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Old 05-20-2013, 07:02 PM   #61
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Originally Posted by Katsmeow View Post
The language quoted in Post 36 does seem to suggest that you count the income of everyone.
From what I read in one of the documents, it seems you are obligated to count all the household income prior to determining your household subsidy. This is going to get interesting!
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Old 05-20-2013, 07:42 PM   #62
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+1, but I think it will be more ER's than entrepreneurs.
That was the case for me.

I have access to DW health plan currently , but if her MegaCorp changes things, then I wanted to have something else between me and the old individual insurance market. I was carefully watching the 2012 election results while planning for a possible ER that became reality in April.

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Old 05-20-2013, 11:07 PM   #63
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The language quoted in Post 36 does seem to suggest that you count the income of everyone.
Yes, I read that, but paragraph one explicitly says to count only the household members who are dependents on a tax return. I know that currently isn't a test for eligibility for coverage on an employer policy, thus my confusion.

I thought of another possibility. Perhaps the "under 26" provision only applies to an employer's policy. For the exchange policies, a dependancy test applies?
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Old 05-21-2013, 05:09 AM   #64
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The way I ready the IRS language, the household income is only from individuals treated as dependents on the tax return. In that case, a 25 year old child that is working is automatically eligible for coverage, but his / her income is not included in the test. I recall a Q&A on this somewhere and have looked around but can't find it - but will look again later.


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(d) Terms relating to income and families
For purposes of this section—
(1) Family size
The family size involved with respect to any taxpayer shall be equal to the number of individuals for whom the taxpayer is allowed a deduction under section 151 (relating to allowance of deduction for personal exemptions) for the taxable year.
(2) Household income (A) Household income
The term ‘‘household income’’ means, with respect to any taxpayer, an amount equal to the sum of—
(i) the modified adjusted gross income of the taxpayer, plus
(ii) the aggregate modified adjusted gross incomes of all other individuals who—
(I) were taken into account in determining the taxpayer’s family size under paragraph (1), and
(II) were required to file a return of tax imposed by section 1 for the taxable year.
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Old 05-21-2013, 05:31 AM   #65
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So my 25 yo DS who is working and living on his own can be included on my HI policy but his income won't be included in my O-MAGI for determining the subsidy? sounds like his coverage would be a freebie then since if there is any extra premium for including him vs just me and DW that it would increase my subsidy.
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Old 05-21-2013, 05:53 AM   #66
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So my 25 yo DS who is working and living on his own can be included on my HI policy but his income won't be included in my O-MAGI for determining the subsidy? sounds like his coverage would be a freebie then since if there is any extra premium for including him vs just me and DW that it would increase my subsidy.
I would imagine that most 26 and under working people are drawing incomes that are below 4x the FPL, so they would be eligible for premium support on their own. Also keep in mind that they must live in the policy coverage area.

Still, this looks like something that we should confirm before jumping in.
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Old 05-21-2013, 05:56 AM   #67
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So my 25 yo DS who is working and living on his own can be included on my HI policy but his income won't be included in my O-MAGI for determining the subsidy? sounds like his coverage would be a freebie then since if there is any extra premium for including him vs just me and DW that it would increase my subsidy.
This is exactly the result I got using the calculator.

On one hand, that was the deal when I kept DD on my employer policy following college graduation a couple of years ago. The premium table stopped at "employee +2". She was the fourth covered person, so the cost of keeping her on the policy was zero.

On the other hand, if DD#2 age 19 earns enough to file a tax return while still qualifying as my dependent, her income will be added to the calculation and the after-subsidy premium will go up. (or worse, given the 400% of poverty level cliff)
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Old 05-21-2013, 06:46 AM   #68
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When plugging numbers into both of these calculators, it seems the payment is the same whether you make $60,000 or $200,000. Is this correct? If so, those just over the threshold get nailed. Is there no sliding scale for incomes beyond the threshold?

Don't know what to say. I've subconsciously avoided delving into this too much hoping "someone" would tweak the law for those of us with private insurance.

Minimally based on these calculators our health care costs will double and possibly triple what it is today.
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Old 05-21-2013, 03:15 PM   #69
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Minimally based on these calculators our health care costs will double and possibly triple what it is today.
Well, based on that statement I can say with impunity "at least you have your health" (otherwise you'd not see the huge price difference). And just think of all of the sick people you'll be helping out by paying extra.
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Old 05-21-2013, 03:39 PM   #70
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Well, based on that statement I can say with impunity "at least you have your health" (otherwise you'd not see the huge price difference). And just think of all of the sick people you'll be helping out by paying extra.
I am in the same boat as Sheesh. We all are a little motivated in our own self interests. I haven't seen any posters who are facing 300-500% increases getting on the soapbox and espousing the virtues of this new act. But, I am resigned to the fact that there will be winners and losers in all laws, and I am going to be a big loser. But on the other side, there will be some big winners who have suffered for a while, and are going to catch a break finally.
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Old 05-21-2013, 03:44 PM   #71
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I haven't seen any posters who are facing 300-500% increases getting on the soapbox and espousing the virtues of this new act.
I support the ACA, and I'll be over the 400% FPL limit as soon as we retire. Some of us are more concerned about our children, the children we help nurture through our church, the children that those children will have, our elderly neighbors, etc., collectively, than we are regarding ourselves.
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Old 05-21-2013, 03:58 PM   #72
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I support the ACA, and I'll be over the 400% FPL limit as soon as we retire. Some of us are more concerned about our children, the children we help nurture through our church, the children that those children will have, our elderly neighbors, etc., collectively, than we are regarding ourselves.
Would your retirement date have changed if the Healthcare Act had not been implemented? Just because the 400% limit does not benefit you, does not necessarily mean you personally do not benefit from the Act itself. FWIW- I have previously said I am not necessarily against it, but that still does not avoid the fact I am a big financial loser in it. I had my plan prior to enactment of law and will now more than likely lose it, even though that wasn't supposed to be the case. BTW- I am working to be as pious as you, but I am still a work in progress.
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Old 05-21-2013, 04:09 PM   #73
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This increase in price will be a real problem for many, and is an issue that deserves much more attention. Our health care costs much more than what most people pay individually, and while it is "good" that the distortions are removed and people see the true cost of healthcare in the US, it is time to move to the next phase, which is to control cost.
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Old 05-21-2013, 04:10 PM   #74
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Oregon may be 'special'

Oregon's 2014 health premium filings spark relief, questions | OregonLive.com

Now there is a concern that insurers are bidding too low.
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Old 05-21-2013, 04:12 PM   #75
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Would your retirement date have changed if the Healthcare Act had not been implemented?
Maybe; maybe not. The point is that it doesn't matter.

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Just because the 400% limit does not benefit you, does not necessarily mean you personally do not benefit from the Act itself.
And just because you feel antipathy toward the ACA doesn't mean that it doesn't currently or won't eventually benefit you or yours.

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FWIW- I have previously said I am not necessarily against it, but that still does not avoid the fact I am a big financial loser in it.
The question that you may want to ask yourself is whether you would prefer to qualify to be a "financial winner". I sure wouldn't, and I know a good number of very hardworking people who will be "financial winners" vis a vis ACA who would have traded their luck for mine, over the course of our lives, in this regard.
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Old 05-21-2013, 04:31 PM   #76
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......... Our health care costs much more than what most people pay individually, and while it is "good" that the distortions are removed and people see the true cost of healthcare in the US, it is time to move to the next phase, which is to control cost.
Amen to that. The cost structure and opacity is ludicrous.

Maybe we can pool our money and buy back Congress.
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Old 05-21-2013, 04:35 PM   #77
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Maybe; maybe not. The point is that it doesn't matter.

Well, it matters in the since that you would benefit from it. I have never read anything you have posted that would suggest this is effecting you financially in a negative way. Saying that you are above the 400% line is not an economic cost to you, and being able to retire because of the Act is a benefit. It that is true, I am certainly happy for you or anyone that this was a roadblock for retirement.

And just because you feel antipathy toward the ACA doesn't mean that it doesn't currently or won't eventually benefit you or yours.

It certainly will not benefit me now, but it is possible it may benefit down the road, as that is an unknown, but in time your assessment could be proven correct. All I know is my insurance has only went up $3 in the past three years, so big rate hikes are something I am not accustomed to.

The question that you may want to ask yourself is whether you would prefer to qualify to be a "financial winner". I sure wouldn't, and I know a good number of very hardworking people who will be "financial winners" vis a vis ACA who would have traded their luck for mine, over the course of our lives, in this regard.
Here is why I come off as being negative to you, about it. When I retired several years ago, I could have stayed on my health plan when I retired. The cost however, was significantly higher than what I could get in private individual insurance, so I went to the individual market. If I had known all of this was going to occur, I would have not done what I did. The rules of the game changed after I played. I don't want to be a "winner" or a "loser" from the Act. I just wanted what I was told I would be able to have, which is keep my current insurance.
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Old 05-21-2013, 04:42 PM   #78
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Amen to that. The cost structure and opacity is ludicrous.

Maybe we can pool our money and buy back Congress.
Me: So you do this procedure over and over, 3 days a week, and meet with patients the other 2 days?
Him: Yep.
Me: And when I ask you how much it costs, you say you can't tell me?
Him: Yep.
Me: Am I any different than anybody else? I have the same insurance carrier and a mainstream policy.
Him: Doesn't matter. Can't nail down the cost until after the procedure.

Oh, and not only that, I can't get the complication rate for the procedure by practice, by location, by doctor, nothing.

In an environment like this we have zero chance of controlling cost.
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Old 05-21-2013, 04:47 PM   #79
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Oh, and not only that, I can't get the complication rate for the procedure by practice, by location, by doctor, nothing.
I found much of that by hospital & department, on line, in a document published by my state health department.
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Old 05-21-2013, 04:55 PM   #80
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Me: So you do this procedure over and over, 3 days a week, and meet with patients the other 2 days?
Him: Yep.
Me: And when I ask you how much it costs, you say you can't tell me?
Him: Yep.
Me: Am I any different than anybody else? I have the same insurance carrier and a mainstream policy.
Him: Doesn't matter. Can't nail down the cost until after the procedure.
.......
You: WTF!
Him: Do you want it or not? I've got 10 more patients waiting in the next room.
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