<p>I have insurance through my employer. How will this affect me?</p>
<p>“No, it’s like being happy that I HAVE a mortgage with no government help, and a slight tax advantage, as opposed to living in a government subsidized, Section 8 rental.”</p>
<p>Let me fix your analogy. It’s like having a mortgage with no govt help for which I am a paying a much higher rate with a slight tax advantage, and I still have to live in a govt subsidized, Section 8 rental.</p>
<p>riporin- it removes lifetime or yearly caps, your children can stay on the plan to 26 </p>
<p>I also have employer coverage and expect no negative change.</p>
<p>Riporin, it depends on your employer. I would imagine in a short period of time they will be talking to their agent about renewing your policy. They can renew before Jan 1 and postpone the day of reckoning for a year. Or they could drop their plans and adopt an Obamacare-compliant plan for 2014. If they do that, they will have a number of options depending of whether your company has more than 50 full-time employees. You might end up with plans with much narrower networks or even higher premiums depending on your age and if your spouse and children are covered by the plan. You will probably find out when you have your open enrollment period.</p>
<p>Yes, goldenpooch, that analogy beats anything I could come up with.</p>
<p>Look, I am the eternal optimist, but honestly when people’s taxes go way up, or interest or health insurance…or the cost of anything skyrockets, nobody thinks, “Oh great. Hey, I’m just so lucky I’m not homeless and eat out of a dumpster. I’m so happy I can pay more money.” The only people who actually think that YOU should think that way are the ones who aren’t taking much of a hit.</p>
<p>The reality is, there are winners and losers in the ACA. There are people who will get health insurance for far less, and others who will be forced to pay far more for worse policies…plus increased taxes, and potentially lose their employer based coverage. And those people who are winners should really just be grateful for those who are paying for the ACA, not try to come up with reasons why people shouldn’t be unhappy doing so. It just doesn’t help to have the attitude of, “I come out better, so tough luck for you.” It would be better to be appreciative and understanding of the sacrifices and additional cost that others are taking on to support this program. I personally am fine with it, even though I know it will cost me a boatload in taxes in the future. Someone has to pay for it. But I know I’d be unhappy if my company also dropped my insurance, and I was forced to pay far more for far less. There’s really no positive spin on that.</p>
<p>Goldenpooch, haven’t seen any enrollment info yet. My company has about 6000 employees.</p>
<p>busdriver11, thanks for your comment. It actually helps to have others who understand our plight.</p>
<p>Someone asked a few pages ago if the out of pocket maximum includes the deductible amount, the answer is yes, in my experience, though you should be able to see that, if you look at plan details, to confirm.</p>
<p>My state outlawed gender rating for disability policies years ago. There were winners (women) and losers (men) in that one too. </p>
<p>For a couple of years we had the choice of a PPO or a high deductible health plan through H’s employer – I was pretty surprised when I ran the math to find that the high deductible plan had a much lower OOP cost for our family than did the PPO plan. (We didn’t have to pay a premium for the high-deductible plan, but did have to contribute a couple of hundred a month toward the PPO plan if we wanted to keep it.) It has certainly made me a much sharper consumer.</p>
<p>The point is, the “losers” are for the most part already better off than the “winners” – who often are “winners” by virtue of the fact that they are scraping buy on minimal incomes or have long since been priced out of the market because they have serious health problems, or simply because they have a medical history that looks like they are at risk of developing serious health problems. </p>
<p>On the subsidy end of things, there is in an income cut off. There’s a little bit of a quirk at the edge of the upper limit, but there’s also a quirk and a steep bump at the 133% income mark. The tax system has always had all sorts of credits and deductions that phase out at certain levels. The quirks happen simply because the schedules need to be developed through legislation, and the numbers that seem to work at the time that the CBO reviews them may not work so well in real life years down the line.</p>
<p>You want to know something really unfair and quirky? It’s the teensy amount of asset protection under FAFSA that I could get as a single parent, which was well under half of what the asset protection available to married couples. </p>
<p>The quirks are just how the tax system has always worked. But the bottom line is that the people on the upper range of the income are also far more likely to be able to take a variety of tax deductions that the poorer people can’t afford to take – that person with the $19,000 income really is making only $19,000, but the person who gets the benefit of the subsidy based on a $45,000 income might easily have an income of $45K PLUS a $5000 IRA contribution PLUS a $2500 student loan interest deduction, etc. </p>
<p>No one likes paying more for insurance but before ACA there were no protections for anyone. You might have employer provided health insurance, but that would disappear if you lost your job. If you got seriously injured or very sick, you were very, very likely to lose your job. You might have been able to buy insurance on the private market, but the private insurers had the ability to price you out of the market, and typically had upper limits on payouts. </p>
<p>All of those people falling off at the bottom – the ones who couldn’t afford or couldn’t get insurance – were becoming a drag on the economy overall and on the whole health care system, driving up costs for everyone else. The reason that the hospital charges $65 for a piece of plastic tubing is to recoup all the lost dollars for the nonpaying patients in the emergency room. </p>
<p>It’s easy enough to qualify for subsidies – all you have to do is reduce your income. That may actually be an attractive choice for people who are in a position to consider early retirement. But most people on the upper side of the economic spectrum also realize that it’s better to maximize their income even if that means that they aren’t eligible for some types of government benefits. </p>
<p>Again, there have always been cutoffs for benefits, often at very low levels. People working at minimum wage jobs who could’t afford to take a slightly higher paying job because their kids would be kicked off of Medicaid – or situations where an extra $50 in income in a month results in the loss of eligibility for $350 worth of food stamps. </p>
<p>So basically, the gripe at the top end of the range is that you aren’t immune from the same life problems that the majority of people have been struggling with for years, one way or another. </p>
<p>The only difference is that in the past the system was structured so that the richest people would be the “winners”, and the people facing the greatest life barriers and struggles would be the “losers.” Now they’ve leveled the playing field and that means that some of the people on the top end of the economic spectrum are feeling a little bit of a pinch too.</p>
<p>calmom - thanks for post 1030. I understand how the deductions on 1040 work now with a cost over 10% of AGI. What I don’t get it is the self employed being abled to write 100% off. </p>
<p>Is there a difference between how taxes work for self insured w-2 employee vs someone who is self employed in terms of how these deductions will work?</p>
<p>somemom, out-of-pocket maximum under ACA DEFINITELY includes the deductible. That’s why I think the Bronze is the generally the best deal for full-payers – the out-of-pocket max is the same and you’ll reach it faster – whereas those on other plans are paying almost as much as the Bronze deductible in their monthly premiums – and of course the premium dollars don’t apply to the out-of-pocket maximum. </p>
<p>The only exception for full payers would be in situations where they have predictable health costs that are pricey but not high enough to hit the maximum, such as someone who is on costly prescription drugs. That person might be better off to be on a plan that will let them have their prescription drug benefit right away, rather than having to spend half the year paying out of pocket for drugs that would be covered under a copay on a Silver or Gold plan.</p>
<p>texaspg, the self-employed can usually take the self-employed health insurance deduction - line 29 on a 1040. This has been available as 100% deduction for many years – it was intended to put the self-employed on par with employees who are not taxed on the value of their health insurance benefits. In other words, you might have a job with great health insurance that your employer is paying $8000 a year for – that’s not income to you, so you don’t have to pay tax on it.</p>
<p>But I’m self employed and have to buy insurance on the private market. So maybe I end up with a policy that costs the same – $8000 (and probably covers less, but that’s beside the point). If you and I both made $50,000, but you are getting $8000 of health insurance tax-free from your employer, and I have to pay $8000 out of my $50K for the same thing - then I am earning $8000 less than you but paying the same tax.</p>
<p>So it’s equalized by simply giving me a way to avoid paying tax on money that I earn that goes toward health insurance. (It has to be on earnings – if I have a business loss I don’t get the deduction). </p>
<p>So that is simply the way the tax law has been for awhile. It’s nice to have, but it still simply puts a self-employed person on the same tax footing as an employed person with health insurance.</p>
<p>
Yes, the self-insured w-2 employee would only have the potential schedule A deduction for medical expenses - which going forward is only available for medical expenses beyond 10% of their AGI.</p>
<p>That’s actually one factor I considered in choosing between self-employment vs. part-time wages. That is, I have a regular client who essentially pays me a retainer and would be glad to treat me as a part-time, hourly employee as an alternative --but would not provide health insurance – I felt that I am better off working as an independent contractor. (That’s clearly proper – but it would be proper either way – there is nothing to prevent a company from paying W-2 wages to a part-time occasional worker.)</p>
<p>So calmom, I do understand your points. But really, here it is. I would like to help and make available excellent health insurance to those who don’t have it. I am horrified by the things that people have suffered, it is incredible. But it doesn’t make me feel better that those who have wonderful health insurance to pay far more, or to lose it. “Level the playing field.” what does that even mean? If you have been doing well so far, for some reason it is better for those who have been struggling, to make it worse for you? How does it help anyone? I never understood that, even when I was very poor.</p>
<p>I guess I just don’t get it. It’s like education. I would love to improve things for kids who are struggling or have a raw deal at the bottom end of the spectrum. But I don’t think it would benefit anyone by pulling the kids at the top down, to, “level the playing field.” I just want to raise everyone up. It seems like we could all pay more to help others, but there is no reason, other than ideology, to make things worse for others. Even if I lost my job and had no health insurance, there is no way I would feel satisfied and happy that others were now forced to get a worse deal to “level the playing field.” I can’t fathom dragging others down to build myself up. I will never get it.</p>
<p>I agree with busdriver, however, I would be much happier if tens of millions of people weren’t going to remain uncovered and the problems of access in some areas had been addressed. I am a compassionate woman, I do a lot for people who have less than I, of my own volition, with my own time and with my own money. But I am worried about the unintended consequences and more worried about the intended consequences that haven’t been communicated. But I am waiting and hoping that more people will be helped than harmed.</p>
<p>I’m with you there, zoosermom! I still am hopeful.</p>
<p>I would like my worries to be unfounded. But I wonder if the people (cc and not) who defend the ACA to the point of abusiveness ever worry that good intentions sometimes don’t get the hoped for results. I can’t understand how anyone of goodwill isn’t worried. But I am a worrier.</p>
<p>I dont know why you are hopeful busdriver11. </p>
<p>You cant subsidize a group of people unless you take from others.
The net result from saying dont take from others is you dont subsidize the poor and lower middle class.</p>
<p>You have to choose. Subsidize the poor, and take from others, or dont subsidize the poor.
Those that say they dont want to take from others have made their choice. </p>
<p>The argument against not taking from others would be stronger in my opinion if that argument was not made by those with subsidized healthcare. Kind of like those that live in glass houses shouldnt throw stones.</p>
<p>There are many people that actually are willing to pay more to help others.
If you dont want to pay more, you dont want to pay more.</p>
<p>One of the arguments is I have my subsidy. Your subsidy puts my subsidy at risk. I dont want your subsidy to put my subsidy at risk. Therefore, I am against your subsidy. This argument is honest. </p>
<p>A lot of the arguments are mathematically impossible. I dont know what is wrong with the truth. At least geeps is honest.</p>
<p>thanks calmom. I guess if I wanted to go independent, declaring myself self employed seems the way to go go for insurance costs.</p>
<p>Yes, dstark, I don’t know what is wrong with the truth either. I am completely for the truth. I am hopeful because that’s just my personality, I am always hopeful. I actually am not for subsidies, tax writeoffs for companies for health insurance. Take them back, and let the chips fall where they may. I am also not talking about my personal situation, because even if I did have to pay the 20K in my state to attempt to match my current policy, it wouldn’t be a huge deal. </p>
<p>I’m fine with taking from others to subsidize those who need it. Totally. But I don’t see why it is necessary to pull everyone down in order to do so. Why not just subsidize people who need the insurance, and that’s it? Why is there a satisfaction in making everyone have the same bad policy as everyone else?</p>