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Redefining Affordable: The Future of Health Insurance Premiums under the ACA

by: DrAbston

Sat Feb 02, 2013 at 08:49:19 AM CST


In a move that goes beyond redefining the word “is”, the IRS has released its final rule on what will be considered “affordable” premiums for families.  Although you will not be on the hook for a tax penalty if the premiums for your entire family exceed 8 % of your income, an increasingly common problem, you will not be eligible to purchase a subsidized plan on the coming Exchanges as long as your individual premium for your employer plan is 9.5% or less of your household income.

 

Do you see where this is going?  Let’s say your employer really doesn’t want to pay the wrist-slap penalty for failing to provide you with an “affordable” insurance option.  So she finds a policy that costs exactly 9.5% of your total household income, which includes your spouse’s two part-time jobs.  You have two children, and your spouse’s jobs don’t include benefits because they are part-time.  Could a policy covering all four of you cost 38% of your income?  I used to have an option for individual or family coverage through my employer, but now there are premiums based on number of persons in my family.  Even those of us with decent incomes are going to be hard-pressed to come up with that money, and remember—this is only the premium.  It does not include the “cost-sharing” of co-pays, deductibles, and non-covered services.

 

For low-paying jobs, where it would be hard to find a policy that meets the criteria of essential health benefits for 9.5% of salary, look to insurers and the feds to get really creative finding loopholes.  Less of your body might be essential than you now imagine.  There are already waivers for so-called “mini-med” insurances until 2014.  Do you really believe the waivers will disappear on schedule?  I’m not holding my breath.  Some sort of redefinition is probably already in the works.

DrAbston :: Redefining Affordable: The Future of Health Insurance Premiums under the ACA

If a state refuses to participate in the Medicaid Expansion, your children might still be covered if you are under the poverty line.  Children in families up to 300% of poverty are generally eligible for the SCHIP programs (ALLKids in Alabama).  But what about you and your spouse?  Oh, well, the IRS says.  You don’t have to buy insurance—we won’t penalize you.  You can “keep the coverage you have”, even if it is no coverage.

 

Can you hear me now? As long as private insurers are part of our healthcare system, our health is at risk.  The insurers need to keep our care costs high, so they can rake in their allowed percentages, so there will be little effort to make serious improvements to healthcare that would keep us healthy at less cost—steps like eliminating subsidies for producers of toxic and obesity-promoting foods, getting corporate food out of the school lunch program, repairing the broken FDA, reducing our exposure to environmental poisons, or financing our public health system effectively.

 

Let’s get serious about healthcare reform—we need Medicare for All, now more than ever.  Look at the estimates for taxpayer funding under this system, a pre-paid plan with no co-pays or deductibles.  It’s affordable for ALL of us, no creative re-defining needed.  Medicare for All—everybody in, nobody out.  Look for a chapter of PNHP (Physicians for a National Health Plan), Healthcare Now, or other single payer groups in your area, and find out what you can do to make it happen!  If you are in North Alabama, we’ll be expecting you.

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This is a travesty (0.00 / 0)

We should have known better than to get in bed with Insurers - actually, we did.

We need a National Health Care plan - not what amounts to a stealth tax of almost 10% off the wages of the poor.



A lie gets halfway around the world before the truth has a chance to get its pants on. -Churchill

"Affordable" is an oxymoron (4.00 / 1)

c'mon.

We all know (or should) that Obama met behind closed doors with the health care industry and pharma.

They both stand to gain big-time from the "Affordable" Health Care Act.

Getting screwed by politicians in bed with Big Business is business as normal.

Hell, even Mark Twain told us that 100 years ago.

Don't be or act surprised. 

 I tried to TELL you guys to vote for the Green Party, but...noooooooo...you didn't listen to me.



"Madness is rare in individuals - but in groups, parties, nations, and ages it is the rule."
Friedrich Nietzsche


we were (4.00 / 1)
too busy trying to keep Sticky Fingers Romney out of the White House, is why. Personally, my heart is with the Greens :) They make the most sense to me.

A lie gets halfway around the world before the truth has a chance to get its pants on. -Churchill

[ Parent ]
exactly.... (4.00 / 1)

Because things would be SO MUCH BETTER with Mitt the serial liar & his gang of sociopaths running the country now.

I remember in 2000, Nader voters telling me in all seriousness that it might be a good thing long term if Bush won because "people need to see just how bad things will get and then they'll understand."

Uh huh.  Ask all those American soldiers and civilians dead in Iraq how much they understand now.  Ask their families how bad it can get.

You never get a perfect politician or legislation or even a political party.  The art of politics is give & take and sometimes you take more than you give.  Then you come back & negotiate for more.

Hey, I'm in favor of single payer and President Obama's lack of support for it in 2008 was a big reason why he was not my first - or second - choice in the primary.  It was maddening later - during the health care reform debate - to hear the early-adopter Obama folks whine that he had reneged on his promise to support single payer.  He did no such thing; they just projected their hopes & policies on him as a candidate without reading the fine print.



"The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness."  - John Kenneth Galbraith




[ Parent ]
surprised? Not me! (0.00 / 0)

I've been saying thing was screwed up since the single payer advocates got kicked out of the Senate hearings during the initial process-- and even more after I read it. Helped get Stein on Alabama ballot by collecting signatures.

But the big point is that whatever party or person is in the WH and legislature, it won't matter as much IF we hold anyone and everyone's feet to the fire.  Folks can't pull their punches to try and avoid something worse or what we will we get?  Something worse with a different last name.

We aren't approaching equal marriage rights because Obama cares about it (I'm not saying he doesn't, just that it is irrelevant)-- it is because the Democratic party needed to bag those votes.

We need all progressives to get on the page with real healthcare reform-- I've got several conservative friends who have an easier time seeing the advantages of it because they are not twisted up trying to defend Obama or the ACA.



[ Parent ]

 

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