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Oh the irony of the "Affordable Care Act".

OP for someone that is healthy you won't need to pay anything for any health insurance after 2014. "Insurance" companies won't be able to deny you for pre-existing conditions. If you happen to get sick or injured, just call the insurance company on the way to the hospital and tell them you want to open a policy. The penalty for not having insurance from the IRS is basically nothing when compared to the actual cost of insurance, I believe it was $95 in the first year.

Also, the IRS won't be auditing health insurance and can't enforce the penalty except by taking your tax refund. They won't be using liens, levies, garnishments, or more aggressive tax compliance tactics. So theoretically someone could avoid paying the $95 penalty by making sure they get a $0 refund at the end of every year.

Health coverage has to work very differently from practically every other type of insurance coverage out there because what it covers is exponentially more important than practically anything else out there.

Having it work differently has caused it to a large extent to morph from health insurance to pre-paid medical care.

geo123 said:   leedsutd67 said:   if your healthy save that money and if you need to go to the Doctor or Hospital offer them $$$$ for a discount.Health coverage has to work very differently from practically every other type of insurance coverage out there because what it covers is exponentially more important than practically anything else out there. You generally do not want to have a health insurance setup wherein there is a significant psychological and a financial incentive to delay obtaining care. This is true even in non-emergency situations.

High deductible plans can increase patient health by reducing unnecessary treatments that do more harm than good.

Annual physicals do more harm then good: http://www.kevinmd.com/blog/2012/11/annual-physicals-harm-good.h...

“Abnormal screening results can also lead to further investigations and accompanying risks: anxiety or psychological distress; lost income due to work absences; difficulties securing insurance; and increased healthcare costs.”

“Ateev Mehrotra, an assistant professor at the University of Pittsburgh School of Medicine, has estimated that unneeded blood tests during physical exams alone cost $325 million annually.” Meanwhile, “[t]he only routine blood test currently recommended by the United States Preventive Services Task Force is a cholesterol check every five years.”

BradMajors said:   High deductible plans can increase patient health by reducing unnecessary treatments that do more harm than good.

Annual physicals do more harm then good: http://www.kevinmd.com/blog/2012/11/annual-physicals-harm-good.h...

“Abnormal screening results can also lead to further investigations and accompanying risks: anxiety or psychological distress; lost income due to work absences; difficulties securing insurance; and increased healthcare costs.”

“Ateev Mehrotra, an assistant professor at the University of Pittsburgh School of Medicine, has estimated that unneeded blood tests during physical exams alone cost $325 million annually.” Meanwhile, “[t]he only routine blood test currently recommended by the United States Preventive Services Task Force is a cholesterol check every five years.”
If you re-read your own article, you'll see that it doesn't say what you think that it says. The article doesn't actually break any new ground here, as I don't think that this topic is particularly controversial in the medical community. There is no question that unneeded tests are wasteful and have the potential to only increase patient anxiety without offering meaningful health benefits. Likewise, there is general consensus in the medical community about most of the tests that are needed as well as certain steps that are necessitated by certain conditions.

What does this have to do with my point or my example above?

brettdoyle said:   Oh the irony of the "Affordable Care Act".

OP for someone that is healthy you won't need to pay anything for any health insurance after 2014. "Insurance" companies won't be able to deny you for pre-existing conditions. If you happen to get sick or injured, just call the insurance company on the way to the hospital and tell them you want to open a policy. The penalty for not having insurance from the IRS is basically nothing when compared to the actual cost of insurance, I believe it was $95 in the first year.

Also, the IRS won't be auditing health insurance and can't enforce the penalty except by taking your tax refund. They won't be using liens, levies, garnishments, or more aggressive tax compliance tactics. So theoretically someone could avoid paying the $95 penalty by making sure they get a $0 refund at the end of every year.
Right, the minimum penalty/tax starts at $95/person (not to exceed 3 times that for a family) in 2014 but goes up pretty quickly after that.

In 2016, for instance, the penalty for a person making $150,000/year will be approximately $3,500/year. The penalty for a person making $200,000/year will be approximately $4,700/year (in each case, not to exceed 3 times that for a family).

By the way, the IRS will have the ability not just to take your tax refund but to sue you, in which case it will not be permitted to collect more than 2 times the amount that you owe. It just won't have the right to pursue you criminally or to seize your assets.

On a related topic, don't misconstrue my posts here as an endorsement of the healthcare reform, as while I agree that our healthcare system needed to be reformed, I completely disagree with the way that it is being implemented. The facts are what they are, however.

leedsutd67 said:   You are right in what you say geo123, you only have to look at Steve Jobs to see in delaying medical treatment can be fatalPrecisely.

I'm not saying you should delay treatment far from it, as alternative to high premiums "pay as you go"Not really. One of the really screwed up things about our healthcare system is the fact that with a few exceptions, insurance negotiated pricing typically gives you a very significant discount on medical costs. In most (not all, but most) cases you just won't be able to come even close to that with cash discounts.

Further, even people who lead very healthy, active lifestyles can end up coming down with rather serious medical issues, the costs of which can often be in the hundreds of thousands of dollars. Without health insurance, very few people out there can afford these types of bills even with some of the deepest discounts available.

Finally, my point above has to do with the fact that psychologically, it can be very difficult to convince yourself to pay thousands of dollars out of pocket to have a medical test that you are well advised to have to rule out a condition that you probably don't have... except that there are serious consequences if you do have it and delay getting it diagnosed.

geo123 said:   brettdoyle said:   Oh the irony of the "Affordable Care Act".

OP for someone that is healthy you won't need to pay anything for any health insurance after 2014. "Insurance" companies won't be able to deny you for pre-existing conditions. If you happen to get sick or injured, just call the insurance company on the way to the hospital and tell them you want to open a policy. The penalty for not having insurance from the IRS is basically nothing when compared to the actual cost of insurance, I believe it was $95 in the first year.

Also, the IRS won't be auditing health insurance and can't enforce the penalty except by taking your tax refund. They won't be using liens, levies, garnishments, or more aggressive tax compliance tactics. So theoretically someone could avoid paying the $95 penalty by making sure they get a $0 refund at the end of every year.
Right, the minimum penalty/tax starts at $95/person (not to exceed 3 times that for a family) in 2014 but goes up pretty quickly after that.

In 2016, for instance, the penalty for a person making $150,000/year will be approximately $3,500/year. The penalty for a person making $200,000/year will be approximately $4,700/year (in each case, not to exceed 3 times that for a family).

By the way, the IRS will have the ability not just to take your tax refund but to sue you, in which case it will not be permitted to collect more than 2 times the amount that you owe. It just won't have the right to pursue you criminally or to seize your assets.

On a related topic, don't misconstrue my posts here as an endorsement of the healthcare reform, as while I agree that our healthcare system needed to be reformed, I completely disagree with the way that it is being implemented. The facts are what they are, however.


Even for someone making 150K a year, it might make sense to not have insurance, as the $3,500 penalty may be cheaper than the actual cost of health insurance. As more and more people weigh the penalty against the cost of insurance they'll realize they don't need health insurance, and they will cancel their policies. There will be less healthy people pay into the health "insurance" system to cover the costs of sick people, and premiums will need to rise for everyone else, making paying the penalty even more attractive, causing more people to cancel. A vicious circle.

At that point they'll either need to make the penalties much, much higher or else use the broken system as a rationale for 100% socialized health care.

the points you make are exultant and only consider my suggestion after careful thought

brettdoyle said:   Even for someone making 150K a year, it might make sense to not have insurance, as the $3,500 penalty may be cheaper than the actual cost of health insurance.It's possible but isn't likely. Remember that the tax penalty is just that, a penalty, which has no impact on your other taxes. On the other hand, for most people health insurance premiums are tax deductible: if you are self-employed, you just deduct them in full; if you are an employee, the vast majority of employers will have their CAFE 125 plans set up, which will also allow you to have insurance premiums withheld from your paychecks on a pre-tax basis.

So, when you factor in tax savings, for a person making $150K a year a $3,500 tax penalty equals an approximately $5,000 healthcare premium. I doubt that you'll find a lot of situations in which paying a penalty will make sense.

atikovi said:   Just got notice from Blue Cross that my monthly premium will be $794 next year, up 20% from $662 now and $483 in 2010. That's like a freakin mortgage payment! I'm early 50s and hardly ever use it. What do some of you self employeds pay? And will Obamacare provide any relief?

That seems high for an individual. Do you have dental, vision, and prescription in that too. Also, do you pay a copay for doctor visits. My father has blue cross and he's 60 and he's paying 480 a month or so but has to pay for his doctor visits out of his own pocket. Insurance is such a ripoff in this country.

Is there something about this healthcare reform that I'm missing? If you don't have health insurance and have to pay a penalty, you are still without health insurance, correct? It seems like people think that if you choose to pay the penalty you are somehow provided with insurance coverage.

Welcome to socialist medicine, coverage of the takers included by assessing the makers.

ksuwldkat said:   Is there something about this healthcare reform that I'm missing? If you don't have health insurance and have to pay a penalty, you are still without health insurance, correct? It seems like people think that if you choose to pay the penalty you are somehow provided with insurance coverage.

Let's say you don't have insurance and you fall down some stairs and break your leg. You simply call up the insurance company in the ambulance on the way to the hospital and tell them you want to open a policy. They legally can't deny you coverage for a pre-existing condition, which would be your broken leg. Then you go to the hospital, and use your newly acquired insurance to cover all of your hospital bills. After treatment, you call and cancel the insurance policy. You get all the benefit of health insurance, without actually having to pay for it.

BarneyFife said:   atikovi said:   Just got notice from Blue Cross that my monthly premium will be $794 next year, up 20% from $662 now and $483 in 2010. That's like a freakin mortgage payment! I'm early 50s and hardly ever use it. What do some of you self employeds pay? And will Obamacare provide any relief?

That seems high for an individual. Do you have dental, vision, and prescription in that too. Also, do you pay a copay for doctor visits. My father has blue cross and he's 60 and he's paying 480 a month or so but has to pay for his doctor visits out of his own pocket. Insurance is such a ripoff in this country.


No dental, no vision, no prescription. Well, it does cover the first $500 a year of prescriptions but that pretty much is none anyway. I don't pay for doctor visits after the $100 deductible per year other than 80/20 up to $1000.

brettdoyle said:   ksuwldkat said:   Is there something about this healthcare reform that I'm missing? If you don't have health insurance and have to pay a penalty, you are still without health insurance, correct? It seems like people think that if you choose to pay the penalty you are somehow provided with insurance coverage.

Let's say you don't have insurance and you fall down some stairs and break your leg. You simply call up the insurance company in the ambulance on the way to the hospital and tell them you want to open a policy. They legally can't deny you coverage for a pre-existing condition, which would be your broken leg. Then you go to the hospital, and use your newly acquired insurance to cover all of your hospital bills. After treatment, you call and cancel the insurance policy. You get all the benefit of health insurance, without actually having to pay for it.
I suspect that you'll discover that even once Obamacare is fully phased in, you won't be able to just purchase health insurance on the spot and that it'll take a little bit of time to bind the policy. If you break your leg, it's a medical emergency and you can't wait a day or two to acquire a policy.

Regardless, as I mentioned above, as of 2016 a person making $150,000/year will be required to pay an approximately $3,500/year penalty for not having health insurance, which is analogous to having an approximately $5,000/year health policy. Most people would be able to purchase a health policy with that... the question is whether you might be able to purchase the cheapest qualifying policy and then quickly "buy up" more if and when they need it, assuming that it's not an emergency.

Yes, people making less will also have lower penalties but at much lower income levels their insurance premiums will also be subsidized.

geo123 said:   brettdoyle said:   ksuwldkat said:   Is there something about this healthcare reform that I'm missing? If you don't have health insurance and have to pay a penalty, you are still without health insurance, correct? It seems like people think that if you choose to pay the penalty you are somehow provided with insurance coverage.

Let's say you don't have insurance and you fall down some stairs and break your leg. You simply call up the insurance company in the ambulance on the way to the hospital and tell them you want to open a policy. They legally can't deny you coverage for a pre-existing condition, which would be your broken leg. Then you go to the hospital, and use your newly acquired insurance to cover all of your hospital bills. After treatment, you call and cancel the insurance policy. You get all the benefit of health insurance, without actually having to pay for it.
I suspect that you'll discover that even once Obamacare is fully phased in, you won't be able to just purchase health insurance on the spot and that it'll take a little bit of time to bind the policy. If you break your leg, it's a medical emergency and you can't wait a day or two to acquire a policy.

Regardless, as I mentioned above, as of 2016 a person making $1,500/year will be required to pay an approximately $3,500/year penalty for not having health insurance, which is analogous to having an approximately $5,000/year health policy. Most people would be able to purchase a health policy with that... the question is whether you might be able to purchase the cheapest qualifying policy and then quickly "buy up" more if and when they need it, assuming that it's not an emergency.

Yes, people making less will also have lower penalties but at much lower income levels their insurance premiums will also be subsidized.


Where do you come up with a 3,500 penalty for someone making $1,500? According to this article it is $0. Link

brettdoyle said:   ksuwldkat said:   Is there something about this healthcare reform that I'm missing? If you don't have health insurance and have to pay a penalty, you are still without health insurance, correct? It seems like people think that if you choose to pay the penalty you are somehow provided with insurance coverage.

Let's say you don't have insurance and you fall down some stairs and break your leg. You simply call up the insurance company in the ambulance on the way to the hospital and tell them you want to open a policy. They legally can't deny you coverage for a pre-existing condition, which would be your broken leg. Then you go to the hospital, and use your newly acquired insurance to cover all of your hospital bills. After treatment, you call and cancel the insurance policy. You get all the benefit of health insurance, without actually having to pay for it.


Blue Cross doesn't allow you to start coverage until the 1st or the 15th of the following month.

Maybe the age requirement for medicare should be eliminated. And what about altering your date of birth so you would be covered by medicare? Although the conversation might be a bit odd when you visit an obstetrician and pull out a medicare card.

And then on the other end... You are basically forced to utilize Medicare over 65, then upon your demise your estate is billed for the cost of benefits incurred.

brettdoyle said:   Where do you come up with a 3,500 penalty for someone making $1,500? According to this article it is $0. LinkI meant $150,000, which is the amount referenced in my prior post.

atikovi said:   Just got notice from Blue Cross that my monthly premium will be $794 next year, up 20% from $662 now and $483 in 2010. That's like a freakin mortgage payment! I'm early 50s and hardly ever use it. What do some of you self employeds pay? And will Obamacare provide any relief?

If you seldom require medical care, get a high deductible plan, open a HSA account and maximize your contribution to your HSA. Or if you have a pre-existing condition you may be able to get into the federal high risk pool. It costs $247 per month in virginia for ages 45-54.

The plan has 2k deductible but covers annual physical at no cost.

brettdoyle said:   Even for someone making 150K a year, it might make sense to not have insurance, as the $3,500 penalty may be cheaper than the actual cost of health insurance. As more and more people weigh the penalty against the cost of insurance they'll realize they don't need health insurance, and they will cancel their policies. There will be less healthy people pay into the health "insurance" system to cover the costs of sick people, and premiums will need to rise for everyone else, making paying the penalty even more attractive, causing more people to cancel. A vicious circle.

At that point they'll either need to make the penalties much, much higher or else use the broken system as a rationale for 100% socialized health care.


Ding ding ding! We have a winner!

The current incarnation of health-care reform appears to my eye to be largely a means to an end: break the system even further than it is today, in such a way that the only solution will be a fully government driven system, whereby all tax-payers are compelled to pay into the system by way of the IRS. Thus, we'll end up with a NEED for "socialized medicine" (which many say we do not need today), rather than a simple desire in certain circles.

ganda said:   I pay ~$10,000 a year for my family of 3, all healthy. That insurance premium is my largest annual expense, and it pisses me off no end.

My situation is almost identical. One daughter left at home, wife and myself, annual premium for SE health insurance just went up to $950/mo. and I expect another large increase next year. I expect within 5 years it will be more than my mortgage payment.

I've been reading up on the 2014 changes, and there is one thing that doesn't seem clear to me regarding the subsidies.

So I am supporting a family of 5, my wife stays at home with our 3 children.
My income puts us, as a family, at about 260% of the federal poverty level.
I am eligible for an insurance plan through my employer, who would pay 100% of my premium, but 0% of my family's premium. (Coverage for my family would be about 18k/yr, or 25% of my income)
I don't know if this is relevant, but my wife and I file our taxes separately.

1) Would I be not eligible for any subsidy for my family at all, because my employer offers coverage for me?
2) Would I be able to use my employer's plan for myself, and get a subsidy for my family's coverage?
3) Would I have to decline my employer's coverage, and get a subsidy for the whole thing?
4) Something else?

Based on the charts I've found, my premiums for option 3 would be about $5500/year, but they also ask if I'm eligible for employer-based coverage.
Regarding that, I found this note:
In general, full-time employees with employer coverage available that meets specified requirements are not eligible for premium subsidies, unless the employee would have to pay more than 9.5% of income for the employer-provided coverage.
So as a family plan, my expense is far more than 9.5% of my income. (25%)

I would prefer #2, but I don't see any explanation saying this would be possible. Also what would the subsidy be based on? Household income? Wife's income? (none)

Perhaps it is #3 because of the 9.5%/25% thing?

I don't think my situation is all that uncommon. I'm surprised I can't find information about it.

Divorce for free healthcare and profit

SUCKISSTAPLES said:   Divorce for free healthcare and profit

I actually discussed that with her today. I'd very much like to keep the kids on my tax return, but I also want them to get free health insurance. Not sure if those two things are compatible.

Good evening FW.I just lost my job and insurance coverage for my two daughters and I. I have atwood small businesses one with 29 employees and one with two employees. I just put myself on my payroll for 30k a year as that is all I need to live off of. I was wondering if I should get individual or small business health insurance in the state of Texas. Also should I start up a 401k program? Sorry about off topic but any help would be greatly appreciated.

SpeedingLunatic said:   I've been reading up on the 2014 changes, and there is one thing that doesn't seem clear to me regarding the subsidies.

So I am supporting a family of 5, my wife stays at home with our 3 children.
My income puts us, as a family, at about 260% of the federal poverty level.
I am eligible for an insurance plan through my employer, who would pay 100% of my premium, but 0% of my family's premium. (Coverage for my family would be about 18k/yr, or 25% of my income)
I don't know if this is relevant, but my wife and I file our taxes separately.

1) Would I be not eligible for any subsidy for my family at all, because my employer offers coverage for me?
2) Would I be able to use my employer's plan for myself, and get a subsidy for my family's coverage?
3) Would I have to decline my employer's coverage, and get a subsidy for the whole thing?
4) Something else?

Based on the charts I've found, my premiums for option 3 would be about $5500/year, but they also ask if I'm eligible for employer-based coverage.
Regarding that, I found this note:
In general, full-time employees with employer coverage available that meets specified requirements are not eligible for premium subsidies, unless the employee would have to pay more than 9.5% of income for the employer-provided coverage.
So as a family plan, my expense is far more than 9.5% of my income. (25%)

I would prefer #2, but I don't see any explanation saying this would be possible. Also what would the subsidy be based on? Household income? Wife's income? (none)

Perhaps it is #3 because of the 9.5%/25% thing?

I don't think my situation is all that uncommon. I'm surprised I can't find information about it.


"The law specifies that employer-sponsored insurance is not affordable if a worker’s share of the premium is more than 9.5 percent of the worker’s household income. The I.R.S. says this calculation should be based solely on the cost of individual coverage for the employee, what the worker would pay for “'self-only coverage.'”

.....

“'The average salary of North Carolina state employees is about $41,000,'” Mr. Goodwin added, “'and the cost of family coverage in the basic plan is $516 a month, which is not affordable for many state employees. Because employee-only coverage for this plan is provided at no cost to the employee, based on the proposed regulations, all family members would be prohibited from obtaining subsidies through the exchange.'”

NYT

A taxpayer making $150K per year is subject to the tax for failure to maintain qualifying coverage if the cost of a bronze plan is less than $12K per year (8% of income). Although individual coverage should be cheaper than $12K per year, it is likely that the cost of family coverage would exceed that this amount which would exempt such a family from any tax for failure to maintain coverage.


"The mandate’s exemptions cover a variety of people, including: members of certain religious groups and Native American tribes; undocumented immigrants (who are not eligible for health insurance subsidies under the law); incarcerated individuals; people whose incomes are so low they don’t have to file taxes (currently $9,500 for individuals and $19,000 for married couples); and people for whom health insurance is considered unaffordable (where insurance premiums after employer contributions and federal subsidies exceed 8% of family income)."

KFF

Thanks for clearing that up ryeny3.

BCBS let us lock in a 10% rate increase next year and a 9% rate increase the following year. We pay 100% of premiums for our employee group. Our agent said that we can pretty much expect premiums to go up 10% a year until the day we die. While I'm not sure if he's necessarily right about that, we figured with implementations of the Affordable Care Act coming, we might as well hedge our bets.

There have been multiple posts about how people earning over $150k annually would have to pay a fine/penalty of $3,500 (up to a maximum of $10,500 for a family of threee or more) if they fail to obtain valid insurance coverage.

Does anyone here seriously think that anyone with an income of $150k annually would NOT have medical insurance coverage?
Is there anyone you know of making $150/year that does not have medical insurance?

I think that any discussion about high wage earners (in most parts of the country $150k is way above what most people earn) being fined for lack of insurance coverage is pointless.

mikeres said:   There have been multiple posts about how people earning over $150k annually would have to pay a fine/penalty of $3,500 (up to a maximum of $10,500 for a family of threee or more) if they fail to obtain valid insurance coverage.

Does anyone here seriously think that anyone with an income of $150k annually would NOT have medical insurance coverage?
Is there anyone you know of making $150/year that does not have medical insurance?

Most have coverage, but it may not be qualifying coverage under the law because of the deductible structure, the exact services covered/not covered, etc.

xerty said:   mikeres said:   There have been multiple posts about how people earning over $150k annually would have to pay a fine/penalty of $3,500 (up to a maximum of $10,500 for a family of threee or more) if they fail to obtain valid insurance coverage.

Does anyone here seriously think that anyone with an income of $150k annually would NOT have medical insurance coverage?
Is there anyone you know of making $150/year that does not have medical insurance?

Most have coverage, but it may not be qualifying coverage under the law because of the deductible structure, the exact services covered/not covered, etc.
Right, depending on the situation, it's not necessarily that uncommon for people making much more than that to only carry catastrophic healthcare coverage with enormous deductibles, which won't qualify as coverage under Obamacare. It's not necessarily that illogical or risky for many of them to do it either.

For instance, there are a ton of dual US-Canada citizens in the US. They already have healthcare coverage in Canada and, for non-emergencies, can just travel to obtain care there. If they are in a border town, even in most emergency situations they can just drive back/be driven back to obtain care in Canada.

SpeedingLunatic said:   Thanks for clearing that up ryeny3.You're welcome.

Your example is both interesting and a bit scary since the ACA may have created financial incentives for your employer to stop providing health insurance. Because the cost of any penalties would be cheaper than the cost of insurance, your employer could save money by discontinuing your employee-only coverage. The lack of employer coverage for you would make you eligible for subsidized family coverage on a health insurance exchange that might cost you less than unsubsidized (or less subsidized) coverage for just your wife and children.

geo123 said:   xerty said:   mikeres said:   There have been multiple posts about how people earning over $150k annually would have to pay a fine/penalty of $3,500 (up to a maximum of $10,500 for a family of threee or more) if they fail to obtain valid insurance coverage.

Does anyone here seriously think that anyone with an income of $150k annually would NOT have medical insurance coverage?
Is there anyone you know of making $150/year that does not have medical insurance?

Most have coverage, but it may not be qualifying coverage under the law because of the deductible structure, the exact services covered/not covered, etc.
Right, depending on the situation, it's not necessarily that uncommon for people making much more than that to only carry catastrophic healthcare coverage with enormous deductibles, which won't qualify as coverage under Obamacare. It's not necessarily that illogical or risky for many of them to do it either.

For instance, there are a ton of dual US-Canada citizens in the US. They already have healthcare coverage in Canada and, for non-emergencies, can just travel to obtain care there. If they are in a border town, even in most emergency situations they can just drive back/be driven back to obtain care in Canada.
I cover all of my employee's and their dependant's health care costs including any co-pays or deductibles, not only for things which are traditionally covered by insurance, but LASIK and other types of care that many plans don't cover. It is much cheaper for us to buy catastrophic coverage, which would not meet the minimum coverage requirements under ACA, and self-insure the rest.

Small group health plans in NY are community-rated, which means that everyone pays the same regardless of age or health. Insurance costs the same for a healthy 24 year old as it would to cover the least healthy 64 year old in NY. A HDHP for a family with a $2,000 individual deductible and a $4,000 family deductible would cost my firm about $23,000 per year. Since the costs of individual plans are even higher than small group plans in NY, it makes sense for even moderately unhealthy residents to select catastrophic coverage instead of selecting a plan that would be considered "qualifying coverage" under Obamacare.

mikeres said:   There have been multiple posts about how people earning over $150k annually would have to pay a fine/penalty of $3,500 (up to a maximum of $10,500 for a family of threee or more) if they fail to obtain valid insurance coverage.

Does anyone here seriously think that anyone with an income of $150k annually would NOT have medical insurance coverage?
Is there anyone you know of making $150/year that does not have medical insurance?

I think that any discussion about high wage earners (in most parts of the country $150k is way above what most people earn) being fined for lack of insurance coverage is pointless.
Thank you everyone for commenting on my post (above) and helping to open my eyes.

I'd like to be able to say that I like Obamacare but I haven't yet read all 2000 pages of the ACA bill and at the time of it's passage neither has any congressman.

I hope it works out to most peoples benefit without raising their costs significantly.

I guess we're going to find out what the "law of unintended consequences" means.

ryeny3 said:   I cover all of my employee's and their dependant's health care costs including any co-pays or deductibles, not only for things which are traditionally covered by insurance, but LASIK and other types of care that many plans don't cover. It is much cheaper for us to buy catastrophic coverage, which would not meet the minimum coverage requirements under ACA, and self-insure the rest.

Small group health plans in NY are community-rated, which means that everyone pays the same regardless of age or health. Insurance costs the same for a healthy 24 year old as it would to cover the least healthy 64 year old in NY. A HDHP for a family with a $2,000 individual deductible and a $4,000 family deductible would cost my firm about $23,000 per year. Since the costs of individual plans are even higher than small group plans in NY, it makes sense for even moderately unhealthy residents to select catastrophic coverage instead of selecting a plan that would be considered "qualifying coverage" under Obamacare.
Ouch. These types of crazy and often inconsistent state rules is one of many reasons that large employers self-fund health benefits plans, which allows them to be regulated by ERISA and exempts them from state regulations (which is of particular benefit to employers with offices in different states, as that greatly reduces multi-state compliance costs), allows them to design their health plans themselves rather than be forced to accept one of the off the shelf plans, eliminates state premium taxes and greatly reduces commissions, insurance company profits and claims service overhead. Hence, large employers can save considerable amounts through these arrangements, while still using stop-loss policies to protect themselves against large unanticipated claims, all while having total flexibility over the benefits that they wish to offer to their employees. Self-funding is unfortunately not a cost-effective option for smaller employers however, which are stuck being at the mercy of their state insurance requirements and regulations.

mikeres said:   
I'd like to be able to say that I like Obamacare but I haven't yet read all 2000 pages of the ACA bill and at the time of it's passage neither has any congressman.



This helped me quite a bit.

and this is how i explain it to my friends.

ragedogg69 said:   mikeres said:   
I'd like to be able to say that I like Obamacare but I haven't yet read all 2000 pages of the ACA bill and at the time of it's passage neither has any congressman.



This helped me quite a bit.

and this is how i explain it to my friends.
Thank you very much for the links.
I read through both links and the first one was particularly helpful.
The real concern, uncertainty and unease is in the implementation of the specific regulations.
For instance (now that I've been educated) will high deductible policies coupled with HSA be considered acceptable coverage, or will people that have that type of coverage be subject to fines?
The devil is in the details - which have yet to be defined.



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