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Sun Jul 1, 2012, 06:47 PM

ACA Mandate Myths & How the Affordable Care Law Affects You

Last edited Sun Jul 1, 2012, 07:37 PM - Edit history (1)

Mandate myths

Myth 1: Everyone is required to buy insurance.

Thatís not true. Over 80%* of Americans have insurance through their employers or receive insurance because they are in the military or are veterans or are poor or old. No one in these categories is required to buy individual insurance.

(Actually no one at all has to buy health insurance because, if they fall under that provision and donít buy it, they can pay the penalty instead. The penalty is far cheaper than the cost of insurance.)

*81% of Americans under 65 have insurance. People over 65 have single-payer coverage; i.e., Medicare (with some holding additional private insurance).

Myth 2: People who donít have insurance will be forced to buy insurance they canít afford.

This is also untrue.

People with the lowest incomes are covered under Medicaid, which was expanded by the ACA for those with incomes up to 133% of the poverty level.

For those with incomes between 133% and 400% of the poverty level, subsidies are available so they can afford to buy health coverage in the new health care exchange.

There is a hardship exemption for those who donít have insurance and say they canít afford it.

And, as noted under myth 1, no one actually must buy health insurance, since they can pay the penalty instead.

(Please Go To Pollways Link For Other Myths, very informative)


____________________________________________


ACA Provisions

How does the Patient Protection and Affordable Care Act (ACA) change health coverage in the U.S.?

The ACA makes dramatic changes to the way millions of Americans access health care. This comprehensive reform of health insurance attempts to make insurance more affordable, higher in quality and more accessible for people. It also expands Medicaid, imposes new responsibilities on individuals to purchase insurance and provides new incentives for employers to provide insurance for their employees. Together, these changes are estimated to expand coverage to 32 million people who were previously uninsured.

Insurance reforms

Beginning in 2014, the ACA requires health insurers to accept all applicants for insurance, regardless of their health status. In addition, insurers will no longer be allowed to charge higher premiums or exclude benefits because someone has a pre-existing condition. Most insurers will also be required to provide coverage that meets federal standards for benefits and cost-sharing.

As of September 23, 2010, a number of insurance reforms went into effect, including requiring insurers to:

Cover certain preventive services without deductibles or cost-sharing
Allow parents to keep adult children up to age 26 on their insurance
Cover all children under the age of 19, regardless of health status
Create an internal and external appeals process to handle consumer complaints and denials
Eliminate lifetime limits on benefits and significantly raise the annual limits for benefits (eventually it will also eliminate annual limits)
Spend a minimum of 80 percent of premiums on medical services and quality improvement
Justify unreasonable premium increases
Eliminate the practice of rescissions (when a health plan retroactively cancels coverage after the enrollee gets sick)
Allow patients to choose their health care professional as a primary care provide


Much more on ACA Provisions at community catalyst here

____________________________________________



____________________________________________

For those that are uninsured
Without question, uninsured Americans will be most affected by health care reform. If you donít have health insurance because youíre unemployed or donít make enough to afford it, youíre going to get a subsidy to help cover the cost of coverage. The subsidy will be based on your income, but the result will be that at least 30 million people who couldnít afford insurance will now theoretically be able to.

And if you have lingering doubts that this group of people really needed the governmentís help, check out a couple of news stories we recently did about how the uninsured suffer:

This one is called Killer Hospital Bills: itís about an uninsured woman went to the emergency room with stomach pains and emerged hours later with a $12,000 bill.
And hereís one about a senior citizen who had to file bankruptcy because of health costs.

So the news is good for uninsured Americans who needed and wanted coverage, but thereís another group of uninsured who may not be so happy: those that can afford insurance but choose to forgo the expense by going without. In an effort to encourage all Americans to have health insurance, beginning in 2014 these people will face fines for that kind of risk-taking. The proposed fine is 2.5% of income, up to $2,085, so the incentive to have insurance will be powerful.


More at MoneyTalksNewshere

____________________________________________

This DHS site has some great information as well
Affordable Care Act: Opportunities for the Aging Network
http://aoa.gov/Aging_Statistics/Health_care_reform.aspx


____________________________________________

Link to the Affordable Care Act (Full Law) here
Link to Affordable Care Act (Amendments) here

____________________________________________

Here is a nifty tool from WaPo that you can use to determine how your family might be affected by ACA.
What does the Supreme Court's health-care ruling mean for me?
The court's decision to uphold all but one component of the health-care law means new rules for insurers that have already taken effect will remain in place. Beginning in 2014, virtually all Americans will have to obtain health insurance or pay a penalty. There also will be new opportunities to get coverage, including state-based marketplaces known as exchanges* (through which individuals will be able to purchase private plans that meet strict benchmarks for quality) and federal subsidies to help low-income people buy plans on the exchanges. The law will also expand the eligibility rules for Medicaid, but the Court found that states can not be penalized if they decline to comply with the expansion, raising questions as to how effectively the federal government will be able to implement it.


Take the quiz at the link and find out

____________________________________________


http://www.healthcare.gov/ is an excellent source of info and policy plans available to you.

Thank you Honeycombe8 for pointing out this one.

____________________________________________

The Affordable Care Act is a step in the right direction. With it in place I believe it will be easier to progress to single payer in the future. The purpose of this OP is for anyone who might not know what all is in the ACA and how it might affect them.

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Replies to this discussion thread
Arrow 39 replies Author Time Post
Reply ACA Mandate Myths & How the Affordable Care Law Affects You (Original post)
SunsetDreams Jul 2012 OP
SunsetDreams Jul 2012 #1
YellowRubberDuckie Jul 2012 #2
SunsetDreams Jul 2012 #4
Honeycombe8 Jul 2012 #3
SunsetDreams Jul 2012 #5
Skittles Jul 2012 #6
SunsetDreams Jul 2012 #8
freshwest Jul 2012 #7
SunsetDreams Jul 2012 #9
Semtex Jul 2012 #13
SunsetDreams Jul 2012 #32
Hissyspit Jul 2012 #10
SunsetDreams Jul 2012 #12
Hissyspit Jul 2012 #15
ProSense Jul 2012 #17
Hissyspit Jul 2012 #20
SunsetDreams Jul 2012 #22
Hissyspit Jul 2012 #26
SunsetDreams Jul 2012 #29
Hissyspit Jul 2012 #34
w0nderer Jul 2012 #11
bigtree Jul 2012 #14
SunsetDreams Jul 2012 #23
Spitfire of ATJ Jul 2012 #16
Tennessee Gal Jul 2012 #18
SunsetDreams Jul 2012 #19
Tennessee Gal Jul 2012 #21
SunsetDreams Jul 2012 #36
RagAss Jul 2012 #24
Wait Wut Jul 2012 #28
Ruby the Liberal Jul 2012 #25
SunsetDreams Jul 2012 #30
Wait Wut Jul 2012 #27
SunsetDreams Jul 2012 #31
SunsetDreams Jul 2012 #33
LineNew Reply .
SunsetDreams Jul 2012 #35
SunsetDreams Jul 2012 #37
ProgressiveEconomist Jul 2012 #38
savalez Jul 2012 #39

Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 07:01 PM

1. Here is more

Section 1332 of the Patient Protection and Affordable Care Act Ė the ďWaiver for State InnovationĒ
http://www.democraticunderground.com/1002888869

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 07:16 PM

2. I had so many people on Facebook posting stupid shit about it...

...I found a link to it and said, here READ THE DAMNED THING. People have shut up or unfriended me. I don't care, honestly. I'm just SICK of people lying.

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Response to YellowRubberDuckie (Reply #2)

Sun Jul 1, 2012, 07:24 PM

4. I know it's rediculous

the amount of misinformation out there, some of it done purposefully.

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 07:20 PM

3. Great! Thx. Also, www.healthcare.gov is an excellent source of info and policy plans available toyu.

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Response to Honeycombe8 (Reply #3)

Sun Jul 1, 2012, 07:33 PM

5. No problem and

thank you so much for that link! I'm going to add it to the OP

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 07:56 PM

6. will the penalty affect credit rating?

just curious

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Response to Skittles (Reply #6)

Sun Jul 1, 2012, 08:14 PM

8. That's a good question

I know that the IRS can file a tax lien for failure to pay taxes and that does affect your credit score for 7 years I believe.
However I'm not sure if it will be applicable here. I'll do some research on it.

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 08:06 PM

7. This is the most comprehensive thread yet. Thanks SunsetDreams. K & R.




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Response to freshwest (Reply #7)

Sun Jul 1, 2012, 08:23 PM

9. My pleasure :)

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Response to SunsetDreams (Reply #9)

Sun Jul 1, 2012, 08:38 PM

13. I have started posting

Links to www.healthcare.gov on my Facebook page so people can inform themselves better about what this law is going to mean to them, rather then to believe the talking points that the right is trying to throw out..usually in the form of a threat.

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Response to Semtex (Reply #13)

Sun Jul 1, 2012, 10:37 PM

32. Yes the right is

trying really hard to spread misinformation about the ACA. They failed with the Supreme Court, so misinformation is all they have. They are so afraid the public will start to see what an improvement the bill really is over what we had. Is it perfect? no, but it is a vast improvement.

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 08:33 PM

10. "The penalty is far cheaper"

Yeah, for me, it's about $844. The $700 I get back every year that helps me from going bankrupt each year.

Looks like I'll probably be able to get into the exchange (maybe) and pay $4,180 for insurance. Which I can't afford. That's $1,000 a quarter, or about $300 plus every month. So I will have $844 taken from me every year. And have no insurance.

Yay.

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Response to Hissyspit (Reply #10)

Sun Jul 1, 2012, 08:35 PM

12. Maybe you will qualify for a subsidy or hardship nt

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Response to SunsetDreams (Reply #12)

Sun Jul 1, 2012, 08:42 PM

15. Isn't that what I factored in?

"You will have the option of buying a health plan through your state's exchange with federal assistance. Based on your income, your annual premiums for that plan would be no more than $4,180. Your maximum out-of-pocket costs for deductibles and co-payments would be capped at 30 percent of the total cost."


I didn't even mention the money I would spend on deductibles.

"You are exempt from the penalty if the least expensive plan option in your area exceeds eight percent of your income."


How do I determine the "least expensive plan option in" my area? Is it some near-worthless insurance? $4,180 is about eight percent of my income, so I MIGHT be exempt from the penalty, but I can't count on that.

I'm hoping that this is wrong and I will be able to afford insurance by 2016 as things improve.

Don't get me wrong. There is much in ACA that is excellent and necessary. Despite being rather disgusted at the lousy strategies and compromises that went into creating it, I am glad it passed and the mandate was upheld. And, yes, there is MASSIVE disinformation out there, and I appreciate your post.

But:

1. Declare victory where victory is real: Democrats should declare victory for the popular provisions of the law: no exclusions for pre-existing conditions, coverage for those who can't afford it, the extension of coverage for children to age 26. Wendell Potter offers a great example of how to "sell" this law to the American people.

2. Don't BS the public: But Democrats would be foolish to oversell this law. In response to the ruling, the President said today that the Court has "reaffirmed a fundamental principle that here in America -- in the wealthiest nation on Earth Ė no illness or accident should lead to any familyís financial ruin." That's the wrong approach for a number of reasons, one of which is that people still feel that they can't afford health care - and they're right.

A majority of those who declare bankruptcy due to medical expenses already have health insurance, and the protections in this law aren't enough to prevent that from happening. Premiums and out-of-pocket costs continue to rise for insured Americans. Health insurance costs rose more last year than they had in six years, to more than $15,000 for a family of four, and they've risen by 50 percent since 2003. Democrats should acknowledge these problems, discuss ways this law will help and, most importantly, promise to do more in the next term.

http://www.ourfuture.org/blog-entry/2012062628/dont-kid-yourself-its-still-corporate-court-here-are-10-ways-respond


And I am still seriously considering Canada. Not kidding.



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Response to Hissyspit (Reply #10)

Sun Jul 1, 2012, 08:48 PM

17. That seems

"Yeah, for me, it's about $844. The $700 I get back every year that helps me from going bankrupt each year."

...seems a little high for the penalty.

http://www.democraticunderground.com/1002881604

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Response to ProSense (Reply #17)

Sun Jul 1, 2012, 08:57 PM

20. Well, I hope you're right.

I really can't afford any penalty AT ALL. (That's the increased 2016 penalty, by the way. See my other post.) I'm a contract employee and there are a couple of months in the year when I don't get paid. I also have a large debt load (thanks to the Bush years). The debt load is the main reason I can't afford insurance (some of it was used to pay for insurance in the past). And if I pay a tax penalty, that's taking away money I can use to decrease the debt load.

What I would like to have is health insurance that I can actually afford.

I guess we'll see.

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Response to Hissyspit (Reply #20)

Sun Jul 1, 2012, 09:19 PM

22. I hope you don't mind

my deciding to respond here. I took the opportunity to read both of your replies in this sub-thread.

I hope that you will qualify for a subsidy or hardship. I hear you about debt, I think the Bush years have done a lot of damage to all of us in the middle class and the poor. The debt has piled up and I wish you much success decreasing your debt load.

Here's to hoping you qualify

On edit thank you for the link to the article above, I will read it.

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Response to SunsetDreams (Reply #22)

Sun Jul 1, 2012, 09:35 PM

26. No problem. I do appreciate your post.

I think I was one of the first here to post the Washington Post "How Will Health Insurance Affect You?" calculator. I think other people will appreciate it.

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Response to Hissyspit (Reply #26)

Sun Jul 1, 2012, 10:33 PM

29. Thanks

I remember seeing the WaPo calculator post here. I think it's a great tool.

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Response to ProSense (Reply #17)

Sun Jul 1, 2012, 11:33 PM

34. Your chart says $625 for 2016.

WaPo calculator said $844. I said $700.

All pretty close.

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 08:34 PM

11. k&r for re-viewing and downloading later n/t

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 08:40 PM

14. awesome post, SunsetDreams

bookmark

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Response to bigtree (Reply #14)

Sun Jul 1, 2012, 09:24 PM

23. Thanks :)

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 08:47 PM

16. As people start getting free checkups we are going to find out just how bad off Americans are

for going for, in some cases decades, without being examined.

It really going to be an eye opener for a lot of people.

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 08:49 PM

18. Noticed there was no link for the chart.

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Response to Tennessee Gal (Reply #18)

Sun Jul 1, 2012, 08:52 PM

19. The chart lists the website directly on it.

You are correct in the link though

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Response to SunsetDreams (Reply #19)

Sun Jul 1, 2012, 08:59 PM

21. Yes, that is how I found the link.

Just thought it might be helpful.

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Response to Tennessee Gal (Reply #21)

Mon Jul 2, 2012, 03:51 AM

36. It is very helpful

thank you

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 09:27 PM

24. Do you really think we're going to see any of this.?

These fascist bastards will do anything to repeal this law. They will devote the rest of their lives to it !

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Response to RagAss (Reply #24)

Sun Jul 1, 2012, 09:58 PM

28. I'm not so sure.

I've noticed that over the past 24 hours a lot of people that were ranting about the ACA are now either really quiet, or asking questions. I think people are starting to see the benefits.

I just hope I live long enough to see the signs someday, "Keep your Government hands off my ACA!!!"

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 09:31 PM

25. Well done.

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Response to Ruby the Liberal (Reply #25)

Sun Jul 1, 2012, 10:33 PM

30. Thanks Ruby :)

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 09:55 PM

27. Thanks!! And thanks to all those that replied with more info! n/t

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Response to Wait Wut (Reply #27)

Sun Jul 1, 2012, 10:34 PM

31. You're welcome

I hope it helps

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Response to SunsetDreams (Original post)

Sun Jul 1, 2012, 11:15 PM

33. kick

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Response to SunsetDreams (Original post)

Mon Jul 2, 2012, 12:38 AM

35. .

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Response to SunsetDreams (Original post)

Mon Jul 2, 2012, 09:35 AM

37. Morning kick

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Response to SunsetDreams (Original post)

Mon Jul 2, 2012, 11:20 AM

38. 2 more links: NY Times Q&A on ACA details and latest CBO estimates of budget

impacts, at http://www.democraticunderground.com/1002890826 .

Note that the estimated 10-year total of healthcare TAX CREDITS (tax cuts) for individuals and other exchange-associated costs is FIFTEEN TIMES the estimated $45 billion to be raised over 10 years in individual penalties for not buying health insurance .

Two years ago, it was common for Democrats to point to the hundreds of billions in tax credits as "the largest middle-class tax cut for healthcare in history'. I just don't understand why they stopped and why they're now allowing Republicans to get away with Orwellian LIES abot "tax increases of the middle class".

See http://www.democraticunderground.com/1002890826 for details and a link to a crucial March 2012 table of updated Congressional Budget Office budget estimates for the Affordable Care Act.

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Response to SunsetDreams (Original post)

Mon Jul 2, 2012, 11:43 AM

39. K&R

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