Budget Fight: Why Don't The Gop De-Fund Medicare / Social Security?

[Bliz]

Suspect you're right, but how do you do that?

I mean, face it, the insurance companies have a motive for reducing the amount they pay out, and they haven't managed to mandate lower costs. Think the federal government can do a better job at that?

 

Now, I have a theory for something that I think might help.  Maybe mandate free (no copay) diagnostic/preventative procedures?  Encourage people to find out about little problems before they turn into bigger ones? 

 

I don't know if that would work.  But it seems logical, to me. 

 

Good idea.

 

That's part of Obamacare.  No deductible or cost-sharing is permitted for certain preventative services, like blood pressure screening, cholesterol screening, mammograms, contraception, colonoscopies, vaccines, and HIV tests.

 

(unless your plan is grandfathered in)

 

Actually that's been in place since 2010

[rictus58]

http://money.cnn.com/2013/09/20/news/economy/obamacare-penalty/index.html?source=cnn_bin

 

For 2014, the penalty is either $95 per adult or 1% of family income, whichever results in a larger fine. (Income is defined as total income above the filing threshold, which is $10,000 for an individual and $20,000 for a family in 2013.) That's still a lot less than premiums, which are generally $200 to $300 a month on average for a silver plan.

 

So a person making $50,000 would not be eligible for a subsidy and would pay full price -- typically around $2,400 to $3,600 a year in premiums -- for a plan. If he declined to get insurance, he would only be subject to a $400 penalty for the year.

 

[Bliz]

The penalty starts going up quickly after 2014.  That's not a viable long-term strategy.  Plus you're talking about the difference between paying $3k (give or take) for something, or $400 for nothing.  So it's not exactly apples to apples

 

I work for a small business. I pay $130 every two weeks for health care for myself.

If I were to add my wife to my plan, the rate would increase to over $700 every two weeks. Therefore, my wife currently has no health insurance.

The system is broken and I'm not sure that ACA will do anything to change that as I see it.

So, what DOES the ACA do for somebody like me? How will this help somebody like myself? I feel that answer is absolutely nothing.

That is failure.

 

There is one quirk that means ACA wont work quite as well for people in that situation as you might think:  Employer plans are not required to cover spouses

 

They are required to cover the employee and kids, but spouses not required.  I'm not sure whether a spouse would qualify for a tax credit if the employer plan doesn't cover them (you'd think they would) but even if they do, usually an employer subsidized plan will be cheaper than a plan through the Exchange plus tax credit to the extent you qualify.

[bearrock]

Suspect you're right, but how do you do that?

I mean, face it, the insurance companies have a motive for reducing the amount they pay out, and they haven't managed to mandate lower costs. Think the federal government can do a better job at that?

 

Now, I have a theory for something that I think might help.  Maybe mandate free (no copay) diagnostic/preventative procedures?  Encourage people to find out about little problems before they turn into bigger ones? 

 

I don't know if that would work.  But it seems logical, to me. 

 

I think this is where the whole conservative/self-responsibility crowd should have supplied some voice and ideas, but they seem so hell-bent on torpedoeing any major reform under a democratic administration, they became the party of no.  

 

One part where discussion has been lacking in my opinion is the individual responsibility aspect of health care.  ACA incentizes people to stop smoking by allowing rate discrimination for smokers.  But how about we extend the idea to people who get annual physicals, people who regularly work out at the gym, etc.  Consider it akin to people who take defensive driving classes to get better rates on car insurance.  Does it guarantee no accidents?  No, but I'm sure it helps.

 

I think ban on pre-existing condition, annual and lifetime cap has the right idea that we should not punish those who fall on misfortune through no fault of their own.  But how about we reward people who take greater initiative on trying to maintain a healthier lifestyle?  i think the focus should be on what people can control, their actions, as opposed to necessarily results.  I think people can try their hardest and still become sick.  But it certainly helps if people get regular checkups and try to take care of themselves.  

[SKINS@THEGOALLINE]

The new health care law is settled law, deal with it. Unless of course, you (GOP) have a better alternative.

[skinsmarydu]

The penalty starts going up quickly after 2014.  That's not a viable long-term strategy.  Plus you're talking about the difference between paying $3k (give or take) for something, or $400 for nothing.  So it's not exactly apples to apples

 

 

There is one quirk that means ACA wont work quite as well for people in that situation as you might think:  Employer plans are not required to cover spouses

 

They are required to cover the employee and kids, but spouses not required.  I'm not sure whether a spouse would qualify for a tax credit if the employer plan doesn't cover them (you'd think they would) but even if they do, usually an employer subsidized plan will be cheaper than a plan through the Exchange plus tax credit to the extent you qualify.

Even if not covered by an employer, I believe the personal subsidy exists.  Shop, explore, and I know that puts a lot of pressure on individuals.  But with research comes benefit, and you can now find a plan that just suits what you need.  If you're not a smoker, and healthy eating, you can get something that just fits what you need at the time...basics & hospitalization in case of emergency.  Single females with no children have been able to get just "basic female care" for years, but now that'll be offered across state lines where you may be able to find a very similar benefit package at a price you can afford, without taking a subsidy.  Works for everyone, helps employment (since the ACA has employed folks who've taken training courses, thereby creating jobs, to help folks work their way through it).  It could be a win-win.  But with crazies in the background just determined to destroy one half-white, half-black man, who knows anymore.

Like I said, I have hope.  I do.

[Mursilis]

Do you have a choice about having car insurance? No.

 

Of course you do.  Not everyone in this country has car insurance, by a long shot. 

[@DCGoldPants]

Of course you do.  Not everyone in this country has car insurance, by a long shot. 

 

[Slateman]

I HOPE (although I'm not certain) that it will do one other thing.

My hope is that the exchanges, and the dropping of the "pre-existing conditions" loophole, will allow consumers to comparison shop between policies that are relatively equivalent, and allow them to switch companies at will. Hopefully, promoting transparency and competition.

Will it do that? Have to confess I'm not at all certain. I could also see them having the effect of promoting the same kind of "race to the bottom" we see in other competitive industries, where everybody constantly struggles to produce the cheapest product that just barely meet the mandated minimum functionality.

 It will drop the "pre-existing conditions" loophole, however, it will result in substantially higher payments from those with healthcare plans. In other words, those of us who have full time jobs will essentially be taxed at a higher amount to cover those who do not have healthcare plans or would be denied  due to pre-existing conditions. If you think the insurance companies and healthcare are simply going to suck up the cost, I have some beachfront property in Nevada I'd like to sell you . . .

Do

you have a choice about having car insurance? No. You are required to

have liability in case you do damage that will cause someone else harm

or expense. 

 

Not in Virginia

 

"To purchase license plates or decals, you must certify that the vehicle is covered by the minimum insurance requirements or pay the uninsured motor vehicle fee.

 

...

 

The $500 Uninsured Motor Vehicle (UMV) fee, which is paid to the Department of Motor Vehicles (DMV), does not provide any insurance; it only allows you to drive an uninsured vehicle at your own risk."

 

You don't have to have insurance to drive a car legally.

[SKINS@THEGOALLINE]

It will drop the "pre-existing conditions" loophole, however, it will result in substantially higher payments from those with healthcare plans. In other words, those of us who have full time jobs will essentially be taxed at a higher amount to cover those who do not have healthcare plans or would be denied  due to pre-existing conditions. If you think the insurance companies and healthcare are simply going to suck up the cost, I have some beachfront property in Nevada I'd like to sell you . . .

Who is paying for those who don't have health care and go the emergency room with chest pains? The insurance companies? You were talking about beachfront property.

[Fergasun]

Since the House gets to put a rule in place and then debate over the legislation there are essentially two times to argue over the same thing.  Quotes from the Congressional Record:

 

Rep Slaughter (D)

In my home State of New York, premiums for some insurance plans have already dropped by 50 percent. This week, Secretary Sebelius announced that many monthly premiums will be less than $100.  Perhaps most importantly--not something I'm sure everybody knows--the Affordable Care Act flips the script and takes the power out of insurance companies' hands. Instead of having lifetime and annual caps on what the insurance company will spend on your health care, the Affordable Care Act enforces limits on what you will have to pay out-of-pocket for your health care. Does everybody know that? Because when your constituents find it out, they're going to be bummed out at you for trying to kill it.  For example, in 2015, those covered under a group health insurance plan will not have to pay more than $6,350 out of their pocket for medical procedures and medicine. That is such a gift. People will no longer have to go bankrupt to pay health bills

Rep Cole ®

As usual, my friend makes a skillful and thoughtful case in defense of the Affordable Care Act. The problem is that the jury is the American people. They're still not convinced. They haven't been convinced for 4 years.

I wish the kind man would explain how Obama got re-elected if this is so unpopular?  

 

They actually spent much of the time discussing sequester and the damage to the economy from sequester and how both sides want to replace sequester.... (which seems like a lie since they've had a year to replace sequester).  There was also some funny bit about having Bob Woodward in their office and one guy says, "I didn't have Bob Woodward in my office, but I had a kitchen re-modeler in my office..." 

[skinsmarydu]

 It will drop the "pre-existing conditions" loophole, however, it will result in substantially higher payments from those with healthcare plans. In other words, those of us who have full time jobs will essentially be taxed at a higher amount to cover those who do not have healthcare plans or would be denied  due to pre-existing conditions. If you think the insurance companies and healthcare are simply going to suck up the cost, I have some beachfront property in Nevada I'd like to sell you . . .

 

Not in Virginia

 

"To purchase license plates or decals, you must certify that the vehicle is covered by the minimum insurance requirements or pay the uninsured motor vehicle fee.

 

...

 

The $500 Uninsured Motor Vehicle (UMV) fee, which is paid to the Department of Motor Vehicles (DMV), does not provide any insurance; it only allows you to drive an uninsured vehicle at your own risk."

 

You don't have to have insurance to drive a car legally.

Please read your first part again...no one with a pre-existing condition will be denied coverage.

To your second point...the insurance companies have to rebate you if at least 80% of your premium is not spent on your care.  So they do absorb their administrative costs, POTUS spoke on this subject TODAY.

Uninsured Motorist Coverage, as I know to understand it in almost every state on the east coast, covers you if you are injured or if your car is damaged by another motorist who is uninsured.  If you do not carry such coverage and are caused damage by such an individual, you can sue, but if that motorist couldn't afford insurance, you're unlikely to get anything for your injuries, as that person could probably not fulfill their liability to your lawsuit any more than they could afford insurance. 

That's why there's a mandate.  It's for everyone to be responsible for themselves, and get insurance. SO WE CAN ALL BE HEALTHY.

In the days when I couldn't afford health insurance, my mother suggested putting $50-$75 away monthly so if anything happened, I could at least get through an x-ray, casting for broken ankle, etc. Good advice back then...if you'd like to follow the Koch brothers and not get insurance, I'll pass this along with some prayers. 

[Tulane Skins Fan]

Because if they so much as vote on a bill to do that, their party will cease to exist 10 minutes later?

 

Exactly.  Because this is all about winning at the polls.

[DCSaints_fan]

Since Republicans seem to love private insurers so much I'm thinking there should be a bill to 

 

1) Privatize (essentially sell off) the VA

2) Replace qualifying active/retired military personnel automatic insurance with a tax credit equal to the current per-capita spending on the VA

3) Allow those personnel to seek out their own plans, if they don't like the VA insurance

 

This should dramatically improve our troops and veterans health care 

[Bliz]

Since the House gets to put a rule in place and then debate over the legislation there are essentially two times to argue over the same thing.  Quotes from the Congressional Record:

 

Rep Slaughter (D)

Rep Cole ®

I wish the kind man would explain how Obama got re-elected if this is so unpopular?  

 

They actually spent much of the time discussing sequester and the damage to the economy from sequester and how both sides want to replace sequester.... (which seems like a lie since they've had a year to replace sequester).  There was also some funny bit about having Bob Woodward in their office and one guy says, "I didn't have Bob Woodward in my office, but I had a kitchen re-modeler in my office..." 

 

Cole isn't wrong.  Entirely.  The problem for Obama and the ACA supporters is that so far the opposition has done an excellent job of entrenching their selling points.  And whether its incompetence, difficulty of selling something more complicated than a bumper sticker, Pubs stripping out funding for publication and distribution...whatever it is, most people don't know about that limitation.  Most people don't know about the things that are theoretically going to benefit them, and Dems, as usual, are doing a bad job of getting their message out.  So far anyway.  October - January will be very interesting.

[twa]

 most people don't know about that limitation.  

most ins policies have a similar limitation,the HSA plan I'm looking at has a $2,500 out of pocket limit .......is that 6K the limit on the Bronze plan,or the silver or the?

 

I wonder if it will be as fanciful as the ins ones LOL

[Slateman]

Who is paying for those who don't have health care and go the emergency room with chest pains? The insurance companies? You were talking about beachfront property.

 

Taxpayers. Now they will have to pay for everytime someone without insurance gets the sniffles or wants birth control

[SKINS@THEGOALLINE]

Taxpayers. Now they will have to pay for everytime someone without insurance gets the sniffles or wants birth control

 

Not if they're insured. (The snifflers and those who want birth control.)

[Redskins Diehard]

I don't think anyone knows. Early returns from the states have them coming in lower than expected. Also with covering pre-existing conditions you figure they would go up some.

just pointing out that "lower than expected" and "going up" are not mutually exclusive

Since Republicans seem to love private insurers so much I'm thinking there should be a bill to

1) Privatize (essentially sell off) the VA

2) Replace qualifying active/retired military personnel automatic insurance with a tax credit equal to the current per-capita spending on the VA

3) Allow those personnel to seek out their own plans, if they don't like the VA insurance

This should dramatically improve our troops and veterans health care

as a veteran I would say that you are probably right.

[Larry]

Not in Virginia

 

"To purchase license plates or decals, you must certify that the vehicle is covered by the minimum insurance requirements or pay the uninsured motor vehicle fee.

 

...

 

The $500 Uninsured Motor Vehicle (UMV) fee, which is paid to the Department of Motor Vehicles (DMV), does not provide any insurance; it only allows you to drive an uninsured vehicle at your own risk."

 

You don't have to have insurance to drive a car legally.

Nor do you have to have health insurance, under Obamacare.

[alexey]

imho healthcare, education, food, shelter, and birth control are basic human rights...  yeah i know, totally radical of me to think that people should have basic rights not to live like animals.

[twa]

imho healthcare, education, food, shelter, and birth control are basic human rights...  yeah i know, totally radical of me to think that people should have basic rights not to live like animals.

those things are easier to have if the humans don't live like animals

[skinfan2k]

reason why that neither party wants to be the one to cut these categories.  

[chipwhich]

imho healthcare, education, food, shelter, and birth control are basic human rights...  yeah i know, totally radical of me to think that people should have basic rights not to live like animals.

 

Having health insurance great.  What doctors will participate in the ACA?  That's the million dollar question.  Today many doctors shy away from dealing with medicare patients.

I for one would love to not worry about health care after retirement.  Not feeling warm and fuzzy right now.

 

For my business, health care costs to small businesses is skyrocketing due to us having to foot the bill to establishing these exchanges.

 

For those who think by having people insured, they won't be footing the bill for the uninsured...well they are wrong.  You will still foot the bill for the uninsured...just now they will be insured and you will pay for them in rate hikes.

My company insurance costs now that I have over 50 employees in the state of Maryland is based on the health of my company.

Same will be true for the exchanges, once they gauge costs of the members, they will price the insurance accordingly.  You will all eventually be in the system.  They will know your health issues.

My insurance company says on average 10% of my employees drive the price of my insurance.  Meaning in my company, it's the 10% of unhealthy people that make the costs of the 90% without health problems rise.

I suspect that percentage will be significantly higher once everyone gets insurance.  Higher unhealthys = higher prices.

 

Meanwhile everyone in this thread are still stuck on "my party" without much factual background.

[deejaydana]

"Meanwhile everyone in this thread are still stuck on "my party" without much factual background."

 

 

 

 

This sentiment/observation runs thru (& applies to) many of the political threads on ES. Sadly.