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<p>Since the only source of income for the federal government is that which the private citizen pays…The answer to the question of who pays for Medicare expansion is simple…those already paying for themselves will just simply pay more.</p>
<p>Quote:
“I fail to understand why people in the individual markets are getting preferentially poor treatment …
We always have. This is nothing new. I have been in the individual market for many years and I never had access to the kind of very affordable health care insurance that my friends with employer funded policies had. There is a simple reason. We have no one to lobby or bargain for us.”</p>
<p>You know, I had realized that it was miserable in the individual market, but I hadn’t realized it was so bad until reading this thread. I never understood why individual policies were so much worse, but yeah, nobody to lobby for you makes sense. I had thought the ACA was going to make it better for this group, so it is surprising to me that unless you’re getting a big subsidy, it is worse. You guys need to buy a politician.</p>
<p>Uhm, that poor Medicaid mom upthread owns a 5-million dollar house and has kids in private schools. Sigh!</p>
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<p>PPACA provisions increase the amount of money that Medicaid pays doctors, to put Mediaid on par with Medicare. So many more doctors will be accepting Medicaid. The money comes from the various funding provisions of the bill (the various tax increases). It will actually cost less than originally budgeted because the bill was written with the idea that Medicaid would be expanded in all states, with the federal government picking up most of the funding. (Lots of $$$ pouring into states, many of which had large numbers of poor & uninsured). But the failure of roughly half the states to move on Medicaid expansion represents a significant savings over the original projected costs, though of course it undermines the goal of the bill to get coverage for most people. </p>
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Yes, of course.</p>
<p>“Currently my premium is $276 and it is a stretch for me to cover. The new plan . . . are you ready . . . projected new rate $415.20. Now I can’t afford health insurance.”</p>
<p>So she owns a $5M house and her kids are in private school, $276/month is a “stretch,” and she can’t afford an additional $135 a month? Really?!?</p>
<p>Nope, in fact according to her income she is too poor to pay for insurance at all. This is all very strange.</p>
<p>“And apparently a far better deal than for those in the individual insurance market. Starting Jan 1st, if you are in that market and want your child to be seen at Children’s, you have to get insurance company approval for a “specialty hospital.” If they end up disapproving, you pay out of pocket, and who knows how long it takes to get approval. Tough luck if it’s an emergency.”</p>
<p>So when I was with Group Health, for 10 years, we needed approval for virtually ALL procedures outside their local hospital/provider network. We were even denied coverage to see an orthopedic surgeon who was specifically included in one of their own panels! (That’s when we left them, thank heavens!)</p>
<p>So Children’s is having a spat with four insurers who don’t want to pay their usual (and inflated) rates. This is not a new situation - they have this fight every year.</p>
<p>Meanwhile, why should you have to pay for Children’s Hospital coverage if you don’t have any children? ;)</p>
<p>Flossy, you are not kidding?</p>
<p>Busdriver11, :)</p>
<p>I think your answer to your question is in emilybee’s 900 page link. Tell us the answer after you read the 900 pages. :)</p>
<p>I am not being funny now. As big as the Obamcare program is… And it is big… There isnt going to be a financial disaster if Obamacare doesnt get enough signups.</p>
<p>The GDP of the US is over $16 trillion.
Health care spending is over $2.9 trillion.
Medicare spending is over $550 billion.
Defense spending is over $500 billion.
Employer based tax subsidies are probably north of $150 billion.
Obamacare expenses are going to average around $120 billion a year. Right now
Obamacare is expected to run a surplus…let’s say the program is a disaster and Obamacare falls $25 billion short a year.</p>
<p>$25 billion in a $16 trillion economy? $25 billion in a $2.9 trillion healthcare market? </p>
<p>There isnt a financial disaster coming with Obamacare.</p>
<p>^^ You are not planning on grandkids mini? I am sure BD is. :D</p>
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<p>By definition, everyone who qualifies for Medicaid is either an adult living in poverty (or just barely above), or a child living in a home that is close to poverty level. Poor people get sick. They get seriously ill and need treatment, probably at a somewhat higher rate than rich people because of the overall impact of poverty on their lives. Many are poor precisely because they already sick. </p>
<p>So we either expand the program designed to cover poor people, or else we do something to eliminate poverty. A significant increase in minimum wage might be a start – it wouldn’t eradicate poverty but it would address the problem of people who work full time to earn poverty-level wages. </p>
<p>I would say that eradicating poverty would be the best possible goal, but that would be a lot tougher and cost a whole lot more than drawing some lines based on income, with the poorest people getting Medicaid, and low-to-moderate income people who can’t get insurance from their employers receiving government subsidies instead. </p>
<p>I’d note that whether it is designated a “tax credit” or “Medicaid” - either way, it is a government handout.</p>
<p>"So she owns a $5M house and her kids are in private school, $276/month is a “stretch,” and she can’t afford an additional $135 a month? Really?!? "</p>
<p>I think the daughter’s story said she is enrolled in Medicaid since they hit submit.</p>
<p>Where did the $5M house info popup? I did wonder about WSJ reporting daughter tied into such a low income parent.</p>
<p>I actually think the Medicaid question goes to a point I made earlier which is all of the subsidies are based only on income not assets. I’m glad to see a real life illustration of the issue. </p>
<p>Carry on</p>
<p>But, this woman says she doesn’t want to be on medicaid and if true the women has considerable assets, even if she has no income - she can buy a plan off the exchange and not go on medicaid. But, according to the article she says $276 is a stretch! Something about this story doesn’t make sense.</p>
<p>Anyone who has assets but doesn’t want to be on medicaid can sell some of their assets and buy off the exchange.</p>
<p>Yeah. I really want this thing to work EB, but I still believe that the income/assets differentiation is a problem.</p>
<p>I don’t as it likely only affects a miniscule amount of people. How many people have a lot of assets, who are under 65, are no longer working and have no income? Most people I know (yes, it’s anecdotal) who aren’t yet eligible for medicare, are all still working. Even the ridiculously wealthy ones. </p>
<p>Now, if the few who fit that category, are loathe to go on medicaid, they have the means to purchase off the exchange. If they have no problem being on medicaid, then so be it. But, regardless, I think we are talking about a very miniscule % of people who this asset rich/income poor scenario fits.</p>
<p>I have no idea about this woman’s situation but my H grew up very poor in a big, giant house that his father left the family when he ran off with another woman. His mom had no money and no job and was older by then and that’s just the way it was. She sold the house before her death to pay for medical care.</p>
<p>No idea how common or uncommon this is but there are an awful lot of scenarios popping up that are too easily dismissed because they don’t affect the vast majority IMHO.</p>
<p>Flossy,
Where did you get the info about the $5mill house (or were you joking)?</p>
<p>The article says she lives in a small cottage in Washington and works part time as a public school “para-educator” and is the mother of the (adult) author of the article.</p>
<p>Bay - No, I wasn’t joking but I don’t know if it’s true. It was in a news report this morning but most of these news reports are at best incomplete or slanted in one way or another so what is and isn’t true is always a bit of a mystery. Either way, it’s an issue with the income-based portion of of this law.</p>
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<p>That hits the nail on the head. Everything comes back to campaign finance and nothing will change until that changes. Insurance and big pharma bought Part D Medicare and they made a huge down payment on the ACA. There are no changes to health care in the US unless the insurance companies are pretty sure they will come out better than they went in.</p>
<p>I have a dear friend who lived in a million dollar house, with two kids in private school. She had no money, paid no taxes, qualified for food stamps, assistance with her utility bills, financial aid including PELL for her kids, and likely would have qualified for Medicaid and any other public programs. She had no income. Her ex let her live in the house, paid for private school and threw her some money once in a while. I knew the situation for years. </p>
<p>I knew a number of people stuck in such plights. Couldn’t feel entirely sorry for them as I work at soup kitchens and food pantries and see those who are truly destitute in that they really have nothing. But there are those who have no job, no money, nothing of their own, but have a famly member(s) , ex or something that keeps them still at a level below the homeless and the streets. Some just can’t get around to selling a house, the house may be in foreclosure proceedings or the subject of some other legal dispute with the right to living in there just for the time being. There are a lot of situations that do not fit neatly in a box.</p>