Cynical US Healthcare questions
#1
Cynical US Healthcare questions
I started to think about this whole healthcare thing from an immigration perspective.
One reason, ex-pats couldn't bring aged parents over was the cost of healthcare. Now it's "free" (that's cynical part 1), is it now viable to bring over the aged parents, thinking at least they are now covered for "major" emergency stuff - plus the option to send them back to the UK for "competing" aged care homes!
Cynical part 2. Won't this happen more too for people having babies in the USA where they become a USA citizen which guarantees them, when they are 18 at least, the chance to come to the USA, if they want. I can see the volume of this floor going through the roof and being repealed by the next Government.
Cynical? Me?
One reason, ex-pats couldn't bring aged parents over was the cost of healthcare. Now it's "free" (that's cynical part 1), is it now viable to bring over the aged parents, thinking at least they are now covered for "major" emergency stuff - plus the option to send them back to the UK for "competing" aged care homes!
Cynical part 2. Won't this happen more too for people having babies in the USA where they become a USA citizen which guarantees them, when they are 18 at least, the chance to come to the USA, if they want. I can see the volume of this floor going through the roof and being repealed by the next Government.
Cynical? Me?
#2
Re: Cynical US Healthcare questions
That may be an "unintended consequence" of the legislation, depending on how the details work out. Two possibilities could eventually come about:
1. Health requirements increased in order to become a migrant (as already happens in Australia and Canada); and
2. Limitations on parent migration, as Australia has done.
If you're not living in the USA, planning to have a baby born in the USA is logistically difficult.
1. Health requirements increased in order to become a migrant (as already happens in Australia and Canada); and
2. Limitations on parent migration, as Australia has done.
If you're not living in the USA, planning to have a baby born in the USA is logistically difficult.
#3
Re: Cynical US Healthcare questions
How is it 'free' for parents (or anyone else for that matter) There'll still be a premium to be paid and it'll likely reflect the patients history non?
#4
Account Closed
Joined: Mar 2004
Posts: 2
Re: Cynical US Healthcare questions
The Dems plan allows premium discrimination based on age
But the subsidy is dependant it seems on income so there may well be possibilities
At the moment the system is skewed towards parents from countries where there is no coverage so they have nothing to lose, a trip to the ER in the US is better than the current option.
But the subsidy is dependant it seems on income so there may well be possibilities
At the moment the system is skewed towards parents from countries where there is no coverage so they have nothing to lose, a trip to the ER in the US is better than the current option.
#5
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: Cynical US Healthcare questions
One reason, ex-pats couldn't bring aged parents over was the cost of healthcare. Now it's "free" (that's cynical part 1), is it now viable to bring over the aged parents, thinking at least they are now covered for "major" emergency stuff - plus the option to send them back to the UK for "competing" aged care homes!
#6
Re: Cynical US Healthcare questions
I don't think it makes that much difference. Medicare eligibility remains the same and sponsors will still be liable for costs from the public purse. I guess the one advantage is that parents under Medicare age with pre-existing conditions will be able to get insurance, although they won't be eligible for government subsidies regardless of income.
#7
Joined: Jan 2008
Posts: 7,605
Re: Cynical US Healthcare questions
We've discussed this a couple of times, but have yet to find a definitive answer. The nightmare scenario is, one bunch of feds says "OK, Mr LPR, you're eligible for the subsidy so it's only just that you be subject to the penalty for not having insurance" while another says "OK, Mrs USC, you signed a contract promising to repay any benefits your sponsee claims and the health insurance subsidy is just such a benefit".
#8
Re: Cynical US Healthcare questions
The lack of clarity about it all is one of the reasons we're headed back to the UK. We can't risk my need for dialysis/transplant etc in a few years bankrupting us.
#9
Re: Cynical US Healthcare questions
I actually agree with Giantaxe, on this one. Even if the bill does have some language about LPRs and eligibility, there's no guarantee that the feds won't take the view that a sponsor's signed contract trumps that.
We've discussed this a couple of times, but have yet to find a definitive answer. The nightmare scenario is, one bunch of feds says "OK, Mr LPR, you're eligible for the subsidy so it's only just that you be subject to the penalty for not having insurance" while another says "OK, Mrs USC, you signed a contract promising to repay any benefits your sponsee claims and the health insurance subsidy is just such a benefit".
We've discussed this a couple of times, but have yet to find a definitive answer. The nightmare scenario is, one bunch of feds says "OK, Mr LPR, you're eligible for the subsidy so it's only just that you be subject to the penalty for not having insurance" while another says "OK, Mrs USC, you signed a contract promising to repay any benefits your sponsee claims and the health insurance subsidy is just such a benefit".
The proposed policies toward nonimmigrants (i.e., those in the United States temporarily, such as students and temporary workers) are more nuanced in large part because some classes of nonimmigrants reside legally in the United States for extended periods of time, some are employed and taxed as a result of those earnings, and some are on a track to become LPRs.
http://www.hlc.org/Att_3_-_CRS_Report.pdf
#10
Joined: Jan 2008
Posts: 7,605
Re: Cynical US Healthcare questions
[B]Legal permanent residents (LPRs) are treated similarly to U.S. citizens under all three major health care reform bills. They are mandated to obtain health insurance, are eligible to purchase insurance through the exchange, and are eligible for the premium and cost-sharing subsidies if they meet the other eligibility requirements. This consistency of treatment holds regardless of when they entered the United States or whether they came initially as refugees or asylees.
#11
Re: Cynical US Healthcare questions
Nowhere does that say "And no branch of the federal government will seek to recover any such subsidies from the LPR's sponsor." LPRs are "eligible" for no end of MTBs, in that there is no specific exclusion, which may well be why the recovery provisions are in the sponsorship agreement in the first place.
I would be extremely surprised if LPRs were not treated the same as US citizens including that the sponsor would not be required to repay the government.
Last edited by Michael; Mar 29th 2010 at 4:10 am.
#12
Re: Cynical US Healthcare questions
I think you are looking for something that was not intended. First of all the subsidy based on income is a tax credit and tax credits have never been treated differently between US citizens and LPRs.
I would be extremely surprised if LPRs were not treated the same as US citizens including that the sponsor would not be required to repay the government.
I would be extremely surprised if LPRs were not treated the same as US citizens including that the sponsor would not be required to repay the government.
LPRs are prohibited from receiving means-tested benefits in their first 5 years as an immigrant.
If they are awarded means-tested benefits, AND the issuing agency chooses to do so, they may be sued (or their sponsor) for repayment of the means-tested benefit.
The easy way to the answer is to ask: Are subsidies considered 'means-tested benefits'? Even though the subsidies are based on income, I'm not sure the answer is 'yes'.
#13
Joined: Jan 2008
Posts: 7,605
Re: Cynical US Healthcare questions
I tend to agree.
LPRs are prohibited from receiving means-tested benefits in their first 5 years as an immigrant.
If they are awarded means-tested benefits, AND the issuing agency chooses to do so, they may be sued (or their sponsor) for repayment of the means-tested benefit.
The easy way to the answer is to ask: Are subsidies considered 'means-tested benefits'? Even though the subsidies are based on income, I'm not sure the answer is 'yes'.
LPRs are prohibited from receiving means-tested benefits in their first 5 years as an immigrant.
If they are awarded means-tested benefits, AND the issuing agency chooses to do so, they may be sued (or their sponsor) for repayment of the means-tested benefit.
The easy way to the answer is to ask: Are subsidies considered 'means-tested benefits'? Even though the subsidies are based on income, I'm not sure the answer is 'yes'.
#14
Re: Cynical US Healthcare questions
I hope you're both correct, I just don't trust the govt to play fair when the word "immigrant" comes up in the context of healthcare. In any case, it's somewhat moot for me, as I should have naturalized by the time it takes effect, but there will be plenty of folks who haven't.
#15
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: Cynical US Healthcare questions
I hope you're both correct, I just don't trust the govt to play fair when the word "immigrant" comes up in the context of healthcare. In any case, it's somewhat moot for me, as I should have naturalized by the time it takes effect, but there will be plenty of folks who haven't.