Affordable Care Act Scene 2 - Insurance Premiums

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<p>Um, the second one is downsizing to enjoy life, or restructuring for tax planning purposes. Now, those are not illegal yet…but a few more pages of edits and corrections to the law and a small expense for ink to fill the executive pen and that little pesky ‘loophole’ can be closed. L-) </p>

<p>So really, the next step should be to define it as ‘illegal’ for a business owner to choose to make the company smaller because…THEY DON"T WANT TO WORK SO DANGED HARD". Wow. </p>

<p>What if Papa Bear 2 said I am a transgendered bear but I am afraid of surgery and hormones. So although I look masculine, I feel I am just as much as a she-bear as Papa Bear 1.</p>

<p>Some people transition without surgery and hormones, and I understand it’s rude to inquire. I don’t know how bears transition, though. (Very odd-- the last message I wrote, two minutes ago, was also about bears, in a completely different context: me, grizzly bears, middle of nowhere.)</p>

<p>And to put this all into simple, real world terms – we don’t have a flat tax system in this country. We have a complex system full of different rules, and if a taxpayer wants a benefit (whether a credit, deduction, reduced tax rate, waiver of penalty, extra time, whatever) – that taxpayer needs to play by the rules.</p>

<p>As I am self employed, one way I can reduce my income in 2014 is by increasing my business expenses. As it happens, I have two business trips planned for the coming year. I am going to places that I would never go to but for the fact that I have been invited to speak about my work to people I do business with. </p>

<p>I am also planning to travel to other cities for personal reasons. I want to go to my son’s graduation, I want to visit my daughter, and I like to visit my father regularly – and they all live in different cities all very far from me. </p>

<p>I would like to be able to subtract the cost of all that travel from my income as well, but I can’t. </p>

<p>IRS has has rules. They say that for me to subtract the travel costs from my income, the trip has to be for a business purpose.</p>

<p>When I sign my tax return under penalty of perjury, I am certifying to the government, among other things, that all of the expenses subtracted off of my schedule C are legitimate business expenses.</p>

<p>IRS can’t read my mind and IRS has no way of looking at my airline tickets and knowing whether I am traveling for business or personal reasons. They are relying on me to be honest. There may be times when the lines are fuzzy - if I stop by to visit my father on the way home from my business trip to another city in the same state, what kind of trip is that? What if I say that the trip is to attend a business conference, but then I don’t show up to the conference and go sight-seeing instead? Or what if I get on the plane fully intending to attend the conference, but I get sick and end up spending time in the hospital at my intended destination instead of going to the conference… but I am in a city where I have no friends and would never be there but for having planned to attend the conference?</p>

<p>In practice, I could probably cheat if I wanted. I probably could deduct a couple of trips to visit family every year as business expenses and IRS would never notice. I don’t do that, and I won’t do that, because I would not like myself any more if I did – but the point is, IRS is relying on me to be truthful.</p>

<p>But if I had a whole lot of travel expenses deducted off my schedule C, way more than usual, or in an amount that was disproportionate to my income or highly unusual for my line of work – IRS would probably audit me. And I would need to come to that audit prepared to show that the travel really was for business. (For example, I can prove that my planned business trips this year are genuine because I will have copies of the invitations or conference brochures showing that I am scheduled to speak to these groups. I would also easily be able to supply the names and phone numbers of the business people who arranged these trips). </p>

<p>And that is simply how the IRS works. </p>

<p>You can see the dilemma we might have now that the govt has to figure out if Papa Bear 2 is real transvestite or is just faking. Maybe Papa Bear 2 is legitimately confused and he is not entirely sure himself.</p>

<p>CF, thanks for the like.</p>

<p>Calmom, I enjoyed very much your bear stories.</p>

<p>I clicked on like. I dont know if it worked or not. I like your IRS post too.</p>

<p>Texaspg, you did a great job editing my post. A little bit was lost in the edit room, but I know I was pushing it. :slight_smile: You are a good sport.</p>

<p>“that taxpayer needs to play by the rules.”</p>

<p>Who the heck can even figure out the rules anymore. Have you ever tried calling the IRS to have them explain their rules. Even they don’t have a clue.</p>

<p>“I don’t do that, and I won’t do that, because I would not like myself any more if I did”</p>

<p>That’s sweet. </p>

<p>Dear GP: One doesn’t call the IRS to get them to explain tax laws; those who try that are more likely to be giving incorrect or partial information than correct information. One contacts a CPA or tax attorney. And that’s the way it always has been with complex tax questions, and not a consequence of the ACA.</p>

<p><a href=“One-Fifth of New Enrollees Under Health Care Law Fail to Pay First Premium - The New York Times”>http://www.nytimes.com/2014/02/14/us/politics/one-in-5-buyers-of-insurance-under-new-law-did-not-pay-premiums-on-time.html&lt;/a&gt;&lt;/p&gt;

<p>One in five didn’t pay. Looks grim for the Pooch, then, because 80% of 728,000 is 582,400.</p>

<p>Dstark, an anecdote of one: I have a personal, close friend who desperately needed and wanted insurance, but missed the December 15 deadline to enroll. He has very low income and significant health problems, and qualifies for a generous cost-sharing-plan along with a monthly subsidized premium that he views as a godsend. I put him in touch with an insurance agent to get signed up when California extended the time, and he did indeed get the application in on time. But he signed up with Anthem… and he wasn’t able to navigate whatever system was needed to actually pay the premium on time.</p>

<p>He is very grateful to have insurance and did pay to get the policy effective February 1. His health actually improved in January even though he couldn’t go to the doctor, just because it was a weight off his shoulders to know that he would be able to go to the doctor in February. </p>

<p>Knowing the issues about payment, I think there are probably many others like him. I’d bet that 20% of nonpayers includes a significant number of people who were trying their darndest to pay, but just couldn’t figure out how. (Or who DID pay, but found that their payments weren’t received or credited in time…)</p>

<p>I think the numbers probably also include a few who signed up via the exchange, then changed their mind and bought an off-exchange policy, or became eligible for employer based insurance, or who were juggling choices between two alternatives and simply opted to stick with the other alternative. (We have several of those who posted in this thread - Romani is one – she signed up on the exchange, then decided to stick with her old policy until Medicaid expansion starts in her state).</p>

<p>Of course there are probably also some who are deadbeats – they signed up and either changed their mind or just didn’t have the cash on hand when the bill came due – but it’s got to be lower than that 20%. </p>

<p>FWIW, my own insurance company never really got the billing thing straightened out for me. I had to spend a lot of time on hold to make payments by phone. I think I am now signed up for auto-pay, but I won’t be sure until I see the March payment on my credit card.</p>

<p>OK, I take that back – I just logged into my insurance web site to check to see billing info, and THEY FIXED IT! I can see everything – my payment history, my current billing status, the whole enchilada. So that’s one thing I don’t have to worry about. Now if all the other insurance companies can also work out the billing kinks, we might have accurate numbers about payment available come April. </p>

<p>CF, :). </p>

<p>Calmom, I appreciate your anecdotes and agree with you why some people havent paid.</p>

<p>I have been reading that there is one more issue that people havent paid. The bill wasnt due.</p>

<p>Those signees between jan 15 and now dont have to pay until Feb 15 for Mar 1 coverage.</p>

<p>On Obamacare enrollment, insurers don’t share government’s optimism</p>

<p>“Looking at the total of 3.3 million, netting out the non-pays, and listening to the anecdotal carrier reports, it doesn’t look like we have more than a fraction–certainly something less than 10%-- of the previously uninsured,” said Laszewski.</p>

<p>“California and Washington State accounted for about a fourth of the January total with a combined 817,000 enrollees. “However, those two states canceled much more than that as of January 1,” said Laszewski.”</p>

<p><a href=“On Obamacare enrollment, insurers don't share government's optimism - CBS News”>http://www.cbsnews.com/news/on-obamacare-enrollment-insurers-dont-share-governments-optimism/&lt;/a&gt;&lt;/p&gt;

<p>How many times do you have to be told to stop posting this guy’s bs? </p>

<p>“But the rosy portrait shatters under an alternate interpretation by insurance industry representative Robert Laszewski of Health Policy and Strategy Associates.”</p>

<p>That guy is a total political nut case. So how many times?</p>

<p>I am going to post something from Fox. The story tries to be negative…but it is very positive by mistake and the author doesnt get it. :)</p>

<p><a href=“Insurance industry raises questions about new ObamaCare enrollment numbers being ‘inflated’ | Fox News”>http://www.foxnews.com/politics/2014/02/13/insurance-industry-raises-questions-about-new-obamacare-enrollment-numbers/&lt;/a&gt;&lt;/p&gt;

<p>" Aetna has said that 70 percent of their enrollees paid premiums in January, and of those who signed up before January, 90 percent paid their premiums"</p>

<p>So…when it is time to pay…it looks like 90 percent of Aetna’s enrollees pay. ;)</p>

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<p>Wellpoint is Anthem. I’m not surprised they are reporting the lowest rate of paying-- for a long time, many people were reporting that no matter what they did, Anthem wouldn’t accept their payment. Maybe if it weren’t so difficult to pay the Anthem bill more people would do it.</p>

<p>So Robert Laszewski says his nonsense. Poor poor insurance industry…</p>

<p>While …</p>

<p><a href=“ObamaCare Part Of 'Unprecedented' Bounty For Insurers, So Far”>http://www.forbes.com/sites/brucejapsen/2014/02/08/obamacare-part-of-unprecedented-bounty-for-insurers-so-far/&lt;/a&gt;&lt;/p&gt;

<p>"“The revenue growth opportunities in front of us may be unprecedented in the history of managed care and we believe our diversified portfolio positions us to capture our fair share and grow operating revenues at double-digit rates,” Mark Bertolini, chairman, president and chief executive officer of Aetna said earlier this week as the company reported fourth-quarter profits nearly double the year earlier period. “These opportunities include: private exchanges, the potential movement of commercial membership from self-insured to fully insured products; Medicare Advantage growth, as 11,000 baby boomers age into the Medicare program on a daily basis; dual eligibles growth, as up to $300 billion in annual spend migrates to managed care; public exchange growth, which could grow to 25 million members by 2020; and Medicaid expansion, as 15 million additional people become eligible for the program under the ACA.”</p>

<p>Wellpoint has had a lot of problems in NY. Wellpoint has to rebate 3 weeks of premiums for those that signed up on an exchange for Jan 1 coverage. The rebates will be paid in April. I cant remember if off exchange plans will also be reimbursed. I guess Wellpoint did not bill correctly and more…</p>

<p><a href=“http://www.governor.ny.gov/press/02092014-empire-blue-cross-blue-shield”>http://www.governor.ny.gov/press/02092014-empire-blue-cross-blue-shield&lt;/a&gt;&lt;/p&gt;

<p>“Failure to Send Premium Bills and ID Cards on a Timely Basis. Many newly enrolled customers complained that Empire either failed to send premium bills, or else failed to send bills in a timely fashion. Furthermore, some newly enrolled consumers complained that they had not received member identification cards from Empire.
Failure to Ensure that Enrollees are Properly Transferred into Appropriate Plans. Consumers complained that Empire had no mechanism for transferring direct pay enrollees into new coverage.
Failure to Timely Answer or Handle Telephone Inquiries. DFS received reports that Empire was not answering calls from consumers and, in other instances, subjecting callers to unreasonably long wait times.
 
In recognition of these and other challenges faced by their policyholders, Empire has agreed to provide three weeks of free coverage to consumers who enrolled through NYSOH and paid for coverage for the month of January, but did not receive care during that period. Those consumers will receive cash payments equivalent to three weeks of premiums paid. An estimated total of 15,000-20,000 Empire consumers are expected to receive this relief. Under the agreement, Empire has also committed $2 million to consumer education to encourage enrollment of the uninsured and others in health care coverage through NYSOH.”</p>

<p>I like the bear story. Who knew calmom had a sense of humor? I like the flesh eating bacteria story too. I’m still laughing.</p>

<p>I understand what the point is now. Transgendered bears get all the good deals. And dstark will never have sex again.</p>

<p>I am hoping for miracles. Medical breakthroughs so I am saved. </p>

<p>And that nobody ever signs up for ACA again. At least nobody healthy. </p>

<p>I find Robert Laszewski very persuasive. </p>

<p>You know the first thing flesh eating bacteria attack, so it’s probably hopeless.</p>

<p>Then again, it’s likely that the ACA will save you. They’ll have those specialists at Kaiser put you back together in no time. They probably have plenty of corpses laying around, still waiting for a slab.</p>