ACA at risk?

[joeea]

Once we FIRE we are moving to Europe until Medicare.

Because of all the political stability in Europe?

 

[youbet]

I think the only way ACA goes away is if we go to Single Payer/Medicare For All type of program. Subsidies could potentially be net worth based. Doesn't make a lot of sense for millionaires to be getting subsidies. I think subsidies will stay as they are until Medicare for all takes over.

The most common point of contention I hear from my anti-ACA friends is that subsidies are unfair, especially at the so-called "cliff" borderline. It seems the folks who have substantial assets and are able to control their MAGI so they get a subsidy, and therefore are partially subsidized by folks who have less wealth, really get talked up. I'm not so sure that scenario is very common, but it seems to be talked up like it is.........

 

[joeea]

So how is it that this considered a tax, and mandated to be uniform throughout the US, that I don't pay anything for it?

There are plenty of taxes that don't apply to you , hence you don't pay anything for it.

I don't pay the tax on cigarettes, since I never purchase any. It's still considered a tax.

 

[joeea]

The most common point of contention I hear from my anti-ACA friends is that subsidies are unfair, especially at the so-called "cliff" borderline. It seems the folks who have substantial assets and are able to control their MAGI so they get a subsidy, and therefore are partially subsidized by folks who have less wealth, really get talked up. I'm not so sure that scenario is very common, but it seems to be talked up like it is.........

That argues for changes to the ACA, not repeal.

That might be a common point of contention among the (relatively small) early retirement crowd, but I doubt if that is the major point of contention outside that group.

 

[Dtail]

That argues for changes to the ACA, not repeal.

That might be a common point of contention among the (relatively small) early retirement crowd, but I doubt if that is the major point of contention outside that group.

Exactly, it is a small portion and is not the reason for the high premiums in some states.

 

[Fred123]

The most common point of contention I hear from my anti-ACA friends is that subsidies are unfair, especially at the so-called "cliff" borderline. It seems the folks who have substantial assets and are able to control their MAGI so they get a subsidy, and therefore are partially subsidized by folks who have less wealth, really get talked up. I'm not so sure that scenario is very common, but it seems to be talked up like it is.........

Yes, one of the unfortunate side effects of Congressional paralysis over healthcare. I remember reading that when the ACA passed many realized that there were significant flaws in it, but expected them to be fixed later. That hasn't happened, for obvious reasons.

 

[skipro33]

There are plenty of taxes that don't apply to you , hence you don't pay anything for it.

I don't pay the tax on cigarettes, since I never purchase any. It's still considered a tax.

Yes, but you are not 'mandated' to buy cigarettes either. Taxes on something we have a choice over is one thing. Taxes on all other things is supposed to fall under,

to pay the Debts and provide for the common Defense and general Welfare of the United States

Congress mandates we all buy a product. The purchase is not considered a tax, but if you do not buy the product, the penalty is considered a tax. The Supreme Court ruling stipulates the 'tax' is to provide the 'Welfare' of the US. Is the penalties collected being used for that? Is there some sort of book keeping reconciliation that proves the tax is indeed being used as the Supreme Court lays out it is limited to be used for? (I know; terrible use of the English language but I don't know how else to phrase it)


My point is; if the ACA was ruled constitutional, it was done so based on the tax being used to SOLVE specific purpose. If it's not, then Congress is in violation of the Supreme Court ruling. The president doesn't have line item veto on the budget, so it would stand to reason he could righteously reject any budget that doesn't meet the Supreme Court's finding on the intent and use of a tax collected on a mandated purchase of a product sold in the US.

 

[joeea]

but if you do not buy the product, the penalty is considered a tax.

You already wrote that you do not buy that particular product. And you don't pay the penalty tax.

Congress mandates we all buy a product.

Like fighter jets?

Is there some sort of book keeping reconciliation that proves the tax is indeed being used as the Supreme Court lays out it is limited to be used for? (I know; terrible use of the English language but I don't know how else to phrase it)

The Supreme Court doesn't stipulate how tax revenues must be used. That's up to Congress.

My point is; if the ACA was ruled constitutional, it was done so based on the tax being used to SOLVE specific purpose. If it's not, then Congress is in violation of the Supreme Court ruling.

That's not what the Supreme Court said.

The president doesn't have line item veto on the budget, so it would stand to reason he could righteously reject any budget that doesn't meet the Supreme Court's finding on the intent and use of a tax collected on a mandated purchase of a product sold in the US.

The president did not veto the budget. And the Supreme Court already ruled on the constitutionality of the mandate. Once the mandate was reduced to $0, red state attorneys general decided to give it another try. We may eventually get to see how the Supreme Court decides the second time around.

It's funny how you use the term "righteously".

 

[statsman]

While my retiree medical plan (under 65) is a bit pricey, it is still cheaper overall than ACA's Gold and Platinum plans. That said, the monthly premiums have spiked since ACA's inception.

Nine years ago, the retiree medical premium for my years of service was less than $50/month for 90/10 coverage with a low deductible and out-of-pocket maximum. Now, it's over $1,100/mo for 85/15 coverage and $700/mo for 60/40 coverage, with increased deductibles and out-of-pocket maximums.

While glad to not have been caught up in the ACA purchasing cycle, it still greatly impacted my medical costs (my wife is over 65 and has been on Medicare since retirement).

 

[skipro33]

You do not buy that particular product. And you don't pay the penalty tax.

No, I don't. That's what has me confused. Insurance is mandatory, I got that. A penalty tax is levied if I don't have insurance. I got that. Not everyone is as fortunate as I was to bargain healthcare after retirement. To those the tax is not fairly levied, since they didn't have the same opportunity as I did to secure health care, they are unfairly being targeted for this 'tax'.



My opinion is just now being formulated about the issue since it's not affected me one way or the other. That could change and I figure I better try and understand the history that leads to the change. I'm just trying to understand if my opinion is valid.

 

[220volt]

Because of all the political stability in Europe?

No, but their healthcare seems to be less affected by political changes. We are also originally from Europe so we are comfortable on either side of the Atlantic. It all depends on which one offers a better health care solution at the time of FIRE.

 

[marko]

You should never, ever bet on any kind of certainty in the US considering its political system. Not ACA, not Roth not SS. Especially something as divisive as ACA.
.

I just wish I had a dime for every scare headline out there that comes to nothing.

While I have no dog in this fight--DW pays about $15K for HI--I just don't see anything major changing.

IMO, all these programs are way too ingrained into our society to make radical changes. A few tweaks, sure, but there's just too much involved to fully yank the hook out of that fish.

 

[skipro33]

The Supreme Court doesn't stipulate how tax revenues must be used. That's up to Congress.

The Supreme Court ruled;

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States

I read it that the Supreme Court limits Congress's ability to levi a tax based on those 3 things; Debt, Defense and Welfare.

This penalty isn't to pay a Debt or provide for Defense, but does fall under Welfare. If that's true, then Congress would need to demonstrate the cause for the tax meets a need.

It's funny how you use the term "righteously".

Defined as "morally justifiable".

 

[youbet]

That argues for changes to the ACA, not repeal.

That might be a common point of contention among the (relatively small) early retirement crowd, but I doubt if that is the major point of contention outside that group.

Well, we're both just conjecturing. I do think that anti-ACA forces can and will use the argument that solidly middle class folks frequently can qualify to be subsidized. I can't think of many folks, other than those being subsidized, who would think that's a good idea. Especially if they think it might be a penny or two of their tax bill doing the subsidizing!

I've heard even ardent pro-ACA folks admit the "cliff" is stooopid and that folks with significant resources sometimes being subsidized by folks with less is draconian.

Fixing the subsidy and funding issues could only help keep the ACA is existence IMHO.

 

[joeea]

My opinion is just now being formulated about the issue since it's not affected me one way or the other. That could change and I figure I better try and understand the history that leads to the change. I'm just trying to understand if my opinion is valid.

No need to worry about this now.

The ACA is currently the law. And the "penalty tax" is $0.

Even if an overturn appeal to the Supreme Court is successful, it will take years. And if the ACA is ever actually repealed, you'll have to form an opinion about whatever follows.

And no matter what, it may still never directly affect you.

 

[Cut-Throat]

Without getting "porky", what do you think the chances are that ACA - particularly the subsidies - is at risk of disappearing?

Just the likelihood of elimination, possible program changes, etc.,. No politics please.....


(question spurred by recent Justice Dept. ruling...)

Sure I think the ACA is at risk of Disappearing, as well as Medicare! ....


50-50 Chance - I'd say since we are a Split Country.

 

[joeea]

Well, we're both just conjecturing.

Cuz that's what we do...

I've heard even ardent pro-ACA folks admit the "cliff" is stooopid and that folks with significant resources sometimes being subsidized by folks with less is draconian.

I don't think the current subsidy rules make a lot of sense.

Fixing the subsidy and funding issues could only help keep the ACA is existence IMHO.

Agreed.

Now, shall we conjecture a bit about the possibilities of fixing the subsidy in the near future?

It certainly wasn't the focus when "repeal and replace" or "skinny repeal" were attempted back when we didn't have a divided Congress.

 

[joeea]

Defined as "morally justifiable".

Still funny in this context.

 

[joeea]

No, but their healthcare seems to be less affected by political changes.

That certainly seems to be true to some extent in some parts of Europe (for now).

We are also originally from Europe so we are comfortable on either side of the Atlantic. It all depends on which one offers a better health care solution at the time of FIRE.

I guess that's a good reason to choose where to live.

 

[joeea]

Sure I think the ACA is at risk of Disappearing, as well as Medicare! ....


50-50 Chance - I'd say since we are a Split Country.

Nowhere near 50-50, IMHO.

 

[ceciledian]

My specific concern is that come July, I've got to pick a horse to ride. I will come off of employer-sponsored health insurance. My two options are:
1) ACA marketplace
2) Join DW's state retirees health care plan.

Option 2 sounds like it would be great, but it isn't. Until DW turns 60 (July 2020) the rate is basically COBRA rates - very high for a pretty sorry plan. Add me to the mix and it is VERY high. Even the reduced rates for both of us once she turns 60 are just OK.

With option 1, I think we can manage MAGI nicely until I turn 65. Currently ACA quotes are FAR cheaper for me.

I only get one chance to join DW's plan, I think, because I don't see any qualifying events for me between now and me turning 65.

The numbers say ACA, but I was wondering what sort of risk factor we'll have. Wonder if loss of ACA in my state would be a "qualifying event"?

I would take her plan, especially since you only have one shot. ACA may be cheaper premiums but now most plans are HMOs and have very limited networks. And I wouldn’t count on losing the ACA plan as a qualifying event. You could lose the subsidy even, who knows?

 

[eroscott]

I would take her plan, especially since you only have one shot. ACA may be cheaper premiums but now most plans are HMOs and have very limited networks. And I wouldn’t count on losing the ACA plan as a qualifying event. You could lose the subsidy even, who knows?

I have been looking at ACA plans and it certainly varies by state. In IL, you are very inaccurate when you same most are HMOs.

https://www.stridehealth.com/coverage
https://www.healthcare.gov/see-plans/

 

[Dtail]

I would take her plan, especially since you only have one shot. ACA may be cheaper premiums but now most plans are HMOs and have very limited networks. And I wouldn’t count on losing the ACA plan as a qualifying event. You could lose the subsidy even, who knows?

Not true at all in Florida. In state PPO with a wide network selection.

 

[explanade]

I heard that initially, the administration wanted the courts to invalidate the requirement for "essential health care benefits" which would remove the ACA requirement for comprehensive coverage.

That was seen as a way to offer cheap plans with much fewer benefits and number of things covered.

Also heard that the ACA did away with lifetime and annual caps not just for exchange plans but also all insurance, including those offered by employers.

 

[ShokWaveRider]

Not true at all in Florida. In state PPO with a wide network selection.

You are dead right my friend. Here is a good Florida stat. We (DW & I) of course live in No: 1.

https://www.usnews.com/news/healthi...communities-in-florida?src=usnpd_HCLocationSS