The Problem With Obamacare Is Obamacare

If the company you are employed by offers you a group health insurance plan, you are not eligible to apply for an "Obamacare" health insurance policy on the government exchanges HEALTHCARE.GOV.

The ACA is not a Universal Health Care Plan. It's only for the individual market. That would be self-employed people or people who work for a small company that does not offer group health insurance coverage.

So, if you work for a GM, ATT or IBM you can't apply for an "Obamacare" policy. Originally Posted by adav8s28

Employee funded healthcare insurance is basically tax free employee pay.

If there were no employee funded healthcare coverage and all that extra money was counted as income in your paycheck then government tax receipts would go up significantly.

People who have to purchase insurance on the marketplace take a tax hit that other people don’t. Or am I missing something?

People who have to purchase insurance on the marketplace take a tax hit that other people don’t. Or am I missing something? Originally Posted by txdot-guy

That is only if you received help from the government to pay the monthly premium. I believe a family of four that makes more than $25,000 and less than $130,000 can receive help from the government to pay the premium on a sliding scale.

If you are a family of four that makes less than $25,000 you don't qualify for a private health insurance policy. You would be directed to apply for "Expanded Medicaid". The states of Kentucky and Arkansas have the "Expanded Medicaid", not all states do.

If you are a family of four that makes greater than $130,000 you would not get help from the government to pay the premium.

These ranges change from year to year. Back in 2014 when the law was implemented the ranges were a little less.

That is only if you received help from the government to pay the monthly premium. I believe a family of four that makes more than $25,000 and less than $130,000 can receive help from the government to pay the premium on a sliding scale.

If you are a family of four that makes less than $25,000 you don't qualify for a private health insurance policy. You would be directed to apply for "Expanded Medicaid". The states of Kentucky and Arkansas have the "Expanded Medicaid", not all states do.

If you are a family of four that makes greater than $130,000 you would not get help from the government to pay the premium.

These ranges change from year to year. Back in 2014 when the law was implemented the ranges were a little less. Originally Posted by adav8s28

What I mean is employer provided insurance comes from your pay pre-tax income. Those insurance premiums are paid from pre-tax money. No fica or income tax is taken out to pay them.

ACA healthcare insurance premiums are taken from post-tax income. I thought that was one of the arguments for the insurance subsidies in the first place.

Employee funded healthcare insurance is basically tax free employee pay.

If there were no employee funded healthcare coverage and all that extra money was counted as income in your paycheck then government tax receipts would go up significantly.

People who have to purchase insurance on the marketplace take a tax hit that other people don’t. Or am I missing something? Originally Posted by txdot-guy

Yes. Health insurance is deductible if you’re self employed and your business is making a profit. If your employer doesn’t pay for health insurance or you’re unemployed, then you can deduct health insurance and out of pocket medical costs to the extent they exceed 7.5% of your taxable income. Finally, please note the tax hit is more-than-offset for many individuals by the Obamacare credits.

How is Yamstein’s repeal and replace going?!

Well, observing yet again the maggies eating their own, MTG made sure to state that said maggies don't have a healthcare plan to offer in place of the ACA.

It really goes to show how mean spirited and hateful those in the Party of No are. But the maggies refuse to believe it.

Not only was the mandate removed, the amount, was set way too low. When there was a mandate people just paid the penalty instead of getting health insurance.

Republicans axed key components of the bill that destablized it. The first jab was Rubio getting rid of the Risk corridor program.

"Marco Rubio destabilized the Affordable Care Act (ACA) primarily by introducing a provision that blocked government funding to the risk corridor program. This program was intended to help insurance companies manage financial risks, and the lack of funding led to many insurers leaving the ACA marketplaces, which in turn hurt the program's stability."

Another piece that hurt the ACA is removing the penalty by the jobs and tax cut act of 2017. Again it should have been raised, not removed. Penalty should have been around $1200 a year for an individual.

Can anyone give one piece of Republican legislation that would have helped the ACA? Besides the one McCain shot down, cause he knew there was no alternative plan, just a stack of blank paper... Cause as Trump said, "I have to tell you, it’s an unbelievably complex subject. Nobody knew that healthcare could be so complicated" well duh....

This paragraph is from your link:

However, once Obamacare went into effect, premiums increased substantially. Now, around half of people at the income cutoff wouldn’t be able to afford insurance, according to the ACA’s affordability standard, and would deserve subsidies under the original Obamacare framework. The increase in premiums between 2009 and 2025 is most evident for people older than 50, which is why Democrats’ examples of unaffordability frequently include these individuals.

The author of the link fails to mention that the ACA law has changed a little from 2009. The individual mandate to purchase health insurance was removed. By removing the individual mandate, some healthy people stopped buying health insurance on the government exchanges (HealthCare.Gov). This leads to an unbalanced risk pool. When you don't have a balanced risk pool the health insurance company won't be able to make a profit (too many sick people submitting claims). The health insurance company will ask for a premium rate increase for the states that they lost money in. Rate increases have to be approved by the Commissioner of Insurance of each state.

In 2009, a family of 4 that made less than $125,000 got a tax credit to help pay the premium. What Biden did in 2021 was increase the maximum number so that a family of 4 that made more than $125,000 would be eligible for a tax credit to help pay for the premium. The tax credits for higher income people were suppose to expire 12/31/2025. Senator Chuck is trying to get these tax credits extended for at least another year. This is the latest compromise that he has offered.

Republican Congresswoman MTG has relatives that are on Obamacare. She claims to not be a fan of Obamacare but supports having the Biden tax credits extended.

Bottom line by removing the individual mandate the law has had problems that the original designers of the legislation could not anticipate.

Group Health Insurance thru the employer does not have this problem. The risk pool is always balanced. You have mostly younger healthy employees in the risk pool. This tends to be the case especially for a company that has more than 10,000 employees.

HRC had proposed a solution that never went anywhere. That was once you hit age 55 you are eligible for Medicare. Medicare is a true single payer system. Current law you have be age 65 before you are eligible. Originally Posted by adav8s28

The only problem with the ACA is the fact that it didn’t go far enough. Removing the insurance from the system and replacing it with a national health plan for everyone would be the fix we need. Originally Posted by txdot-guy

I would not say “The only problem with the ACA is the fact that it didn’t go far enough…” removing the insurance from the system when it was authored by the insurance companies to protect them and to increase their profits!!

Affordable Care Act, what a joke, who the fuck is it affordable to? My premiums quadrupled, my deductibles tripled!!! Only one good the came out of ACA/ObamaCare and that is the minimization of Pre-existing Condition Unacceptance.

I would not say “The only problem with the ACA is the fact that it didn’t go far enough…” removing the insurance from the system when it was authored by the insurance companies to protect them and to increase their profits!!

Affordable Care Act, what a joke, who the fuck is it affordable to? My premiums quadrupled, my deductibles tripled!!! Only one good the came out of ACA/ObamaCare and that is the minimization of Pre-existing Condition Unacceptance. Originally Posted by ManSlut

It was fucked so hard by Republicans to try to destroy it, ACA became unaffordable depending on income and how you are employed. I think self employed and employees of small businesses got fucked the hardest. Take a self employed contractor that makes a decent salary, and they can end up spending 1000 a month or more for a plan for a small family. A basic single person can be 600-700 a month with a high deductible. Not sure how that works tax wise.

But if you work for a big company this mostly gets subsidized by the group health plan.

Yes "most" hospitals are non profits, however that is misleading as around 40% are for profit. And all hospitals aggressively pursue debts owed for those that can pay over time but wont.

Most hospitals are nonprofits that don't pursue collection of unpaid bills from indigents.

That's not to say that the USA shouldn't have universal health care. Most here probably believe it should. The question is how are you going to get there. And lower costs and improve outcomes. I believe free market solutions with some help from government, or even a single payer system favored by TxDot, would work better than doubling down on what we've got now, which is what Obamacare did. Originally Posted by Tiny

Affordable Care Act, what a joke, who the fuck is it affordable to? My premiums quadrupled, my deductibles tripled!!! Only one good the came out of ACA/ObamaCare and that is the minimization of Pre-existing Condition Unacceptance. Originally Posted by ManSlut

You have made two good points. However, the original legislation contained two mechanisms to keep premiums and deductables low. The individual mandate and the risk corridor program were put in place to keep the policy price low. The republican party had both mechanisms removed.

The individual mandate would lead to more healthy people being in the risk pool of policy holders. The risk corridor program simply reimbursed the health insurance companies for agreeing to sell a policy to individuals who "were already sick". The health insurance companies were not going to sell health insurance to individuals "who were already sick" on the government exchanges without the risk corridor program. As mentioned above Sen Rubio led the charge to get rid of the risk corridor program. The health insurance companies (those that did not drop out) simply asked for increasing rate changes year after year. Thus, your premiums have gone up significantly this year.

To your second point, yes before the ACA was passed in 2010 in the individual market health insurance policies were NOT sold to people with pre-existing conditions (people who are considered already sick).

Until the root cause(unbalanced risk pools) of the problem is addressed premiums will continue to go up.

The risk corridor program simply reimbursed the health insurance companies for agreeing to sell a policy to individuals who "were already sick". The health insurance companies were not going to sell health insurance to individuals "who were already sick" on the government exchanges without the risk corridor program. As mentioned above Sen Rubio led the charge to get rid of the risk corridor program. The health insurance companies (those that did not drop out) simply asked for increasing rate changes year after year. Thus, your premiums have gone up significantly this year. Originally Posted by adav8s28

Adav8 - I'm not sure if I follow your logic here. If the risk corridor program was abolished, wouldn't that improve the health profile of the remaining (non-sick) individuals? If so, shouldn't it have allowed insurers to reduce their rates?

Adav8 - I'm not sure if I follow your logic here. If the risk corridor program was abolished, wouldn't that improve the health profile of the remaining (non-sick) individuals? If so, shouldn't it have allowed insurers to reduce their rates? Originally Posted by lustylad

Problem is a lot of the "non-sick" said fuck it I'll just pay the penalty instead of getting on board. Paying the penalty was cheaper than getting a health care package. Then the mandate and penalty was shot down also. There were lots of moving pieces to get all this working and piece by piece key components were taken out and the system fell apart. All republican doing. They wanted to fix it, but never had a replacement plan. And still don't.

Just a couple of years after Obamacare was enacted, a big part of the problem was elucidated by several doctors working in an Oklahoma surgery center. From Reason TV:



(And very few of our political "leaders" have done a damn thing in the way of making a coherent effort to properly address the issues since then. The progressives' most commonly suggested "solution" has been to pour more and more money down the drain while not lifting a finger in any effort to promote market-based reforms or anything remotely resembling pricing transparency.)

Of course, to some progressives, a healthcare-related fiscal blowout is a feature, not a bug. In their view, outrage over exploding costs may germinate louder and louder clamoring for a single-payer system such as "Medicare-for-all."

Supporters envision this as an inexorable transition from the middlegame to the endgame.

Adav8 - I'm not sure if I follow your logic here. If the risk corridor program was abolished, wouldn't that improve the health profile of the remaining (non-sick) individuals? If so, shouldn't it have allowed insurers to reduce their rates? Originally Posted by lustylad

With the risk corridor program being abolished, the Federal Government does not reimburse the health insurance companies for their losses incurred for selling a policy to people who were already sick. The health insurance companies are still required to sell health insurance to people with pre-existing conditions. An individual with a pre-existing condition can't be denied a policy. This can lead to a unbalanced risk pool. The claims paid out by the health insurance company is greater than premiums collected for a particular state/county. Thus, the premium price for the next year would increase.

When the risk corridor program was in place the Federal Government would reimburse the health insurance company for their loss. The government would get reimbursed for excess profit as well. This link below goes over the risk corridor program.

https://theincidentaleconomist.com/w...isk-corridors/