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  1. #1
    Senior Member Judy's Avatar
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    Is Obamacare really affordable? Not for the middle class

    Is Obamacare really affordable? Not for the middle class

    by Tami Luhby @Luhby November 4, 2016: 8:20 AM ET

    For the 85% of enrollees with lower incomes, federal subsidies make the premiums somewhat more affordable. Those even closer to the poverty line can get additional subsidies that reduce the deductibles, which can run into the thousands of dollars.

    But for many middle class Americans -- a single person earning more than $47,520 or a family of four with an income of $97,200 -- the pricey premiums and deductibles mean health care coverage remains out of reach.

    "The middle class are getting squeezed," said Larry Levitt, senior vice president at the Kaiser Family Foundation. "They aren't getting subsidies and these deductibles are hard to afford."

    This schism is turning Obamacare into another government benefit program for lower- and moderate-income Americans. The typical enrollee has an income of only 165% of the federal poverty level, or $40,000 for a family of four.

    The real problem is that health care is very expensive, Levitt said. But most Americans don't realize the true cost because they are shielded by their employers.

    Some 150 million people have insurance through work, paying only about $440 a month for a family plan, while employers cover the rest, or about $1,075.

    Related: Employers push health care costs onto workers

    For the 10.5 million enrollees on the Obamamcare exchanges, health insurance costs are more transparent. And more of the burden falls on the consumers. That is leaving an untold number of Americans opting to remain uninsured, rather than shell out thousands a year for premiums and deductibles. In 2015, 46% of uninsured adults said that they tried to get coverage but did not because it was too expensive, a Kaiser study found.

    The big price spikes for 2017 have some current Obamacare enrollees wondering whether they'll renew their plans next year or opt to pay the penalty of $695 per person, or 2.5% of income, whichever is larger.

    Take Irene Solesky of Towson, Maryland. A mortgage underwriter, Solesky and her husband earn too much to receive a subsidy. So next year, they will have to pay $1,351 a month for a CareFirst Bronze plan for themselves and their two sons. On top of that, they face a $13,100 family deductible.

    "It's a catastrophic policy as far as I'm concerned," said Solesky, 55, noting her Obamacare policy costs twice as much as her mortgage. "Medical insurance was meant to keep medical expenses from driving you in financial ruin, not for the medical insurance to drive you in financial ruin."

    Before the Obamacare exchanges opened in 2014, Solesky had an individual insurance plan that cost her $215 a month to cover herself and her two sons. The deductible was $5,000. But the carrier wouldn't cover her husband because he had high blood pressure.

    Initially, Solesky was looking forward to Obamacare because it did not allow insurers to exclude those with pre-existing conditions, like her husband. But she did not expect the prices to be so high. She's now considering dropping her plan and paying the penalty, especially since the only medical care the family received this year beyond an annual check-up was a mammogram for Solesky.

    While costs vary widely across states and carriers, the average national prices give some insight into just how steep Obamacare premiums and deductibles can be for the non-subsidized. A 30-year-old will pay an average of $311 a month for the lowest-level bronze plan for 2017, while a 60-year-old will pay an average of $744, according to a review by HealthPocket, which analyzes insurance plans. Both rose 21% from this year. And the average deductible on a bronze plan will top $6,000 next year for an individual and come in at nearly $12,400 for a family.

    Health Department officials acknowledge that Obamacare premiums and deductibles can be pricey, especially for those who don't qualify for subsidies.

    "These costs are largely a symptom of the fact that medical costs in this country are extraordinarily high," said Kevin Counihan, CEO of the federal exchange, "We have an 800-lb gorilla here, which is exploding health care costs."

    In the short term, officials are trying to make sure enrollees know about the services they can receive that aren't subject to the deductible. These include an annual check-up, various preventative screenings and, depending on the plan, additional doctor visits and some medications. They are also working with insurers to expand the services they provide outside the deductible.

    Longer term, Obamacare has several provisions designed to slow the growth of health care costs, such as rewarding doctors for delivering more efficient, coordinated care of patients and penalizing hospitals with high readmission rates.

    For lower- and moderate-income Americans, federal subsidies take out some of the sting. They can reduce premiums to just under 10% of a family's household income ... or even lower depending on the policy one picks. Some 72% of all enrollees can find a plan for less than $75 a month. Still, many of these folks have to contend with deductibles of thousands of dollars.

    Those who earn less than $30,000 a year, or $48,000 for a family of four, are also eligible for so called "cost-sharing" subsidies that lower the deductibles and co-pays, as well. Some 57% of Obamacare enrollees receive these additional subsidies.

    A 30-year-old Houston man earning $22,000 a year could find a plan for $100 a month with a $500 deductible next year, thanks to both subsidies. But that same plan would cost $251 a month and come with a $2,400 deductible if he earned $35,000, making him ineligible for any government help.

    "The subsidized are insulated from market realities," said Kev Coleman, head of research and data for HealthPocket. "For the unsubsidized, how attractive are these plans going to be?"

    Related: Obamacare enrollment projected to grow 9% in 2017

    For Michael Horbal, 49, the premium subsidies allows him to select a silver plan rather than a bronze one that would mean higher out-of-pocket costs. Horbal, who is married with four children, paid about $600 a month this year for a policy that originally cost $1,200. The plan has a $4,500 deductible.

    "Having that subsidy ... has allowed us to buy a better plan that we could not otherwise afford," said Horbal, a Newtown, Pennsylvania resident who owns "It's a huge benefit."

    But the reality is very different for Clare Lee, 62. The Midland, Michigan, resident finds himself skimping on care even though he has coverage through Obamacare. Since he and his wife don't qualify for subsidies, they pay $1,200 a month for a Blue Cross bronze plan that comes with a $12,000 deductible.

    Lee, who is in retail sales, didn't go to the doctor when he had a cough in March. He didn't want to pay the full price since he hadn't met his deductible. The cough lasted a month.

    "There were other times I should have gone, but all that comes out of my pocket," said Lee, who, prior to Obamacare, had a Blue Cross plan with a $532 monthly premium and $4,000 deductible. "So I see if I can just work through it."
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  2. #2
    Senior Member Judy's Avatar
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    OH MY GOD!! Were you all aware of these outrageous premiums and deductibles? This is far worse than I thought it was. Oh my God, Republicans, you have to end this dumbest domestic deal ever done by an idiot President and repeal Obamacare. You can't force Americans in our land of the free to make purchases like this. What in the hell is wrong with you, you lazy inept bastards? Someone needs to track down that traitor John McCain and stuff him a hole with Murkowsi and Collins neck-high, cover their heads with honey and ... walk away.
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  3. #3
    Senior Member Beezer's Avatar
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    And if this tax plan gets approved and double the Standard Deduction...more money in people's pockets.

    Sooo....cut off the welfare, the food stamps, free school lunch, the Child Tax Care Credits and all the other subsidies piled on TOP of the lower tax brackets and double deduction. No more smorgasboard of freebies.

    People get enough FREE stuff...time to pass a tax that is within your means...and cut off these other programs!

    No daycare parent work days...the other work nights...or wait to have a family YOU can afford.



  4. #4
    Senior Member JohnDoe2's Avatar
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    OCT 13, 2017 @ 03:11 PM 3,398
    Middle Income 50-Somethings Will Be Big Losers In Trumpcare

    Howard Gleckman , CONTRIBUTOR
    I cover news on Washington

    U.S. President Donald Trump speaks as Sen. Rand Paul (R-KY) (L), Secretary of Labor Alexander Acosta (3rd R) and Secretary of the Treasury Steven Mnuchin (2nd R) look on during an event in the Roosevelt Room of the White House October 12, 2017 in Washington, DC. President Trump signed the executive order to loosen restrictions on Affordable Care Act "to promote healthcare choice and competition." (Photo by Alex Wong/Getty Images)

    President Trump’s multi-pronged administrative attack on the Affordable Care Act would sharply increase premiums for middle-aged people who purchase insurance in the individual market, likely driving many to drop coverage.

    Most would not feel the effects until 2019, though some will face sharply higher premiums in 2018—rate hikes they’ll see when the open enrollment season begins next month.

    The President announced several changes to the ACA this week.

    They are complicated and address different parts of the 2010 law. But the overall effect will be that millions of older, sicker Americans will be priced out of comprehensive coverage while many younger, healthier people may get access to new low-cost, low-benefit policies. Those who are aged 50-64, just before they are eligible for Medicare, could be among the biggest losers.

    Trump’s first step was to order federal agencies to open the door to a broad expansion of those low-cost, low benefit policies. They’d be sold through so-called association health plans, loose groups of businesses that join together to buy insurance.

    Because Trump would largely exempt them from the ACA’s coverage requirements, they could sell policies that exclude hospital care, drug costs, or pre-existing conditions. Such policies would be unattractive to older buyers, who would prefer to stick with traditional ACA exchange coverage. But because younger consumers would likely gravitate to the cheap policies, exchange plans—left with an older and sicker risk pool-- would become increasingly expensive.

    Despite his high-profile signing of yesterday’s executive order, Trump can’t simply establish these plans with the wave of a pen. The changes will require complicated new regulations, a process that could take many months. And it will almost certainly generate lawsuits. Even if they stand up in court, these new rules are not likely to kick in before 2019.

    The more far-reaching was leaked late on Thursday night. The Administration said it will immediately stop paying $7 billion in cost-sharing subsidies to insurance companies. These government subsidies (which are different from the ACA’s premium subsidies) reduce out-of-pocket costs such as deductibles for low- and moderate-income buyers of individual insurance. Without the subsidy, insurers must provide the discounts on their own—a step that will cause them to withdraw from the individual market or raise their rates. The ACA explicitly allows insurers to stop selling exchange coverage if the cost-sharing subsidies are eliminated.

    Because Trump has been threatening to kill that government funding for months, some carriers built their added costs in to their rate applications for 2018. Those higher rates will hit middle-income buyers hardest, since their income is too high to receive premium assistance. A single individual loses premium support under the ACA once her income hits about $48,000.

    Insurance companies have warned that Trump’s move will destabilize the non-group insurance market. It comes on top of other White House moves to wreck that market including efforts to shrink the enrollment period, slash funding for marketing of exchange-based insurance, and cut support for local consumer advisers. All these steps are likely to reduce enrollment, especially by younger people who are less motivated to buy coverage.

    All of Trump’s moves will have the same effect: Buyers are more likely to be older and sicker. And as they increasingly dominate the risk pool, their insurance premiums will rise, making insurance les and less affordable.

    Trump wants to create separate insurance markets for healthy consumers and for those with chronic conditions—who are often 50 or older. Unlike the failed bills that aimed to replace the ACA earlier this year, these administrative changes won’t allow Trump to directly raise premiums on 50-somethings. But they’d let him do so indirectly, and he seems to be doing everything he can to reach that goal.
    Last edited by JohnDoe2; 10-15-2017 at 10:38 PM.

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  5. #5
    Senior Member Judy's Avatar
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    Under Trump's plan, no one is forced to buy or provide insurance, that means insurance companies will have to drop their premiums and lower the deductibles to sign up customers and being able to do so across state lines, they'll have larger pools, lower rates, better deductibles and more options and services..
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