Supreme Court to hear arguments tomorrow on ACA Subsidy

[Fermion]

They sure do. Some say not very well though.

Mike

Perhaps, but if you try to take away Medicare from a senior citizen, prepare for denture marks on your hand. They may grumble but they sure seem to like it over nothing.

 

[poorcarver]

The real issue for many of us is that if they somehow "gut" the ACA in particular the guaranteed right to buy regardless of health history then a lot of folks are going to be in trouble. My wife is a cancer survivor and could not buy private insurance (other than through her employer) on the strength of the ACA she retired. We don't qualify for a subsidy, we just need the ability to buy.

 

[Texas Proud]

+1

I am COBRAing for a while anyway because my excellent former empl*yer's health plan is much less expensive than a platinum plan under the ACA. But I decided all the politics surrounding this issue would not stop me from living my dream. If I had to, I'd move to a state where the coverage was available.

So I retired last week, politics be dam*ed.

I do not know what a platinum plan would cost... but my COBRA was over $1700 per month.... I went bronze...

 

[samclem]

The real issue for many of us is that if they somehow "gut" the ACA in particular the guaranteed right to buy regardless of health history then a lot of folks are going to be in trouble. My wife is a cancer survivor and could not buy private insurance (other than through her employer) on the strength of the ACA she retired. We don't qualify for a subsidy, we just need the ability to buy.

Guaranteed issue is part of every replacement/alternative plan I've read about. Details obviously matter, but this issue is thoroughly understood and appreciated.
Many people are painting this as "ACA or nothing," which is obviously a false dilemma. Whether the thing changes now or later, it's gonna change. Even its strongest proponents acknowledge that, and have sometimes modified the law's implementation as a stopgap means to try to make it work. It's probably better to really fix things the right way.

 

[Brat]

Don't fool yourself into believing that because you don't receive a subsidy that it won't impact what you pay for insurance.. it will because many lower income healthy (typically young) people will not subscribe. Their participation is helping to pay for colder, sicker subscribers. Insurance rates will increase, including what employers are providing.

Hospital systems will loose money forcing them to increase their rates across state lines.

 

[Helen]

The real issue for many of us is that if they somehow "gut" the ACA in particular the guaranteed right to buy regardless of health history then a lot of folks are going to be in trouble. My wife is a cancer survivor and could not buy private insurance (other than through her employer) on the strength of the ACA she retired. We don't qualify for a subsidy, we just need the ability to buy.

Bingo. There was a guy who posted on here in the pre-ACA days. He lived in Florida, had $3 million saved for retirement but couldn't retire because he couldn't get health insurance. He had some minor problem that prevented him from being insured.

Perhaps, but if you try to take away Medicare from a senior citizen, prepare for denture marks on your hand.

Thanks, I needed a laugh this morning!

 

[Texas Proud]

Man... better post before it gets closed.... getting too political on this thread...

To answer the OP question... no, it does not change my decision... I have not yet retired, but now work sporadically... I do consulting work and have had 4 different policies in the last year and half... this is my second time on Obamacare...

I was thinking that I would be able to get a subsidy last year, but sold funds to get a few years of expenses in bond funds and the good distributions put me way over.... so I did not get it...

This year I am hoping for the same and do not have to sell anything... however, if the subsidies are overturned I still need insurance... before ACA I would be refused because I answered a question 'has the doc talked to you about diabetes'.... yes, he has... he said I am pre-diabetic..... I take medication to help control my glucose level and have cut out some things I used to eat all the time...


I do not see how insurance will double or more... I am paying over $800 now for family... and they do not have to pay for anything until I meet my $6K deductible...

 

[Texas Proud]

Don't fool yourself into believing that because you don't receive a subsidy that it won't impact what you pay for insurance.. it will because many lower income healthy (typically young) people will not subscribe. Their participation is helping to pay for colder, sicker subscribers. Insurance rates will increase, including what employers are providing.

Hospital systems will loose money forcing them to increase their rates across state lines.

I do not think so.... rates did not go down when the law took effect... why would they more than double if the young did not sign up Their premiums are not as high as the old folks... it is funny that there is an age component in the exchange but not at work... I remember a lot of the young people coming to complain how expensive insurance was at my old firm... but the rate was the same if you were 24 or 64.... not so in the exchange....

 

[Midpack]

Do you really think having our government TOTALLY control our healthcare is a good thing?

Whether it is or not, what's the alternative? Surely not the (prior) unaffordable status quo...at double the cost per capita vs the average of every other developed nation. No other citizens pay nearly as much as Americans, for middling outcomes.

 

[Silver]

This article was in the Daily Beast this morning; "The Technicality That Could Save Obamacare". The article states that the four primary plaintiffs have no standing because they either already have government sponsored insurance (veterans) or otherwise qualify for a subsidy, and therefore cannot demonstrate "harm".

The article believes the entire case may be dismissed for lack of standing. You would think if that were true it wouldn't have gotten this far.

The Technicality That Could Save Obamacare—and the Supreme Court’s Reputation - The Daily Beast

 

[wrigley]

Perhaps, but if you try to take away Medicare from a senior citizen, prepare for denture marks on your hand. They may grumble but they sure seem to like it over nothing.

I agree with you. Grandfather Medicare but don't let the government get their paws on healthcare for all Americans. I'm not crazy about John McCain but I do think he had a valid idea when he talked about the voucher system to pay for healthcare. I also believe that affordable healthcare should be available for every American regardless of pre-existing conditions.

Mike

 

[wrigley]

Whether it is or not, what's the alternative? Surely not the (prior) unaffordable status quo...at double the cost per capita vs the average of every other developed nation. No other citizens pay nearly as much as Americans, for middling outcomes.

My perfectly healthy 23 old year son ventured onto the Healthcare.gov website to take a look around at health insurance. $239.00 a month with a $4000 deductible was the best he could do. Needless to say he elected to pay the penalty. Prior to the ACA he had a catastrophic plan that primarily covered major medical issues but he was also able to routinely see a doctor if he wished with affordable/manageable co-pays. $92.00 a month was his premium. If you are young and healthy the ACA shafts you because that is the only way they can afford to pay for the not young and healthy!

Mike

 

[Fermion]

My perfectly healthy 23 old year son ventured onto the Healthcare.gov website to take a look around at health insurance. $239.00 a month with a $4000 deductible was the best he could do. Needless to say he elected to pay the penalty. Prior to the ACA he had a catastrophic plan that primarily covered major medical issues but also was able to routinely see a doctor if he wished with affordable/manageable co-pays. If you are young and healthy the ACA shafts you because that is the only way they can afford to pay for the not young and healthy!

Mike

But that 60 year old who has a few health problems and no kids likely paid tens of thousands of dollars for your 23 year old son's pubic education via taxes. He didn't have a lot of choice when forced to pay for your child's education.

 

[Midpack]

I also believe that affordable healthcare should be available for every American regardless of pre-existing conditions.

My perfectly healthy 23 old year son ventured onto the Healthcare.gov website to take a look around at health insurance. $239.00 a month with a $4000 deductible was the best he could do. Needless to say he elected to pay the penalty. Prior to the ACA he had a catastrophic plan that primarily covered major medical issues but he was also able to routinely see a doctor if he wished with affordable/manageable co-pays. $92.00 a month was his premium. If you are young and healthy the ACA shafts you because that is the only way they can afford to pay for the not young and healthy!

I don't know what to say reading these two statements. I'd like to see the plan that meets both of your criteria, recognizing actual underlying health care costs in the USA. You might as well wish for free healthcare for all...

$239/mo w $4K deductible is a great deal relative to the cost of health care - well below average cost.

How did you think health insurance worked? How do you think Soc Sec & Medicare work?

 

[tfudtuckerpucker]

Not sure if that means we'll be paying penalties or not, but we'll find out soon enough. Even with penalties we STILL save many thousands in premiums over any of the ACA plans.

You're right- it's cheaper to buy that insurance and pay that penalty, than buy from ACA. At least it was for us.

Our neighbor is a single mom with 4 kids, and she doesn't qualify for ACA subsidies, since her income is slightly above the threshold. So she gets an "exemption" from ACA insurance requirements. So she can buy "nonqualified" insurance without paying a penalty. It's just another weird twist in this law. It's sad because health insurance is still unaffordable for her family, and the ACA does nothing to help.

 

[wrigley]

$239/mo w $4K deductible is a great deal relative to the cost of health care - well below average cost.

Then how come all the young healthy kids in this country haven't flocked to sign up?

Mike

 

[Midpack]

Then how come all the young healthy kids in this country haven't flocked to sign up?

I don't have enrollment figures for young adults, do you?

And when you're young an invincible, you'd rather spend your money on iPhones and fun stuff, not health insurance. No one likes to pay for home or auto insurance either, but most do.

By your logic your son shouldn't pay for Soc Sec or Medicare since he doesn't need it now.

 

[2B]

Let's just hope the SCOTUS doesn't gut the whole thing.

SCOTUS had a chance to gut the whole thing and passed. This case is very specific. Are people eligible for subsidies in states that do not have an exchange that the state created. Only eligibility of subsidies is an issue. This case (unless SCOTUS goes off on a tangent which occasionally happens ) doesn't address the requirement to have coverage, how coverage is defined or penalties if one does not have coverage.

As we've beaten to death earlier, a state could create a portal to the existing federal exchange for little cost. The original intent of the law was clearly to force the individual states to create the exchanges so the federal government wouldn't have to do it. When the law was passed, those voting for the bill couldn't imagine a state not jumping on the expansion of Medicare or the need to create an exchange to get the subsidies. When so many states didn't, the feds had to rush their half baked exchange into operation that belatedly seems to be working. The costs and problems associated with creating individual state exchanges (IMHO) seems to vindicate the states that didn't try to take on the task.

The obvious, cheapest solution in the event of SCOTUS deciding that a law should be as written and not wished a couple of years later is to change the ACA to allow the federal exchange to get subsidies. It won't be that easy or pretty. I expect the portal websites to be done.

 

[wrigley]

I don't have enrollment figures for young adults, do you?

And when you're young an invincible, you'd rather spend your money on iPhones and fun stuff, not health insurance. No one likes to pay for home or auto insurance either, but we do.

I totally agree with you. But the point is.......this is EXACTLY the intention of the ACA from the beginning. Make the young and healthy pay for the old and sick. (and if the young and healthy refuse to pay the UNAFFORDABLE rates, we'll penalize them!) Our President sold this as "healthcare for all" not taking into consideration that that the young and healthy bulletproof were not going to take part.

Mike

 

[2B]

I don't have enrollment figures for young adults, do you?

And when you're young an invincible, you'd rather spend your money on iPhones and fun stuff, not health insurance. No one likes to pay for home or auto insurance either, but most do.

The young and healthy are subsidizing the sick and old. That's baked into the bill. If a young, healthy person does not qualify for a subsidy, there is no reason for them not to feel like they are getting the short end of the stick in this bill. Before the ACA act, they were the only people that could get reasonably priced heath insurance. The ACA greatly increased their costs.

 

[MichaelB]

The thread topic is not about the merits of the ACA. That discussion has led to a multitude of health care threads being closed, and if it continues, is likely to happen once again.

It is about the Supreme Court case, which deals with the legality of providing subsidies to policies acquired on Federal health exchanges. All other provisions of the ACA have been implemented and are in force, such as essential health benefits, coverage for family members under age 26, and guaranteed coverage.

Why not stick to the thread topic? If the Supreme Courts decides against the subsidies, how will that affect us, and what options will we have?

 

[steelyman]

The thread topic is not about the merits of the ACA. That discussion has led to a multitude of health care threads being closed, and if it continues, is likely to happen once again.

Two thread topics in particular, the ACA and pensions, always make me think, "Hoo boy, here we go again...".

Information posted that is informative has been a great help, especially back in the confusing period during the ACA rollout. I even pointed the nice Japanese lady who does my hair (seeing her again this afternoon) to E-R.org to help her understand what was happening.

 

[samclem]

An update from the deliberations. From the WSJ:

The Supreme Court sparred Wednesday over a centerpiece of the Affordable Care Act, with swing Justice Anthony Kennedy voicing concerns about potential constitutional consequences of a ruling that strikes down tax credits in the law.
Justice Kennedy said he saw "a serious constitutional" question with the challenger's argument that states were supposed to choose between setting up their own exchanges and forfeiting the tax credits. His concern has a direct link with the 2012 health-care ruling, in which the justices voted 7-2 that Congress couldn't put excessive financial pressure on the states to implement a portion of the law that expanded Medicaid.

Maybe the collateral effects of that earlier ruling are still being felt.

We won't know the results until June, the questions being asked by the Justices are all we have as far as a crystal ball right now.

 

[ERhoosier]

......Why not stick to the thread topic? If the Supreme Courts decides against the subsidies, how will that affect us, and what options will we have?

+1

Will be interesting to read coverage of today's oral arguments before the Court, even though formal decision not expected for many weeks. (possibly June).

FWIW- I would NOT expect overturn of subsidies to open the door to "cheap" catastrophic HI plans. Catastrophic plans, even for those under 30, are not much cheaper than Bronze plans. US health care costs are HIGH, and HI companies only have a net operating profit margin is in 3-5% range. So regardless of what SCOTUS decides in this case, large HI premium cuts just ain't happenin'

 

[timo2]

update on arguments

3 huge surprises at Obamacare?s oral arguments - Vox