Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[twa]

http://www.forbes.com/sites/theapothecary/2013/12/14/government-takeover-white-house-forces-obamacare-insurers-to-cover-unpaid-patients-at-a-loss/

we are just winging it now apparently

[chipwhich]

http://www.forbes.com/sites/theapothecary/2013/12/14/government-takeover-white-house-forces-obamacare-insurers-to-cover-unpaid-patients-at-a-loss/

we are just winging it now apparently

 

Well that's one step closer to free health care for all. 

[Wrong Direction]

Sort of on topic...

 

http://www.nationalreview.com/article/366307/ryan-saves-gop-itself-larry-kudlow

 

Ryan Saves GOP from Itself
Ryan-Murray is a political solution, not a fiscal one.

 

Everyone acknowledges that Ryan-Murray is not a great deal. But the fact is, its passage will avoid a government shutdown. That’s crucial.

 

If the GOP wants to retake the Senate and hold the House in 2014, the key issues must be the catastrophic pitfalls of Obamacare and better economic growth. A shutdown would be a distraction. It would take the heat off Obama and Obamacare, and all the Democrats who falsely promised that if you like your insurance and doctor, you can keep them.

...

The purest path for the budget talks would have been a clean bill keeping all the sequestration budget cuts. But the votes were never there in the House. Defense hawks and others would have left that bill short by 40 to 50 Republican votes. And Democrats would never have supported it. Hence the shutdown threat.

...

Fortunately for Republicans, the Obamacare disaster erased the political downside of the shutdown. Paul Ryan understands this.

 

[twa]

Expanded Medicaid’s fine print holds surprise: ‘payback’ from estate after death

http://seattletimes.com/html/localnews/2022469957_medicaidrecoveryxml.html

As fine print is wont to do, it had buried itself in a long form — Balhorn’s application for free health insurance through the expanded state Medicaid program. As the paperwork lay on the dining-room table in Port Townsend, Prins began reading.

She was shocked: If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.

The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said..

;

Unpleasant surprise

People in their 50s and 60s make up about 30 percent of the adults who have signed up for health insurance through Washington’s exchange marketplace, and about 18 percent of adults who have enrolled in health insurance through Apple Health.

Some 55- to 64-year-olds, who may have taken early retirement or who were laid off during the recession, have found themselves plunged into a low-income bracket. Unlike Medicaid recipients in the past — who were required to reduce their assets to qualify — they’re more likely to have a home or other assets.

For health coverage through Medicaid, income is now the only financial requirement.

At first, Prins was pleased at the prospect of free coverage.

But the more she thought about the fine print, the more upset she got. Why was this provision only for people age 55 and older? Why should those insured by Medicaid have to pay back health expenses from their estates when people with just a bit more income who get federal subsidies don’t? Why didn’t she and Balhorn know about this before getting to the application stage?

As Prins began searching for answers, she found that even those trained to help people sign up for insurance under the ACA weren’t aware of this provision, nor were some government officials.

Around the country, the issue has sizzled away in blogs and commentaries from both right and left. The National Women’s Law Center noted the ACA and its regulations prohibit age discrimination in programs such as Medicare and Medicaid.

Dr. Jane Orient, executive director of the politically conservative Association of American Physicians and Surgeons, writing in the The Washington Times, called the recovery provision “a cash cow for states to milk the poor and the middle class.”

“People will think this is wonderful, this is free insurance,” Orient said in an interview. “They don’t realize it’s really a loan, and is secured by any property they have.”

Even states that are now limiting estate recovery, she warned, can change the rules again if budget problems become more intense.

Unclear rules

One reason this snafu has become so troublesome is that ACA rules appear to give those who qualify for Medicaid little choice but to accept the coverage.

People cannot receive a tax credit to subsidize their purchase of a private health plan if their income qualifies them for Medicaid, said Bethany Frey, spokeswoman for the Washington Health Benefit Exchange.

[mikered30]

I heard this morning on NPR that Obama got lie of the year award for his health care lie of keeping your insurance.

[twa]

I heard this morning on NPR that Obama got lie of the year award for his health care lie of keeping your insurance.

 

He should have to share it with his loyal apologists.

 

 

Meanwhile the cluster**** snowballs.....

 

 

Obama administration relaxes rules of health-care law four days before deadline

http://www.washingtonpost.com/national/health-science/obama-administration-relaxes-rules-of-health-care-law-four-days-before-deadline/2013/12/19/81bc3132-690b-11e3-8b5b-a77187b716a3_story.html

 

 

“This latest rule change could cause significant instability in the marketplace and lead to further confusion and disruption for consumers,” said Karen Ignagni, president of America’s Health Insurance Plans, the industry’s main trade group.

Another health insurance official, who spoke on the condition of anonymity because he lacked authorization to discuss the matter publicly, pointed out that the hardship exemption also gives one group the ability to buy coverage whenever they want, rather than during annual open-enrollment periods. As a result, he said, more people might not buy insurance unless they get sick.

[Larry]

Wow.  I'm shocked. 

 

Obama relaxes the rules that people are complaining about, and is immediately attacked for doing so. 

[Gallen5862]

http://www.washingtonpost.com/national/health-science/obama-administration-relaxes-rules-of-health-care-law-four-days-before-deadline/2013/12/19/81bc3132-690b-11e3-8b5b-a77187b716a3_story.html?hpid=z1

 

Obama administration relaxes rules of health-care law four days before deadline

 

 

The Obama administration on Thursday night significantly relaxed the rules of the federal health-care law for millions of consumers whose individual insurance policies have been canceled, saying they can buy bare-bones plans or entirely avoid a requirement that most Americans have health coverage.

The surprise announcement, days before the Dec. 23 deadline for people to choose plans that will begin Jan. 1, triggered an immediate backlash from the health insurance industry and raised fairness questions about a law intended to promote affordable and comprehensive coverage on a widespread basis.

This second change, prompted by a group of Democratic senators — most of whom face tough reelection campaigns next year — goes substantially further in accommodating people upset about losing their policies. The latest rule will allow consumers with a canceled health plan to claim a “hardship exemption” if they think the plans sold through new federal and state marketplaces are too expensive.

The ability to get an exemption means that the administration is freeing these people from one of the central features of the law: a requirement that most Americans have health insurance as of Jan. 1 or risk a fine. The exemption gives them the choice of having no insurance or of buying skimpy “catastrophic” coverage.

Until now, the law allowed people younger than 30 to buy catastrophic coverage — an exception to the law’s benefit rules in an effort to attract young adults who have been particularly prone to avoiding coverage in the past. The law also has allowed hardship exemptions for people 30 and older who could not afford the regular coverage.

[chipwhich]

Wow.  I'm shocked. 

 

Obama relaxes the rules that people are complaining about, and is immediately attacked for doing so. 

 

 

It's a moving pig constantly getting lipstick applied.  What you want?  A cookie?  We all new he had to relax the rules, he needed to delay the thing for a year, every milestone we miss screws up something else.

[Wrong Direction]

The stories will change, and be more negative, post January 1. That's when people lose their Dr., when Dr.'s don't know who to bill, when patients experience huge deductibles, and when those cancellations are effective.

 

The bureaucratic story has been unfolding. The human interest story is about to hit.

[nonniey]

OK is there anyone that posts here who formally supported Obamacare now in opposition? Just curious I think we have become so partisan in our support (both sides) that even failure will be reinforced because it is what one previously supported, or it is from the side one supports. 

 

Bottom-line  Obamacare is a disaster that is not quite yet a catastrophe, but that is coming unless those who supported this policy turn around. The individual insurance piece has failed which covered 5-8% of the population. Next year the employer piece covers over 70% of the population and that is where the catastrophe lies. The President's delay of this part for a year does present the opportunity to reverse course. Can it happen or is he so tied to it he'll go down with the ship and take us all in him for a longshot hope that somehow, someway the policy will work? 

Edited December 21, 2013 by nonniey

[Kilmer17]

So people who lost insurance, won't be penalized this year if they don't buy it. But yet of they don't buy it now, and get a serious disease, they can still buy it later because the rule about pre existing still applies.

So why would ANYONE buy it until they needed it?

[chipwhich]

OK is there anyone that post here who formally supported Obamacare now in opposition? Just curious I think we have become so partisan in our support (both sides) that even failure will be reinforced because it is what one previously supported, or it is from the side one supports. 

 

None of the pro Obamacare crowd on this board would dare say a bad thing about it.  Gotta keep that partisanship going.

[skinsmarydu]

Because you might bleed all over your paperwork?

[Kilmer17]

Because you might bleed all over your paperwork?

Picturing the knight in the Holy Grail

[twa]

Because you might bleed all over your paperwork?

reminds me of the time I sliced my wrist at work,went to a ER and they wanted paperwork filled out before treatment

when I let go of the pressure bandage it filled out more than my paperwork.

  amazing how they change priorities with the right prompting 

 

 

 

they still have to provide emergency care and under most plans you would be the one paying to stop the bleeding even if insured.

 

you would lose applying it to your deductible

[skinsmarydu]

amazing how they change priorities with the right prompting 

The Friday that Boston was hunting the younger bomber down: I had to go to the "doc in the box" for a work excuse & medicine for a chest infection...a lady in line behind me was bleeding from a cut on her hand, it was dripping from the plastic bag she had over it, and me being me, I let her go ahead of me in line, just common sense, I thought...she thanks me, but other folks complained about the line being interrupted. I swear, one of my bigger facepalm moments.

[mikered30]

Obama granted a last minute 24 hour extension to sign up for January 1st coverage.

[twa]

kinda interesting and informative

 

http://www.politico.com/story/2013/12/irs-could-face-blame-for-obamacares-unexpected-tax-bite-101574.html?hp=t1

 

Obamacare’s rollout dented the Department of Health and Human Services in just the first month. Up next year: the Internal Revenue Service.

A key piece of the health care law gives Americans making less than 400 percent of the poverty line subsidies to buy insurance. But if buyers don’t alert the insurance exchanges to big life changes throughout the year — like a divorce, promotion or new job for them or a spouse— they could wind up with sticker shock at tax time.

Continue Reading

It’s a new responsibility for this group — many of whom are just struggling to sign up

..

Right now, the IRS does explain the issue on its website, but consumers would have to be looking for the information to find it.

All experts interviewed on the topic worried that most tax credit recipients do not have a clue about the new reporting responsibilities, noting that even policymakers are still trying to grasp how the process works.

 

In California alone, 38 percent of tax credit recipients are projected to have to pay back more than $850 — if no income changes are reported during the year, according to a September Health Affairs study.

Most repayments would likely mean smaller tax refunds, rather than a new tax bill. That’s because those most likely to use the credits receive around $3,000 in tax refunds each year, said Ken Jacobs, a University of California Berkeley professor and co-author of that study.

Still, a smaller refund can bring hardship for this population, whose members often rely on the annual tax refund check to help pay basic bills.

 

Individuals have the option to get their Obamacare credits in advance, or they can wait until the year ends and bereimbursed during tax season for premiums they paid the year before.

Tax preparers expect individuals to choose the so-called “advanced” option since many simply don’t have the cash flow to pay the full premium costs upfront.

The true-up process is known among wonks as a type of “reconciliation” — a term with little meaning to the uninsured.

“For the rest of us, everything has been done through our employer in terms of our tax withholding … and if my income changes, my tax withholding is adjusted automatically,” Jacobs said. “In this case … you have to actually go in and report.”

..“People in lower-income families may be working one or two jobs, or picking up shifts,” said Lynn Quincy, senior policy analyst for Consumers Union. “If there comes an option to make more money, they’ll take it.”

Her group is trying to educate subsidy recipients about the new regime.

“Consumers struggle with tax concepts to begin with, and these new tax credits for health insurance layers on additional features they haven’t seen before,” she said.

A sidebar in one of Consumers Union’s brochures reads, “AVOID REPAYMENTS!” and tells a hypothetical story of a couple who qualified for a $4,800 subsidy in January. But when the wife got a new job in August, “We forgot to tell our Health Marketplace.”

They had to pay $2,000 back at tax time.

Policymakers realized the repayment risk when they wrote the law, so they capped the size of the clawback to protect individuals from large repayment liabilities (although lawmakers have raised the cap twice to find government budget savings).

Taxpayers within 200 percent of the poverty line only have to pay back a maximum of $300 per individual and $600 per family. That increases incrementally to $1,250 per person and $2,500 per family up to 400 percent of the poverty line.

But if credit recipients wind up earning more than 400 percent of the poverty level — about $45,900 per person or $94,000 for a family of four, the cutoff for qualifying for credits — the protections disappear and they have to pay back every penny.

That could mean thousands of dollars.

The same applies for situations where a subsidy recipient gets a new job with health insurance. He would have to notify the insurance exchanges to halt the credits, or pay them back the next year. That’s because ACA requires those who have the option of employer-provided health insurance to take it.

Read more: http://www.politico.com/story/2013/12/irs-could-face-blame-for-obamacares-unexpected-tax-bite-101574_Page2.html#ixzz2omjAQpnJ

[chipwhich]

Libs trying by any means necessary to get anyone to enroll in this mess. Hope one of these videos goes viral.  You can't make this stuff up.

 

http://blog.sfgate.com/nov05election/2013/12/24/hottest-obamacare-ad-ever-lgbt-division/

[skinsmarydu]

as to post #1719, if your taxes are paid correctly through the year, you're rewarded with nothing except being a responsible taxpayer.

No refund, you only gave up your share, and are not angry that you loaned the fed your money for no interest.

No bill, you still only gave up your share.

They can't take it from you later if they've had it all along.

[chipwhich]

as to post #1719, if your taxes are paid correctly through the year, you're rewarded with nothing except being a responsible taxpayer.

No refund, you only gave up your share, and are not angry that you loaned the fed your money for no interest.

No bill, you still only gave up your share.

They can't take it from you later if they've had it all along.

 

No what it is saying is you will have gotten a benefit for which you have not used, therefore getting higher paychecks due to untaxed money.  At years end you will owe it all back to uncle sam.

[Bang]

I have had no health insurance for about 20 years.

October 1 I went down to our local library where the state of MD had set up sign-up stations, and signed up.

My wife also signed up.

Same day they call us and tell us that we need one more piece of info from my wife, so we took it back down to them.

We were told in a few weeks we'd get a package that would explain our options and we could choose a plan.

3 weeks later they call up and need the same piece of info from my wife that we drove back down to give them.

Nothing.. nothing... nothing...

3 weeks ago I get a call on a Sunday morning from someone saying they were from the MD exchange, and they needed my income info, tax returns, etc. IO said they already had it, and she said there must be some error, she just needed a small piece of info, and ifi could just give it to her.. blah blah blah.

red flag went up, I said no, i won't just give it to her over the phone.

Oh well you can fax it to me, she says, let me give you the number.

I said NO, why don't you send me an official letter thru the mail and I'll send it to you then.

Click. She's gone.

Anyway, i am STILL not registered. i went down the DAY they said do it, and they have YET to get me in the system. We find this out 2 days before the deadline, and of course, the website does not accept the password they give us over our frantic "WTF IS GOING ON" phone call does not work, and after 3 tries the website security kicked in and locked us out. apparently THAT works.

So here I am, still uncovered, still unregistered, and an attempt was made on my identity through it.

Yay.

~Bang

[No_Pressure]

From all of my experiences with this crap (and no, I don't have time to elaborate), it is the worst of both worlds. That is to say, it neither brings the actual admirable aspects of socialized health care, or the useful aspects of free-market health care. It's a disgusting merger of bureaucracy and corporate health care. It's such a ****ing disaster, and since they neither changed enough by implementing it but changed just enough to somehow create a system most people dislike even more than the prior one, I'm totally looking forward to the day when this stuff all goes away. Either go a full measure or scale it back, but this half assed **** is supremely frustrating.

[Larry]

It is, I think, a valid conundrum.

How much subsidy people get, is determined by their annual income. But, they don't know what their annual income is going to be, till the year's over.

How do you deal with this?

I can think of several possible ways, none if them really all that good.

Make people's subsidy based on LAST YEAR'S income? Seems simplest. Maybe an exception whereby somebody who, say, gets laid off, can get his subsidy recalculated, based on his new, lower, income?

Maybe make the "Obamacare year" start on May 1st, or some such, so people can file their taxes, and then calculate their subsidy?

Maybe have people ESTIMATE their income? I'm sure we can all see potential problems with that idea. Although the IRS already has rules in place for requiring people to do that, with estimated tax payments. And rules in place for enforcing it.

Maybe make it so that, when people file their taxes, if it turns out that their subsidy was too big or too small, then they "fix it" at tax time? (Although, I could see a problem if they're handing out PENALTIES for too big a subsidy, without demonstrating that the taxpayer did something intentionally wrong).

I agree. It's a tough thing to do, fairly.