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>> An estimated 16 million policies in the individual market What percentage of people with individual plans (who need to get new plans) would actually qualify

• hga 13y ago
  True, I suspect the fraction is relatively smaller; when I put on my political hat, I call them kulacks. And they're more likely to be up to the task of finding all of this out on their own. But I think we can also assume the numbers who are not up to this, or are in the expiring high risk pool, are in the millions. People are going to suffer, because of lapses in insurance, or because they simply can't afford the costs of new Obamacare compliant policies (between the new essentials like coverage for your kids till age 26, and all the cost shifting), or are too proud, moral, or whatever to divorce to get their costs down. ADDED: This is going to really hit the early retirement thing and availability of slots for people to move up in. A very large fraction of the horror stories I'm reading are about early retirees who are not yet 65 and therefore moved to Medicare. Is CoveredCA really working that well? From an anti-Obamacare site, some statistics and analysis: http://insureblog.blogspot.com/2013/11/coveredca-statistics-along-with-some.html http://insureblog.blogspot.com/2013/11/coveredca-statistics-...
• tanzam75 13y ago
  > What percentage of people with individual plans (who need to get new plans) would actually qualify for subsidies? I don't, so I have more options: (1) I can buy another individual plan from my insurer (2) I can shop other insurers or (3) I can buy from california exchange I don't understand why you're required to use the exchange to get the subsidies, anyway. Why not let people claim the subsidy directly through an insurer? Then turn healthcare.gov into a static site that simply displays the options and redirects to an insurer's web site. After all, the subsidies are only an estimate. The actual amount is only calculated on the 1040 tax return. So why should this be any different from tax withholding? We don't make everyone pay estimated taxes through a centralized site. We let employers withhold an estimated amount, and then the IRS balances the accounts annually, in a batch process.
  • hga 13y ago
    Well, as I understand it the subsidies result in direct draws on the Federal fisc by the insurers, and the latter can't afford to wait till the next calendar year to get paid. And there's certainly a desire to avoid fraud given that schedule of payments, if I'm correct about it. Erk: if you're right about estimates and it depending on that years tax return; what do you do if you lose your job and can't afford to pay the unsubsidized rate? What if you earn a lot more money, spend too much of it, and then get hit with a huge bill next April 15th? I'm disabled and on Medicare so I haven't been looking into these fine details ... this all sounds unworkable to me at first glance, unless it's retrospective based on ... the last year's tax return, but, erk, can't do that either since that don't be doable before the mid-December deadline necessary to get you into a insurer's system. WTF??? ADDED: this probably explains why the Federal system has to do this, access to IRS payments data (e.g. withholding) is required, it's sensitive data and only they have all of it. Although Experian has a income verification role (people without credit, like sick young adults who can't leave the nest are at last count thoroughly screwed because the Federal site isn't handling this manual intervention well or at all), but I assume that's a double check. Maybe not? Maybe they couldn't get that info out of the IRS's generally high latency (often weeks and months, sometimes years) computer systems?
    • tanzam75 13y ago
      > And there's certainly a desire to avoid fraud given that schedule of payments, if I'm correct about it. But why is it any different than the desire to avoid fraud through underwithholding of income tax? If someone files an in incorrect W-4 and underwithholds by $2000, then the Treasury is out $2000. If someone files a fraudulent insurance application and gets $2000 of unwarranted subsidy, then the Treasury is also out by $2000. It's the same $2000, whether the Treasury writes some checks to the insurance company, or fails to collect it from an individual on his paychecks. Either way, the $2000 gets paid back on the tax return -- or the IRS goes after you. > Erk: if you're right about estimates and it depending on that years tax return; what do you do if you lose your job and can't afford to pay the unsubsidized rate? What if you earn a lot more money, spend too much of it, and then get hit with a huge bill next April 15th? Again, not different in principle from income tax withholding. If you do not withhold the right amount, then you may get hit with a big bill or receive a big refund when you file your 1040. The main difference is that the subsidy does not automatically adjust. Withholding tends to automatically go up and down with income, because it's calculated by the employer on the paycheck. Whereas the insurance subsidy stays constant unless you make changes. If you lose your job, you're supposed to tell the exchange so that you can get a bigger subsidy. If your income goes up, you're supposed to tell the exchange so that you can get a smaller subsidy.