The Washington Post: Obamacare: Understanding the Affordable Care Act

From the Washington Post Twitter feed:

Obamacare starts Tuesday, shutdown or no shutdown. Here's how to sign up wapo.st...

Obamacare: Understanding the Affordable Health Act

To help readers understand and maneuver through Obamacare — the Affordable Care Act — the Washington Post has published a variety of consumer stories, FAQs, online chats and video segments, linked below. Check back for regular updates.

Archived chats:

Obamacare enrollment: How does it work?

Obamacare Q&A: Health reporters and columnists

Obamacare Q&A: Health reporters Mary Agnes Carey and Julie Appleby

Thanks to the Washington Post for that... let me check this over... okay. It looks like the Question and Answer sessions start with the most relevant question and then get more specific, and they do answer the questions. I honestly know hardly anything, so I find this helpful.

The first link is more general it seems, and then the second two links get into specific, more complicated scenarios.

reply to post by darkbake


Other links:

HR3590: Patient Protection and Affordable Care Act

This is the link to the actual text of the bill in case anyone wants to go there to interpret the legal side of things. If you download the .pdf file, you can search it for certain keywords to help find things faster - including the numbers used in the table of contents.

Wikipedia: Affordable Care Act

Wikipedia on the Affordable Care Act. It has an entire section on Myths, and has details on stuff like the cost of the program and the opposing opinions to it that wouldn't be found on the other links.





From The Washington Post:

Q.
OBAMACARE CONTACTS
Do you have a list of the "specific" people, phone numbers, email, web address and organization they are with? I need to be able to contact someone for sign up into the health care program both nationally and state by state. I have been looking for several months online and calling state officials, and I cannot find anything! Two weeks before enrollment and I have to ask a private news organization who to contact about a federal program.

– September 16, 2013 3:29 AM Permalink

A.
MARY AGNES CAREY :
Start with healthcare.gov, which can tell you if your state is running and exchange and if so will send you to that specific web site. You can also call 800-318-2596 to contact someone at healthcare.gov.

Yeah, I thought that was an important question.

reply to post by darkbake




Anyway I thought I would add something entertaining. So a music video. It took me a while to pick this one. Just watch it and think of Obama Care being the clean up crew -

Thank you! S/F for posting a link to the entire, original bill that started this whole dog and pony show. That's invaluable for reference and context, no doubt. Good suggestion on PDF. That's the best way to handle BIG files in my experience. Searching is fast and Government docs often have a table of contents PDF readers will pick up too.

I would note, to add to your point and in no way to detract from it.... The ACA left enormous latitude in how the infrastructure was developed for specifics. ..or to put it a less generous way? 'We'll figure it out when we get that far'. That's important in just knowing to look for what has happened to define or even change (usually for the chaotic or worse) what is in the original foundation of the law.

Just imagine the mess to consider that enormous thing...with pages and pages to define, regulate and interpret each page of IT ..somewhere out there by now. As each area is used...more pages. It's the little monster that keeps growing. Chia pet had nothing on this.

reply to post by darkbake


I just received a letter from the VA administration that states if you are signed up with the "Veteran's health care program" you have coverage under the standards of the health care act.

I know that those vets that are signed up with the VA are getting this letter but I don't know if those that are not signed up are getting it. This may be the time to consider sighing up, it may be the single best thing you get from serving your country to be able to get out from under this mess.

Thanks for the post darkbake.

www.washingtonpost.com...

If my employer doesn't offer affordable coverage - and I don't get insurance in my state's exchange - do I still have to pay the fine?

SK: Generally the answer is yes: If you don't buy health insurance in 2014, you will likely face a tax penalty ($95 or 1 percent of your income, whichever is higher).

There is one exception to this: If you cannot find a health insurance plan that is affordable, the federal government will not require you to purchase a plan. The federal government defines "affordable" as something that costs less than 9.5 percent of your income.

I've read posters saying the premiums would cost over half their income or more. But 9.5 or less % is considered affordable, though I think it should be a lot less, more like 2.5%.

reply to post by Unity_99


That's affordable according to you.

I know many people living paycheck to paycheck that can not afford that amount, regardless of what people like you or the government tell them is affordable.

reply to post by Unity_99


That's affordable according to you.

I know many people living paycheck to paycheck that can not afford that amount, regardless of what people like you or the government tell them is affordable.

reply to post by Tinkerpeach


Im guessing on what is considered affordable in this system, when it should be free. For those on fixed incomes or below poverty level it is free in Canada. And I'm trying to guess if say a person earned 1800 a month clear, what 70 dollars a month for medicare works out to as a percentage. I think world wide health care without cost, is essential myself. That was just scaling down the outrageous cost of 9.5.

reply to post by Unity_99


I still look at this as a additional tax, not affordable healthcare. Just another way to fleece the taxpayers of their money. Since when has the IRS been in charge of our health until now?

It would not surprise me if they use this tax (and tax laws attached) to start claims on homes and property. We are heading to a debtors prison before to long.

Let's say that you have inherited a house with property from your parents. But your job has reduced both you and the spouse to part-time because of this act. Combined, you both can still pay the property tax and provide the basics in life, keeping a roof over your head.

Now along comes the ACA, which you cannot afford, but still have to pay the fine. It'll only be a matter of time before the IRS comes along and seizes your house and property.

reply to post by TDawgRex


Already here in about 1/3 of the States.

Judges can send you to prison for failing to pay in certain cases.

www.huffingtonpost.com...

reply to post by TDawgRex


Well it looks like one of the most costly medicare systems in the world and will directly affect the economy. How many will be frequenting local restaurants, that employ many university students making their educations possible? How many will be frequenting the small and local businesses, eating well even for that matter?

What doesnt make sense to me is why the businesses aren't boycotting and lobbying against this and refusing to cooperate. Since this is going to bankrupt many of them.

I still can't afford it and I still don't want it. The deductibles are a joke and the money spent on the monthly premiums would be better off spent on food for the family. How I choose to get heath care, is none of the Government's business. For me and millions of other Citizens it is just another brick in the wall.

Wrabbit2000
Thank you! S/F for posting a link to the entire, original bill that started this whole dog and pony show.

Just imagine the mess to consider that enormous thing...with pages and pages to define, regulate and interpret each page of IT ..somewhere out there by now.

Thanks, Wrabbit. I wanted to make a post on Obama Care that started with lots of links to facts because it seems super complicated - I don't think the conversation would get very far if there weren't those links.

Also, more than likely, it would fall apart during the implementation phase. I was wondering, what happens when a white inspector puts a black family on an intervention plan? Or a Christian inspector does the same to a gay family?

Then who is going to point fingers? Well, probably not at Obama Care but at Republicans. Our news media is insane and sensationalist, so I could see those stories being blown to illogical levels.

But the truth of the matter is, Obama Care has the potential to be the vehicle for that.

reply to post by Unity_99


I am wondering about the effect on the economy as well. In addition - for those not on healthcare - healthcare is now a requirement, just like insurance on your car.

This is a subsidy calculator:

NPR: Obama Care Subsidy Calculator

By the way, one of the questions there is if you smoke or not, it does affect your subsidies.

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Prescription drugs may not be as affordable, at least not in New Jersey.

Overall, experts say those who already have heath coverage may see higher premiums to cover the new drug benefits, but lower out-of-pocket pharmaceutical fees. But less expensive insurance plans will probably cost the consumer more down the road in higher out-of-pocket prescription medication charges.

recent analysis of seven states whose health care exchange plans have been submitted shows the higher the plan’s premium cost, the lower the prescription prices. Those who choose the bronze and silver plans, however, will pay higher out-of-pocket costs, according to the analysis by HealthPocket, an independent research firm that compares and ranks health plans by state. Because certain drugs not covered by specific plans aren’t subject to out-of-pocket limits, HealthPocket found that consumers must make sure a particular medication is within the drug benefit before selecting the right plan.

Prescription Drug Coverage Under ObamaCare Comes at an Unspecified Price

reply to post by darkbake


Here are the essential services provided, according to Obama Care Facts:

Essential Health Benefits

The Affordable Care Act ensures Americans have access to quality, affordable health insurance. To achieve this goal, the law ensures that health plans offered in the individual and small group markets, both inside and outside of Affordable Insurance Exchanges (Exchanges), offer a core package of items and services, known as “essential health benefits.” EHB must include items and services within at least the following 10 categories:

Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance use disorder services, including behavioral health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care

Obama Care Facts

I am wondering if preventive services are required, or just essential.

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That amount – $328 per month – is the national average for the mid-tier “silver” premium based on HHS calculations for approved plans in 48 states. The challenge, of course, is that like all of healthcare itself, your mileage will vary.

Another important factor in all of this is the extended open enrollment period. Unlike most 90 day health insurance enrollment windows, this one (for 2014 coverage) will run a full 6 months – until March 31, 2014.

Forbes: Average Cost for Obama Care Silver Plan $328 Per Month

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From the same source:

Unlike a cell phone plan, however, health insurance for many is a product that won’t get daily – or even weekly or monthly use. Which remains one of the 4 big unknowns to the President’s signature legislation. Will the uninsured – those without access to insurance through an employer and those that tend to be in lower income brackets – actually buy health insurance at scale as the President hopes? Or will the penalty be more of the default choice?

The penalty may seem minor for year 1, but it does increase dramatically for the second and subsequent years.

* 2014 – $95 per uninsured person (or 1% of household income over filing threshold)
* 2015 – $325 per uninsured person (or 2% of household income over filing threshold)
* 2016 (and beyond) – $695 per uninsured person (or 2.5% of household income over filing threshold)

According to KFF, there remains large confusion over both the plans themselves and their cost. A tracking poll released by KFF last week (here) shows that 51% of the public generally and 67% of the uninsured (a key demographic for ACA success) don’t have enough information about the law to know how it will impact their families.

From the same source, this time on the exchanges:

Perhaps even more problematic is that only about 13% of the uninsured know that at least some of the online exchanges (places to shop and then buy insurance) will be open this Tuesday – October 1.

This is where you want to go if you are looking for coverage:

The Commonwealth Fund: Healthcare Exchange Information by State

So hey... this is pretty complicated.

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The individual mandate to buy health insurance and the public exchanges designed to create a new consumer marketplace are really key components to the larger shift. That shift is designed to create a new consumer model and options for both insurance purchase and healthcare consumption. As the President also said last week:

It’s a historical accident that in this country health care is attached to employers. President Barack Obama (9/24/2014)

His signature legislation – the Affordable Care Act – is clearly designed to create more consumer options which will also move more financial and clinical responsibility to each of us as individuals for our own healthcare. The official start for that sizeable shift has finally arrived. It is this Tuesday – October 1.

The real question remains. Just how successful has the President been on convincing Americans of the need to buy into managing their own healthcare cost – either near or long term? The KFF poll isn’t encouraging – but either way – we’re about to find out.

So, there could be possibilities here -

Kumo77
I still can't afford it and I still don't want it.

You will have to pay an increasing yearly tax then, I think. I placed a chart above - hopefully that is in yearly payments.

Tinkerpeach
reply to post by Unity_99

 

That's affordable according to you.

I know many people living paycheck to paycheck that can not afford that amount, regardless of what people like you or the government tell them is affordable.

This is why a lot of us wanted universal healthcare. Those with lower incomes or going through hard times would have a small percentage of their income taken out as tax depending on what the income cutoff is at the lower end instead of trying to pay for more expensive insurance premiums.

reply to post by Kaploink


I just tagged those taxes in Pink above for anyone who is interested.