Affordable Care Act and Ramifications Discussion

<p>Feel free to PM me if you have questions.</p>

<p>just doesn’t seem right that a family of 4 making $95k has to sudsidize a family of 4 making $94k…and the tax credit for the $94k family is not too shabby.</p>

<p>Taxpayers subsidize all sorts of things. I no longer have kids in k-12. I don’t take all the highways that exist, nor the bridges being funded for critical repairs. It goes on. If my city or town chooses to give a discount to lure an employer, that may not produce anything tangible for me. But it is all, one way or another, supported by my dollars.</p>

<p>I think car insurance is a good example- do we say, I’ve never had an accident, I won’t buy it? In effect, my rates are based on my community, including plenty of poor drivers, the cost issues related to uninsured motorists, rates of car thefts, etc.</p>

<p>geeps, I’d rather subsidize that family’s insurance so that they can get preventive and subacute care in a doctor’s office, than subsidize their trips to ER because that’s the only place they can go.</p>

<p>Someone once told me a director in one of the large technology companies in Boston took a step all the way down to a lowly janitorial manager in order to make his 4 kids eligible for full financial aid since he would have been broke putting them through college just because he had a much higher income.</p>

<p>There is a message in there for those making 95k instead of 94k. :p</p>

<p>“There is a message in there for those making 95k instead of 94k”</p>

<p>That’s right. At 95K, you are stinking, filthy rich. You’d better watch it that you don’t make a dollar more than you’re allowed.</p>

<p>I can’t believe they didn’t think about the consequences. God forbid you get a tiny raise. I hope they fix these kind of flaws quickly.</p>

<p>That sounds like one of those third-hand urban legends. The only places that give financial aid good enough to make it worthwhile for someone to step down to a janitor position have less than 10% acceptance rates, and the entire family would have to take a huge cost of living adjustment for that.</p>

<p>There has to be a cut off somewhere. If the cut off was at $105,000, people making $105K would complain. If the cut-off was $134,000 people would complain…</p>

<p>^^They could have considered dwindling the cutoff dollar for dollar at a certain point, or some sort of ratio. Not at XX you get a decent subsidy, and XX+1 you get zip.</p>

<p>busdriver, that could happen. I think of ACA as the starting point, and heaven knows, we had to start somewhere. But I think as time goes by, a lot of it will get tweaked.</p>

<p>I do agree it could have dwindled better. But, agree with LasMa. </p>

<p>Based on earlier points discussed, I am not sure we know yet how MAGI will work, whether our insurance costs will be subtracted. If I missed some revelation, apologies.</p>

<p>If some person earning a high tech director salary had stepped down to janitor (not that you just walk into a janitor job, nowadays,) I’d say he had to do it several years before the first kid was eligible and stick with it through the last kid. And be good enough not to be laid off. And I’d be pretty sure he had something stashed away for expenses, some nice safe-but-convertible retirement. Or other hidden assets. The house paid off, some rare books he could sell, some under the table consulting work. Something.</p>

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<p>If this urban legend is true, I suspect he wasn’t a very good director :slight_smile: Ya don’t really have to be a genius to work out that a measly pell grant will buy you nothing more than community college and a cup of coffee these days…and that the rest of fed loans are non-dischargeable debt at near usuary interest rates…which still won’t cover the nut :slight_smile: Hope his 4 kids are a shade brighter (and better socialized, because hey, we’re all in this together.)</p>

<p>I’m curious, shrinkrap and CF, about this shift of Aspergers to general autism spectrum dx move in the DSM-V. Is it a services/coverage clawback? Or am I just overly cynical? </p>

<p>I don’t exactly have a dog in the race these days (my son, shrinkrap, was dx’d with inattentive type ADD in his first year of university…before that, in CDA, with CAPD, which doesn’t appear to be considered its own dx here…but my nephew is severely (non verbal at 13) autistic so I’ve attempted to educate myself on the spectrum, if you will.)</p>

<p>On the NP topic, don’t get me wrong, I really like and generally trust my doc, but his NP has earned her keep in my eyes this summer. I dont care who owns or runs the practice as long as there’s continuity of care between the two :)</p>

<p>In this example, Mcson was very ill after the grad crunch and saw doc, who thought he had a 1-2 combo of nasty virus going around. He’s a hardy kid and we had thought it’d progressed to something nastier – we don’t generally bother going to doc for something if we think its viral…and generally don’t see consistent temps higher than 104 for days if its just a bug. A week later, mcson was no better and had developed orange sputum, which he then googled and determined he had pneumonia, which was what I’d thought in the first place. Booked himself right away into NP, who was avail when doc wasn’t, and sure enough, she confirmed his self-dx. Bounced back as soon as he had a Zpack.</p>

<p>I smell urban legend when I hear a manager stepped down to the salary of a janitor for college expenses. He could have remortgaged his house, or had his kids go to one of the many good uni’s which reduce tuition if siblings attend together. Now once his kids are out of school, what does he do? That’s why he either a) is an idiot or more likely, b) doesn’t exist.</p>

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<p>There was an article a couple of months ago about single dad with 3 kids having to decline a raise that came with a promotion. The raise would have made him ineligible for day care aid, but the raise was not enough to cover the loss of aid. The family was already stretching their budget.</p>

<p>Then at some point, the threshold for getting aid was lowered and he had to actually ask for decrease in his salary. It was going on for couple of years until the threshold were raised again and he could finally get a raise.</p>

<p><a href=“Working single dad takes pay cut to keep childcare benefits”>Working single dad takes pay cut to keep childcare benefits;

<p>“That sounds like one of those third-hand urban legends. The only places that give financial aid good enough to make it worthwhile for someone to step down to a janitor position have less than 10% acceptance rates, and the entire family would have to take a huge cost of living adjustment for that.”</p>

<p>"If some person earning a high tech director salary had stepped down to janitor "</p>

<p>I said manager of janitorial staff and not janitor. It is an income drop from somewhere in 200k+ to 60-70k from what I understood. The kids were attending Catholic schools or something and doing well and moved on to some of the top 30-40 ranked schools with FA. </p>

<p>This was something a colleague told me back in 2005 about another person he knew, when the admit rates were still pretty high and very few had heard of college confidential. Our kids were still in elementary school and we were going, “why would someone do it”. Taking such a step down is unheard of just to send kids to college.</p>

<p>Edit: I just thought about the FA policies back then. I think 2007 was when Princeton came out with extended FA that decreased with income all the way to 180k even for the first kid. That’s when the applications started exploding at the top schools.</p>

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<p>Ah yes, “someone I know knows someone.” One of the telltale marks of an urban legend.</p>

<p>"I’m curious, shrinkrap and CF, about this shift of Aspergers to general autism spectrum dx move in the DSM-V. Is it a services/coverage clawback? Or am I just overly cynical? "</p>

<p>There are many spins on this, but outside of the areas served by large specialty influences, one spin is more of a “we are all in this together” idea. Every community must have a “regional center”, funded to provide evaluations and referrals for kids with major developmental disabilities.These specifically include mental retardation, autsim, and cerebral palsy. They typically do at least part of the evaluation themselves, sometimes to confirm or exclude a qualifying diagnosis, but also to asses the level of impairment. I believe I posted a link to an article that says the differences in geographical distribution of ADHD diagnosis cannot be explained by an actual difference in true prevalence. Instead, it is explained by the availability of services. </p>

<p><a href=“Wide Disparities in ADHD Treatment Suggest Flawed Management of the Disorder”>www.prweb.com/releases/2013/prweb10997025.htm</a></p>

<p>Similar influences with Autism</p>

<p><a href=“http://sfari.org/news-and-opinion/blog/2013/comparing-prevalence[/url]”>http://sfari.org/news-and-opinion/blog/2013/comparing-prevalence&lt;/a&gt;&lt;/p&gt;

<p>but I believe NOT at the level of the our regional centers. Other cultural influences are at play as well, as evidenced by the UK docs diagnosing more autism than ADHD. </p>

<p>Regional Centers are tasked with stretching a government allocation to meet the needs of an entire community.</p>

<p>I am not doing a very good job of explaining this, but if we are truly “all in this together”, I suspect there will ultimately be a shift in the way some diagnosis are used.</p>

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<p>that doesn’t really make sense. The $94k family can’t afford a plan, yet the $95k family can?</p>

<p>I see a lot of small businesses reducing their income(increasing expenses) to get under that $94k.</p>

<p>geeps, what do you think the cutoff should be?</p>

<p>^should slowly fade down so there isn’t an obvious incentive to get below a magic number. That’s just common sense, something our lawmakers apparently lack.
Of course location isn’t taken into account, families making $94k in many parts of the country do not need any help.</p>