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The American Health Care Act

The American Health Care Act

Old May 24th 2017, 7:05 pm
  #346  
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Default Re: The American Health Care Act

Originally Posted by Boiler View Post
Single-payer healthcare could cost $400 billion to implement in California - LA Times

Do not think this has been mentioned, California is looking at a Single Payer scheme, costs look challenging.
If they can make the numbers work why not ? If they control medical costs at same time maybe it could work out well. Cant be worse than the current system.
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Old May 24th 2017, 7:17 pm
  #347  
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Default Re: The American Health Care Act

Originally Posted by morpeth View Post
The idea that the working poor can afford medical insurance even after subsidies I think must depend on the state. I lived in a place in the Midwest that simply lower paid workers made too much for Medicaid, but couldn't afford premiums for medical insurance. Zero hour employers had to offer medical insurance but simply premiums too high and deductibles too high.
Plug in the numbers. $20k of income, one person gave me a premium cost of $83 a month (4.96% of income). In addition, at that income level cost sharing is available to help with deductibles/copayments (actuarial value must exceed 87% according to the numbers I put in, i.e. $2350 max out of pocket).

Without subsidies the cost of that insurance would be $282 per month.

Subsidy Calculator Widget
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Old May 24th 2017, 8:52 pm
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Default Re: The American Health Care Act

Originally Posted by Giantaxe View Post
Plug in the numbers. $20k of income, one person gave me a premium cost of $83 a month (4.96% of income). In addition, at that income level cost sharing is available to help with deductibles/copayments (actuarial value must exceed 87% according to the numbers I put in, i.e. $2350 max out of pocket).

Without subsidies the cost of that insurance would be $282 per month.

Subsidy Calculator Widget
Tried it out for 2 states I know, figures didn't work out. One it said low paid worker made to much for Medicaid, other if worker was with company that offered insurance it said Medicaid was available but in that state ( I did a cost study and employee survey on this issue)temp workers couldn't get reasonable costing insurance.

Having said that, in that particular state I knew many people who were on Obamacare who had reasonable premiums and deductibles. In between health insurance plans I was on Obamacare for several months- I have nothing but praise for it. Excellent service, reasonable premium, and nice to have had the "just in case". Premium was $1,100 per month before subsidy- then when I got private insurance through company, the company portion of the premium was $1,200 per month , employee portion around $300, so $1,500 per month total. But the following year the Obamacare premium increased $150 or so.

I don't know why company didn't switch over to the marketplace unless they couldn't.

Even with Obamacare, someone making $20,000 a year
cant afford much especially if they have a family.
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Old May 24th 2017, 8:56 pm
  #349  
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Default Re: The American Health Care Act

So the CBO scoring of the latest revision of the AHCA is out:

"23 Million Fewer Americans Would Have Health Coverage Under Obamacare Repeal Plan, Budget Office Confirms"

It's actually even worse in its effects than that because...

"But the reasons health insurance would be less expensive for some aren’t much to cheer about, the budget report makes clear. Prices would come down for healthy people because those who are sick or have illness in their medical histories would have less access to coverage ― and the policies available on the market would tend to be a lot less comprehensive.

In other words, the price for lower premiums would be some combination of higher out-of-pocket costs, fewer covered services, and coverage that would be harder to get for the people who need it most."

23 Million Fewer Americans Would Have Health Coverage Under Obamacare Repeal Plan, Budget Office Confirms | HuffPost

Last edited by Giantaxe; May 24th 2017 at 8:59 pm.
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Old May 25th 2017, 12:47 am
  #350  
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Default Re: The American Health Care Act

Originally Posted by morpeth View Post
Even with Obamacare, someone making $20,000 a year
cant afford much especially if they have a family.
$20k and a family they'd be eligible for Medicaid.
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Old May 25th 2017, 1:00 am
  #351  
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Default Re: The American Health Care Act

Originally Posted by morpeth View Post
If they can make the numbers work why not ? If they control medical costs at same time maybe it could work out well. Cant be worse than the current system.
The single payer system would cost about 3x the current California government budget, weel in reality nobody really knows.They say it would be funded by an increase in Income Tax by 15%. Nobody seems to be discussing controlling costs.
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Old May 25th 2017, 1:05 am
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Default Re: The American Health Care Act

Originally Posted by Anian View Post
Why healthcare in Iowa shouldn't be seen as a sign for other states:
Is Iowa Obamacare’s canary in the coal mine? Not really. | PolitiFact

Makes me curious about this $12 million man.
I read the same story and had the same thought. Seemed a lot even with US costs. Presumably lots of very expensive drugs, an interest Societal question as well.
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Old May 25th 2017, 1:17 am
  #353  
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Default Re: The American Health Care Act

Originally Posted by Giantaxe View Post
Plug in the numbers. $20k of income, one person gave me a premium cost of $83 a month (4.96% of income). In addition, at that income level cost sharing is available to help with deductibles/copayments (actuarial value must exceed 87% according to the numbers I put in, i.e. $2350 max out of pocket).

Without subsidies the cost of that insurance would be $282 per month.

Subsidy Calculator Widget
Entering some numbers in the calculator, I see that the subsidy is suddenly cut off at a point, rather than being gradually phased out. So it looks like somebody earning just above that point could be a couple of thousand dollars or more worse off than somebody earning just below. I wonder why that is, or maybe there's some way round it.
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Old May 25th 2017, 1:26 am
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Default Re: The American Health Care Act

Originally Posted by Asg123 View Post
Entering some numbers in the calculator, I see that the subsidy is suddenly cut off at a point, rather than being gradually phased out. So it looks like somebody earning just above that point could be a couple of thousand dollars or more worse off than somebody earning just below. I wonder why that is, or maybe there's some way round it.
I remeber when it first came out there was a rather large hold, in the case I looked at and it is not actlly possible to be definitive but when you went over 22k you had to get to 30k before you would be better off.
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Old May 25th 2017, 1:33 am
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Default Re: The American Health Care Act

Originally Posted by Boiler View Post
The single payer system would cost about 3x the current California government budget, weel in reality nobody really knows.They say it would be funded by an increase in Income Tax by 15%. Nobody seems to be discussing controlling costs.
$400bn cost, $200bn from re-purposed federal health funds currently received. Additionally businesses spend between $100 and $150bn on health insurance. Not sure how much individuals spend. It does highlight how difficult, if not impossible, a transition to single-payer would be.
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Old May 25th 2017, 1:34 am
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Default Re: The American Health Care Act

Originally Posted by Asg123 View Post
Entering some numbers in the calculator, I see that the subsidy is suddenly cut off at a point, rather than being gradually phased out. So it looks like somebody earning just above that point could be a couple of thousand dollars or more worse off than somebody earning just below. I wonder why that is, or maybe there's some way round it.
Yes, I've pointed this "cliff" out before. It's crazy it was implemented that way. Of course, with a cooperative Congress, it would be easy to fix.
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Old May 25th 2017, 6:51 am
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Default Re: The American Health Care Act

Originally Posted by Giantaxe View Post
Yes, I've pointed this "cliff" out before. It's crazy it was implemented that way. Of course, with a cooperative Congress, it would be easy to fix.
Good point, if Congress had the willpower, many of the flaws in Obamacare could be fixed rather easily.

The calculator you provided I am not sure if it reflects each state correctly in terms being qualified for Medicaid. I put in for one state North Carolina, and I know a few people there, who cant get private insurance nor qualify for Medicaid. For Ohio , I believe there are some qualification rules the preclude some from getting Medicaid even though it seems they qualify. Not sure why. The "cliff" definitely an issue.

I do know in the county I am familiar with, that the working poor and lower working class often don't qualify for Medicaid and cant afford even employer provided medical insurance. I do not know if this is a greater number than those who now can get insurance because of Obamacare, probably much lower but I am just guessing. Still it is unacceptable and disgusting that people cant get medical care in a developed country
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Old May 25th 2017, 6:55 am
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Default Re: The American Health Care Act

Originally Posted by Boiler View Post
The single payer system would cost about 3x the current California government budget, weel in reality nobody really knows.They say it would be funded by an increase in Income Tax by 15%. Nobody seems to be discussing controlling costs.
Certainly a lot of details would need to be worked out, and if the plan included cost control maybe it would work much better than expected.
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Old May 25th 2017, 10:50 am
  #359  
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Default Re: The American Health Care Act

One wonders if healthcare really works at all. The American system is broken, the NHS is breaking. What's the alternative? Every man for himself?
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Old May 25th 2017, 11:01 am
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Default Re: The American Health Care Act

One of the biggest issues for single-payer in America - from a political perspective - is that the Americans who barrack for it generally don't understand how it actually works or how much it costs (nor do they really understand the European safety net in general). They think single-payer will be the same system they have now, just free and better. They understand that there will be a tax increase but they are thinking pennies and not the whopping figures others threw about in earlier posts. Oh, and they think there is no private insurance at all in Europe and that wait lists are right-wing scare points.

So if single-payer arrives, here is the scenario I see arriving. There is a huge, enormous tax bill, and you are assigned to a specific doctor that's virtually impossible to change (as in Italy) - or you are mandated to buy private insurance anyways or face a tax penalty (as in Australia) - the same people who supported it, will screech and revolt. They will accuse the Democratic president of selling out to corporate interests and making a tax giveaway to the rich. They will spew that the continued existence of private insurance is proof that the US is just as racist as it ever was, since private insurance is mostly bought by the upper classes and more minorities are poor and can't afford it.

Then - they will find a Corbynista to rally around, so they can primary the incumbent Democrat. Then the big banks and white-collar lobbyists will find a right-wing "corporate Democrat" to run against the incumbent from the right, vowing to roll back "the chaos that single-payer has wrought" (or some other weasel words). And that politician who brought in single-payer, won't even make it out of the primary in the next election.

Average social media commentator may not be thinking in those terms, but the pollies are. "Never, ever" said Hillary Clinton . . .
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