Affordable Healthcare Act

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jerosen said:   
btuttle said:   
jerosen said:   
IMBoring25 said:   
tmonkey said:     Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source     
  ...And VAT...

  And we have sales tax and state income taxes.

I have neither, and certainly don't pay a 20+% VAT.

  
Which state doesn't have sales or income taxes?   Alaska?

 

  
Florida has no state income tax.  That's why a lot of athletes call it home

Jerosen said:


"There is a 9.5% threshold on whether or not you can itemize and deduct your health care out of pocket spending."



You can still write all medical expenses off except the medical threshold was raised to more then 10%.


The 9.5% means a little more. When you measure the insurance your employer has for you, If it causes you to exceed 9.5% of your income in medical spending, you can opt out of your employer plan and go to the exchange to keep your expenses under 9.5%. If you employer has like 30 or more and in 2015, your employer will be given a choice, improve the coverage or pay the exchange for the 30 or more people who moved to the exchange. Employers now have to consider what an employees pay is and are they likely to have to spend more then 9.5% in medical expenses under the employer plan. Call pay or play for employers.

jerosen said:   
btuttle said:   
jerosen said:   
IMBoring25 said:   
tmonkey said:     Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source     
  ...And VAT...

  And we have sales tax and state income taxes.

I have neither, and certainly don't pay a 20+% VAT.

  
Which state doesn't have sales or income taxes?   Alaska?

 

  Alaska has no sales or income tax. New Hampshire also doesn't have a sales or income tax.    Texas, Florida, Nevada, Washington, Alaska, Tennessee, South Dakota, Wyoming have no income tax (at least on wages), while Delaware, Montana, Oregon and New Hampshire have no sales tax.

jerosen said:   
borges said:   
RS4Rings said:   ..... Have to love a country where I can spend almost $200k on a car and then get the Government to pay a big chunk of my insurance.
  most countries pay not "a big chunk", but cover the whole cost of it (look to the north for instance).

back to the subject: i buy insurance myself, I guess "on exchange" (Mass Connector in my case) and I do not see much improvements, though I am not qualified for any subsidy, of course.
to get to 10% expense is very extreme I think and it seems to me the Gov pays only when you get over that threshold.

  

What do you mean the government only pays when you get over that threshold?

THe subsidies under the new law are based on income levels.   It has nothing to do with out of pocket costs.     There is a 9.5% threshold on whether or not you can itemize and deduct your health care out of pocket spending.   These aren't the same things.

  
Look up at the thread, - they write about 9.5% even though i  think it is about 7 something last time i checked.
Anyways regardless, the thread is all about how to get as much profit as you can in new environment.
What I am saying is that even though if you reach 7 or 9,5% in medical expenses, - you will get nothing back in terms of tax return deductions;
only in the excess of 9,5% will be deductible, i think.
I do not see people who can get any subsidies, and those who's eligible will not be able to file proper forms anyway...

The medical deduction was raised to 10%. You have to reach 10% of your income before you can write off medical expenses. It was raised from the prior 7% to 10%. And just like before,it is used to write down your income.


The 9.5% of your income applies to the maximum you should spend on medical insurance with your employer. It also means your employer has to try and get you under 9.5% of AGI or let you leave to go on the exchange.

Borgus said:
I do not see people who can get any subsidies, and those who's eligible will not be able to file proper forms anyway...
 

Considering the threshold to receive subsidies begins at  $92,000 adjusted gross income for a family of 4, if you know no one in that category you know some people who are very comfortable financially.

 

syber said:   The 9.5% means a little more. When you measure the insurance your employer has for you, If it causes you to exceed 9.5% of your income in medical spending, you can opt out of your employer plan and go to the exchange to keep your expenses under 9.5%. If you employer has like 30 or more and in 2015, your employer will be given a choice, improve the coverage or pay the exchange for the 30 or more people who moved to the exchange. Employers now have to consider what an employees pay is and are they likely to have to spend more then 9.5% in medical expenses under the employer plan. Call pay or play for employers.
  
The 9.5% is for premiums for self-only coverage, not all medical expenses and not even family coverage. Per IRS Notice 2011-73 : "Coverage under an employer-sponsored plan is affordable to a particular employee if the employee’s required contribution (within the meaning of §5000A(e)(1)(B)) to the plan does not exceed 9.5 percent of the employee’s household income for the taxable year." 26 USC §5000A(e)(1)(B)  defines required contribution as "the portion of the annual premium which would be paid by the individual (without regard to whether paid through salary reduction or otherwise) for self-only coverage."

ETA: If you think I am wrong, please cite a reliable source and I will be happy to add a correction.

The 9.5% is for premiums for self-only coverage, not all medical expenses and not even family coverage.


That is correct. Great to clarify that fact. I think this is a downside to the ACA that only the employee is considered when the employer insures the entire family. But it is what it is.

here is a question answer I found from a consultant web site:

I have 75 employees.  Will I be required to provide insurance for my employees?Yes. An employer that fails to offer “minimum essential coverage” to its employees will be subject to a penalty of $2,000 for each of their employees beyond the first 30. In your case, this penalty would be $2,000 x (75-30) = $90,000.  Employers that do offer minimum essential coverage will be assessed a penalty of $3,000 per employee that is eligible for, and receives, a subsidy through the Exchange because their share of the premium for the employer’s group health plan exceeds 9.5% of their household income.  This penalty may not exceed $2,000 times the number of employees, disregarding the first 30 employees.


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Link

syber said:   The medical deduction was raised to 10%. You have to reach 10% of your income before you can write off medical expenses. It was raised from the prior 7% to 10%. And just like before,it is used to write down your income.


The 9.5% of your income applies to the maximum you should spend on medical insurance with your employer. It also means your employer has to try and get you under 9.5% of AGI or let you leave to go on the exchange.

Borgus said:

I do not see people who can get any subsidies, and those who's eligible will not be able to file proper forms anyway...
 

Considering the threshold to receive subsidies begins at  $92,000 adjusted gross income for a family of 4, if you know no one in that category you know some people who are very comfortable financially.

 

  All I said was that you have to spend over $9K (for $92K AGI, btw why for 4? not 6?) to get anything in terms of tax write-offs!  it is pretty extreme, i had few years with major medical expences and never reached even 7% of my AGI (for a family of 4).

I think an average person, like me, does not have enough time to squize literally just few bucks from all this reform/system.... And I can even use Excel! What can we tell about poor folks, really poor, who are eligible fro the new benies, but do not know even how to use a calculator?!
 

borges said:   I do not see people who can get any subsidies, and those who's eligible will not be able to file proper forms anyway...
  I will be getting around $13k in subsidies and even though I'm moderately retarded I'm sure I can figure out the forms, but doesn't matter since I have an accountant that does mine 

Study just out on the cost for state implementing there own ACA.

Link

RS4Rings said:   
borges said:   I do not see people who can get any subsidies, and those who's eligible will not be able to file proper forms anyway...
  I will be getting around $13k in subsidies and even though I'm moderately retarded I'm sure I can figure out the forms, but doesn't matter since I have an accountant that does mine 

  this fact only confirms my thought about who CPAs clients are...
re: phatom $13K in your pocket, -  there is a proverb - "while Moishe is dreaming about the chicken, the inspector is having it".

borges said:   
RS4Rings said:   
borges said:   I do not see people who can get any subsidies, and those who's eligible will not be able to file proper forms anyway...
  I will be getting around $13k in subsidies and even though I'm moderately retarded I'm sure I can figure out the forms, but doesn't matter since I have an accountant that does mine 

  this fact only confirms my thought about who CPAs clients are...
re: phatom $13K in your pocket, -  there is a proverb - "while Moishe is dreaming about the chicken, the inspector is having it".

  Go screw your chicken . Not sure why you are in this thread since you don't have a clue as to what you are talking about. Many will be getting subsidies, I think maybe even enough to help bankrupt the Country

RS4Rings said:   
borges said:   
RS4Rings said:   
borges said:   I do not see people who can get any subsidies, and those who's eligible will not be able to file proper forms anyway...
  I will be getting around $13k in subsidies and even though I'm moderately retarded I'm sure I can figure out the forms, but doesn't matter since I have an accountant that does mine 

  this fact only confirms my thought about who CPAs clients are...
re: phatom $13K in your pocket, -  there is a proverb - "while Moishe is dreaming about the chicken, the inspector is having it".

  Go screw your chicken . Not sure why you are in this thread since you don't have a clue as to what you are talking about. Many will be getting subsidies, I think maybe even enough to help bankrupt the Country

  the most dangerous retarded people are those who think they "have a clue".

the fact is, of course, many people will get subsidies (CPAs, lawyers, white collar thieves,  etc..), but not those who are supposed really to get them.
this always happens when people who are sure "have a clue"  (meaning retarded ones) create new laws.

borges said:   
 
the fact is, of course, many people will get subsidies (CPAs, lawyers, white collar thieves,  etc..), but not those who are supposed really to get them.
this always happens when people who are sure "have a clue"  (meaning retarded ones) create new laws.

  I think the law is very dumb and am not for it, but i am eligible for the subsidies under it so of course will take them, also could do this easily on my own without my CPA. And this thread is for those people who are suppose to get them to learn how to get them

So many are against the subsidies and it will be of interest to see how many opt out of receiving the subsidy. People can pay the full cost of a policy under the act if they choose. If one decides to reject the subsidy, they can write off the entire amount if medical costs and premiums exceed 10% of there income. The calculator at the beginning provides the full cost of the policy with out subsidy.

Also MA has had the exchange for a few years but I never really looked at it and just kept the policy I had when I was working. I found a much better plan on it, price is cheaper than what my renewal rate was going to be and no deductible, old plan I paid first $1k for each person. Even has a dental plan which my old one did not have. The exchange is who will handle the subsidies for you, they can be used to pay part of your monthly payment or you can take in lump sum at year end 

syber said:   So many are against the subsidies and it will be of interest to see how many opt out of receiving the subsidy. People can pay the full cost of a policy under the act if they choose. If one decides to reject the subsidy, they can write off the entire amount if medical costs and premiums exceed 10% of there income. The calculator at the beginning provides the full cost of the policy with out subsidy.
Or you can be self-employed with a HDHP/HSA and have Uncle Sam subsidize both the premiums and HSA contributions. The subsidy is both your tax rate and the FICA rate.

I know uncle sam will subsidize the cost of a HDHP but I had not heard they will contribute to an HSA account as well for the self employed.

syber said:   If one decides to reject the subsidy, they can write off the entire amount if medical costs and premiums exceed 10% of there income.
  
You only get to deduct the amount that exceeds 10%. So if your AGI is $50,000 and you have $5,001 of medical expenses, you get to write of $1 if you itemize your deductions. I wish I could red this thread twice.

I cited this article because it highlights the importance of an insurer's network when evaluating the quality and cost of coverage. If Anthem’s claim that “premiums would have been 25 percent higher with a larger network” is accurate, excluding many hospital and doctors in order to reduce the cost of coverage may be a reasonable trade-off. Unfortunately, in NH, unlike most other states; there is only one insurer offering policies on the exchange and the option to pay more for a more comprehensive network doesn’t appear to be readily available in 2014. 

"CONCORD, N.H. (AP) — Starting in January, 10 of New Hampshire’s 26 hospitals won’t serve patients who get individual health insurance through Anthem Blue Cross and Blue Shield.

Anthem will be the only company providing individual health insurance plans through the new marketplaces, or exchanges, required under the federal Affordable Care Act. It’s creating a new provider network for individuals who purchase plans either on or off the exchange that includes 16 New Hampshire hospitals and one in Massachusetts.

Senate President Chuck Morse criticized the development Thursday, saying many people will lose access to their long-time doctors. But Anthem said premiums would have been 25 percent higher with a larger network. Those who bought plans before March 2010 won’t be affected by the changes."


boston.com    
 

I think we will get into trouble by providing news articles and accepting them as accurate. That has been the real problem is accuracy. Also the quoting of politicians when they have said so many different things. So if we want to quote the news or quote a politician, it will not help people learn the truth.

There are afew sources out there who are helping gear up for this program and may be more reliable.

syber said:   I think we will get into trouble by providing news articles and accepting them as accurate. That has been the real problem is accuracy. Also the quoting of politicians when they have said so many different things. So if we want to quote the news or quote a politician, it will not help people learn the truth.

There are afew sources out there who are helping gear up for this program and may be more reliable.

  Such as? If you exclude news articles and politicians (and their surrogates), there aren't many sources left. Saying there are other sources that may be more reliable without actually providing them doesn't really add to the discussion. If you have different information about NH's health exchange, even if it is from a politican or news article, please provide it.

This one out today on the amount people will pay in various states.

Kayser is pretty reliable and not connected to the insurance industry.

Link

I'm looking forward to all the news reports regarding the widespread "fatwallet effect" that will inevitably spread once this poorly planned policy goes into place.

While I hate to get political, they are going about this entirely wrong; health care in the country is a problem for many reasons (although, there's a reason why the richest Shahs come here for their surgery...)
If we truly want a nationalized health system, the government needs to start from the ground up-
take over all the medical schools and hospitals in the country- have med schools take students right out of high school into shortened programs and subsidize the cost (how much debt do docs in Europe graduate? I believe 0...)
Then, allow them to complete residency programs working 40-50 hours per week instead of 120, and pay them a fair living wage all along.
Have the government run all hospitals and health care facilities in the country to control cost (OK, that may be dangerous in the US given our government's history, but it works elsewhere.) Remove most forms of malpractice suits.

The downside- things WILL get rationed (my buddy in Canada has to wait a year to get a knee arthroscopy) and all medical judgment and research will be stymied by the government protocol.
The upside- all will receive a similar quality of care, which is what I guess the government wants.

Well I am sure we can go on and on of what could have been, what should have been. In three weeks the law which passed 3 years ago will go into effect. It is time to address what people need to know in three weeks. People need to know if they will save money by going on an exchange or not save money. What the differences are between states. Spme people prefer the bronze level which leaves more exposure and some desire the gold plan with more coverage. How much a person makes and the subsidy they will receive. These are the issues to be confronted in three weeks.

The system in Sweden, the best healthcare in the world would have been nice but that is not what passed.

syber said:   This one out today on the amount people will pay in various states.

Kayser is pretty reliable and not connected to the insurance industry.

Link

Umm, its spelled Kaiser, just like Kaiser Permanente (hint) - I know they say they are unbiased but come on 

syber said:   October 1, 2013 Americans can sign up for Medical insurance coverage through the government. There have been a lot of misinformation and people will have to decide who they believe. From the perspective of personal finance, this will be a very big choice for many people. From my reading I will provide the basics and not argue it.

Each state will have 100 medical policies which people can choose from. These are from the same companies and the same policies we have seen in the past. They are also at the same cost as in the past.
The difference is if your family income is less then 400% of the federal poverty level, the government will pay a part of your monthly income. A family of 4 making $92,000 a year is under 400% of the poverty level. A family of 2 making under $40,000 a year is under 400% of the poverty level. So how much you will pay depends on last years adjusted gross income on your federal return and the government pays the rest. Some people do not want the government helping them pay so there is an option of paying the full cost each month yourself. A decent family policy runs between $1000 and $1400 monthly and you make the pick. A family of 2 making $40,000 a year is at $250% of the poverty level and will pay about $200 monthly and the government will pay $1200 monthly for this couple. One other thing to consider if you currently have a high deductible health plan and also pay premiums. If your deductibles, co-pays, and premiums cost you more then 9.5% of your income each year, you can apply under the affordable care plan to keep your health expenses below 9.5% of total health costs. Here is a calculator you can use to see what % of the poverty level your family is at, how much your will pay and how much the government will pay. Remember, use adjusted gross income.
calculator      

Video- aca explained 

Unlike plans that we have purchased in the past, no individual exchange plans in NY provide out-of-network coverage. Making matters worse, we don't know if any of the doctors that we have used in the past will be part of any exchange plan's network. Do other states have broader networks? 



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