Nice summary from Ways and Means on proposed changes to ACA released today...

[6miths]

No domestic wines in Canada right, all imported?

Yes there is good deal of grape growing and wine making in Canada actually. The Okanagan Valley of British Columbia and the Niagara region of Ontario are the two primary areas. I grew up in the Niagara region and it is known as 'Grape and Wine Country' locally. I can't speak to quality...

 

[Fedup]

It would be nice if it were that simple. I've been on HDHP with HSA for the past 2 years. Both years I maxed out the OOP/deductible. The first year because my kids had a series of sports injuries (DS#2 broke left elbow in basketball; DS#1 broke orbital socket/face in baseball accident; DS#2 breaks other arm's wrist in baseball accident. DH gets food poisoning after visiting a place (yosemite) that has signs warning of plague - after phone consult with insurer advised to go to ER.) The second year was confined to one family member - dentist finds DS#1 has an ameloblastoma eating away at this jaw - major surgery to remove it.

We're told to eat right, exercise (including playing sports), brush our teeth, get sleep. We did all that - and the sports got us one year and random chance got us the year.

Not all medical expenses are lifestyle issues.

I'm sure not all can be controlled. But there are some people out there who can help themselves. And some are just plain genetic. You can't help with accidents but that's exactly the reason for health care insurance.
My sister does a lots stupid things, like not finish taking antibiotics because she doesnt think she needs to. I never do that. Very risky behavior.

I never had to use my insurance for nearly years now for accident or anything like that. I rarely go to the doctors if I can help it. I go once a year for general check up. But I do use acupuncturist until she retired a few years ago. But I don't have HDHP because I'm piggy back on my husband's plan. I don't think I have a choice, he might need it because he is older. Even for dental plan, only two cleanings per year. I don't even have vision plan. It's not worth it for my family.

 

[tulak]

No domestic wines in Canada right, all imported?

Tons of good Canadian Wines. I had a great Cab Franc a couple of weeks ago in Whistler that was around $14 USD a bottle and DW enjoyed a nice Sauv Blanc (~$10 USD). I was going to buy some Cab Franc for home, but they sold out. Bummer.

Not sure about Eastern Canada, but in BC you have the Okanagan Valley and they make some great wines. On the US side of the border, this is where some Washington state wines come from.

I've tried to find Okanagan wines in the US, but it looks like they aren't exported.

Slight thread derailment (ok, not so slight). Back to talking about healthcare insurance...

 

[Starsky]

I don't understand how without CSRs, low income families will be able to afford insurance. Tax credits are worthless to people who pay no taxes.

 

[MichaelB]

Tons of good Canadian Wines.

So, tons of tuns?

Slight thread derailment (ok, not so slight). Back to talking about healthcare insurance...

Actually, the talk of Canadian wine is much more interesting.

 

[zinger1457]

I don't understand how without CSRs, low income families will be able to afford insurance. Tax credits are worthless to people who pay no taxes.

My understanding is that the tax credits with the new plan are refundable so you would get back any excess (if any) after subtracting taxes owed.

 

[IQuit]

Kaiser interactive map showing tax credit comparison between ACA and AHC

This was a real eye opener showing county by county differences ...

Tax Credits under the Affordable Care Act vs. the American Health Care Act: An Interactive Map | The Henry J. Kaiser Family Foundation

 

[audreyh1]

No domestic wines in Canada right, all imported?

Yes Canada produces wine.

 

[laurence]

My understanding is that the tax credits with the new plan are refundable so you would get back any excess (if any) after subtracting taxes owed.

I heard the kickbacks (or whatever we call them) are going directly to the insurance companies, is that true?

 

[bamsphd]

Once I get past the distraction of credits/subsidies, which though critical for many Americans won't imperil my FIREd state, I personally have medium-term and long-term personal concerns with this bill.

Over the medium term, I already have only a few disappointing insurance options in my state, but at least I can somewhat reasonably compare them. Under this bill (quote from this article):

insurers don’t have to be tethered to giving an actuarial value for their coverage, which means they can supply fake insurance with giant deductibles and co-pays that doesn’t pay for much of anything.

Over the long-term is worse. The current proposal hastens the Medicare Trust Fund exhaustion by about 4 years. I just noticed that means the trust runs out of money before instead of after I qualify, and long before my wife qualifies. If I have to adjust our budget for no Medicare I should probably be working on my resume not posting here.

 

[Pilot2013]

Once I get past the distraction of credits/subsidies, which though critical for many Americans won't imperil my FIREd state, I personally have medium-term and long-term personal concerns with this bill.

Over the medium term, I already have only a few disappointing insurance options in my state, but at least I can somewhat reasonably compare them. Under this bill (quote from this article):
Over the long-term is worse. The current proposal hastens the Medicare Trust Fund exhaustion by about 4 years. I just noticed that means the trust runs out of money before instead of after I qualify, and long before my wife qualifies. If I have to adjust our budget for no Medicare I should probably be working on my resume not posting here.

Is that from HUFFPOST, or BAZZAR?

 

[zinger1457]

I heard the kickbacks (or whatever we call them) are going directly to the insurance companies, is that true?

Not sure how that will work with the new plan. With ACA you do estimate your subsidy and have the option of sending it directly to the insurer every month and applying it against your premium, but it's not required.

 

[MichaelB]

Keep in mind folks, this is not a new plan, just a proposal - a bill under consideration. Usually, implementation specifics are not determined until the bill has been signed into law. Lots of sausage-making ahead.

This is probably not the best thread to discuss Medicare.

 

[Fedup]

Once I get past the distraction of credits/subsidies, which though critical for many Americans won't imperil my FIREd state, I personally have medium-term and long-term personal concerns with this bill.

Over the medium term, I already have only a few disappointing insurance options in my state, but at least I can somewhat reasonably compare them. Under this bill (quote from this article):
Over the long-term is worse. The current proposal hastens the Medicare Trust Fund exhaustion by about 4 years. I just noticed that means the trust runs out of money before instead of after I qualify, and long before my wife qualifies. If I have to adjust our budget for no Medicare I should probably be working on my resume not posting here.

There is no proof that Medicare is running out sooner. Please do not post thing like this. Pure speculation.

 

[NW-Bound]

... Lots of sausage-making ahead.

Sure. We are talking about the ingredients that are lined up to go into that sausage, what we like and don't like.

Man, oh man. Only a few more years till Medicare, then I will get a different kind of sausage. Don't know what will be served up by that time.

 

[donheff]

Keep in mind folks, this is not a new plan, just a proposal - a bill under consideration. Usually, implementation specifics are not determined until the bill has been signed into law. Lots of sausage-making ahead.

This is probably not the best thread to discuss Medicare.

maybe some sausage making but the planned schedule in the House is markup underway with an up or down vote next week. That may or may not work and the Senate may want to put their hands in the bowl. But the plan is fast track.

 

[MichaelB]

The only purpose of my comment was to remind people that many implementation details will not even exist until the bill becomes law, if that should happen.

 

[daylatedollarshort]

There is no proof that Medicare is running out sooner. Please do not post thing like this. Pure speculation.

Are you sure? The taxes on the wealthy that were part of the ACA helped the Medicare trust fund. The Brookings Institution says that repealing these taxes hastens exhaustion of the Medicare Trust fund by 4 years.

This was pointed out by a columnist for the LA Times analyzing the repeal plan.

 

[tulak]

So, tons of tuns?

Nice.

Actually, the talk of Canadian wine is much more interesting.

The drinking can be fun too. I hear there are also some health benefits. I should find a study. Or better yet, participate in a study. Heck, I think I'll run a study of n=1 later. If I can convince DW to participate, we'll up it to n=2. This thread has been truly inspiring!

 

[Mulligan]

I like the higher HSA contribution limits. Can't beat the triple tax advantage of HSAs. I'll definitely take advantage of that if this provision of the bill passes. I'm beginning to worry though because my HSA account balance is already more than 3X the pile of medical receipts I've accumulated. That gap is now likely to grow even faster. I'm not sure band-aids are going to help much. But if I could include premiums, that would be a significant positive change.

That was just what I thought if they increase the HSA. If I stay healthy, there may be a decent chance it is the biggest part of my portfolio come 65. I will worry about that problem then. Will shovel as much as they will let me into my reserve retirement account. Oops, I mean health savings account.

 

[Winemaker]

But are those taxes only used to pay for health care or other things?

Is it only on import items?

Imported wine might be hit by low Canadian dollar?

I take an assortment of my wines to my BIL and SIL to a retirement community in FL where there is a significant number of Snowbird Canadians. There is a daily happy hour where neighbors travel around the neighborhood to imbibe in adult beverages. When we are down there visiting, all complain about the high cost of alcoholic beverages in Canada and blame the health care system for the higher price. All profess to take souvenirs home to last until next season. Several make their own wine, as it is not illegal to purchase grapes or juice.

 

[explanade]

What do they do if they need health care while they're down in FL? Pay out of pocket or go back to Canada to use that health care system which they blame for higher prices?

Taking wine back to Canada may subject them to customs duties unless it's a couple of bottles?

 

[Fedup]

Are you sure? The taxes on the wealthy that were part of the ACA helped the Medicare trust fund. The Brookings Institution says that repealing these taxes hastens exhaustion of the Medicare Trust fund by 4 years.

This was pointed out by a columnist for the LA Times analyzing the repeal plan.

Well you should read the whole article. There are ways to fund the replacement plan too.

 

[daylatedollarshort]

Well you should read the whole article. There are ways to fund the replacement plan too.

The Brookings article was not about the current repeal plan - just what would happen if the taxes that extended the Medicare trust fund were repealed, which does seem to be in the current GOP plan. Are any of those ways of alternate funding in the current GOP ACA repeal plan? If so do you have a source? I've not read any articles that the Medicare funding would be replaced.

A former administrator of the Centers for Medicare and Medicaid Services wrote in the Chicago Tribune that the current GOP ACA repeal bill would cut several years from the life of the Medicare trust fund.

 

[6miths]

What do they do if they need health care while they're down in FL? Pay out of pocket or go back to Canada to use that health care system which they blame for higher prices?

Taking wine back to Canada may subject them to customs duties unless it's a couple of bottles?

Yes Customs is quite strict about two things coming back across the border and ask specifically - alcohol and tobacco. The limit is something like two bottles of wine or a 40 oz liquor per trip after 48h (or something like that). People can say what the want but as recent events have shown, the truth is often another matter. Canada has a national sales tax(GST) of 5% and almost all provinces have a provincial sales tax (PST) in the 7-9% range).

People buy travel insurance. Unless they are absolutely crazy. If they have a significant health problem, they try to get back to Canada asap. Pre-existing health problems are often the end to the snowbird lifestyle (to the US at least) as insurance becomes unaffordable for most.