Will the Health Reform Really Help Americans?

reply to post by maybereal11


Ashley concern is real, fair and is not rant. Most of Americans are asking the same question.

If the promises of great insurance for all was so good, then, why the study done in Massachusetts show that people are still no able to afford to use their insurances due to higher deductibles, premiums and out of pocket expenses.

See just because the government tells you is going to be great for you it doesn't mean that will actually work.

Obviously citizens in Massachusetts are finding out the hard way.

Still the biggest problem is that is no regulations on private insurances with the bill and expect none in the future, after all they made sure is stay as profitable for them as possible.

Premiums will not be controlled and people will have to take whatever is offered to them because is Mandatoryregarless if is cost efficient for them or not.

If they really cared about us and not about profits then all they needed to do was fix the over pricing that is going on with hospitals, create a few laws here and there. I mean screw health insurance all together, my uncle was beaten near death and didn't have insurance and after his few weeks of care he was presented with a bill of over 300k dollars. It's not like they installed some special battery-powered electromagnetic Iron Man like device inside him. Hospitals shouldn't be charging so much for every thing. Fix this and all is well.

This is just more concentration of our economy into gov't hands, first the banks and insurance companies, then the auto mobile industry and now this. This gov't is becoming an all controlling corporation. 1984 on a global scale is escalating. Don't be surprised if in ten years we have cameras watching us everywhere we go.

[edit on 31-3-2010 by Sheeper]

reply to post by marg6043


Hey Marge...We don't always agree, but I view you as honest.

In that light I won't be snarky. Please re-read my post. See the links.

Premiums are capped for families at risk of not being able to afford them. There are out of pocket subsidies as well. this bill is not a Mass. twin.

Originally posted by marg6043
reply to post by maybereal11

 

Premiums will not be controlled and people will have to take whatever is offered to them because is Mandatoryregarless if is cost efficient for them or not.

I will try again...Marge, lets have an honest discussion...

The government intends to cap premiums for people who make below a certain income. For people who buy insurance on the exchanges, a family of four making $88,000 would have a cap of 9.5 percent of their income. Lower incomes would have lower caps.

www.politifact.com...

if your income is below 400 percent of the poverty level, your out-of-pocket health expenses will be limited..

GREAT ONLINE HEALTHCARE REFORM CALCULATOR
www.kaiserhealthnews.org...

For a family of four making up to 88k Premiums will be capped to no more than 9.5% of income. Families of four making 60K capped at 8.69% of income. 30k capped at 3.18%...play with the calculator.

Lastly...YOU CAN OPT OUT OF HAVING HEALTHCARE IF IT IS A FINANCIAL HARDSHIP TO YOU AND YOU CAN DEMONSTRATE IT.

So if you genuinely cant afford it...then you don't have to get it.

If you can almost afford it they will chip in so you can get it.

Subsidies are available for both Premiums and Out of pocket expenses for those that are struggling.

AND Premiums are capped for anyone making up to 4 times the poverty level.

I don't mind folks being opposed to the bill...but is honesty counts.

reply to post by maybereal11


Basics? From my understanding the people that passed this trash didn't know the basics. This legislation was rammed through Congress, most didn't even bother to read it. Just like the Federal Reserve Act of 1913, don't read it, just pass it. The Congressional mantra for those that didn't understand and were on the fence about passing was: "pass it now, we'll fix it later." You must be the only person in this country that understands it, therefore, I must defer to you.

But, like everything the government does, it isn't supposed to be understood. A good con artist makes things as confusing and complicated as possible, so as to make it impossible to prosecute them for their fraud (Goldmansachs and their default swap nonsense.) Much like the IRS tax code, we aren't supposed to get it, only aquiesce to the powers that claim the authority and power to understand it, while enforcing it. How do the common people protect themselves against something that they don't understand, they are forced to defer to an authority or pay the price? It's like your parents telling you to do something because they said so.

From my understanding, this whole thing will be run by the IRS, which will determine who or what gets these subsidies based on your income and taxes. These subsidies will be in the form of a tax break... they may not call it a tax break, but that is essentially what it is. And just what the people of this country need, more taxes and more gestapo IRS.

Originally posted by AshleyD

2). SOME CANNOT AFFORD TO PAY THEIR DEDUCTIBLES OR USE THEIR INSURANCE

Although far more Massachusetts residents have health insurance coverage than residents nationwide, a significant portion of Bay Staters are still struggling to pay for needed healthcare, a new survey shows...

Thirteen percent of residents with insurance said they were unable to pay for some health services in the past year. The same percentage of insured people said they did not fill at least one prescription because it was too expensive or their insurance copayment was too high. The numbers rise to 14 percent if both insured and uninsured residents are considered.

If you can't afford to buy health insurance you can either...acept government subsidies to do so or declare financial harddship exemption...How is that not getting through?????

13% of MA residents with insurance said they were unable to pay for "some" health services last year?

This bill is not MA...but let's for the sake of discussion swallow that bit of rhetoric..

13%? Lets compare to the USA at present..

"The percentage of households that had difficulty in paying for care in the last year was statistically unchanged between March and April (about 25 percent)."

They found 40 percent of all households planned to postpone care in the coming three months,

www.reuters.com...

Harvard Study: 60% of Bankruptcies Caused by Health Problems

A new study finds that more than 60% of personal bankruptcies in the United States in 2007 were caused by health-care costs associated with a major illness. That's a 50% increase in the number of bankruptcies blamed on medical expenses since a similar study in 2001.

www.consumeraffairs.com...

AND THAT WAS 2007...what do you think the numbers are for the last 2 years???

13% not being able to afford some parts of thier healthcare is starting to look pretty good!

That said this plan has many more consumer financail safeguards, caps and outs than MA.

I am citing Kaiser, the CBO, Harvard Medical School etc.. Not WND or Huffington Post...seriously...can we at least be honest about the facts?

[edit on 31-3-2010 by maybereal11]

[edit on 31-3-2010 by maybereal11]

reply to post by maybereal11


Which sections of the bill this falls under, I try my best to find out but I am having problems.

Are this last minute Amendments?

I went to the link but It doesn't say where in the bill will this issues fall under.

I agree with number one in the link, HCR is not a government take over and never was

The bill this from the final HCR bill was modeled was the baucus bill they impose the penalties, the fees and the mandate, but it fell short in October after passing the senate to control how private insurance works.

Private insurers continue to be exempt from anti-trust laws.

The link on number 2, 3 talks about caps and regulations but when I link to the link in it doesn't really tells how this is going to be done as with no regulations, how much insurances will be expected to go on raising premiums.

See the problem here

In number 5 talks about people no seen significantly changes on their premiums, but like I said with no regulations the sky is the limit.

Actually after reviewing the days of the link you posted they from back 2009.

So I will not go any farther, we already know that regulations were not enforced in the bill, that an Amendment was passed last Thursday on Medicare and actually your link said that Medicare will be controlled for cost, the Amendment is going to increase the Medicare coverage and that means higher cost.

I understand where you stand but with the passing of the bill last week many of the 2009 overviews things has changed.

Like I say the regulations on the private insurance were never added, now the stand as two separate bills that if they are taken seriously could control private insurances but neither the two parties in congress wants to touch.

Originally posted by HothSnake
reply to post by maybereal11

 

Basics? From my understanding the people that passed this trash didn't know the basics. ....

From my understanding, this whole thing will be run by the IRS, which will determine who or what gets these subsidies based on your income and taxes. These subsidies will be in the form of a tax break...

Your understanding is flawed. Not in the form of a tax break...I have provided links repeatedly explaing the specifics...

If perhaps you sought "understanding" through sources other than Beck, Limbaugh, Fox et al. You might actually have an understanding of what this bill contains.

The bill that passed the senate has been online for 6 months.
The reconciliation bill is online.

The Kaiser foundation and several other sites have done an excellent job of summerizing the current law.

I have provided these links repeatedly...

There is nothing "cryptic" about this bill....that idea is a propagandist appeal to conservatives inherent distrust of government.

If you are unwilling to check out the links I provided and continue to repeat innaccurate information...then I can't help you with your "understanding" issues. You are not interested in understanding...you just want to feed your world-view.

reply to post by maybereal11


My friend here is an updated view of the bill as March 21, just before it was passed and still doesn't have the new Medicare amendment that will make Medicare the biggest insurer of the poor and will grow to incredible debt

March 21, 2010 6:31 PM
Health Care Reform Bill Summary: A Look At What's in the Bill

www.cbsnews.com...

Only people considered in the poverty level Federal Poverty Level for family of four is $22,050 will get subsidies.

Subsidies:

Individuals and families who make between 100 percent - 400 percent of the Federal Poverty Level (FPL) and want to purchase their own health insurance on an exchange are eligible for subsidies. They cannot be eligible for Medicare, Medicaid and cannot be covered by an employer. Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale.

Now who will impose the Cap for the premiums? the government? well if the bill doesn't have regulations I guess private insurances will.

www.cbsnews.com...







[edit on 31-3-2010 by marg6043]

reply to post by marg6043


This is all updated including last weeks reconciliation bill…nothing from pre-passage..

Summary of Coverage Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010
www.kff.org...

Actual online calculator to determine how it will effect you..
healthreform.kff.org...

Some General Q&A
www.kaiserhealthnews.org...

Originally posted by marg6043
Only people considered in the poverty level Federal Poverty Level for family of four is $22,050 will get subsidies.

Subsidies:

Individuals and families who make between 100 percent - 400 percent of the Federal Poverty Level (FPL) and want to purchase their own health insurance on an exchange are eligible for subsidies. They cannot be eligible for Medicare, Medicaid and cannot be covered by an employer. Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale.

[edit on 31-3-2010 by marg6043]

I underlined something for you....400%. Take the current povertyy level of $22,050, which is adjusted upward each year for inflation...and multiply it times 4.

A family of 4 making up to $88,200 will recieve subsidies.

Edit: I don't know how my whole post got bolded and I am too tired to track it down..

[edit on 31-3-2010 by maybereal11]

reply to post by maybereal11


I found the link to the baucus (senate) bill and the lack of regulations that the just passed HCR have and the reasons why Democrat and Republicans didn't want it to regulate them.

The Max Tax: Baucus Plan Fails to Control Growth of Insurance Premiums

fdlaction.firedoglake.com...

Here is the amendment to the Medicare

Healthcare reform fallout: Which states are the winners?

www.allvoices.com...

reply to post by maybereal11


Yes I understand but read the find lines, the biggest insurances in the nation are the ones that are to impose the caps and premiums.

No the government, remember is not control on how the premiums will be raised and the bill failed to do that.

reply to post by maybereal11


BTW thanks a lot for the great work helping understand the bill my friend.

reply to post by maybereal11

For a family of four making up to 88k Premiums will be capped to no more than 9.5% of income. Families of four making 60K capped at 8.69% of income. 30k capped at 3.18%...play with the calculator.

How far does 88,000 go in an urban area?

Furthermore, Don't the subsidies only apply to those buying on the exchange?

reply to post by maybereal11


On the govenremnt link I look for the references to private insurance regulations, I found none.

Just that they will be forced to cover anybody with pre existing conditions.

I only found this in the Changes to private insurance

• Increases in health plan premiums will be subject to review.

Actually that has been always part of the individual states regulation on the insurance businesses and we all know what good they ahve done so far to the private insurance business overall

The reviews will fall under The “internal appeals process” that is in the hands of the insurance companies themselves, and the “external” one is up to each state

Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal leve

firedoglake.com...




[edit on 31-3-2010 by marg6043]

Originally posted by marg6043
reply to post by maybereal11

 

Yes I understand but read the find lines, the biggest insurances in the nation are the ones that are to impose the caps and premiums.

Not to be confrontational...but that is just not true.

I have provided charts and calculators that specifically show what the limits are that an individual will pay in premiums as determined BY THE BILL THAT WAS PASSED. NOT the insurance companies.

See the calculator in my post above..

Premiums are capped BY THE GOVERNMENT for those making up to 4 times the poverty level. 88k or so..

And for those that make more than that and feel like thier premiums are too high, but they don't qualify for subsidies/caps...they can turn to the exchange which will include insurance options run by NON-PROFITS or state run options who would be required to invest any profits back into health coverage of it's members or reducing premiums...

Any Commercial Insurance providers in the exchange must actually open thier books to regulators and justify premium increases.

Here is an outstanding summary of the law as it stand today after passage...
www.kff.org...

[edit on 31-3-2010 by maybereal11]

Originally posted by jam321
reply to post by maybereal11

 

For a family of four making up to 88k Premiums will be capped to no more than 9.5% of income. Families of four making 60K capped at 8.69% of income. 30k capped at 3.18%...play with the calculator.

How far does 88,000 go in an urban area?

Not far...trust me But I am glad it is there for those that need it.
And for those making more than that and feel pinched by premiums...they can go to the exchange and choose between two state-run plans with assumedly lower premiums or a mandated non-profit insurer for each state...and the non-profit is required to take it's profits and lower premiums rather than pocket it. See my post above.

Furthermore, Don't the subsidies only apply to those buying on the exchange?

I would assume that anyone eligiable for subsidies would be looking for the most competitive plans...which will be on the exchange...People getting insurance from employers don't need subsidies...so I am unsure what that means? But maybe you are right in that it only applies to the exchanges..I's have to research it, but I am unsure if I get the point. I think the exchange is the obvious place to go for those folks anyways.

reply to post by maybereal11


No confrontation at all my friend.

Everything we have so far on the caps and premiums is provided by insurance companies no the government.

And as with everything is subject to change depending how the coverage that is to include over 30 million new people in the future will affect the profits of the crocks in the health insurance business.

The calculators are only projections and can change at anytime.

With the debate going on with the health care reform you will not find any negativity coming from the government right now or the insurance companies.

BTW the Kaiser family foundation is a branch of the health care provider Kaiser permanent, and on the top 10 in the nation.

So the cap on premiums as well as subsidies/limits for both out of pocket expenses and premium payments only applies to those making up to about 88k for a family of four...4 times the poverty level.

What if you make more than that ..lets say 100k, but life is expensive and now you don't have any subsidies or limits on premiums?....AND you don't get insurance via your employer?

You can go to the exchange...and choose between both commercial plans as well as a state-run plan as well as a Non-Profit Plan...Same benefits...lowest cost wins...and the non-profits will be required to take any profits and put it toward LOWERING Premiums...get it? Any Private Insurance company can outbid them, but they have to do it better...have better ways of doing it, to make a profit...which is possible in a capitalistic economy..even encouraged


This AGAIN is current law...this is what passed.

www.kff.org...

Creation and structure of health insurance exchanges

• Create state-based American Health Benefit Exchanges and Small Business Health Options Program (SHOP) Exchanges, administered by a governmental agency or non-profit organization, through which individuals and small businesses with up to 100 employees can purchase qualified coverage. Permit states to allow businesses with more than 100 employees to purchase coverage in the SHOP Exchange beginning in 2017. States may form regional Exchanges or allow more than one Exchange to operate in a state as long as each Exchange serves a distinct geographic area. (Funding available to states to establish Exchanges within one year of enactment and until January 1, 2015)

Public plan option

• Require the Office of Personnel Management to contract with insurers to offer at least two multi-state plans in each Exchange. At least one plan must be offered by a non-profit entity and at least one plan must not provide coverage for abortions beyond those permitted by federal law. Each multi-state plan must be licensed in each state and must meet the qualifications of a qualified health plan. If a state has lower age rating requirements than 3:1, the state may require multi-state plans to meet the more protective age rating rules. These multi-state plans will be offered separately from the Federal Employees Health Benefit Program and will have a separate risk pool.

Consumer Operated and Oriented Plan
(CO-OP)

• Create the Consumer Operated and Oriented Plan (CO-OP) program to foster the creation of non-profit, member-run health insurance companies in all 50 states and District of Columbia to offer qualified health plans. To be eligible to receive funds, an organization must not be an existing health insurer or sponsored by a state or local government, substantially all of its activities must consist of the issuance of qualified health benefit plans in each state in which it is licensed, governance of the organization must be subject to a majority vote of its members, must operate with a strong consumer focus, and any profits must be used to lower premiums, improve benefits, or improve the quality of health care delivered to its members. (Appropriate $6 billion to finance the program and award loans and grants to establish CO-OPs by July 1, 2013)