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PostPosted: Thu Sep 13, 2018 7:59 am 
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triviawayne wrote:
with your definition of a Cadillac plan, "very low" is not a definition, so what is very low, and how did you come to conclude that my plan isn't in this boundary you failed to define?


A Cadillac plan is a plan whose cost (the amount paid by the insured employee and employer combined but not including deductibles and co-pays) exceeds threshold amounts that are currently $10,200 for individuals and $27,500 for families. These figures will be adjusted upwards by 2022 when the tax takes effect. These plans tend to be those covering higher paid employees who command better benefits in general, but they can apply to companies that have a large number of older, less healthy or employees in high risk job classifcations. The first study I saw estimated that 11% of employees would be subject to the tax when it takes effect in 2020.

Because the definition of these plans is based solely on premium cost, high deductible health plans (which are the only plans offered by a number of companies) would not be considered Cadillac plans.

Employees who have "affordable" coverage can apply for plans in the Obamacare exchange but can't receive subsidies. Affordable coverage is currently about 9.6% of the employee's pay. If the employer health plan costs more, the employee can go to the exchange and would undoubtedly qualify for a subsidy.

As for the mandate, there are exemptions to the mandate. The most frequent are minimum income ($12K/24K married), affordability (least expensive bronze plan costs more than 8.1% of household income), living in a non-expanded Medicaid state when income applies for Medicaid, and hardship (includes things like being evicted, homeless, filing bankruptcy, recent deaths in family, domestic abuse victims, natural disaster damaged home). So, a lot of people with low or no incomes can at least get exemptions from the mandate.

In any case, Obamacare coverage includes preventive checkups and a number of medications and vaccinations (flu shots), so there is benefit to it without deductibles and co-pays going into effect.

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PostPosted: Thu Sep 13, 2018 8:10 am 
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triviawayne wrote:
Bob Juch wrote:
triviawayne wrote:
amazing all that's been said, yet none of it answers the question I asked in the first place:

How many people are being forced to pay for insurance they can't afford to actually use?

This is a real problem, and just like the politicians in Washington, nobody here is acknowledging its existence.

Our health care system is broken even for those with healthcare. Even with my insurance, I often don't go to doctors when I should because of the co-pays and co-insurance.

While nobody has an answer to fix it, making things worse for those already in bad situations while claiming to be helping them is just ridiculous.

Who's forcing people to pay for insurance they can't use? No one that I know of.

You told about insurance that you had through your employer, that you erroneously called a Cadillac plan*, that you couldn't use because of high copays and coinsurance. Who forced you to have that?

(I was in the same situation: I couldn't afford to get a colonoscopy because it wasn't free as it is now, and my deductible was high. When I used some of my BAM winnings to get one, they found a polyp that was very close to bursting through the colon wall.)

*By definition, a Cadillac plan has very low or no copayments and deductibles.


I think you need to look up the definition of "mandate"

with your definition of a Cadillac plan, "very low" is not a definition, so what is very low, and how did you come to conclude that my plan isn't in this boundary you failed to define?

"Very low" is almost zero.

If you had had a Cadillac plan, you would not have had to worry about copayments.

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PostPosted: Thu Sep 13, 2018 9:13 am 
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triviawayne wrote:
Bob78164 wrote:
triviawayne wrote:
amazing all that's been said, yet none of it answers the question I asked in the first place:

How many people are being forced to pay for insurance they can't afford to actually use?

This is a real problem, and just like the politicians in Washington, nobody here is acknowledging its existence.

Our health care system is broken even for those with healthcare. Even with my insurance, I often don't go to doctors when I should because of the co-pays and co-insurance.

While nobody has an answer to fix it, making things worse for those already in bad situations while claiming to be helping them is just ridiculous.
I did answer. My answer was none. With the possible exception of working poor in states that rejected the Medicaid expansion, in which case the answer is for those states to adopt the Medicaid expansion. --Bob


none with a possible exception to blah blah blah is not none; and this problem doesn't know state lines
Given the affordability exceptions that sss sets forth in his post, I don't see how anyone who can't afford housing or food could be subject to the mandate (and that's before this year's repeal of the tax penalty for failing to comply with the mandate), yet that's what you say has happened to you. How? --Bob

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PostPosted: Fri Sep 14, 2018 5:40 am 
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Bob Juch wrote:
triviawayne wrote:
Bob Juch wrote:
Who's forcing people to pay for insurance they can't use? No one that I know of.

You told about insurance that you had through your employer, that you erroneously called a Cadillac plan*, that you couldn't use because of high copays and coinsurance. Who forced you to have that?

(I was in the same situation: I couldn't afford to get a colonoscopy because it wasn't free as it is now, and my deductible was high. When I used some of my BAM winnings to get one, they found a polyp that was very close to bursting through the colon wall.)

*By definition, a Cadillac plan has very low or no copayments and deductibles.


I think you need to look up the definition of "mandate"

with your definition of a Cadillac plan, "very low" is not a definition, so what is very low, and how did you come to conclude that my plan isn't in this boundary you failed to define?

"Very low" is almost zero.

If you had had a Cadillac plan, you would not have had to worry about copayments.


nice of you to decide these things for me...but what is "almost zero"?


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PostPosted: Fri Sep 14, 2018 5:42 am 
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Bob78164 wrote:
triviawayne wrote:
Bob78164 wrote:
I did answer. My answer was none. With the possible exception of working poor in states that rejected the Medicaid expansion, in which case the answer is for those states to adopt the Medicaid expansion. --Bob


none with a possible exception to blah blah blah is not none; and this problem doesn't know state lines
Given the affordability exceptions that sss sets forth in his post, I don't see how anyone who can't afford housing or food could be subject to the mandate (and that's before this year's repeal of the tax penalty for failing to comply with the mandate), yet that's what you say has happened to you. How? --Bob


I never said which ones are subject to paying and which ones aren't. What I have said is there are those that are subject to paying, are paying because they are forced to, and it doesn't do them any good because of the deductibles and copays.


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PostPosted: Fri Sep 14, 2018 9:38 am 
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triviawayne wrote:
Bob78164 wrote:
triviawayne wrote:

none with a possible exception to blah blah blah is not none; and this problem doesn't know state lines
Given the affordability exceptions that sss sets forth in his post, I don't see how anyone who can't afford housing or food could be subject to the mandate (and that's before this year's repeal of the tax penalty for failing to comply with the mandate), yet that's what you say has happened to you. How? --Bob


I never said which ones are subject to paying and which ones aren't. What I have said is there are those that are subject to paying, are paying because they are forced to, and it doesn't do them any good because of the deductibles and copays.
You said there are people who are "forced to pay" who are worse off because they "can't afford" the deductibles and copays. I assumed you were referring to yourself. I'm trying to understand how it can happen that people who have so little money that they can't afford copays and deductibles can be in a position where they are "forced to pay" for insurance. --Bob

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PostPosted: Fri Sep 14, 2018 9:40 am 
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Jonathan Chait wrote:
It would be extremely reasonable for a liberal who favors Obama-Romney-style subsidized private insurance to conclude that market-based insurance is simply too vulnerable to right-wing sabotage, and the only safe path for covering people who can’t afford their own insurance is through public programs.
I've been thinking this for a while now. I'm glad someone clearly articulated it. --Bob

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PostPosted: Sun Sep 16, 2018 12:29 pm 
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BackInTex wrote:
T_Bone0806 wrote:
BackInTex wrote:

Just curious, what part are you "wow"ing at?



The "self-inflicted" part. I realize you said "most", but to me, "most" is still off-base.


We could debate that but smoking, obesity, lack of exercise, poor diet, and drug use are pretty much all self-inflicted and probably are the main contributing factors in most life threatening medical conditions for folks under 65 or 70. There are some minor exceptions for obesity and poor diet being self-inflicted.

Maybe I'd lose that wager, but how about saying a large portion of life threatening conditions?
Cancer's a pretty big one, and usually isn't linked to any of these (except for smoking, and smokers pay higher premiums).



--Bob

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