somebody had asked yesterday about an Obamacare enrollee who moves across state lines:

    From a WaPost chat today: Obamacare: Questions Answered

    Yes, if you lose your job outside of open enrollment, you will be able to get a plan right away in the exchanges. While there is indeed an open enrollment period (this year, from October 1 to March 31), the health care law allows people who have certain life-changing events to sign up outside of that period. Losing a job, along with moving to a new state or having a baby, count as those life-changing events.

  100. 100
    Another Holocene Human says:

    @Kay:

    What they ask is if people “like them” will get “free” insurance, when they don’t. They make about 25-30K, and they pay varying amounts towards employer-provided insurance, but 100 a month isn’t uncommon.

    Well… no… and this is going to be a problem. Already is a problem with some of the manufacturing unions. They traded wages for benefits and now the benefits are nothing special so they’re pissed. And people moving from job to job may be good for the household but bad for union organizing generally.

    The good news is that only the person employed there has to take the employer health insurance and only if what they pay is less than 9.5% of income. The rest of the family can purchase through the exchange.

    My employer has a good employee rate but awful spouse/family rates so I’ve been encouraging everyone to look at the exchange.

  101. 101
    gelfling545 says:

    @jl: When I did my taxes for last year my copy of the return included a calculation by the tax preparers that based on my income as shown I would qualify for a subsidy. Now, I have not qualified for anything (except for the first 2 years I was teaching & my kids got free lunch) so I was a bit surprised. My pension income is not great but not poverty level either. I have no dependents (that I can claim) and file single. I think a lot of people are assuming that income levels for subsidies will be like current medicaid levels when actually they are a good bit higher. I have decent retiree insurance & medicare will kick in in 2 years so it’s not a big deal for me but it will be for many people.

  102. 102
    gelfling545 says:

    @FoxinSocks: Might you qualify under the medicaid expansion?

  103. 103
    Jeremy says:

    From Think Progress on the Study : In the 36 states where the federal government supports or fully runs the Health Insurance Marketplace, a 27-year old who does not qualify for tax credits will pay, on average, $163 for a plan that covers approximately 60 percent of health care expenses (a so-called bronze-level plan), while a 27-year-old with an income of $25,000 could pay $83 dollars per-month after subsidies. Individuals up to 30 years old will also have the option of buying cheaper catastrophic coverage outside of the marketplaces, though they will not qualify for subsidies. A family of four in Texas with an income of $50,000 would pay as little as “$57 per month for the lowest bronze plan after tax credits,” the report finds.

    So in other words if you have a low income you will pay less than the initial prices because of the subsidies.

  104. 104

    @Another Holocene Human:

    funny, all-hail-the-patriarchy spits in fathers’ eyes.

    SC loves the WHITE patriarchy in their own borders…they not only suffer from southern bigotry but also state bigotry (there should be a word for such a thing).

  105. 105
  106. 106
    I'mNotSureWhoIWantToBeYet says:

    @👾 Martin: Meh.

    If we good guys want to trumpet the low, low cost of these plans, we need to make sure that the low-information voters who don’t have the time or inclination to get all of the details actually get low, low numbers that fit into their actual budgets.

    It’s tough to get real hard numbers now because the exchanges aren’t live yet. That’s a problem.

    But we don’t help our side by framing the costs incorrectly. Just as in over-hyped software reviews from days of olde, “affordable” is always a personal decision based on personal circumstances. The 15 page HHS flyer does a little bit of that, but the numbers can still be scary:

    Young adults will pay lower premiums and also have the option of a catastrophic plan that covers prevention, some primary care, and high costs in cases of major accident or illness. 13 The weighted average lowest monthly premiums for a 27-year-old in 36 states 14 will be (before tax credits): $129 for a catastrophic plan, $163 for a bronze plan, and $203 for a silver plan. More than half of the uninsured potentially eligible for the Marketplaces live in a state where a 27-year-old can purchase a bronze plan for less than $165 per month before tax credits. There are an estimated 6.4 million uninsured Americans between the ages of 25 and 30 who may be eligible for coverage through Medicaid or the Marketplaces in 2014. 15

    Premiums after tax credits

    Tax credits will make premiums even more affordable for individuals and families. For example, in Texas, an average 27-year-old with income of $25,000 could pay $145 per month for the second lowest cost silver plan, $133 for the lowest cost silver plan, and $83 for the lowest cost bronze plan after tax credits. 16 For a family of four in Texas with income of $50,000, they could pay $282 per month for the second lowest cost silver plan, $239 for the lowest silver plan, and $57 per month for the lowest bronze plan after tax credits. 17

    Footnote 16 This analysis concerns only tax credits and premium costs, but we note that cost sharing reductions are not available in bronze plans except for American Indians and Alaska Natives. Cost sharing reductions are available to individuals and families with incomes below 250 percent of the FPL who enroll in silver plans, and to American Indians and Alaska Natives enrolled in metal level. These cost sharing reductions reduce consumer costs (such as out-of-pocket maximums, copays, and coinsurance) at the point of service, whereas tax credits reduce only premiums.

    The numbers in that after tax credit excerpt are a little less scary, but there are complications in the footnotes that makes the choice of metal non-obvious for those trying to get the greatest bang for the least cost.

    tldr; Don’t shoot the messenger, but implore him to be careful about making sweeping “affordability” arguments.

    Cheers,
    Scott.

  107. 107
    MomSense says:

    Not sure if this has been asked, but do individuals or families pay the full premium each month and then wait until they file their taxes for the tax credit or is that amount subtracted and people pay the lower amount per month?

  108. 108
    Another Holocene Human says:

    @Higgs Boson’s Mate: Are those tax credits applied to withholding or are they applied to your annual income tax? If it’s the latter then those who are struggling are still screwed. Waiting for payday can be an eternity, waiting for an annual tax credit will be impossible for many.

    Pretty sure you get it right away but if you lied about your income you get a big bill at the end of the year because one of my rush-listening coworkers was mad about it (IRS!! No auditing by HHS!!) and I calmed him down by saying it was like when you have overtime and put in that W4 saying you have 10 dependents but then you forget to put in a corrected one two weeks later. Also, did he really think with the IRS checking behind that the government was going to get ripped off in the end?

    Yeah, these clowns tried to get people angry that others would be ripping off the system but also get them pissed off about the enforcement agency so the system wouldn’t get ripped off!!!!!

  109. 109

    @jibeaux:

    his might be a straightforward question or a difficult one, I don’t know, but I know the exchanges can’t deny you coverage based on a pre-existing condition, but how does it handle rates with pre-existing conditions?

    ACA says that rates can only be based on age, location, and household size. Your current health is not at all a factor. You could have stage 5 triple ass cancer and the rate would be the same.

    So when you see disparities on rates geographically for the same age/household group, you’re really seeing the varying cost to provide health care. You’ll see costs in urban areas be LOWER because health care networks are vastly more efficient in urban areas. LA residents will pay almost half of what people in rural california counties will pay (despite the income disparity being the opposite). You’ll also see southern state be a lot more expensive than new england states because people in the south are in worse health overall (more smoking, more obesity) and because their care markets are more poorly regulated (Texas) and therefore fleece consumers more.

    One benefit of this approach is that costs now are transparent. You might think cost of living in Mississippi is lower than New York, but for healthcare it’s 25% more expensive – and nobody realized that. People will demand answers to that. The health policy folks are going to have a field day with all of this.

  110. 110
    Elizabelle says:

    @👾 Martin:

    I would just like to note that the criticism over the affordability of these plans is exactly what the GOP and their corporate backers want you to do.

    What Martin said. Pay a living wage, and a lot of this quibbling is beside the point.

    And that’s hopefully the next step: people won’t be chained, in fear, to their employer who pays health insurance, or afraid to take a job with better long-term prospects for lack of health insurance. Or start their own small business.

    If employees are more mobile and have better options, the game changes for corporate America.

    Obamacare could be a huge job creator, and a whack at employee serfdom.

  111. 111
    goblue72 says:

    It seems no matter how you slice it, there’s a segment of the population for whom the ACA is going to be a squeeze – in particular younger, single, childless workers who don’t have health insurance. They make just barely too much to qualify for Medicaid (even under the newer, higher cutoffs), but work the kind of service or administrative sector mediocre jobs that don’t provide health insurance. Currently, they don’t buy any health insurance and just wing it. And for the overwhelmingly majority of these younger workers, that works just fine. Only a small, small portion ever wind up needing the kind of medical care for which the costs drive the uninsured into bankruptcy.

    Its a low low probability event for these workers. If it wasn’t, then the actuaries would price them higher. These are precisely the low cost healthcare users we want to force into the system to balance out against the older, higher cost healthcare users currently INSIDE the system. There are lots of fairness reasons to do so, but let’s not pretend that from the perspective of these younger workers, its going to be a burden, and potentially a moderately painful one.

    $145 monthly premium for someone earning $25k per year is nearly 7% of their gross annual income. Put another way, that’s significantly higher than that worker is likely paying as a tax rate for their entire state income tax (which tends to average around 5% nationally for those states with a state income tax)

    For those quoting that with subsidies, it’ll average around $80-$90, that’s still 4% of gross income. For a lot of these workers, the combined costs of housing, transportation, food, utilities and clothing consume the vast portion of their AFTER tax income, let alone gross.

    Again, I’d expect they won’t starve or go homeless from this, but it will be tight. So let’s not pretend it’s “affordable” for those workers, just because its affordable for most other workers. These workers are sort of the donut hole of the ACA. Here’s hoping over time, as we take back the country from the wingnut fascists, that we can sneak in raising Medicaid eligibility over time and/or increase the deepness subsidies. Public option by stealth and increment.

  112. 112
    Another Holocene Human says:

    @Robert:

    Around $219-260 a month for a bronze plan in Jersey? My goodness. I can actually afford real insurance again. And it’s better than the crap insurance my substitute teacher hiring firm offers.

    Make sure you OPT OUT during open enrollment. Employers are required to sweep everyone into the insurance plan this year.

  113. 113

    @Fair Economist:

    Personal cost of having Republicans run your state: Over $2,000/ per year.

    Dems need to advertise the sh*t out of this kind of stat, because it’s true. Gov. Wags-her-finger-in-the-Prez-face Brewer is killing Arizona.

  114. 114

    @goblue72:

    t seems no matter how you slice it, there’s a segment of the population for whom the ACA is going to be a squeeze – in particular younger, single, childless workers who don’t have health insurance. They make just barely too much to qualify for Medicaid (even under the newer, higher cutoffs), but work the kind of service or administrative sector mediocre jobs that don’t provide health insurance.

    A lot of that is due to the Supreme Court who made the Medicaid expansion optional. In those states, the population you describe are really fucked. Congress will need to find a fix for that.

  115. 115
    Higgs Boson's Mate says:

    @Another Holocene Human:

    Maybe it’s all a scheme to halt the Great Migration and make families decide that the cold, job free North is preferable to the warm, no Medicaid, job free South?

    Good point! Unintended consequences may make for some interesting times. I just hope that they’re painfully interesting for Republicans. It doesn’t look to me as though our party’s leadership has what it takes to fight the long, slow battle to break the R’s stranglehold on the House so maybe ACA will do it via a three cushion bank shot.

  116. 116
    Another Holocene Human says:

    @Just Some Fuckhead, Thought Leader:

    So what the hell was Obama talking about when he said health care coverage was cheaper than yer monthly cell phone bill? Is someone really paying that much for their monthly cell phone? If so, isn’t that a problem?

    It’s a problem for Apple if their phones only come with $100/mo and up contracts when there are Virgin plans for $30/mo. I’m paying $35/mo with Boost after shrinkage.

    It’s a problem for shitty ISPs (“No, I’ll take the slower internet plan. Yes, I know the fastest is faster. I don’t illegally download movies or play XBox online so it’s really okay.”), cable companies, land line telephone in their “cream” areas (they’re all too eager for rural customers to bail) and so on. People have cut back all this shit already but there’s more to cut and they know it. Hmmm, iPhone or healthcare, iPhone or healthcare. To a working class person, “your health is your wealth”. Middle class knowledge workers may see things differently.

  117. 117
    goblue72 says:

    @Elizabelle: Agreed. A $15 per hour minimum wage would help, but not a lot. $25,000 per year, for a full time worker (2,080 hours) is $12 per hour. Current federal minimum wage is $7.25. That means increasing minimum wage 65% just to get to the $25k income we are talking about.

  118. 118
    Betty Cracker says:

    @👾 Martin:

    But then cell phone costs in the US is about as inflated relative to the rest of the world as our health insurance is.

    Damn right! Maybe Obama can get started on telecom reform next. Now that would be something the kiddies would appreciate!

  119. 119
    PurpleGirl says:

    @Gin & Tonic: TY. NYS does have some of the worst web sites there are.

  120. 120
    Yatsuno says:

    @Elizabelle: Copulators of rodentia gotta copulate. He’s been a ratfucker here for ages but tries to sell himself as a purity troll.

  121. 121
    MattR says:

    Anyone want to guess how many people voted in favor of Cruz’s plan to fillibuster the spending bill?

  122. 122
    Elizabelle says:

    From the WaPost chat:

    Q: If my employer doesn’t offer affordable coverage – and I don’t get insurance in my state’s exchange – do I still have to pay the fine?

    A: Generally the answer is yes: If you don’t buy health insurance in 2014, you will likely face a tax penalty ($95 or 1 percent of your income, whichever is higher).

    There is one exception to this: If you cannot find a health insurance plan that is affordable, the federal government will not require you to purchase a plan. The federal governmetn defines “affordable” as something that costs less than 9.5 percent of your income.

  123. 123
    goblue72 says:

    @👾 Martin: No, it is not. Medicaid eligibility under the ACA – that is, the expanded cutoffs, for a single person without dependents is $15,281. In other words, still really really poor. Even if SCOTUS had not allowed states to opt out, a single adult worker earning $25,000 per year would be ineligible for Medicaid.

  124. 124
    Seanly says:

    I’m very glad that the exchanges are generating rates lower than expected. But will this mean anything to those of us on company provided plans? My rates shot up last year – BC/BS raised them as much as they could and my company matched less of the raise than they usually do.

    I’m not sure if my company has company-only rating (though I don’t think so because different states use different health care providers) or uses community rating in the state in question.

    Will the community rating requirements of ACA apply to company provided healthcare?

    I’d love to see my rates hold steady or even decrease (hahahahha).

  125. 125
    MattR says:

    @Elizabelle: FWIW, that is 213.75 per month (assuming the 9.5% is based on the full 27K)

    @MattR: The vote was 100 – 0. Cruz didn’t even have the balls to cast a symbolic protest vote.

  126. 126
    Shakezula says:

    @FoxinSocks: Nothing wrong with being a regular. I’m sure they’re glad to hear from someone like you (a constituent and sane) rather than some jackoff from Louisiana shouting Limbaughisms.

  127. 127
    The Moar You Know says:

    $145 a month for the cheapest Bronze plan for a 27 year old making $25,000 a year is definately affordable

    Back when I was making that kind of money $145 would have left me with the rather grim choice between food, housing, or healthcare, pick any two. I hope they are planning to subsidize anyone making that little money, because otherwise it won’t be doable.

  128. 128
    jon says:

    @MomSense:

    Not sure if this has been asked, but do individuals or families pay the full premium each month and then wait until they file their taxes for the tax credit or is that amount subtracted and people pay the lower amount per month?

    When you sign up, you have the option of having the subsidy be applied each month directly to the insurance company that handles the plan you choose or you can get it as part of your tax returns after you file in the next year. It’s your choice.

  129. 129
    Richard Mayhew says:

    @Ms. D. Ranged in AZ: Mississippi’s problem is that there is one dominant insurer (a BCBS affiliate) and the start-up costs of starting a new health plan in any state are very high. Without competition, there is little reason to compete on price OR service or anything else

  130. 130
    Chris says:

    @Richard Mayhew:

    And here I thought red states were all about the glory of market competition…

  131. 131
    Richard Mayhew says:

    @Seanly: not much on company provided plans. The major policy changes from Obamacare relating to commercial group insurance was a mandate for a better benefit package (preventative care without co-pays, no life time limits, allowing adults up to age 26 to stay on parental insurance, covering maternity care), all of those things increase premiums (~4% or 5% on average)

  132. 132
    goblue72 says:

    @Elizabelle: There’s your new potential donut hole. 1% of $25k is $21 per month. If net costs for a $25k single adult for insurance are $85 per month, will said 27 year old pay an extra $64 per month in order to have health insurance.

    Could go either way, but I’d expect some will, and some won’t. And then over time we will need to increase the subsidies to close the gap.

  133. 133
    goblue72 says:

    @Richard Mayhew: We are awaiting on pins and needles at my workplace for what our total company cost next year for health insurance is going to be (we have more than 50 but less than 100 employees)

  134. 134
    charmtrap says:

    @goblue72: It was my understanding that the penalties increase. By 2016, the penalty goes up to around $700 per year. At that level, just getting the damn insurance seems a lot more reasonable.

  135. 135
    Richard Mayhew says:

    @srv: I don’t do snark well :)

  136. 136
    pamelabrown53 says:

    @Another Holocene Human: Great advise. And I did mean companies, not counties. We are gonna have to fight like hell to make Obamacare work better for all Americans. There will be glitches and problems that normally would be solved by a sane congress , solving problems. Hopefully, we can fix this horrific decline in the mid-terms.

    For those of you pissed that there is no single-payer or public option: the dream will be pissed away until we get our toe-hold-Obamacare-to be successful.

  137. 137
    Goblue72 says:

    @charmtrap: if that’s the case, then agreed. The gap at that level gets narrow enough that the marginal monthly cost (the “delta”) is likely worth the benefit to those workers.

  138. 138
    Kilkee says:

    @Elizabelle: And with all due respect to my fine 27-year old citizen friends, an awful lot of them happily pay $5 day for a Starbucks latte that provides zero protection against catastrophic medical expenses.

  139. 139

    Heh. I gave the below from a college buddy a light fisking on FB and the flying monkeys are attacking. So many things wrong in there but the kicker is calling others uninformed.

    The sole reason Obamacrap was sodomized upon America was to provide 10% of uninsured Americans low cost health care. Did anyone ever stop to realize that there is no such thing as an uninsured person? (more accurately an uncovered person) NOBODY is denied medical care in America. That is why illegal immigrants (of all races) try so hard to get just one foot on our soil to squeeze out a kid. That kid is now provided health care from birth to death as a citizen through private ins as job benefit or cost sharing, Medicare, Medicaid and the myriad govt and community programs that provide preventative care like Planned Parenthood. Or unplanned parenthood. Deplanned? I digress, NOBODY is denied medical care in our country, especially emergency care. Our health care system needed tweaks but it was the best in the world. Now our medical system is on a path of massive govt bureaucratic red tape wherein the trusty IRS overseers enforcement. BTW, how does Obamacrap solve the uninsured issue? It fines the uninsured if they do not purchase private ins or purchase OC. The fine is taken from tax returns which they may not even notice or care about seeing as the income class OC claims to help typically receive large EIC refunds. The list of OC crony exemptions is unethical. This is the most shady, overreaching bill ever passed entirely by one party with 0 opposition votes. If this was a Rep bill there would be rioting in the streets as America itself turned into an “occupy” event of un informed debauchery. Someday soon people will realize that OC wasn’t created for the uninsured but created for the uninformed.

  140. 140
    Elizabelle says:

    @goblue72:

    I remember being very healthy in my 20s, but you do need GYN visits and birth control and you could take a spill or get bronchitis.

    I got an infected ankle from a scrape at a Habitat for Humanity volunteer project; it swelled up and reddened horribly. No idea what any of that medical care cost in reality, because I had job-provided healthcare. Which today’s 20-something may find harder to come by.

    $64/month is $768/year. $800 does sound like a lot, but a 20s- something is going to need some kind of care, at some time.

    [FYI: You need to hand over $135 to even be seen at many of the Patient First walk in centers, and then there’s the prescription, if you’re without insurance. It can add up, even for healthy people. For me, the $800/annually to sleep better at night would be worth it.]

    I hope the economy improves. Maybe it will, if we roust enough Republicans in 2014 (even using all the Obama-scare stuff they’re saying now, against them).

    We need a rising tide that lifts more than yachts.

  141. 141
    MomSense says:

    @jon:

    Thank you! That will make the difference between affordable and not affordable for many individuals and families.

  142. 142
    WereBear says:

    @👾 Martin: You might think cost of living in Mississippi is lower than New York, but for healthcare it’s 25% more expensive – and nobody realized that.

    Reminds me of the 1980’s, when New Yorkers started noticing that they could get a 3 bedroom home in Florida for a third of what it costs on Long Island, much less Queens.

    Then… they discovered the Florida wages were miniscule.

  143. 143
    Suffern ACE says:

    @Chyron HR: So its Logan’sRunacare?

  144. 144
    Chris says:

    @ranchandsyrup:

    “Between you and me, why can’t people think? Why can’t people just think? Don’t it make you mad?”

  145. 145

    @Richard Mayhew: I know, and the reason there is no competition is because the population of Miss. is notoriously unhealthy (I believe they had one of the highest rates of obesity in the country) and no company wants to ensure them. They tend to be unhealthy because they are one of the poorest due to poor diets and cheap food (lots of millionaires though, example of how wealth does NOT trickle down). And they are one of the poorest states mainly due to the fact that they’ve had horrible leadership (actually both Rep and Dem) but all of them on the conservative end of the continuum. And they have an aversion to anything called progress. My family is from the Coldwater area (since back before the Civil War) so I am pretty familiar with the state.

  146. 146
    Seanly says:

    @ranchandsyrup:

    I’ll be perfectly honest – your college buddy is an uninformed idiot and a big douche nozzle.

  147. 147
    MomSense says:

    @The Moar You Know:

    Ok, but as a woman I remember shelling out between $35 and $65 a month just for birth control and the cost of an annual exam plus all the tests is very expensive. So you have to add that in to the calculation. It is not like young adults are not spending money each month on health care.

    Figure $65 per month (which would now be included in your benefit) subtracted from the $145 is only $80 more per month and that is assuming no other out of pocket costs.

  148. 148
    ruemara says:

    I have a guv plan, thanks to my underpaid, unstable job. I save $26 a month with ACA on the silver plan. I don’t believe I can jump ship to that plan, but I’m glad it’s there, because when this position gets terminated next year, at least-with my chronic health problems-I know I can keep getting medicine and have a few doctor visits.

  149. 149
    kc says:

    @Kilkee:

    Okay, I gotta ask: How many people do you actually know who are 1) not supported by their parents 2) making $25k or less a year and 3) spending $5.00 a day on Starbucks?

    Be honest.

  150. 150

    @Chris: I wish we all deduced like Sherlock.

  151. 151
    gogol's wife says:

    These threads are so fantastic. I wish they could be broadcast to replace some MSM TV show.

  152. 152
    Mnemosyne says:

    @gelfling545:

    I think a lot of people are assuming that income levels for subsidies will be like current medicaid levels when actually they are a good bit higher.

    It depends on your state, though. In states like California that accepted the extra Medicaid money from the feds, you will go from Medicaid to subsidized private premiums fairly seamlessly. In states that did not accept that money, people will hit a “donut hole” where they make too much for Medicaid and too little to get a subsidy. Thanks, Supreme Court assholes!

    Also, what the hell is up with Republicans constantly creating holes in coverage? They did it with Medicare Part D as well.

  153. 153

    @Seanly: More than a fair assessment. I’m shadenfreuding the desperation contained in his screed.

  154. 154
    Elizabelle says:

    @ranchandsyrup:

    The sole reason Obamacrap was sodomized upon America

    Hey. That black guy rammed it down their throat.

    And then he had a cigarette.

  155. 155
    Villago Delenda Est says:

    @ranchandsyrup:

    They are very desperate. “Nobody is denied medical care”…right. Go to an ER and get treatment for a condition after it develops, instead of doing it the smart way, preventing it from happening in the first place with regular checkups and care.

    To be a “conservative” is to be a fucktard.

  156. 156
    Elizabelle says:

    OT: Northern Virginia gubernatorial debate tonight, between Terry McAuliffe and Ken Cuccinelli.

    Chuck (“Edward R. Murrow”) Todd is the moderator.

    7-8:00 p, NBC.

  157. 157
    Villago Delenda Est says:

    @Elizabelle:

    ROFL.

    Chuckles the Toad needs to be boiled in oil.

    And served up on the Champs Elysee

  158. 158
    MattR says:

    @ruemara:

    I don’t believe I can jump ship to that plan, but I’m glad it’s there, because when this position gets terminated next year, at least-with my chronic health problems-I know I can keep getting medicine and have a few doctor visits.

    I know this gets mentioned occassionally, but I really don’t think it has gotten enough focus. Obamacare helps so many more people than those who immediately obtain insurance on the exchange. It provides both freedom and piece of mind to me, you and who knows how many others who are trapped in their job or terrified of losing it because they know that is the only way they can get the affordable insurance/health care that they need.

  159. 159
    Mnemosyne says:

    Also, too, I’m expecting that states that refused the extra Medicaid money from the feds will have a “well, duh!” moment in the near future when they suddenly discover that their healthcare costs went up because they have a group of people too rich for Medicaid and too poor to get a subsidy, so that care will fall onto the state. And they will whine because hoocoodanode that would happen? You know, like they were whining in Texas because they cut funding to Planned Parenthood and now will have to spend millions more than they “saved” on care for the babies that were born because their mothers couldn’t afford birth control.

  160. 160
    Suffern ACE says:

    @Villago Delenda Est: Yep, go to the emergency room for a chronic condition that isn’t yet life threatening and see what kind of care you get. Some kind of G/I tract issue, say, that takes a few trips to diagnose.

  161. 161
    piratedan says:

    @Elizabelle: I would expect a long line of pointed questions about Terry’s business dealings and zero questions about Cooch’s tie ins to the Governor’s scamming issues or anything regarding Ultrasound or womens issues

  162. 162
    Mister Harvest says:

    So:

    Per the CA calculator, a bronze plan for a 25 year old who is (somehow) living in 94110 on $25,000 a year would be from $32 to $72 per month out of pocket. If they are living in 92368, it’s $99 to $111.

    Speaking as a small business owner, PPACA is going to be a godsend. I am going to be able to pay 100% of my employees’ premiums (as a direct benefit), cover one of my employee’s spouses who currently is uninsured, add one employee I can’t cover right now, and do so at a cost about 25% of what I’m paying now.

  163. 163
    Elizabelle says:

    @Suffern ACE:

    AND you will get charged a non-insured rate, that’s much higher than what the insured pay

    AND, as Kay informs in comment 72, debt collectors will come after you.

    They better be uncollectable (unemployed) if they rack up a hospital bill.

    Providers in this county are extremely aggressive on collections. If they’re working, they’re getting garnished. There seems to be this idea they will stroll away from medical bills. They won’t. The provider gets a judgment and then takes a cut of their pay. …

    Ranch’s friend may not realize that it’s not just illegal immigrants and other freeloaders that show up in ERs.

    It’s conservative patriots without insurance too.

  164. 164
    Elizabelle says:

    @piratedan:

    It’s also going to be Terry’s glad-handing personality.

    That is one reason a local high tech council gave for endorsing Cuccinelli (and flabbergasting many).

    McAuliffe was breezy and unprepared and they just did not like his personal style.

    Being tech wizards, the fact that Cuccinelli is spearheading a vendetta against climate change researchers at the University of Virginia? crickets

  165. 165

    @eric:

    and THAT is the true goal of Obamacare….stop tying health care to employment and the economy will boom because people will take more chances and risks because they are not exposing themselves to catastrophic health care costs.

    And THAT is precisely why the wingnuts are so afraid of it. It takes away the primary tool bosses have for keeping the workers in line.

  166. 166
    WereBear says:

    @goblue72: Currently, they don’t buy any health insurance and just wing it. And for the overwhelmingly majority of these younger workers, that works just fine. Only a small, small portion ever wind up needing the kind of medical care for which the costs drive the uninsured into bankruptcy.

    But if it does happen to these uninsured folks, it is disastrous; even if they fully recover from their medical crisis. The financial fallout can screw up the rest of their lives.

    And I seriously question if they are “just fine.” I know these young people; they don’t go to the doctor. They struggle along, let infections rage out of control, not treating something like walking pnuemonia that drags on for months; and not getting any help with the diabetes that starts at this age, starts doing damage at this age, but they are young and strong and they suffer in silence.

    What they pay for will get them to the doctor.

  167. 167
    Kay says:

    @Mister Harvest:

    I’ll never understand why small business people don’t support it. Maybe because a lot of them were misinformed. I had a landscaper tell me Saturday he has to buy insurance for his employees by Oct. 1st. He has 3 year-round employees. I hope he isn’t getting all his business advice from random wingnuts who follow him around ranting while he’s trimming their hedges.

  168. 168
    Another Holocene Human says:

    @srv: The new class snobbery will be claiming you paid full freight for your family plan and Obamacare surtaxes beside, because you don’t want anyone to know at the cocktail party that you’re lying about your ‘uuuuuuge income and you’re actually getting some subsidies.

  169. 169
    Another Holocene Human says:

    @Ms. D. Ranged in AZ: Ot, but this reminded me: SC loves the WHITE patriarchy in their own borders…they not only suffer from southern bigotry but also state bigotry (there should be a word for such a thing).

    So I was hearing about this Atlanta-based franchise: 9 in Atlanta alone, 3 in NC, 1 in FL. Notice anything? 0 in SC. State’s passed over. But but but SC doesn’t believe in minimum wage, job killing regulations, job killing income tax, gas taxes, etc. It’s a job creators paradise, shouldn’t there be 20 in SC?!?!?

  170. 170
    Mister Harvest says:

    @Kay: Yeah, for small employers, the PPACA is going to be one of the best things ever, if they are getting the right advice. I’m well below the threshold for having to insure my employees, but I’m doing it away ’cause reasons, and this is going to save me thousands of dollars a year, even if I pick up 100% of their premiums.

  171. 171
    What Have the Romans Ever Done for Us? says:

    Anyone know how people living abroad are affected. I have a friend who lives in Canada and gets covered by Canada’s health service while there (he’s employed). He’s being told that he has to buy a policy in the US for when he comes here to visit. I think, from what he says, that anyone whose paying US taxes has to buy a policy if they don’t have other US-based coverage. Are there super-cheap travel insurance type options for this situation?

  172. 172
    Another Holocene Human says:

    @goblue72: That’s what catastrophic plans are for, and those plans are cheap.

    Also, what about the surveys showing high interest in that demographic?

    And what about the fact that a lot of these single, childless workers with shit paychecks are still living at home anyway or with other relatives!? Yes, some are emancipated (all the more reason to get a catastrophic plan b/c you don’t have anyone to put you on their plan or bail you out).

  173. 173
    Another Holocene Human says:

    @Kay: He’s probably getting it from the radio. Yeah, it’s sad, people are getting fed scary disinfo.

  174. 174
    fuckwit says:

    @J.D. Rhoades: DING DING DING. This is exactly the reason for the freakout.

    Employer-based insurance– and impossibly high medical costs and insurance costs when not not employed– is a form of terror. It keeps the masses in line.

    I will draw my own analogy: it’s a lot like the terror the KKK used to keep black people in line before MLK. Randomly, white people would go ape-shit and murder a bunch of black people. That terror is what kept them away from the lunch counter and at the back of the bus, keeping them out of the good schools, keeping their eyes down, keeping them from even trying to vote. It was a mortal terror. The Civil Rights movement ended that.

    And now we have an end to the terror the 1% have been keeping us under for over 40 years, possibly longer.

    You can start a business. You can quit your WALMART job. You can contract and consult. You can work for a smaller business that doesn’t have the money to pay for expensive medical insurance. You can get a Kickstarter going (well, the kids who have been on their parents insurance thanks to ACA for a few years now have been getting Kickstarters going already, and it’s amazing the innovation and coolness they are accomplishing). You can work for social justice for a nonprofit and still not risk dying or bankrupted if you get sick.

    This, in a week or two, is the beginning to the end of the terror in the USA. It’s an amazing, beautiful, celebratory time.

  175. 175
    Betsy says:

    @goblue72: When I made FAR LESS than $25,000 a year, I GLADLY paid $150 a month for an individual policy — to ensure that my parents wouldn’t exhaust their savings and all their retirement plans if I was in a bad accident.

    Right, there were other things I had to forgo. It was a good choice.

    .
    .
    Also too — hello?? these young people are going to get middle-aged and then old one day, and then they too will benefit from the younger, healthier people’s premiums.

    It’s not like everyone is only in one, oppressed age group or the other.

  176. 176
    Suffern ACE says:

    @WereBear: We we have options. One is to somehow get injured at work. The other is to get too sick to be gainfully employed! I like these options.

    I am actually surprised at how low these rates are considering that our healthcare system costs twice as much as anyone else’s. No, not twice the average. Twice as much as number 2! Those bronze plan rates that cover 60% of expenses probably match the component of the taxes paid by your average Swede who makes the equivalent of 25K to be 100% covered.

  177. 177
    Yatsuno says:

    @What Have the Romans Ever Done for Us?: There won’t be a subsidy unless he’s also a US citizen, then he could buy a policy on the exchange in his state of residence. Otherwise lots of companies have travel policies that are pretty inexpensive for foreign travelers. But AFAIK there is no requirement for foreigners to purchase insurance.

    I’m waiting to see what happens with Vermont. Hopefully they will have reciprocation agreements with other countries that have single payer. Their tourism would go through the roof.

  178. 178
  179. 179
    TopClimber says:

    @Higgs Boson’s Mate: The credit is based on your taxable income (before deductions and exemptions) but is credited a year in advance. It goes to directly lower your premiums. You don’t wait for a refund or increased take home on your paycheck to pay for it.

  180. 180

    @Another Holocene Human: LOL, yeah, the same thing has been happening in AZ. See, some of the red states suck so bad, no one wants to live in them. So companies don’t want to open up shop there and force their employees to live in such crappy states. Plus such states tend not to have the talent base for certain industries.

    Caveat with AZ, the weather draws people here. After a while the young ones realize how sh*tty it is but by then, they’re either stuck or they leave. The retirees stay because, well, they’re retired and don’t want to pay taxes for other peoples kids anyway. Their quality of living is great! They don’t care about jobs or infrastructure…just whether they can get to Coco’s for the early bird specials.

  181. 181
    Kay says:

    @Mister Harvest:

    We used a great contractor for this office (and a bathroom in the house, and new windows) and he was really happy about it, but he’s sharp and takes every small business break that he can possibly apply for. He actually got a yard sign in 2012, and I would never have pegged him for a Dem voter.

  182. 182
    jl says:

    @ranchandsyrup:

    ” Did anyone ever stop to realize that there is no such thing as an uninsured person? (more accurately an uncovered person) NOBODY is denied medical care in America. ”

    That wingnut logic is very strange, seeing they are obsessed by the prospect of poor lucky ducky moochers and looters and takers getting free goodies from the hardworking tax payer.

    So, yes, everyone gets lousy healthcare if the probability rises above some arbitrary level that they will drop dead due to some accident or illness. And there is a good chance that the bills will be higher than the value of their assets that will be collected. So, they should be let off the hook for paying premiums? There is no logic to their argument at all, just incoherent raving. The have a lunatic fear and hatred of any collective decision making based on (their crazy ) ideology.

    On average, people will be healthier and live longer with health care reform. You can go to the WHO or OECD Health websites and look at what happened to life expectancies from birth to 60 after Australia, Switzerland, even (back in the 70s) basket cases like Portugal after health universal coverage and adequate insurance and provider regulations improved health care.

  183. 183
    What Have the Romans Ever Done for Us? says:

    @Yatsuno: He’s a US citizen, working in Canada for a Canadian company. As I understand things, that set-up comes with coverage through the Canadian national health plan. So, he’s covered in Canada, but being told that Obamacare will require him to buy a second policy here, which would be a big waste if he has to pay a premium that reflects full-time US residency and coverage. Basically the coverage in Canada is already insuring against most of his risk because he spends most of his time there. But, he’s being told he has to have a largely redundant US policy under Obamacare.

  184. 184
    fuckwit says:

    @Mnemosyne: It’s to keep the poor down. It’s more like a moat than a donut hole. Unless you’ ve been poor, you don’t know the terror of that moat. Thank Clinton, the fucker, for “welfare reform”. You have to swim across that moat. See, when you’re dirt poor, you still have a few key government resources available to you– SNAP, General Assistance, etc. As you try to crawl from poverty towards the castle of middle-class security, suddenly you hit the moat– you make too much to qualify for those resources anymore–, and you are now thrown back down into destitution again. Lather rinse repeat, if you’re stupid enough to try again. This is why the important thing if you’re poor is to work off the books, hide your assets in cash/gold/bitcoin/whatever, and lie out your ass and risk perjury at every time you deal with a government “assistance” agency. Means-testing is a fucking moat to keep poor people poor.

  185. 185
    Jim, Foolish Literalist says:

    @Another Holocene Human: also, too, “small business” is one of the most cheerfully abused terms in our political discourse.

    @Betsy: Everything you say is true, but it requires a lot more long term thinking than most Americans and most younger people (and I used to be one) are used to. One of the things that rang truest to me in Brian Beutler’s essay on how he bought insurance I think literally the day before he was shot was that it was his father’s nagging that got him to finally sign up. I was uninsured for a couple of years, ignored my old man’s advice, more out of a sense, of “oh yeah, I’ll do that tomorrow” than youthful invincibility (I was past thirty). I got a minor injury that got infected and it wound up costing me ten grand.

  186. 186
    Elizabelle says:

    @What Have the Romans Ever Done for Us?:

    From that WaPost chat today: anyone legally in the US can buy from the insurance exchanges. That includes green card holders, and presumably folks on short-term work visas (?) too.

    The insurance exchanges will not work for Americans living abroad, nor will expats be fined for not participating.

    Maybe there will be an insurance market for foreign citizens legally working or residing in the US (although it’s likely an employment perk for the more highly-skilled now?)

  187. 187

    @goblue72: Someone I know very well was diagnosed with Non Hodgkins Lymphoma in his early thirties. Just because you are young you are not invincible. Before the cancer diagnosis he had never been sick.

  188. 188
    Yatsuno says:

    @What Have the Romans Ever Done for Us?: He might get hit by the penalty, since he’s required to file taxes in the US. But that’s not the same thing as being forced to buy a policy when he’s in the US for any space of time. I have known Canadians who have had a health issue insist on being transported north of the border after a health crisis, so that’s also an option. I think the worst consequence he’s facing is losing part of his refund to the mandate penalty. I wonder if this is an issue with other expats, I haven’t heard anything about this.

  189. 189
    Trollhattan says:

    @Kay:

    I hope he isn’t getting all his business advice from random wingnuts who follow him around ranting while he’s trimming their hedges.

    Which brings up a critical question: how do you tell a two-stroke leaf blower from a wingnut? One blows leaves while deafening you, while the other merely deafens you.

  190. 190

    @Elizabelle: The Massachusetts Law covers permanent residents but not those on short term visas. International students have to have medical insurance, that is one of the per-requisites to get the appropriate student visa.

  191. 191

    @jl: Defining emergency care as “being covered just like insurance” completely ignores the payment and cost control side of things. My buddy tried to take that out of the discussion by saying that the “sole” reason for ACA was to provide for uninsured.

  192. 192
    Betsy says:

    @Jim, Foolish Literalist: Welp, now, under the LAW they will have to do that long-term thinking, or pay the penalty (literally).

    Learning occurs! Small increases in maturity accrue! People are forced to act like the adults they are! Yay!

  193. 193
    Redshift says:

    @Elizabelle: Virginia isn’t running its own exchange. We’ve got this weird arrangement where the feds will run the exchange, but the state gets to set the rules for it. (I don’t understand how they managed that, either.) So healthcare.gov is the place to get information about the exchange in Virginia.

  194. 194
    Elizabelle says:

    @schrodinger’s cat:

    Good to know.

    I could not ascertain quickly whether H-1B employers are required to provide healthcare insurance along with the prevailing wage, but maybe it’s usually included [if not mandated] since H-1Bs are professional employees with college degrees.

  195. 195
    fuckwit says:

    @Elizabelle: Yeah, it seems there’s a male gender bias in these examples of young people who don’t want to pay for insurance and never need a doctor. I’ve found women much more likely to do regular checkups and doctor visits than men, even at a young age, and to recognize the utility of insurance.

    @gogol’s wife: Indeed, I find these threads the most informative and interesting on BJ right now. I learn stuff. And I hear other people’s stories. And I feel better after reading them (unlike a lot of other threads).

  196. 196
  197. 197
    jl says:

    Say what you want about McCaskill, she understands Green Eggs and Ham, and explained it to Ted.

    McCaskill: Cruz Doesn’t Understand The Moral Of ‘Green Eggs And Ham’

    http://talkingpointsmemo.com/l.....e-tried-it

    Edit: BTW, early this morning the national news treated me to Ted Cruz reading from Green Eggs and Ham in his fake filibuster. And I just knew it would be an interesting day.

  198. 198

    Just found out that due to the failure of our New Republican Overlords in NC to cooperate in any way whatsoever, we’ll have fewer choices in the exchange and pay higher rates than average. Thanks, McCrory, you ASS.

  199. 199
    Redshift says:

    @Elizabelle:

    That is one reason a local high tech council gave for endorsing Cuccinelli (and flabbergasting many).

    That whole story of that endorsement and how it was supposedly “stunning” that they endorsed Cuccinelli was mostly crap. The Northern Virginia Technology Council is a heavily Republican-leaning group that endorsed the Republican in the last two elections for governor. While it was painted as a big loss for McAuliffe because he lobbied them heavily, it was really in the category of his other “trying to get an endorsement from some Republicans,” but the media really bought into the idea that it was some totally nonpartisan business group.

    I believe their “reasons” for endorsing Cuccinelli about as much as I believe the “reason” Republican businessmen are screwing their workers is because of Obamacare…

  200. 200

    @Elizabelle: I would say that most H1-Bs get health insurance via their employers..

  201. 201

    @Trollhattan: HA! that one is outstanding. Everyone knows a guy like that. That tactic works way more than it should.

  202. 202
    Jim, Foolish Literalist says:

    @Elizabelle: Being tech wizards, the fact that Cuccinelli is spearheading a vendetta against climate change researchers at the University of Virginia? crickets

    Zuckerberg has run ads supporting Keystone and offshore drilling, held a fundraiser for Chris Christie, and last week met with Cantor and a bunch of other GOP ‘critters. Climate science ain’t his science

  203. 203
    Richard Mayhew says:

    @Redshift: States set the insurance rules in all states regardless of who runs the Exchange/marketplace/Connector etc. Federalism at work.

  204. 204
    Villago Delenda Est says:

    What a sizeable portion of the 1% don’t seem to realize is they’re not loathed because they’re rich.

    They’re loathed because they’re assholes.

  205. 205
    Richard Mayhew says:

    @fuckwit: That is the typical usage pattern. Women tend to actually go to the doctor and do their follow-up visits when recommended. Men don’t. That and the fact that a woman between the age of 18 and mid-40s (the cohort eligible for the Exchange) is extremely likely to have one or more high cost medical events that men can’t get (pregnancy). Under the old system, women paid more then men, so even if a woman in her mid-twenties was in perfect health and could get awesome individual underwritten insurance, she is probably breaking even with Obamacare exchange rates — and if she had any health problems that either led to an uprating OR denial, she is way better off.

  206. 206
    Villago Delenda Est says:

    @ranchandsyrup:

    Y’all should read all of ranchandsyrup’s link, but this stood out:

    Allen stated that, in the end, he believes elected officials know how great their responsibility is to the American people, and that they would ultimately of course never let something as petty as party politics get in the way of that.

    Snap!

  207. 207
    bemused says:

    I seriously doubt that people who bring up emergency rooms as a way to get health care have ever had to use one and get the bill. Even if they have health insurance, it’s not cheap especially if they have high deductibles.

  208. 208
  209. 209
    Elizabelle says:

    @Redshift:

    Yeah, I read the Post’s story more closely and noticed the 3 GOP gubernatorial endorsements in a row.

    Also that Cooch promised them he would leash himself. Or let them think that, anyway.

    [per the TechPAC chairman,] Cuccinelli assured TechPAC Trustees during the interview process that his administration will focus on jobs and the economy, and not on a divisive social agenda, which TechPAC believes would seriously hurt the appeal of Virginia as a place to locate and grow businesses. Cuccinelli also committed to preserving and efficiently implementing the transportation funding legislation passed by the General Assembly earlier this year.”

    Transportation bill that Cooch opposed, job creator that he is.

    PS: thanks for the info on the insurance exchanges in VA.

  210. 210
    Origuy says:

    @What Have the Romans Ever Done for Us?: Travel insurance is pretty cheap. I plugged in some numbers at TravelGuard’s website. For a 31-year-old resident of Ontario traveling for two weeks, the cost was $42 with no deductible.. Not sure if that’s US or CA dollars. Apparently the destination doesn’t make a difference.

  211. 211
    Chris says:

    @Kay:

    I’ll never understand why small business people don’t support it.

    Well, as we’re seeing right here on this page, there are quite a few that do. Those that don’t? Probably in large party because they’re losing one of their biggest tools of control over their employees. But I also think the super-rich have done a great job of appealing to small business owners with the whole spiel about how the government’s keeping them down – and since the super-rich are the embodiment of what the small business owners wish they were, they listen. (At least the conservative ones do).

  212. 212
    Jim, Foolish Literalist says:

    Latest example of Leadership from The Boner: We will now have weekly Continuing Resolutions to fund the US go’t

  213. 213
    gwangung says:

    I seriously doubt that people who bring up emergency rooms as a way to get health care have ever had to use one and get the bill.

    They’re not thinking, period.

    They’ve basically conceded the argument and all we’re doing is arguing on how to pay for that health care—and doing it through emergency rooms is WAY more inefficient and costly.

    In essense, these goobs are MAKING government be more expensive and inefficient.

  214. 214
    raven says:

    ira-NY

    Don’t be posting fucking FDL links here dork.

  215. 215
    Randy P says:

    Can’t be true. I just heard from the local office wingnut that premiums are going through the roof, that Medicare for instance is going up by 75%.

    So who am I supposed to believe?

  216. 216
    bemused says:

    @gwangung:

    “They’re not thinking, period.”

    This sentence sums up most Republican voters, period.

  217. 217
    Redshift says:

    @Elizabelle:

    PS: thanks for the info on the insurance exchanges in VA.

    I knew about it because I happened to have poked around in the site a month or so ago. Healthcare.gov is a good place to tell anyone to start; it’ll direct you to the state site if there is one. So if you’re talking to someone in another state, you don’t have to know if they have a state-run exchange to help them get started.

  218. 218
    ira-NY says:

    @raven:

    Do you ever tire of being a bully?

  219. 219
    max says:

    @Elizabelle: Chuck (“Lobotomized Edward R. Murrow”) Todd is the moderator.

    Fixed that for you.

    max
    [‘It’s just amazing how many ostensibly ‘neutral’ entities are actually R establishment outposts. Particularly in VA.’]

  220. 220
    Robert Sneddon says:

    @Origuy: Travel insurance is premised on the cost of a medevac back home and not much more for most travellers. A few unlucky ones will be unfit enough to travel and require extended hospitalisation in-country but for the rest it’s a question of getting patched up enough to get on the next flight home or maybe an ambulance and medical support across the border to local healthcare facilities in Canada.

  221. 221
    burnspbesq says:

    @Higgs Boson’s Mate:

    Are those tax credits applied to withholding or are they applied to your annual income tax? If it’s the latter then those who are struggling are still screwed. Waiting for payday can be an eternity, waiting for an annual tax credit will be impossible for many.

    If you know you’re getting a credit, increase your withholding allowances to take it into consideration, and give your employer a new W-4. If your employer gives you a hard time about it contact the local Legal Aid Society, or go on the IRS website and find the nearest low-income tax clinic.

  222. 222
    Chyron HR says:

    @ira-NY:

    Don’t you know? All true progressives Stand With Rand Cruise With Cruz in his noble quest to KILL THE BILL.

  223. 223
    PaulW says:

    @pamelabrown53:

    Living in Florida, there is no exchange info. available til Oct. 1. So yesterday I called my insurance co. (I’m self-insured), BC/BS of FL. to find if they are participating in the exchange. Talked to an Obamacare expert (their term!) and yes they are participating. The really good news is that there will be 10 co. on the exchange. This shocked be because the level of nasty obstructionism from of Tea Party governor has been off the charts. I expected 2 or 3 co., meaning little or no competition.

    when there’s money to be made a company will do it. One of the things Republicans can’t understand about health care socialism is that companies can make money off it. The trick is to get the companies to do things in a way that benefits the nation or communities.

  224. 224
    PaulW says:

    @Chyron HR:
    didn’t he just vote FOR the continuing resolution…?

  225. 225
    Suffern ACE says:

    @Elizabelle: so he lied and they believed them. Dear Techcouncil, he will be taking your porn and no you won’t be getting that road.

  226. 226
    PaulW says:

    @Randy P:

    Can’t be true. I just heard from the local office wingnut that premiums are going through the roof, that Medicare for instance is going up by 75%.

    So who am I supposed to believe?

    Brian Boitano. You can always ask him.

  227. 227
    Chyron HR says:

    @PaulW:

    BETRAYAL FROM ALL SIDES!!!

  228. 228
    RaflW says:

    A quick search shows WSJ and Fox Business titling their web stories “Prices Set for New Health-Care Exchanges” and “Here are the Prices for New Health-Care Exchanges.”

    Huh. I thought I heard somewhere that prices are lower than expected.

    Bahhh. That’s not news!

  229. 229
    burnspbesq says:

    @Villago Delenda Est:

    You’d better not be eating deep-fried Chuckles the Toad unless you’ve got health insurance. That stuff turns to concrete in your arteries.

  230. 230
    Bubblegum Tate says:

    The WSJ story has this graph showing that ZMG OBAMACARE STICKER SHOCK!

    It being the WSJ, I’m pretty sure they’re *ahem* finessing the numbers a bit. Perhaps our esteemed blogger can tell us exactly how?

  231. 231
    Patrick says:

    @Randy P:

    Can’t be true. I just heard from the local office wingnut that premiums are going through the roof, that Medicare for instance is going up by 75%. So who am I supposed to believe?

    Well, according to Chuck Todd, you are supposed to believe the party that has the best messaging apparatus on this (and any) issue.

  232. 232
    fuckwit says:

    The wingnuts can holler, Cruz can pretend to filibuster… but…

    http://www.youtube.com/watch?v=nRnAJkRnzGk

  233. 233
    jl says:

    @Bubblegum Tate: I would be interested in hearing from Richard too.

    Looks like the WSJ is comparing the cost before subsidies under ACA to the lowest bare bones catastrophic of out-of-state scam policies now available.

    If anyone knows the average benefit, and more importantly, average historical performance, of current low cost policies that are being used for comparisons, that would be interesting.

  234. 234
    MattR says:

    @What Have the Romans Ever Done for Us?: @Yatsuno: From the IRS website:

    12. Are US citizens living abroad subject to the individual shared responsibility provision?

    Yes. However, U.S. citizens who live abroad for a calendar year (or at least 330 days within a 12 month period) are treated as having minimum essential coverage for the year (or period). These are individuals who qualify for an exclusion from income under section 911 of the Code. See Publication 54 for further information on the section 911 exclusion. They need take no further action to comply with the individual shared responsibility provision.

  235. 235

    @Bubblegum Tate:

    It being the WSJ, I’m pretty sure they’re *ahem* finessing the numbers a bit. Perhaps our esteemed blogger can tell us exactly how?

    They’re comparing a Bronze plan on the exchanges to the cheapest plan now, which is probably a catastrophic coverage plan that barely qualifies as insurance. So the prices have gone up, but the coverage has gone up a lot more. Also, of course, anyone in that age group can buy the Bronze plan, regardless of their pre-existing medical conditions, while the plan they’re comparing to was undoubtedly restricted to people who were in perfect health. As somebody said, it’s not just comparing apples to oranges, it’s comparing apples to oranges that you may not be able to buy.

  236. 236
    Patricia Kayden says:

    “This thing is going to work.”

    That’s why the Repubs are going CRAZY!

  237. 237
    Kilkee says:

    @kc: More than a few. Lots — most, I’d say — of my kids’ friends, from what I can see and guess. I’m not with them everyday, but they are scrambling to make a buck at multiple minimum wage jobs, and probably coming up short of $25k. Not to deny them their small treats that make life worth living, but five bucks worth of coffee each day is not remotely an uncommon observation. So while I hate the circumstances that have led to this sort of horrible job market and income inequality, I have to say at least they have it better than others did before them, who had no choice but to live in terror of a significant medical bill.

  238. 238
    Davis X. Machina says:

    This model has been in place in Switzerland for at least a decade: example: 500 CHF deductable, 56-year old, living in zip code 1006 (Lausanne): 360 CHF/mo. give or take. ($390) And a premium cap at 8% of gross income.

    (The Swiss basic plan is at least ‘silver’ by US standards — my son had to buy a supplement to very good BC/BS to pull it up to Swiss minimum standards when he lived there 2011-12)

  239. 239
    goblue72 says:

    @WereBear: I’d strongly disagree. What you are talking about (young people who encounter serious medical issues) are in the minority. And a much smaller minority than older people needing equivalent care. What I mean is, younger people – statistically speaking – are healthier and have lower healthcare costs than older workers. And from their perspective, if the costs to acquire health insurance feel expensive relative to their perceived need (and lower risk of needing healthcare), they will respond with forgoing buying insurance. Yes, occasionally it doesn’t pan out – but for the vast majority it does.

    For every “I know this young person who didn’t have insurance and got diabetes” you likely have 99 young people who spent their entire 20s never having anything worse than a flu or sinus infection. And in many cases, they just bear through it without going to a doctor because they are young and eventually bounce back.

    As noted above, if the penalties are increasing over time though, then I can see it making financial sense from the perspective of a lower income twenty something.

    As for the $5 latte crack someone made above, for $5 a latte, you could buy over 20 of them a month for the $130 monthly premium. Put another way, that’s the equivalent of $30 worth of beer money for each Saturday night. When I was 25, I know what I’d do. Drink beer and roll the dice. Because spending every Saturday night home because you spent it all on a health plan that only pays 60% of costs is NOT. GONNA. HAPPEN.

  240. 240
    goblue72 says:

    @Kilkee: I spent the vast portion of my twenties un-insured and I never once “lived in terror of a medical bill.”

    I thing all you olds vastly over-exaggerate the “fear” of medical bills that twenty-somethings have. The biggest “fear” twenty-something have on average is running out of beer money at midnight on a Saturday night and not getting laid.

  241. 241
  242. 242
    aimai says:

    @goblue72: Its so incredibly funny that you think that all people in their 20’s are single and male–your twenties is when a lot of sexually active women need gynecological exams and birth control and abortions and, of course, maternity policies. So half of the population you think don’t care about health care? They care.

  243. 243
    goblue72 says:

    @aimai: Actually, I don’t. You stepped in and made a completely unwarranted assumption. Most of the women I knew in my 20s were not on the “pill”. Birth control was mainly via condom for most 20 somethings I knew. AIDS changed everything. A gyno exam could be had for a couple hundred bucks. And again, all this adds up to cheaper than $1600 a year.

    But thanks for shooting first, asking questions later as is your M.O.

  244. 244
    billgerat says:

    Does anybody have a list of what the average copay costs will be for the lower tiers of the basic plans?

  245. 245
    Villago Delenda Est says:

    @burnspbesq:

    Hmmm…pretty much the way Chuckle’s head is solid concrete.

  246. 246
    Mnemosyne says:

    @goblue72:

    And from their perspective, if the costs to acquire health insurance feel expensive relative to their perceived need (and lower risk of needing healthcare), they will respond with forgoing buying insurance.

    I have yet to meet any of these young people who are voluntarily foregoing insurance. I didn’t know any of them when I was in my 20s myself, though I knew many who complained because their employers didn’t even offer the crappy insurance I got. Everyone who didn’t have insurance lived in fear of getting hit by the proverbial bus or getting appendicitis and being completely wiped out financially.

    ETA: Foregoing it because it was unaffordable, sure. I had mild pre-existing conditions that meant I was going to be charged $400 a month. If $165 a month had been available, I would have leapt at the chance.

  247. 247

    @Elizabelle: “Wait until that 27 year old breaks an ankle or an arm with a paying job — so she is not eligible for hospital “charity care” — and gets hit with a $12,000 medical bill.”

    That’s all right; under the bronze plan he’ll pay $4800 of it—two months salary. Bronze plans only pay 60%.

    Really they should be called “lead” plans. Only for healthy people under 30, who can’t afford better health insurance and are willing to risk bankruptcy.

    The whole naming system ought to be rescaled. Instead of gold, silver, and bronze, let’s have iron, tin, and lead. The iron plan is good basic health insurance. If you’ve got to have something less, do a tin plan.

  248. 248
    MattR says:

    @billgerat: I have not seen that info yet. But I have seen this list of preventive services that will now be free of charge (no co-pay no deductible)

  249. 249
    Mnemosyne says:

    @Raven Onthehill:

    That’s all right; under the bronze plan he’ll pay $4800 of it—two months salary.

    Weird, I was under an impression that $4,800 was a smaller amount than $12,000. You have some interesting math up on that hill if you think that paying $12,000 is actually better than paying $4,800.

  250. 250

    @Ms. D. Ranged in AZ: you probably are eligible for a subsidy.

    @Robert: If you’re over 40, don’t buy a bronze plan, if you can afford anything better; what you save in premiums, you will spend in health-care costs. (That’s based on a rough assessment; the numbers aren’t available yet. But I’d be very surprised if it works out differently.)

  251. 251

    @Mnemosyne: $12,000 is medical bankruptcy, though hospitals will sometimes forgive the debts of people who truly can’t pay. $4,800…well, only perhaps bankruptcy.

    In other words, very little difference. I worry that the bronze plans will swing people over to the Tea Party side.

  252. 252
    cckids says:

    @goblue72:

    A gyno exam could be had for a couple hundred bucks. And again, all this adds up to cheaper than $1600 a year.

    Not sure how long ago you are talking about, but a gyno exam today with a pap test could easily cost you $800. Plus that $75-80 per month for the pill. Plus anything else you might need a doctor for.

  253. 253
    jl says:

    @Raven Onthehill: I called it a robot’s breakfast of plans. I think there is too much variation. A commenter above compared the Bronze plans to mandatory Swiss coverage, and gave a link, which I visited. The Swiss site emphasizes that every insurance company offers the exact same basic mandatory plan with the exact same benefits. Much simpler that way.

    I am curious if Richard Mayhew can compare the age specific premiums to actuarial work on expected costs at birth for different age groups. That is the relevant comparison for social insurance. Not some ex post selected group of healthy twenty somethings. CMS has estimates for 19 to 44 year olds in 1999, closest to the relevant ‘young’ people we are talking about. In 2012 dollars, the average personal healthcare expenditure for that group was $371 per month.

    It would help if commenters would try to explain the points they are trying to make about these twenty somethings. That it’s unfair? People don’t like to pay bills? What?

    Seems to me you could make the same point about compulsory auto insurance. You could go out and find some drivers who have not had a serious accident over the last few years and rage about the fact that they had to pay premiums, but retrospectively, had zero bills from auto accidents.

  254. 254

    @TopClimber: “The credit is based on your taxable income (before deductions and exemptions) but is credited a year in advance. It goes to directly lower your premiums. You don’t wait for a refund or increased take home on your paycheck to pay for it”

    And if you have a windfall, and your income is higher than expected, you have to repay it. If you are really unlucky, the windfall will carry you across the line where the subsidy cuts out. That’s one of fuckwit’s moats; the amounts involved can be thousands.

    Caveat emptor.

  255. 255

    @jl: “It would help if commenters would try to explain the points they are trying to make about these twenty somethings. That it’s unfair? People don’t like to pay bills? What?”

    I think fuckwit’s discussion of “moats” makes the point very well; it’s going to push some people who are just squeaking along into one of the moats, as well as other people who are trying to make the jump up from lower middle class.

    And the highest costs are put on the the people with the least ability to pay.

  256. 256
    The Pale Scot says:

    Can anyone explain why the ACA counselor/navigators are being described as “federal employees” when everything I can find indicates that they are members of charities that have been trained to be navigators.

    Although not specified in the regulations directly, the preamble states that the FFM will only designate organizations (not certify individuals directly), thereby delegating some oversight of individual CACs to the designated entity. Specifically, the FFM is looking for organizations that 1) have processes in place to screen staff and volunteers who are certified to ensure they will protect personal information; 2) engage in services that position them to help connect people to coverage; and 3) have experience providing social services to the community. The preamble goes on to say that the FFM will limit CAC entities to:

    Community Health Centers (such as FQHCs)
    Hospitals
    Health Care Providers
    Indian Health Services and Providers
    Ryan White HIV/AIDS providers
    Behavioral or mental health providers
    Agencies with experience providing social services such as SNAP outreach, energy assistance, or tax assistance

  257. 257
    NobodySpecial says:

    I note from the links that are going around FB that the cost of the lowest Gold plan versus the second lowest Silver plan in Illinois is about $30/month. I think I can find a dollar a day to save 10% off my bills.

  258. 258

    @jl: I like your remarks. I call it the the Steampunk Mad Scientist Heath Plan: It has lots of weird-looking parts and whirling gears. It does strange and wonderful things. And every so often, it goes clunk, hisses, emits a cloud of steam, and stops dead.

    The other reason to be concerned about the effects on twentysomethings, as well as on people in the 55-64 age group, is that there will be a political reaction. By 2016, I think everyone will know someone who got pushed over the edge by the PPACA. People are going to realize that the bronze plans are poor insurance and wonder why the government is marketing them. And you may be sure that Ted Cruz will be there to tell these people’s stories.

  259. 259
    The Pale Scot says:

    @The Pale Scot: Can anyone explain why the ACA counselor/navigators are being described as “federal employees,

    Cont. That seems to be a big misrepresentation by the MSM

  260. 260
    Aunt Kathy says:

    @I’mNotSureWhoIWantToBeYet: Amen. I’m not in that twenty-something decade, but AM in that income neighborhood. No way could I pay that. Absolutely no way.

  261. 261
    jl says:

    @Raven Onthehill: I did understand what fuckwit was talking about, and I think he (guessing ‘he; from the handle) made good points.

    The CMS estimates also show average personal health care expenditures of 190 per month for people 18 and younger (edit: in 2012 dollars). So, is there any evidence that the costs for twenty somethings suddenly drop to near zero and zoom up at 35 or 40?

    The age specific estimates also show that the 19 to 44 year old age group gets a much larger than average share of care paid for by ‘other public’, not private insurance, not medicare disability, not medicaid. So I will look through the methodology to see what that ‘other public’ is when I have time. But there seems to be an assumption among some commenters that there is a big group of twenty somethings whose expected costs of care (ex ante) is damn near close to zero. What is the evidence? And is this age group now getting some de facto subsidies because of lack of insurance?

    Maybe Richard has some info on it.

  262. 262
    I'mNotSureWhoIWantToBeYet says:

    @The Pale Scot: I’ve not seen that. Linky?

    Thanks.

    Cheers,
    Scott.

  263. 263
    jl says:

    @Raven Onthehill: I agree with you. Probably what was needed to get something passed though, and we muddle along from here.

    I mean, it’s not like far sighted public leaders, and powerful presidents have been trying to pass health reform for a hundred years, and failing. Right?

  264. 264
    jl says:

    I found the most detailed age breakout of the CMS 2004 age specific estimates.

    age 18 and under: $293 / mo
    age 19 to 44: $375 / mo

    In 2012 dollars.

  265. 265
    geg6 says:

    @goblue72:

    You have no idea what you’re talking about. None. I have lived without health insurance, back in MY 20s. Most of the single (hell, and the married) women I knew we’re like me: on the pill (or some other prescribed device), prone to yeast infections and other female problems that men are completely clueless about (at that age especially) that require medical interventions, getting a yearly Pap smear and pill prescription, various respiratory infections, allergies, and the odd accident requiring stitches or X-rays or tetanus shots. I paid straight out of pocket for all of it and I had medical creditors come after me more than once. I made less than twenty grand a year and would have been thrilled beyond imagining to pay less than a hundred bucks a month to have most of that care covered. You may think you know what these women you knew then paid for their medical care, but I really don’t think they discussed their yeast infections and chlamydia and endometriosis with you.

  266. 266
    Violet says:

    NBC Nightly News just did a segment on the ACA. They showed the various levels of plans and said costs would vary by state. They showed an example of a 60 year old woman in Dallas earning $50k and said the plan would cost $575/ month for silver level coverage, while the same woman in Indianapolis would pay $725/month. So evil red state Texas has a cheaper plan than less-red Indiana?

  267. 267
    jl says:

    @jl: Also in 2004, 19 to 44 year old group still had higher proportion of care paid by ‘other public’: 10.4 percent versus 6.8 percent. Also a higher proportion of care from ‘other personal health care’ That part of the methodology I am familiar with. ‘Other personal health care’ is mostly care provided by public clinics, it is really a payer defined category, not a service category like drugs and inpatient care, though it is used in the service category breakouts (edit: I don;t know why that is, maybe not enough info available from care provided at public clinics for breakouts by type of service or product)

  268. 268
    Mnemosyne says:

    @Raven Onthehill:

    $12,000 is medical bankruptcy, though hospitals will sometimes forgive the debts of people who truly can’t pay. $4,800…well, only perhaps bankruptcy.

    Great, so write me a check for $12,000. After all, it’s no bigger of a bite out of your income than $4,800, right?

    I worry that the bronze plans will swing people over to the Tea Party side.

    If only there was some provision in the PPACA that put an upper limit on the amount you have to pay out of pocket, perhaps a “maximum out of pocket cost.”

    Seriously, do you actually know anything about the PPACA, or do you just go by the scaremongering on DU and Firedoglake and never bothered to actually, y’know, check those “facts” for yourself?

  269. 269
    jl says:

    @geg6: Too beered up, maybe?

  270. 270
    rikyrah says:

    @Elizabelle:

    If employees are more mobile and have better options, the game changes for corporate America.

    Obamacare could be a huge job creator, and a whack at employee serfdom.

    I do think that’s the road we’re going down.

  271. 271
    goblue72 says:

    @geg6: well actually several of them (the several of them being my various girlfriends) did discuss their yeast infections with me, thank you very much.

  272. 272
    goblue72 says:

    @jl: nothing more granular? because the difference between a 19 year old and 40 year old – biologically – is pretty big deal. that’s a two decade age difference.

  273. 273
    The Pale Scot says:

    @I’mNotSureWhoIWantToBeYet:

    I spent the day trying to figure out what’s going on in FL. Multiple articles in FL media described it so.

    Digging into my history:

    Florida Counties Defy Rick Scott’s Obamacare Navigator Ban

    Lead Paragraph.

    Individual counties in Florida have decided not to follow state officials in their call to block federal employees tasked with enrolling Floridians for health insurance exchanges under the Affordable Care Act.

    Government hires ‘navigators’ to help consumers enroll in health exchanges

    To chart these murky health insurance waters, the federal government is spending millions dollars to hire navigators who can help consumers enroll

    There were others, but I read a lot stuff today and can’t remember everything. I was looking to find a navigator to talk and also trying to find out how to become one. Thinking back it might have been theFL based MSM saying this (big surprise) and perhaps elsewhere is different, but it sure does sound like a Tea Ranty to me.

  274. 274
    Mnemosyne says:

    @goblue72:

    Did they discuss with you how much it cost for a doctor’s appointment so they could get the prescription to cure it? It’s only in the last few years that yeast infection medication was available OTC — until then, you had to pay a doctor to diagnose it and then pay again for the prescription medicine.

  275. 275
    jl says:

    @goblue72: Nothing narrower in the published reports or file downloads. Maybe Richard Mayhew has better info.

  276. 276
    mclaren says:

    @PaulW:

    Until the Republicans sabotage everything with the debt ceiling hostage taking.

    I don’t think that’s going to work. The ACA is the law of the land. Republicans can shut down the government, they can force America into default, but they don’t have the votes to repeal the ACA.

    So in the end, all the Republicans can do is make the voters really really pissed off. Because shutting down the government will delay old peoples’ SSI checks, and forcing America into default will raise interest rates for everyone and force the economy back into a recession and damage the whole country financially because of our lowered bond ratings &c.

    This issue is not a winner for the Repubs.

  277. 277
    goblue72 says:

    @schrodinger’s cat: Where did I say that some segment of young people can’t get ill? Where did I say them having health insurance was a bad thing? Where did I say its bad public policy to get the young into the system?

    I didn’t all y’alls suffer from poor reading comprehension. Yes, its good to get the young into the system. Yes, bad things can happen.

    BUT, (and this was my only point before everyone’s poor score on the reading comprehension section of the SAT kicked in), if the cost to secure a so-so Silver policy represents a significant gap from just paying the penalty, then there’s a risk that young people on the lower end of the income range will just pay the penalty as the value proposition from their perspective will not be there – for the reasons I’ve noted ad naseum.

    You can babble on about “I know this 24 year old who got cancer and then hit by a truck and boy she could have used health insurance” but so what? That applies to anyone. But it doesn’t change that in aggregate young people spend less on healthcare than other people. I’ve seen NIH study data that average annual healthcare expenditures for a person age 40 is roughly 80% greater than a person at age 20. (and in both cases – age 20 and age 40 – the expenditures paled in comparison to age 65, with slope in annual average expenditure increases starting to bend more steeply starting around age 50.)

    This isn’t about it being “bad” for young people to buy health insurance. Its about whether the costs vs subsidies are appropriately set to truly incentivize the under 30 crowd from buying health insurance. We’ll all see soon enough, won’t we?

  278. 278
    mclaren says:

    And now for a dose of reality: the typical 27-year-old with a masters degree is likely to be working 4 hours per day as a barista at Starbucks, pulling in a whopping total of about $9000 per year. This typical 27-year-old can’t afford $145 per month.

    So that typical 27-year-old (who lives with 3 other 27-year-olds including his girlfriend in a one-bedroom apartment, for which they all pay $1600 per month in a major city, with two of the occupants sleeping in the living room on futons) will have to go on Medicaid to get his insurance. Unfortunately, states are slashing Medicaid right and left because it’s the biggest item in their state budgets and it’s bleeding them broke.

  279. 279
    I'mNotSureWhoIWantToBeYet says:

    @The Pale Scot: Thanks for the links.

    I find it’s usually best to try to get close to the source in situations like this. OnlineNavigator quotes the PPACA:

    NAVIGATORS.—
    (1) IN GENERAL.—An Exchange shall establish a program under which it awards grants to entities described in paragraph (2) to carry out the duties described in paragraph (3).

    […]

    (3) DUTIES.—An entity that serves as a navigator under a grant under this subsection shall—
    (A) conduct public education activities to raise awareness of the availability of qualified health plans;
    (B) distribute fair and impartial information concerning enrollment in qualified health plans, and the availability of premium tax credits under section 36B of the Internal Revenue Code of 1986 and cost-sharing reductions under section 1402;
    (C) facilitate enrollment in qualified health plans;
    (D) provide referrals to any applicable office of health insurance consumer assistance or health insurance ombudsman established under section 2793 of the Public Health Service Act, or any other appropriate State agency or agencies, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage; and
    (E) provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by the Exchange or Exchanges.

    […]

    (6) FUNDING.—Grants under this subsection shall be made from the operational funds of the Exchange and not Federal funds received by the State to establish the Exchange.

    How one twists that into saying Navigators are federal employees is a bit of tricky yoga, it seems to me. And that seems to me to apply in states that have Uncle Sam run their Exchanges as well.

    But good luck convincing people otherwise. :-/

    I could be wrong, but this seems pretty clear to me. (IANAL though)

    FWIW.

    Cheers,
    Scott.

  280. 280
    goblue72 says:

    @jl: I can’t find either via CMS. I’ve found some narrower bands from NIH studies, based on extrapolations for various sources (CMS and otherwise). What is clear, is that the younger end of the range (age 20) pays a lot less than upper end (age 40) from the NIH info. Both pale in comparison to age 65 and older though. By many orders of magnitude.

  281. 281
    Mnemosyne says:

    @mclaren:

    And now for a dose of reality: the typical 27-year-old with a masters degree is likely to be working 4 hours per day as a barista at Starbucks, pulling in a whopping total of about $9000 per year.

    Starbucks offers health insurance to its part-time employees, so s/he would be covered by that.

  282. 282
    slightly_peeved says:

    @Raven Onthehill:

    By 2016, I think everyone will know someone who got pushed over the edge by the PPACA. People are going to realize that the bronze plans are poor insurance and wonder why the government is marketing them.

    If only there were some sort of cheaper Catastrophic Health Care Plan such people could get…

    Also, it seems like you’re completely neglecting all the other changes to the health insurance market that Obamacare creates – no recission, set levels of basic coverage and care. Bronze insurance under Obamacare is better than most insurance pre-Obamacare, because the insurance company can’t kick you off when you get sick.

  283. 283
    Mnemosyne says:

    @goblue72:

    there’s a risk that young people on the lower end of the income range will just pay the penalty as the value proposition from their perspective will not be there – for the reasons I’ve noted ad naseum

    And yet I have yet to hear from anyone in that age range who says they will voluntarily go without health insurance because of cost considerations, and a lot of counter-evidence that the majority of them are eager to buy it.

    So what percentage of those young people are you estimating will not buy health insurance? 50 percent? 60 percent? From my experience, I think it’s going to be more like 10 percent, if that, because contrary to what libertarians tell you, most young people are not stupid and would rather stretch their budgets a little to have health insurance than gamble and go without.

  284. 284
    jl says:

    @goblue72: Thanks for info.

    For the CMS studies from front page go to ‘Research, Statistics, Data and Systems’, look for ‘National Health Expenditure Data’ under ‘Statistics Trends and Reports’ and look at LH sidebar.

    Do you have links for the NIH studies?

    And thanks for clarification on your point.

    I hope Richard can point to some data that will clarify whether there will be problems with buy-in with these damn kids today.

  285. 285
    mclaren says:

    @Mnemosyne:

    Do all part-time employers offer health insurance to their employees? I think not. Starbucks is just one example of an employer. The point is that most 27-year-olds now work part-time precisely because their employers can get away with not offering ’em health insurance if they work 20 instead of 40 hours per week.

    Once again, your objecti is completely beside the point. The hard cold reality for most workers under 30 is that they don’t get health insurance on the job and most of ’em can’t find full time jobs — some recent graduates, about a third, can’t find any job, but let’s not talk about those folks. Instead, let’s focus on the recent graduates who got lucky and did find a job.

    They still don’t get health insurance under the ACA. They have to rely on Medicaid, which is collapsing. Google “States slash Medicaid” to see what I mean.

  286. 286
    TopClimber says:

    From:

    http://billingsgazette.com/new.....46115.html

    The maximum amount of payback is tied to your actual 2014 income. If you earn anywhere from 100 percent to 199 percent of the federal poverty level, your maximum payback is $300 for an individual and $600 for a family.

    The maximum payback rises gradually to $1,250 for an individual and $2,500 for a family for those earning 300 percent to 399 percent of the poverty level, and, for those at 400 percent of poverty and higher, you must pay back all of the overpayment.

    ****

    So, for an individual earning up to about $22,000 (200% of poverty level), the max payback is $300, and for a family earning about $47,000, it is $600. I believe this may be less than the subsidies you get in the first place. Remember, folks at these levels get considerable help with copays and deductibles, and not just premiums.

    For those hitting the 400% range, yes it may be that the penalty is higher than the subsidies, especially since folks here are paying at a marginally higher tax rate for any extra income. I would welcome definitive analysis.

    Three points:

    1. It doesn’t seem an imposition to have windfall profits go back to paying subsidies. We are trying to help people afford health insurance who can’t, not help people who have the means to pay live off taxpayer largess. (I am a liberal of the thrifty persuasion).

    2. One year’s windfall will not affect he following year’s subsidy. The year 2 subsidy will be based on your good faith estimate of year 2 income. Of course, if you are so lucky that your income takes you substantially past your estimate, how is that a bad thing?

    3. For people who do not qualify for subsidies, the exchanges should tend to be a better deal because a larger pool will make all rates lower for equivalent policies vs. today’s rates. So you may be forced to pay back something, but you are still paying less than without Obamacare.

    Poverty level ranges, 2013:

    Individual…100% = 11,490. Multiply by 2,3,4 for higher ranges.

    Family of 4…100% = 23,550

  287. 287
  288. 288
    mclaren says:

    @Mnemosyne:

    So what percentage of those young people are you estimating will not buy health insurance? 50 percent? 60 percent? From my experience, I think it’s going to be more like 10 percent, if that, because contrary to what libertarians tell you, most young people are not stupid and would rather stretch their budgets a little to have health insurance than gamble and go without.

    Let’s do the math.

    A recent college graduate who works 20 hours a week is lucky to get $9/hour before taxes. That’s 52 x 20 = 1040 hours * $9/hour = $9360 per year before state and federal taxes.

    States taxes scrape 10% right off the top of that take-home, while FICA + the other taxes scrape another 10% off the top. So now you’re looking at a whopping $7488 per year of take-home pay after state and FICA taxes. I’m assuming that $9360 will be at the minimum level below which you don’t need to file federal taxes, so you won’t have any federal taxes (this is why 47% of the American population doesn’t pay federal taxes, incidentally).

    So now let’s add up the typical rent + food + transportation + amenities (toilet paper, socks, etc.) for your typical 20-something living with 3 other 20-somethings in a typical one-bedroom apartment in a major city. Rent – $1600/month split 4 ways, so you’ve got $400/month for your share of rent. Food? Figure $200/month. You’ve got a smartphone, so figure $50/month for unlimited data + text + talk (every 20-something has a smartphone, don’t ask me why). Now figure another $50/month for amenities, and another $50/month for transportation — say, a bus pass, or BART tokens, or subway fare, or something like that. A 20-something certainly cannot afford a luxury like a car. And figure $50/month for your share of internet/cable TV/electric bill split 4 ways.

    What are your monthly expenditures?

    $750/month.

    What’s your monthly income?

    $7488/12 = $624/month.

    So your expenses are actually greater than your income. Meaning that you need another part-time job just to make ends meet. Oh, but wait…you went a state college like Berkeley and wound up $100,000 in debt (yes, that’s kind the debt you get just for a good state school like UC Berkeley nowadays for 6 years), so you’ve got $500/month in debt payments on your college debt. So even with a second part-time job, you now have $1248/month income after taxes, but $1250/month expenses including college debt.

    Whoops.

    Where does that $145/month come from, Mnemosyne? Does that 20-something rob liquor stores to get that money? How exactly does someone working a pair of part-time jobs and paying off exorbitant college debt afford $145 per month for some goddamn health insurance?

    Explain it to me, genius.

    Oh…and by the way — the situation is actually worse than I assume here, because getting a second part-time job pushes our hypothetical recent college grad into a federal taxable bracket, so because there’s going to be about 10% federal taxes on the total take-home, our hypothetical 20-something will actually be taking home less than the $1248 we assume here. I’m guessing our hypothetical 20-something can deal with that by not getting cable TV (that might save $25/month per person) and might even choose not to have internet at home (if they have a smartphone and can connect via free wifi hotspots), which might save another $20/month per person.

  289. 289
    The Pale Scot says:

    @I’mNotSureWhoIWantToBeYet: Thanks for the Online Navigator link, looks interesting,

  290. 290
    Mister Harvest says:

    @mclaren: In the scenario you give, they get Medicare, for which they pay $0 (at least, in California, but that’s below the Federal poverty line anywhere). Yes, that’s a second- (or fourth-) best option, but they’re still covered.

    If they are making $16,000, which is just above the Medi-Cal limit, the cost is $41 through $80. That’s not free, but it’s not insanely high, either.

    (I used Kettleman City as the target, which is a cheap place to live. If they are in San Francisco, the cheapest plan is $7 per month.)

  291. 291
    mclaren says:

    @TopClimber:

    These hilarious fantasy-land assumptions of individuals making $22,000 per year are straight out of the Land of Oz. Hire this guy as a Hollywood screenwriter, he can make a sequel to Oz the Great and Powerful.

    Out here in the real fucking world, recent college graduates do not make $22,000 per year. They’re lucky to work part-time getting $9 per hour. In fact, if they live in New York or some other similar shithole, they’ll make less than $9 per hour. They might have to scrape by on $8 per hour.

    As for $47,000 per year…what a laff riot. Who the fuck makes $47,000 per year nowadays? Boomers.

    That’s why the only people you see buying cars are over age 60. Those are the only fuckin’ people in the American economy who have any money nowadays.

    Get real. These delusional fantasies of 20-somethings making $22,000 are straight out of an LSD trip. Out here in the real world, on planet earth, a 20-something recent graduate is lucky to find a part-time job at minimum wage, let alone something paying $22,000.

    With the help of a small army of researchers and associates (most importantly, Chris Matgouranis, Jonathan Robe, and Chris Denhart) and starting with help from Douglas Himes of the Bureau of Labor Statistics (BLS), the Center for College Affordability and Productivity (CCAP) has unearthed what I think is the single most scandalous statistic in higher education. It reveals many current problems and ones that will grow enormously as policymakers mindlessly push enrollment expansion amidst what must become greater public-sector resource limits.

    Here it is: approximately 60 percent of the increase in the number of college graduates from 1992 to 2008 worked in jobs that the BLS considers relatively low skilled—occupations where many participants have only high school diplomas and often even less. Only a minority of the increment in our nation’s stock of college graduates is filling jobs historically considered as requiring a bachelor’s degree or more.

    Source: “The Great College-Degree Scam,” Richard Vedder, Chronicle of Higher Education, 9 December 2010.

    Observable reality, motherfucker. Deal with it.

  292. 292
    TopClimber says:

    @mclaren: I shall consider myself schooled.

  293. 293

    @mclaren:

    They have to rely on Medicaid, which is collapsing. Google “States slash Medicaid” to see what I mean.

    Let me Google that for you.

    Now find me a link on that page from 2013.  Not the 2010 link from the Wall Street Journal or the WSWS, but an actual current link with information from the last 12 months.

    You’re working off information that’s at least 3 years old, if not older.

  294. 294
    TopClimber says:

    @Raven Onthehill: See #286. Botched the reply method.

  295. 295

    @mclaren

    Fascinating how all of your scenarios depend on the fantasy that Medicaid and subsidies somehow don’t really exist.

    You do realize that California accepted federal Medicaid funds, right? No Medicaid slashing here — in fact, we’re expanding it. So your hypothetical low-wage worker riding the BART is paying ZERO for healthcare coverage via Medi-Cal.

  296. 296
    mclaren says:

    @Mister Harvest:

    If correct, this suggests that Obamacare is actually back-dooring universal health care via a stealth “Medicare for all” option. Certainly for the vast majority of 20-somethings.

    That’s actually pretty clever.

    If we also figure that our hypothetical 20-somethings will get more vocal and vote more often as they get older (only 30% of the under-25 population votes in presidential elections, while 60% of over-60s vote in presidential elections), this would also create a huge voting bloc with personal incentive to improve Medicare.

    That’s actually pretty smart strategy on Obama’s part.

    At least…it would be, if only Medicare costs weren’t skyrocketing. You do realize that if most 20-somethings wind up on Medicare, this only going to exacerbate the cost crisis with Medicare, don’t you?

    Take a look at this chart and explain to me how we make a stealth “Medicare for all” reform work without a massive overhaul of our broken U.S. health care system to implement savage and scorched-earth cost reduction (AKA big pharma bribery elimination, sweetheart contract shutdown, elimination of the AMA cap on annual medical school enrollments, etc., etc., etc.)…

    And everyone who’s looked at the situation (except the insane Republicans who applauded when Republican presidential candidates in 2012 suggested that people without health insurance should “be allowed to die”) says that to achieve this level of cost reduction in the American health care system, we’re going to need nationalized single-payer health care with government cost controls on all the procedures and all the medications. Which is basically what I’m been banging the table for lo, these 7 years or more.

  297. 297
    Mister Harvest says:

    @mclaren:

    If correct, this suggests that Obamacare is actually back-dooring universal health care via a stealth “Medicare for all” option. Certainly for the vast majority of 20-somethings.

    This is why the matching funds fight was a big deal.

    By July 2014, doing anything to cut PPACA will be about as popular as Ebola, and the Republicans know this.

  298. 298
    mclaren says:

    @Mnemosyne (iPhone):

    Apparently you don’t realize that in order to get on MediCal (that is the California medicaid program), a single person can’t have any more than $3000 in assets. So that laptop and that iPhone that 20-something owns, plus the stereo and TV and bed and sofa and table and whatnot?

    Oops!

    More than 3 grand. No MediCal for you!

    You just don’t live in the real fucking world, do you, Mnemosyne?

    California MediCal property limits available as a government pdf here.

    Oh, and if you live in California…sweetheart, you bet your ass, you own a car, even if you’re a 20-someting. And guess what? That car you own just blew your $3000 personal property limit right out the window. If you live in California and own a car, you do not qualify for MediCal.

    Unless you’re pregnant and under 19, that is.

    Jesus Christ on a skateboard, am I the only person on this fucking site who actually reads the goddamn legislation?

  299. 299
    Mister Harvest says:

    @mclaren: None of those assets count towards the $3,000.

    Excluded are:

    * Your primary home
    * One vehicle
    * Household goods and personal belongings

  300. 300
    Elizabelle says:

    @Mnemosyne:

    What’s more, a lot of young people are seeing what’s happening to their parents and older siblings who are struggling without insurance.

    I would guess you and I saw less of that when we were 20somethings because corporate America was more generous with bennies and you hadn’t had the outsourcing madness yet. College was more affordable too — you weren’t in debt peonage until midlife.

    The young get a rougher deal now.

  301. 301

    @Mister Harvest:

    I guess mclaren missed that part when she was carefully reading every word of the legislation.

  302. 302
    Mister Harvest says:

    @mclaren: Before we go down the rabbit-hole about the car, the document you are looking at is for section 1931(b) Medi-Cal. That’s a different program than the expansion under PPACA (Medi-Cal has like 40-odd different programs). Under every other Medi-Cal program, including the PPACA expansion, one vehicle is exempt regardless of value.

  303. 303
    Mister Harvest says:

    @mclaren: Actually, the PPACA-appropriate exemptions are right there in the document you linked to. Cruise down to Part 2. Notice, “one vehicle.”

    If you want to argue that recent college graduates these days are getting an incredibly raw deal, I’ll agree. If you want to argue that there will be people who will hit a super-uncomfortable place where they make enough that they have to buy insurance but not enough that the insurance will be comfortably affordable, I’ll agree. If you argue that the Republicans that run the states that are withholding participation in exchanges are going out of their way to screw their own constituents to the wall so that the Kenyan Usurper can’t claim a victory, I’ll double-high-five you.

    And if you want to argue we should have something like Canada’s Medi-Cal or the NHS, I’ll say “From your lips to God’s ears.”

    But don’t piss on PPACA more than it deserves. This is going to fundamentally change how millions of people interact with medical care, and will save thousands of lives.

    Let’s be real here. If the Republicans thought that this was a terrible bill that would crash and burn and permanently tar Obama’s record, do you think they’d be fighting it? Does that sound like the Republican party we know?

  304. 304
    mclaren says:

    @Mnemosyne (iPhone):

    What Mister Harvest says is simply not correct according to the documents on MediCal’s website.

    * Personal property is not exempt unless owned by a child.
    * A car is only exempt if it is used for self-employment (commuting is specifically excluded as a reason for exemption).

    Check the MediCal rules. They’re online.

  305. 305
    Mister Harvest says:

    @mclaren: With all due respect, I have no idea where you are getting this information.

    In Part 1 (which, remember, is for a different program than PPACA’s expansion) “Household items and personal effects including TVs, VCRs, computers, and jewelry” are listed under the exemptions. Motor vehicles are exempt if they have a fair market value under $4,650, or if the equity value is under $1,500; in short, if they are beaters, which is a pretty logical assumption for what such a person would own.

    But that does not matter, because Part 1 is not the section that applies to PPACA. Part 2 is. In Part 2, which starts on page 4 of the document you linked to, the following is listed as exempt without qualification:

    * One motor vehicle.
    * Personal effects. This includes clothing, heirlooms, wedding and engagement rings, and other jewelry with a net value of under $100.
    * Household items.

    In short, your hypothetical 22 year old above, with a $2,000 laptop, $6,000 car, and $1,500 in furniture, will qualify for Medi-Cal. Full stop.

  306. 306
    Ruckus says:

    One thing I haven’t seen anyone ask or answer is…
    Assume I purchase a plan and make all the payments.
    Who makes sure that the insurance companies actually pay the bills? Isn’t that a big part of the problem now? We pay outrageous amounts and many things now get denied. What mechanism is there, if any to get the insurance companies to pay what they agreed to when I purchased? Is the fact that the metallic plans all set the covered issues? And if that’s it, is that enough?

  307. 307
    Betsy says:

    @goblue72: that’s nonsense, you over-generalize from your own experience perhaps. I worried a lot in my twenties when I had to go without health ins a few times between jobs or school. I could have gotten pregnant for one thing, or been in an accident. Young women know starting in high school that you arre supposed to get a yearly ob-gyn exam whenver you start being esxually active and therafter. And all women are supposed to get an annual exam and Pap smear, and our cycles constantly keep us aware that things are always happening inside our bodies (including signaling with various irregularities, which are very common, that something might not be quite right, which is also very common). Also maybe as women we are socialized to have a lot more consideration for the parents who would cash in their retirement savings to save a sick or injured adult kid from harm. So I think your automatic male-centric assumptions about risk evaluation are baloney. I paid 450 a month a few years ago to keep myself on health insurance when I made less than 20,000 a year, and it was worth it because who wants to find out that you’re screwed?

  308. 308
    Betsy says:

    @goblue72: a gyno exam could be had for 200 bucks

    Not if it turns up the need for fibroid surgery or cervical abnormalities, you idiot

  309. 309

    @mclaren:

    Scroll to Page 2 of your PDF. Exemptions include property used as a home, motor vehicles valued under $4650, and household items.

    Again, you need to read your own links once in a while.

  310. 310
    Betsy says:

    Ps and don’t talk that way to aimai
    She’s a lot smarter and more observant than you will ever be

  311. 311
    Betsy says:

    @jl: It might be young women getting their primary and ob gyn care from Plannned Parenthood, county health department clinics, and college health services/ infirmaries. These are significant enough for ages 18-35 to add up to nearly that percentage.

  312. 312
    Betsy says:

    @goblue72: oooooOooooooOOOOOoooooooooOOOOOOOooooohh so you had a GRILFRIEND and that allows you to mansplain it to us, does it.

  313. 313
    Ruckus says:

    @Betsy:
    I’m a guy but I still understand that women have, generally, more health care needs than men. Especially women under what 55ish? Your bodies work somewhat differently. I’m always amazed when men seem to forget that, and all the while seemingly liking the differences.

  314. 314
    Richard Mayhew says:

    @Ruckus: A couple of things will help to make sure the bills are getting paid:

    1) State and federal regulators control which companies are qualified to sell on the exchanges. No one wants to lose access to 7 million potential sales.

    2) With the ban on denials for pre-exisiting conditions, one of the big drivers of denials/appeals will be disappearing.

    3) Back-end risk/cost sharing will reduce incentive for denials — (insurers with post-facto sicker populations will get some money from insurers with healthier populations)

    If this does not work, complain to your state regulator and your state rep — everyone likes to beat up on insurance companies, and this time, it might do you some good.

  315. 315
    Ruckus says:

    @Richard Mayhew:
    Thanks!

    I figured something like that but wondered if there was any enforcement details that I hadn’t heard about.
    I get my healthcare from the VA. A big thank the deity of your choice for fascist, socialist, communist, government healthcare. Up until 2005 I had employee health care insurance. Got into the VA system in 2012. Without a doubt the best care I’ve ever had. It is a bureaucracy for sure but a well run one. I give thanks that they quite possibly saved my life.

  316. 316
    Mister Harvest says:

    @Ruckus: I have mixed feelings about Kaiser, but if they are available in your state, they have a couple of big advantages:

    1. They put it all into care. They have of the best care/admin ratios of any of the large providers.

    2. They are both the insurer and the provider, so there’s a lot less finger-pointing than you get when those are separate organizations.

  317. 317

    @@TopClimber: The problem comes in at the top edge of the subsidy. Here, try this: this is a link to the Berkeley Labor Center calculator. Go there. Try a typical older couple. He’s 58, she’s 57. No children on the tax return. Run the calculation for $62,000 MAGI, then for $63,000 MAGI—that’s just at the edge of 4 x FPL. The resulting difference is $11,300.

    Pretty big moat. That couple’s income, like many people’s is variable and I don’t think the subsidy is worth the risk for that couple, if their expected household income is above $50,000/year. If possible, I suggest they tighten their belts (that’s hard, I know) and if the subsidy is available, take it as a refund at the end of the year.

  318. 318

    @jl: “It would help if commenters would try to explain the points they are trying to make about these twenty somethings. That it’s unfair? People don’t like to pay bills? What?”

    Thinking it over, it’s also that it’s coming into effect during the deepest depression in 50 years. Young people are already hurting, and this is just one more thing. And—they’re not stupid. They know that this depression is a result of policy. They know that this is also a result of policy. I don’t know what the political reaction will be, but I expect it to be huge.

  319. 319
    Ruckus says:

    @Mister Harvest:
    My experiences with Kaiser are all second hand. Have friends with Kaiser and visited him in the hospital. Not bad care but a lot more hectic and more uncertainty among the nurses. Not so at the VA. Two things the VA does real well, first they check at every step to make sure they have the right person and procedure happening. Sounds a little silly, everyone does this. But everyone really doesn’t do it as well in my experience. Second, they will take the time to explain everything along with never giving me the brush off if I have questions. If the person I’m taking to doesn’t know the answer(rare) they ask or send you to someone who does. Only once did I hear someone not have answers. That was on July 5th and he told people up front that he worked in another clinic and had never worked in this clinic before and was only there due to the holiday. And he called and got answers for several people. To sum up it’s a no bullshit org that provides great medicine. Everyone should be so lucky and have this good of care. That’s what I thought I was enlisting for, the betterment of all of us. How stupid of me.

  320. 320
    Ruckus says:

    @The Raven on the Hill:
    Some even seem to be less stupid than some of their parents and grandparents and realize that long term health care is better if used properly and over the course of one’s life rather than only in case of an accident. And that tying health care and recessions is important in that during the recessions, health care insurance (especially less expensive) is still much better than no health care insurance. Cause if you don’t have a job you will most likely be subsidized so that you still have care and no bills. Not a bad tradeoff.

  321. 321
    Another Holocene Human says:

    @ranchandsyrup: Many cults promise freedom from disease, decay, aging, and even death itself.

  322. 322
    Another Holocene Human says:

    @schrodinger’s cat: My friend was 26. Thank goodness his professor kept him on as an RA on the books so he’d retain his health insurance.

  323. 323
    Another Holocene Human says:

    @Ruckus: Either that, or the poster is a lesbian who lived in a separatist community, enjoyed good reproductive health (“no news is good news”) and has no frigging clue about the health needs of heterosexually active women. And is such a dick that nobody’s ever told her about their: fibroids, hemorrhaging, hysterectomy….

  324. 324
    Betsy says:

    @The Raven on the Hill: Yeah, but, so, what would you propose as an alternative? That people get insurance entirely without cost? It does cost something.

    The problem you are describing is one of the economy and stupid policies around the economy and jobs. I don’t see why attacking the health care law is helpful.

    The argument you are making about unaffordable premiums is economic. People got no jobs, people got no money. It’s true.

    But the alternative is to say, “OK, no health insurance; just like before. We’ll just settle into being a third world country now.”

    Or, “everyone will get it for free.” Then who pays? Right now the subsidies are already pretty high and it’s paid by taxes on the wealthy (basically). We could do more of that, I suppose.

    But I think that it’s OK to ask people to help pay. Less, for those people who make less. They are after all getting a valuable thing. People value what they have to pay for, at least in part.

  325. 325
    The Raven says:

    @Betsy: “Yeah, but, so, what would you propose as an alternative?” Medicare for all. The only reason we don’t have that is because the insurance companies would be shut out. Probably the best way to pay for it is out of a graduated income tax with lots of steps. Medicare is actually a two-tier system. Providing a basic level of care with tax funding, and some supplementary levels would work very well.

    “Less, for those people who make less.” But that’s not what this law will do. Instead, people who make less will pay more, if (1) they are healthy or (2) they have an serious illness or injury. This follows the fine American tradition of trying to make the poor pay for their charity, and that trick never works. In housing it failed so spectacularly they had to demolish buildings.

    And wow are they going to hate it.

    It’s also going to create two more barriers to upward mobility; people who are working to get off Medicaid are going to have a hard time of it, and people who are trying to make the jump from lower middle class to the middle of the middle class are going to have a hard time of it.

    It’s a really awful plan…and here we are trying to make it work.

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    TopClimber says:

    @The Raven on the Hill: Thank you for clearing up how subsidies fall off the cliff. However, I don’t understand what the “risk” would be in taking the subsidy unless there is a penalty and interest for paying it back. At worst you pay what it would have cost you anyway without the ACA. Unless exchange premiums are higher than what they were before for comparable individual plans or you really wanted a plan with fewer benefits than now mandated, yes its is a stupid way to allocate subsidies but is the household any worse off?

    No doubt this has been covered elsewhere but then I am sure you will be kind enough to point out where. (No snark intended).

  327. 327
    The Raven says:

    @TopClimber: The penalties for late payment, as far as I can tell, would be the same as those for not paying taxes.

    I don’t know about you, but a chance of unexpected $12,000 expense at the end of the year sure sounds like a risk to me. So my hypothetical couple either saves the money during the year, or just lets the IRS take it in the first place. That’s why I say they’d be best off not bothering with the early credit if their income is over $50,000—either way, they can’t spend the money, and if they don’t have it in savings there will be no temptation to spend it. (This changes, of course, if interest rates go back up. Then it makes sense to save the money and make a bit of interest on it.)

    And they have to hope that their income doesn’t fall into the moat of $62,000 to $73,000, which is a hell of a thing to hope for—hope you don’t make more money. Talk about a disincentive!

    I don’t think this has been written up anywhere else yet, so I think you’ve heard it first, here. I wonder if anyone who passed the law knew. I wonder if anyone cared.

  328. 328
    Richard Mayhew says:

    @The Raven: The moat is not absolute. Using the Kaiser Foundation subsidy calculator for a family of two adults on a US national average plan, they receive no subsidy at $60,000 a year, and a $320 subsidy at $50,000 a year:

    http://kff.org/interactive/sub.....-tobacco=0

  329. 329

    @Richard Mayhew: Your link is for 21-year-olds, fergawdsakes. For 40 year olds, it’s $1,730, for 50 year-olds, it’s $4,306. Pretty damn hard on older couples, wouldn’t you say?

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    (Sorry, wrong ‘nym used. There’s too many of us birds.)

  331. 331

    I think the bottom line here is that this is, well, cruel. It’s a plan that hits hard on two groups most affected by the depression: young people and people in their mid-to-late 50s and early 60s. It wouldn’t have been hard to predict this. Thanks, guys.

    And, somehow, we’re supposed to make the best of it. Well, when handed a lemon…

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