<p>And I know many middle-class people benefitting a lot. One is a friend who had cancer and couldn’t get insurance at all. Another is a family with a child with severe asthma who can now pay for his care.</p>
<p>Of course, how you see it may depend on whether your income really is middle-class, when compared to most Americans or if it’s middle-class compared to people who live in upper middle-class and wealthy enclaves in and outside of major cities.</p>
<p>Anecdotes do not tell you what it happening overall. There are always exceptions.</p>
<p>I suggest that if you find the law is not working for you, get involved to improve it. A public option would make a real difference, as would lowering the age people can get Medicare.</p>
<p>Well, your examples are anecdotes, too. Thank you for the suggestion.</p>
<p>That’s quite true, actingmt! We’ll have to wait for studies to be done to find out how things have shaken out overall.</p>
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<p>Its a dynamic market that isnt attempted to be modeled in anything more than a crude way in the CBO analysis. </p>
<p>For instance- Obamacare applies a Employer Mandate which either reduces the uninsured or generates revenue. Ha! Unless companies react by reducing people to part time hours [and/or maybe off shore]. Now there are more people who require subsidies <em>and</em> we dont we the Employer Mandate fines. Doh.</p>
<p>The tax on Insurers raises $116B. Unless of course the new pools arent profitable, in which case it becomes a $116B tax on existing health care premiums. ie a tax on us.</p>
<p>But Cadillac insurance costs the Feds money. It’s a tax deduction for employers. So if employers respond by lowering their insurance to get under the limit, that will save the federal government money. That’s the benefit of taxing things you don’t like: either you get the tax, or you get rid of the undesirable thing you’re taxing.</p>
<p>“Busdriver11, you receive subsidies. I guess you don’t care about the costs either.”</p>
<p>I’m starting to pay attention to the costs. Then again, my company is self insured, and we rarely make any significant claims, especially over the long run. So they probably make money on us, after we pay our premiums and co-pays. I don’t think that companies should be able to write off the cost of health care. I also wonder, though, if they actually take in more from us than they spend, if they have to declare that as income.</p>
<p>The 116b has already been cut to 80b. The numbers are going to be continuously adjusted.</p>
<p>Wow, this thread is really starting to veer off into a political debate. Can we please get back to a discussion of how the law works/will work and leave the political conversations to a different forum? There are some very knowledgeable posters (thank you calmon and Cardinal Fang) with great info to share.</p>
<p>Syralum. If you want info from Calmom she’s started a blog on this subject. You should visit it. It’s informative. Particularly if you are on California. </p>
<p>All the states are working differently. </p>
<p>I’ve noticed a very high level of satisfaction among our California posters CF, Calmom and Dstark. So I’m guessing their system is the best one so far. </p>
<p>Others can’t get any prices. It’s tough to do much but speculate in the case of 36 states. Except for those of us who are going with a private plan. </p>
<p>Which state are you in? Did you have specific questions?</p>
<p>“I’ve noticed a very high level of satisfaction among our California posters CF, Calmom and Dstark. So I’m guessing their system is the best one so far.”</p>
<p>I am from California and I don’t think you can put me in this category!</p>
<p>BTW, my sister-in-law who lives in LA informed me today her premium is going from $427 to $958 a month next year for a family of three. Her deductible is going down, but she rather pay the lower premium for the higher deductible.</p>
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<p>Lol- I’d say that is the downside in thinking that all the money belongs to the government in the first place. Its doesn’t “cost” the government money- its money they never had in the first place. </p>
<p>“Cadillac insurance” is part of a compensation package. A part that unions will tell you was negotiated lieu of other compensation. Lets suppose that Google or a union employer were offering a package that is worth $120K of which $20K is a Cadillac insurance plan. They decide to drop the plan and now the compensation plan is worth $110K to the employee. </p>
<p>Well they werent offering the Cadillac plan for no reason. They were doing it either because the union negotiated or the feel they need to offer it to attract and retain the right level of talent.</p>
<p>So the $110K isnt going to stay $110K. If the marketplace had already determined that the company needed to offer $120K then the money will show back up in other compensation. Which will be deductible overhead. </p>
<p>And hence wouldnt be subject to the Federal tax on corporate earnings anyway.</p>
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Yes, when there is uneven distribution of resources, and more people are helped than hurt, and the degree or type of “hurt” is significantly less than the “harm”. </p>
<p>As the law was structured, two-thirds of all Americans who do not have employer-based coverage would either qualify for Medicaid or subsidies geared to limit their insurance premiums to under 10% of their household income. That figure is simply based on income distribution-- roughly 2/3 of households nationwide have income under 400% of the FPL.</p>
<p>The beneficiaries are probably a higher percentage than that, because among those who have incomes in that upper third, a larger percentage of them probably have employer-provided insurance than those with lower incomes. Or to put it another way, the group of people who do not have employer-provided insurance is probably poorer overall than those who do. That just stands to reason – people who are unemployed, marginally employed, or employed only part time make less money than those with full time employment – and overall people who are capable of earning higher salaries are more likely to work for employers who provide insurance. </p>
<p>The “hurt” that a minority are experiencing is higher insurance premiums and reduced networks. By definition that minority are individuals in the upper third of income earning, and even the greatest increases in premiums are far less than the potential loss someone who is uninsured would typically suffer with a hospital stay of a few days. So it’s a monetary loss, but it is a loss that is limited in scope.</p>
<p>The benefit that is experienced by the larger group, in addition to reduced premiums for some, is access for a large segment that was shut out of the market-- who by definition were also the ones most likely to need medical care. </p>
<p>Let me put it another way: suppose rather than an individual mandate, you had a choice: you could buy insurance at a higher rate, or you could waive your right to ever buy health insurance. How many people would choose to save money by opting out of the health insurance market entirely? I don’t think you would like facing that choice – but that is precisely the position that thousands were in already, not because of a voluntary waiver, but because of the insurance company practices of excluding people with pre-existing conditions.</p>
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For the company – but if it shows up in the employee’s paycheck, then it will be taxable income to the employee. That is not a detriment to the employee, however, because the employee would still end up a higher paycheck and more discretionary income. </p>
<p>I don’t think a lot of employees realize how much of their potential paycheck is going to insurance premiums – they see only their own contribution amount, not the full premium. That’s a hidden cost that probably is especially detrimental to younger workers, who probably earn less and whose employers are probably paying disproportionately high premium in relation to their age.</p>
<p>Calmom, if your explanation of how the law was going to work was explained clearly to the people who make in excess of the 400% of the threshold, do you think the ACA legislation would have been enacted?</p>
<p>That sound lovely but we really do have to look at the real world.</p>
<p>I know a small business owner who elected not to have insurance and raised 3 kids with cash pay and urgent care. Risky? Yes. Would I do it? My H would freak. But, people do. And he had always nicer cars newer houses and fancier gadgets than us. No-one got sick. On the other end, my neighbor who has a propensity to fall in love with ex-convicts is costing the system bucketloads. But seriously, she is making some pretty poor choices.</p>
<p>GP, $427 a month is an incredibly low premium for a 3-person family. I was paying more than that to insure myself and 2 kids in the 90’s. Since you say that the new problem has a lower deductible that your sister prefers, I 'm guessing that the only way she got that low rate was with an extremely high deductible - especially as you say, “Her deductible is going down, but she rather pay the lower premium for the higher deductible.” Since we know that the she can get a Bronze plan on the market with a $10,000 family deductible, that means that she previously was opting for a higher deductible - perhaps higher than the $12,700 out of pocket maximum under ACA.</p>
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<p>I think the penny will drop when they go from a no-copay and small out-of-pocket to a much higher one. Hence I doubt the major loss to their compensation plan will go unnoticed. </p>
<p>I’d imagine a rational response would be employer contributions to the employees HSA- which would be tax advantaged.</p>
<p>In my previous post about my sister-in-law, her deductible went from $8,000 per individual to $5,000 (I think?), but as I said she was happy paying the lower premium for the higher deductible. Why won’t the law allow a higher deductible plan for her? She doesn’t qualify for the catastrophic plan.</p>