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The Affordable Care Act "Tax"


T. H. O' Sullivan

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I have thoughts, but promised BH I wouldn't.

 

We're soooooooo screwed :angry:

 

I agree, on both premises! Surprise!

 

 

It's not a political discussion, it's about health insurance & taxes, and it's now the law, upheld by the Supreme Court. I am just curious if anyone else has

considered the nationwide revolt when hardworking folks' tax refunds are being confiscated by the I.R.S.

 

Sorry Ma & Kids, no Summer trip to Disney World this year :angry:

 

 

Perhaps in your mind, compadre, it is not political, but you are quite the agent provocateur!:D

 

Buena suerte, amigo

eGG

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It seems we took a medical insurance system that needed some revisions and fixes and totally destroyed it. I guess that's part of the Fundamental Transformation of the United States?

 

Government policy, take something and fix it till its broke.

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I started asking health insurance brokers about the impending changes. Brokers do the "benefits shopping" for individuals and smaller/ish businesses. Larger businesses are almost always self funded with benefit companies administering the coverage. Brokers are paid by the insurance providers, so the competition among insurance firms to put good rates forward in bids is fairly healthy right now. So, the "shopping" performed by the broker is not directly charged to the person or company who buys the insurance.

 

I received an interesting comment that suggests ... when the exchanges go live and people can buy insurance there, brokers will be impacted substantially. The days of getting free advice / quotes / etc from a broker will end.

 

Last, it looks like the rates to be offered on the exchanges are the un-discounted rates so you get to pay top dollar.

 

I can just envision Flo selling healthcare benefits now... :lol:

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Honestly, I haven't paid enough attention to the actual provisions of this legislation; I need to do some reading. All during the "public debate", I didn't hear or see a single, comprehensive analysis of what this new law was actually going to do, or how. Seems like our legislators weren't the only ones who failed to read the bill....

 

Right now, medical and dental insurance cost us about $2000 a month - that's full BC/BS plus Delta Dental - family plan. As expensive as that is, we can't afford to be without it. Until this year, when I left my firm to start a new one, I was paying an increasing percentage of the total cost - every year it went up over the last 5 - until we were up to about 20% last year.

 

There is no doubt that something is broken. I just am not sure about how to fix it. If we don't have a mandatory coverage requirement, the reality is that you end up with indirect national health insurance. Before Romney Care in MA, if you had no coverage, you showed up at a public hospital, and they treated you for "free" - with that cost passed back to the State and ultimately paid by you and me in taxes. So, I was paying toward my health insurance, my employer was paying the rest, and the both of us were funding healthcare for those who could not or would not fund their own. Now, I'm still paying, but individuals who used to rely on publically funded care MUST make SOME contribution, either by purchasing mimimal coverage or by paying the "fine" for failing to do so. Here, health insurance is viewed like auto insurance - you have to have it, or pay a fine if you don't - because you are hurting others if you run without it. Nothing has really changed for me as long as I can afford my private coverage. Sure, you still have the battles with the private insurers, and the rates still are rising - but the government otherwise leaves me and my doc alone.

 

The troubling thing I was hearing about ObamaCare is that once you leave or lose your private coverage, you cannout go out and find more; that we are slowly being "weaned" from private insurance, and moved instead into the government plan. That this is a design, intended to provide increasing levels of funding for the government program, which cannot survive by taxes alone. That the government wants what was my insurance dollar, and intends to deliver lower services for the same premium dollar, and so stretch it further, leaving me stuck with lower levels of care and no alternatives. I don't know if that's true - and so I need to read.

 

I can't help but wonder if we are approaching all of this from the wrong end. You can't keep trying to sqeeze the same amount of care out of a shrinking medical dollar. Somehow, we need to find a way to shrink the cost of services. And I do not mean death panels or end-of-life suicide counseling. We need to change (1) the demand for services, by increasing our national health; and (2) the cost of services, by smarter use of the available resources and controlling the profit derived from supplying basic services. Somewhere in there has to be a re-thinking of the system under which we develop new drugs and devices - right now, it is a winner-take-all race to FDA approval, with huge risks and rewards, and the costs are ultimately borne by those least able to carry them.

 

So I'm off to find a copy of the bill....and hopefully some thoughtful commentary not juiced up by political considerations. Wish me luck.

 

LL

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Honestly, I haven't paid enough attention to the actual provisions of this legislation; I need to do some reading. All during the "public debate", I didn't hear or see a single, comprehensive analysis of what this new law was actually going to do, or how. Seems like our legislators weren't the only ones who failed to read the bill....

 

Right now, medical and dental insurance cost us about $2000 a month - that's full BC/BS plus Delta Dental - family plan. As expensive as that is, we can't afford to be without it. Until this year, when I left my firm to start a new one, I was paying an increasing percentage of the total cost - every year it went up over the last 5 - until we were up to about 20% last year.

 

There is no doubt that something is broken. I just am not sure about how to fix it. If we don't have a mandatory coverage requirement, the reality is that you end up with indirect national health insurance. Before Romney Care in MA, if you had no coverage, you showed up at a public hospital, and they treated you for "free" - with that cost passed back to the State and ultimately paid by you and me in taxes. So, I was paying toward my health insurance, my employer was paying the rest, and the both of us were funding healthcare for those who could not or would not fund their own. Now, I'm still paying, but individuals who used to rely on publically funded care MUST make SOME contribution, either by purchasing mimimal coverage or by paying the "fine" for failing to do so. Here, health insurance is viewed like auto insurance - you have to have it, or pay a fine if you don't - because you are hurting others if you run without it. Nothing has really changed for me as long as I can afford my private coverage. Sure, you still have the battles with the private insurers, and the rates still are rising - but the government otherwise leaves me and my doc alone.

 

The troubling thing I was hearing about ObamaCare is that once you leave or lose your private coverage, you cannout go out and find more; that we are slowly being "weaned" from private insurance, and moved instead into the government plan. That this is a design, intended to provide increasing levels of funding for the government program, which cannot survive by taxes alone. That the government wants what was my insurance dollar, and intends to deliver lower services for the same premium dollar, and so stretch it further, leaving me stuck with lower levels of care and no alternatives. I don't know if that's true - and so I need to read.

 

I can't help but wonder if we are approaching all of this from the wrong end. You can't keep trying to sqeeze the same amount of care out of a shrinking medical dollar. Somehow, we need to find a way to shrink the cost of services. And I do not mean death panels or end-of-life suicide counseling. We need to change (1) the demand for services, by increasing our national health; and (2) the cost of services, by smarter use of the available resources and controlling the profit derived from supplying basic services. Somewhere in there has to be a re-thinking of the system under which we develop new drugs and devices - right now, it is a winner-take-all race to FDA approval, with huge risks and rewards, and the costs are ultimately borne by those least able to carry them.

 

So I'm off to find a copy of the bill....and hopefully some thoughtful commentary not juiced up by political considerations. Wish me luck.

 

LL

 

Loophole LaRue

 

I look forward to your commentary and will synchronize it with what I can get from health care brokers and other industry sources.

 

When you say "we" I will assume you mean an all inclusive United States of America "we". Right now, the number one driver of health services usage according to my source is: obesity. Time to get rid of what makes us fat, in my opinion.

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Loophole, Pard, you better be ready for a looong and confusing read. over 2000 pages worth :rolleyes:/> <_</> :blush:/>

 

 

HA! A walk in the park....and a great break from the usual pile of statutes, regulations, insurance policies, acquisition agreements, construction contracts, and similar legal stuff that's on my desk.

 

Given the length, maybe I'll do "progress reports" as I work my way through.

 

LL

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Here is an abbreviated version of "the layman's information" from a benefit broker. The law:


  •  
  • Generally requires most individuals to have a minimum level of health care coverage (aka minimum essential coverage).
  • Health Benefit Exchanges per state where individuals can buy coverage.
  • Provides refundable health care premium tax credits and cost-sharing reductions for individuals/families with income up to ~$88,200 a year.
  • Penalties on individuals who fail to carry minimum essential coverage. There are exceptions for those with low income.
  • Allows for personal or employer provided coverage to stay in place if minimum essential coverage requirements are met.
  • Employers are not required to provide at least minimum essential coverage to employes, however, incentives and penalties exist to encourage employers to provide.

More later...

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I suppose that if it's that bad in 2014, then the Congressional elections then, and the presidential election 2 years later, will address it.

 

Unlike Dirty Dan, I've had health insurance since I left home at 18 in 1966, which is over 46 years ago, now. First at college through student health programs, ever since then by private employer-provided insurance.

 

The cost has skyrocketed. I'm lucky to still have it. Some of my five long-since-adult children have great difficulty affording it.

 

I didn't hear any great solutions posted in this thread, except to go back to the good old days when we didn't have health insurance. Except, in my good old days (I'm 64), we did have it, which in fact was good.

 

Obamacare is still an insurance-based plan, with insurance being, in effect, compulsory. We'll see how it works.

 

I assume that nobody who denounces "federal" medical plans is on Medicare, of course....

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I suppose that if it's that bad in 2014, then the Congressional elections then, and the presidential election 2 years later, will address it.

 

Unlike Dirty Dan, I've had health insurance since I left home at 18 in 1966, which is over 46 years ago, now. First at college through student health programs, ever since then by private employer-provided insurance.

 

The cost has skyrocketed. I'm lucky to still have it. Some of my five long-since-adult children have great difficulty affording it.

 

I didn't hear any great solutions posted in this thread, except to go back to the good old days when we didn't have health insurance. Except, in my good old days (I'm 64), we did have it, which in fact was good.

 

Obamacare is still an insurance-based plan, with insurance being, in effect, compulsory. We'll see how it works.

 

I assume that nobody who denounces "federal" medical plans is on Medicare, of course....

 

Enjoy.

 

GG

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Honestly, I haven't paid enough attention to the actual provisions of this legislation; I need to do some reading. All during the "public debate", I didn't hear or see a single, comprehensive analysis of what this new law was actually going to do, or how. Seems like our legislators weren't the only ones who failed to read the bill....

 

Right now, medical and dental insurance cost us about $2000 a month - that's full BC/BS plus Delta Dental - family plan. As expensive as that is, we can't afford to be without it. Until this year, when I left my firm to start a new one, I was paying an increasing percentage of the total cost - every year it went up over the last 5 - until we were up to about 20% last year.

 

There is no doubt that something is broken. I just am not sure about how to fix it. If we don't have a mandatory coverage requirement, the reality is that you end up with indirect national health insurance. Before Romney Care in MA, if you had no coverage, you showed up at a public hospital, and they treated you for "free" - with that cost passed back to the State and ultimately paid by you and me in taxes. So, I was paying toward my health insurance, my employer was paying the rest, and the both of us were funding healthcare for those who could not or would not fund their own. Now, I'm still paying, but individuals who used to rely on publically funded care MUST make SOME contribution, either by purchasing mimimal coverage or by paying the "fine" for failing to do so. Here, health insurance is viewed like auto insurance - you have to have it, or pay a fine if you don't - because you are hurting others if you run without it. Nothing has really changed for me as long as I can afford my private coverage. Sure, you still have the battles with the private insurers, and the rates still are rising - but the government otherwise leaves me and my doc alone.

 

The troubling thing I was hearing about ObamaCare is that once you leave or lose your private coverage, you cannout go out and find more; that we are slowly being "weaned" from private insurance, and moved instead into the government plan. That this is a design, intended to provide increasing levels of funding for the government program, which cannot survive by taxes alone. That the government wants what was my insurance dollar, and intends to deliver lower services for the same premium dollar, and so stretch it further, leaving me stuck with lower levels of care and no alternatives. I don't know if that's true - and so I need to read.

 

I can't help but wonder if we are approaching all of this from the wrong end. You can't keep trying to sqeeze the same amount of care out of a shrinking medical dollar. Somehow, we need to find a way to shrink the cost of services. And I do not mean death panels or end-of-life suicide counseling. We need to change (1) the demand for services, by increasing our national health; and (2) the cost of services, by smarter use of the available resources and controlling the profit derived from supplying basic services. Somewhere in there has to be a re-thinking of the system under which we develop new drugs and devices - right now, it is a winner-take-all race to FDA approval, with huge risks and rewards, and the costs are ultimately borne by those least able to carry them.

 

So I'm off to find a copy of the bill....and hopefully some thoughtful commentary not juiced up by political considerations. Wish me luck.

 

LL

 

WHAT ? . . a COPY OF THE BILL . . . . didn't you see that image on TV of a gal with a hand dolly taking "the bill" to a public place so that folks could read it ? . . . . At first it looked like "Oh she has those boxes with copies of the bill so that people can take one and read it". Nice. :mellow: Until the information was included that the stack of boxed that filled the hand cart was ONE COPY OF THE BILL. So NO ONE could read and digest the whole damn thing. :wacko:

 

I also remember congress woman whut's her name being asked . . . what is in the bill. . . and her reply ( on national TV ) . . .pass it and then you'll know what is in it.

 

Well . . . it got passed . . . and the public is going to find out how bad they have been HAD. . . . :excl::huh::angry:

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I suppose that if it's that bad in 2014, then the Congressional elections then, and the presidential election 2 years later, will address it.

 

Unlike Dirty Dan, I've had health insurance since I left home at 18 in 1966, which is over 46 years ago, now. First at college through student health programs, ever since then by private employer-provided insurance.

 

The cost has skyrocketed. I'm lucky to still have it. Some of my five long-since-adult children have great difficulty affording it.

 

I didn't hear any great solutions posted in this thread, except to go back to the good old days when we didn't have health insurance. Except, in my good old days (I'm 64), we did have it, which in fact was good.

 

Obamacare is still an insurance-based plan, with insurance being, in effect, compulsory. We'll see how it works.

 

I assume that nobody who denounces "federal" medical plans is on Medicare, of course....

Yup, I guess the Government knows better, and should be in charge from cradle to grave of each individual, and should provide and dictate how ones life directions. Unbelievable,MT

 

Just adding after some thoughts, seems everyone agrees on the high cost of medicine, be it doctors, hospitals, insurance etc. But doctors and hospitals have for years told the public about how easy and often lawsuits are filed and millions, and billions are rewarded with the bulk going to lawyers, especially class action suits. Pharmaceutical manufacturers even with warnings on labels, are being sued, and millions going to lawyers, with a pittance of reward to those that signed on Class actions. The cost of these awards have led to doctors ordering tests upon test, same for hospitals. These lead to increases in medical insurance cost. Many times lawsuits are frivolous, the ones you don't hear about because no one got a huge amount, and the doctor or hospital won, these cost money, and are passed on to the patients through insurance rates.

As all things run by goverment, mostly inefficient and lowballed, the cost will be passed on to those that have jobs, and dectuctions from paychecks will increase. From what I read, and hear, some believe, or have the belief that this health care will be free for all.

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WHAT ? . . a COPY OF THE BILL . . . . didn't you see that image on TV of a gal with a hand dolly taking "the bill" to a public place so that folks could read it ? . . . . At first it looked like "Oh she has those boxes with copies of the bill so that people can take one and read it". Nice. :mellow:/>/> Until the information was included that the stack of boxed that filled the hand cart was ONE COPY OF THE BILL. So NO ONE could read and digest the whole damn thing. :wacko:/>/>

 

I also remember congress woman whut's her name being asked . . . what is in the bill. . . and her reply ( on national TV ) . . .pass it and then you'll know what is in it.

 

Well . . . it got passed . . . and the public is going to find out how bad they have been HAD. . . . :excl:/>/> :huh:/>/> :angry:/>/>

 

Wolfgang:

 

I did see those scenes, and I heard Nancy Pelosi reveal (once again) her shocking ignorance by suggesting that the Congress had to PASS the bill in order to see what was in it......utter stupidity.

 

A 2000 page bill may be daunting, but it is not impossible. You just need to break it down into manageable pieces, get the definitions straight, and think a bit.

 

There has been way too much emotional speculation about the content and effect of this bill on both sides. Now that the worst of it has died down, I want to take a serious look at what we are facing - the good and the bad. Wailing and cussin' won't solve anything.

 

LL

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Yup, I guess the Government knows better, and should be in charge from cradle to grave of each individual, and should provide and dictate how ones life directions. Unbelievable,MT

Sounds an awful lot like the tenants of Nikita Kruschev doesn't it :(

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There's several factors with the insurance thing to consider:

 

Insurance of any kind is one of those things that started out as a great idea and turned into a racket..The insurance companies care far more for their stockholders than they do their policyholders..BUT-They are only partly to blame, the courts have upheld too many ridiculous lawsuits brought by people that either got injured out of their own stupidity, or were simply looking to make some big bucks..As well as upholding too many lawsuits brought by patients against doctors (some legit, many not) that has caused malpractice insurance to go through the roof and has resulted in increased fees for medical insurance and health care ..Also the billing departments of medical practices have for too long now overcharged the insurance companies for medical fees, there is a HUGE difference between what a cash-paying patient gets charged compared to one with insurance..Accordingly they have raised the prices of premiums till Joe Average can't afford medical insurance..Now we have this "obcare"..I can't help but wonder how much the gov. will make from tax penalties of people without coverage? How many will simply pay the penalty every year and continue to not buy insurance? I suspect that was taken into account when obcare was being drawn up.. :angry:/>/>/>/>/>

 

And sadly, I have to agree we're screwed..I've always fairly confident about the country being able to turn a bad situation around, but this time I'm not so sure..My advice to anyone is learn how to grow a garden, learn how to hunt, how to shoot firearms, reload ammo, and shoot and hunt with bows and arrows, it wouldn't hurt to learn how to build bows and arrows as well! Learn how to dress out and process your own meat, and how to tan the skins..And how to build a fire with something besides matches or Bic lighters..How to can veggies and cure meat..Skills that not too many years back most folks knew..And some that when needed, can come in REAL handy..Skills that may keep one from starving or freezing someday!

 

I tried to warn at least one young person I know who is a hardcore BO supporter what was going to happen at tax time next year, but they didn't believe it would effect them..Oh well.. <_</>/>/>/>/>

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Gunner, not only do doctors not like it, many are leaving the medical profession because of it and going into other fields.

The law is so large and so complex that there are all kinds of "experts" giving their two cents worth. It will take years to figure it out. All I can say is we have the finest health care in the wortld, if you can afford it. If you can't, die quickly. Seen all my folks ever worked for taken to pay their medical bills. As far as doctors leaving, what are they going to do? Some probably need to leave. Only industrial nation in the free world that runs health care for a profit. DO NOT feel sorry for the insurance companies, they are going to do quite well under Obamacare, we always seem to take care of them.

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As far as doctors leaving, what are they going to do? Some probably need to leave. Only industrial nation in the free world that runs health care for a profit. DO NOT feel sorry for the insurance companies, they are going to do quite well under Obamacare, we always seem to take care of them.

 

How are Doctors leaving? Well this past year 3 have left our group,and according to the letters sent out to those that used the group, 1 went into a professional Football league as a team doctor (he was one of mine), another went into research for a Pharmaceutical company, the other doctor went into a large oil company as a company doctor, all left private practice.

They are leaving, rest assure. As to goverment run health care, even before the new care system, talk to seniors and ask how hard it is/was to find doctors that will take on Medicare patients. I know, ask me how many doctors I had to call before I found one that would accept Medicare patients, or talk to some that have dropped Medicare patients, and to reasons why.

Now the place has 3 less doctors to see patients. MT

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If we end up going down the road to a single payer, nationalized healthcare, there are other things to consider. I have a cousin who is a Nephrologist in Vienna, Austria. She indicates that under socialized medicine, a doctor's pay scale has determining factors set by the government. Because of this, the best and the brightest students do not opt for general medicine or even the specialized fields. Many will go to work for private companies in medical research, or just business in general where the money is to be made. She says that may be the future in the United States, where the best students choose other occupations which provide the opportunity for a greater income. So at some point, we may end up with a smaller pool of doctors who were not at the top of their class, perhaps like VA doctors :angry:/>

 

Speaking of the same family, her uncle (also my cousin) has a bone spur in his right heel, which will require surgery. He is presently on pain meds and has a year long wait before surgery. This gentleman happens to live in Lund, Malmöhus, Sweden, and we all know how wonderful socialized medicine is in Sweden ;)/>.

 

T.H. O'Sullivan

Black Mesa Ranch

New Mexico

:FlagAm:/>

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A little more info...

 

The Small Business Exchange each state is supposed to have, is intended to enable small firms can pool together to spread out financial risk and buy coverage for employees. Small means a firm with up to 100 full time employees. Larger firms MAY get access in 2017.

 

Seasonal workers don't count in the math. I could not tell if contact workers (1099s) count.

 

Tax credit for small employers is like 35% or more on employer paid premiums. Its a sliding scale depending on how many full time employees there are and how much they make. The credit can be as high as 100% in 2013 and is good for only 2 years.

 

The penalty is for firms with 50 or more employees. If minimal essential coverage is not offered, or unaffordable, or does not cover health care costs very well, the larger firm can be assessed a tax of $2000 or more per employee. This is also a sliding scale of sorts with some peculiar caveats about coverage that can make the penalty lower.

 

Knowing what health care premiums are like, $2000 is a cheap tax. If it is cheaper than providing coverage, the firms that have not had to deal with this cost, will *have to do so soon*. What are the options? No new hires. Maybe some layoffs. Getting rid of full time employees in favor of 1099s. Possible bankruptcy for those firms on the edge.

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