The government is willing to subsidize some premiums but not others. If you don't qualify for subsidies / small business credits / any other offsets, you are going to be supporting more of the issuance pool out of your pocket than those who do qualify. It's pretty straight forward.
I'm beginning to think self-employed people who make enough to disqualify for assistance are in that portion that will be funding the rest.
I have a different understanding of it (or maybe we really are saying the same thing ) .
The ACA states that everyone needs to be covered or they pay the mandated fee. The ACA will subsidize those who qualify when buying through the Exchanges.
The insurance corporations are regulated as what must be covered in order for them to be able to qualify to participate in the Exchange. Once in the Exchange, the competitive pricing is what's going to attract enrollment in to each insurer's plan. The large number of people buying through the Exchange is what allows for the insurers to be competetive. They still sell policies outside of the Exchange, but within the regulated system they sell way more and profit more.
None of those profits go to the Federal government, I've previously stated where I think the money is coming that allows this to be a net positive.
So my original point (many posts back) was that an unsubsidized policy you buy from the exchange is still a better deal that what you'll get outside the Exchange. I don't see this as a portion that is "funding the rest". That's all. Either way you and Jim are getting screwed because the insurance corporations aren't forced to help those in your income bracket with no dependents.
Loc: Alexandria, VA
So my original point (many posts back) was that an unsubsidized policy you buy from the exchange is still a better deal that what you'll get outside the Exchange. I don't see this as a portion that is "funding the rest".
Look at it this way: We both have the same Greatest Insurance Policy In The World™ which has a premium of $100/month. It's a great plan. Takes care of everything. A tremendous deal. Both of us pay our $100 /month into a pool, along with millions of other people who also have the same Great Plan. The idea being that some people will actually need that money to pay for healthcare, while others will not. Which sounds like a gamble, since you might never need the cash but will still be paying into the pool regardless. But that's the risk we're willing to take, and we comfort ourselves that this really isn't a form of Socialism. Honest.
So just by paying premiums, each one of us is already "funding the rest," especially since what we take out of the pool (if and when we do) will probably amount to vastly more than we contributed. Like I said: not Socialism. At all.
So now the government comes along and says that *everyone* has to participate in the pool. Since this means more people taking money out of the pool, costs will go up. But there's also more people paying in premiums, so maybe that will cover those costs. Heck, it might even save us money. The CBO says so, so it's probably true.
The government also says it will help out some of the people in the pool by covering, say, $90 of their $100 premiums. Those not qualifying for the government largesse with still have to pay the whole $100. The $100 premiums are still funding the pool, but now some people are only having to put in $10 out of their pockets, while others are still putting in $100.
To me, it would seem that those who are still paying $100 are "funding the rest" out of their pockets more than are the other folks. Mind you, the coverage is still great, still takes care of everything, is a tremendous deal. But that doesn't alter the fact that, everything else being equal, some are putting more into the pool ("funding") than are others.
Not that there's anything necessarily wrong with that, everyone according to their needs I guess. Just remember: not Socialism ;-)
Either way you and Jim are getting screwed because the insurance corporations aren't forced to help those in your income bracket with no dependents.
Er, no. The insurance companies aren't being forced to help *anyone* at all, so I'm not really sure why they should be forced to help folks like Jim and me. It's the government that's doing all the helping. Jim and I are being screwed, relatively speaking, because instead of a single payer system where the government helps everyone, we get this scheme where the government helps some people and lets the rest pay full boat.
Which I don't really have a problem with if we actually realize the societal benefits this is supposed to bring. But I still think single payer would be a lot simpler, efficient and effective. We'll see ;-)
Lawrence O'Donnell had a great segment on tonight that spoke directly to you and Jim. He had a chart showing the percentages of people effected by the ACA. 80% not at all - either on Medicare or employer coverage. A largest portion of the remaining was for those eligible for Medicaid. 4% of the country is like me, individual/family buyers qualified for federal assistance. The last and smallest group was 1.4% individual buyers that did not qualify. I heard that and felt your pain.
I understand your view. I disagree that buying a policy and paying a premium is contributing to a pool. It's not a collected fund held by anyone other than the corporation you bought it from. It's a pool only in the sense that it's a growing subset of insured bodies within the population. The insurance corporations didn't want to conform to the new regulations, but they must if they want to jump on this gravy train. The pool is all their's. That's where all the premium money goes, including the part subsidized by the federal government.
Medicare and the ACA is socialism in spirt and intent, but under the surface it's all corporate capitalist nugget-filling same as always. At least it's a start at something better, for now in Blue states anyway.
Loc: Alexandria, VA
I disagree that buying a policy and paying a premium is contributing to a pool.
Of course it is. Otherwise insurance couldn't exist. And it obviously does, because that's what pays for claims. It doesn't really matter if it's controlled by a corporation and paid for by premiums, or controlled by the government and paid for by taxes. The concept is basically the same: pooling resources to provide coverage for everyone in the pool. That someone profits from this doesn't mean it doesn't exist or that premiums don't contiribute to it.
It's not a collected fund held by anyone other than the corporation you bought it from.
Nevertheless it still exists, and your premiums fund it. The government doesn't fund it (except now in a limited sense, via subsidies). The corporation certainly doesn't fund it. Basically, your premium funds it and is the only thing that makes the whole thing even possible. The fact that a corporation makes a profit from this scheme doesn't make that any less a fact.
The pool is all their's.
Yes, it is. And until the government takes it over, it will remain so. That doesn't mean that in the meantime the pool doesn't exist or that your premiums don't contribute to it. Nor does it mean that if the government subsidizes some contributions to it, others are paying more out of their pockets to fund it. Which is my entire point.
Insurance in concept is a completely Socialist construct. It wouldn't be tolerated in this country (because: Socialism!) if someone hadn't figured out a way to insert themselves as a middleman and skim profits. That magically makes it okay (because: profits!). It's one of the great ironies of our society (along with other radical Socialist ideas such as … communities … and states … and taxes … and other stuff that basically makes our country work) ...
"If it turns out that President Barack Obama can make a deal with the most intransigent, hard-line, unreasonable, totalitarian mullahs in the world but not with Republicans? Maybe he’s not the problem."
Loc: Alexandria, VA
Just as an update, I decided to go ahead and pull the trigger and enroll on the Federal site today.
Hopped-on to may account (yes, "hopped" -- login was zippity-split!), went to my options, selected one and hit "Enroll." "Grats!" says the website, "you've successfully enrolled! Your carrier will contact you in a day or two with payment details."
Whole thing took about 30 seconds =D
NOW we'll see if I actually *have* that insurance -- apparently that's where the bugaboos are theses days. We'll see in a day or so ...
Loc: Alexandria, VA
So … after having not heard anything over the past week, I called CareFirst today to see if they had my application from the marketplace.
Oops! Glad I checked, since the healthcare,gov site still says I've been enrolled. Anyways, after making sure that if the application from healthcare.gov does show up eventually it won't screw-up anything else in the works, I applied directly on CareFirst's own website …
… and got approved about 20 minutes later.
So: stories that the government site's front-end works well, but the back-end (insert butt and/or Santorum joke here) still needs work appear to be true ...
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