Before I made my decision on how I feel about this new Health Care Reform law, I downloaded a copy of the full Bill myself before it was passed into law and have read much of it. I have verified points driven home by both sides of the issue - those for and against it. I have found for myself how this law will affect me and my family.
Using the calculator established by the Washington Post at this link http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/ we can see what the real effect will be on average, real people and their families.
Let’s take a look at a few:
A family of 3 earning $46,500:
Takes effect in 2014. This family will receive tax credits to help with paying insurance premiums offered in the newly created exchanges and assistance with co-pay and deductibles. A family this size with this income is ensured of not spending more than $3743.25 to $4417.50 for their premiums. Their co-pay and deductibles are capped at 30% of the total cost. This family is required to have health insurance and if they don’t they will have a tax penalty of up to $2085 or 2.5% of their household income.
To view for yourself – go to the calculator and enter the following parameters: Do not currently have insurance, 3 members in household, annual income of $46500 and married.
A married couple earning $30,000:
Takes effect in 2014. This couple will receive tax credits to help with paying insurance premiums offered in the newly created exchanges and assistance with co-pay and deductibles. This couple with this income is ensured of not spending more than $1890 to $2415 on their premiums. Their co-pay and deductibles are capped at 27% of the total cost. They are required to have health insurance and if they don’t they will have a tax penalty of up to $2085 or 2.5% of their household income.
To view for yourself – go to the calculator and enter the following parameters: Do not currently have insurance, 2 members in household, annual income of $30000 and married.
A single person earning $22,500:
Takes effect in 2014. This person will receive tax credits to help with paying insurance premiums offered in the newly created exchanges and assistance with co-pay and deductibles. The tax credits this individual will receive will ensure that they spend no more than $1417.50 to $1811.25 on premiums. Their co-pay and deductibles are capped at 27% of the total cost. They are required to have health insurance and if they don’t they will have a tax penalty of up to $695 or 2.5 percent of their household income.
To view for yourself – go to the calculator and enter the following parameters: Do not currently have insurance, 1 members in household, annual income of $22500 and single.
Takes effect in 2014. This family will be able to buy health insurance in the newly created exchange but they will not receive any help with their premiums and they get no assistance to pay for their co-pay or deductibles. They are required to have health insurance and if they don’t they will have a tax penalty of up to $2085 or 2.5% of their household income.
To view for yourself – go to the calculator and enter the following parameters: Do not currently have insurance, 4 members in household, annual income of $95000 and married.
A single person earning $12,000: (that’s a 40 hour /week - $6/hour – 50 weeks a year, employee)
Takes effect in 2014. This person will receive tax credits to help with paying insurance premiums offered in the newly created exchanges and assistance with co-pay and deductibles. The tax credits this individual will receive will ensure that they spend no more than $360 to $480 on premiums. Their co-pay and deductibles are capped at 6% of the total cost. They are required to have health insurance and if they don’t they will have a tax penalty of up to $695 or 2.5 percent of their household income.
To view for yourself – go to the calculator and enter the following parameters: Do not currently have insurance, 1 member in household, annual income of $12000 and single.
Now lets take a closer look at a few of these examples...
The single person earning $12,000 -
This person will receive "tax credits" to help them purchase health insurance. The most their expense should be to buy this insurance is $480 per year.
But keep in mind an important fact here - this is a TAX CREDIT - meaning that you won't see it until you file your taxes. It will be delivered to you the same way your taxes are refunded now - the cost will come out monthly - you will pay FULL COST MONTHLY and then be REFUNDED the difference, if there is any, when you file your taxes. Much like how your payroll deduction comes out of your paycheck on each and every payday and you don't get that "over payment" back until you file your taxes in the form of a refund.
Can you afford the monthly expense when you’re only earning $12,000 a year to begin with? Sure - you are supposed to get that money back but if you are living paycheck to paycheck as it is - how can you make it until that refund comes through?
Furthermore - this is not 100% coverage. You don't get "free" healthcare at this income level - you are still responsible for up to 6% of the cost of your medical bills.
What does this mean? Let's say you are this person and you have to have a medical procedure that costs $1,000. You are already paying the monthly premium for your insurance – let’s say it's $100 a month (with the balance refunded at the end of the year) now you have this procedure - you are stuck paying the full premium until you get your refund and you are also stuck owing up to $60 on the procedure.
So at $12,000 a year an individual is required by law to lay out the cash for the insurance - and hope they get the refund when they file their taxes (and not an IOU as some states are already doing) and still having to pay 6% of the cost of medical bills.
All of this is enforced by the IRS who will receive a type of "1099" from your health insurance company that they will use to verify - MONTHLY - that you have insurance the government feels is "reasonable" and that you have paid yours premium. If you do not have insurance - EVEN FOR JUST ONE MONTH- you are levied a fine as punishment.
When you go to the exchange to find a health insurance program you supposedly can afford, the IRS is required to release to the Dept. of Health and Human Services (if requested) your SS# and any financial information on you that they can then pass on to the exchange to help them determine what policy you can afford - what "group" you fit into. They (the government) will decide what you can afford and match you with a policy that THEY feel is adequate for your needs.
This is all done in the view that society must require you to be covered so that society doesn't have to pick up the tab should you become sick. In essence it's the way for the government to make you "pay your way" ... don't people see that? They aren't "giving" you anything - they are forcing you buy something that you may or may not be able to afford depending upon your personal lifestyle choices (where you live and how you spend your money) so that they (we - society, the government) are not stuck paying for your health care IF you get sick.
The married couple with 2 kids earning $95,000...
First of all –I realize that too many people this sounds like a lot of money. That totally depends on "where" you live.
If a couple (keep in mind that if both parents work that's only up to $47,500 earned by each parent) lives in New York city on this income they have much less purchasing power than say a couple that lives in Iowa City. Most people need to remember that what they earn is only important as to what it provides for you with your needs - and the cost of your needs changes depending upon what geographic area of the country you live in. Believe me - rent is a WHOLE lot more expensive in any city than it is in almost any "town". Costs are not the same countrywide and therefore we should never charge people on a sliding income scale as this fact is never taken into account.
Secondly - this family may or may not have insurance available through their employers. If they do have it through their employers but find that they can get better insurance through the exchange program the government is setting up - their employers will be punished (fined) if either of them "opt out" of their employers coverage and choose the insurance available through the exchange.
I wonder what impact that will have on their job or their employer’s ability to stay in business? Anyway, let’s say they get this wonderful insurance through the exchange.
At this income they are apparently considered "wealthy" by these government figures - a married couple with each person earning less than $50,000 is determined to not need assistance to buy insurance - even if they live in New York City where rent is out of control - is determined to NEED NO HELP -yet they are still REQUIRED to purchase insurance.
They are "allowed" to buy it from the exchange - but even then there is no guarantee that these policies available through the exchange will be "affordable" - here is how the Wash Post defined an "exchange"
"Small businesses and people buying their own insurance would buy coverage in a new, regulated marketplace called an "exchange," with strict rules banning practices such as denying coverage based on preexisting conditions. The theory is that by pooling many people in one marketplace and inviting competition among insureres, it will lower premiums."
- - - did you catch that word "theory" - - this means they hope that this is what will happen, but there is no government enforced price control so there is no guarantee that these policies will be "affordable" and they have not even opened the door to allow insurance companies from one state to sell to policy holders in another state - you only get to choose from those people who are licensed to do business in your state. Depending upon the state you live in your "pool" of insurers that you get to choose from could only be only two or three different companies - in some states there are currently only three insurance companies allowed to sell insurance to their citizens - and you cannot go to another state to buy it.
How is this not a monopoly?
How are they not forcing you to participate in supporting this monopoly by forcing you to buy their product yet not forcing more competition?
This married couple would essentially be better off by lowering their income because they are getting no help, yet - depending upon where they live - they may not be able to pay the expenses they currently have and are still forced to spend money on a product they may not be able to afford.
Yes, if they or their kids get sick they will now be covered - but keep in mind they will still be paying 100% costs of the premium - and will be responsible to pay whatever portion of the medical procedures that their insurance companies require them to pay – there is no cap at this income level as to what percentage of the medical expenses you are responsible for.
So theoretically - they may still have to pay up to 50% of their medical expenses yet still pay full cost for their premiums. How is this going to keep this family from filing bankruptcy if they are hit with a catastrophic medical crisis - I can tell you - it won’t! When my husband had a heart attack the medical bills were outrageous - if we had had to pay even half of them, while maintaining our insurance premium costs - we still would have had to file bankruptcy. There would have been no way we could have paid it unless our medical providers would have taken a monthly payment program extended over a term of many years.
A single person earning $22,500:
Now this is a reasonable income level for a recent college grad. Let's pretend this is a 27 year old starting their career out. At this age they no longer can be on their parent’s policy and they have to buy insurance. Let’s pretend that they had to move to a city to start their career, say Chicago or New York or Los Angeles.
Cost of living is expensive, rent's are out of this world and other necessities such as gasoline, car insurance, food - are all more expensive than living in small town. But because most small towns are not currently experiencing economic growth - they have to live in one of these cities to get a career started.
This income, $22,500 / year, isn’t very much money to cover these expenses - esp. with the state and federal taxes also being taken out of the paycheck. They are actually living on $1875 a month BEFORE taxes and BEFORE mandatory health insurance.
Sure they will get a tax credit - AT THE END OF THE YEAR - making sure their premiums are no more than $1811.25 per year, but they again have to pay for the insurance up front and wait for the refund.
So what do you think the insurance companies will charge for a healthy 27 year old premium monthly: $100 a month - $150, $200? Whatever it is they will be required by law to pay it and wait for their refund at the end of the year when they file their taxes to cover the expense.
When you are only earning $1875 a month BEFORE taxes to begin with - even that $100 a month is a lot of money. It effects what you can afford for rent, food, transportation or even clothes that may be necessary for your new career. Simple things that you feel you have to have may become luxuries because the law says you must be insurance first.
Again, this will be monitored monthly by the IRS and if you miss your premium - even one month - you will have some portion of a fine levied against you. For not carrying insurance for the entire year you can be fined up to $650 or 2.5% of your income - whichever is greater. If you miss one month it is realistic to assume that you will be fined 1/12 of that fee.
Keep in mind too that the IRS rules regarding "interest" and "penalties" will apply. So if you don't pay your fine on time - guess what, it will grow. In addition to the cost of the premiums this individual must pay - because they make this amount of money - they will also only be guaranteed to never have to pay more than 27% of the cost of a medical procedure - so that $1000 procedure we talked about before will cost this individual up to $270 - in ADDITION to the cost of the premiums.
This is NOT free health care people - it will still cost you and possibly cost you a lot, depending upon your income and your policy.
These are some "real world" examples of how this new law will affect those of us somewhere in the middle. We aren't wealthy and yet we aren't poor enough to qualify for Medicaid - this is where the majority of people will fall.
This doesn't even go into issues like:
· whether or not Alternative forms of medicine are included (acupuncture, chiropractics - many issues some Americans would prefer to try before heading towards invasive procedures),
· whether or not the government will ever be able to dictate your behavior because of the "impact" your behavior may have on the cost of insurance or healthcare (smoking, drinking, poor diet, lack of exercise, obesity, etc),
· Whether or not these rates will stay the same (we all know that Congress never surprises us with changing things like tax rates or income qualification levels - right?),
· whether or not the monies collected for this program will actually go to the program or if they will simply be thrown into a general fund that then can be used for whatever means Congress deems important (war? monuments? Pay Raises for Congress?) - do you trust your current Gov enough to give them this power without finding for yourself first what requirements are put ON THEM?
All we hear are what is required of US - not what the Government is required to do outside of the Medicare and Medicaid programs - and they can't EVEN FUND THOSE!! We all know that congress has NEVER been guilty of raiding the Social Security or Medicare funds for their own purposes, right? Why should we think they would do it to the Health Insurance taxes?
Do you still feel good about this program? Do you honestly look at your paystub every payday and think "that's a reasonable amount to withhold for what I get from the government" - do you honestly feel the government is run in a fiscally responsible and efficient manner?
Because these are the people that will be enforcing your involvement with the Health Insurance industry - they will have final say on whether or not you are "complying" with the law. Don't you feel good about the fact that the people you trust so much already, the IRS, will be the ones deciding whether or not you have "complied"? In fact they will be establishing a new "compliance" division full of over 15,000 new agents to do just that - make sure you are "complying" with the new law. And we all know how they are always right already, never make any mistakes and don't act before you have had a chance to prove yourself innocent on an issue involving them. The IRS is a fair and just department of the government, right? It's good to know they will make sure all of us are "playing fair" as well. After all, it's for our own good.
I completely agree that we need massive Health Insurance reform - but that reform cannot come in the form of this law.
It must address issues such as the dwindling number of professionals entering the health provider industry, the overall cost of unnecessary procedures, the current waste and fraud running rampant in our system, the non-compete factors of purchasing insurance by being required to only doing business with those in your own state, the unethical practices of current insurers of dropping people when they get sick. I'm all for the regulation changes allowing young adults to stay on their parents policies longer, ending the pre-existing (if they can stay in business while doing this), ending the quick-drop when you suddenly get sick, ending the unfair rates established because you are female or other issues - yes it needs to be reformed and dramatically so.
But this isn't making it any better for many people. The horror stories will still be occurring - it will just be a different "class" of people you will be hearing them from.
Now it will be not be from those cheated by their insurance companies and the poor - but it will come from the middle-class who can no longer pay their rent or afford quality food because they are forced to purchase a product they cannot afford.
This is not lifting the poor out of their situation - but pushing down the middle class to be equal to them. It is discouraging investment from those who have the money to invest because now they are taxed on all investments they make - even rent collected from renting out an apartment in their basement - to pay for a program they don't use.
It is unfair.
When Robin Hood stole from the Rich to give to the Poor - he stole from the CORRUPT rich - he was protesting the CORRUPT GOVERNMENT - not the wealthy per say. He RETURNED the money stolen from those that were now poor. He seemed to have no problem with the rich existing and enjoying their spoils when it was collected under what he deemed a fair government - King Richard - it was only under the corrupt and unfair government that he protested it. This is not the government of King Richard - this is a plan of an unfair and unjust government that punishes you for finding success - at any level, not just the extremes and not only by means of theft or unfair practices.
Just my thoughts on why I will not support this program: even though I currently do not have health insurance, even though my husband requires life-saving medication on a monthly basis that we can barely afford, even though my young adult children do not have insurance – I cannot support this law.
I do not support this program because it will not improve my daily life - it will not "give" me health care but instead force me to have it.
I do not support this program because I already have problems with the IRS and I don't need them being even more invasive in my life.
I do not support this program because it takes away the power of choice and replaces it with the power of the IRS to mandate your health.
I do not support this program because it is forced mediocrity of insurance and health care on all of us and penalizes those who accomplish something in their lives.
I do not support this program because I believe it will lead to job loss and deter many from going into business that would otherwise enter the marketplace.
I do not support this program because it rewards you for the less you do and punishes you for the more you accomplish. But that's the way our whole tax structure is anyway - why should I have expected this to be any different.
You don’t believe me? You think I’m offering an extreme point of view or that I am mistaken?
Where? – Show me my errors.
But first – go to the online calculator to see how this Law will affect you and your family. But don’t stop there – also see how it will affect you if you get that big promotion you are dreaming of. Or how it will affect your parents, your siblings, your friends, your neighbors? Don’t just think of yourself – think of everybody you know and try to figure out how this program will affect them. Then – tell me where I am wrong.
Yes – it is VERY good that many of the truly poor will now be included in the Medicaid program, that the idea of the Exchanges will drive down the cost of insurance – but at what expense and with what guarantee? Those added to the Medicaid program may very well be the final straw that breaks their states budgetary backs – and those exchanges offer no guarantee that their insurances will be affordable – it’s a theory. A theory that is unproven and that we are still forced to participate in.
One more thing….
For those of you who are comparing this to a European Model of Healthcare – please keep in mind that because it is our Federal Government demanding these changes and not the individual states, it is more like the European Union dictating to each individual European country what healthcare they would have to provide. Remember – the United States is a large and diverse country, much as each country in Europe is unique - so is each state in our Union. Within each individual state is where these changes should be occurring – structured to fit the unique population and economy of that state.
Related Links:
Washington Post Health Care Calculator:
http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/
http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/
Full text of the Senate Bill – now Law:
http://docs.house.gov/rules/hr4872/111_hr3590_engrossed.pdf
http://docs.house.gov/rules/hr4872/111_hr3590_engrossed.pdf
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