Willa Rogers posted:

According to the instructions, you only have to formally file for an exemption for a handful of situations but I agree about keeping records.

I came across that while helping someone who had medical bills last year that came to half her gross income, and I told her to keep her medical receipts with her taxes if she's gonna use the exemption form just in case they ever contest.

On the other hand, it was p. easy to get the exemption when you filed for it even under Obama.

JustJeff88 posted:

I'm hosed in regards to this and I don't know what to do. I had health coverage through my employer in 2017 through May of that year. My job officially ended on 15 May but my health care ran through the 31st. I didn't even try to get anything else because I was in a shite southern state that didn't accept the Medicaid expansion. However at the end of July '17 I moved to another state and that is a solidly "red" state, so I assumed that it didn't opt for the expansion either. It turns out that I was wrong, but I didn't end up signing on to the expansion until July of 2018 because I very literally believed that I couldn't get Medicaid in this lovely state. I was unemployed from when I arrived in this other state from about 29 July until the second half of November. The job that I took was technically full-time and offered insurance, but it the insurance on offer was awful: the monthly premium wasn't terrible but the job paid so poorly that it ate up a huge portion of wages, plus the plan had a huge deductible/excess as well as high out-of-pocket costs and other woeful inadequacies. I changed jobs in February of 2018 and it was the same story there... technically full-time, but horrid benefits that would eat up huge portions of my income for gently caress all coverage. I've been unemployed since 30 April '18 and on Medicaid, which has been great to me and literally saved my life, since about July.

I filed my taxes for 2017 and claimed hardship, but I didn't back it up with anything. I couldn't afford to pay the huge mandate penalty and I assumed that being unemployed half the year counted as harship, but I may have just been grasping at straws due to being broke and not being able to absorb a steep fine for not paying for terrible insurance that does sod all. I was unemployed for 8 out of 12 months of 2018 and on Medicaid for about half the year, and I don't see much choice except to do what you mentioned earlier, Willa, about filing hardship (yet again, for me). Plus, I keep having to not try for jobs because the insurance they offer is awful but the income is high enough to disqualify me from Medicaid and I have a lot of health problems (the state classifies me as "medically frail", so I have access to all Medicaid benefits) and thus have to see a lot of doctors, so taking a job that costs me Medicaid would ruin me financially and healthwise. But, the max income for Medicaid is so low that I can't find jobs whose salary keeps under the threshold.

Of course, America still has the best health care in the world. Apologies if I rambled; I'm half asleep as I write this. If anybody has any advice I'm all ears, but I'm very, very worried - particularly about tax year 2017 but also 2018. I have a feeling that the IRS is going to come back and cut my nuts off, but I only have a few hundred dollars to my name and, well, poverty makes people do stupid things.

Invalid Validation posted:

Get yourself better friend, it may not be the answer you want but the IRS is so understaffed they probably aren't going to audit someone at poverty level cause there's nothing to gain and it's a waste of resources.

JustJeff88 posted:

mastershakeman posted:

So my friend said TurboTax is telling him that using the exchange hosed him. He had 4 months of unemployment with exchange healthcare, then 8 months employed. It calculated his subsidy based on the whole year AGI, so all subsidies he got have to be repaid in full - about 2 grand. For earning income when he wasn't receiving the health insurance since he had private in that period

What a loving mess

Rhesus Pieces posted:

Humalog hasn’t changed at all, not even the packaging. It’s pure greed and they know they can get away with it.

Azhais posted:

Considering insulin is so basic why isn't anyone else making a pen?

Devor posted:

Humalog and Novolog, manufactured by separate companies, both fill the same role in acting as short-term insulin for taking with meals, and both have pens (pens are amazing compared to vials and syringes)

But it turns out that you make more money by following your competitors upwards in price instead of undercutting them

The health insurance model for insulin, as for doctors, doesn't reward competitors who price competitively, and does reward competitors who raise their prices

Devor posted:

Humalog and Novolog, manufactured by separate companies, both fill the same role in acting as short-term insulin for taking with meals, and both have pens (pens are amazing compared to vials and syringes)

But it turns out that you make more money by following your competitors upwards in price instead of undercutting them

The health insurance model for insulin, as for doctors, doesn't reward competitors who price competitively, and does reward competitors who raise their prices

No Safe Word posted:

Yeah, blockchain-as-ledger is ... what it does. So it's not like they're shoe-horning blockchain into something like a billion other lovely startups. But, that said, my default position on any new blockchain venture is extreme skepticism until proven otherwise.

Discendo Vox posted:

I was surprised to see this doesn't appear to have gotten a mention. To be clear, despite being a Trump appointee, Gottlieb has been the most effective commissioner in decades and has been following through on all of his initiative announcements so far.

Invalid Validation posted:

That’s probably not completely true, there’s probably something else they can do. Medicare for all isn’t bulletproof, but imagine now you actually work minimum wage and it’s just enough to not be eligible for Medicaid but all you can afford is a catastrophic plan. Oh and your medication isn’t covered so you have to pay 150 dollars a month just on meds.

JustJeff88 posted:

It’s entirely possible that Medicaid forcing us to stay the course will cost them more money in the long run, not to mention giving me more grief, but that's bureaucracy for you.

BlondRobin posted:

Source: my mom and dad both take warfarin and both of their insurance sources, Medicare for my mom and a high-end tech corporation’s policy for my dad, both refuse to provide anything else.

KingNastidon posted:

Is it for an indication which pradaxa, xarelto, or eliquis are approved? Are they on the formulary at all, require step edit / prior auth, or what's the insurance company's rationale for denial? The success of the NOAC class has been aided by both MDs and payers seeing value over warfarin given less monitoring + potential secondary costs of adverse events. Whether the copays are affordable is a separate issue, but assumed they're widely covered.

BlondRobin posted:

It isn’t me personally so I don’t know that much, since I don’t manage either of their affairs and they’ve been on the prescriptions for several years, so if insurance attitudes have changed semi recently it could be that they simply haven’t reappraised their medicinal options. My mother was diagnosed with afib seven...? years ago and was temporarily given a newer drug as a series of samples but when time came to actually get a consistent prescription was told the insurance would not cover anything except warfarin. My father has blood clots and was prescribed warfarin, about 3-4 years ago, and commented on the same thing to me at the time, that his insurance refused to cover anything but warfarin. From what I gathered they were basically told “yeah but those drugs are $200 a month, warfarin is cheap so that’s all we’ll cover!” which is the extent of my knowledge.

BRAKE FOR MOOSE posted:

Reposting this here because USPOL is mostly the Trump Made A Tweet thread.

https://www.vox.com/policy-and-politics/2019/1/28/18192674/medicare-for-all-cost-jacob-hacker

This is a pretty extensive interview with Jacob Hacker, whose work informed the new "Medicare for America" M4A plan. It's one of the plans that has been picking up momentum around the party because it provides universal comprehensive coverage, includes cost controls, but spares private insurance and employer-sponsored plans and has a less "controversial" funding mechanism (that is, it's nicer to donors). This interview is good because Hacker lays out his reasoning pretty clearly without weaseling around, and accurately confronts the realities of upending health care.

I think HR 676 is objectively better, but I've been warming to Medicare for America as a not-terrible solution that I would have been legitimately excited about in 2008.

quote:

No. 3 is you have to be able to finance it. Now, I’m not putting these in order of importance. I once was talking to a seasoned policy expert and he said there are three important things in health care reform: financing, financing, financing.

Health care plans have foundered again and again on the shoals of figuring out where to come up with the money. To me, this is in some ways the biggest argument for a Medicare expansion that isn’t single-payer. Where do you come up with the money if you try to essentially socialize the costs of the most costly medical system in the world? There’s a lot of money going through the employment-based system and other pathways that would suddenly go on the federal ledger.

Bernie Sanders’s own team said their plan would cost about 9 to 10 percent of GDP. I’ve pointed out that the tax increase to fund World War II was about 5 percent. That’s a big number. They’re right that you’re just switching private premiums over into public taxes. But I’m incredulous about the idea that you could actually implement that kind of new tax financing as quickly as would be needed to have a universal Medicare system.

But even if you do a different Medicare expansion, you’ve got financing challenges because you wouldn’t want employers or individuals to pay the full cost of the coverage for two reasons: politics and economics. Politics, there’s going to be a huge backlash. Economics, you want employers to find this an attractive option. You want individuals to feel they’re getting a good deal. So in the Medicare for America plan, employers pay 8 percent of payroll, which is below what most of them would pay for comparable health insurance.

Morbus posted:

All these talking heads are making GBS threads out their mouths about "a bloo hoo hoo how do we paaay for it" while ignoring the fact that if we literally copy/pasted the NHS we would have an immeasurably better healthcare system with zero or close to zero costs at the point of service, while actually saving more than a trillion dollars per year. It is absolutely loving bonkers that nobody is challenging them on this bullshit when single payer systems employed elsewhere offer demonstrably MUCH lower costs while providing demonstrably MUCH better care.

KingNastidon posted:

Generally it will be something like Warfarin is Tier 1 (preferred, cheapest) on formulary and at least one or two of the other drugs on Tier 3 (more expensive). Especially with afib since all are approved for that indication. The doctor may encourage patients to go on the Tier 1 drug based on their perceptions of efficacy vs. cost, but Tier 3 should still be an option if they're willing to put in the leg work for prior auths and all that. Doctors are often just very apathetic and will only tell someone the Tier 1 option is available until they have a reason not to. Saw this play out in the prostate cancer space regarding generic casodex vs. zytiga/xtandi.

This doesn't mean that the out of pocket cost pre or post donut hole will be affordable, but it should be an available option. I'd try to get their insurance/PBM details and look it up in the medicare formulary online.

Azhais posted:

Don't need to tell me, I'm paying ~$150 a month for diabetic care after insurance

Kommienzuspadt posted:

the very real obstacles

Accretionist posted:

What did you have in mind?

I think area's over-stated. For the most part, we're pretty consolidated

Accretionist posted:

What did you have in mind?

zonohedron posted:

That suggests that the people in the frontier counties, as Public Law 94-171 apparently calls them, don't really matter. It also suggests that because "Texas Triangle" and "Front Range" are both population centers they can be treated identically, which is almost-certainly not the case.

JustJeff88 posted:

The biggest problem is that so-called leaders aren't working towards finding the best solution for America. They're either trying to protect the interests of their rich friends, forwarding their sociopathic "Bootstraps!" agendas, concern trolling in order to not have to do hard work yet keep their positions or covering everything with smokescreens like border walls, shutdowns and states of emergency, none of which are in the slightest way justified.