<p>Now that people are hearing from their insurances, the time has come to discuss real issues and solicit advice from other members who seem to take pleasure in answering questions, such as “who do I give my new baby to when my company won’t insure her (kidding) or rather where and how do I get insurance for her”.</p>
<p>The above thread will be closed and this new thread will be used to discuss premiums, exchanges, bronze, silver, and gold plans and anything and everything about health insurances.</p>
<p>The premiums released for my area are beyond my wildest hopes.</p>
<p>I may well choose to buy a fancier plan, but the fact that there are two different silver plans priced at $212 per month that cover the category of my preexisting condition…that I actually have that option…it’s hard to find the words.</p>
<p>I feel a lot of gratitude and relief that at long last, my entrepreneurial dreams are becoming reality. I grossed $10,000 in July, but I’d still have to go back to a day job if I couldn’t get coverage next year. Thank you, thank you, thank you, everyone who worked to make this possible.</p>
<p>“who would start a business because they would have to pay for medical ins. for their employees.”</p>
<p>Well, one thing of interest to small businesses like me is that we may be able to compete for talent without providing benefits because people can buy coverage at reasonable prices on their own. I don’t plan to expand, but if I ever did want to hire a bookkeeper or secretary, this makes it more realistic that I’ll find a competent person, not less. A 55-year-old woman could now make the rational choice to work for me instead of for some giant corporation. If she is dependent on her employer for her access to a big risk pool, no wage or working condition I can offer could ever compete.</p>
<p>Hanna, I have looked high and low for the Chicago area premium data but can’t find it. Do you have a link? Keeping my fingers crossed that there will be a reasonable cost plan for my D.</p>
<p>Illinoismom, if she’s in her 20s, she’ll qualify for the cheapest comprehensive plan at $120/month without subsidy and a slightly better plan at $144.</p>
<p>C Fang, even when they weren’t profitable, they were making their founders rich, which is all that matters for purposes of motivating entrepreneurs.</p>
<p>For those thinking that the uninsured will suddenly overburden the healthcare system: remember that most of these people who needed healthcare, at least on an emergency basis, already received it. If you are having a heart attack, you get to the ER regardless of insurance - you just don’t pay for it. We, as taxpayers, paid for it. </p>
<p>The difference is that those currently uninsured will be able to get insurance including annual physicals. Therefore many of that population will be diagnosed earlier and taken care of before their condition becomes emergent. </p>
<p>The delta will be those who did not have emergency situations (yet) and will now get care. Consequently, the increased need for healthcare will be a materially small number than 30 million.</p>
<p>Edited to add: Hannah, I’m so happy for you. All the best for your business’ success!</p>
<p>I have an Iraqi refugee living with me, who is on Medicaid. He can’t currently afford to work at a low wage for fear he will lose his medical coverage, which he desperately needs. Come October 1st, he can start looking for work!</p>
<p>If you faint as a result of cancer and end up in the ER, you will be treated for fainting, but not for cancer. You will end up in the ER repeatedly, until you die.</p>
<p>^Exactly. ER’s do not do operations, or chemo, etc. this is such a big deal. H and I have thought of starting some type of business, but it’s the insurance premiums that made it unfeasible. I think a lot of small interpreneurship will blossom out of this (opening up jobs for others, also.)</p>
<p>^^Sounds like they are going to jack up the rates, somemom. I think if I was considering it and I found a good deal, it would be worth it to sign up before the end of the year. Or I wonder if they’re just trying to get a larger number of participants.</p>
<p>I’ve known a number of people, particularly in Southern states, who suffer from conditions and they can’t see a doctor for treatment so they wait until they’re so ill they go to an ER. Well, they’re sometimes rejected by ER’s on dubious legal grounds, but often they get just enough care to get them out the door. It makes working for a living very hard and supporting a child even more difficult.</p>
<p>It is going to be a mess, but there is some protection in the “clawback” provisions, because the maximum tax that the IRS can collect back from a low-income person is $600.</p>
<p>So let’s say that someone has earnings under the FPL, but they can’t get medicaid because their state didn’t buy into the expansion. </p>
<p>That person applies to the exchange, and fills out the forms saying that they expect their income to be just above the FPL (the minimum needed to qualify for a premium). So that person then gets heavily subsidized insurance, because they said that their 2014 income was going to be $12,000. Let’s say the value of that subsidy for the year is $5000.</p>
<p>In 2015, that person files a tax return which shows his income in 2014 was actually only $8000. Because his income is too low to qualify for the “tax credit” subsidy, he owes money to the IRS – but because his income is so low, the maximum tax is $600. </p>
<p>There’s a point at which a person can be charged with fraud for submitting documents knowing full well that they are false – but I don’t see that happening for someone who is guesstimating that they will earn a poverty-level income. All that person has to say is that they were planning to get a part time job in 2014. Who is to say that wasn’t their “plan”? And in any case, what’s in it for IRS to try to impose a fine for fraud against someone who has no money?</p>
<p>I don’t know how it will work in future years --but it seems to me that as long as the system is based on a person’s expectation of income for the coming year, those people who were left in the lurch by their state’s failure to expand medicaid could keep on engaging in wishful thinking with their income estimates. Of course that requires poor people in some states to pay premiums for services that they would be getting for free in other states – it would tend to be something that would be done only by people whose poverty is closely tied to their already significant medical expenses.</p>
<p>I realize that most people who fall into that category probably aren’t in a position to understand what I’ve outlined above – they will be told they are not eligible and leave it at that. But if I had a family member in that situation, I’d be advising them to follow the process I just outlined.</p>
<p>somemom, interesting that the insurance company didn’t say a single word about the profitable new healthy young subscribers they’ll also be getting, which will offset those additional costs they mentioned.</p>
<p>You want to scroll down the page and read section (f)(2)(B):</p>
<p><a href=“B”>quote</a> Limitation on increase</p>
<p>(i) In general In the case of a taxpayer whose household income is less than 400 percent of the poverty line for the size of the family involved for the taxable year, the amount of the increase under subparagraph (A) shall in no event exceed the applicable dollar amount determined in accordance with the following table (one-half of such amount in the case of a taxpayer whose tax is determined under section 1 (c) for the taxable year):</p>
<p>If the household income (expressed as a percent of poverty line) is: // The applicable dollar amount is:
Less than 200% - $600
At least 200% but less than 300% - $1,500
At least 300% but less than 400% - $2,500.