An end to ACA Subsidies for the FIRE Community?

[Fru-Gal]

People living in the HOL areas are not all high-income, but it’s a great place to do arbitrage if you’re able to keep your living expenses down. Jakob of ERE fame saved the bulk of his high salary as a physicist or something in Northern California and was able to FIRE in seven years.

If you get your housing and transportation and cooking under control, living in a HOL is quite feasible. The subway is always affordable. There’s always biking — and bike lanes. There’s rent control. Or, if you bought your forever home a couple of decades ago, you don’t have to worry about that anymore. If you live car-free that that’s another huge expense eliminated.

The ACA in these HOL areas is usually exceptionally good.

[bacchi]

God forbid people are living in multi-generation households, have roommates, live in communal settings, or are un-housed. But lets just push the narrative that because it is California, there must be rampant abuse. This is a community/form of love and inspiration to improve the world. Your bigotry is not welcomed here.

Also, not everyone in California lives in LA or SF or SD. If you bought a $150k house in Fresno a few years ago, your housing costs are low.

[Must_ache]

It doesn't take a genius to suspect there's rampant abuse.

'Aint that the truth! Shit, I've heard there's even an entire website of rich assholes on the internet who cosplay pretending to be poor just to fully exploit getting maximum deductions on their healthcare by fully exploiting the loopholes in the social safety net, while hoarding millions of dollars of funds in a market optimized to steal the wages of millions of workers to help pay for the expenses of investors who refuse to work, instead of just paying for their fair share.

Exactly what loopholes are you referring to?   

The ACA has made health insurance for early retirees very affordable.  I have 1.7M and could afford to pay full-price for healthcare, but I don't have to because the ACA only asks for your income.  Same goes for Medicaid, in Iowa you needs to be 19-64 and have your income below 133% of the federal poverty level.  I could not work and be eligible for that as well since it is income based. 

Unless there is law mandating means testing (which I would not be against, but that could conceivably result in fraud), low income is the key.  Are the loopholes you refer to something else entirely? 

[Ron Scott]

My explanation is widespread under-reporting of income in the service and gray-market economy, which then qualifies that population for Medicaid (and a bunch of other programs).

There is undoubtedly a large number of people who screw the rest of us by taking payments in cash, underreporting their income, paying low or no income tax, and hacking social programs like Medicare.

Many of us who lived on W2s and 1099s would love to see that bunch on a highway chain gang somewhere. Not only are they cheats, they make it difficult for society to afford better social programs for those truly in need. They are literally taking the food out of poor babies mouths.

Low-lifes…

[classicrando]

My explanation is widespread under-reporting of income in the service and gray-market economy, which then qualifies that population for Medicaid (and a bunch of other programs).

There is undoubtedly a large number of people who screw the rest of us by taking payments in cash, underreporting their income, paying low or no income tax, and hacking social programs like Medicare.

Many of us who lived on W2s and 1099s would love to see that bunch on a highway chain gang somewhere. Not only are they cheats, they make it difficult for society to afford better social programs for those truly in need. They are literally taking the food out of poor babies mouths.

Low-lifes…

I didn't realize billionaires and politicians typically took their grift cuts in the form of pallets full of cash, but the notion of watching them pick trash on the highway under the noonday sun fills me with delight. 

Thanks for brightening my day. :)

[FrugalToque]

My explanation is widespread under-reporting of income in the service and gray-market economy, which then qualifies that population for Medicaid (and a bunch of other programs).

There is undoubtedly a large number of people who screw the rest of us by taking payments in cash, underreporting their income, paying low or no income tax, and hacking social programs like Medicare.

Many of us who lived on W2s and 1099s would love to see that bunch on a highway chain gang somewhere. Not only are they cheats, they make it difficult for society to afford better social programs for those truly in need. They are literally taking the food out of poor babies mouths.

Low-lifes…

The most clever thing that rich Americans ever did was to teach the middle class Americans that the REAL PROBLEM(TM) was poor Americans.

I mean, Jesus, your billionaires are having a fun-time space-tourism race while your schools are falling apart and you have a thing called "medical bankruptcy", but you're trained to believe that a waitress not reporting her tips is the problem?

[salt cured]

My explanation is widespread under-reporting of income in the service and gray-market economy, which then qualifies that population for Medicaid (and a bunch of other programs).

There is undoubtedly a large number of people who screw the rest of us by taking payments in cash, underreporting their income, paying low or no income tax, and hacking social programs like Medicare.

Many of us who lived on W2s and 1099s would love to see that bunch on a highway chain gang somewhere. Not only are they cheats, they make it difficult for society to afford better social programs for those truly in need. They are literally taking the food out of poor babies mouths.

Low-lifes…

The most clever thing that rich Americans ever did was to teach the middle class Americans that the REAL PROBLEM(TM) was poor Americans.

I mean, Jesus, your billionaires are having a fun-time space-tourism race while your schools are falling apart and you have a thing called "medical bankruptcy", but you're trained to believe that a waitress not reporting her tips is the problem?

The outrage is hilarious. Bully to anyone from the lower classes who cheats on medicaid rules.

[Manatee]

It isn't "abuse" to qualify for a program and sign up for it.  Are people "abusing" Social Security when they sign up for it at 62?  No. 

Idiots get their talking points and go marching out with them.

I have zero problem with people who actually qualify for programs getting them. I know you use Medicaid in New York, and while I wouldn't do that myself, like, great? I don't care, good for you for finding something that works for you. I'm pretty sure you actually qualify for this.

Coming back to my California example which clearly ruffled some feathers:

California minimum wage: $16.50/hour, roughly $34k/year.
Medicaid cutoff: $21k/year for single, $29k for a married couple
Californians on Medicaid: 38%

Yes this includes children, the disabled, etc.

Do you really think there are that many people who honest to God make this little money (less than minimum wage) yet somehow manage to live in the most expensive state in the country? I don't. Last I checked landlords want real money, not vibes. My explanation is widespread under-reporting of income in the service and gray-market economy, which then qualifies that population for Medicaid (and a bunch of other programs).

Couple this with a state who has made it its policy to qualify as many people as possible without asking too many questions (the feds pick up most of the tab) and you get those high-popping numbers that stretch credulity.

If someone has a better explanation, I'm all ears.

Children can qualify for Medicaid separately from their parents, and the family income thresholds for children are higher. In my county in California, a family of 4 can make $100k annually and the children (but not the parents) will qualify for Medicaid. Twenty percent of California's population is under 18.

[MMMarbleheader]

It isn't "abuse" to qualify for a program and sign up for it.  Are people "abusing" Social Security when they sign up for it at 62?  No. 

Idiots get their talking points and go marching out with them.

I have zero problem with people who actually qualify for programs getting them. I know you use Medicaid in New York, and while I wouldn't do that myself, like, great? I don't care, good for you for finding something that works for you. I'm pretty sure you actually qualify for this.

Coming back to my California example which clearly ruffled some feathers:

California minimum wage: $16.50/hour, roughly $34k/year.
Medicaid cutoff: $21k/year for single, $29k for a married couple
Californians on Medicaid: 38%

Yes this includes children, the disabled, etc.

Do you really think there are that many people who honest to God make this little money (less than minimum wage) yet somehow manage to live in the most expensive state in the country? I don't. Last I checked landlords want real money, not vibes. My explanation is widespread under-reporting of income in the service and gray-market economy, which then qualifies that population for Medicaid (and a bunch of other programs).

Couple this with a state who has made it its policy to qualify as many people as possible without asking too many questions (the feds pick up most of the tab) and you get those high-popping numbers that stretch credulity.

If someone has a better explanation, I'm all ears.

Children can qualify for Medicaid separately from their parents, and the family income thresholds for children are higher. In my county in California, a family of 4 can make $100k annually and the children (but not the parents) will qualify for Medicaid. Twenty percent of California's population is under 18.

Agreed, to me the sweet spot for most non-lean FIRE folks with families is kids on CHIP (kids medicaid) and parents on an ACA exchange plan. I personally don't want anything to do with adult medicaid, it seems much more restrictive than Dr Dynasaur aka CHIP aka kids Medicaid here in Vermont. Below are the income cliffs for CHIP in Vermont

https://info.healthconnect.vermont.gov/compare-plans/medicaid-and-dr-dynasaur

A family of 4 could make up to $97k and still be on CHIP (with a monthly premium)

[Arbitrage]

It isn't "abuse" to qualify for a program and sign up for it.  Are people "abusing" Social Security when they sign up for it at 62?  No. 

Idiots get their talking points and go marching out with them.

I have zero problem with people who actually qualify for programs getting them. I know you use Medicaid in New York, and while I wouldn't do that myself, like, great? I don't care, good for you for finding something that works for you. I'm pretty sure you actually qualify for this.

Coming back to my California example which clearly ruffled some feathers:

California minimum wage: $16.50/hour, roughly $34k/year.
Medicaid cutoff: $21k/year for single, $29k for a married couple
Californians on Medicaid: 38%

Yes this includes children, the disabled, etc.

Do you really think there are that many people who honest to God make this little money (less than minimum wage) yet somehow manage to live in the most expensive state in the country? I don't. Last I checked landlords want real money, not vibes. My explanation is widespread under-reporting of income in the service and gray-market economy, which then qualifies that population for Medicaid (and a bunch of other programs).

Couple this with a state who has made it its policy to qualify as many people as possible without asking too many questions (the feds pick up most of the tab) and you get those high-popping numbers that stretch credulity.

If someone has a better explanation, I'm all ears.

Children can qualify for Medicaid separately from their parents, and the family income thresholds for children are higher. In my county in California, a family of 4 can make $100k annually and the children (but not the parents) will qualify for Medicaid. Twenty percent of California's population is under 18.

I'd guess this is a big factor.  Plus, it's a gross oversimplification to think of California as homogenously expensive, and it's also erroneous to think that just because it's expensive, incomes follow.  Coastal California is expensive.  Central, Eastern, and Northern California are generally lower income, outside of greater Sacramento. 

A few numbers I pulled from a quick glance at CA statistics:
- Nearly half of CA counties have median HHI below the national HHI.  Most of those are fairly low-population, but they still add up to ~4.5 million people.
- Adding in a few counties just over the national HHI, and you add another 2.5 million people (mostly thanks to San Bernardino County).
- Los Angeles County, with around 10 million people, has a median HHI of $87k, only slightly larger than the national median HHI of close to $81k. (2023 numbers, which all of these are based upon). 

So, I'm not finding the hand-wavey accusations to be terribly compelling.  I'm sure there's fraud and abuse.  I know there's also tons of fraud, abuse, and loopholes that rich people and corporations regularly engage in to skirt taxes (even zeroing them out despite being multi-billion or even trillion dollar comps)...going so far as to lobby/bribe politicians to maintain or open these loopholes up further.  Given that both cost us taxpayer dollars, which do I find more displeasing: people who maybe aren't quite poor enough getting health care, or super rich people and corporations getting even richer?

[bmjohnson35]

If our elected officials made a serious attempt to clean up the industry, the costs wouldn't be so high.  The entire healthcare industry in the US is broken.

[FIREin2018]

I have no idea how to use chatgbt/ai.
I feel like my parents with computers in the 1990s.

Ugg.. any tutorials that help dinosaurs on how to use these Ai sites in everyday life?
Ie: scan all weekly grocery ads in my area and give me the best deals

[FIREin2018]

To Fired people who are on Medicaid being screwed by this bill because work requirement, go on Obamacare with Max subsidies by doing Roth conversions

[jim555]

I'm glad to be getting close to Medicare age.  I am tired of the constant attacks on my coverage options every time a certain party gets in power.  Went through this in 2017 and again now and it is getting old.

[FIREin2018]

I'm glad to be getting close to Medicare age.  I am tired of the constant attacks on my coverage options every time a certain party gets in power.  Went through this in 2017 and again now and it is getting old.

Medicare (and ss) is next.
I'm thinking they're going to cap lifetime payments to whatever you put into it.

No inflation, no interest on your $ they were holding for decades

[FrugalToque]

Given that both cost us taxpayer dollars, which do I find more displeasing: people who maybe aren't quite poor enough getting health care, or super rich people and corporations getting even richer?

Exactly.

Again, this is either because I was born in Canada or because I was raised not be a selfish prick but instead to care about the least of my brothers, but the concept of (paraphrasing) "not quite poor enough to 'deserve' health care" is horrifying.

[Fomerly known as something]

The end of Social Security and Medicare is way far off.  I use the evidence of what effecting federal workers has been dropped from the current bill.  Vouchers for healthcare to replace the Federal Employee Healthcare Program and the dropping of the ending for the Retirement Annuity Supplement which is a separate amount paid to all employees who are eligible between 57-62 sort of replacing social security and even longer for those that are special category employees (I get an extra 19k a year for 15 years with this supplement).