Is ObamaCare saving you money?

[NetSkyBlue]

Not so good on this front. My fiance has never had health insurance, and doesn't earn a lot. When he (rarely) needed to go to the doctor, he paid cash. And I realize that's a risky way to live, but he doesn't *have* several thousand dollars to spare each year. While he might qualify for subsidies now, I'm sure he won't in 3 months when we get married, and while I do make a bit above my portion of the bills, it's only about $300 to spare each month - and that's all we have to save. My company just eliminated its quarterly bonus program. I'm just lucky that I only ever budgeted that into savings, and never counted on it for paying the bills.

He's been on the government website and making calls all week trying to find something we can afford to pay for. He may have fractured his wrist and can't go to the doctor for fear of what will happen if he goes and doesn't have insurance (that being illegal, now). He's barely able to do his job right now, and is probably making things worse by working anyway.

It's just so frustrating. I wish the cost of health care would come DOWN - so that it wouldn't cost a catastrophic amount that we must insure against. Not that we would have to pay the salaries of everyone working in the insurance industry.

[Gailete]

can't go to the doctor for fear of what will happen if he goes and doesn't have insurance (that being illegal, now)

I'm not sure I understand that statement. It isn't illegal to go to the doctor without health insurance. We have until March 15, 2014 (I think the date is) to be signed up for the year. Even after the fact, going to the doctor without insurance won't be illegal. If he doesn't sign up for insurance this year he will pay a fine on his 2014 taxes and each year after that, but they certainly won't be arresting him or putting him in jail or anything else like that. But maybe I misunderstood what you were trying to get across.

He needs to go get that arm looked at. Do you have an urgent care center in your community? I hear they are cheaper than an emergency room, especially if his once in a while doctor is only going to see him, charge him, and send him to the ER. Call the urgent care place first to see if they can handle a fractured wrist.

[NetSkyBlue]

I'm not sure I understand that statement. It isn't illegal to go to the doctor without health insurance. We have until March 15, 2014 (I think the date is) to be signed up for the year. Even after the fact, going to the doctor without insurance won't be illegal. If he doesn't sign up for insurance this year he will pay a fine on his 2014 taxes and each year after that, but they certainly won't be arresting him or putting him in jail or anything else like that. But maybe I misunderstood what you were trying to get across.

I guess we didn't realize that. We thought as of 1/1/14 it WAS illegal to not have health insurance. He said when he started checking last year, the lowest quote he was offered was $400-something a month.

Maybe this is even more problems this Act could be causing - the uninformed like him are now MORE afraid to go to the doctor. Before this year, he would have just gone, and we'd have saved up and paid for the doctor bill. He's been putting off going to the doctor out of fear he'd be found out of committing a crime.

[Gailete]

My hubby has told me that if we can't afford the ACA he will commit an act of 'civil disobedience' and not sign up at all.

I'm at the point that all I have to figure out with his, is if an out of state doctor (but fairly close by) would be considered out of network, as the main thing he needs currently is at least one of his corneas replaced due to a genetic eye disease. We don't have any experts in that field close by. Otherwise, I think we will be able to get him insurance, but I did have to finagle the numbers, not to lower our income but to make it look HIGHER! Putting in our taxable income from last year got me a he isn't eligible for help determination, but adding $600 more dollars to the amount brings up the positive eligibility. So if your boyfriend is having problems when working through the preliminary stuff and he isn't getting a positive eligibility determination, up his income a bit until you find that sweet spot for your state.

[hamchan]

Pennsylvania is one of the states that didn't expand Medicaid, so if you had to increase your income to be eligible then you can thank your state for that, not the ACA. The ACA would have given you free coverage.

[NetSkyBlue]

Can you explain what you mean about the positive eligibility determination? I REALLY don't understand all this stuff, I've always had employer-paid health insurance and have only ever been to the doctor 4 times in my adult life. I wish we could afford to put him on my company's plan, but that would be just under $600 a month additional.

When we get married, will they be looking at my last years' income? Due to the elimination of bonuses, I've just been forced to take a 7% pay cut.

Edit: And my state doesn't have a state exchange.

[hamchan]

Basically if your state refused federal funds for the Medicaid expansion, if you make between 100% and 133% of the federal poverty level you cannot get Medicaid or a subsidy on a qualified health plan. The only good news in this scenario is that you probably won't have to pay the penalty either.

[ua_guy]

My hubby has told me that if we can't afford the ACA he will commit an act of 'civil disobedience' and not sign up at all.

It's not an act of civil disobedience. ACA mandates signing up for health insurance coverage OR paying a penalty, for 2014, which is the greater of $95 per year, or 1% of a person's income. Of course, this is all if you don't qualify for Medicaid.

Enforcement of the penalty is handled by the IRS. The IRS cannot impose liens levies or criminal penalties for not paying, but they will deduct what you owe from coming and future tax refunds.

[Gailete]

Can you explain what you mean about the positive eligibility determination?

But if you NEED insurance like we do, you can probably wiggle the numbers some. Thought at minimum, when deciding eligibility, they would take a peek at last years tax forms. Nope. On my first application for him, the page barely had time to reload when I was told he wasn't eligible for assistance in paying for premiums (what I called negative eligibility not an official phrase, positive is when I redid the application and was told he was eligible). The worst part was all the legalese on the eligibility letter, that made no assumption that someone may have accidently inputted the wrong numbers, it was instant but you had to jump through a lot of hoops and it could take up to 90 days to contest the eligibility. In other words if someone inputted $15250 for their income instead of $51250 they would get this letter depending on their state. To fix it, is clear out your computer/cookies, restart it, and go into the site again and where there is the beginning of the application is the word remove up in the right hand corner if I remember right. If you did your application wrong, you can click on remove and try to do the application again. They of course don't make it that easy to find or know about it.

If you can get an application in by Jan 15, you can have your insurance start on Feb. 1.

Some states aren't going along with the plan and just because mine isn't doesn't mean we should continue to be without insurance for him. I would guess (hate to make any assumptions about this program) that they would ask you about your income once a year prior to continuing your insurance for the next year. I was genuinely surprised at how LITTLE they asked in the way of personal finances. I've signed up at websites that have to do with sewing where they make me input my chosen password twice during sign up to be sure it was right, yet this program that seems to based entirely on your income asks for one number, doesn't ask you to confirm it and that is all they ask. I think it is odd, maybe no one else does.

[Gailete]

It's not an act of civil disobedience

Civil disobedience in his mind is choosing to not follow the laws of the land. The ACA is now the LAW. Nor does he see any reason to pay a fine for not buying something he can't afford in the first place. When the numbers started coming out about what he would probably have to pay, it was grim and totally undoable by us and I'm sure many other people whose income leaves them in the 'cracks' financially. Just a tad over poverty level, not enough to get government help for anything, yet being expected to jump on the bandwagon of new laws or be fined which is downright silly and obviously thought up by some people who have more wealth than they need, to think that a fine is the solution to people not signing up in the first place because they can't afford it. They forget that some of these people that can't afford to sign up and whose state won't help them, are already shelling out thousands a year personally for healthcare and they want to fine them on top of that?!?

[ua_guy]

Civil disobedience in his mind is choosing to not follow the laws of the land. The ACA is now the LAW. Nor does he see any reason to pay a fine for not buying something he can't afford in the first place. When the numbers started coming out about what he would probably have to pay, it was grim and totally undoable by us and I'm sure many other people whose income leaves them in the 'cracks' financially. Just a tad over poverty level, not enough to get government help for anything, yet being expected to jump on the bandwagon of new laws or be fined which is downright silly and obviously thought up by some people who have more wealth than they need, to think that a fine is the solution to people not signing up in the first place because they can't afford it. They forget that some of these people that can't afford to sign up and whose state won't help them, are already shelling out thousands a year personally for healthcare and they want to fine them on top of that?!?

Yes, because the thought there is that if you are spending that much on healthcare out of pocket, paying for the insurance is likely to be cheaper at that point.

If you are in a state that is not participating in expanded Medicaid eligibility, you can thank your State for that, not ACA. In fact, you can thank your conservative state leaders for that. Remember to vote blue in 2016.

The ACA mandates are not required if health insurance premiums constitute more than 8% of income.

I have no doubt that some people will be marginalized by the law, but that's in stark contrast to a very large population that was being marginalized prior to the passage of ACA. $0.02.

[hamchan]

You know, not to sound unkind but it somewhat amuses me to hear people gripe about how they don't know what they are going to do because they can't afford insurance. People, this is but a small sampling of what those of us with significant health issues have been dealing with for decades. You know what you do? You arrange your entire life around it. I had to give up a good paying job I loved a few years ago because they stopped offering health coverage. My husband had to delay getting divorced from his ex by over a year because having health insurance is literally a life or death scenario. We make a higher than average income but our health care expenditures are so high that we have a pretty minimal standard of living. No car, crappy apartment in a bad part of town, no vacations, few luxuries of any kind. I've been working 28-29 days a month just so we can keep up with these expenses. You think insurance is too expensive? Welcome to our world.

[NetSkyBlue]

It's not an act of civil disobedience. ACA mandates signing up for health insurance coverage OR paying a penalty, for 2014, which is the greater of $95 per year, or 1% of a person's income. Of course, this is all if you don't qualify for Medicaid.

Enforcement of the penalty is handled by the IRS. The IRS cannot impose liens levies or criminal penalties for not paying, but they will deduct what you owe from coming and future tax refunds.

How can this be correct? If you take the quote that my fiance says he got the first time he started looking - $400-something a month, that's $4,800/year. That's 1% of the income of someone making $480k a year. That just can't be right. Why would anyone who was comfortable enough not having insurance NOT choose to pay the fine, in that case?

[NetSkyBlue]

I guess the biggest problem I have with Obamacare is that if everyone has to purchase health insurance, the majority of them/(us) will be paying more in premiums - A LOT more, than we will ever use in health care services in our lifetime. Some (un)lucky few will certainly have more covered in their medical bills than what they paid in, but that's the exception to the rule. That's the very NATURE of insurance. If the majority of people "broke even" or made out well on the deal, the insurance company would go bankrupt.

To be honest, I'd find it less of a problem (somewhat) if they took the actual health care costs of all Americans and levied it across the American population in taxes. At least we'd be paying only for services rendered.

We're paying not only that, but the wages of every employee in the health insurance industry, and their CEOs. And this is not something we're given a choice about.


I know you can make the same argument against auto insurance, but I do have the choice not to drive, and even if I choose to drive, the total amount in dollars we're talking about is vastly smaller.

[hamchan]

A single payer system would be ideal. Until the US pulls it's head out of it's ass, we will not be getting that.