Patient Protection and Affordable Care Act

[John Galt III]

Quote:

Originally Posted by Texas Proud I am not trying to make a political comment here.... just a comment to the people who are stating that they can start taking COBRA next week and be 'in the clear' with the new law... I read that since Roberts said it was a tax, then Congress can repeal this tax with a simple majority with no filibuster option... if it were me and I had to choose a date, I would wait until the elections to make the jump.... if the Senate is split 50-50 and Romney wins, I would bet that this part of the law will be overturned. I am not sure what else would happen, but would not want to chance it myself if I were relying on this law....

Texas Proud,

Thanks for pointing out that Obamacare can be repealed. Cobra-takers should remember that.

JG3

[wanaberetiree]

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Originally Posted by John Galt III Texas Proud, ... Obamacare can be repealed... JG3

Probably not an easy and guaranteed process...

[sheehs1]

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Originally Posted by MichaelB This from the Kaiser Family Foundation summary. Nowhere near 60. More like 6, if you count new taxes and changes in tax rates.

Thanks MichaelB. News media reported it was 60 plus. I really need to spend some time digging into this but have not had a lot of time thus far.

[Texas Proud]

Quote:

Originally Posted by John Galt III Texas Proud, Thanks for pointing out that Obamacare can be repealed. Cobra-takers should remember that. JG3

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Originally Posted by wanaberetiree Probably not an easy and guaranteed process...

Agreed that it is not easy or guaranteed.... and if the dems win anything, (house, senate or president) I would say that it would not be repealed... I think a full repeal would take 60 votes and I do not see that happening...

I think they were talking about only the 'mandate' tax...

I do wonder if they can get rid of the other 6 taxes mentioned earlier with a simple majority vote....

However, all I was pointing out is that I would not jump on this law as my saving grace if I knew I could not get any coverage except for this law... to risky IMO.... if you do not have to worry about insurance without this law, then by all means take the plunge and RE....

Note to mods....
I am not trying to get into the politics of will this law be repealed or not.... just pointing out that relying on it has risks that some might not think about....

[Katsmeow]

Quote:

Originally Posted by DFW_M5 Also, the so called coverage of kids up to 26 under their parents plan is not universal either as it does not apply if your parent happens to be covered under a retiree health plan vs an active employee plan (unless your former company does so out of the goodness of its heart).

Actually, the megacorp DH retired from does do this for its retiree plan! I guess it really is out of the goodness of its heart.

I am very glad the Act was upheld. That said, I have read some speculation that upholding the Act would result in employers cancelling retiree plans on the theory the retirees could get insurance from the exchanges.

My fear is that the speculation turns out to be true and Megacorp ends the retiree plan and then the ACT is repealed or modified in some way such that we can't get the insurance (or that it is very expensive -- right now we are paying $328 a month for family coverage with a high deductible plan), but megacorp doesn't reinstate the retiree plan. I hope I am worrying about nothing....

[clifp]

Quote:

Originally Posted by Texas Proud However, all I was pointing out is that I would not jump on this law as my saving grace if I knew I could not get any coverage except for this law... to risky IMO.... if you do not have to worry about insurance without this law, then by all means take the plunge and RE.... .

Retiring early is risky. While I understand your point, it is one of those case where do you need to belt and suspenders and 2.5% WR or do you want to keep working at job you hate to add an emergency parachute. There are folks on this forum where medical insurance is the last thing standing in the way of retiring.

If ObamaCare was repealed than the understandable concern of how can I get insurance with my pre existing condition would give many people pause. The prohibition of insurance companies denying coverage for pre existing conditions seems to have bipartisan support. Even if the Republicans do succeed in repealing and replacing ObamaCara I suspect that odds that they will do so without some type of system for letting people with pre existing conditions get insurance are awfully small.

[donheff]

Quote:

Originally Posted by Texas Proud Agreed that it is not easy or guaranteed.... and if the dems win anything, (house, senate or president) I would say that it would not be repealed... I think a full repeal would take 60 votes and I do not see that happening... ut....

As with TP I don't want to make this political but the law does stand on shaky ground until the changes take effect and become integrated into our system. And Texas, I think you were right on your first guess that repeal would not require a supermajority in the Senate. IIRC they get one shot on a budget reconciliation exception with a straight majority. Didn't the ACA itself squeak through on that exception? The point is that ERs looking for assurances that this is here to stay need to wait till the end of the year.

[marko]

Between O'Care subsidies and the potential "end of the Bush cuts", when do we see a thread on 'controlling your taxable income' pop up?

Many of us seem to be just above the thresholds...a little creativeness would drop us below.

[Midpack]

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Originally Posted by clifp Retiring early is risky. While I understand your point, it is one of those case where do you need to belt and suspenders and 2.5% WR or do you want to keep working at job you hate to add an emergency parachute. There are folks on this forum where medical insurance is the last thing standing in the way of retiring. If ObamaCare was repealed than the understandable concern of how can I get insurance with my pre existing condition would give many people pause. The prohibition of insurance companies denying coverage for pre existing conditions seems to have bipartisan support. Even if the Republicans do succeed in repealing and replacing ObamaCara I suspect that odds that they will do so without some type of system for letting people with pre existing conditions get insurance are awfully small.

All true enough, but at what cost? That's still a huge central question IMO...

[MichaelB]

The PPACA is the law of the land. Some measures are already implemented, the rest underway. Service providers, health insurance companies and some State Governments are working to implement provisions as well. Overturning this is not easy, because the health care industry is now behind it.

My plans going forward assume full implementation. I'll keep a contingency in case something happens. The important questions in my mind are what are the next steps or new measures to improve this.

[marko]

I have to say that they did a lousy job at selling/marketing this!

A lot of resistance/pain could've been avoided if everyone had got a flier/notification of a website with just 10 points on: 1) why this is good for you, 2) how this is different from what you have, 3) what it will cost you.

Not 3000 pages...just 10 bullet points.

For instance, I was against this act until YESTERDAY when I realized (through this forum) that it has the potential to drop my HC premium from $15K to $5K!

I doubt most self insuring Americans realize that they can get a $izable subsidy.

We had to pass this law in order to find out what's in it??!!

Just poor marketing.

[samclem]

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Originally Posted by marko I have to say that they did a lousy job at selling/marketing this! A lot of resistance/pain could've been avoided if everyone had got a flier/notification of a website with just 10 points on: 1) why this is good for you, 2) how this is different from what you have, 3) what it will cost you. Not 3000 pages...just 10 bullet points.

I'm surprised anyone could be on this site for more than a few weeks and not get exposed to the info needed. Anyone who can't use Google to do a search is unlikely to be saved by a leaflet. This info has been well packaged and presented on many sites. No issue has been more thoroughly discussed and debated, with plenty of information from all "combatants"--often in the all-too-simplistic sound-byte style you are yearning for. No short leaflet can adequately cover the ramifications of the passage of this law. Anyone looking strictly at the promised subsidy and planning to apply that money to their present insurance rate is definitely not getting the whole picture. Rates are going to change, availability of care is going to change, and delivery mechanisms are going to change. Hang on.

[Purron]

I read an opinion piece this morning which I don't want to link to since it's very political. One thing that interested in me in the article was a statement regarding the lack of penalties on individuals. I confirmed this by going directly to the bill which I read here on the Government Printing Office (GPO) website:

http://www.gpo.gov/fdsys/pkg/PLAW-11...111publ148.pdf

From the bill:


‘‘(2) SPECIAL RULES.—Notwithstanding any other provision of law—
‘‘(A) WAIVER OF CRIMINAL PENALTIES.—In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.
‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretary shall not—
‘‘(i) file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty imposed by this section, or‘‘(ii) levy on any such property with respect to such failure.’’.

Since non-payment of the penalty will not result in criminal charges, liens, levies, or additional penalties, it appears a taxpayer could avoid payment simply by making sure they are not due a refund. If any taxes due are paid, other than the penalty payment under the PPACA, it looks as though no collection actions would be taken or additional penalties placed.

I thought this might be of interest, particularly to those people who choose to self insure for health care by earmarking sufficient savings to cover anticipated medical costs.

[Mulligan]

Quote:

Originally Posted by marko I have to say that they did a lousy job at selling/marketing this! A lot of resistance/pain could've been avoided if everyone had got a flier/notification of a website with just 10 points on: 1) why this is good for you, 2) how this is different from what you have, 3) what it will cost you. Not 3000 pages...just 10 bullet points. For instance, I was against this act until YESTERDAY when I realized (through this forum) that it has the potential to drop my HC premium from $15K to $5K! I doubt most self insuring Americans realize that they can get a $izable subsidy. We had to pass this law in order to find out what's in it??!! Just poor marketing.

Personally, I think who may be in favor or against it, probably depends on which side of the "$izable subsidy" fence you sit on. Being a person with currently cheap individual insurance and guaranteed monthly income above the subsidy line this may put someone like me behind the 8 ball, if subsidized costs spiral out of control. I am withholding judgement for a while and will let things play out. I don't mind paying a little more for the greater good, but I worry people with decent fixed monthly incomes but modest assets, could be possibly be exposed way more than people who can adjust yearly income, but have sizable assets if premium costs become unruly. I hope the HSA and its contribution amounts are allowed to stay intact as presently it appears. That is the only meaningful deduction I have left.

[explanade]

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Originally Posted by Purron Since non-payment of the penalty will not result in criminal charges, liens, levies, or additional penalties, it appears a taxpayer could avoid payment simply by making sure they are not due a refund. If any taxes due are paid, other than the penalty payment under the PPACA, it looks as though no collection actions would be taken or additional penalties placed. I thought this might be of interest, particularly to those people who choose to self insure for health care by earmarking sufficient savings to cover anticipated medical costs.

It also seems like the penalties will be far lower than most premiums. If that is the case what's to prevent somebody from paying the penalties and only buying insurance when they need it?

[Purron]

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Originally Posted by explanade It also seems like the penalties will be far lower than most premiums. If that is the case what's to prevent somebody from paying the penalties and only buying insurance when they need it?

Nothing I can see, but what would happen if they had an accident, heart attack, or some other medical condition requiring immediate treatment?

[donheff]

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Originally Posted by Purron Nothing I can see, but what would happen if they had an accident, heart attack, or some other medical condition requiring immediate treatment?

MA allegedly has 98% insured with a similar system with weak penalties. Most people who can afford HI want it because an accident, cancer or whatever can cost them a bundle before they will be able to get a policy. Very poor people will get Medicaid and borderline (e.g. some of this board's ERers) will get enough help to make the proposition attractive. Only a relatively small number of outliers will blow it off - many probably because they are so out of touch the won't even realize they are eligible for subsidies.

[MichaelB]

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Originally Posted by explanade Even if they lack the votes to repeal some states are saying they won't implement. And you could have an administration hostile to the law put in charge of implementing it.

State health exchanges will be implemented regardless because a federal offering will be made if the state chooses not to. Expansion of Medicaid is optional, by state.

A few members are trying to figure out what could stop this, but most are looking at how it affects them and how they should take advantage of it. I think the rest of the country, people, businesses and institutions, are doing the same thing. As the implementation momentum builds it will be more likely to continue.

Upcoming elections can change that and many other things as well. This is something always present that we can acknowledge and consider in our plans.

Quote:

Originally Posted by explanade It also seems like the penalties will be far lower than most premiums. If that is the case what's to prevent somebody from paying the penalties and only buying insurance when they need it?

It appears individuals today are choosing to have insurance rather than not have it. Some people may game the system but most appear to want coverage.

[Brat]

One way to prevent 'just in the nick of time' behavior is to limit coverage opportunities to once or twice a year and upon specific events (marriage, birth of a child, loss of a job) as employers do today.

[Mulligan]

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Originally Posted by Brat One way to prevent 'just in the nick of time' behavior is to limit coverage opportunities to once or twice a year and upon specific events (marriage, birth of a child, loss of a job) as employers do today.

Your comment reminded me of a poster a few days back wrote the state of Washington tried guaranteed coverage. He commented a lady wrote to the insurance company thanking them for paying all the bills on her pregnancy. She wrote that if she ever needed health insurance again, she promised to use them. That still cracks me up. I haven't decided yet if she is one of the dumbest people I have heard about, or the smartest.