Trump to gut ACA via executive order

[Anonymous]

Anonymous wrote:You would have thought that 1,000+ pages of Obamacare would have made it cheaper to process insurance claims, but that's not the case:

"Just processing the insurance forms costs $58 for every patient encounter, according to Dr. Stephen Schimpff, an internist and former CEO of University of Maryland Medical Center." That's just crazy, but next time you go to the doctor, make note of the number of staff they have processing claims, and think of their counterparts at the insurance company.

https://www.thedailybeast.com/how-being-a-doctor-became-the-most-miserable-profession

Why would the ACA make it easier to procecss insurance claims? The ACA's a market-based system that introduced more health insurers and insurance plans into the mix, so what part of that would mean administrative simplification? That you would even think the ACA would have made processing claims cheaper gives away the idea that you have no idea what you're talking about.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So now that I don't have my subsidy anymore do I still have to have insurance? Without my subsidy my monthly bill is 350. That's a lot of money for me. What about next year.

The liberal media, in trying to make Trump look as bad as possible, has misleading headlines all over the place. The premium insurance subsidies are NOT going away. It's only the cost-sharing subsidies, which were ruled illegal by a court, that are being discontinued. You will continue to get taxpayer assistance to pay for your insurance, just like this year.

What is the difference? What is the cost sharing subsidy?

OK, I'm back....There are two categories of "taxpayer assistance" with Obamacare, beyond those who get Medicaid (the really poor folks).

1) Premium subsidies. This is the amount that moderate earners (say, $30kish to $48kish) get to offset the cost of the insurance plans, capping their share at 9% of income. So a 58-year-old earning $35,000, for example, might only have to pay $280 for a $680 insurance plan. They qualify for a $400 premium subsidy.

2) Cost-sharing reimbursements. But there's a second category, say....for people earning somewhere in the teens (the point where Medicaid would kick in) and $30k. They still get the premium subsidies, so a person earning $25,000 would only have to pay around $180 for that same $680 plan (9% of income), but they get EXTRA taxpayer subsidies to help with the out-of-pocket costs. An example would be that instead of having to pay the $20 copay for a doctor visit, they would only pay $5.

It is this latter category that a court ruled illegal, and which Trump is stopping. You will till get premium subsidies, the first category. (That's it in a nutshell, and I estimated numbers for examples because the 9% cap is actually slightly more at 9.xx%.)

Correct... and when the premiums go up, which they will do because Trump is doing away with #2, #1 subsidy still remains in place, and the net difference of the increae in premiums will be passed on to higher earners in the form of higher premiums for them.

Again, the lower/middle will be fine. It's the middle/upper who will be screwed.

Let's not forget that when people lose their insurance and they then get uncompensated care in more expensive settings at more expensive times in the disease process, those of us with insurance will pay more to compensate for those costs, too.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So now that I don't have my subsidy anymore do I still have to have insurance? Without my subsidy my monthly bill is 350. That's a lot of money for me. What about next year.

The liberal media, in trying to make Trump look as bad as possible, has misleading headlines all over the place. The premium insurance subsidies are NOT going away. It's only the cost-sharing subsidies, which were ruled illegal by a court, that are being discontinued. You will continue to get taxpayer assistance to pay for your insurance, just like this year.

What is the difference? What is the cost sharing subsidy?

OK, I'm back....There are two categories of "taxpayer assistance" with Obamacare, beyond those who get Medicaid (the really poor folks).

1) Premium subsidies. This is the amount that moderate earners (say, $30kish to $48kish) get to offset the cost of the insurance plans, capping their share at 9% of income. So a 58-year-old earning $35,000, for example, might only have to pay $280 for a $680 insurance plan. They qualify for a $400 premium subsidy.

2) Cost-sharing reimbursements. But there's a second category, say....for people earning somewhere in the teens (the point where Medicaid would kick in) and $30k. They still get the premium subsidies, so a person earning $25,000 would only have to pay around $180 for that same $680 plan (9% of income), but they get EXTRA taxpayer subsidies to help with the out-of-pocket costs. An example would be that instead of having to pay the $20 copay for a doctor visit, they would only pay $5.

It is this latter category that a court ruled illegal, and which Trump is stopping. You will till get premium subsidies, the first category. (That's it in a nutshell, and I estimated numbers for examples because the 9% cap is actually slightly more at 9.xx%.)

Op here I'm in the second category so I have lower co pays and lower deductible. So what happens to me now ? I'm most worried about ny premium going up. So far I haven't even used my insurance this year as I'm thankfully healthy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So now that I don't have my subsidy anymore do I still have to have insurance? Without my subsidy my monthly bill is 350. That's a lot of money for me. What about next year.

The liberal media, in trying to make Trump look as bad as possible, has misleading headlines all over the place. The premium insurance subsidies are NOT going away. It's only the cost-sharing subsidies, which were ruled illegal by a court, that are being discontinued. You will continue to get taxpayer assistance to pay for your insurance, just like this year.

What is the difference? What is the cost sharing subsidy?

OK, I'm back....There are two categories of "taxpayer assistance" with Obamacare, beyond those who get Medicaid (the really poor folks).

1) Premium subsidies. This is the amount that moderate earners (say, $30kish to $48kish) get to offset the cost of the insurance plans, capping their share at 9% of income. So a 58-year-old earning $35,000, for example, might only have to pay $280 for a $680 insurance plan. They qualify for a $400 premium subsidy.

2) Cost-sharing reimbursements. But there's a second category, say....for people earning somewhere in the teens (the point where Medicaid would kick in) and $30k. They still get the premium subsidies, so a person earning $25,000 would only have to pay around $180 for that same $680 plan (9% of income), but they get EXTRA taxpayer subsidies to help with the out-of-pocket costs. An example would be that instead of having to pay the $20 copay for a doctor visit, they would only pay $5.

It is this latter category that a court ruled illegal, and which Trump is stopping. You will till get premium subsidies, the first category. (That's it in a nutshell, and I estimated numbers for examples because the 9% cap is actually slightly more at 9.xx%.)

Op here I'm in the second category so I have lower co pays and lower deductible. So what happens to me now ? I'm most worried about ny premium going up. So far I haven't even used my insurance this year as I'm thankfully healthy.

If your main worry is about your premium, relax. You'll continue to get generous subsidies to help pay the monthly charge. As far as the cost-sharing subsidies, it doesn't sound as if it's likely to imoact you at all. You sound young and healthy, so you should be fine.

And remember, the cost-sharing subsidies WERE ruled illegal, so it seems to me that Trump is just following the law. He's leaving the premium subsidies untouched.

[Anonymous]

So much winning.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think that's a great thing. i want it to collapse.

It was poorly thought out and rammed through. It's been a disaster. No need to throw more money at it. Everywhere this type of government run healthcare is tried, it fails.

Do you know what else was failing, even worse? The healthcare system that preceded the ACA.

That was true for some, not true for others. ACA created an entire new class of "underinsured middle-class Americans." My friend's SIL is a doctor, and he said he saw a big switch in his patient base - many more low income people (getting free care) and much fewer middle income people (who can no longer afford it).

+1 I think Obama's main focus was on the uninsured and very poor. The very wealthy aren't really affected by what happens. It's the middle class worker and small business owner who have been hit by much higher rates.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So now that I don't have my subsidy anymore do I still have to have insurance? Without my subsidy my monthly bill is 350. That's a lot of money for me. What about next year.

The liberal media, in trying to make Trump look as bad as possible, has misleading headlines all over the place. The premium insurance subsidies are NOT going away. It's only the cost-sharing subsidies, which were ruled illegal by a court, that are being discontinued. You will continue to get taxpayer assistance to pay for your insurance, just like this year.

What is the difference? What is the cost sharing subsidy?

OK, I'm back....There are two categories of "taxpayer assistance" with Obamacare, beyond those who get Medicaid (the really poor folks).

1) Premium subsidies. This is the amount that moderate earners (say, $30kish to $48kish) get to offset the cost of the insurance plans, capping their share at 9% of income. So a 58-year-old earning $35,000, for example, might only have to pay $280 for a $680 insurance plan. They qualify for a $400 premium subsidy.

2) Cost-sharing reimbursements. But there's a second category, say....for people earning somewhere in the teens (the point where Medicaid would kick in) and $30k. They still get the premium subsidies, so a person earning $25,000 would only have to pay around $180 for that same $680 plan (9% of income), but they get EXTRA taxpayer subsidies to help with the out-of-pocket costs. An example would be that instead of having to pay the $20 copay for a doctor visit, they would only pay $5.

It is this latter category that a court ruled illegal, and which Trump is stopping. You will till get premium subsidies, the first category. (That's it in a nutshell, and I estimated numbers for examples because the 9% cap is actually slightly more at 9.xx%.)

Op here I'm in the second category so I have lower co pays and lower deductible. So what happens to me now ? I'm most worried about ny premium going up. So far I haven't even used my insurance this year as I'm thankfully healthy.

Well, since everyone assumes that my family can afford the $2,700/month premium AND the 5K deductible AND the co-pay so you can float, I'm not terribly concerned if you pay an extra $15 bucks for an office visit.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So now that I don't have my subsidy anymore do I still have to have insurance? Without my subsidy my monthly bill is 350. That's a lot of money for me. What about next year.

The liberal media, in trying to make Trump look as bad as possible, has misleading headlines all over the place. The premium insurance subsidies are NOT going away. It's only the cost-sharing subsidies, which were ruled illegal by a court, that are being discontinued. You will continue to get taxpayer assistance to pay for your insurance, just like this year.

What is the difference? What is the cost sharing subsidy?

OK, I'm back....There are two categories of "taxpayer assistance" with Obamacare, beyond those who get Medicaid (the really poor folks).

1) Premium subsidies. This is the amount that moderate earners (say, $30kish to $48kish) get to offset the cost of the insurance plans, capping their share at 9% of income. So a 58-year-old earning $35,000, for example, might only have to pay $280 for a $680 insurance plan. They qualify for a $400 premium subsidy.

2) Cost-sharing reimbursements. But there's a second category, say....for people earning somewhere in the teens (the point where Medicaid would kick in) and $30k. They still get the premium subsidies, so a person earning $25,000 would only have to pay around $180 for that same $680 plan (9% of income), but they get EXTRA taxpayer subsidies to help with the out-of-pocket costs. An example would be that instead of having to pay the $20 copay for a doctor visit, they would only pay $5.

It is this latter category that a court ruled illegal, and which Trump is stopping. You will till get premium subsidies, the first category. (That's it in a nutshell, and I estimated numbers for examples because the 9% cap is actually slightly more at 9.xx%.)

Op here I'm in the second category so I have lower co pays and lower deductible. So what happens to me now ? I'm most worried about ny premium going up. So far I haven't even used my insurance this year as I'm thankfully healthy.

Well, since everyone assumes that my family can afford the $2,700/month premium AND the 5K deductible AND the co-pay so you can float, I'm not terribly concerned if you pay an extra $15 bucks for an office visit.

I just lowered my taxable income to 300% above poverty level, I have Cancer and learned long ago to find ways to make the US healthcare system work for me or I would have been dead a long before Obama.

[Anonymous]

Sorry if this was posted but Bannon said at the "Values Summit" that the point of cutting off CSRs was to intentionally blow up the insurance markets (http://talkingpointsmemo.com/edblog/bannon-admits-it)

Craig Garthwaite (a Republican health care economist critical if the ACA) said the same thing on twitter-- doing it two weeks before enrollment means it was intentional sabotage of the insurance markets.

It just boggles my mind that this Administration would be so blinded by its hate of anything Obama-related that it would intentionally hurt Americans who need individual insurance.

[Anonymous]

This disproportionately impacts the red states, so I guess they like shooting themselves in the foot, though those voters probably won't care because their impact won't be truly felt until after the 2018 election.

[Anonymous]

Anonymous wrote:Sorry if this was posted but Bannon said at the "Values Summit" that the point of cutting off CSRs was to intentionally blow up the insurance markets (http://talkingpointsmemo.com/edblog/bannon-admits-it)

Craig Garthwaite (a Republican health care economist critical if the ACA) said the same thing on twitter-- doing it two weeks before enrollment means it was intentional sabotage of the insurance markets.

It just boggles my mind that this Administration would be so blinded by its hate of anything Obama-related that it would intentionally hurt Americans who need individual insurance.

What's happening today is perfect strangers are being intentionally hurt by the artificial consequences of Obamacare, which are crazy-high premiums and a mandate that you will give up a bigger and bigger part of your pay check for them.

Stop taking what Trump does personally. For every person you see hurt by him, he's trying to alleviate the "hurt" of another (much as Obama did - I'm going to levy a tax on person A for the benefit of person B).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think that's a great thing. i want it to collapse.

It was poorly thought out and rammed through. It's been a disaster. No need to throw more money at it. Everywhere this type of government run healthcare is tried, it fails.

Do you know what else was failing, even worse? The healthcare system that preceded the ACA.

That was true for some, not true for others. ACA created an entire new class of "underinsured middle-class Americans." My friend's SIL is a doctor, and he said he saw a big switch in his patient base - many more low income people (getting free care) and much fewer middle income people (who can no longer afford it).

+1 I think Obama's main focus was on the uninsured and very poor. The very wealthy aren't really affected by what happens. It's the middle class worker and small business owner who have been hit by much higher rates.

Yes, and that's the problem with liberals - and why they lost the election. They were so focused on the poor/working poor, as usual, that they ignored the impact it would have on the lower-middle class. (As you point out, the upper-middle and wealthy could absorb the added costs.) There's no way a self-employed person, making a livable but modest income of $50,000, can afford to pay $700 or $800 a month for an insurance policy that still leaves him responsible for thousands of dollars in doctor's visits, treatments, lab work, and prescriptions every year.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So now that I don't have my subsidy anymore do I still have to have insurance? Without my subsidy my monthly bill is 350. That's a lot of money for me. What about next year.

The liberal media, in trying to make Trump look as bad as possible, has misleading headlines all over the place. The premium insurance subsidies are NOT going away. It's only the cost-sharing subsidies, which were ruled illegal by a court, that are being discontinued. You will continue to get taxpayer assistance to pay for your insurance, just like this year.

What is the difference? What is the cost sharing subsidy?

OK, I'm back....There are two categories of "taxpayer assistance" with Obamacare, beyond those who get Medicaid (the really poor folks).

1) Premium subsidies. This is the amount that moderate earners (say, $30kish to $48kish) get to offset the cost of the insurance plans, capping their share at 9% of income. So a 58-year-old earning $35,000, for example, might only have to pay $280 for a $680 insurance plan. They qualify for a $400 premium subsidy.

2) Cost-sharing reimbursements. But there's a second category, say....for people earning somewhere in the teens (the point where Medicaid would kick in) and $30k. They still get the premium subsidies, so a person earning $25,000 would only have to pay around $180 for that same $680 plan (9% of income), but they get EXTRA taxpayer subsidies to help with the out-of-pocket costs. An example would be that instead of having to pay the $20 copay for a doctor visit, they would only pay $5.

It is this latter category that a court ruled illegal, and which Trump is stopping. You will till get premium subsidies, the first category. (That's it in a nutshell, and I estimated numbers for examples because the 9% cap is actually slightly more at 9.xx%.)

Op here I'm in the second category so I have lower co pays and lower deductible. So what happens to me now ? I'm most worried about ny premium going up. So far I haven't even used my insurance this year as I'm thankfully healthy.

Well, since everyone assumes that my family can afford the $2,700/month premium AND the 5K deductible AND the co-pay so you can float, I'm not terribly concerned if you pay an extra $15 bucks for an office visit.

Agree - and I've made that point before.....that we shouldn't have people show up in the ER or doctor's office and pay $5 - or nothing - and suggested a payment of $15. Well! You should have seen the libs come out of the woodwork, castigating me for not appreciating how difficult it is for a poor person to come up with $15. My response has always been that it is no more difficult than for a lower-middle class person to come up with $3000 or $4000 for an unexpected medical emergency, because Obamacare doesn't cover it for them. There's usually llittle sympathy to the person just getting by on $55k in this town....only the poor get the sympathy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sorry if this was posted but Bannon said at the "Values Summit" that the point of cutting off CSRs was to intentionally blow up the insurance markets (http://talkingpointsmemo.com/edblog/bannon-admits-it)

Craig Garthwaite (a Republican health care economist critical if the ACA) said the same thing on twitter-- doing it two weeks before enrollment means it was intentional sabotage of the insurance markets.

It just boggles my mind that this Administration would be so blinded by its hate of anything Obama-related that it would intentionally hurt Americans who need individual insurance.

What's happening today is perfect strangers are being intentionally hurt by the artificial consequences of Obamacare, which are crazy-high premiums and a mandate that you will give up a bigger and bigger part of your pay check for them.

Stop taking what Trump does personally. For every person you see hurt by him, he's trying to alleviate the "hurt" of another (much as Obama did - I'm going to levy a tax on person A for the benefit of person B).

Exactly! I was supposed to get PT twice a week, but at $160 each time (and that was the discounted rate with insurance!), I could only afford once a week. The poor people in the waiting room told me that they are going twice a week, as the doctor said, but Medicaid was paying in full.

And to add insult to injury, the self-pay rate was only $90. When I found out about that, I said I'd switch to self-pay, and then could afford 2x a week. (Funny....it COST me more to use insurance.) But they wouldn't permit it. They said I HAD to use the insurance, and that it was the insurance "policy." So the reward for paying $800 month in insurance is that I have to pay MORE than the uninsured?

[Anonymous]

Anonymous wrote:This disproportionately impacts the red states, so I guess they like shooting themselves in the foot, though those voters probably won't care because their impact won't be truly felt until after the 2018 election.

You want to think so because you get pleasure "punishing" the Trump voters in red states, but it's not true. Most of the people are high school educated working class, own modest homes, and will still get the premium subsidies.