I saw this comment on one of mistermix’s Obamacare posts, and I think it’s a good point to discuss:
I’m not talking about people with good salaries who don’t buy insurance, I’m talking about people who are living paycheck to paycheck and yet don’t qualify for the Obamacare tax credits. These people do not have an extra few hundred bucks a month to pay for health insurance, they can barely pay the bills they have. Don’t you know anyone like that?
As an aside, most people with good salaries already have employer-provided health insurance and will continue to have it after Obamacare is implemented. I’m talking about people with part-time jobs and so on.
If we want to compare two people after the Patient Protection and Affordable Care Act we could compare two people with the same modest income, where one has employer-provided insurance and the other doesn’t, because people who have employer-provided health insurance generally pay something towards it. How much does the person who has employer-provided health insurance pay towards their employee plan and how much will the person who doesn’t have employer-provided health insurance pay towards the PPACA? I think that’s a worthwhile comparison, because the idea was to put the uninsured person on roughly the same footing with the insured person, not to have the Obamacare person come out ahead of a person who is insured through their employer. Love it or hate it, the idea was to preserve the existing system, and add the uninsured.
People who make $25,000 a year at one large company here pay about $110 a month towards their employer-provided health insurance plan. In comparison, an uninsured 30 year old adult who makes $25,000 a year will pay $144 a month under Obamacare. I recognize that employee contributions towards employer-provided health insurance vary widely, but I do think $110 a month is about the middle locally. I’ve seen higher and lower. Looking at this 2012 report (pdf) on what people are contributing towards employer-provided insurance, this is the average they have, annually:
Looking at the dollar amounts that workers contribute, the average annual premium
contributions in 2012 are $951 for single coverage and $4,316 for family coverage
For a lower wage worker, I chose $9 dollars an hour because that’s the going rate for temps here. That person will pay $72 a month under PPACA, if full time. If that person has a part time job at $9 an hour they qualify for Medicaid, and pay nothing (in cash, but of course we all pay taxes).
One could also consider two other parts of the PPACA when looking at lower or middle income workers, and those are the large employer mandates, where the employer will be fined if they don’t provide insurance, and the provisions for small business. It’s an attempt at a universal system, so piecing it out won’t always tell the whole story. Our uninsured worker could end up with employer-provided insurance, or end up as a “small business”. We have a lot of self-employed people here, they have a truck and tools, they don’t make a whole lot, and they’re all uninsured unless they have insurance through a spouse. The person who always comes to my mind is an acquaintance of mine who installs carpet. Truck and tools and magnetic sign. He broke his hand two years ago and could not afford the $11,000 for surgery. He now has a permanently crippled hand because he went without surgery. He’s 50, and all he knows is installing carpet. He works with the damaged hand.
As far as the politics of charging this uninsured person $144 dollars a month for the PPACA, I think one has to look at both groups of people, those who currently have employer-provided health insurance and contribute towards that and those who don’t. While charging the uninsured person $144 dollars a month may be unpopular, charging the uninsured person nothing while the (currently) insured person pays $110 dollars a month for essentially the same insurance through their employer would also be problematic politically. People won’t think that’s fair.
I think we could have a more honest discussion about health insurance parity between groups if we refused to accept it when media and conservatives characterize employer-provided health insurance as a generous gift to employees from employers. Employers don’t generally give employees gifts worth thousands of dollars, obviously. That’s ridiculous. It’s all compensation for work, in one form or another. I don’t know what else it could be. Charity? Really? In this example it doesn’t matter, because we’re talking about an employee’s actual weekly cash contribution towards health insurance not the employer side of that equation, but I think it’s important to keep in mind that we’re all paying for our employer-provided health insurance, one way or another, and people wil be paying for Obamacare, too.
Kay @ Top:
Depending on what state they’re in. Much of my family is in Pennsylvania, where asshole governor Tom Corbett just fucked over most of his poor and/or aging constituency by turning down Medicaid expansion.
I’m telling you guys, Corbett doesn’t the press some of the other asshole governors get, but he’s every bit as vile as Rick Scott and Scott Walker.
“The person who always comes to my mind is an acquaintance of mine who installs carpet. Truck and tools and magnetic sign. He broke his hand two years ago and could not afford the $11,000 for surgery. He now has a permanently crippled hand because he went without surgery. He’s 50, and all he knows is installing carpet. He works with the damaged hand.”
We have a friend in the same position. We worry a lot because he is only 1 serious illness away from living in our attic. One problem for these folks is that their income varies a great deal from month to month and year to year depending on demand. What they could pay one month can change dramatically in the next.
Don’t forget that your person with the hypothetical salary of $25k is also paying taxes on anything the employer is “contributing” towards healthcare. Employer contributions to insurance are salary that your employer has already spent for you.
Right, but what you would hear from the carpet installer who works for another and has health insurance is “he chose to go out on his own”. I think, politically, you have to accept that.
That’s true. I actually didn’t know about Corbett. I thought we were on a R guv roll there, and they were all folding.
I’m wondering if there’s any link between the stagnating wages for middle class and lower and the increasing costs of healthcare? Because it is part of the compensation, perhaps that where any increase in pay has gone?
In related news, the House includes no funding for the implementation of the insurance exchanges in their continuing resolution(funding bill for remainder of FY13).
That’s ridiculous. It’s all compensation for work, in one form or another.
While that’s true, the trend in rightie framing is that all work – currently public-sector but soon enough private – is actually pretty much the same thing as welfare and ALL compensation for it is down to the goodness of rich people’s hearts.
Have we forgotten the subsidies? There will be subsidies for people and their families, depending on income limits and size of family, of up to $88K/yr.
Here’s a fairly simple explanation: Health care reform bill 101: Who gets subsidized insurance?
“Most people will be required to buy health coverage under the healthcare bill now before the House. About 20 million American households will qualify for subsidized insurance, according to the Congressional Budget Office.” That’s households, not people.
And here is the Fed site: http://www.healthcare.gov/
My brain turned that into “Fuck You 13”. Seems appropriate.
I don’t know how all this will shake out in the long run, but three people I work with are having their hours cut so that they don’t qualify for health insurance. They will each lose between $150 to $180/month which is a big deal for them. Of course, the boss is an ass and is over-cutting their hours.
@Kay: We’ve got a brand new winger in NC, McCrory, perfectly happy to let our poor citizens go without insurance.
I know! It’s true, too. It must be. My favorite is when people who use minimum wage workers say they won’t hire new workers if the minimum wage goes up 30 cents. Ordinarily they would hire spare people to just stand around, but that raise in the minimum wage is a deal breaker? Please. They hire exactly the necessary number. No “spares”.
@Hill Dweller: the old you can “have” Obamacare but we refuse to fund it so it’s essentially dead gag eh?
Did they actually pass the bill, or is this yet another bill that Boehner is going around touting to the Village that he doesn’t have the votes to pass?
Also, too, my employer is pretty up-front that the portion of my health insurance that I pay comes out of my salary, though they conveniently withhold the money so I don’t actually see it show up in my check and then have to write a separate check for it. I sometimes wonder if that automatic withholding causes some problems for the less-bright among us, because they don’t quite get that — for example — when the government withholds income tax from my paycheck, I am paying income tax. They keep insisting that they pay real income tax because they write a check to the IRS, but my withheld payments aren’t really income tax because I don’t write a check.
It puts them at the very bottom of employers:
The problem with varying income is one that always stymies my household. During a good month we could pull in $3000. During a bad month we pull in $0. It’s a constant frustration how many govt benefits that we could definitely use from time to time (food stamps, discount utility bills, cheaper health insurance, unemployment insurance) have zero applicability to us because … hell, that’s the nature of running your own business. (Plus paying both halves of SSI and Medicare.)
I still haven’t figured out how the ACA will affect us. Is it based on yearly salary? Will it result in a tax rebate at the end of the year–and if so, will we have to itemize our taxes? (I don’t think we’ve ever made enough for that to be worth it.) I’m pretty politically aware, and I just keep hoping eventually we’ll get something in the mail telling us what to do.
ETA: I should mention we are already seeing benefits from the ACA, all complaining aside. We now get birth control for free, which used to cost $80 a month. And when you’re pulling in $0 a month $80 is HUGE.
It’s probably not much consolation for them, but they will probably be able to get either Medicaid (assuming you’re not in one of the states that turned down the expansion) or a subsidy to buy insurance on the exchanges.
At some point, Congress is going to have to address the fact that some employers are gaming the system by cutting hours, but I’m not even sure how to do that.
Employer payments to medical and dental insurance (and life/ADD to limited extent) are not taxable as compensation.
That’s one argument in favor of the current system versus single payer, those with employer coverage are getting non-taxable income they would otherwise be taxed on via single payer
By the way our employer is the government — local government. I work for a public library.
My company has decided to become it’s own insurance company which is a way to get around a lot of the regulations supposedly.
I went from having a classic health insurance to a Health Savings Account that is being managed by the people who hire and fire us. Can you say conflict of interest?
They had full time employees with no health insurance?
BTW, since a lot of people even here don’t seem aware of it, there’s a whole website with all of the ACA information (reasonably) easily accessible:
It is where pay increases have gone. That’s not in dispute. Nailing an exact number on how much of pay has gone to healthcare is more difficult.
In my case absolutely, I haven’t had a raise in years because it goes to my health insurance premium instead of me.
@Kay: One of Corbett’s first moves was eliminating the state program subsidizing health insurance for people working but not making enough to buy it—your $25,000/year person.
Fortunately, his polls are so bad even fellow Republicans are publicly considering running against him in 2014.
You may want to consider finding a good accountant. It shouldn’t be all that expensive (I think it was $249 for our tax returns) and they should be able to help you find some extra deductions and figure out your best options. You’d probably qualify for small business health insurance rather than having to go out on the individual market.
@Mnemosyne: I guarantee that extremely few people understand what they’re paying in taxes year by year, or how the refund structure is supposed to work. Just the other day I was thinking that there should be a line or two on the tax form that calculates what you paid in income taxes as a percentage of your gross income. I know that I don’t know that figure for my own household.
Another Halocene Human
@Mnemosyne: It’s easy: charge employers based on FTEs (full time equivalents). They should have done it from the very beginning. They could still find a way to excuse off seasonal employment.
@gene108: not to mention the lack of anything good that has been purchased with that money. Quite a racket.
@Kay: These employees average 33 hours a week. We are on a three week rotation to cover weekends. Our boss only needs to cut one 4 hour work period every three weeks to get them under 30 hours but she is cutting a 4 hour work period every week. And yes, they don’t get health insurance but they do get pension benefits. Who knows. Our library is small but I guess we are officially village employees and the village employs over 50 FTE.
OT: North Korea threatens to cancel the 60-year old cease fire on the Korean peninsula on March 11, just as a joint US-South Korean military exercise is about to begin. Party time. Also, good timing, Dennis Rodman.
@batgirl: I’ve heard of employers doing this–cutting hours to avoid paying insurance. Isn’t that what that Denny’s did? Making that sort of thing public may turn public opinion against the employers doing it. I don’t know…
We moved to high deductible plan three years back. We had two catastrophic claims that doubled our premium under traditional plans. In short, it was all we could afford.
The pressure to balance costs and benefits has shifted to offering the best option you can afford. The bargaining power of non- huge employers is pretty limited, when dealing with insurance companies.
An old friend just told me the heartbreaking story of her younger sister (probably in her late forties): lives simply as part of some buddhist commune with her male partner. Both unemployed for years. Both without health insurance. Never got themselves on medicaid or into the welfare system. Suddenly diagnosed with a brain tumor (benign but dangerous). First: huge bills from the ER visit, the diagnosis, the shunt and stabilization. Second: no ability to go back and get an evaluation or the surgery she needs because no insurance. No clear understanding of how to get on Medicaid or apply for disability and medicaid. Totally at sea. OK, they both sound incompetent and hysterical and there’s no excuse for that but if we had a system where people could receive well checkups and everyone was insured no matter what their employment circumstances they wouldn’t be in this fix. The taxpayers will already foot the bill for the treatments they had at the hospital that they have no hope of repaying–we would all have been better off transferring their care from the ER to the doctor’s office for years prior to this incident.
It’s bad. I don’t know what to do about it, though. There’s this crazed effort to push health care off on someone else, a spouse’s employer, a parent’s employer, Medicaid, uncompensated care, and it has to land somewhere eventually.
These kinds of ‘point in time’ analyses of ‘lets take this person and next year pretend that the only thing that’s changed is the mandate arrives’ are useless. This isn’t chess where you move one piece at a time. Policies like Obamacare are designed to move all of the pieces at the same time.
Not only will the employer mandates and medicaid expansion help fill the gap, so will the regulation on insurance premiums, the bazillion different forms of cost control – most of which are small, but will aggregate into something big – and once all of these people (40 million, all told) flow onto the insurance rolls and shift from ER care to structured care, there will be a free-market effect as well – most of which will be positive.
In short, there’s not much point worrying about individual cases too much – it’s too complex a set of policies to predict how individual behavior will intersect with all of it. There will be a lot of people stranded on ice floes in this, but we won’t know who in advance, and we’ll run around and rescue them group by group once they pop up. HHS under Obama is quite responsive – and I have no doubt they’re prepared to trim a lot of sails come Jan 1.
72 dollars dollars?
@gene108: I work for a company with 300k individuals. The excuse given was that “this is going to happen to other retailers so we are just getting ahead of the game.”
Also, the price of elastically priced things that everyone buys (such as housing) will adjust to reflect the adjustments to available disposable income that occur as a result of Obamacare.
To play this out in the case of housing prices — Both rental and boughten housing are priced at just what the market will bear based on incomes in an area. Low incomes = lower housing prices for the same product, all other things being equal. Higher incomes = higher housing prices (ditto). If Obamacare really does significantly reduce available disposable income, the price of housing will tend to reflect that, meaning some adjustment back toward the same or similar amount of disposable income in households overall.
This is a great point. We all pay(for almost everything really) for the things we get and many we don’t. Our taxes pay for the “free” ER, if not for directly, through loss deductions by hospitals(One reason non-payment ER rates are so high) I paid for my VA coverage by serving in the military(at about 1/8 my then civilian pay), we all pay taxes for our(now crappy) roads. And on and on. But many of us don’t know how much our employers pay for our health insurance and how much of that we reimburse them. My last job the company held meetings twice a year to explain all the important info and we never were told the overall number. I had to ask the VP of finance to find it out. We paid a very small percentage of the total.
I had a discussion with someone the other day about taxes in Europe and how high they were. I asked him if he knew how much his overall tax rate was, including gas, utility, sales, property, income, SS/medicare, etc etc. He had no idea. I’ll bet if we add it up our total tax rates in the US and Europe they are similar but what we get is not even close to the same.
The ER isn’t even “free”. for those who can’t pay. They initiate collection actions when people don’t pay their hospital bill. Then they garnish wages. Writing it off is the last resort, and attempting to collect it costs.
Conservatives hope that death comes before that cost lands on them.
Liberals want to reduce the cost in the first place so the shared amount and the medical issue won’t hurt any more than it has to.
I’m sure glad we did everything and anything we could to make sure the insurance companies flourish and prosper.
Yeah, but the people who are in those states? Screwed. Really very and completely.
My partner is disabled, and I remember the teary celebration we had when she finally received her disability rating from SSA. Not because of the monthly pittance, but because it meant she was eligible for Medicaid. We were living in Tennessee at the time, and of course she couldn’t be on my insurance – we’re both female – and she’s not employable because of the host of medical conditions that she needed treatment for. Before SSA said Yes, she’s disabled? Medicaid in TN told her to go fuck herself. She went without vitally necessary treatments for a long time before that. If her conditions had been deadly without treatment? I’d be a widow.
On the flip side, there are loads of people who think their tax refund means they’re getting money from the government, not just getting their withholding back. If I was president, I’d propose raising taxes and raising the default withholding more. The government would get more revenue, and most people would think they’d gotten a tax cut.
@Kay: Yes, this is the frightening spiral my friend’s sister is in. Present at the ER with a complication like a brain tumor. Its not like you can refuse treatment (or want to) and the hospital must treat you. Then get sent home with a bill so massive, that arrives slowly in pieces months after you went in–what are you supposed to do? You end up being dunned to death at the moment that you are weakest, most terrified, sickest and least able to pay an amount that no sane person could ever think you could pay. But, presumably because of MORAL HAZARD the hospital billing department will pretend to think they can dun you to death and you will produce a high percentage of a bill they a) inflated and b) know you couldn’t pay even 10 percent of.
Another data point — in VA, McDonnell folded, but the wingnuts in the legislature didn’t completely. In order to get Medicaid included in the budget, they demanded “reforms” from the feds, and there’s a legislative commission that will decide whether those conditions have been met before we get the Medicaid expansion.
On the positive side, apparently the reforms are not actually bad ideas or gutting it and calling it “reform.” On the negative side, the commission is apparently packed with anti-Medicaid wingnuts, so who knows if they’ll ever take yes for an answer.
You are correct – of course and always.
But at the end of the year whatever the unrecoverable loss is that and the hospital will be able to deduct it. And we are all paying for that. Also the recovery costs are also paid by that wage garnishing, adding even more to the cost of that ER visit. Which I think we should call catastrophic care not health care.
Davis X. Machina
The answer to two-thirds of these problems, and crises, and tragedies, at minimum, is an NHS-US.
The feds own the bricks and mortar, hire the help. GFR(1) the whole thing.
The blood-sacrifices we make annually to shibboleths from the Ricardo-and-Malthus era of economics are a shande. People die daily, suffer daily, unnecessarily, in the service of a theory.
(General federal revenue)
Except your numbers are bullshit, Kay. Try more like $1200 a month for a family of three for COBRA coverage. It will probably be more like $900 once open enrollment is available to purchase our own.
You seem incredibly cavalier about the actual costs to purchase health insurance on your own.
If we actually see health insurance costs go down then the PPACA will have lived up to its promise. In the meantime, a lot of people are going to see what I see – a government mandate to purchase an absurdly overpriced private product.
But I’m sure I can hop on here so that you can tell me how awesome it is.
@gelfling545: The first thought that comes to mind is why the hell would surgery on a broken hand , surgery that would probably be done on an outpatient basis, cost $11,000 dollars?
Do you have a lot of uninsured? That matters. I was surprised at how few uninsured Wisconsin has, for example. It varies. Isn’t VA fairly well-off, as a state, lots of people with health insurance (college degree)?
I have absolutely no love or even liking for insurance companies but think about all the people out of jobs had we gone directly to single payer. It’s not just the insurance co employees, you have to account for all the people who work in DR offices, coding and billing. My last private Dr. office had more people working in coding and billing than medical professionals.
It will take years to get there without more pain than what we now have.
They patched his hand in an ER and it was really badly damaged, but he let it go. He went for (I guess) an “estimate” to an surgeon we both know slightly and that’s what they told him, 11k. He was setting it himself at one point, extend it, splint it, tape it, like that.
Was that $11K for the surgery but not the hospital, anesthesiologist, $1k bandages, PT, etc, etc? Because I can easily see a badly mangled hand repair costing way more than that. I’ve had both hands in casts(at different times) and I’ll bet the total of just one, which was about 1/3 slice through the thumb, cutting or hitting nerves, artery and tendon was higher than that.
They will not flourish or prosper under this plan. They won’t suddenly die, though, either with nothing to fill the void. This is a soft landing for the insurance industry. Single payer is still coming.
As Ruckus said – had we gone straight to single payer as many Dems wanted (which will never happen – it will be at most single payer for hospitalization and market for medical) then not only would you be looking at millions of jobs lost nationally, but states like CT would be ravaged.
300k employees is probably why they can self-insure.
In the end, the current system of health insurance is a case study in diminishing returns, i.e. paying more money for fewer benefits.
Hopefully Obamacare will stop the death spiral.
Why wouldn’t it cost $11000. sounds pretty reasonable to em by the standards of our time. Several very extensively trained people because Docs have to have help monitoring, handing them things etc. An expensive special room with special equipment every op pays part of the cost of and …insurance. Mal practice insurance really is rising. It’s also got even more slow paperwork and more hoops to prove than our own medical insurance so that means hospital people paid to just help the docs get it done every year. Supplies for the op. Safe storage for the supplies drugs locked up/ blood and tissue starts refridgerated and sterile…I keep thinking of more things involved in hospitals…x rays before x rays after, techs to take the x rays, docs to interpet….My sister the doc just had ankle surgery on herself. She said the real cost insurance had to pay was over $100000.
Northern Virginia is fairly well-off, the rest of the state, not so much. And even here, there are a lot of low-income people. I serve on a citizen advisory board for some of the anti-poverty programs in Fairfax, and one of the statistics quoted is that even though we’re like the third wealthiest county in the country, there are more people below the poverty line in Fairfax than in some states.
Considering the general wealth and income, I think there would be support for the government doing more here, but the only tax counties are allowed to have is a property tax, and they can’t adjust anything about it except the residential and commercial tax rates. That makes it hard to use more local money without unintended consequences.
And of course, there’s the usual wingnut paradox that many of the places that would benefit most from Medicaid vote for people who are most against it.
@? Martin: also, try telling people who DO have health insurance through a private company that now they’re all going to be on The Government Plan. They’re not going to like that any more than they would like being told that, in order to combat homelessness, everyone was being moved into high-rise cinderblock dormitory towers.
I wonder if they vote against it because they continually get told it will cost them more(faux and friends) and they just don’t have more and don’t know how to earn or get more. Also I seem to remember that southern VA has more churches per square mile and/or per capita than any place else I’ve ever seen. All of which creates a continuous stream of “The only place to look for help is the church”.
MOTU don’t care about poverty, they don’t live in poverty, don’t expect to ever live in poverty and don’t know anyone who lives in poverty. And they will do anything and everything so all of that remains true.
I am new to this thread, but one thing I find completely lacking in Kay’s analysis is what that monthly premium buys. Once you account for deductibles, co-pays, caps, and what is and is not covered, what I pay in monthly premium’s is the beginning of the conversation of what I spend each month not the end. I have recently purchased two policies as an individual, pt worker in two states and the difference in prescription benefit alone accounted a $75 a month difference between the two policies. I am currently paying more a month now through my partner’s insurance than I did in my last state on my own, but the new policy covers eye care and dental, so in the long run it will be cheaper.
How you can pretend to have this conversation without considering what the policies covered is beyond me. I know ACA sets minimum standards, but those are minimums and many policies will vary widely.
Employer provided healthcare is straight up compensation. You know how I know? I had to pay taxes on my employer’s contributions towards Kate’s health insurance. It has to count as income thanks to DOMA.
Hey, that was my question! Thank you for the thoughtful response.
$144.00 per month for a 30 year old making $25,000.00 per year doesn’t sound too bad. But. According to that UC Berkeley calculator, 40 year old making $25,000.00 per year, is going to have to pay $317.00 per month for health insurance premiums. That’s WITH the subsidy. Ouchie. Granted, he should have insurance. But he probably doesn’t have it because he can’t afford it. I don’t see this making it any more affordable, from his perspective. So, it still appears to me that a number of individuals who don’t have employer-provided health insurance are going to be faced with having to pay several hundred a month out of pocket for health insurance, OR pay the penalty.
1) The penalty is rather low–if your hypothetical 40 year old (single) person making only 25,000 a year can’t access any subsidies and is not eligible for medicaid then paying the penalty is the price he/she pays for the country needing to get everyone insured and get everyone paying into the system. Since, in the event of a catastrophic health care event he/she will then be throwing him/herself on the taxpayer’s mercy for emergency care it might even be seen as perfectly fair.
2) the reason the 40 year old pays more is that the 40 year old actually probably needs more health care coverage–is more likely to have a health care disaster. See my friend’s sister upthread–her family begged her to buy coverage and offered to pay for it but she assumed that health was something she could control and she refused to buy into the (no doubt expensive) health insurance market. End result: the taxpayers and the hospitals and other poor/uninsured people are going to foot the bill.
3) They haven’t yet done away with the insurer’s ability to charge a different amount to differen age groups (I think) but they have done away with a bunch of other things that kept people from being able to buy the insurance.
@Davis X. Machina:
But of course the big difference is that NHS is socialized medicine, not just socialized insurance. Cost savings would be tremendous, far more than single payor alone. Though people wouldn’t like the death panels that disallow expensive treatments that do either nothing or damn near nothing.
@Kay: I know what to do about it — include part-time employees in the employer mandate. They have to be covered somehow.
I mean, the real solution is some kind of government guaranteed coverage. But removing inducements to cut hours would really help.
Also, the 2013 Throw Gov. Corbett Into A Hill Of Fire Ants Act.
@liberal: Man, remember the reaction when a panel recommended less aggressive intervention on prostate cancer in elderly men? The evidence suggested that, in most cases, natural death would come before the cancer became a serious issue, and that surgical interventions tended to have worse complications than the cancer itself. Cost savings weren’t even the consideration.
Well, of course that got treated as “GOVERNMENT DEATH PANEL WANTS OLD MEN’S GENITALS TO BE DEVOURED BY CANCER JUST TO SAVE MONEY”.
I’ve done a couple of posts on community health centers ( I loved the one I went to, years ago, for pregnancy care) and I have to tell you, the reaction wasn’t positive from people who have health insurance.
There’s a perception that it’s lesser or cut-rate care.
Americans, IMO, do not yet know what they want from a health care system. They want payment, but they also want no limits on care, a private physician, and no waiting around.
There’s a lot of fear among “the haves” that they’ll lose what they have.
That’s a political problem for anyone trying a drastic change.
I’m not going to weigh in because there is an IRS rule that muddies the issue.
I’m not clear that tgese folks are going to be able to dodge by cutting hours.
@WA_Dave: We have, but only in the medicare supplemental plans. Still, though. Before the ACA we were averaging 12% increases every year (no, that’s not a typo).
The point is the ACA is supposed to supplement the cost so even if the plan costs $1,200 (which by the way – when I was on COBRA for the first time it was both the best and most expensive insurance I had ever had) you will only have to pay like 500, or 200, or nothing based on income. So health insurance costs are decreasing as far as the end consumer is concerned.
@Gex: Huh? How? Did they send you a 1099?
The example I used is a real person, except he’s not 30, he’s 25. While health insurance is still age-rated, so he would pay more at 40, he would also be much less likely to be making 25k at 40, and single.
The hypothetical groups start to get very small. Now we’re talking about a 40 year old single person. Do you see what I mean? We’re not talking about a huge group of people the further we narrow the parameters on “low income who have to pay several hundred dollars a month”
LePage here in Maine is also holding out and refusing Medicaid expansion. We have so many people who are self employed here so this is a big blow to us.
YES there is a link! Also too if the costs of healthcare go up you might not hire more people, or only hire part time workers, or hire people as independent contractors so they have to pay their own healthcare and benefit costs.
thank you for this, kay
@FridayNext: Yeah, that “Bronze Plan” is a beaut, especially for the money.
I think you’re forgetting the fact that employers receive a tax write off for providing health insurance. It reduces their cost to the levels you cited.
I think you are equating fairness w/ equality of outcome. If you want equality of outcome the ACA will have to provide more subsidy to individuals