Affordable Care Act Scene 2 - Insurance Premiums

<p>Did you drive 250 miles that dstark had to?</p>

<p>“GP and Busdriver… do I have to write using smaller words so you guys can get the point?”</p>

<p>Pea brained dumb blonde cavewoman need big brained lawyer to write shorter paragraphs that get to the point quicker to prevent pea brain from falling asleep by the end.</p>

<p>Cavewoman also want big brains to explain what actingmt said,“Okay, so is an individual shuffling money around to get subsidies cheating? Just curious. Because it seems as though some of the people who think that’s just adapting to the law are being very hard on a business doing the same thing, basically. Neither is really anything new.”</p>

<p>Dumb blonde want to know why reducing costs is cheating on taxes, while big brains encourage people to put more in 401K to get bigger subsidies. Good thing government is being nice and doing medium sized businesses favor. </p>

<p>Now dumb woman has to go work all day and night to pay taxes so other people can retire early and get subsidies, insurance companies keep their profits, her dogs can lay snoring on the couch, and donations to the sugar industry continue.</p>

<p>(Insert the most annoying emoticon possible here)</p>

<p>Waited since last week, wooden bench in the lobby.<br>
You all see the thread about how mammos and colonoscopies are not preventive if something is found (easist example, if they biopsy a polyp found during the C.) But there’s a good blog detailing how the insurer works down the patient charges, using “allowed” charges.</p>

<p>eta: oh, the blogger was a doc on medicare. But illustrative. I’m wrapping my head around how this works. So far: if they find nothing, you don’t pay.</p>

<p>LOL, Busdriver!</p>

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<p>It isn’t illegal. NO business HAS to certify to the IRS, ever, as to why they have reduced their workforce – UNLESS they WANT to APPLY for RELIEF from the legal mandate.</p>

<p>The law says: if a business has more than 100 employees it needs to provide insurance. </p>

<p>The law says the number of employees is determined from the prior year. So if my business has more than 100 employees last year, I’ve got to provide insurance for my employees now.</p>

<p>If I employed between 50-99 last year, I’ve got an automatic extension to 2015. But what if I don’t think I will be ready to provide insurance in 2015? I can get an extension to 2016, but I have to apply for it.</p>

<p>The law also says that all taxpayers have to file their returns by April 15th… but if we aren’t ready, we can get an extension until October 15… but we have to pay the taxes we think we owe in order to get it. So those of us who can’t get our taxes prepared in time submit a short, one-page form that asks for the extension, and some of us send a check along with it. In other words, we can get 6 more months to file if we aren’t ready with the paperwork, but we can’t get extra time if the problem is simply that we don’t want to pay our taxes until later – extension or not we have to pay.</p>

<p>Now what happens if I run a business that had 120 employees last year but I’ve fallen on hard times – let’s say I own a local chain of bookstores and I’ve fallen on hard times, and plan to close 2 of my stores, reducing my total payroll to 90. The last thing I can afford is insurance or a tax penalty this year or next.</p>

<p>Well, I’m in luck – I can go ahead and downsize in 2014, and use my 2014 numbers to qualify for an extension to 2016 – but I have to check a box certifying that I am downsizing for some business reason other than to merely avoid the obligation to provide insurance. </p>

<p>I honestly don’t understand why this concept is difficult for anyone to understand. It’s the difference between calling in to work on Monday morning and saying, “I’m not coming in today because I’ve got the flu” and calling in and saying, “I’m not coming in today because I’m not in the mood to work.” </p>

<p>BD - did you leave any under the bench for anyone to bet on your behalf?</p>

<p>What is the penalty for companies if they don’t meet the insurance requirement?</p>

<p>Not a thing under the bench, texas. I couldn’t take a side, because I hadn’t followed it closely enough. But I was given permission to join in on the toast, so I did. That was last night, just in case you are wondering, I am completely sober now (should there be any doubt while reading my ridiculous posts).</p>

<p>“This is a big favor the government is doing to help medium size businesses.”</p>

<p>This is the attitude that has led to a humongous govt with their tentacles in all aspects of our economy, including my medical care. Because the govt is doing us big favors, we have a tax code only god can understand. </p>

<p>Something is wrong here when the govt that I hire and pay is now doing me big favors.</p>

<p>The government is doing these businesses a favor. LOL! That’s actually very funny. I doubt they see it that way. Something tells me they insisted on the favor rather vehemently. The unions are getting a favor, too. No favors for individuals. LOL!</p>

<p>GP, I respomded to your Menlo Park post. Sorry you missed it </p>

<p>I see you sre still are the pot calling the kettle black.</p>

<p>The bet may be officially over next welk. I hsve a long list of things you will have to apologize for…</p>

<p>If not mext week, the official announcement will come…</p>

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<p>This isn’t new. The only thing new is a requirement that the preventive part of the procedure be offered for “free”.</p>

<p>When I was 50 or thereabouts, I went to get my first mammogram. At the time, my insurance policy said that I was to pay $40 for an annual mammogram, so that’s what I thought it would cost. That $40 was a special, cut-rate that the insurance policy offered to encourage the screening (less than my copay would have been for diagnostic work).
But the technician saw some sort of little blip and I asked to talk to the doctor about it, and the doctor suggested that we do an ultrasound, and it turned out that there was a small but harmless cyst. No problem… until I got the bill for $900! </p>

<p>Well, I protested the bill because I had never been told that the ultrasound was an extra charge-- I thought it was all part of the same visit – and my protest didn’t go anywhere, so 3 years went by and I wouldn’t get a mammogram because I owed the lab money and I was afraid of another big bill. Kid #2 was still in college at the time, on my dime, so I really didn’t have extra $$ to spare. Eventually the lab gave up on collecting the money and waived the parts that I was disputing, and I went in for another mammogram – but the 2nd time around I was very careful to make sure they would tell me before doing anything that could cost extra. </p>

<p>Do you actually believe what you write, GP? Or yanking our chains? Or really an anarchist? Ha. Running this country has long involved complexities. </p>

<p>But I am glad you see it as a favor.</p>

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<p>As I understand it, if one (1) of their employees goes to the exchange and qualifies for a subsidy because they don’t get employer insurance, then they have to pay a “shared responsibility” tax of $2000 each for all of their employees. (I’m relating this from memory because I don’t have time to look it up, so there might be some wrinkles I’m missing.) But basically, if company A. has 150 employees, and because they don’t give their employees insurance, some of the employees get subsidized policies off of the exchange, then the next year, company A. pays $300,000 in additional taxes to compensate for that. Of course, the reality is that a lot more than 1 employee will be forced onto the exchange, especially since it tends to be lower-paid employees who work for places that don’t offer insurance – but the 1 employee is the trigger.</p>

<p>Medium size business – 50-99 employees – have an automatic extension until 2015 to provide insurance (or, to put it another way, a waiver of the tax penalty) – and they can apply for an additional extension until 2016.</p>

<p>Lookingforward, I think you are misunderstanding that exchange. I can’t explain now, though. Still laughing.</p>

<p>“GP, I respomded to your Menlo Park post. Sorry you missed it”</p>

<p>Must have been a good post.</p>

<p>Interesting, calmom. Also, I didn’t follow it deeper, but (I think) Nolo.com refers to ERISA having some impact on layoffs, too. Maybe I’ll go back and look.</p>

<p>From dstark - the “edited” version of his travails.</p>

<p>I am having a similar experience as the Menlo Park guy. I stubbed my toe and after calling two doctors, I could not find anybody that would accept my Anthem plan. As I was hobbling in agony, a friend called and said a doctor will look at you. He is 250 miles away. I called the doctor and confirmed. I went on my way. </p>

<p>When I got to the doctor’s office I was shocked to see a line of 17.753 patients. It seems that this is the only doctor that will take Anthem plans. For some reason some people were wearing Star Wars gear.</p>

<p>Luckily, there was a bouncer and although I would never pay a dollar more in taxes than the absolute minimum to keep the government going, I paid the bouncer $12.457 and I was able to see the doctor immediately.</p>

<p>The doctor said I may have an infection but antibiotics will clear it up. I was given a prescription for the antibiotics and I paid the doctor 8 cents for his time ( which was 87 seconds).</p>

<p>I was feeling better because I was going to get the antibiotics but then I started worrying that maybe the antibiotic wasnt covered in my plan and that the drugs would cost me $97,000.</p>

<p>And as I was worrying about this, I started thinking…what if the antibiotics dont work? What if I have the flesh eating bacteria? What is it called? OMG! The flesh eating bacteria is eating me up slowly. OMG! I am going to lose a toe. No wait. A foot. A leg. My private parts are going to be eaten away. I am going to die. I am going to die.</p>

<p>“ACA” did this to me. I am going to die and never have sex again.</p>

<p>As I sit here with the bacteria eating me away, all I can think about is how the middle class is screwed because of ACA.</p>

<p>I can see why I didn’t get to read the post. I am sure the unedited version is a lot more colorful.</p>

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<p>The Cave version, featuring Papa, Mama, and Baby Cave Bear.</p>

<p>Papa Bear is very big, and the LAW (carved in a stone tablet) says that Papa Bear must provide insurance for all his workers right away, this year, pronto.</p>

<p>Baby Bear is very small, so Baby Bear doesn’t have to buy insurance for his workers, ever.</p>

<p>But Mama Bear is in the middle and just the right size, so Mama Bear is allowed to wait until NEXT year to insure all her workers. In fact, if Mama Bear wants, she can even ask for an more time, so she won’t have to buy insurance for TWO years. </p>

<p>Papa Bear 1 says: "But I’m a transgendered Bear! I’ve always wanted to be a She-Bear and I was hoping to transition next year.</p>

<p>So the government says: “Well that’s ok, just go ahead with your hormone treatment and surgery and what have you, Give us a paper certifying that you are are transitioning to become a Sow-bear instead of a Boar-Bear and we will also allow you an extra year, just like Mama Bear.” </p>

<p>Now, Papa Bear 2 comes along and says, “That’s not fair! I want more time too!”</p>

<p>The government asks, “Are you also a transgendered Bear?”</p>

<p>Papa Bear 2 says, “Oh no, I am a very big and very masculine bear! But I’ll tell you what: I’ll start wearing a kilt to work every day, and even put on lipstick so then I’ll look kind of like a She-Bear.”</p>

<p>Government says: no, I’m sorry, that isn’t good enough, you’ll have to abide by the same rules as all the other Papa Bears. </p>