Can anyone explain how Obamacare will change things for our family (self-employed, OOP payments)

[TXMomof4]

double post

.

[QueenCat]

The AHA reduced the amount we can put aside in our Flexible Spending Account (like a health care savings account). This money is for medical expenses not paid for by insurance. We used to be able to set aside $5,000 a year, beginning 2013 it will be capped at $2,500.

 

This is one of the few bad parts imho. Our medical is excellent, but we used it for dental and vision, as well as orthodontics.

[Mrs Mungo]

But, I don't want to take advantage of subsidies. I don't want the burden of insuring my guys to fall in the laps of other tax payers.

 

Do you not take other tax write-offs? They are offering tax benefits to help off-set costs because things that help small businesses help the economy at large. You're never required to take all of the tax credits/write-offs that are available to you. :)

 

There are actually several benefits to small businesses listed on that page. Some of them even apply to the self-employed.

[aggie96]

For those Small Business Employers (like me), this might be useful...

 

http://www.healthcare.gov/news/factsheets/2010/06/increasing-choice-and-saving-money-for-small-businesses.html

[butterflymommy]

We won't have access to any more healthcare than we have now. So, like many people in our area, we have insurance that would hypothetically cover healthcare expenses or at least a portion, but no doctors or hospitals that accept the insurance.

 

My understanding is that, until recently, Canada didn't even allow doctors to operate "out of network" (the universal healthcare). Only a few years ago were doctors allowed to accept cash payment. Unless the problem of in/out of network drs is addressed I fear the country will be full of people who are insured in name only. This probably varies from place to place in the US. Where I live people on medicaid tend to have better coverage and access to more doctors than people on middle tier plans (like us). When DS was evaluated for lupus none of the top recommended rheumies took our insurance but they did accept medicaid. And all the major hospitals here accept medicaid. So it's an upside down two tiered program in my vicinity.

[LisaKinVA]

Is the FSA amount per family or per person? That doesn't make any sense at all to me to reduce that amount. I've got 3 coming up to braces in the next 2 years and I was looking forward to a little bit of a tax break putting the money in a FSA.

 

It is per participant -- a participant is an employee who is qualified to have an FSA account. If an employed spouse is also qualified for an FSA account that spouse may also place $2500 into an FSA. Since DH is the only qualified participant in our family, our family is limited to $2,500. There is a dependent care provision that is unaffected (to pay for day care...that amount remains $5,000).

[LMA]

My understanding is that, until recently, Canada didn't even allow doctors to operate "out of network" (the universal healthcare). Only a few years ago were doctors allowed to accept cash payment. Unless the problem of in/out of network drs is addressed I fear the country will be full of people who are insured in name only. This probably varies from place to place in the US. Where I live people on medicaid tend to have better coverage and access to more doctors than people on middle tier plans (like us). When DS was evaluated for lupus none of the top recommended rheumies took our insurance but they did accept medicaid. And all the major hospitals here accept medicaid. So it's an upside down two tiered program in my vicinity.

 

That will be an issue. Many doctors will not just accept an insurance plan as they see fit. It's going on right now. My Ob/Gyn doesn't take Medicaid anymore. My primary doctor has a list of insurance plans they don't take on the receptionist's window. And many of the plans are specific plans of insurance companies, not the entire insurance company. So you could buy plan A from Company A, but your doctors may not take it, but your doctor may take plan B from Company A.

 

In fact, several doctors have become "cash/credit cards" only. So people will have insurance but they will be limited by who takes it "in-network."

[LMA]

It is per participant -- a participant is an employee who is qualified to have an FSA account. If an employed spouse is also qualified for an FSA account that spouse may also place $2500 into an FSA. Since DH is the only qualified participant in our family, our family is limited to $2,500. There is a dependent care provision that is unaffected (to pay for day care...that amount remains $5,000).

 

 

The savings accounts (HSA and FSA) will be phased out eventually. They want to tax more income.

[CAMom]

Do you not take other tax write-offs? They are offering tax benefits to help off-set costs because things that help small businesses help the economy at large. You're never required to take all of the tax credits/write-offs that are available to you. :)

 

There are actually several benefits to small businesses listed on that page. Some of them even apply to the self-employed.

 

 

Still researching the AHA but is it simply a write off like you would take for your mortgage or charitable donations?

 

We did qualify for the earned income credit last year but did not take it. It was a hard pill to swallow since just 4 years ago we had a low 6 figure salary but the state of the economy has put us in a tough position.

[cave canem]

My understanding is that, until recently, Canada didn't even allow doctors to operate "out of network" (the universal healthcare).

Does anyone know whether this was in fact the case?

[Murphy101]

That will be an issue. Many doctors will not just accept an insurance plan as they see fit. It's going on right now. My Ob/Gyn doesn't take Medicaid anymore. My primary doctor has a list of insurance plans they don't take on the receptionist's window. And many of the plans are specific plans of insurance companies, not the entire insurance company. So you could buy plan A from Company A, but your doctors may not take it, but your doctor may take plan B from Company A.

In fact, several doctors have become "cash/credit cards" only. So people will have insurance but they will be limited by who takes it "in-network."

 

 

This is true for us. Absolutely frustrating as all get out. We called our insurance to be sure our drs accepted them and our insurance says yes. But the truth is no. Not a single one of them accept our actual plan. Upon deeper digging, we found out there are about five drs total that accept our plan and they have horrid reputations and a very long wait. That's the awful no good bad news.

 

The good news is that forced us to seek cash only options and we have found excellent providers for surprisingly decent and reasonable prices. I'm very happy with our new drs and the care they provide.

[PeacefulChaos]

For the most part, the whole thing makes no sense to me.

Sorry.

I'm sort of clueless when it comes down to it. I read through pages of replies and I think I might...sort of...be beginning to understand a little of it, but overall? No clue.

So bear with me. These questions (I bolded the actual questions) may be really naive.

 

Based on what I'm reading here, we all have to have insurance as of January of 2014 or pay a penalty, correct?

How do we go about doing that? DH's employer offers insurance but we can't afford it. The kids are on Medicaid (think what you like, I know there is a stigma attached to it. Sigh...) DH and I don't have any insurance, but are able to get relatively affordable healthcare by working with hospitals and hospital systems who offer financial aid on a sliding scale (this includes all doctors, etc, associated with the hospital). For example, DH went to the doctor a few months ago and his appointment (regular cost would be $135) cost us 33.75. We have 3 hospitals/systems in our surrounding area that do this, and we always use those 3.

Is the quality of our healthcare going to be affected by this? I know that could be a touchy thing to ask, but I'm really curious. Right now, we go to a state of the art facility for important things. I had my kids there. Pink was in the NICU for a month there. Will these places remain state of the art? Will we still have excellent hospitals, not just 'here', but in the US as a whole? Will we still have excellent doctors, excellent facilities, etc?

[LisaKinVA]

The savings accounts (HSA and FSA) will be phased out eventually. They want to tax more income.

Well, they're getting about $2500 more from us thanks to new regulations...and that's assuming the current rates remain the same. Our taxes for 2013 will go up by over $6k if they are eliminated.

[nmoira]

Does anyone know whether this was in fact the case?

 

I don't know that there have been changes, but one of the requirements of the Canada Health Act was/is? that the doctors must work in each provincial network... no second tier was allowed. Some practitioners of uncovered services like non-reconstructive plastic surgery could operate outside the network, but that's it.

[fairfarmhand]

Is the FSA amount per family or per person? That doesn't make any sense at all to me to reduce that amount. I've got 3 coming up to braces in the next 2 years and I was looking forward to a little bit of a tax break putting the money in a FSA.

 

per worker...I think. I know that since we are single income family we only get the 2500. Which is horribly unfair to large families. I have a friend with twins who is getting the braces put on in 2 separate years because of this. I can't imagine those with 5-6 kids and lousy insurance plans. It must be awful. And that flexible spending plan kept us out of a higher tax bracket. Also the HSA is part of my dh's benefits package at work. I really hope it doesn't go away, because I can't see his employer upping his pay to compensate.

[delaney]

The savings accounts (HSA and FSA) will be phased out eventually. They want to tax more income.

The savings accounts (HSA and FSA) will be phased out eventually. They want to tax more income.

Yes and that really stinks! We got 2 through on braces and our ortho is willing to let us do 3 payments for the next one (Dec 31st, Jan 1, and the following Jan 1) for the next kid to get in as much as we can.

[nmoira]

Does anyone have a cite for the FSAs being phased out? I know the health savings accounts are going, but this is a "spending" account. I've read about the new limits (and written my congressman, because like many we are looking at braces in the near future), but otherwise I've seen only that limits will increase yearly with inflation.

 

ETA: I'm wrong about the HSAs. They are not being phased out.

[FairProspects]

But do self-employed people even have access to HSAs and FSAs? We've never had a company that offered this as an option in all of dh's career.

 

The problem is that we have dealt with most of the crummy insurance issues on this thread for our entire adult lives - paying $1200+ per month for high deductible insurance, paying 10% + of our income, no access to any HSA at all, etc. This was the only health insurance reality for a lot of people, including us. I don't like that everyone has to experience it now, but that is the crux of the issue, some people had great access to insurance and some did not, no matter what they paid in premiums. At least people are starting to understand what things have been like for those of us with issues, and maybe now it can start to change for the better overall.

[Jean in Newcastle]

Yes and that really stinks! We got 2 through on braces and our ortho is willing to let us do 3 payments for the next one (Dec 31st, Jan 1, and the following Jan 1) for the next kid to get in as much as we can.

 

When are the HSA accounts going? That is really frustrating because they save us so much money and make health care (sort of) affordable to us. If they get rid of it, I'll have to start all over again with our insurance.

[SunnyDays]

Does anyone have a link to information about the HSA accounts? We have a HDHP with an HSA right now, and it sounds like most of the plans through DH's employer are going that route.

 

 

ETA: I found this online, that was posted from a company's HR department... it indicates HSA plans will NOT be discontinued. I'm curious if anyone has a source that states differently? I'd really like to figure this out.

 

http://www.utoledo.edu/depts/hr/forms/Benefits%20Forms/11_Healthcare_Reform_HSA.pdf

[SunnyDays]

Ugh, double post.

[mamajag]

Aren't you military?

 

Nope. International oil field contractor and for a smallish firm, not a major. We have had a lot of acquisitions lately but they kept the best insurance of all the companies in the merger.

 

We're blessed and we know it. :)

[TranquilMind]

'GWOB':

I cannot believe I am wading into this discussion, but it is late, my husband is not home, and I have insomnia.

 

 

That's as good a time as any!

 

We had a family of 5. I suffered so much because of the lack of healthcare. I often missed weeks of school because we could not afford a doctor visit.

Well, that's just wrong. We had a family of six and made half that, I think. But Dad was a federal worker so we had good insurance that actually covered things after you paid premiums.

 

 

. We have excellent healthcare. We pay about $160/month for a high deductible/ low premium plan for our entire family. Our premiums have not increased because of the AHA. Our deductibles have not increased due to AHA. We have Blue Cross/Blue Shield.

 

 

How High of a deductible? There comes a point where you are paying premiums just to get a discount in the rare occasion you ever meet your deductible, which is unlikely unless in the case of serious illness.

 

 

There has been so much misinformation spread about the AHA. The misinformation is entirely political. When I think about the AHA, I always remember the words of Thomas Jefferson. "We holds these truths to be self evident, tall men are created equal, that they are endowed by their Creator with certain unalienable Rights,, that among these are Life, Liberty, and the pursuit of Happiness." That means something to me. "Life", to me, means we all have a right to adequate healthcare, since we are all Created equal. That means that a 16yo girl should not have to watch her mom (psychotic though the mother is) bleed out on an ER floor because the mom cannot afford insurance. That means that even though, previously, the parents could afford healthcare, the parents of a 12yo girls should not have to file bankruptcy because they could not afford the premiums on their "Cadillac" insurance policy because the mother developed pre-eclampsia.

 

No, no one should. If you think that this Act is going to change this, I truly believe you are mistaken. This will still happen because people still won't be able to afford their premiums. They simply will now be taxed for being poor!

 

 

Prematurely raising insurance rates? Greed. Reducing hours worked by employees so you can afford private jets? Greed. The AHA does not require companies to raise premiums. Greed requires that. Evil human nature requires that, not "Obamacare".

 

No arguments here. It's always greed. Follow the money. It's just greed one way or the other.

 

 

As I stated before, the law will not affect my professional, Nuclear Engineering Degree husband. Perhaps, by working for a public utility, we are isolated from the greed of major corporations. However, I have no problems paying a little extra in taxes (though we do not make enough to have our tax rate increased) so some other 16yo kid does not have to watch her "pre-existing condition" mom almost bleed out on an ER floor.

 

Well, good for you guys. It has sure affected our professionally-degreed family hard. And we are only at the beginning. I'm confused how you think no other 16 year old will go through this though, as now, the Mom will be "covered", such as it is, but she won't be able to keep up her federally mandated insurance payment because...she has that preexisting condition, and health care costs have been unaffected and continue to rise. So now, she will pay higher premiums, tax if she fails to maintain the premium, and have a deductible in the stratosphere, that she will only reach from chronic illness or major acute care.

[Rosie_0801]

I don't know that there have been changes, but one of the requirements of the Canada Health Act was/is? that the doctors must work in each provincial network... no second tier was allowed. Some practitioners of uncovered services like non-reconstructive plastic surgery could operate outside the network, but that's it.

 

 

Such American use of language. :) We would have said "have to."

 

(No comment on Canada's system since I know little about it.)

[butterflymommy]

I don't know that there have been changes, but one of the requirements of the Canada Health Act was/is? that the doctors must work in each provincial network... no second tier was allowed. Some practitioners of uncovered services like non-reconstructive plastic surgery could operate outside the network, but that's it.

 

 

We have a family acquaintance from canada who suffered from tendonitis. It was a quality of life issue not a life or death issue. He could not find any help through the universal health care program (I don't know what it's called in canada) but about 4 years ago was able to go to a cash doctor who helped him. He said up to that point it was illegal to pay cash to a dr (for fear of a 2 tier system developing) but the rules changed. He was amazed that the dr spent 45 minutes with him.

 

I should add, though, that he did receive a lot of excellent care for more serious issues through the national health coverage.

[OrdinaryTime]

I just wanted to address the OP's question somewhere in the middle of the thread about what income would be used to determine eligibility for the subsidy for health insurance costs. I believe someone erroneously mentioned that it would be based on the past year's income. In fact, the final determination of one's eligibility and for how much will be based on the income of the current year in which you are receiving the subsidy. You may use the past year's tax returns as documentation to pre-apply for a subsidy and receive it in advance, to pay for your insurance that year, but at the end of the year, the IRS will determine your subsidy eligibility and amount abased on the new information from that current year's tax returns. So if you under-estimated your income, you will have to possibly pay back some or all of the subsidy. If you over-estimated, you could receive more assistance. (This is why the ACA has increaed the need for more IRS agents to readjust all the estimations of income with actual income at the end of the year.) I thought it was important the OP understood this since her income changes so dramatically from year to year.

 

From the CBO on this issue:

 

Income eligibility for advance tax credit payments may be determined using income as reported on the most recent tax return available. Under the law, individuals eligible for premium tax credits can apply for advance payments of the credits, which will be paid directly to their insurer. This is important for helping to make coverage affordable at the time it is needed. The ACA provides that income eligibility for advance payments may be determined using income as reported on the most recent tax return available, which for many people may reflect income for two years prior to the year for which assistance is being requested. The law also requires that procedures be in place to collect more current income information from people who experience a change in their financial situations or family circumstances since filing a return, or do not file a tax return.

 Income eligibility for premium tax credits ultimately will be based on an individual’s annual income for the year in which credits were received. At the end of the year, any advance premium credit payments received will be reconciled against the credits for which individuals are eligible based on their annual income that year, which will be determined based on their annual MAGI as reported on the tax return. If the advance payments exceed the amount of credit for which individuals are ultimately eligible, some or all of the overpayment must be repaid.1 This could cause a financial burden for families and discourage some individuals from applying to receive advance payments of the subsidy.

[OrdinaryTime]

Oops, the quoted material is not from the CBO, but this Kaiser Family Foundation report.

http://www.kff.org/healthreform/upload/8168.pdf

 

 

[Slartibartfast]

I don't know what Canada has to do with it, we aren't getting the same thing as what they have.

 

I already wait 6 months for one of my specialists but it is a urologist so they have a lot of medicare patients. I don't think, "if it weren't for all these old people I could get an appt faster! Gah!" That idea has never even entered my mind. I don't think more people getting care is a bad thing.

 

I have friends in Canada, they love their insurance. They particularly love it when they see how badly some Americans really have it.

[nmoira]

I don't know what Canada has to do with it, we aren't getting the same thing as what they have.

 

I already wait 6 months for one of my specialists but it is a urologist so they have a lot of medicare patients. I don't think, "if it weren't for all these old people I could get an appt faster! Gah!" That idea has never even entered my mind. I don't think more people getting care is a bad thing.

 

I have friends in Canada, they love their insurance. They particularly love it when they see how badly some Americans really have it.

 

I think it started with a discussion about perceived inevitability of a tiered system.

 

I miss OHIP (Ontario)... especially this year. I'm still trying to wrap my head around how things work down here. Why do ER doctors bill separately from the hospital? *And* the trauma nurse who did a lousy job putting in DD's staples? -- heck, I don't even want to pay her. Why way-back-when was I charged $250 for a post-partum care pack from the hospital containing generic Tylenol, a couple tabs of stool softener, and some Astroglide? I don't get it.

 

ETA: I had never once even seen a medical bill before moving down here 15 years ago, and I'm almost embarrassed how long the "EOB is not a bill" took to sink in.

[OrdinaryTime]

No problem, Eliana. It is a very confusing situation right now. My husband is a government healthcare contractor so I hear A LOT about the nitty gritty details day in and out.

[Slartibartfast]

 

How High of a deductible? There comes a point where you are paying premiums just to get a discount in the rare occasion you ever meet your deductible, which is unlikely unless in the case of serious illness.

 

According to the CDC 1 in 2 Americans has a chronic illness and those numbers are expected to rise. It is extremely likely and without serious illness.

 

http://www.cdc.gov/chronicdisease/resources/publications/aag/chronic.htm

 

No, no one should. If you think that this Act is going to change this, I truly believe you are mistaken. This will still happen because people still won't be able to afford their premiums. They simply will now be taxed for being poor!

 

I disagree. Sure, some will not be insured but MORE people will be insured. That will be good for all of us. The AHA is expected to reduce the number of uninsured Americans by 60 percent. That is significant.

 

http://www.urban.org/health_policy/States-and-the-Affordable-Care-Act.cfm

 

Studies that I have read have stated that seniors are getting better care and more young adults are covered than before the law.

 

 

Well, good for you guys. It has sure affected our professionally-degreed family hard. And we are only at the beginning. I'm confused how you think no other 16 year old will go through this though, as now, the Mom will be "covered", such as it is, but she won't be able to keep up her federally mandated insurance payment because...she has that preexisting condition, and health care costs have been unaffected and continue to rise. So now, she will pay higher premiums, tax if she fails to maintain the premium, and have a deductible in the stratosphere, that she will only reach from chronic illness or major acute care.

 

 

A ban on pre-existing exclusions and increased costs is in the bill so why would that be the case? The taxes do not take effect until after the exchanges are in place and we still have not seen what these insurance exchanges will look like.

[Audrey]

We have a family acquaintance from canada who suffered from tendonitis. It was a quality of life issue not a life or death issue. He could not find any help through the universal health care program (I don't know what it's called in canada) but about 4 years ago was able to go to a cash doctor who helped him. He said up to that point it was illegal to pay cash to a dr (for fear of a 2 tier system developing) but the rules changed. He was amazed that the dr spent 45 minutes with him.

 

I should add, though, that he did receive a lot of excellent care for more serious issues through the national health coverage.

 

 

I am curious as to where your family acquaintance actually lived and acquired such services, as the bolded parts above are erroneous. Canada has no national health coverage. It is entirely provincially administrated. While it varies from province to province (some have a small surcharge) any covered services are paid to the doctor by the province. This notion of a "cash doctor" for something as basic as tendonitis seems highly unusual. Perhaps you misunderstood this acquaintance's story.

[Audrey]

duplicate post, sorry

[Audrey]

I don't know what Canada has to do with it, we aren't getting the same thing as what they have.

 

I already wait 6 months for one of my specialists but it is a urologist so they have a lot of medicare patients. I don't think, "if it weren't for all these old people I could get an appt faster! Gah!" That idea has never even entered my mind. I don't think more people getting care is a bad thing.

 

I have friends in Canada, they love their insurance. They particularly love it when they see how badly some Americans really have it.

 

 

Indeed, Canada doesn't have anything to do with it. The American AHA bears absolutely no resemblance to our healthcare system whatsoever. It isn't even a healthcare system as I see it, but rather a minor bit of health insurance reform.

[Slartibartfast]

You can call it whatever you like. I was merely pointing out the fact that the name of the act is not "Obamacare." It is the Affordable Health Care Act. Personally, myself and many others call this a welcome step toward health care reform.

 

astrid

 

It is an important distinction. If you google "Obamacare impact studies" for instance, you are not going to get the politically unbiased studies. None of the non-biased organizations are calling it "Obamacare."

[astrid]

It is an important distinction. If you google "Obamacare impact studies" for instance, you are not going to get the politically unbiased studies. None of the non-biased organizations are calling it "Obamacare."

 

YES. Exactly. I was treading lightly because I wasn't sure whether it would be considered a political post or not. But yes. Very different google results.

 

astrid

[misty.warden]

 

Sure, some will not be insured but MORE people will be insured. That will be good for all of us. The AHA is expected to reduce the number of uninsured Americans by 60 percent. That is significant.

 

 

This may seem very selfish of me, but I have a problem justifying and agreeing with a plan that in theory will be "good for all of us" and not actively help me and my family at all. You're saying I should be grateful that others will have insurance, even if I never am able to afford it personally or benefit from it because somehow them being insured will eventually trickle down and help me? I think it's obvious that you're not part of the "some" who (not be insured) are being sacrificed for the greater good.

[Mrs Mungo]

I don't know why so many people are assuming that they won't be able to afford insurance once everything kicks in. You be able to participate in the insurance exchanges (intended to bring down the cost of insurance for many). Families making up to 400% of the poverty line will qualify for a tax benefit, which will help pay for insurance. http://www.healthcare.gov/law/timeline/index.html#event41-pane Right now, the federal poverty line calculator tells me that a family of 5 can bring in $9,000/month and be just squeaking under 400% of the poverty line. http://www.safetyweb.org/fpl.php. Why do so many people believe that these things won't apply yo them and they still won't be able to afford it?

 

 

[Murphy101]

Indeed, Canada doesn't have anything to do with it. The American AHA bears absolutely no resemblance to our healthcare system whatsoever. It isn't even a healthcare system as I see it, but rather a minor bit of health insurance reform.

 

 

I completely agree. That's the main problem with it. Everyone is talking like the AHA is a synonym for universal healthcare. It isn't. Not by any stretch. It's actually a step AWAY from universal healthcare, imnsho.

 

This may seem very selfish of me, but I have a problem justifying and agreeing with a plan that in theory will be "good for all of us" and not actively help me and my family at all. You're saying I should be grateful that others will have insurance, even if I never am able to afford it personally or benefit from it because somehow them being insured will eventually trickle down and help me? I think it's obvious that you're not part of the "some" who (not be insured) are being sacrificed for the greater good.

 

 

Indeed. It's robbing Peter to pay Paul. With the additional jab of telling Peter he should be happy about it.

 

On a side note, every time I hear or read "It's for the greater good." in my head, I hear the voices of the citizens in Hot Fuzz chanting it together around the garden stone table. :)

[Mrs Mungo]

I completely agree. That's the main problem with it. Everyone is talking like the AHA is a synonym for universal healthcare. It isn't. Not by any stretch. It's actually a step AWAY from universal healthcare, imnsho.

 

 

There is no doubt that it is not universal health care, that isn't opinion, that is fact. But, will it move us toward a single payer system? Maybe.

[misty.warden]

Mrs Mungo, I'm assuming that I won't be able to afford it because there's no guarantee that a plan I can afford will exist in my area or that there will be any doctors that accept it, exchanges or not. Just because it *might* be available (because that's what the bill was intended to do) does not mean it actually will. I'd like to be optimistic, however I also have to be realistic and even if I qualify for not being taxed at the end of the year because the available plans in my area are deemed too expensive by whatever criteria they use to decide such a thing, I am still in the same boat NOT having any insurance.

[Mom-ninja.]

It is an important distinction. If you google "Obamacare impact studies" for instance, you are not going to get the politically unbiased studies. None of the non-biased organizations are calling it "Obamacare."

 

 

The President said he's come to like the term "Obamacare" :)

[Murphy101]

Yes. What Misty said.

 

The AHA does not guarantee anyone insurance and it sure does not guarantee them insurance they can use. Having insurance does not guarantee medical care. There are many people who have insurance now doing without medical care every day.

[Mrs Mungo]

Mrs Mungo, I'm assuming that I won't be able to afford it because there's no guarantee that a plan I can afford will exist in my area or that there will be any doctors that accept it, exchanges or not. Just because it *might* be available (because that's what the bill was intended to do) does not mean it actually will. I'd like to be optimistic, however I also have to be realistic and even if I qualify for not being taxed at the end of the year because the available plans in my area are deemed too expensive by whatever criteria they use to decide such a thing, I am still in the same boat NOT having any insurance.

 

 

There is being realistic and then there is being pessimistic or even defeatist. There are an awful lot of ifs in your statement to be so negative, IMO.

 

The President said he's come to like the term "Obamacare" :)

 

 

The term still won't get you unbiased information, even I liked it more than Paula Deen likes butter.

[GWOB]

There is no doubt that it is not universal health care, that isn't opinion, that is fact. But, will it move us toward a single payer system? Maybe.

 

 

One can hope.

[TranquilMind]

Sis:

According to the CDC 1 in 2 Americans has a chronic illness and those numbers are expected to rise. It is extremely likely and without serious illness.

 

http://www.cdc.gov/c...aag/chronic.htm

 

 

I can only think of one year - last year, due to unexpected surgery -that we ever met our deductible in 25 years (not that I'm complaining about good health). It is not "extremely likely" for most people, especially now that deductibles are $4000-10,000 per person or family on many insurance plans. You do realize this is right out of our pocket with only a discount for showing the insurance card, right?

 

I disagree. Sure, some will not be insured but MORE people will be insured. That will be good for all of us. The AHA is expected to reduce the number of uninsured Americans by 60 percent. That is significant

 

We shall see. Insurance that you can't afford is no different than what we are doing now, shifting ever-rising costs onto the middle class insured folks.

 

http://www.urban.org...le-Care-Act.cfm

 

 

Studies that I have read have stated that seniors are getting better care and more young adults are covered than before the law.

 

Not my experience here. Insurance is far more expensive for seniors, and Medicare covers little these days. The Medi-gap plans are a must now, and expensive.

 

 

A ban on pre-existing exclusions and increased costs is in the bill so why would that be the case?

 

There is NO ban on "increased costs". They simply spread the increased costs to everyone instead of those who are higher risk. So you will be paying higher premiums every year all year long for those who live riskier lifestyles than you, instead of in the class with people like you (agewise, general health and risk level, smokers/non, drinkers/non, etc).

[TranquilMind]

I'm entering this discussion late, but I'd like to say that companies never, ever actually 'pay' the tax. It is (as much as I can tell) 100% of the time, passed along to the consumer. Especially an insurance company....you can bet your bottom dollar they *will* remain profitable. Period. This is important.

 

 

It's not only important - it is the critical point that makes the rest a joke.

[TranquilMind]

The AHA reduced the amount we can put aside in our Flexible Spending Account (like a health care savings account). This money is for medical expenses not paid for by insurance. We used to be able to set aside $5,000 a year, beginning 2013 it will be capped at $2,500 (that's for our entire family of 7, not per person). This is money we used to use for my dental work, the kids' braces, glasses/contact lenses...and paying for home birth of our children (which isn't covered by our insurance... at all... of course they will pay 100% for a hospital birth that costs roughly 3x the amount here).

 

The AHA increased the amount you must spend OOP before you can deduct it from your taxes, it used to by 7% and beginning in 2013, it will be 10%

 

Stuff that wasn't covered by our insurance before will still not be covered.

 

Our insurance premiums went up nearly 30%. I guess they had some catching up to do..

 

So, from our perspective, the AHA will increase our taxable income, and in essence have us spend more OOP each year. I still have $11,000 of dental work to finish. I have one son starting in braces Dec. 11, and 5 behind him...we have four in glasses, and in need of vision care. And, this doesn't include work that I know is coming (dd 4 has 2 of her front teeth that came in facing each other...dd 6 has an extra tooth that has attached to another primary tooth, that will need to be pulled). Almost all of this work will be paid OOP, We used to be able to space stuff out, and took full advantage of our FSA.

 

Lisa

 

 

Yes...all of this! Few wanted to look at the practical implications when there are taxes/profits to be had.

[GWOB]

I can only think of one year - last year, due to unexpected surgery -that we ever met our deductible in 25 years (not that I'm complaining about good health). It is not "extremely likely" for most people, especially now that deductibles are $4000-10,000 per person or family on many insurance plans. You do realize this is right out of our pocket with only a discount for showing the insurance card, right?

We shall see. Insurance that you can't afford is no different than what we are doing now, shifting ever-rising costs onto the middle class insured folks.

http://www.urban.org...le-Care-Act.cfm

Not my experience here. Insurance is far more expensive for seniors, and Medicare covers little these days. The Medi-gap plans are a must now, and expensive.

There is NO ban on "increased costs". They simply spread the increased costs to everyone instead of those who are higher risk. So you will be paying higher premiums every year all year long for those who live riskier lifestyles than you, instead of in the class with people like you (agewise, general health and risk level, smokers/non, drinkers/non, etc).

 

 

See, our deductible is only $1,200 per person and/or $2,400 for our family. Our premiums have increased by a whopping $5/month in the 4 1/2 years we have been here. We do have a HSA with the company matching our contributions up to a certain amount. I am a little ticked that I can no longer use my HSA funds to purchase my necessary allergy meds, but oh well.

 

I am not 100% married to the AHA. I think it's a step in the right direction, but I really wanted a single-payer system. I think, like the situation here on the boards when the format changed, many people are scared and resistant to change. This will not fix all the healthcare problems in our country, but we are moving in the right direction. When all the changes go into effect and everyone calms down, I do think things will be better. Perhaps some would consider me naive for thinking that way. That's fine. I just want to put it out there that some, perhaps even many, people are not suffering due to the AHA. And that statement in no way diminishes the suffering of people at the mercy of large corporations who refuse to provide adequate healthcare to their workers or greedy insurance companies.

 

[misty.warden]

There is being realistic and then there is being pessimistic or even defeatist. There are an awful lot of ifs in your statement to be so negative, IMO.

 

 

 

Mrs Mungo, I respect your optimism and wish I could share it myself. What sounds unnecessarily defeatist to you is a reality for me whether I like it or not, and I do not enjoy being or go out of my way to be pessimistic by any means. My default position is not optimism, sadly this may be a product of my experiences or my general disposition. Not everyone is a natural optimist and who knows why that is? I'm not opposed to being pleasantly surprised if this works out perfectly and I end up with insurance for the first time in more years than I care to remember. That is obviously the intent of AHA and I do appreciate the theory.

 

 

Are there a lot of ifs in my posts? Yes. However, in the face of how many ifs are in AHA to begin with (IF the money for subsidies can be found, and IF insurance companies agree to provide packages that are affordable to all income levels, and IF those packages are accepted by doctors in all areas, and IF people have any money left over after paying their necessary expenses, remembering that some people have overdue medical bills, garnishments, etc in excess of normal bills for rent and food and the like) I do not think my opinion is unjustified. Neither is yours. Our lives are obviously different, and that's not a bad thing. They are both realities that many others face every day and deserve to be heard and considered.