<p>We will not discuss what is political what is not here. Suffice it to say that I consider the intent of the poster, whether it is relevant to the thread, whether a post was made with an intent to retort or bicker with other posters and whether the follow ups are distracting the thread from the goal of the thread. The goal of this thread is to ** TO HELP PEOPLE with insurance issues **. Many extraneous discussions go on if they don’t step outside of TOS, people remain civil to others, and discuss things in a way that improves everyone’s understanding. The law is here and it is impacting millions in different ways. We are here to help a few that need some help in figuring out their choices. </p>
<p>I read post #3307 as the impact of the law. Since it is the law, understanding what it results in is important. The structure of the law is exactly as how it is stated - increase Medicaid eligible income levels to provide free care, give subsidies to the middle and cover the costs to government in different ways. Since the law is already effective, what labels people want to put on that law is immaterial to this thread. </p>
<p>Whether you love the law or hate it, that is not part of the discussion. HOW YOU MIGHT BE PERSONALLY IMPACTED IS DEFINITELY PART OF IT.</p>
<p>I got this magazine by mail with bold title ACAnews this week. I got all excited and thought it is about ACA and I will be more informed reading it.</p>
<p>Turned out some chiropractor decided to use my home address as her own.</p>
<p>Only a few of the many plans are HSA eligible and many were funding them because of the large deductibles. The deduction is certainly for less than “their full insurance deductible”. Roughly $1,800 or so…many have much larger family deductibles and were paying much less than they have to pay now.</p>
<p>Hmmm. Post 3307 is interesting but income without asset testing doesn’t tell you much does it? Some of these people losing affordable plans can now not afford their mortgages. Most seem to be small business owners and such who may not have retirement plans or young people who while not poor are living pretty much paycheck to paycheck and could have student loans. Bigger paychecks than “average” but still. Sigh!</p>
<p>(This is why I dislike data. It does not tell the whole story.)</p>
<p>Back in the day when we had Blue Shield, my chiropractor was covered for a limited number of visits a year. This was critically important to my family, as both my husband and I had back pain, aggravated by our jobs. Sporadic issues, but a few treatments later, and we were able to deal without anything more than OtC pain relief. </p>
<p>I have Kaiser, so I had to pay cash for a few visits with a new chiropractor last year when I slipped a disk in my back. Cheaper, more effective than visit the spinal doc and I could be seen in hours, rather an weeks and I could get back to my life. I learned what moves were setting off the disk pain and what to do to strengthen core while dealing with this pain. Indispensable.</p>
<p>it always amuses me how people with employer plans, or receptionist at doctor’s offices, gasp when I tell them about our huge deductible and that we will be paying out of pocket for the visit. Their first thoughts are always sympathy in that the plan must be horrible. We have never spent more than 1k out of pocket in the last 20 years, but have saved thousands on paying $5-6K for our HD plan opposed to a $10-12k plan that everyone thinks is so much better.</p>
<p>The bottom line is that families should be able to decide what plan is right for them. In many cases, those plans are now not available to them. That is not right, IMO…People in this country should be able to do what is best for their families.</p>
<p>dusktodawn, we have “group” insurance since our small business consists of my husband and myself. We have the HIGHEST deductible plan, $5,000 per person, $10,000 per family, and we still pay almost $18,000/year. It’s almost as much as our mortgage payment (which is large because we put on an addition which contains our home office).</p>
<p>And you DON’T know when your family might be struck with high expenses. This year alone, our son required psychiatric hospitalization ($32,000 plus), and my husband dropped a small knife on his foot and severed a tendon (surgery plus hospital stay was over $18,000).</p>
<p>It is really all about luck, isn’t it? Some families see the inside of hospitals more than others, due to genetics or circumstances, often outside of their control. </p>
<p>What works for one family may not work for another when it comes to insurance, especially deductibles.</p>
<p>^ wow $18k is ridiculous…Yes, no one knows when a disaster will strike, that’s why I wish more emphasis would be placed on the importance of HSAs, especially for the self employed and self pay.</p>
<p>Since all plans, including employer subsidized plans, have to be ACA compliant by 2014, you’re employer plan should have to cover a chiropractor.</p>
<p>I agree with texaspg that this issue is immaterial to the thread, but there is a practical/logistical reason that the law was structured this way. Simply this: the system of subsidies, penalties, and tax credits is built to function and be administered via the tax system - IRS. We don’t tax “assets” on a national federal basis – only income (including gains from the sale or exchange of assets. (A gift or estate tax is still tied to the exchange of property).</p>
<p>So a system of asset-based means testing would require a whole new infrastructure and a system of monitoring and enforcement. It would be complex and costly to create, and complex and costly to administer. </p>
<p>The IRS is also complex and costly to administer, but it already exists. They are in the business if figuring out and collecting the needed paperwork to calculate taxes and refunds, and to integrate that with our nation’s banking system (so we can all pay our taxes or get our refunds electronically).</p>
<p>I think the subsidy system is easiest to understand is you simply think if it all in the context of what it is: taxes and/or tax rebates. Just as with any other tax or rebate, it could go up or down depending on how our other income figures shake out. there also may be choices that people make that could impact eligibility – one thing I haven’t seen discussed is the impact of capital gains. As far as I can tell, they will be counted as income just like anything else, but it could mean that a family loses subsidy eligibility for a given year if they sell their house. Even a very modest net gain - let’s say $30,000 – would probably be enough to change the eligibility picture for many middle class families.</p>
<p>Dstark, the more important definition is what is “catastrophic” insurance. The purest form of catastrophic insurance under ACA will be a policy with a $6350 deductible (for one) or $12,700 (for two or more), that pays nothing until the deductible is met, and then 100% thereafter. It can’t get any worse than that, at least for in-network care, under ACA.</p>
<p>I’m confused by your math. Currently, and individual can contribute (and deduct) $3300 to an HSA, and a family can contribute $6550. Taxpayers over age 55 can add $1000 to that. For an account to qualify as an HSA, it must have a deductible of at least $1250 for an individual, $2500 for family – so the allowable contribution is well over the minimum deductible for a qualifying family. And certainly way beyond “1800 or so”.</p>
<p>For the past two years I’ve had a policy with a $3500 deductible. I’m over age 55 and I’ve been depositing the full contribution + $1000 each year, so my HSA contribution has been somewhat more than my deductible. Under ACA, I’ll have a policy with a $4500 deductible instead, so my 2014 HSA contribution of $4300 will be slightly less than my new deductible, but still relatively close. </p>
<p>I realize some people choose to buy plans with even higher deductibles, but my comment about the tax deduction available for HSA’s function as a subsidy stands. Presumably the premiums are lower on the higher deductible plans.</p>