Affordable Health Care Law under review by SCOTUS

[cardboardbox]

Sorry. Here's my response:

1. What I said was in jest.
2. It was an alternative fact.
3. Many of the posts are still under audit.
4. It only seems like a couple of thousand posts because so many of them are like #1049.

You just wait until I get your posts from 2005!!

[GwynnInTheHall]

You just wait until I get your posts from 2005!!

You'll be Lucky if you do.

[In the Corn]

I think this covers the differences between "bronze" plans and "catastrophic" plans. Catastrophic plans are supposed to have substantially lower premiums. In practice, the actual out of pocket costs of the bronze plans are supposed to work out lower than the listed deductibles.


1-Bronze Plans

2-Catastrophic Plans


Available to
1-Anyone who is eligible to buy a plan on the health insurance marketplace.
2-Only those under age 30 or who cannot find coverage for less than 8 percent of their income.

Premium tax credits
1-Individuals making up to $46,680 (or families of four making up to $95,400) can use a new kind of upfront tax credit to lower their monthly premiums.
2-Premium tax credits are not available for catastrophic plans.

Covered services
1-Covers 60 percent of health care costs for the average person and specified preventive services at no cost. Covers three primary care visits and specified preventive services before the deductible.
2-Only covers additional services after the plan deductible – $6,600 for an individual plan or $13,200 for a family plan – has been met.

Actuarial Value
1-Bronze plans will have an “actuarial value” of 60 percent, meaning they will cover 60 percent of all health care costs for the average person.
2-Catastrophic plans will likely have an actuarial value of less than 60 percent. Catastrophic plans will only cover health care costs (beyond three primary care visits and specified preventive services) after the plan deductible has been met.

Deductible
1-Maximum deductible of $6,600 for an individual plan ($13,200 for a family plan), but actual deductibles are likely to be significantly lower because plans must cover 60 percent of health care costs for the average person.
2-Deductible will be $6,600 for an individual plan ($13,200 for a family plan).

Out-of-pocket limits
1-Out-of-pocket expenses are capped at $6,600 for self-only plans ($13,200 for family plans).
2-Out-of-pocket expenses are capped at $6,600 for self-only plans ($13,200 for family plans).

Preventive services
1-Covers specified preventive services at no cost.
2-Covers specified preventive services at no cost.

Essential health benefits
1-Covers 10 categories of “essential health benefits.”
2-Covers 10 categories of “essential health benefits.”

So the difference is I get the privilege of having 60% of the cost covered by my insurer.

On my Bronze Plan, with my premium being more than $850/month, and again the majority of the is subsidized, on a bad year insurance for my wife and me would be just over $24,000. Again, my premium is almost completely subsidized, but my deductible is going to take longer to meet.

If I had a Catastrophic Plan, in some quick research my premium would be less than $200 (subsidies aren't allowed) and a deductible roughly the same. So on a bad year, I would potentially save $7,200.

Again, in reality, how is my Bronze Plan not a catastrophic insurance plan?

[The Feral Slasher]

So the difference is I get the privilege of having 60% of the cost covered by my insurer.

On my Bronze Plan, with my premium being more than $850/month, and again the majority of the is subsidized, on a bad year insurance for my wife and me would be just over $24,000. Again, my premium is almost completely subsidized, but my deductible is going to take longer to meet.

If I had a Catastrophic Plan, in some quick research my premium would be less than $200 (subsidies aren't allowed) a a deductible roughly the same. So on a bad year, I would potentially save $7,200.

Again, in reality, how is my Bronze Plan not a catastrophic insurance plan?

Almost as if it was designed so that a certain party could claim they increased the number of insured without actually helping them very much.

[In the Corn]

Almost as if it was designed so that a certain party could claim they increased the number of insured without actually helping them very much.

No, we wouldn't want to play politics...

And remember, I a single-payer advocate.

[Hornsby]

Well, Ryan and the GOP caved today, and admitted that in order to pass Trumpcare/Ryancare/IDontCare, they're going to have to do major revisions to the bill. I have mixed feelings about this, while I'd love to see the thing implode on the GOP,and Implode THE GOP, I'm much happier haveing at least decent health care for all Americans. Not that this is going to do that, but maybe they'll hurt less people while doing it.

By Mike DeBonis, Elise Viebeck and David Weigel March 15 at 7:21 PM

House Speaker Paul D. Ryan said Wednesday that his health care proposal must change to pass the House, marking a significant retreat from his earlier position that the carefully crafted legislation would fail if altered.

The shift came after a private meeting of House Republicans from which Ryan (R-Wis.) emerged to tell reporters that his proposal to revise the Affordable Care Act would “incorporate feedback” from the rank-and-file. Ryan attributed the change of strategy to the impact of an analysis issued Monday by the Congressional Budget Office. Among other details that prompted a fresh round of criticism of the proposal was a projection that 14 million fewer Americans would be insured after one year under the Republican plan.

Ryan backed away on Wednesday from his previous rhetoric of calling the measure’s fate a “binary choice” for Republican lawmakers.

“Now that we have our score ... we can make some necessary improvements and refinements to the bill,” he said, referring to the CBO’s estimate of the impact on the number of those covered by health insurance and what the GOP proposal would cost.

Ryan did not detail what changes are under consideration.

Vice President Pence also spoke to House Republicans in the meeting, acknowledging that changes to the legislation — which heads to the House Budget Committee for approval Thursday — are in the works. President Trump has offered his support for Ryan’s measure, while still meeting with conservative lawmakers who have expressed serious doubts about the plan.

“This president is ready to put the full weight of his bully pulpit and all of his tools” behind the bill, Pence told Republicans, according to Rep. Kevin Cramer (R-N.D.). “It was very important for us to hear that, because there are a lot of people who need that shoring up.”

Pence told conservatives that the plan was still under negotiation at a private lunch meeting of the Republican Study Committee, a large caucus of conservative House Republicans, according to several attendees.

https://www.washingtonpost.com/powerpost/speaker-paul-ryan-doubles-down-on-gop-health-care-plan-amid-opposition/2017/03/15/872c4f3c-0974-11e7-93dc-00f9bdd74ed1_story.html?utm_term=.9fe183b0d563&wpisrc=al_alert-COMBO-politics%252Bnation&wpmk=1

[Redbirds Fan]

You just wait until I get your posts from 2005!!

That's pretty damned funny.

[Redbirds Fan]

So the difference is I get the privilege of having 60% of the cost covered by my insurer.

On my Bronze Plan, with my premium being more than $850/month, and again the majority of the is subsidized, on a bad year insurance for my wife and me would be just over $24,000. Again, my premium is almost completely subsidized, but my deductible is going to take longer to meet.

If I had a Catastrophic Plan, in some quick research my premium would be less than $200 (subsidies aren't allowed) and a deductible roughly the same. So on a bad year, I would potentially save $7,200.

Again, in reality, how is my Bronze Plan not a catastrophic insurance plan?

I'm not trying to pry into your business, and I haven't said your plan isn't essentially a catastrophic plan, but I have a couple of questions about things I don't understand about your post.

Is the $850/mo before or after the subsidy? And what does it mean that on a bad year the insurance is $24K? Is that $850 times 12 plus $13,200 in deductibles?

Everybody's situation is different. I know that for me, having a good idea what my medical bills could be, it made sense to get a gold plan even though the premiums were too much higher than the silver or bronze, since I was almost 100% sure it would be made up in out-of-pocket expenses. Some people can't cover premiums, or won't have enough out-of-pockets to justify the choice.

I know that when I was on Obamacare and has very little income, my premiums were subsidized and I paid something like $100 a month for the short time I was on it. I do remember that it helped when Ms. Lucky fell, broke her ankle, was taken to the ER, etc., etc.

Sympathy for the high medicals, as there must be conditions to go with them, and I certainly understand that.

[baldgriff]

You can look at it that way. Another option would be just to make health care a government function, like national defense, education, prisons, social security.

Hey, we're forced to "buy" the military whether we want it or not, because the government thinks it is in our best interest.

I don't use it. And I'm tired of subsidizing the military-industrial complex. Boeing, Lockeed Martin, Bechtel, Haliburton...they've been screwing us for decades. It's a disaster!

And this is why we differ... we look at healthcare through different lenses, and what we assign as a government responsibility.

We appear to agree that Defense and Infrastructure are the responsibility of the government. We also agree on the Social Security program - which I honestly have no expectation will be available to me in 20 years to take use (another argument that gov't is extremely ineffective at running most programs - including military budgeting).

I will also agree that prisons (enforcement of govt laws) should be a government function and I very much struggle with the privatization of prisons - when government "outsources" it just seems to get more expensive.

I will agree with you, that our government spending on defense appears excessive. In my mind, this is due in part to our attempting to spread democracy by force (for lack of a better term) and playing police for world. National Defense is real legitimate expense of the government, and some companies have successfully taken advantage of the programs and budgets.

I believe that the Federal Gov't should stay out of the education business and that they have forced some really bad curriculum down the throats of the states by making funding contingent on the implementation of bad curriculum (i.e. Common Core).

[Redbirds Fan]

And this is why we differ... we look at healthcare through different lenses, and what we assign as a government responsibility.

We appear to agree that Defense and Infrastructure are the responsibility of the government. We also agree on the Social Security program - which I honestly have no expectation will be available to me in 20 years to take use (another argument that gov't is extremely ineffective at running most programs - including military budgeting).

I will also agree that prisons (enforcement of govt laws) should be a government function and I very much struggle with the privatization of prisons - when government "outsources" it just seems to get more expensive.

I will agree with you, that our government spending on defense appears excessive. In my mind, this is due in part to our attempting to spread democracy by force (for lack of a better term) and playing police for world. National Defense is real legitimate expense of the government, and some companies have successfully taken advantage of the programs and budgets.

I believe that the Federal Gov't should stay out of the education business and that they have forced some really bad curriculum down the throats of the states by making funding contingent on the implementation of bad curriculum (i.e. Common Core).

Some people would have us believe that Common Core is a federal program. It is not. It was developed by private non-profit groups and state boards of education. States may adopt it or not. It is purely voluntary. States first began to adopt it in 2010, so I'm not sure the jury is in on whether it works or not.

Saying that state funding is contingent upon it is not true. There are certain grants for which states can apply, and having Common Core programs gives those states a better chance at getting those grants. Nobody is denied funding. No funding is withheld.

Common Core is another boogey man of the GOP. Don't believe the hype.

[baldgriff]

Some people would have us believe that Common Core is a federal program. It is not. It was developed by private non-profit groups and state boards of education. States may adopt it or not. It is purely voluntary. States first began to adopt it in 2010, so I'm not sure the jury is in on whether it works or not.

Saying that state funding is contingent upon it is not true. There are certain grants for which states can apply, and having Common Core programs gives those states a better chance at getting those grants. Nobody is denied funding. No funding is withheld.

Common Core is another boogey man of the GOP. Don't believe the hype.

My apologies - it is not a Federal Program. However, the adoption of the program did earn states points for in Race to the Top funding. So I suppose one can say that funding is not denied or withheld - however, it works to your benefit to have implemented.

[Redbirds Fan]

My apologies - it is not a Federal Program. However, the adoption of the program did earn states points for in Race to the Top funding. So I suppose one can say that funding is not denied or withheld - however, it works to your benefit to have implemented.

No need for an apology. We're all here for a rough and tumble exchange of ideas.

My point was that the heavy-handed, jack-booted federal mandates of Common Core that some of the guys in Congress get all excited about is just a myth. I think it is important to recognize the difference. Unlike 'No Child Left Behind', which mandated certain changes in order to avoid the loss of Title I funding, Race to the Top provides incentives for additional grant funding.

Obtaining an RTTT Grant does not require adoption of any type of federal program. One of the criteria that makes getting grant more likely is having a common set of K-12 standards. The federal government doesn't tell the states what to teach.

[baldgriff]

No need for an apology. We're all here for a rough and tumble exchange of ideas.

My point was that the heavy-handed, jack-booted federal mandates of Common Core that some of the guys in Congress get all excited about is just a myth. I think it is important to recognize the difference. Unlike 'No Child Left Behind', which mandated certain changes in order to avoid the loss of Title I funding, Race to the Top provides incentives for additional grant funding.

Obtaining an RTTT Grant does not require adoption of any type of federal program. One of the criteria that makes getting grant more likely is having a common set of K-12 standards. The federal government doesn't tell the states what to teach.

Not directly - as I pointed out they do get "extra credit" for having Common Core.

[In the Corn]

I'm not trying to pry into your business, and I haven't said your plan isn't essentially a catastrophic plan, but I have a couple of questions about things I don't understand about your post.

Is the $850/mo before or after the subsidy? And what does it mean that on a bad year the insurance is $24K? Is that $850 times 12 plus $13,200 in deductibles? The $850 is before the subsidy, as I stated my subsidy covers most of the premium. My actual cost is about $120/month. Yes the $24 was that. My real cost if I max out my deductible is closer to about $15,500. Just for reference, and I have no issue sharing, that is one-third of my income. So if Mrs. ITC or myself need some type of surgery, I'm sure we'd max out. Where would you have me cut my budget to pay that $13,900 deductible? I suppose bankruptcy is an option, but then I get to deal with those ramifications for the next X amount of years.

Everybody's situation is different. I know that for me, having a good idea what my medical bills could be, it made sense to get a gold plan even though the premiums were too much higher than the silver or bronze, since I was almost 100% sure it would be made up in out-of-pocket expenses. Some people can't cover premiums, or won't have enough out-of-pockets to justify the choice.

I'd love to have Silver or Gold Plan. I had a Silver in the first year of the ACA. It was great insurance, affordable premium and the deductible was $4000 for the family. The company that offered that plan left the exchange after that year, as they under-estimated and had huge losses.

I know that when I was on Obamacare and has very little income, my premiums were subsidized and I paid something like $100 a month for the short time I was on it. I do remember that it helped when Ms. Lucky fell, broke her ankle, was taken to the ER, etc., etc.

Sympathy for the high medicals, as there must be conditions to go with them, and I certainly understand that.[/QUOTE]

My next question is what do we do for the numerous people that only have one insurance plan to "choose" from because no other insurer will enter their market? These single policy areas are basically government sanction monopolies, as people have to have insurance, but they have no open market.

[baldgriff]

My next question is what do we do for the numerous people that only have one insurance plan to "choose" from because no other insurer will enter their market? These single policy areas are basically government sanction monopolies, as people have to have insurance, but they have no open market.

So are you saying that the lack of competition is allowing prices to be held artificially high - because there are no other options??

[And no - ITC and I did not talk about this post in advance]