|
A very good guide for Open Enrollment: https://medium.com/get-america-covered/what-it-means-for-you-the-administrations-cost-sharing-reduction-funding-cuts-88da80cfd590 quote:If you qualify for tax credits that lower your monthly premiums — and 8 out of 10 people do — the amount of financial assistance you receive will increase dollar for dollar as much as your rates are increasing because of the change. That’s because the Affordable Care Act was designed to protect people from the unexpected — not just from accidents but from rate increases too. Because of the protections that are in place, if you qualify for financial help, you’re protected against any rate increase from your insurer due to the consequences of the president’s actions. quote:What if you qualify for financial help? If you qualify for extra savings with the Cost Sharing Reductions that lower your out of pocket costs, it’s probably still smart to pick the silver plan. But if you only qualify for tax credits to reduce your monthly premiums but not cost sharing reductions, you might be able to get a better deal by switching to a Gold plan. Gold plans have lower deductibles, so they normally have higher premiums. But this year, for people eligible for financial assistance, Gold plans will often be cheaper than Silver plans.
|
#
?
Oct 17, 2017 01:43
|
|
|
|
| # ? May 16, 2024 02:03 |
|
|
Paracaidas posted:A very good guide for Open Enrollment: Does anyone have actual text of the Alexander/Murray bill? I keep reading that it basically locks in CSR payments for 2 years & guarantees ACA signup marketing funding with the concession to the GOP being the allowance of anyone to sign up for a catastrophic plan. Not the worst deal ever - if a rich person wants to gamble with a $12,500 deductible I'm fine with that. But Trump's language on this has literally been all over the place. He's gone from ranting that Obamacare doesn't even exist anymore (what?), to saying that Obamacare is too expensive to insurers, to saying that Obamacare is letting insurers make too much money. Then he caps all of that off by this morning's tweet that basically says he doesn't like the Alexander/Murray agreement so he may very well veto it assuming the last person to talk to him before making his decision tells him that's the best decision. I swear that the health insurance companies and their lobbyists must be walking around with IV drips of xanax right now because Washington DC's approach to health policy right now is literally just "create as much chaos as possible."
|
|
#
?
Oct 18, 2017 16:33
|
|
|
Crashrat posted:I swear that the health insurance companies and their lobbyists must be walking around with IV drips of xanax right now because Washington DC's approach to health policy right now is literally just "create as much chaos as possible." which would be loving ~delectable~ if it wasn't for the whole "also they're going to pass the pain right onto the most vulnerable people possible" thing
|
|
#
?
Oct 18, 2017 16:53
|
|
|
gee, your livelihoods rest in the hands of a bunch of people who are profoundly incentivized to gently caress you over for the crime of addressing your concerns being too complicated for them to handle that must be loving awful
|
|
#
?
Oct 18, 2017 16:55
|
|
|
Crashrat posted:Does anyone have actual text of the Alexander/Murray bill? I keep reading that it basically locks in CSR payments for 2 years & guarantees ACA signup marketing funding with the concession to the GOP being the allowance of anyone to sign up for a catastrophic plan. Axios has the draft text but the bill hasn't been finalized yet. The most important thing in there is that it attempts to prevent insurers from benefiting from the rate hike while also eventually getting the CSR payments from lawsuits. Which is actually sound policy. So insurers would have to go back to the models they submitted to state insurance regulators where they assumed they were still going to get the CSR payments, i.e., we wouldn't see 30-40% premium increases next year. The bad thing is that this bill needs to be passed approximately, uh...two months ago. e: also Paul Ryan has come out against it so good luck even trying to shove this thing through the House The Phlegmatist fucked around with this message at 17:50 on Oct 18, 2017 |
|
#
?
Oct 18, 2017 17:48
|
|
|
Crashrat posted:Does anyone have actual text of the Alexander/Murray bill? I keep reading that it basically locks in CSR payments for 2 years & guarantees ACA signup marketing funding with the concession to the GOP being the allowance of anyone to sign up for a catastrophic plan. I thought it wasn't just rich people, basically, anyone could sign up for a catastrophic plan. If anything, it more or less undermines one of the goals of the ACA which was to have some type of decent available insurance. If anything it is how the entire system is designed to run. Trump scares the public with some executive orders, everyone flips out, and the insurance industry gets a concession.
|
|
#
?
Oct 18, 2017 17:51
|
|
|
Ardennes posted:I thought it wasn't just rich people, basically, anyone could sign up for a catastrophic plan. If anything, it more or less undermines one of the goals of the ACA which was to have some type of decent available insurance. So what's the game here for the GOP because all I see is a big gamble. They're gambling that poorer people won't sign up because the news is saying they won't have subsidies, and that the upper-middle class people who do sign up will be angry because their premiums have gone up? What are the odds the Democratic Party can effectively explain to voters that the reason for the increased costs on the middle class is GOP fuckery?
|
|
#
?
Oct 18, 2017 19:46
|
|
|
Crashrat posted:So what's the game here for the GOP because all I see is a big gamble. Given that people tend to blame the president and their party when things aren't great, I'd say the odds are pretty good. I wouldn't put it past the Democrats to gently caress it up, but they have that built-in advantage.
|
|
#
?
Oct 18, 2017 19:51
|
|
|
If the GOP were at all competent they would have silently dismantled the ACA behind closed doors, because HHS has a large amount of power over ACA implementation. That way you could just let it fail on its own and a lot of people wouldn't even figure out what was going on. But no, Trump is jumping in front of every camera he sees talking about he's personally ending Obamacare.
|
|
#
?
Oct 18, 2017 20:11
|
|
|
Crashrat posted:So what's the game here for the GOP because all I see is a big gamble. Same game as they've played for years. Get (re)elected on the promise of repealing Obamacare. It's all they have left. Might as well go out fighting than just concede the race now. /\/\/\:The tried to kill it over years in the first couple of repeal drafts this year. Too many true believers wanted it to happen now! today! Ceiling fan fucked around with this message at 20:17 on Oct 18, 2017 |
|
#
?
Oct 18, 2017 20:11
|
|
|
Ceiling fan posted:Same game as they've played for years. Get (re)elected on the promise of repealing Obamacare. It's all they have left. Might as well go out fighting than just concede the race now. The Phlegmatist is saying that the Secretary of HHS has a LOT of power in the PP-ACA bill language. I mean there's massive chunks of the PP-ACA that literally say "the Secretary shall" which leaves a shitload of wiggle room. So what I think The Phlegmatist is getting at is that is that the whole of the PP-ACA could have been sliently tore apart until it died in a whimper rather than a bang. So for example the Secretary could have: * Drastically reduced coverage mandates * Drastically reduced the medical loss ratio (which could have led to random WereTotesLegitHealthInsurance insurers literally going bankrupt trying to pay premiums) * Give every state a waiver to do pretty much whatever they want in combination with the loosened mandates * Allow temporary insurance to last longer than 3 months. Make it 11 and make it count as having insurance for the year to get rid of the tax penalty. * And probably biggest of all, basically make the 'minimum actuarial value' determination a null one But I guess the above isn't really an option when your entire campaign was built around "repeal and replace" - so you'd better goddamned well repeal and replace. Because conservatives want to shove it in the face of their "liberal" friends that Obamacare is dead now. Killing it by a thousand cuts would be called "pussyfooting around" and the House would be primaried to hell in 2018. --- But in all of this I don't see a GOP victory strategy at all. They're still going to get primaried hard because 3 GOP Senators refused to hate poor people. Meanwhile Congress is getting a whole loving lot of nothing done. I mean I get that "Congress getting nothing done" is the same joke that's always made about Congress, but it's even more so now.
|
|
#
?
Oct 18, 2017 20:42
|
|
|
Yep, that's exactly right. Also it's been an open secret for a while that you can get a waiver from the individual mandate from HHS with basically whatever reason you come up with. This admin passes them out like candy.
|
|
#
?
Oct 18, 2017 21:20
|
|
|
The Phlegmatist posted:Yep, that's exactly right. I dunno on the waiver bits. Iowa's would have hosed the poor the hardest, and HHS rejected it. Oklahoma's would have created a reinsurance program - it wasn't perfect, but it would have likely helped lower premiums - and the Trump administration was literally working on it with them right up until the deadline wherein the Administration literally just said "welp deadline has passed, nvm." Every 1332 waiver bit of news I've seen has litearlly not happened because of shear incompetence by the Trump Administration's HHS rather than ill-will. Edit - Nevermind I think you meant the individual insurance waiver. As far as I've seen people just claim they can't afford health insurance and then they never end up having to pay the penalty. Crashrat fucked around with this message at 22:35 on Oct 18, 2017 |
|
#
?
Oct 18, 2017 22:29
|
|
|
Well I guess the IRS may stop handing out those waivers like candy. The link only addresses people not answering the question or turning in paper forms without it, but I choose to read into it that the IRS will not be letting people just say "I didn't have it because I can't afford it" if their incomes are high enough. I mean regulatory-wise the only people who should get the "I can't afford it" exemption are the people who make too little money to qualify for subsidies, but their state didn't expand Medicaid - that's the only people who should be getting it. And FYI - for anyone living in a non-expansion state - the HHS all but flat out recommended people *lie* on their income levels when signing up if they were in a non-expansion state and wanted to get healthcare. The reason being your subsidy would be high enough to basically make catastrophic coverage free, and the CSR-based silver plans were nominally expensive for the narrow networks. Most people don't realize that the PP-ACA created no legal means of reconciliation if your income turned out to be *below* the Medicaid line at tax time. It just meant you could receive the maximum APTC back on your tax return if you had insurance AND you didn't take the full amount in advance (like if it exceeded your premium). This could have easily handed people a few thousand dollars a year at tax time if they just knew about it. You only have to pay the APTC back if your income exceeded your estimate during enrollment. If you're under the estimate you just get more APTC applied to your tax return.
|
|
#
?
Oct 20, 2017 06:02
|
|
|
Crashrat posted:Well I guess the IRS may stop handing out those waivers like candy. The link only addresses people not answering the question or turning in paper forms without it, but I choose to read into it that the IRS will not be letting people just say "I didn't have it because I can't afford it" if their incomes are high enough. It appears I can now properly announce “I told you so” to some folks who asked about leaving things blank last tax season, which I noted might just be volunteering for heightened IRS scrutiny later. quote:I mean regulatory-wise the only people who should get the "I can't afford it" exemption are the people who make too little money to qualify for subsidies, but their state didn't expand Medicaid - that's the only people who should be getting it. It’s anybody whose cost of insurance would have been over 8.13% of their taxable income, which isn’t just Medicaid expansion people. Had a lot of business people fall into the category because they guessed income but not expenses right for example. My software has a worksheet I have to do for everybody to double check the affordability exemption stuff. Not all that common though of course. quote:Most people don't realize that the PP-ACA created no legal means of reconciliation if your income turned out to be *below* the Medicaid line at tax time. It just meant you could receive the maximum APTC back on your tax return if you had insurance AND you didn't take the full amount in advance (like if it exceeded your premium). This could have easily handed people a few thousand dollars a year at tax time if they just knew about it. Oddly enough I fell into that myself on my personal return, got a ridiculous refund the first year. Kinda got the opposite problem this year because I picked up an unexpectedly high number of hours though.
|
|
#
?
Oct 20, 2017 17:59
|
|
|
MadDogMike posted:It appears I can now properly announce “I told you so” to some folks who asked about leaving things blank last tax season, which I noted might just be volunteering for heightened IRS scrutiny later. I wish I had recorded the phone calls I had with various HHS personnell who were really pissed at the states that didn't expand Medicaid. Conversations basically boiled down to: "I'm not telling you to lie about your income. I'm just telling you that if you happened to overestimate your income, say right above the Medicaid eligibility limit, and then later it turns out you made less - well that's no big deal and you keep your assistance. Hopefully I'm making myself clear, though, because you definitely shouldn't overtly lie - but hoping you'll make more and then ending up making less is not something the law penalizes."
|
|
#
?
Oct 22, 2017 06:20
|
|
|
Is there no way for HHS to screw people who assume they'll make enough to qualify for subsidies and don't, now that Trump is running things?
|
|
#
?
Oct 22, 2017 15:59
|
|
|
PerniciousKnid posted:Is there no way for HHS to screw people who assume they'll make enough to qualify for subsidies and don't, now that Trump is running things? Nope, there's no mechanism for that in the law. So if you estimate your income at, say, 120% FPL and wind up making 70% FPL you are fine. There's no penalty for falling under the 100% FPL cutoff. And also if you estimate your income at 120% FPL, get a silver CSR plan that's basically better than a platinum plan and make 300% FPL or something, you'll have to pay back some of the premium tax credits but there's no mechanism for paying back the fact that you were on a CSR plan when you shouldn't have been.
|
|
#
?
Oct 23, 2017 02:41
|
|
|
The Phlegmatist posted:Nope, there's no mechanism for that in the law. So if you estimate your income at, say, 120% FPL and wind up making 70% FPL you are fine. There's no penalty for falling under the 100% FPL cutoff.  I often do erratic contract work for a living. This entire situation is just a nightmare to deal with. Luckily, I have a good health insurance broker to help me out with it.
|
|
#
?
Oct 23, 2017 09:23
|
|
|
Qu Appelle posted:
It makes perfect sense when you realize the medicaid expansion was not actually optional and the supreme court made it optional. As written there was never any incentive to highball your income to get on the exchanges instead of getting medicaid because medicaid was going to be available in your state.
|
|
#
?
Oct 23, 2017 15:22
|
|
|
The Phlegmatist posted:Nope, there's no mechanism for that in the law. So if you estimate your income at, say, 120% FPL and wind up making 70% FPL you are fine. There's no penalty for falling under the 100% FPL cutoff. IANAL but I think the no drawbacks for overstating income is a regulatory thing which the IRS can change. 36b.f.2.B.i has no lower limit which implies that they can claw back up to $600 in subsidy from someone below the FPL.
|
|
#
?
Oct 23, 2017 15:40
|
|
|
Kaine and Bennett, purple state senators extraordinare, have put out their health care proposal now as well. They've termed it MedicareX (public option) and have a solid conversation with Vox's Kliff, who along with Stein and the whole outlet, has been awesome on healthcare. https://www.vox.com/platform/amp/health-care/2017/10/20/16504800/medicare-x-single-payer Phoneposting so I'm not going into a ton of detail, but a couple points: It uses the medicare network and name but not the funding mechanism, and also covers all of the ACA's essential benefits. This is likely represents the other end of the spectrum from single payer for 2018 and especially 2020. A real test for the party will be if both can be treated as valid options during the primaries. The establishment rejecting SP out of hand will turn off the lefter wing of the party, while that same wing decrying this as a corporate handout by shill centrists will lead to this expansion being read as a loss, and we saw how that plays in 2010.
|
|
#
?
Oct 23, 2017 15:58
|
|
|
My issue with Medicare For All is that Medicare is not...actually that great. Part B bankrupts people pretty often due to the 20% coinsurance. We can do a whole lot better than that.esquilax posted:IANAL but I think the no drawbacks for overstating income is a regulatory thing which the IRS can change. It's probably technically possible but the IRS has shown no interest in actually enforcing it. And the GOP is currently trying to severely slash their budget (which is probably the reason why they're actually not taking returns for this year that don't have insurance coverage info on them, dealing with all of those has been expensive for them) so I don't think they will change things around.
|
|
#
?
Oct 23, 2017 17:47
|
|
|
The Phlegmatist posted:My issue with Medicare For All is that Medicare is not...actually that great. Part B bankrupts people pretty often due to the 20% coinsurance. We can do a whole lot better than that. I thought the goal of Medicare For All was to just steal a popular name but then actually implement something that looks more like a good insurance policy.
|
|
#
?
Oct 23, 2017 17:51
|
|
|
The Phlegmatist posted:My issue with Medicare For All is that Medicare is not...actually that great. Part B bankrupts people pretty often due to the 20% coinsurance. We can do a whole lot better than that. You can buy medicare supplement policies to cover that 20% if you're worried about catastrophic professional claims.
|
|
#
?
Oct 23, 2017 17:58
|
|
|
Reik posted:You can buy medicare supplement policies to cover that 20% if you're worried about catastrophic professional claims. For certain values of "you."
|
|
#
?
Oct 23, 2017 18:06
|
|
|
Sir Kodiak posted:I thought the goal of Medicare For All was to just steal a popular name but then actually implement something that looks more like a good insurance policy. It is this, at least on the Bernie plan.
|
|
#
?
Oct 23, 2017 18:06
|
|
|
Sir Kodiak posted:I thought the goal of Medicare For All was to just steal a popular name but then actually implement something that looks more like a good insurance policy. Some of the proposals I've heard have been a straight Medicare buy-in. MedicareX (which is an incredibly dumb name though) seems fine as a public option, since it just piggybacks onto the existing Medicare network but would be managed differently with its own schedule of benefits.
|
|
#
?
Oct 23, 2017 18:14
|
|
|
The Phlegmatist posted:MedicareX (which is an incredibly dumb name though) seems fine as a public option, since it just piggybacks onto the existing Medicare network but would be managed differently with its own schedule of benefits. Gotta have a name that idiots understand, because otherwise it gets demonized by the Republicans.
|
|
#
?
Oct 23, 2017 18:21
|
|
|
The Phlegmatist posted:My issue with Medicare For All is that Medicare is not...actually that great. Part B bankrupts people pretty often due to the 20% coinsurance. We can do a whole lot better than that. medicare for all is a rebranding of (depending on the speaker) either a public option or a single-payer system. none of the proposals are actually medicare for all, they're a new system kinda like medicare. The Phlegmatist posted:Some of the proposals I've heard have been a straight Medicare buy-in. That's generally only proposed when lowering the medicare age to 55 (like Obamacare was going to do before Lieberman threw a fit and killed it).
|
|
#
?
Oct 23, 2017 18:31
|
|
|
evilweasel posted:That's generally only proposed when lowering the medicare age to 55 (like Obamacare was going to do before Lieberman threw a fit and killed it). It was floated around (in healthcare circles at least) earlier this year. The idea being that, since Medicare doesn't cover pediatric or maternity coverage and a buy-in would be very cheap to implement since CMS can just keep the same rules, it becomes incredibly cheap and good option for millenials who don't plan on having children, older DINKs, same-sex couples, etc.
|
|
#
?
Oct 23, 2017 18:46
|
|
|
The Phlegmatist posted:It was floated around (in healthcare circles at least) earlier this year. The idea being that, since Medicare doesn't cover pediatric or maternity coverage and a buy-in would be very cheap to implement since CMS can just keep the same rules, it becomes incredibly cheap and good option for millenials who don't plan on having children, older DINKs, same-sex couples, etc. sounds like a recipe for an exchange death spiral (or whatever replaces the exchanges as the option for people who do want to have kids), you might as well just remove maternity coverage from the exchanges and call it a day
|
|
#
?
Oct 23, 2017 19:16
|
|
|
Sir Kodiak posted:I thought the goal of Medicare For All was to just steal a popular name but then actually implement something that looks more like a good insurance policy. Medicaid for all would be a not-bad option. Presuming rates were raised so there were sufficient Medicaid providers.
|
|
#
?
Oct 23, 2017 19:21
|
|
|
Hieronymous Alloy posted:Medicaid for all would be a not-bad option. Presuming rates were raised so there were sufficient Medicaid providers. yeah but medicaid is for poor people (including many, gasp, minorities) and medicare is for good, honest old people (mostly white) who worked their whole life and earned it so you can see why people pick the latter and not the former for their branding
|
|
#
?
Oct 23, 2017 19:34
|
|
|
Hieronymous Alloy posted:Medicaid for all would be a not-bad option. Presuming rates were raised so there were sufficient Medicaid providers. After the Medicaid expansion debacle I don't think states can be legally coerced into accepting a Medicaid buy-in or automatic acceptance of indigent patients. That would be the ideal solution though. e: basically I see the path forward to national health care in the US looking like automatic baseline coverage from the government with the option to buy additional coverage from private providers (because single payer overnight is going to...basically immediately crash our economy so it needs to be dealt with using kid gloves.) So basically something like Medicare For All but with the option of Medicare Advantage. The Phlegmatist fucked around with this message at 19:41 on Oct 23, 2017 |
|
#
?
Oct 23, 2017 19:38
|
|
|
The Phlegmatist posted:After the Medicaid expansion debacle I don't think states can be legally coerced into accepting a Medicaid buy-in or automatic acceptance of indigent patients. They could've if we had a liberal Supreme Court - oh wait.
|
|
#
?
Oct 23, 2017 19:40
|
|
|
Or the House Majority the Dems earned in 2012 were it not for gerrymandering. Or retaining a house majority in 2010 in the first place. Voting: kind of important. The Phlegmatist posted:(because single payer overnight is going to...basically immediately crash our economy so it needs to be dealt with using kid gloves. Ugh. Centrists. I did want to double back - I harp on a lot of single payer bills for being little more than signaling efforts that are long on rhetoric and short on workability or detail, kicking the can to others or to later. From everything I've seen thus far (haven't looked too deeply), that applies to MedX as well. Of course, I do hold them to a different standard since what they propose maintains continuity for the bulk of Americans. I'm less concerned about transition and implementation compared to SP.
|
|
#
?
Oct 23, 2017 20:38
|
|
|
evilweasel posted:yeah but medicaid is for poor people (including many, gasp, minorities) and medicare is for good, honest old people (mostly white) who worked their whole life and earned it so you can see why people pick the latter and not the former for their branding Branding is VERY important. The weak-rear end branding of the ACA is what got it called Obamacare, because no-one could remember what it was really called. If a new system isn't branded with a name that even morons instantly take to, it's going to get named by the Republicans, and they always have a "sparkling" turn of phrase that sticks in the mind. Medicaid is a terrible name because it evokes charity and shame. You need people to be proud to say "I have a medicare-for-all plan!" rather than humiliated.
|
|
#
?
Oct 23, 2017 20:45
|
|
|
Paracaidas posted:Or the House Majority the Dems earned in 2012 were it not for gerrymandering. Or retaining a house majority in 2010 in the first place. Voting: kind of important. Whats your opinion of a bill that would strike the over 65 clause and assess the 2.9% medicare tax to unearned income? Don't know if the 2.9% on unearned income would be enough to cover striking premium payments on A and B.
|
|
#
?
Oct 23, 2017 22:22
|
|
|
|
| # ? May 16, 2024 02:03 |
|
|
Doc Hawkins posted:For certain values of "you." quote:You can avoid underwriting, and enroll in any Medigap plan that's available where you live, if you sign up for the Medigap plan during your six-month Medigap Open Enrollment Period. This period begins on the first day of the month that you're both 65 years old and enrolled in Medicare Part B. For example, if you turn 65 on July 14, and are enrolled in Medicare Part B, you have until December 31 to enroll in a Medigap plan. If you apply for a Medigap plan during your Medigap Open Enrollment Period, your acceptance into the plan is guaranteed, and the plan can't charge more if you have a health condition. https://www.ehealthmedicare.com/faq-medicare-supplement-plan-and-underwriting/
|
|
#
?
Oct 23, 2017 22:26
|
|