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Obamacare, the Mandate & Perspective
Author: Raine    Date: 10/25/2013 17:59:38

In June of 2012, The Supreme Court Ruled that the Affordable care act was indeed constitutional. That included the much disputed individual mandate that people be insured. It was upheld. ObamaCare would go forward as written with one exception, States could opt out of the feederal Medicaid expansion. Today I'd like to focus again on the Individual Mandate.
Chief Justice John Roberts joined with the court’s four liberal justices in the ruling, which says Congress had the authority to impose the law’s individual mandate under Congress’s taxing power.

There was one rebuke to the Obama administration: The court ruled that the states can reject the law’s Medicaid expansion.
Many states opted out of the expansion, thus putting the onus of the exchange on the Federal Government. They will not see the benefits of the expansion. Many will be exempt from the individual mandate penalty.

It is beneficial for people to understand the number of people that will be affected by the Individual Mandate slated to go into effect in 2014. That deadline is March 31, 2014. This is the individual mandate. Basically, if you or your family do not have insurance by a set time you will be required to buy an insurance plan or pay a penalty.
Q. I don't have health insurance. Will I have to get it, and what happens if I don't?

A: Under the legislation, most Americans will have to have insurance by 2014 or pay a penalty. The penalty would start at $95, or up to 1 percent of income, whichever is greater, and rise to $695, or 2.5 percent of income, by 2016. This is the individual limit; families have a limit of $2,085 or 2.5 percent of household income, whichever is greater. Some people can be exempted from the insurance requirement, called an individual mandate, because of financial hardship or religious beliefs or if they are American Indians, for example.

How many people will be affected by the Individual mandate? Let's start by looking at who is not required to purchase insurance. Among the exemptions:
These include individuals who will be exempt for religious reasons -- for example, Christian Scientists; incarcerated individuals; undocumented aliens; individuals who can't afford coverage (i.e., their required contribution would exceed 8 percent of their household income); individuals who will be without coverage for less than three months; other individuals deemed to be in a "hardship situation," as will be defined eventually by the Secretary of Health and Human Services (Update: "hardship situations' have been defined); individuals with incomes below the federal tax-filing threshold; and members of Indian tribes.
After that, take away people who are covered by employee-sponsored health insurance and those that will have been deemed to have the basic minimum insurance such as those on Medicaid, Medicare and Veterans Benefits. Let's see approximately how many people will be required to purchase the basic essential coverage: the Mandate.
In the final analysis, the Urban Institute researchers concluded, 18.2 million Americans -- 6 percent of the total population -- will be required to newly purchase coverage or face a penalty. Of that number, 10.9 million will be eligible to receive federal subsidies to help pay for coverage. Just 7.3 million people -- 2 percent of the total population -- will have to newly buy coverage under the ACA and won't receive any federal assistance to pay for it.
2% -- that's it. 2% of people would be required to purchase insurance at face value. Of that 2%, the poorest and most vulnerable are not included. Religious objectors are not included. Prisoners are not included. Small businesses with less than 50 employees will not face penalties. In July 2013 the courts upheld the employer mandate for larger businesses:
The Circuit Court’s decision in favor of the employer mandate came just nine days after the federal government put off for a year, until January 1, 2015, that requirement, which applies to employers with more than 50 employees. If such employers do not have coverage by the deadline, they face penalties of up to $2,000 for each employee.
The first 30 employees are exempt from that penalty. The employer mandate is totally separate from the individual mandate. Often, these two things get conflated.

As stated above, 2% of the population would have to face this penalty should they choose not to purchase insurance. Statistically, they can afford it. When you think about it, the penalty is a pretty sweet deal compared to the cost of purchasing health insurance before the ACA, and the subsequent Insurance Exchange (which was deemed constitutional in 2012) was implemented on the first of October. According to Kaiser Health:
The average cost of a single health insurance premium in 2009 was $4,824. Patients with health insurance provided by their employers typically don't pay the entire cost themselves. For family insurance plans in 2009, workers paid an average of $3,515 of the cost. For single plans, employees paid an average of $779. People who buy their own insurance see lower premiums---though they typically don't have an employer contributing---and higher out-of-pocket costs, according to second survey by the Kaiser Family Foundation of 1,038 people conducted in 2010. According to the survey, the average cost for a single-coverage insurance premium was $3,606. For family premiums, the average cost was $7,102.

The idea of getting everyone insured is meant to help spread the risk, thus reducing insurance premiums over the long term. Last June, we found out that the ACA has played a part in seeing for the first time since the 1970's, a decline in medical care costs. New York - a state that has decided to set up its own exchange by accepting the medicaid expansion - is set to see a 50% average drop in rates.
State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.
This is important. It's why people have been encouraged to get insurance. It's why people are being encouraged to shop around for private insurance: it increases competition. The cost of health insurance is dropping, no matter the reports to the contrary, it is happening.

There are a lot of great and educational stories here.

I just wanted to point out that what is being debated is actually less than 2% of the population that may be required to purchase individual insurance fully out of pocket. 6% total including subsidization, as mentioned above. This all seems like a lot of hoopla to protect the 2%.

People who have no insurance right now -- those people are the ones that really need the ACA. People who already have insurance can shop for more affordable insurance. They will not go without. The many people complaining about the mandate and it's penaly most likely already have or provide insurance. Individuals most likely can afford the penalty, (should they choose) and employers can make the choice: pay the fine or invest in your employees as a worthwhile investment in your business.

It's really that simple. There is nothing wrong with wanting everyone to have insurance in order to access the best healthcare in the world. Until Single Payer comes around, this is what we have. It's a helluva lot better than what we had before when we saw far too many headlines like this: Medical Bills Are the Biggest Cause of US Bankruptcies: Study or stories of people who were denied health insurance due to pre existing conditions. In 2009, it was estimated that 45,000 people died from lack of health coverage In the United States of America.

Putting it in perspective, the mandate is a very VERY small price to pay, literally and figuratively.

and
Raine
 

58 comments (Latest Comment: 10/25/2013 22:44:54 by Raine)
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Comment by clintster on 10/25/2013 13:37:41
Mornin' everybody!

Happy Fridee!

Comment by wickedpam on 10/25/2013 13:43:08
Morning

Comment by Scoopster on 10/25/2013 13:48:23
Mornin' all..

Day 5, still working on no more than two cups of coffee a day. I was in the trenches all day yesterday, and probably will be today too.

Comment by Raine on 10/25/2013 13:50:54
good morning. This head cold has been kicking my ass -- and I just woke up about 20 minutes ago.

Comment by TriSec on 10/25/2013 13:54:40
Two cups of coffee a day?

I go into a torpor if the caffeine content of my bloodstream drops below 80%.

Large Regulah -->

Comment by Mondobubba on 10/25/2013 14:16:13
Way to report badly, NPR.

They interview a woman in New York and a woman in Georgia about their experiences with the healthcare.gov. The woman in New York has problems, the woman in Georgia gets set up and purchases insurance. Problem here would be, healthcare.gov directs the woman in New York to the state's insurance website since New York has a state level exchange. Any problems she's having aren't problems with heathcare.gov

Comment by wickedpam on 10/25/2013 14:20:21
Quote by Raine:
good morning. This head cold has been kicking my ass -- and I just woke up about 20 minutes ago.



<- Tea with honey and a shot of rye (my cousin swears by it )

Comment by Raine on 10/25/2013 14:20:27
Comment by Raine on 10/25/2013 14:23:35
Quote by Mondobubba:
Way to report badly, NPR.

They interview a woman in New York and a woman in Georgia about their experiences with the healthcare.gov. The woman in New York has problems, the woman in Georgia gets set up and purchases insurance. Problem here would be, healthcare.gov directs the woman in New York to the state's insurance website since New York has a state level exchange. Any problems she's having aren't problems with heathcare.gov
This is the kinda stuff that irritates me.




Comment by trojanrabbit on 10/25/2013 14:23:51
Morning all. Is it Fridee?

I'm working today, so I guess it is.

Mrs. Rabbit was moved to a rehab facility last night so they can wean her onto blood thinners and start doing therapy. I figured the best thing to do is let them work with her and I can be there tonight and during the weekend. All the stuff she asked me to bring to her has been packed in my car.

The outpouring of support from friends, family and co-workers reinforces the feeling of how blessed I really am.

Comment by Raine on 10/25/2013 14:29:30
This meme that insurance companies are dropping coverage are actually the result of them not wanting to fall under the new guidelines of the ACA. They aren't - by choice - not meeting the requirements of the exchange.



Comment by Mondobubba on 10/25/2013 14:30:34
Quote by Raine:
Quote by Mondobubba:
Way to report badly, NPR.

They interview a woman in New York and a woman in Georgia about their experiences with the healthcare.gov. The woman in New York has problems, the woman in Georgia gets set up and purchases insurance. Problem here would be, healthcare.gov directs the woman in New York to the state's insurance website since New York has a state level exchange. Any problems she's having aren't problems with heathcare.gov
This is the kinda stuff that irritates me.





Time to twitter bomb or call NPR's ombudsman to point out the problem with the the story.

Comment by BobR on 10/25/2013 14:32:38
Comment by TriSec on 10/25/2013 14:36:49
Say folks, did we talk about Governess Half-Term attacking the pregnant, diabetic lady at the Obama Presser?

I de-faced my RWLM Scouter friend over that this morning. It's Marti Rudy; some of you have tangled with him on my Book of Face before.



Comment by Scoopster on 10/25/2013 14:38:42
Quote by TriSec:
Two cups of coffee a day?

I go into a torpor if the caffeine content of my bloodstream drops below 80%.

Large Regulah -->

Well there's two reasons behind it..

1) Every morning since I got my espresso pot, I've been drinking an entire pot when I wake up (3 shots). On weekends AND days off, that went up to 3 pots a day.
2) As part of an overall change in diet I'm trying to eliminate as much milk as I can. Now I can't stand to drink coffee without milk, I've tried. I think I'll save the espresso for when I have company over - and we can enjoy it black with some Zambuca.

Comment by Mondobubba on 10/25/2013 14:41:32
Quote by BobR:
Hey little girl...



There is a joke about a Mr. Balls needing a brozillian in here somewhere. But, I am too busy looking for eye bleach.

THANKS, OBAMA!

Comment by wickedpam on 10/25/2013 14:42:07
asshole callers today, jeez

Comment by Raine on 10/25/2013 14:42:15
Trolling callers are trolling this morning.

Comment by clintster on 10/25/2013 14:42:30
I'm smelling a new right wing troll caller meme: "You know (insert liberal show host name here), I support Obama and Obamacare, but my premiums blablablablaBLA!

Comment by Mondobubba on 10/25/2013 14:42:45
Quote by TriSec:
Say folks, did we talk about Governess Half-Term attacking the pregnant, diabetic lady at the Obama Presser?

I de-faced my RWLM Scouter friend over that this morning. It's Marti Rudy; some of you have tangled with him on my Book of Face before.




He of the semi-incoherent anti-Tesla comments?

Comment by Raine on 10/25/2013 14:47:14
Quote by clintster:
I'm smelling a new right wing troll caller meme: "You know (insert liberal show host name here), I support Obama and Obamacare, but my premiums blablablablaBLA!

That is exactly what is happening -- I spent a few hours yesterday trying to debunk that meme from the CBS article.

People are being told that thier coverage is being dropped because those companies don't want to comply with the new ACA regulations -- most of those people are being offered better coverage -- and subsidies <-- Guh.

Comment by Raine on 10/25/2013 14:58:17
Comment by TriSec on 10/25/2013 14:58:18
Quote by Mondobubba:

He of the semi-incoherent anti-Tesla comments?


The same.

"This is the parting between you and me. My father is Type-I; you don't know what you're talking about."



Comment by Raine on 10/25/2013 15:08:48
This is the article Momma quoted from on the show -- another one worth bookmarking.

I knew the shit would hit after the first -- I am telling you, insurance companies are trying to squeeze every last ounce out of customers while they can.

Comment by Mondobubba on 10/25/2013 15:09:37
So, how about those Red Sox?


:whispered voice over: He's going with the best lure in his box.

Comment by Scoopster on 10/25/2013 15:13:27
Quote by Mondobubba:
So, how about those Red Sox?


:whispered voice over: He's going with the best lure in his box.

All I'm gonna say at this point is the Cards are doing better so far than they did in '04.

The keystone kops routine they did in the first game doesn't have my hopes up.

Comment by trojanrabbit on 10/25/2013 15:14:27
Quote by Mondobubba:
So, how about those Red Sox?


:whispered voice over: He's going with the best lure in his box.


Didn't I say (I knew I said it somewhere) that everyone would be gloom and doom if the Sox lost Game 2 because the next 3 games were in St L?

The Sox have notoriously not given Lackey any run support all year.

Not that I would know, 8:07 PM games on the East Coast are insane. People who work for a living can't stay up that late and function the next day. I turned it off in the 5th.

Comment by Raine on 10/25/2013 15:15:46
Quote by Raine:
Here this is a good rebuttal to this new caller meme.

Suggestion to bookmark.
Both Independence and Highmark are cancelling so-called “guaranteed issue” policies, which had been sold to customers who had pre-existing medical conditions when they signed up. Policyholders with regular policies because they did not have health problems will be given an option to extend their coverage through next year.

Consumer advocates say such cancellations raise concerns that companies may be targeting their most costly enrollees.

They may be “doing this as an opportunity to push their populations into the exchange and purge their systems” of policyholders they no longer want, said Jerry Flanagan, an attorney with the advocacy group Consumer Watchdog in California.

Insurers deny that, saying they are encouraging existing customers to re-enroll in their new plans.





Comment by Mondobubba on 10/25/2013 15:17:09
Quote by TriSec:
Quote by Mondobubba:

He of the semi-incoherent anti-Tesla comments?


The same.

"This is the parting between you and me. My father is Type-I; you don't know what you're talking about."





As you should have. Ass-hats hating on diabetics.

Comment by Mondobubba on 10/25/2013 15:18:30
Quote by trojanrabbit:
Quote by Mondobubba:
So, how about those Red Sox?


:whispered voice over: He's going with the best lure in his box.


Didn't I say (I knew I said it somewhere) that everyone would be gloom and doom if the Sox lost Game 2 because the next 3 games were in St L?

The Sox have notoriously not given Lackey any run support all year.

Not that I would know, 8:07 PM games on the East Coast are insane. People who work for a living can't stay up that late and function the next day. I turned it off in the 5th.



:yanks back on rod to set the hook:

:excited whisper: He's got a real fighter on the hook!

Comment by wickedpam on 10/25/2013 15:19:19
Quote by Raine:
This is the article Momma quoted from on the show -- another one worth bookmarking.

I knew the shit would hit after the first -- I am telling you, insurance companies are trying to squeeze every last ounce out of customers while they can.



it doesn't help when you have stupid HR people either - when ours has gone up that last couple of years, she would tell people to thank Obama for that.

Comment by trojanrabbit on 10/25/2013 15:19:33
The ladies are fighting over me.....

Since Mommy is not around, Cleo has made me Substitute Mommy and wants to curl up on my left side when I'm sleeping. Sophie, my 4 legged alarm clock, sleeps on my right side. My body became a battleground.

Comment by Raine on 10/25/2013 15:22:25
Quote by wickedpam:
Quote by Raine:
This is the article Momma quoted from on the show -- another one worth bookmarking.

I knew the shit would hit after the first -- I am telling you, insurance companies are trying to squeeze every last ounce out of customers while they can.



it doesn't help when you have stupid HR people either - when ours has gone up that last couple of years, she would tell people to thank Obama for that.
Yes, because health insurance NEVER went up before Obama took office.




Comment by TriSec on 10/25/2013 15:24:08
Quote by Mondobubba:
So, how about those Red Sox?


:whispered voice over: He's going with the best lure in his box.



Spits hook, goes deep.



Comment by wickedpam on 10/25/2013 15:24:22
Quote by Raine:
Quote by wickedpam:
Quote by Raine:
This is the article Momma quoted from on the show -- another one worth bookmarking.

I knew the shit would hit after the first -- I am telling you, insurance companies are trying to squeeze every last ounce out of customers while they can.



it doesn't help when you have stupid HR people either - when ours has gone up that last couple of years, she would tell people to thank Obama for that.
Yes, because health insurance NEVER went up before Obama took office.





exactly - she's an idiot

Comment by BobR on 10/25/2013 15:30:01
Quote by Raine:
Quote by Raine:
Here this is a good rebuttal to this new caller meme.

Suggestion to bookmark.
Both Independence and Highmark are cancelling so-called “guaranteed issue” policies, which had been sold to customers who had pre-existing medical conditions when they signed up. Policyholders with regular policies because they did not have health problems will be given an option to extend their coverage through next year.

Consumer advocates say such cancellations raise concerns that companies may be targeting their most costly enrollees.

They may be “doing this as an opportunity to push their populations into the exchange and purge their systems” of policyholders they no longer want, said Jerry Flanagan, an attorney with the advocacy group Consumer Watchdog in California.

Insurers deny that, saying they are encouraging existing customers to re-enroll in their new plans.


I've worked in the corporate world long enough to know that sometimes employers change not just policies, but insurers from one year to the next if another insurer is offering better and/or cheaper coverage. Do people freak out over that? Why should they be freaking out over this?

Comment by Raine on 10/25/2013 15:45:53
They aren't going to get a penalty unless they are one of the 2% Dammnit all.

I think I may have to rewrite this blog.

Comment by Scoopster on 10/25/2013 16:22:29
Almost out of the work ditch.. My sanity is being held together by mid-90s groove-lounge music. Someone roll one, willya?!



Comment by Mondobubba on 10/25/2013 16:39:19
Quote by BobR:
Quote by Raine:
Quote by Raine:
Here this is a good rebuttal to this new caller meme.

Suggestion to bookmark.
Both Independence and Highmark are cancelling so-called “guaranteed issue” policies, which had been sold to customers who had pre-existing medical conditions when they signed up. Policyholders with regular policies because they did not have health problems will be given an option to extend their coverage through next year.

Consumer advocates say such cancellations raise concerns that companies may be targeting their most costly enrollees.

They may be “doing this as an opportunity to push their populations into the exchange and purge their systems” of policyholders they no longer want, said Jerry Flanagan, an attorney with the advocacy group Consumer Watchdog in California.

Insurers deny that, saying they are encouraging existing customers to re-enroll in their new plans.


I've worked in the corporate world long enough to know that sometimes employers change not just policies, but insurers from one year to the next if another insurer is offering better and/or cheaper coverage. Do people freak out over that? Why should they be freaking out over this?



But Obama said... Right Obama said many times if you like your coverage you can keep it. Did he say anything about your insurance company canceling your policy because it isn't ACA compliant? NO! So STFU.

Comment by Mondobubba on 10/25/2013 16:42:04
Comment by TriSec on 10/25/2013 16:56:28
Virginia PD gets an actual Armored Personnel Carrier. Not a souped-up civvie, an actual piece of army equipment, for "SWAT" use.

Sieg Heil, y'all!



Comment by TriSec on 10/25/2013 17:06:47
Pizza, Ready to Eat?

From recent conversations in this space, it may also be an improvement over what is currently available in DC, too!



Comment by TriSec on 10/25/2013 17:13:13
Comment by Mondobubba on 10/25/2013 17:55:19
Quote by TriSec:
Virginia PD gets an actual Armored Personnel Carrier. Not a souped-up civvie, an actual piece of army equipment, for "SWAT" use.

Sieg Heil, y'all!




Yeah the Army is selling off MRAPs cheap. No, Culpeper Sheriff's department, you didn't need one, you wanted one.

Comment by Mondobubba on 10/25/2013 17:58:22
Code monkey? I just did italics in a post. Now, when I view the blog, all the posts but mine on in italics.

Comment by BobR on 10/25/2013 18:05:12
Quote by Mondobubba:
Code monkey? I just did italics in a post. Now, when I view the blog, all the posts but mine on in italics.

You mixed up the opening and closing tags. Fixed.

Comment by livingonli on 10/25/2013 18:20:07
Another night when I went to bed too late and then crashed into the afternoon. I need a normal structure and I'll need a sleep aid so I can get up early tomorrow for my 12-hour shift.


Comment by Raine on 10/25/2013 18:23:28
Quote by Mondobubba:
But Obama said... Right Obama said many times if you like your coverage you can keep it. Did he say anything about your insurance company canceling your policy because it isn't ACA compliant? NO! So STFU.
Thanks Obama

Read this article.
The insurers in the Blue Cross Blue Shield Association are major players in the individual market. They are readying new product lineups for 2014, according to Kim Holland, the trade group's executive director of state affairs. She expects most existing Blue Cross individual plans to be discontinued.

"They are going by the wayside," she said. "Plans will have to conform to the higher level of benefits."

Consumers buying individual plans will be able to choose between four levels of coverage next year: platinum, gold, silver and bronze.



Comment by Raine on 10/25/2013 18:28:59
****** BLOG IS POSTED *******






Comment by TriSec on 10/25/2013 18:54:43
Given:

1. The ACA has touched off a huge hiring boom in the healthcare industry.
2. TriSec was hired back to a payor on a full-time, permanent basis with full benefits.
3. TriSec had insurance when his appendix attacked him last year, and revealed a cancerous tumour.
4. TriSec didn't die; he is now alive and well and in remission.
5. Mrs. TriSec was also just hired back to a payor on a full-time, permanent basis with full benefits.
6. Mrs. TriSec's plan is cheaper than regular TriSec's plan
7. Because the ACA protects pre-existing conditions, we can all switch without fear of losing coverage and actually save money.

T H A N K S, O B A M A!

The GOP can go to hell.