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That’s why, tonight, I ask every American who knows someone without health insurance to help them get covered by March 31st. Moms, get on your kids to sign up.

That’s why, tonight, I ask every American who knows someone without health insurance to help them get covered by March 31st. Moms, get on your kids to sign up. Kids, call your mom and walk her through the application. I have no health insurance, and I don't plan on getting it. This is, of course, crazy. But the reason is because I can't afford it. I'm in the same position as many others across the nation. Under Obamacare, I am going to be fined some hundreds of dollars for not having health insurance; health insurance which, itself, costs at least $200/mo (even under Obamacare). Then next year, I'm going to be fined triple that amount iirc, with increasing penalties each year. Isn't this the opposite of free health care? I'm not involved in this debate one way or the other. I don't know enough about the issues. But I will say that I don't appreciate the government intruding on my private life, forcing me to buy a product for at least $200/mo, a $200/mo I literally can't afford. I don't know how this is going to play out, but the government's expectation that everyone will buy health insurance just because they're enacting tax penalties seems somewhat naive. People simply have no money for $200/mo of extra costs. People are also bad at long-term planning, so the impending threat of "next year I'll probably be fined" isn't going to persuade those who are bad at finances (the vast majority of Americans) to sign up for an immediate $200/mo expense.

hahainternet 13y ago
I am not American, but as I understand it, if you earn so little that you can't afford a plan, you can get vouchers to cover the cost. I'm not sure of the specific boundaries and I think it varies per state. If you detail more information I can always Google.
- sillysaurus2 13y ago
  If I can't afford my lunch after being given so many opportunities to earn it myself, then it would be unfair for me to ask my countrymen to foot the bill. It's my problem, not theirs. I would have an extreme moral aversion to seeking a handout, even if that aversion is to my own personal detriment. Perhaps I should be trying to maximize every possible opportunity offered to me. But I just can't stomach the idea of taking money away from other people to pay for my own personal problems.
  - benburleson 13y ago
    The thing is, what you think is your "own personal problem" doesn't really affect only you. If your neighbors can help keep you healthy and productive, there's a benefit in that for them as well.
    - dllthomas 13y ago
      "If your neighbors can help keep you healthy and productive, there's a benefit in that for them as well." Economically and socially, of course, but epidemiologically as well!
  - dangerlibrary 13y ago
    If you go to the emergency room with an untreated, preventable illness that has become critical, and you can't pay the bill, other people wind up footing the bill anyway. Maintenance is cheaper than repair.
    - webXL 13y ago
      Except mandatory "maintenance" doesn't lead to fewer repairs in this case. Google Oregon Medicare study and Emergency Room usage. A comment from reason.com sums it up nicely: "Emergency rooms are required by law to treat it. If you are poor, they are unlikely to ever collect the bill for doing so. So why would a poor person wait days or weeks to see a doctor then they can go down to an emergency room and see one in hours? Moreover, if you are being forced to pay for health insurance, you are more likely not less likely to seek treatment since you will rationally think "well I am paying for it so I might as well use it.". The idea that making people buy insurance will reduce overall healthcare costs has always been an insane one." http://reason.com/blog/2014/01/02/no-obamacare-wont-reduce-emergency-room#comment_4219297 http://reason.com/blog/2014/01/02/no-obamacare-wont-reduce-e...
      - d23 13y ago
        > So why would a poor person wait days or weeks to see a doctor then they can go down to an emergency room and see one in hours? Because if you don't have a life threatening condition, you're not going to see a doctor in "hours" in the emergency room. You're going to be triage'd to the lowest possible slot, and it's my understanding that if they believe you can just be sent on your way, they'll do that. You can't go in for an ear ache. > Moreover, if you are being forced to pay for health insurance, you are more likely not less likely to seek treatment since you will rationally think "well I am paying for it so I might as well use it." The idea that making people buy insurance will reduce overall healthcare costs has always been an insane one. First of all, there are plenty of respected folks who don't think that's "insane". Presumably more respected than "John" from the comments section. But regardless, that's what co-pays and deductibles are for. Let's also not forget that going to the doctor is still not a joy ride. There's forms, and there's a wait. I have health insurance, and I don't take a trip to the doctor's office like it's the local candy shop. Why would the poor, who feel the impact of a co-pay even more than I do?
- waterlesscloud 13y ago
  This isn't exactly correct, there's something of a gap you can fall into. If you earn very little, you might qualify for Medicaid, which is essentially taxpayer-paid healthcare via the government. If you earn low amounts, you might qualify for various levels of subsidies on private insurance plans through the state-run health exchanges. However, there are certainly situations in which you may not qualify for medicaid, and still not earn enough to afford a private plan, even with subsidies. There are definitely people in this situation. This wasn't unforeseen, it was known it would happen.
  - jbooth 13y ago
    The gap is covered in about half the states. The other half don't like Obama so they refused the free money from the feds to cover the gap for their citizens. Can't make this stuff up.
    - protomyth 13y ago
      "free money" Its not "free money", its taxes paid by taxpayers. There is no "free money" in government.
      - dragonwriter 13y ago
        No, the money that was refused did not reduce anyone's taxes, so your statement is false. Obviously, expenditure has to come from somewhere, but when the government operates in a deficit, marginal spending comes from debt, not taxes.
        protomyth 13y ago
        Debt taken out by the government has to be paid by the tax payers in both principal and interest. There is no free money. Not spending additional federal money is a virtue not a problem.
        dragonwriter 13y ago
- ensignavenger 13y ago
  The subsidies only start after you earn a certain amount of income. If you earn less than that, you don't get any subsidies. Also, the subsidies won't pay for all of it, and the more you earn, the less subsidy you get. The original plan was to force the States to extend Medicaid (Government provided health insurance) to cover those that would not be getting subsidies because they made too little. The problem was, the Federal Government was only going to float the bill for this for a few years, then it was going to be up to the States to come up with the money to keep it going! Many States balked and refused to expand Medicaid, citing the fact that they could not afford this massive increase in their budget. The Supreme Court agreed with the States that the Federal Government could not force them to expand Medicaid unless the Federal Government was going to float the bill. So now, anyone that doesn't earn a certain amount of money will be without health insurance, and the cost of healthcare will be higher for them when they do get sick (For many reasons, such as the medical device tax). Fortunately, for now, if you live in a State that did not expand Medicaid, and you would have qualified had they expanded it, you won't have to pay the penalty tax.
  - asnyder 13y ago
    The only reason those states didn't extend Medicaid is that they dislike Obama and what he stands for. It's 100% covered by the federal government for 3 years, and then 90% until 2022. http://obamacarefacts.com/obamacares-medicaid-expansion.php http://obamacarefacts.com/obamacares-medicaid-expansion.php
    - ensignavenger 13y ago
      "It's 100% covered by the federal government for 3 years, and then 90% until 2022." Exactly this. So, who pays for the 10% after three years? The 100% after 2022? That's right, the State. Sure, maybe they didn't like Obamacare. But that doesn't mean there wasn't a real concern for a very real budget, which the legislature is constitutionally required to keep balanced.
aerolith 13y ago
As long as you're cool with bleeding to death on the steps of the emergency room, I'm ok with your not having insurance. But expecting US taxpayers to pay for your treatment (indirectly via higher premiums) while complaining about being forced to buy insurance is, at best, inconsistent.
- MrZongle2 13y ago
  As long as you're cool with bleeding to death on the steps of the emergency room And exactly how common of an occurrence is that in the United States? Yes, one can bemoan the lack of preventative medicine and proper follow-ups, but if you show up at the E.R. of most American hospitals with a life-threatening condition, you're going to get treated regardless of how much you can pay. If we're going to properly fight the problem, hyperbole needs to go out the window.
  - maxerickson 13y ago
    You read the parent wrong. Their point was that you can't take a moral stand and refuse healthcare when the standard of care is to treat emergencies.
  - zaphar 13y ago
    I'm pretty sure you missed the point. You are right that there is near to zero chance of that occuring. Which is probably what the previous poster meant. Since you can show up with a life threatening issue at a hospital and get stabilizing life saving treatment regardless of your insurance anyone who doesn't have insurance is effectively already leeching.
  - TheCoelacanth 13y ago
    > if you show up at the E.R. of most American hospitals with a life-threatening condition, you're going to get treated regardless of how much you can pay. Yes, and taxpayers are going to foot the bill. If taxpayers are going to foot the bill anyway, they might as well do it in a way that is efficient (preventative care) rather than one that is extremely inefficient (emergency care).
  - deleted 13y ago
Datsundere 13y ago
A relative of mine earns around 16k. Family of 3. The result was that he wasn't covered for earning less than 19k. They gave no tax credits(discounts) whatsoever and took him directly to buy plans for paying the full amount. There is medicaid but not every state is accepting new people.
- ensignavenger 13y ago
  This is pretty close to my own situation, and I live in Missouri, which could not afford to expend Medicaid, so no insurance for me. If I do get sick, ObamaCare only makes it more expensive for me!
  - gamblor956 13y ago
    Solution: move to a state which is not so rabidly against the health of its citizens that it won't subsidize healthcare for those earning below the poverty level.
    - ensignavenger 13y ago
      Perhaps, but that is more easily said than done. For both me (to move) or for the State (to pay for the expansion of Medicaid)- remember, the State can't just print money like the Federal Government can! As far as moving, I have many other considerations, and my wife and son have good insurance, so I am satisfied to stay where I am (physically) for now while we work on the financial issues.
      - d23 13y ago
        > Perhaps, but that is more easily said than done. For both me (to move) or for the State (to pay for the expansion of Medicaid)- remember, the State can't just print money like the Federal Government can! Just to let you know, this is not about the state not having the money. This is about them not accepting the money from the federal government solely out of political spite. And you and your family are on the receiving end of that.
saraid216 13y ago
I actually fall roughly into this camp as well. I can technically afford $200/mo, but I'd rather not. I need to figure out what I'm actually going to do in the next month and I haven't gotten around to doing so. > Isn't this the opposite of free health care? I'm not involved in this debate one way or the other. I don't know enough about the issues. One of the side effects of not being involved in the debate means you don't realize that the actual "free healthcare" option was taken off the table due to spirited lobbying. On the balance, I'm willing to eat the cost either way (getting healthcare, or being penalized) if it means people who were entirely unable to get it before are able to do so now. But then again, I'm crazy. Either because I'm nominally altruistic or because I don't have health care or whatever. I'm sure a reason can be found. I would have preferred to have the dread specter of "long lines" combined with actual free health care for everyone than this, but eh. Politics.
skwirl 13y ago
You do realize that Massachusetts has had this system in place for a while now, right? The insured rate went from 86.6% in 2006 to 96% today. The uninsured rate is 3 times less than it was just a few years ago. On this topic, you can look at real data and not rely on idle speculation. I just don't see a reasonable way to draw the conclusion that "the government's expectation that everyone will buy health insurance just because they're enacting tax penalties seems somewhat naive." Unless you literally mean every single last person.
anigbrowl 13y ago
This really doesn't have anything to do with the topic, which is about analytics rather than the SOTU as it affects you.
Angostura 13y ago
Where does the money come from when you inevitably fall sick and need care?
gizmo686 13y ago
The idea behind the penalty is not to force people who cannot afford health insurance to buy it; your case is an unfortunate side effect. The point is to incentive people who can afford insurance, but rationally say that it costs them more then their expected benefit, to buy it.

hahainternet 13y ago

I am not American, but as I understand it, if you earn so little that you can't afford a plan, you can get vouchers to cover the cost. I'm not sure of the specific boundaries and I think it varies per state. If you detail more information I can always Google.

sillysaurus2 13y ago
If I can't afford my lunch after being given so many opportunities to earn it myself, then it would be unfair for me to ask my countrymen to foot the bill. It's my problem, not theirs. I would have an extreme moral aversion to seeking a handout, even if that aversion is to my own personal detriment. Perhaps I should be trying to maximize every possible opportunity offered to me. But I just can't stomach the idea of taking money away from other people to pay for my own personal problems.
- benburleson 13y ago
  The thing is, what you think is your "own personal problem" doesn't really affect only you. If your neighbors can help keep you healthy and productive, there's a benefit in that for them as well.
  - dllthomas 13y ago
    "If your neighbors can help keep you healthy and productive, there's a benefit in that for them as well." Economically and socially, of course, but epidemiologically as well!
- dangerlibrary 13y ago
  If you go to the emergency room with an untreated, preventable illness that has become critical, and you can't pay the bill, other people wind up footing the bill anyway. Maintenance is cheaper than repair.
  - webXL 13y ago
    Except mandatory "maintenance" doesn't lead to fewer repairs in this case. Google Oregon Medicare study and Emergency Room usage. A comment from reason.com sums it up nicely: "Emergency rooms are required by law to treat it. If you are poor, they are unlikely to ever collect the bill for doing so. So why would a poor person wait days or weeks to see a doctor then they can go down to an emergency room and see one in hours? Moreover, if you are being forced to pay for health insurance, you are more likely not less likely to seek treatment since you will rationally think "well I am paying for it so I might as well use it.". The idea that making people buy insurance will reduce overall healthcare costs has always been an insane one." http://reason.com/blog/2014/01/02/no-obamacare-wont-reduce-emergency-room#comment_4219297 http://reason.com/blog/2014/01/02/no-obamacare-wont-reduce-e...
    - d23 13y ago
      > So why would a poor person wait days or weeks to see a doctor then they can go down to an emergency room and see one in hours? Because if you don't have a life threatening condition, you're not going to see a doctor in "hours" in the emergency room. You're going to be triage'd to the lowest possible slot, and it's my understanding that if they believe you can just be sent on your way, they'll do that. You can't go in for an ear ache. > Moreover, if you are being forced to pay for health insurance, you are more likely not less likely to seek treatment since you will rationally think "well I am paying for it so I might as well use it." The idea that making people buy insurance will reduce overall healthcare costs has always been an insane one. First of all, there are plenty of respected folks who don't think that's "insane". Presumably more respected than "John" from the comments section. But regardless, that's what co-pays and deductibles are for. Let's also not forget that going to the doctor is still not a joy ride. There's forms, and there's a wait. I have health insurance, and I don't take a trip to the doctor's office like it's the local candy shop. Why would the poor, who feel the impact of a co-pay even more than I do?
waterlesscloud 13y ago
This isn't exactly correct, there's something of a gap you can fall into. If you earn very little, you might qualify for Medicaid, which is essentially taxpayer-paid healthcare via the government. If you earn low amounts, you might qualify for various levels of subsidies on private insurance plans through the state-run health exchanges. However, there are certainly situations in which you may not qualify for medicaid, and still not earn enough to afford a private plan, even with subsidies. There are definitely people in this situation. This wasn't unforeseen, it was known it would happen.
- jbooth 13y ago
  The gap is covered in about half the states. The other half don't like Obama so they refused the free money from the feds to cover the gap for their citizens. Can't make this stuff up.
  - protomyth 13y ago
    "free money" Its not "free money", its taxes paid by taxpayers. There is no "free money" in government.
    - dragonwriter 13y ago
      No, the money that was refused did not reduce anyone's taxes, so your statement is false. Obviously, expenditure has to come from somewhere, but when the government operates in a deficit, marginal spending comes from debt, not taxes.
      - protomyth 13y ago
        Debt taken out by the government has to be paid by the tax payers in both principal and interest. There is no free money. Not spending additional federal money is a virtue not a problem.
        dragonwriter 13y ago
ensignavenger 13y ago
The subsidies only start after you earn a certain amount of income. If you earn less than that, you don't get any subsidies. Also, the subsidies won't pay for all of it, and the more you earn, the less subsidy you get. The original plan was to force the States to extend Medicaid (Government provided health insurance) to cover those that would not be getting subsidies because they made too little. The problem was, the Federal Government was only going to float the bill for this for a few years, then it was going to be up to the States to come up with the money to keep it going! Many States balked and refused to expand Medicaid, citing the fact that they could not afford this massive increase in their budget. The Supreme Court agreed with the States that the Federal Government could not force them to expand Medicaid unless the Federal Government was going to float the bill. So now, anyone that doesn't earn a certain amount of money will be without health insurance, and the cost of healthcare will be higher for them when they do get sick (For many reasons, such as the medical device tax). Fortunately, for now, if you live in a State that did not expand Medicaid, and you would have qualified had they expanded it, you won't have to pay the penalty tax.
- asnyder 13y ago
  The only reason those states didn't extend Medicaid is that they dislike Obama and what he stands for. It's 100% covered by the federal government for 3 years, and then 90% until 2022. http://obamacarefacts.com/obamacares-medicaid-expansion.php http://obamacarefacts.com/obamacares-medicaid-expansion.php
  - ensignavenger 13y ago
    "It's 100% covered by the federal government for 3 years, and then 90% until 2022." Exactly this. So, who pays for the 10% after three years? The 100% after 2022? That's right, the State. Sure, maybe they didn't like Obamacare. But that doesn't mean there wasn't a real concern for a very real budget, which the legislature is constitutionally required to keep balanced.

aerolith 13y ago

As long as you're cool with bleeding to death on the steps of the emergency room, I'm ok with your not having insurance. But expecting US taxpayers to pay for your treatment (indirectly via higher premiums) while complaining about being forced to buy insurance is, at best, inconsistent.

MrZongle2 13y ago
As long as you're cool with bleeding to death on the steps of the emergency room And exactly how common of an occurrence is that in the United States? Yes, one can bemoan the lack of preventative medicine and proper follow-ups, but if you show up at the E.R. of most American hospitals with a life-threatening condition, you're going to get treated regardless of how much you can pay. If we're going to properly fight the problem, hyperbole needs to go out the window.
- maxerickson 13y ago
  You read the parent wrong. Their point was that you can't take a moral stand and refuse healthcare when the standard of care is to treat emergencies.
- zaphar 13y ago
  I'm pretty sure you missed the point. You are right that there is near to zero chance of that occuring. Which is probably what the previous poster meant. Since you can show up with a life threatening issue at a hospital and get stabilizing life saving treatment regardless of your insurance anyone who doesn't have insurance is effectively already leeching.
- TheCoelacanth 13y ago
  > if you show up at the E.R. of most American hospitals with a life-threatening condition, you're going to get treated regardless of how much you can pay. Yes, and taxpayers are going to foot the bill. If taxpayers are going to foot the bill anyway, they might as well do it in a way that is efficient (preventative care) rather than one that is extremely inefficient (emergency care).
- deleted 13y ago

Datsundere 13y ago

A relative of mine earns around 16k. Family of 3. The result was that he wasn't covered for earning less than 19k. They gave no tax credits(discounts) whatsoever and took him directly to buy plans for paying the full amount. There is medicaid but not every state is accepting new people.

ensignavenger 13y ago
This is pretty close to my own situation, and I live in Missouri, which could not afford to expend Medicaid, so no insurance for me. If I do get sick, ObamaCare only makes it more expensive for me!
- gamblor956 13y ago
  Solution: move to a state which is not so rabidly against the health of its citizens that it won't subsidize healthcare for those earning below the poverty level.
  - ensignavenger 13y ago
    Perhaps, but that is more easily said than done. For both me (to move) or for the State (to pay for the expansion of Medicaid)- remember, the State can't just print money like the Federal Government can! As far as moving, I have many other considerations, and my wife and son have good insurance, so I am satisfied to stay where I am (physically) for now while we work on the financial issues.
    - d23 13y ago
      > Perhaps, but that is more easily said than done. For both me (to move) or for the State (to pay for the expansion of Medicaid)- remember, the State can't just print money like the Federal Government can! Just to let you know, this is not about the state not having the money. This is about them not accepting the money from the federal government solely out of political spite. And you and your family are on the receiving end of that.

saraid216 13y ago

I actually fall roughly into this camp as well. I can technically afford $200/mo, but I'd rather not. I need to figure out what I'm actually going to do in the next month and I haven't gotten around to doing so. > Isn't this the opposite of free health care? I'm not involved in this debate one way or the other. I don't know enough about the issues. One of the side effects of not being involved in the debate means you don't realize that the actual "free healthcare" option was taken off the table due to spirited lobbying. On the balance, I'm willing to eat the cost either way (getting healthcare, or being penalized) if it means people who were entirely unable to get it before are able to do so now. But then again, I'm crazy. Either because I'm nominally altruistic or because I don't have health care or whatever. I'm sure a reason can be found. I would have preferred to have the dread specter of "long lines" combined with actual free health care for everyone than this, but eh. Politics.

skwirl 13y ago

You do realize that Massachusetts has had this system in place for a while now, right? The insured rate went from 86.6% in 2006 to 96% today. The uninsured rate is 3 times less than it was just a few years ago. On this topic, you can look at real data and not rely on idle speculation. I just don't see a reasonable way to draw the conclusion that "the government's expectation that everyone will buy health insurance just because they're enacting tax penalties seems somewhat naive." Unless you literally mean every single last person.

anigbrowl 13y ago

This really doesn't have anything to do with the topic, which is about analytics rather than the SOTU as it affects you.

Angostura 13y ago

Where does the money come from when you inevitably fall sick and need care?

gizmo686 13y ago

The idea behind the penalty is not to force people who cannot afford health insurance to buy it; your case is an unfortunate side effect. The point is to incentive people who can afford insurance, but rationally say that it costs them more then their expected benefit, to buy it.