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Old 04-06-2013, 10:28 AM   #321
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Nothing wrong with Nurse Practitioners for routine health care. Many have specialties as well (obstetrics, cardiac re-hap, geriatrics). They are trained to listen.
They are also licensed and capable of doing 75-85% of what a physician does. Surgery is one of the very few things NP's cannot perform.
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Old 04-06-2013, 11:09 AM   #322
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If 16.1% of drivers are uninsured, and (subsidized) health care will be more expensive, it's reasonable to assume more than 16.1% will be ACA "miscreants." "Outnumber" is probably correct, but over 16% is quite a drag on ACA if that's how it shakes out. Time will tell...
CBO published some estimates on how many people will decline health care and pay the tax.

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Of the remaining 11 million to 12 million uninsured people, ... CBO and JCT now estimate that about 6 million people will pay a penalty because they are uninsured in 2016 (a figure that includes uninsured dependents who have the penalty paid on their behalf )
http://cbo.gov/sites/default/files/c...te_Penalty.pdf

Note there are another 20M people who won't get insurance but are not subject to the tax because they are say unauthorized immigrants (can't receive subsidy etc.) or have other issues.

They estimate 1.8M people who above the 400% FPL who will decline healthcare and pay tax. This seems surprising to me since I believe you don't have to pay the tax if healthcare would be > 8% of income and 400% FPL is quite a decent amount of income. I guess these are strategic defaulters?
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Old 04-06-2013, 12:59 PM   #323
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but over 16% is quite a drag on ACA if that's how it shakes out. Time will tell...
There will always be non-compliance. Heck, I've made a career out of compliance assurance - no - two separate careers, built around compliance assurance. You wouldn't think compliance would be so difficult to arrange for, but as selfishness has increased, the need for compliance assurance has increased. However, that's a societal trend - not anything unique to health care or ACA. It appears in practically every aspect of society, financial and non-financial. It's the underlying drag on everything in society.
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Old 04-11-2013, 08:29 AM   #324
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I found ct. new exchange page.

their calculator asks the persons in family who need coverage differently.

california does not ask how many people in family need coverage. ct. does

if there are 2 people in your family and one of them is on medicare then whole familys amount of money is used but just one person covered hard to get subsidy.

How to save | Access Health CT


compare to californias calculator and how questions phrased


http://www.coveredca.com/calculating_the_cost.html


this calculator mirrors california but not CT.


http://www.coveroregon.com/calculator.php
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Old 04-11-2013, 08:57 AM   #325
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They are also licensed and capable of doing 75-85% of what a physician does. Surgery is one of the very few things NP's cannot perform.
We also will see an increase in PA's (physician assistants)
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Old 04-11-2013, 09:20 AM   #326
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Cover Oregon


cover Oregon is up with their obamacare exchange some info

Very nice site and easy to use. Thanks for the link. The calculator says my premiums will drop about $300 per month with the subsidy and my out of pocket max will drop almost 60%!!!
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Old 04-11-2013, 11:33 AM   #327
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I tried the CT calculator and if I need insurance for two the payment is $250/mo. If I need insurance for just one of us the payment is $301.

That does not make sense. It must be assuming that the income I put in is just for the one person needing insurance and it's not, it's for both of us, with only one of us needing insurance.

I'm not in CT so I guess it's not relevant.
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Old 04-11-2013, 12:00 PM   #328
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I tried the CT calculator and if I need insurance for two the payment is $250/mo. If I need insurance for just one of us the payment is $301.

That does not make sense. It must be assuming that the income I put in is just for the one person needing insurance and it's not, it's for both of us, with only one of us needing insurance.

I'm not in CT so I guess it's not relevant.
IT MIGHT be relevant if all the other state calculators that don't ask how many actually need insurance did

Ct. retirements calculator makes you enter all family income. it asks how many in your family need insurance.(corrected)

it appears to then default to single coverage parameters if you say 1.

say 2 of you have income of 55000. but only 1 of you need coverage-it uses the 45,700 cap for single but still uses your total 55000 income.

the reason i bring this up is the california and oregon calculators don't ask this. it just assumes if you have 2 in household you both need insurance and give this calculation.

my wife is on medicare but i am not. i can get my magi down to
based on joint return but cannot get to less than 47,000


i.m wondering if this would happen in all calculators if it asked the same ct. question
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Old 04-11-2013, 02:31 PM   #329
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IT MIGHT be relevant if all the other state calculators that don't ask how many actually need insurance did

Ct. retirements calculator makes you enter all family income. it asks how many in your family but then asks you how many require insurance.

it appears to then default to single coverage parameters if you say 1.

say 2 of you have income of 55000. but only 1 of you need coverage-it uses the 45,700 cap for single but still uses your total 55000 income.

the reason i bring this up is the california and oregon calculators don't ask this. it just assumes if you have 2 in household you both need insurance and give this calculation.

my wife is on medicare but i am not. i can get my magi down to
based on joint return but cannot get to less than 47,000

i.m wondering if this would happen in all calculators if it asked the same ct. question
Where do you see the Ct retirement calculator? I only saw one for individuals or businesses and the one for individuals didn't have the options you mentioned.
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Old 04-11-2013, 02:38 PM   #330
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Where do you see the Ct retirement calculator? I only saw one for individuals or businesses and the one for individuals didn't have the options you mentioned.
2/3 of the way down click on individuals and family

How to save | Access Health CT


i t words it differently-you have to list all family income-then asks how many in family will get insurance

the other calculators give you just choice of single or family-and if you use family minimim of 2 and uses 2 as the number of members who need insurance automatically

i worded my prior post incorrectly

i guess the simplest way to say it is if your 2 in a family but only one needs insurance then your goverend
by the single calculation even if you need to base it on all family income.
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Old 04-25-2013, 04:38 PM   #331
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I couldn't help myself and finally called Blue Cross today, to see if they had any information about what they were doing with their "grandfathered plans" or whether we were going to get dumped into the health insurance exchange on our rears. They are still keeping a tight lid on the matter. All the lady would say was information on the matter would be sent out later in the year. I tried to ask it in a different manner a few times and she kept reading from the same cue card, so they definitely aren't willing to share any information yet, or possibly don't know either. I definitely know the customer service agent knows nothing about it.
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Old 04-25-2013, 11:23 PM   #332
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i guess the simplest way to say it is if your 2 in a family but only one needs insurance then your goverend
by the single calculation even if you need to base it on all family income.
Yes, this seems to be flawed. It is almost like none of these calculators can envision a household where there is one person on medicare and then another person or persons not on medicare.

Right now the kids and I are on DH's retiree coverage but I don't know if it will survive so I'm curious about the exchanges. DH just went on medicare so it is 2 adolescents and me that need coverage. I might be able to get our income into the family of 4 parameter to get a subsidy (around $92k) but I couldn't get down to the family of 3.

Once calculator said our premium would be almost $2k a month with no subsidy (putting in income of $92k) because they were counting our full income but then for subsidy were treating us like a family of 3....
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Old 04-26-2013, 06:38 AM   #333
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How long before the subsidies get taxed.
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Old 04-26-2013, 06:42 AM   #334
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They probably won't ever be.
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Old 04-26-2013, 07:42 AM   #335
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I saw this in today's New York Times:

NYT: Health Chaos Ahead

Obviously, it's an OpEd, but still interesting.
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Old 04-26-2013, 07:58 AM   #336
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I saw this in today's New York Times:

NYT: Health Chaos Ahead

Obviously, it's an OpEd, but still interesting.
David Brooks OpEd about difficulties implementing the PPACA.
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Old 04-26-2013, 08:12 AM   #337
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David Brooks OpEd about difficulties implementing the PPACA.
Thought provoking article. The most salient point that he makes, IMHO, is that the ACA doesn't address the cost issue.

I don't see any movement there under current circumstances.
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Old 04-26-2013, 08:26 AM   #338
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I saw this in today's New York Times:

NYT: Health Chaos Ahead

Obviously, it's an OpEd, but still interesting.

A very interesting article.... and I do not see him with an ax to grind (I think he is liberal, but not sure... he does have good opinions when on the talk shows)...


I think the telling paragraph is this (my bold):

"Then there is the cost cascade. Nearly everybody not in the employ of the administration agrees this law does not solve the cost problem, and many of the recent regulatory decisions will send costs higher. A study in California found that premiums could increase by an average of 20 percent for people not covered by federal subsidies. A study by the Society of Actuaries found that by 2017 costs could rise by 32 percent for insurers covering people in the individual exchanges, and as high as 80 percent in states like Ohio."


Not trying to bring bacon... just pointing out that Obamacare does not solve the problem that Obamacare was supposed to solve...
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Old 04-26-2013, 08:53 AM   #339
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Also not trying to bring bacon, and keeping this completely factual, based on the actual wording of the law... ACA is supposed to solve the problem of lack of affordability of health coverage for those with pre-existing conditions, with conditions that otherwise would exceed a lifetime cap, etc., as well as with regard to the working poor, in general. Not for everyone.

And it definitely does those things.

If the objective was to lower health care costs overall, then there was a completely different approach available. That just simply wasn't the objective that we decided to pursue as a nation.
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Old 04-26-2013, 09:17 AM   #340
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And with an eye on Porky - there are two elements of health care under discussion. One is cost shifting among the insured to benefit the previously uninsurable, the second is the general high cost of healthcare in general in the US, as compared to other western nations.

I'm sure that no one would try to take political advantage over confusion between the two.
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