<p>axw, in the State of Illinois, that person is directed to apply for Medicaid. I expect that is the case in every state that has chosen to expand Medicaid coverage. In those states that have refused the expansion, I’m not sure where they would go.</p>
<p>We have run into this aspect of the law with my D. She is a grad student with a part-time paid internship making under the poverty level. She turns 26 at the end of November and falls off of our family coverage. Grad school doesn’t end until May 2014.</p>
<p>According to the calculators I have seen in Illinois, she will be eligible for Medicaid. I’m sorry, but that is not happening. Unless her school plan improves drastically between now and then, we/she will be forced onto the individual market. I think that there should be an option for those below the poverty line to be able to participate in the exchanges. </p>
<p>Needless to say, we are keeping our fingers crossed that she lands a job with good benefits soon after graduation. So looking forward to her successful launch next year!</p>
<p>Thank you, IllinoisMom2006. I’m not in Illinois, but I’m curious if you possibly know the answer to this question as it applies to Illinois, since you’ve looked into this. For a low income person who would be directed toward Medicaid, what happens if they have too many assets to qualify for Medicaid? Are the Medicaid qualification rules changing?</p>
<p>axw, assets don’t play a role as far as I know under the Medicaid expansion rules. But I’m by no means an expert. So many unknowns… I’m waiting until October to get more clarity on what will be available for my D.</p>
<p>If you scroll down to #5, you’ll see this: “The new MAGI system is also important in terms of what sources of income it counts and doesn’t count (importantly, it doesn’t count assets), and in how family size is determined.”</p>
<p>EMMI1 that graph you mentioned was comparing govt’s share of healthcare costs among many countries. The US govt costs are similar to some other countries but when you add in the private market costs… The US healthcare costs are out of sight compared to other countries.</p>
<p>A cost plus model leads to higher costs and that is part of our healthcare model.</p>
<p>To clarify, Canada has socialized/government owned insurance, but health care providers are private (for the most part). In the UK, the government owns, has socialized, both insurance and providers, who are government employees. Switzerland–similar to the ACA–has a privatized system, but insurers are required to sell an adequate policy on a non-profit basis. They make money by selling added value products.</p>
<p>It’s a little too late in history to think that even employee based insurance is not government run. Insurance is one of the most heavily government regulated industries. The effect of the ACA is to introduce more federal regulation. But even here, it’s limited, since the exchanges and the expansion of Medicaid will occur at the state level. </p>
<p>There are many paths to decent national health. The key seems to be running it on a nonprofit basis.</p>
<p>That I agree with and why I posted previously look at what works in other countries and how do they keep costs down and seem to have results their citizens think are worthwhile.</p>
<p>Do other countries have the same angst about hc that the US- so much that it is a focal point of elections?</p>
<p>If I understand it correctly, the ACA will have the effect of making it less likely that employers will get out of the business of healthcare, because now they will pay a penalty if they do. Correct?</p>
<p>I read that the penalty is not much of incentive to keep insurance. I thought the argument was the penalty is much cheaper than the cost of insurance. I think companies will make the insurance decision based on what it costs them and continue to push cost sharing to their employees as much as possible.</p>
<p>Bay, employers don’t provide healthcare NOW. Nor is the ACA “government run healthcare.” We are talking about insurance. Under ACA, both health care and health insurance will be provided by private entities, not the government. </p>
<p>The problem which ACA addresses is actually a very simple one: how to get more Americans covered by insurance. I agree with tom1944 and others; single-payer would have been a whale of a lot easier to implement, and would have freed employers from what has become an onerous burden. Imagine if no American company ever had to worry about this again. </p>
<p>bclintonk’s excellent post #940 explains how we got this nutty system in the first place, why we’ve kept it, and how it distorts the labor market and the economy, not to mention wreaking havoc in millions of individual lives.</p>
<p>ETA – momfromme, I have a simple solution to the Obamacare resisters of any age: Require them to sign something accepting full responsibility for the cost of their medical care. We are bending over backwards to make it possible for everyone to get covered. After all of that, if they still refuse, I say not a penny from taxpayers or from those of us who took responsibility for getting insurance.</p>
<p>Bay, I think it needs to be said. ACA detractors have successfully conflated health care and health insurance in the public mind, leading, among other things, to the idea that ACA is “government run health care.” This phrase is widely used in certain places. It’s catchy, scary, and completely inaccurate.</p>
<p>The tax/fine is tiny, much less than the cost of insurance. That’s a perverse incentive. If the fine were say $25K, I think most people would begin to see the wisdom of getting coverage.</p>
<p>Lasma, the problem with your idea is that it is simply unenforceable. When the person shows up in the emergency room with a serious disease or injury, he will be treated, no matter what paper work he has signed. If the person runs up a bill that can’t be paid, the hospital will turn it over to a collection agency, for a return of pennies on the dollar at best. If it’s a huge bill, the person can discharge it in bankruptcy.</p>
<p>Signing a paper doesn’t make any difference – any person without insurance is already financially liable for whatever charges they incur. The problem comes up when health care costs dwarf the person’s ability to pay. </p>
<p>The whole point of health care reform is to provide a better source of funding for all of the uninsured, so that the hospitals have someone to bill who is reasonably likely to pay. </p>
<p>The preventive care benefits of the ACA are there to entice the consumers – to give them a sense that they are getting a direct benefit from being insured — but the societal cost is for the unpaid catastrophic stuff.</p>
<p>Pretty clear here who has dug into the info currently available and who’s going on hearsay or “I think.” Or, hanging on one piece of info without taking it further. You don’t get far with any of that. Just sayin’.</p>