Author Topic: What comes after the ACA?  (Read 349452 times)

Iplawyer

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Re: What comes after the ACA?
« Reply #1200 on: March 02, 2017, 01:10:30 PM »
Seriously, for a moment, let's just indulge in the idea that Hillary was President (you know, the spouse of the former President that floated universal healthcare).  Do you really think that Hillary would let the ACA either fall apart due to neglect

If Hillary Clinton was the US President right now, the health insurance market would not look materially different because the Republicans haven't changed much yet, and what changes they have promised haven't gone into effect.

But I can wager that she would be trying desperately to fix some of the identified flaws with the ACA, and Republicans would be stonewalling her all the way.  They would be wailing about death panels and the end of America at the top of their lungs, and simultaneously refusing to do anything about it.  Remember the Party of No?  Republicans would force the US to live with the ACA exactly as it currently exists, warts and all, for as long as possible.

But what's the end game in that?  I mean EVENTUALLY they were going to get a Republican majority, so holding the ACA in current form would just delay their current problem until that later time, and it's not like they haven't had six years to figure this shit out.  Why would they want that problem later instead of now? 

No, I think I agree with EV2020 and that they are absolutely committed to repeal at this point, consequences be damned.  They'd rather throw 20 million Americans off of their current insurance, and try to spin it as "it's for your own good" than conceded that the Democrats actually helped people.  They'll throw in some tax breaks for their wealthiest constituents to try to save face for fucking with the poor, like they always do.  Maybe their replacement plan will actually be better for some folks, probably rich self-employed business owners or other high-income folks without employer insurance, but I don't see how it could possibly be anything but worse for everyone else.

Well scratch that, I do see one way.   They can always just deficit spend the bejeezus out of it.  They could wholly repeal the ACA and then give every American family a $15,000 refundable tax credit for health insurance.  It would crash the federal budget, but it would technically deliver on their promises of potentially better coverage, with more choices, at lower cost to Americans.
I can't see Hillary trying to fix any of the problems. The dems can't admit there is any problems with the ACA they've fought so hard to keep unchanged for 6 years. Just like the republicans can't admit there is any good parts (though they sort of have, with saying they won't repeal the popular provisons). Hillary would be hamstrung by a congress that wouldn't put forth any bills to improve it, insurers would still be hiking premiums and withdrawing from market places just like they are doing now.

Would such a tax credit be a bad thing? Sure it would crash  the budget, but once the republicans are voted out Dems could raise taxes or at least repeal some of their recent tax cuts and fund it. Would be a win win.

But tax credits don't help with lifetime maximum caps or pre-existing conditions.  And they don't help if the insurance cost many times more than the credit.

snapperdude

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Re: What comes after the ACA?
« Reply #1201 on: March 02, 2017, 01:30:32 PM »
Seriously, for a moment, let's just indulge in the idea that Hillary was President (you know, the spouse of the former President that floated universal healthcare).  Do you really think that Hillary would let the ACA either fall apart due to neglect

If Hillary Clinton was the US President right now, the health insurance market would not look materially different because the Republicans haven't changed much yet, and what changes they have promised haven't gone into effect.

But I can wager that she would be trying desperately to fix some of the identified flaws with the ACA, and Republicans would be stonewalling her all the way.  They would be wailing about death panels and the end of America at the top of their lungs, and simultaneously refusing to do anything about it.  Remember the Party of No?  Republicans would force the US to live with the ACA exactly as it currently exists, warts and all, for as long as possible.

But what's the end game in that?  I mean EVENTUALLY they were going to get a Republican majority, so holding the ACA in current form would just delay their current problem until that later time, and it's not like they haven't had six years to figure this shit out.  Why would they want that problem later instead of now? 

No, I think I agree with EV2020 and that they are absolutely committed to repeal at this point, consequences be damned.  They'd rather throw 20 million Americans off of their current insurance, and try to spin it as "it's for your own good" than conceded that the Democrats actually helped people.  They'll throw in some tax breaks for their wealthiest constituents to try to save face for fucking with the poor, like they always do.  Maybe their replacement plan will actually be better for some folks, probably rich self-employed business owners or other high-income folks without employer insurance, but I don't see how it could possibly be anything but worse for everyone else.

Well scratch that, I do see one way.   They can always just deficit spend the bejeezus out of it.  They could wholly repeal the ACA and then give every American family a $15,000 refundable tax credit for health insurance.  It would crash the federal budget, but it would technically deliver on their promises of potentially better coverage, with more choices, at lower cost to Americans.
I can't see Hillary trying to fix any of the problems. The dems can't admit there is any problems with the ACA they've fought so hard to keep unchanged for 6 years. Just like the republicans can't admit there is any good parts (though they sort of have, with saying they won't repeal the popular provisons). Hillary would be hamstrung by a congress that wouldn't put forth any bills to improve it, insurers would still be hiking premiums and withdrawing from market places just like they are doing now.

Would such a tax credit be a bad thing? Sure it would crash  the budget, but once the republicans are voted out Dems could raise taxes or at least repeal some of their recent tax cuts and fund it. Would be a win win.

But tax credits don't help with lifetime maximum caps or pre-existing conditions.  And they don't help if the insurance cost many times more than the credit.

It is total bullshit to say that Democrats don't want to fix ACA. Obama and other Democrats have been saying for years that there are things about ACA that need to be improved.

Roland of Gilead

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Re: What comes after the ACA?
« Reply #1202 on: March 02, 2017, 01:31:14 PM »
Separately and unrelatedly, Trump's general income tax proposal had proposed increasing the individual standard tax deduction to $15k (as discussed in this Kitces article), which is why you might have heard the $15k number come up as part of an actual proposal outside the four corners of this forum.
Thanks for clarifying. I would definitely be in support of increasing the individual standard deduction to $15000. At the same time we can get rid of deductions such as for mortgage interest, health insurance premiums (both employee/employer), HSAs, 529s etc. Plus if they also increase IRA contribution limits to $15-20K, I'd also be in favor of getting rid of deductions for retirement accounts like 401ks, 403bs, SEP-IRAs.

Plus public and private pensions should be taxed on accrual as income, especially if the pensioner is also eligible to contribute to a IRA.

sol

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Re: What comes after the ACA?
« Reply #1203 on: March 02, 2017, 01:37:34 PM »
Plus public and private pensions should be taxed on accrual as income, especially if the pensioner is also eligible to contribute to a IRA.

They already are.  Do you know of any exceptions?

Some portion of social security isn't taxable.  Everyone gets a standard deduction that makes the first part of their income nontaxable.  But in general, pensions are taxable income and are treated as such.

Or did you mean they should be taxed as you contribute to them each month while working, before being taxed as income when they pay out?

rpr

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Re: What comes after the ACA?
« Reply #1204 on: March 02, 2017, 01:39:33 PM »
Separately and unrelatedly, Trump's general income tax proposal had proposed increasing the individual standard tax deduction to $15k (as discussed in this Kitces article), which is why you might have heard the $15k number come up as part of an actual proposal outside the four corners of this forum.
Thanks for clarifying. I would definitely be in support of increasing the individual standard deduction to $15000. At the same time we can get rid of deductions such as for mortgage interest, health insurance premiums (both employee/employer), HSAs, 529s etc. Plus if they also increase IRA contribution limits to $15-20K, I'd also be in favor of getting rid of deductions for retirement accounts like 401ks, 403bs, SEP-IRAs.

Plus public and private pensions should be taxed on accrual as income, especially if the pensioner is also eligible to contribute to a IRA.
Agreed.

brooklynguy

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Re: What comes after the ACA?
« Reply #1205 on: March 02, 2017, 02:00:47 PM »
Ryan's super secret repeal bill was supposed to be in a hidden location.  Rand Paul was seen dragging a copy machine behind him to make a copy of it.  After a search of hidden rooms the bill was nowhere to be found. 

I am not making this up!

One could be easily forgiven for assuming these news reports were coming from the pages of The Onion.

http://www.vox.com/2017/3/2/14792196/gop-obamacare-bill-search

Roland of Gilead

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Re: What comes after the ACA?
« Reply #1206 on: March 02, 2017, 02:15:56 PM »
Or did you mean they should be taxed as you contribute to them each month while working, before being taxed as income when they pay out?

Yes, this.  Right now a person contributes somewhere between 0% and what, 30%? toward their pension while the employer contributes the other half (or fails to fund it as some entities seem to do).   I do not believe the employer contribution is taxed as income at the time it is made but I may be wrong?

If we are going to just have everyone get a IRA contribution deduction and remove 401K deductions then I think you have to examine pensions also, to be fair.

sol

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Re: What comes after the ACA?
« Reply #1207 on: March 02, 2017, 02:19:55 PM »
Or did you mean they should be taxed as you contribute to them each month while working, before being taxed as income when they pay out?

Yes, this.  Right now a person contributes somewhere between 0% and what, 30%? toward their pension while the employer contributes the other half (or fails to fund it as some entities seem to do).   I do not believe the employer contribution is taxed as income at the time it is made but I may be wrong?

If we are going to just have everyone get a IRA contribution deduction and remove 401K deductions then I think you have to examine pensions also, to be fair.

So you just want to end all tax deferred retirement vehicles?  That's probably going to be an unpopular opinion on an early retirement website.

Do you not want people to save for retirement?  Do you want them to save, but for congress to make it much harder for them to do so?

infogoon

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Re: What comes after the ACA?
« Reply #1208 on: March 02, 2017, 02:40:27 PM »
Preexisting conditions makes health insurance incredibly expensive.  Imagine if house insurance allowed coverage after a fire started? 

I was trying to explain this concept to someone on Facebook earlier this week -- the mandate exists because insurers can't just deny coverage for preexisting conditions any more, those clients are more expensive, and so more money needs to come in to balance the books. Apparently applied arithmetic is only for "libtards".

Roland of Gilead

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Re: What comes after the ACA?
« Reply #1209 on: March 02, 2017, 02:41:50 PM »
Or did you mean they should be taxed as you contribute to them each month while working, before being taxed as income when they pay out?

Yes, this.  Right now a person contributes somewhere between 0% and what, 30%? toward their pension while the employer contributes the other half (or fails to fund it as some entities seem to do).   I do not believe the employer contribution is taxed as income at the time it is made but I may be wrong?

If we are going to just have everyone get a IRA contribution deduction and remove 401K deductions then I think you have to examine pensions also, to be fair.

So you just want to end all tax deferred retirement vehicles?  That's probably going to be an unpopular opinion on an early retirement website.

Do you not want people to save for retirement?  Do you want them to save, but for congress to make it much harder for them to do so?

No, it was rpr that brought it up, I just added in pensions because people may not realize the tax benefit you get on them (just like 401k has a tax benefit).

rpr

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Re: What comes after the ACA?
« Reply #1210 on: March 02, 2017, 02:46:38 PM »
Or did you mean they should be taxed as you contribute to them each month while working, before being taxed as income when they pay out?

Yes, this.  Right now a person contributes somewhere between 0% and what, 30%? toward their pension while the employer contributes the other half (or fails to fund it as some entities seem to do).   I do not believe the employer contribution is taxed as income at the time it is made but I may be wrong?

If we are going to just have everyone get a IRA contribution deduction and remove 401K deductions then I think you have to examine pensions also, to be fair.

So you just want to end all tax deferred retirement vehicles?  That's probably going to be an unpopular opinion on an early retirement website.

Do you not want people to save for retirement?  Do you want them to save, but for congress to make it much harder for them to do so?

No, it was rpr that brought it up, I just added in pensions because people may not realize the tax benefit you get on them (just like 401k has a tax benefit).
Yes  -- I did bring it up. My initial suggestion was to just increase IRA limits to $15-20K per person and get rid of all other vehicles such as 401ks, 403bs, pensions, SEP-IRAs etc. 

jim555

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Re: What comes after the ACA?
« Reply #1211 on: March 02, 2017, 02:53:52 PM »
I didn't contribute anything to my company pension, only 401K, IRAs, SS.

fuzzy math

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Re: What comes after the ACA?
« Reply #1212 on: March 02, 2017, 04:36:24 PM »


True, I did discount this segment of the population. But this is the segment who will never change their behaviors even if they "have skin in the game" like the previous poster was alluding to.
These people probably have Medicaid, or are uninsured. Cutting their insurance is not going to make them suddenly less dumb or mentally ill, won't make them more employable, and they're still going to be seeking out the ER for their care, except now the hospital is going to have to write it off (if they aren't already).

I don't really understand what any of this has to do with the ACA.  If people are making emergency calls for non-emergency matters, shouldn't the fix be to bill them for the services?  If that's not feasible, the problem is going to happen whether or not they have ACA, Medicaid, or no insurance at all.  Even before the ACA, all my insurance plans had a small/no copay for emergency services if admitted, but higher/full responsibility otherwise.  Preventing people from abusing emergency services seems to be a completely orthogonal issue.

You're agreeing with me. I'm not sure if you couldn't tell what my point was. Someone argued that free Medicaid people would ration their care more if they were kicked off and put on a HDHP where they'd suddenly have the sense to ration their care.
It would be great if these people were billed. It would be greater if they suddenly had the means and common sense to pay those bills.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1213 on: March 02, 2017, 08:24:41 PM »
It is total bullshit to say that Democrats don't want to fix ACA. Obama and other Democrats have been saying for years that there are things about ACA that need to be improved.
I haven't seen any legislation proposed or passed by Democrats to address this. Do you have the bill numbers so that i might look up the changes they have suggested?
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Re: What comes after the ACA?
« Reply #1214 on: March 02, 2017, 08:29:33 PM »
Ryan's super secret repeal bill was supposed to be in a hidden location.  Rand Paul was seen dragging a copy machine behind him to make a copy of it.  After a search of hidden rooms the bill was nowhere to be found. 

I am not making this up!

One could be easily forgiven for assuming these news reports were coming from the pages of The Onion.

http://www.vox.com/2017/3/2/14792196/gop-obamacare-bill-search
They'll just have to pass it to find out what's in it.
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sol

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Re: What comes after the ACA?
« Reply #1215 on: March 02, 2017, 09:02:27 PM »
It is total bullshit to say that Democrats don't want to fix ACA. Obama and other Democrats have been saying for years that there are things about ACA that need to be improved.
I haven't seen any legislation proposed or passed by Democrats to address this. Do you have the bill numbers so that i might look up the changes they have suggested?

You are aware that the minority party doesn't get to advance any bills at all, right?

But President Obama spent YEARS trying to fix the ACA, only to have Congress block him at every turn.  Starting with bringing in a whole new team to fix the botched rollout of healthcare.gov.  He has signed (or failed to veto) a whole bunch of bills that modify the ACA. 

Some of them were even sponsored and cosponsored by Democrats!  The most recent was apparently HR 34, sponsored by Democrats from Oregon, which was targeted at reducing Medicare/Medicaid fraud by healthcare providers.  It became law two and a half months ago.

The next most recent was apparently S 599, sponsored by a Democrat from Maryland, which expanded psychiatric care to Medicaid recipients.

Here's a brief summary of overall ACA changes in less technical language (from 2015, so it's missing some stuff), for folks who don't like to read real documents:  http://www.huffingtonpost.com/entry/congress-passed-bill-to-change-obamacare_us_5612af43e4b076812702b75f
« Last Edit: March 02, 2017, 09:28:46 PM by sol »

Metric Mouse

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Re: What comes after the ACA?
« Reply #1216 on: March 02, 2017, 09:27:32 PM »
It is total bullshit to say that Democrats don't want to fix ACA. Obama and other Democrats have been saying for years that there are things about ACA that need to be improved.
I haven't seen any legislation proposed or passed by Democrats to address this. Do you have the bill numbers so that i might look up the changes they have suggested?

You are aware that the minority party doesn't get to advance any bills at all, right?

But President Obama spent YEARS trying to fix the ACA, only to have Congress block him at every turn.  Starting with bringing in a whole new team to fix the botched rollout of healthcare.gov.  He has signed (or failed to veto) a whole bunch of bills that modify the ACA. 

Some of them were even sponsored and cosponsored by Democrats!  The most recent was apparently HR 34, sponsored by Democrats from Oregon, which was targeted at reducing Medicare/Medicaid fraud by healthcare providers.  It became law two and a half months ago.

Here's a brief summary of overall ACA changes in less technical language (from 2015, so it's missing some stuff), for folks who don't like to read real documents:  http://www.huffingtonpost.com/entry/congress-passed-bill-to-change-obamacare_us_5612af43e4b076812702b75f
Can only the majority party introduce or sponsor legislation? You seem to be arguing that Republicans should be held responsible for all of the positive changes in the ACA since their rise to power in 2010, if they are the only ones who can advance legislation.

Thank you for the list. Still much work to do to improve.
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sol

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Re: What comes after the ACA?
« Reply #1217 on: March 02, 2017, 09:34:02 PM »
You seem to be arguing that Republicans should be held responsible for all of the positive changes in the ACA since their rise to power in 2010, if they are the only ones who can advance legislation.

Yes, that is exactly what I'm suggesting.  The American political system is structured in such a way that the majority party has 100% control over each chamber.  Every law that passes only does so because the majority party wants it to.  The majority can always refuse to take up any bill they don't like, or pass it to a committee they control where it can be killed.  They don't even have to vote against it if they don't want to, they can just not let it go up for a vote.

I sometimes talk to congressional staffers, in my job, and they are a disillusioned bunch.  If you are a congressional staffer for the minority party, you basically have nothing to do.  You hold your job in the hopes that someday your party takes control and lets you work on something. 

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Re: What comes after the ACA?
« Reply #1218 on: March 02, 2017, 09:51:23 PM »
Well good. Then we can put the "Republicans refused to improve the ACA" myth to bed. I myself did not know they had positively amended the ACA.
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Erica

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Re: What comes after the ACA?
« Reply #1219 on: March 02, 2017, 11:51:04 PM »


True, I did discount this segment of the population. But this is the segment who will never change their behaviors even if they "have skin in the game" like the previous poster was alluding to.
These people probably have Medicaid, or are uninsured. Cutting their insurance is not going to make them suddenly less dumb or mentally ill, won't make them more employable, and they're still going to be seeking out the ER for their care, except now the hospital is going to have to write it off (if they aren't already).

I don't really understand what any of this has to do with the ACA.  If people are making emergency calls for non-emergency matters, shouldn't the fix be to bill them for the services?  If that's not feasible, the problem is going to happen whether or not they have ACA, Medicaid, or no insurance at all.  Even before the ACA, all my insurance plans had a small/no copay for emergency services if admitted, but higher/full responsibility otherwise.  Preventing people from abusing emergency services seems to be a completely orthogonal issue.

You're agreeing with me. I'm not sure if you couldn't tell what my point was. Someone argued that free Medicaid people would ration their care more if they were kicked off and put on a HDHP where they'd suddenly have the sense to ration their care.
It would be great if these people were billed. It would be greater if they suddenly had the means and common sense to pay those bills.
Except now with medicaid expansion there is a whole segment of the population WITH THE MEANS to pay their own medical bills. Eligibility for medicaid expansion is based on MAGI so all you have to do is donate to your 401k, and/or an IRA to whatever extent to lower MAGI. No resource limit either.
« Last Edit: March 03, 2017, 01:04:44 AM by Erica »

NoStacheOhio

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Re: What comes after the ACA?
« Reply #1220 on: March 03, 2017, 06:06:51 AM »
Except now with medicaid expansion there is a whole segment of the population WITH THE MEANS to pay their own medical bills. Eligibility for medicaid expansion is based on MAGI so all you have to do is donate to your 401k, and/or an IRA to whatever extent to lower MAGI. No resource limit either.

That's going to be a pretty small group of people without employer-sponsored insurance who are willing to shelter that much income and live on ~$16k just to get Medicaid.
The first step is acknowledging you have a problem, right?

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BeanCounter

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Re: What comes after the ACA?
« Reply #1221 on: March 03, 2017, 06:35:58 AM »


True, I did discount this segment of the population. But this is the segment who will never change their behaviors even if they "have skin in the game" like the previous poster was alluding to.
These people probably have Medicaid, or are uninsured. Cutting their insurance is not going to make them suddenly less dumb or mentally ill, won't make them more employable, and they're still going to be seeking out the ER for their care, except now the hospital is going to have to write it off (if they aren't already).

I don't really understand what any of this has to do with the ACA.  If people are making emergency calls for non-emergency matters, shouldn't the fix be to bill them for the services?  If that's not feasible, the problem is going to happen whether or not they have ACA, Medicaid, or no insurance at all.  Even before the ACA, all my insurance plans had a small/no copay for emergency services if admitted, but higher/full responsibility otherwise.  Preventing people from abusing emergency services seems to be a completely orthogonal issue.

You're agreeing with me. I'm not sure if you couldn't tell what my point was. Someone argued that free Medicaid people would ration their care more if they were kicked off and put on a HDHP where they'd suddenly have the sense to ration their care.
It would be great if these people were billed. It would be greater if they suddenly had the means and common sense to pay those bills.
Except now with medicaid expansion there is a whole segment of the population WITH THE MEANS to pay their own medical bills. Eligibility for medicaid expansion is based on MAGI so all you have to do is donate to your 401k, and/or an IRA to whatever extent to lower MAGI. No resource limit either.
Yeah, this sounds like a bunch of conservative rhetoric.
 I don't see how this is possible for most. If you work then you likely have some sort of employer sponsored insurance which would exclude you from Medicaid. If you don't have an employer option, you can only max out your 401k at $18k. So that would be employed people with no employer provided insurance who make no more than $30-$40k?
If you don't work then you don't have a 401k option or an IRA option (other than Roth and that doesn't shelter income). I guess some early retirees could do it by living on a cash surplus with no other source of income?

jim555

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Re: What comes after the ACA?
« Reply #1222 on: March 03, 2017, 07:11:10 AM »
This board is not typical of the average Medicaid user.  Probably 99.98% do not have huge stashes laying around.

NoStacheOhio

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Re: What comes after the ACA?
« Reply #1223 on: March 03, 2017, 07:23:38 AM »

If you don't work then you don't have a 401k option or an IRA option (other than Roth and that doesn't shelter income). I guess some early retirees could do it by living on a cash surplus with no other source of income?

Even then, it isn't sustainable over the long-term.
The first step is acknowledging you have a problem, right?

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sol

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Re: What comes after the ACA?
« Reply #1224 on: March 03, 2017, 10:17:05 AM »
Well good. Then we can put the "Republicans refused to improve the ACA" myth to bed. I myself did not know they had positively amended the ACA.

That's exactly the problem in both sides, though.

Republicans don't want to amend the ACA because it will look like they are trying to save obamacare instead of repeal it.  Democrats don't want to amend the ACA because it will look like they are admitting it has problems. 

Basically, everyone gains political advantage by letting it alone, warts and all.  Congress is so caught up in their partisan divide that they can't do what is best for their constituents.  Frankly, it's kind of amazing they've been able to find anything to fix that they can agree on, but they snuck some changes through as part of other bills when they thought no one would notice.

Notice that not one of the 20 ACA revision bills that have thus far become law made the news in any way.  You are not alone in being unawares.

jim555

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Re: What comes after the ACA?
« Reply #1225 on: March 03, 2017, 11:33:06 AM »
So it looks like the tax credits based on age will now also have an income test.  Employee health benefits to be taxed.

brooklynguy

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Re: What comes after the ACA?
« Reply #1226 on: March 03, 2017, 12:03:26 PM »
So it looks like the tax credits based on age will now also have an income test.  Employee health benefits to be taxed.

Source?  Politico is reporting that means-based eligibility criteria are under consideration but none have yet been added to the draft legislation.  (Note that these do not necessarily have to take the form of an income-only test; an asset test is also within the realm of possibility, which would generally be worse for mustachian early retirees.)

In any event, it's still way to early to say what will or will not be happening.  This is simply a draft version of a single GOP proposal, which has not yet been released to the public or even to the all legislators who would need to vote on it and is likely to undergo significant changes.

jim555

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Re: What comes after the ACA?
« Reply #1227 on: March 03, 2017, 12:26:40 PM »
I don't have a definitive source, but based on the House maniac caucus they were wailing about refundable tax credits going to the rich.  Logically the way to limit this would be to have an income phase out range.  A resource test would be too complex and intrusive. 

This whole thing is based on getting the taxes on the super rich taken away and put on the middle class.  They could care less people will die.

snapperdude

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Re: What comes after the ACA?
« Reply #1228 on: March 03, 2017, 01:33:45 PM »
It is total bullshit to say that Democrats don't want to fix ACA. Obama and other Democrats have been saying for years that there are things about ACA that need to be improved.
I haven't seen any legislation proposed or passed by Democrats to address this. Do you have the bill numbers so that i might look up the changes they have suggested?

You are aware that the minority party doesn't get to advance any bills at all, right?

But President Obama spent YEARS trying to fix the ACA, only to have Congress block him at every turn.  Starting with bringing in a whole new team to fix the botched rollout of healthcare.gov.  He has signed (or failed to veto) a whole bunch of bills that modify the ACA. 

Some of them were even sponsored and cosponsored by Democrats!  The most recent was apparently HR 34, sponsored by Democrats from Oregon, which was targeted at reducing Medicare/Medicaid fraud by healthcare providers.  It became law two and a half months ago.

The next most recent was apparently S 599, sponsored by a Democrat from Maryland, which expanded psychiatric care to Medicaid recipients.

Here's a brief summary of overall ACA changes in less technical language (from 2015, so it's missing some stuff), for folks who don't like to read real documents:  http://www.huffingtonpost.com/entry/congress-passed-bill-to-change-obamacare_us_5612af43e4b076812702b75f


What he said.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #1229 on: March 03, 2017, 01:42:20 PM »
In doing my taxes I found that getting my AGI low by putting such a large amount into my Solo 401K and tIRA is giving me a whole lot of premium tax subsidy support.  It really makes a big difference.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1230 on: March 04, 2017, 10:19:41 AM »
Any thoughts on the republican suggestions for the government to push HSA s, and fund or "seed" them for low income individuals?
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NoStacheOhio

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Re: What comes after the ACA?
« Reply #1231 on: March 04, 2017, 10:51:57 AM »
Any thoughts on the republican suggestions for the government to push HSA s, and fund or "seed" them for low income individuals?

That's probably the only way you'll get people to put any money into them at all. The problem with HSAs is that they presume people have money to put into them.

If my family suddenly got thrown on a HDHP with no corresponding increase to our income (because let's face it, that's exactly what would happen), it would be a problem.
The first step is acknowledging you have a problem, right?

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JLee

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Re: What comes after the ACA?
« Reply #1232 on: March 04, 2017, 11:12:12 AM »
Separately and unrelatedly, Trump's general income tax proposal had proposed increasing the individual standard tax deduction to $15k (as discussed in this Kitces article), which is why you might have heard the $15k number come up as part of an actual proposal outside the four corners of this forum.
Thanks for clarifying. I would definitely be in support of increasing the individual standard deduction to $15000. At the same time we can get rid of deductions such as for mortgage interest, health insurance premiums (both employee/employer), HSAs, 529s etc. Plus if they also increase IRA contribution limits to $15-20K, I'd also be in favor of getting rid of deductions for retirement accounts like 401ks, 403bs, SEP-IRAs.

Increasing IRA contribution limits by $10k while erasing $18k in 401k would be terrible.

Monkey Uncle

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Re: What comes after the ACA?
« Reply #1233 on: March 04, 2017, 11:59:48 AM »
Any thoughts on the republican suggestions for the government to push HSA s, and fund or "seed" them for low income individuals?

Refundable tax credits, subsidies, seeding HSAs; it's all the same thing - the government giving people money so they can afford their health insurance and out of pocket costs.  The amount is what matters.  Everything I've seen from the repubs so far suggests that they aren't willing to give low income people nearly enough to enable them to actually afford their premiums and out of pocket costs.
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Metric Mouse

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Re: What comes after the ACA?
« Reply #1234 on: March 04, 2017, 01:58:47 PM »
Any thoughts on the republican suggestions for the government to push HSA s, and fund or "seed" them for low income individuals?

Refundable tax credits, subsidies, seeding HSAs; it's all the same thing - the government giving people money so they can afford their health insurance and out of pocket costs.  The amount is what matters.  Everything I've seen from the repubs so far suggests that they aren't willing to give low income people nearly enough to enable them to actually afford their premiums and out of pocket costs.
It is much the same. And no, the numbers floated haven't been very high. But say they were: would this direction give more people more choices, while funding low income people's health insurance? Obviously the devil is in the details and this would not address rising insurance costs, but it could be a step in the right direction overall?
Give me one fine day of plain sailing weather and I can mess up anything.

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Lance Burkhart

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Re: What comes after the ACA?
« Reply #1235 on: March 04, 2017, 02:26:38 PM »
Just out of curiosity, how many of you on here are paid to post in support of Obamacare? We know MMM makes a lot of money off his website and he posts in support of Obamacare.  I'm just connecting the dots here.

Quote
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”

geekette

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Re: What comes after the ACA?
« Reply #1236 on: March 04, 2017, 02:33:09 PM »
Just out of curiosity, how many of you on here are paid to post in support of Obamacare? We know MMM makes a lot of money off his website and he posts in support of Obamacare.  I'm just connecting the dots here.

Quote
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”
Dang, where's my paycheck?

I googled and found the article you're referring to, and I wonder how much this "digital expert" was paid to provide this quote...

jim555

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Re: What comes after the ACA?
« Reply #1237 on: March 04, 2017, 02:34:17 PM »
Just out of curiosity, how many of you on here are paid to post in support of Obamacare? We know MMM makes a lot of money off his website and he posts in support of Obamacare.  I'm just connecting the dots here.

Quote
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”
I'm waiting for those checks to come in.  Its a great side gig.

waltworks

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Re: What comes after the ACA?
« Reply #1238 on: March 04, 2017, 02:52:57 PM »
I think if you do a tiny bit of digging (just look at post histories) on the folks on this thread (on all "sides" of the debate) you will not find any sock puppets. If there's someone who looks suspicious (ie, only comes here to talk about the ACA or other off-topic stuff) you can just flag them and a mod will ban them.

That said, where can I sign up? :)

Seriously, that kind of allegation just discredits you. You can disagree with Sol or whoever, but accusing him of being a paid shill is pretty low.

-W

Metric Mouse

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Re: What comes after the ACA?
« Reply #1239 on: March 04, 2017, 02:53:34 PM »
Just out of curiosity, how many of you on here are paid to post in support of Obamacare? We know MMM makes a lot of money off his website and he posts in support of Obamacare.  I'm just connecting the dots here.

Quote
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”
I'm waiting for those checks to come in.  Its a great side gig.
I feel like I've been doing it wrong....
Give me one fine day of plain sailing weather and I can mess up anything.

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Roland of Gilead

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Re: What comes after the ACA?
« Reply #1240 on: March 04, 2017, 02:57:18 PM »
Just out of curiosity, how many of you on here are paid to post in support of Obamacare? We know MMM makes a lot of money off his website and he posts in support of Obamacare.  I'm just connecting the dots here.

Quote
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”

Shhh.  The pay is under the table.

Also, 95% of digital experts are really analog.

fuzzy math

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Re: What comes after the ACA?
« Reply #1241 on: March 04, 2017, 03:04:45 PM »
Just out of curiosity, how many of you on here are paid to post in support of Obamacare? We know MMM makes a lot of money off his website and he posts in support of Obamacare.  I'm just connecting the dots here.

Quote
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”

Your dot connecting sense is off. You're supposed to go from 1-2-3 etc. you appear to have gone off the paper, drawn on the wall and made an arrow pointing to your trash can.

The major premise of MMM has never been supporting the ACA. If that's all you've gotten from his writings, you ought to start over from the beginning. If anything, he harps on trucks to the point that you would have more basis (still virtually 0) in calling him an EV spokesperson.

I work in healthcare, and would probably have my compensation lowered if single payer ever came to pass. That doesn't stop me as a consumer from advocating for it. My immediate benefit < my long term benefit (as an old retired person receiving care) < society as a whole.

Also, there's a good chance that the people posting during work hours, are posting personally while at work. Any good paid trolling organization knows that you have to have your workers do 12 hour shifts day and night https://www.nytimes.com/2015/06/07/magazine/the-agency.html?_r=0

jim555

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Re: What comes after the ACA?
« Reply #1242 on: March 04, 2017, 03:17:27 PM »
Just looking at the ACA enrollment numbers.

Exchange enrollees: 12,235,500  (8,234,891 with high subsidies)
Medicaid enrollees:   14,977,083
BHP enrollees:              752,000  (NY and MN Basic Health Plans)
-------------------------------------
Total:                       23,963,983

Lets see what happens when you screw 20 million people out of health coverage.

https://docs.google.com/spreadsheets/d/1swuGOSJox2XEp3nYR6hCNxZhE60bYqTNg7T3VmTeuWU/edit#gid=1632264295

sol

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Re: What comes after the ACA?
« Reply #1243 on: March 04, 2017, 03:41:59 PM »
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”
 

It wouldn't surprise me if 60% of the posts on this forum come from the top 100 posters.  Of course, some of those top 100 absolutely hate the ACA.

It also wouldn't surprise me if (a different) 60% of posts were made between 9am and 5pm.

But I'm especially enamored of this quote, because it manages to tie together active denial of the fact that Americans are protesting the GOP repeal of the the ACA, a conspiracy theory about paid protestors, and a dig at left coasters.  All in one succinct little pile of crazy.

dragoncar

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Re: What comes after the ACA?
« Reply #1244 on: March 04, 2017, 04:41:35 PM »
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”
 

It wouldn't surprise me if 60% of the posts on this forum come from the top 100 posters.  Of course, some of those top 100 absolutely hate the ACA.

It also wouldn't surprise me if (a different) 60% of posts were made between 9am and 5pm.

But I'm especially enamored of this quote, because it manages to tie together active denial of the fact that Americans are protesting the GOP repeal of the the ACA, a conspiracy theory about paid protestors, and a dig at left coasters.  All in one succinct little pile of crazy.

I 100% agree most of them were paid to post.  By their employers, but for the job they were supposed to be doing instead of screwing around on the internet.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #1245 on: March 04, 2017, 09:14:48 PM »
Just out of curiosity, how many of you on here are paid to post in support of Obamacare? We know MMM makes a lot of money off his website and he posts in support of Obamacare.  I'm just connecting the dots here.

Quote
A majority of online and social media defenders of Obamacare are professionals who are “paid to post,” according to a digital expert.

“Sixty percent of all the posts were made from 100 profiles, posting between the hours of 9 and 5 Pacific Time,” said Michael Brown. “They were paid to post.”

Your dot connecting sense is off. You're supposed to go from 1-2-3 etc. you appear to have gone off the paper, drawn on the wall and made an arrow pointing to your trash can.



ROFLMAO !!!

Monkey Uncle

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Re: What comes after the ACA?
« Reply #1246 on: March 05, 2017, 04:54:36 AM »
New article today on MSN about the Republican plan:

http://www.msn.com/en-us/news/politics/what-we-know-about-the-gops-healthcare-bill/ar-AAnNlma

The article is mostly old news, as it appears to be based on the draft that leaked a week or two ago.  But I thought this quote was very instructive regarding the Freedom Caucus attitude about health care:

Quote
Rep. Michael Burgess (R-Texas), the chairman of the Energy and Commerce health subcommittee, said last month. "If the [coverage] numbers drop, I would say that's a good thing, because we've restored personal liberty in this country."

Yes, let's restore the liberty to go without health insurance because you can't afford it.

There's some re-hashing of things we already knew about, but the basic mechanism by which 20 million people lose coverage bears repeating:

Quote
ObamaCare bases its tax credits on income, meaning that low-income people get extra help. The Republican plan, in contrast, would provide a tax credit based on age, with older people receiving more money.

A study from the Kaiser Family Foundation last week found that the average tax credit to help people buy insurance would be at least 36 percent lower in 2020 under a leaked House GOP bill or a previous plan from then-Rep. Tom Price (R-Ga.) than under the Affordable Care Act.

Avik Roy, a leading Republican health policy expert, wrote in Forbes that not adjusting financial assistance for income is a "key flaw" in the GOP plan.

"It means that millions of highly vulnerable people - those near the poverty line and those with poor health status - will not receive enough in tax credits to afford the coverage they need," he wrote.

Republicans argue that giving more assistance to people with lower incomes is a disincentive to work and earn a higher income.

"You don't get the implicit tax on making more income" under the GOP plan, said Doug Holtz-Eakin, president of the American Action Forum.

So it's very simple.  People who are barely scraping by in blown-out rust belt towns by working at a convenience store out by the highway just need to find a way to make more money, and the health care conundrum will be solved!

And then the coup de grace:

Quote
The GOP bill would keep the ObamaCare protection that bans insurers from rejecting people with pre-existing conditions - but with a twist.

Insurers would be allowed to charge people 30 percent higher premiums for one year if they have had a gap in their healthcare coverage.

So once we've kicked low income people off of their health insurance, we're going to make it even harder for them to get back on.  Mwu-ha-ha-ha-ha-ha-ha.

"Take this job and shove it" - David Allan Coe

Monkey Uncle

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Re: What comes after the ACA?
« Reply #1247 on: March 05, 2017, 04:57:29 AM »
Oh, and who do I see to get my check?  I posted what you said I should post, now where's my money?  WTF?

What, I don't get anything because I'm in a red state, in Appalachia, in the Eastern time zone, posting on a Sunday before 7 am?  Liberal bigots!
« Last Edit: March 05, 2017, 04:59:11 AM by Monkey Uncle »
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Mr Mark

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Re: What comes after the ACA?
« Reply #1248 on: March 05, 2017, 05:53:35 AM »
Yep. This is going to be a disaster for poor people and people who are either sick or get sick. But I bet they'll crunch the numbers and make sure it mainly has negative impact on democratic voters. While giving the rich a big fat tax benefit.  And they'll let the states take medicaid from super poor people thus a state issue.

We are now looking at returning to NZ for FIRE... hello socialism that works.
Mr. Mark

WhiteTrashCash

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Re: What comes after the ACA?
« Reply #1249 on: March 05, 2017, 06:06:40 AM »
I just posted on my Journal about a Pre-ACA health experience I had when I was really poor. Something that really was a minor issue could have become much worse because I couldn't afford health insurance.