Serious Questions About Obamacare

CuteOldGuy's Avatar
Ok, I really am looking for answers to these questions.

1. If you don't have to file a tax return, for whatever reason, will you still have to have health insurance or pay the tax?

2. If you are exempt from purchasing health insurance, who pays for your health care?

3. If you have previously been unable to afford health insurance, where does the money come from to buy it now?

4. If you do not buy health insurance and pay the tax, do you have to pay for health care?

5. Are there limits on how high the premiums can be for insurance policies that must cover pre-existing conditions?

6. How does a person qualify for "free health care" that people have been talking about?

I genuinely don't know the answers to these questions. I know how you love to hate me, but I'd appreciate some serious answers as well.

Fuck, I hope this Bullshit will go away. Maybe not IDN. Ozombies will let us know...
joe bloe's Avatar
I'm not concerned about how Obamacare is supposed to work. For the moment, I'm assuming it's going to be repealed. If we fail in November, I'll worry about it then. It's so enormously complex, I don't think anyone understands it. I still can't believe Congress passed, what may be the most important bill in American history, and no one even read it.
TexTushHog's Avatar
3. I know some of the answer to this question, at least in general terms. The first part of the answer is "It depends on your income." There is a sliding scale subsidy, via a tax credit, for families making up to four times the poverty level (or around $80,000 or so). That subsidy is paid first by the Federal government. If you are employed, and your employer is above a certain size, and chooses to either 1) not offer insurance; or 2) offer insurance that is substandard under the terms of the ACA; then the employer is assessed a penalty for each employee that claims the subsidy. That encourages employers to cover employees, and helps employers like me who pay the entire premium for their employees maintain competitiveness. Of course the employer penalty is just one of the funding mechanisms for the act.

4. Why wouldn't you?

5. Not sure what the limits are on pre-existing policies, but there is a high risk pre-exisitng insurance plan. However, there is a serious problem with it in that you have to go for six months without insurance to qualify for it. But this is a temporary program that lasts only until the full plan kicks in in 2014. At that point Exchange plans will cover pre-existing condition applicants and there is supposed to be no price discrimination.

6. I don't think that anybody but the right wing corporate owned media echo chamber has been talking about "free health care."
CuteOldGuy's Avatar
TTH, regarding #5, will insurance companies be required to sell the same policy to a person with pre-existing conditions at the same price as those who do not have pre-existing conditions?

Thanks for answering seriously, BTW.
TexTushHog's Avatar
After 2014, I think the general answer is yes. They will be required to sell policies to those who have pre-existing conditions on the same terms as they would sell to others of the same age group. In other words, if you, I, and 9998 other people are in the same age group and 500 of us have a pre existing condition, the pre existing condition is underwritten across the entire 10,000 person age group, not just those who loose the genetic lottery. It's called "guaranteed issue." Those who don't have the conditions pay a bit more, but those who would have been previously uninsurable get covered.

This is a very big deal to e because I am uninsurable outside a group policy, thus I'm forced to work just to maintain insurance even though otherwise I could afford to retire and live off investments. Of course getting, creating, or keeping some job sufficient to have insurance isn't hard if you are a well off professional. I can go "of counsel" for some firm, let them put my name on the letterhead, come in once a month and reimburse them the group premium. But many in my situation can't just do that, plus, it's a hassle.
I can answer some for you.

#1. NO, even if you file taxes and don't buy insurance, you never HAVE to pay. You will get a penalty issued by the IRS, but Obamacare expressly exempts individuals from prosecution or levies against your assets or wages. No politician would sign on if prison sentences or levies were in the bill, so basically the IRS can send you letters and call you on the phone until the day you die, but that's it.

#2. You will be issued a "bronze level" insurance policy from the gov. Nobody knows what that is yet, have to wait for it.

#6. I don't think the qualifications have been set yet, but if you don't buy insurance, see #1 and #2. I consider insurance to be "free", if you never have to pay for it even if you don't qualify due to income or you get a toothless penalty every year for life.
CuteOldGuy's Avatar
TTH, won't that make insurance more expensive for everyone? I mean, if a person discovers he has cancer, and then decides to get insurance, the risk will have to be spread out among the pool. At this time, the risk can be quantified, and the insurance company can determine approximately how much they will have to pay. If the insured doesn't have to cover the risk with his own premium, then it gets spread out to the pool, correct? Then everyone's cost goes up. Or am I missing something here?
chefnerd's Avatar
As far as #5, this is straight from H.R. 3590. Looks like it should be the same premiums as no preexisting. But then, I am not a lawyer.
‘SEC. 2701. FAIR HEALTH INSURANCE PREMIUMS.
‘(a) Prohibiting Discriminatory Premium Rates-

‘(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--

‘(A) such rate shall vary with respect to the particular plan or coverage involved only by--

‘(i) whether such plan or coverage covers an individual or family;

‘(ii) rating area, as established in accordance with paragraph (2);

‘(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and

‘(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and

‘(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).
BigLouie's Avatar
Here is one honest truth


CuteOldGuy's Avatar
So how much will it cost, Louie? That's the question. How will the cost be determined?
joe bloe's Avatar
So how much will it cost, Louie? That's the question. How will the cost be determined? Originally Posted by CuteOldGuy
It might be more productive to spend our time trying to figure out the best way to kill this monster, instead of trying to understand it. I think it's safe to assume that the new system is going to be a disaster; that's all I need to know. We need sensible healthcare reform that encourages competition and uses market forces to control costs.
This is a very big deal to e because I am uninsurable outside a group policy, thus I'm forced to work just to maintain insurance even though otherwise I could afford to retire and live off investments...... Originally Posted by TexTushHog
Are you saying your beloved France won't cover you when you move there?