Obamacare

[ziggy29]

Quote:

Originally Posted by grasshopper How long before the subsidies get taxed.

Here's a question: If you expect to have low income in 2014 but high income in 2012 (guilty as charged), and you pay "full price" for HI in 2014 and you itemize the cost of HI above 10% of AGI, will the subsidy you get as a tax credit off your 2014 return itself be taxable, since you wrote off much of what you paid? The mind boggles.

[bUU]

Quote:

Originally Posted by travelover the second is the general high cost of healthcare in general in the US, as compared to other western nations.

And that would definitely make a great topic for a discussion thread.

Quote:

Originally Posted by ziggy29 Here's a question: If you expect to have low income in 2014 but high income in 2012 (guilty as charged), and you pay "full price" for HI in 2014 and you itemize the cost of HI above 10% of AGI, will the subsidy you get as a tax credit off your 2014 return itself be taxable, since you wrote off much of what you paid? The mind boggles.

Interesting. I sure hope that they thought of that scenario.

[ziggy29]

Quote:

Originally Posted by bUU Interesting. I sure hope that they thought of that scenario.

It *seems* to me the logical thing to do would be to take a tax credit *instead* of a Schedule A deduction on your 2014 tax return, but we're talking about the IRS so you never know.

[wmc1000]

Ziggy29 - right you are - credits are so much better than deductions!

[ERD50]

Quote:

Originally Posted by bUU 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.

OK, but there is no reason for them to be mutually exclusive.

For the most part, the people w/o coverage (for whatever reason) were getting treated. It might have bankrupted them, or they might have been subsidized one way or the other. But it is still a 'cost' in terms of 'total health care cost' for the nation. So from a total cost POV, covering these people probably won't add much to overall health care spending, if done reasonably efficiently - it could lower costs in some cases if preventative measures or early treatment help.

I just feel there should have been more done for controlling overall costs - there are lots of opportunities that have been discussed in previous threads.

-ERD50

[bUU]

Would-a been nice.

[explanade]

First of all, Brooks is not liberal. Not as conservative as others in his party but he's far from liberal.

Second, they passed what they were able to pass. If they didn't pass even these tepid changes to the the health care system, there would be no chance of more serious reforms.

If they tried to attack the cost issue, like maybe leveling the pharmaceutical pricing structure in this country, or being more strict about non-profit hospitals or change the payment system (compensating providers based on results, instead of procedures performed, regardless of the results), the political opposition would have been far greater.

It's not as if the ACA could have been swept aside and Congress would have voted for a better reform law. If it failed to pass, then we likely would not have had another attempt at reform for at least another decade, with things getting worse.

[pb4uski]

Quote:

Originally Posted by ziggy29 Here's a question: If you expect to have low income in 2014 but high income in 2012 (guilty as charged), and you pay "full price" for HI in 2014 and you itemize the cost of HI above 10% of AGI, will the subsidy you get as a tax credit off your 2014 return itself be taxable, since you wrote off much of what you paid? The mind boggles.

I would think that they would require that the deduction for health insurance premiums on Schedule A be reduced by any subsidies being claimed on that return (and the subsidy would be known since it is based on O-MAGI and premiums paid and could be calculated before the deductible premiums are calculated). IOW, it'll probably be built into TurboTax.

[MichaelB]

Quote:

Originally Posted by ziggy29 It *seems* to me the logical thing to do would be to take a tax credit *instead* of a Schedule A deduction on your 2014 tax return, but we're talking about the IRS so you never know.

The tax credit should always be greater than the reduced tax from using the deduction. When the net is in your favor it seems like a pretty straightforward process to get it, just net it when filing. The issue I see is when the real income is higher so the subsidy earned is less than the one given upfront.

The Brooks OpEd is a laundry list of potential and real issues and problems. He can do better than that, and should. The lack of cost reduction is a red herring, because that never has been part of the this initiative.

[youbet]

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Originally Posted by bUU They probably won't ever be.

Unless they are.

[youbet]

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Originally Posted by MichaelB The lack of cost reduction is a red herring, because that never has been part of the this initiative.

Although cost control and reduction was an important talking point in selling the initiative.

[MichaelB]

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Originally Posted by youbet Although cost control and reduction was an important talking point in selling the initiative.

While implementation of the PPACA may lead to cost control, I don't recall it being part of the discussion. Cost reduction was never part of the proposed or approved legislation, or part of the process, AFAIK.

[youbet]

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Originally Posted by MichaelB While implementation of the PPACA may lead to cost control, I don't recall it being part of the discussion. Cost reduction was never part of the proposed or approved legislation, or part of the process, AFAIK.

It was part of the discussion, an important selling point. If nothing else, the fact that our health care cost per person was high while our outcome effectivity was not, was repeated again and again calling for change and the establishment of a "reformed" system.

I'm not against Obamacare. I just think it's been over promised, especially on cost control.

[MichaelB]

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Originally Posted by youbet It was part of the discussion, an important selling point. If nothing else, the fact that our health care cost per person was high while our outcome effectivity was not, was repeated again and again calling for change and the establishment of a "reformed" system. I'm not against Obamacare. I just think it's been over promised, especially on cost control.

Do you have a source? I am familiar with election campaign rhetoric about health care costs but not the legislation. My recollection is very much a discussion about breadth and reach of coverage, insurance options, and the mandate.

[youbet]

Exactly.

Health care cost reduction was an important part of campaign rhetoric. Then legislation was proposed and passed which will likely not be effective in bringing about cost reductions.

[Mulligan]

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Originally Posted by youbet Exactly. Health care reduction was an important part of campaign rhetoric. Then legislation was proposed which will likely not be effective in bringing about cost reductions.

That is exactly the interpretation I have perceived during the process.

[MichaelB]

Let's acknowledge that agreement (it's not often) and get the conversation back to the PPACA. Implementation issues, coverage, roll out, etc.

ETA: If it wasn't clear, let's keep election rhetoric out of the thread.

[youbet]

Quote:

Originally Posted by MichaelB Let's acknowledge that agreement (it's not often) and get the conversation back to the PPACA. Implementation issues, coverage, roll out, etc. ETA: If it wasn't clear, let's keep election rhetoric out of the thread.

OK, I'm glad you agree. And I have no problem not discussing election rhetoric. I only mentioned it since you pushed for a source.

But, the cost vs effectiveness of health care in the USA and the need for reform and improvement has been discussed extensively here on the ER forum. Are you suggesting that will no longer be allowed? Or, are you just saying not on this thread which should be focused only on the existing Obamacare program staus quo?

[MichaelB]

Quote:

Originally Posted by youbet OK, I'm glad you agree. And I have no problem not discussing election rhetoric. I only mentioned it since you pushed for a source. But, the cost vs effectiveness of health care in the USA and the need for reform and improvement has been discussed extensively here on the ER forum. Are you suggesting that will no longer be allowed? Or, are you just saying not on this thread which should be focused only on the existing Obamacare program staus quo?

If you want to talk healthcare reform please do so, in a separate thread. All I'm trying to do is keep this thread on topic.

[travelover]

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Originally Posted by youbet Exactly. Health care cost reduction was an important part of campaign rhetoric. Then legislation was proposed and passed which will likely not be effective in bringing about cost reductions.

Wasn't the single payer option, which was dropped prior to passage of the ACA, supposed to force rates for services down, as it does for Medicare?