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[…] Reader Piquoiseau asks a good question on underwriting: […]
Come for the politics, stay for the snark.
So it was an October Surprise A Day, like an Advent calendar but for crime.
You can’t love your country only when you win.
In my day, never was longer.
I see no possible difficulties whatsoever with this fool-proof plan.
If you tweet it in all caps, that makes it true!
Some judge needs to shut this circus down soon.
And we’re all out of bubblegum.
It’s always darkest before the other shoe drops.
Americans barely caring about Afghanistan is so last month.
It may be funny to you motherfucker, but it’s not funny to me.
When I decide to be condescending, you won’t have to dream up a fantasy about it.
Hot air and ill-informed banter
People are complicated. Love is not.
Whatever happens next week, the fight doesn’t end.
Pessimism assures that nothing of any importance will change.
Being the leader of the world means to be the leader of peace.
A democracy can’t function when people can’t distinguish facts from lies.
They fucked up the fucking up of the fuckup!
🎶 Those boots were made for mockin’ 🎵
… pundit janitors mopping up after the GOP
This really is a full service blog.
I’m pretty sure there’s only one Jack Smith.
Republicans seem to think life begins at the candlelight dinner the night before.
Let there be snark.
ruemara
This is one of the things I don’t understand. I get a subsidy, but it’s not enough. I don’t earn that much and it seems that the ACA does not look at expenses even though it looks at income. It doesn’t seem to be well considered.
satby
The GOP plan: a fig leaf of money that they know most people can’t actually get, because with help that meager they can’t pay for a policy. “But there’s always GoFundMe” has probably become a real talking point for our GOP policy makers.
MomSense
Is the Price plan just a subsidized HSA? I mean that $100 to $250 isn’t going to go very far.
Xantar
@ruemara:
Theoretically, the Federal Poverty Level on which subsidies are based takes expenses into account in the sense that it’s a line below which the government thinks you cannot buy the things you need to live. The problem of course is the definition of what the government thinks is necessary.
Situations like yours are why the CBO projected that a large chunk of the uninsured would get coverage but not all of them. It would still be unaffordable to a lot of people. We would hope over time to make coverage better, keep down costs, and make the subsidies more generous. But for that to happen, we’d need a functional Congress.
So…get out the vote in 2016.
Belafon
@ruemara: That would probably be something your state could take care of. I imagine it would have been really tough to get the ACA through Congress if the law tried to say that New York gets more money per person than Nebraska because it costs more to live there. I’m sure Ben Nelson would have given up; he tried to get Nebraska its own special rules anyway.
It would also be something to push for as a change to the ACA.
cmorenc
Richard:
We need to thank you for your in-depth explanations of the workings of the Health-Care Insurance market – you shouldn’t be discouraged by the relatively shorter comment response threads to some of these, because it’s more challenging for lay folks to make worthwhile knowledgeable comments to these threads than in threads about GOP political mendacity, selfish mean-spiritedness, or stupidity, which are much easier pickings for writing off-the-cuff responses. Ditto for responding to John’s threads about cute, mischievous dogs and Steve the marvelous cat.
Wag
It looks like about half of the comments on this have been deleted. On my iphone before I left home there are 10 thoughtful comments, now on my work computer there are only 6. Refreshing the screen on my iphone, I now see 11 comments. Is someting in FYWP borked?
Richard Mayhew
@MomSense: All numbers in that chart are per person per month
@Wag: FYWP being borked — unpossible
@cmorenc: I expected 0 on topic comments to this thread as it was a pure placeholder and a committment mechanism for a much larger post that is marinating right now… as I’ve said before, I know the things I write about are not comment conducive, and I’m fine with that as I know where my personal satisifaction/validation that I’m not wasting my time is coming from and those things are real, frequent and notable.
MomSense
@Richard Mayhew:
Ok, but is that $100 to $250 a subsidy for an HSA?
Someone with regular lab work and a prescription will burn through that amount each month and that is without a doctor’s visit for a med check.
JPL
Price’s wife is on the city council. Roswell is an amazing community and supports parks, recreation and the arts.
She was the only no vote on the recent budget.
Hoodie
The Price plan is classic GOP false advertising that is aimed at the sweet spot of resentment, i.e., poors are getting bigger subsidies than near poors (who want to think they’re middle class while getting a subsidy), with all being royally screwed by the end to community rating and other nastiness in the bill. How do these people sleep at night? Oh yeah, vampires sleep during the day.
Richard Mayhew
@MomSense: If I am reading the outline correctly, the $175 or $250 is the “medical assistance” tax credit so it could be used for an HSA, it could be used to pay premiums, it could be very broadly used…. but yeah, if anyone actually needs to use services, they are screwed within the first 30 minutes of seeing a doc. Feature not a bug in Price’s world.
Brachiator
The Treasury Inspector General for Tax Administration (TIGTA) reports some numbers and data on ACA.
F
The MSM is flipping their shit because George Stephanopoulos gave FIFTY THOUSAND WHOLE AMERICAN DOLLARS to the Clinton Foundation, which is clearly worse than six Hitlers. Or something. Hopefully they’ll all slit their wrists from disappointment if a republican isn’t elected in 2016.
JPL
@F: Why should he disclose gifts to a charitable organization?
MomSense
@Richard Mayhew:
They always make screwing people over priority number 1. What is happening in the non-expansion states is just heartbreaking. Maine is now trying to cut low income young adults off of Medicaid. The feds have said no and our AG has said this is not a case worth pursuing so our Governor is pressing ahead with private counsel. The messaging is all about not giving welfare to able bodied people who should just get jobs even though our economy is not doing well and there really aren’t many good jobs to be found. It is incredibly depressing.
satby
@cmorenc: Second this, both for the thanks and the fact that though the comments be short, the posts are widely read!
TriassicSands
@ruemara:
@Xantar:
That is a flaw that extends well beyond the PPACA. As with most, if not all government programs, you can make a tiny bit more income, which can cause you to lose a disproportionate amount of benefits or services. And the health status, as it relates to health care expenses, isn’t taken into consideration at all. For example, Medicare has programs for low income individuals. This may or may not involve Medicaid, which has state eligibility criteria. If a person makes $991/month, Washington State will pay the Medicare premiums, as well as any co-payments. Add one dollar to that $991/month, and the state will no longer pay co-pays. A single office visit makes the “richer” person less well off than the poorer person. One expensive procedure can mean she has no way to pay the bill. That same kind of mechanism is in effect for higher levels of income, too. A person getting $1050/month will have to spend more than $1900 out-of-pocket in a six month period before Medicaid will help. That would leave him less than $750 to pay rent (which is likely to be at least $550-$600/month) and all other monthly expenses. It’s obvious that Medicaid is designed to kick in only after a poor or low income individual is either bankrupt, homeless, or both.
ruemara
@TriassicSands: basically. All I know is, I was invited to participate in a paid focus group, which paid me immediately and I can now pay my premium. So, healthcare for this month,
Villago Delenda Est
@cmorenc: As opposed to Steve the moronic commenter.
Lolis
I have a nice story that is the opposite of the story about the man going blind from his refusal to buy into Obamacare. I met with a woman with Crohn’s disease yesterday. She is getting vocational services to keep her current job at a nursing home. She had no health insurance. The previous counselor educated her about the health exchange and she got a big subsidy. She has a gold plan for $100 per month. She said she had been resistant to the idea. This is Texas. She loves her insurance and said Obama is now her favorite person and hands off her Obamacare. It was nice to hear.
WereBear
This is key to the wingnut whining about “the poors getting stuff handed to them.” To get much of ANYTHING, one must have a whole lot of NOTHING.
Richard Mayhew
@Lolis: Quick question — given that she is paying $100 for Gold, that implies her subsidy level is fairly high which implies her income is fairly low
Did she look at Cost Sharing Silvers as the premiums are lower, and the deductibles/co-insurance are lower as well… Something to think about for next year.
Frankensteinbeck
My mother is an ER psychiatrist in Kentucky. Over the year since Obamacare kicked in, she says that changes have been shockingly better than the best expectations. One positive change is that it is now so much easier to get routine care and medication that in-patient service rates have dropped from ‘never enough beds available’ to ‘hospitals begging for other hospitals’ patients.’
fuckwit
@cmorenc: Well, there’s enough meat in Mayhew’s posts that one doesn’t need to read the comments. A pupdate has no real content; it’s all about the conversation. Mayhew’s stuff seems more meant for reading, analyzing, and understanding. Indeed, he’s doing a great service with his writing.
fuckwit
@WereBear: And it’s designed to KEEP THEM THERE. I think means-testing is a horrible form of economic violence. Once you’re poor, STAY FUCKING POOR DAMMIT, because if you dare to crawl your way out of poverty, the means-testing will kick you right back down into the gutter again. It seems almost designed to keep people from getting ahead.
Brachiator
@Lolis:
@Frankensteinbeck:
These are all great stories. I hope the Democrats can use this stuff in the various upcoming election campaigns. They need to emphasize how good policy has helped people, and how the Republicans stupidly want to undo what has been accomplished.
WereBear
@fuckwit: Exactly. The minute you cross that imaginary line you are knocked back further by losing the help that got you this far.
Do Republicans set up systems that create an underclass? Apparently.
MomSense
@WereBear:
An underclass was the regular state of affairs until some basic worker protections like the 40 hour workweek, overtime, unemployment insurance,Social Security, Medicare, etc. Ever since these programs were passed the Republicans have been trying to get rid of them.
Lolis
@Richard Mayhew:
I will check with her if I see her again soon. I may be wrong about her plan too. She just told me it was one of the best plans so I assumed it would be gold. She said she has a $900 deductible and low prescription copays. Her insurance is better than my state employer provided one.
KithKanan
@Lolis: A $900 deductible sounds like it probably is a cost sharing silver, since looking at healthsherpa most other plans set their deductibles at nice round numbers like $500 or $1000.
Piquoiseau
@RichardMayhew
The word “non-smoker” appears in the chart you posted. In five years of reading about the ACA, this is the first time I’ve seen a reference to individuals being treated differently on the basis of their smoking or not smoking. While it was understandable that premiums would be higher for smokers in the days of underwriting, I had assumed that Guaranteed Issue and Community Rating meant that smoking — like other risk factors — would no longer affect individuals’ insurance options. I hope that you will post at some point about how insurance options differ for the large minority of people given to this particular vice.
(I write this as a 1–3-cigarettes-a-week smoker who isn’t eligible for subsidies).