Affordable Care Act: Coverage May Be Unaffordable For Low-Wage Workers

[Purveyor]

Posted: 10:04 AM
By: Associated Press

WASHINGTON - It's called the Affordable Care Act, but President Barack Obama's health care law may turn out to be unaffordable for many low-wage workers, including employees at big chain restaurants, retail stores and hotels.

That might seem strange since the law requires medium-sized and large employers to offer "affordable" coverage or face fines.

But what's reasonable? Because of a wrinkle in the law, companies can meet their legal obligations by offering policies that would be too expensive for many low-wage workers.

For the employee, it's like a mirage -- attractive but out of reach.

The company can get off the hook, say corporate consultants and policy experts, but the employee could still face a federal requirement to get health insurance.

Many are expected to remain uninsured, possibly risking fines. That's due to another provision: the law says workers with an offer of "affordable" workplace coverage aren't entitled to new tax credits for private insurance, which could be a better deal for those on the lower rungs of the middle class.


Read more: http://www.abc15.com/dpp/news/national/affordable-care-act-coverage-may-be-unaffordable-for-low-wage-workers#ixzz2W7NOjiXV

[datasuspect]

1. the 1% laughs all the way to the bank

they set this shit up like this on purpose.

there's a bigger pool of working schlubs to use as an ATM for the elites.

[bike man]

4. It is important to remember, I think, that the "they" to whom you refer is Congress.

They are the "they" that passed the bill, the very bill that House Speaker Pelosi spoke of saying 'We have to pass the bill to see what's in it' (or words to that effect).

Now, *that's* our representatives in action - the ones that we reelect at about a 90% rate.

[datasuspect]

5. *they* are mostly wealthy people

who directly and indirectly benefit financially from their tenure as politicians.

that's why they are as parsimonious as fuck with their own campaign funds, but will spend your money like drunken poets.

[bike man]

8. And *they* will pass no law that will adversely affect their wallets, or the wallets of

their country-club buddies.

The rest of us are screwn.

[datasuspect]

9. one of the fundamental rules of life:

don't bite the hand that feeds you.

[Major Nikon]

46. It's also important not to propagate right wing speaking points

What Pelosi was saying is that the Senate had to first pass the bill (and get past the three-fifths Senate requirement for cloture) before the House could pass a reconciliation bill with the Senate (which only requires a simple majority in the Senate). Pelosi's detractors were claiming all sorts of nonsense was put into the bill, which at that point didn't even exist.

Pelosi's statement without the correct context is disingenuous tripe.

[dreamnightwind]

55. +1

Thanks for taking the trouble to spell this out. It's way too easy to parrot empty talking points, much more difficult to accurately represent what happened.

[kenny blankenship]

11. all the way to their Etrade account to buy stock in Wellpoint, United Healthcare, Aetna...

Why just look at Obamacare reining in the illgotten gains of those robber barons, who're taking our money and denying us medical treatment!


Just look at it.

[metalbot]

57. To be fair

That's pretty much what the rebound looked like for a lot of companies, including Apple and IBM.

(Not that the insurance companies weren't really, really happy with ACA).

[upaloopa]

2. I wish we would talk more about affordable care and not

so much about insurance. Low cost insurance means limited care. Providers are not required to contract with all insurance companies. If they don't like the amount of reimbursement they don't usually accept the insurance.
That is the problem with the ACA. It tries to compensate for the profit motive of insurers and employers who find loopholes in the law. If we wanted to provide "care" and not insurance we would have went for single payer.

[cbdo2007]

3. That means it also MAY be AFFORDABLE. See how that works???

Stupid news stories nowadays getting people worked up with "may" or "maybe" or "might" or "speculation" etc.

[Bluenorthwest]

7. I see how this works.....

[Kolesar]

10. It's sour grapes by the Romney fans...eom

[Dragonfli]

31. Romney fans like Romney/Heritage care.

[leftstreet]

56. Wasn't this basically Romney's plan? n/t

[KG]

6. as a low wage worker, it wouldn't be affordable for me.

[L0oniX]

42. ...neither will the fine.

[flamingdem]

12. For $85 a month most low wage workers can get good coverage under

Obamacare.

Not even Medicare is "free".

I would say it's more the middle class that will not benefit so much.
They'll get better plans and have many good things like kids covered until 26
and no pre existing... but it's not cheap, yet.

For the low wage worker subsidies are very good in general.

[liberal_at_heart]

13. Not everybody can afford Medicare either.

My father just dropped his clinical and prescription Medicare coverage. All he has now is hospital coverage.

[flamingdem]

15. Do you happen to know what that costs?

I have to admit I used to think it was all free after age 65.

Turns out it can be more than $200 -- meaning one might be better off as a poor person under Obamacare.. also I think that might be the secret. Eventually everyone will be better off under this program as it becomes more single payer

[liberal_at_heart]

19. sorry, I don't consider Obamacare single payer. With single payer you pay a tax and when you

walk out of the doctor's office there is $0 in premiums, deductibles, or copays. That is what we need, but letting the insurance industry write the law insured that we would not be getting single payer.

[flamingdem]

20. If it wasn't for Obama fighting as he did

we'd have nothing.

I'm just stating the facts..

[watoos]

54. Medicare premium is $100.00 / month

[enlightenment]

60. Define "good"

How much is the deductible?
What are the co-pays?

Subsidies only pay toward the insurance premium, not the cost of care - so a policy that carries a $2500 deductible (not uncommon) and offers coverage at the "silver" level will only pay about $5250 of a $10000 bill. That's assuming they would pay a full 70%, rather than the more common "reasonable and customary" charge percentage, which is usually less than what a patient is billed.

So, that low-wage worker may need to pony up almost $5000 - probably more when all is said and done. For someone making $15000 a year (about minimum wage), that's a third of their gross income.

Doesn't look particularly "good" from that perspective.

[flamingdem]

63. anyone making 15000 a year would probably qualify for Medicaid

at least in California

[eridani]

64. Only if you consider high deductible plans that cover only 60% of your costs to be "good" n/t

[srican69]

14. We may be without coverage at the end of this month ...the quotes I have gotten so far

for a family of 3 are between 900 to 2000 a month .....

What the ?????


the $900/ month BCBS only provides $700/year/person in office visits - If I go over then I am fully responsible for it ... the rest of the policy is essentially a catastrophic coverage with tons and tons of exclusions ...

as I was saying ..What the ????

[flamingdem]

16. Any chance you can qualify for subsidies?

That seems very high!

[srican69]

18. nope .. i make too much money for subsidies .. I am shopping for insurance at ehealthinsurance.com

Me and my wife are planning to go without coverage .. and just get insurance for our baby

[flamingdem]

21. Assuming here you are not covered through an employer?

Is this plan family w/o employer?

[srican69]

23. I am self employed ... my wife works for a hospital .. and we were covered through that ...

. but the grant funding her research was not renewed... and unless her employer finds a different lab for her by this month end - we will be out of luck ..

the Cobra will cost us 2000/month - too much for us to afford.

[liberal_at_heart]

27. yeah, we opted not to take Cobra as well.

[liberal_at_heart]

17. we are paying $925/month in premiums, and forget about paying the co-pays. They go to collections.

[flamingdem]

22. Is this with employer insurance, is this after 2014?

Or is this now?

Do things improve for you in 2014?

[liberal_at_heart]

24. We have private insurance. We may qualify for tax deductions but not subsidies. We would still

have to pay upfront and get reimbursed at the end of tax season. Coming up with that money upfront is not easy.

[kenny blankenship]

25. The ACA fixed all that.

By making it a law that you have to buy it, no matter how high it goes.
So fear not, you'll be insured, citizen, or the IRS will come a-knocking to find out why. Don't you feel better now, now that the burden of choice has been lifted from your shoulders?

Next up: fixing homelessness!

[srican69]

26. I think I will pay the fine instead ..

no way I am spending 900/month for crappy coverage

[L0oniX]

28. Let's hope we can afford to pay the fine ...or the IRS will do something to us. What, I don't know.

[kenny blankenship]

33. The IRS is supposed to be prevented from aggressively prosecuting non-compliance

but after the first year, the fine, which we're not supposed to call a fine or punishment, but rather a tax (wink), starts to go up.

It goes up from a trivial $95 for an individual plus additional half that amount for each of your kids to about $700 for an individual in 2016, and half that ($347) for each kid. Your household penaltax (I almost said penalty- hah!) can be as high as $2,085 or 2.5 percent of your household income, whichever is greater. And you will still be without health care access. After 2016, though, these levels of financial reprisal from the IRS are supposed to level off and stay the same forever. Call me crazy but I don't think they will.

My expectation is that when Obamacare fails to approach its enrollment targets, the penaltax will be the first area to receive its "we'll fix it later!" review.

The cry around here will be "We're the good health insurance buying citizens who want Obamacare to succeed. All our premiums are going up and up! Why is it fair for the Penal-Tax to stay the same for the scofflaws, while we pay more and more? Waaah!

And the pain -which is the only thing this government likes to share out liberally- will go up.

[L0oniX]

38. I can hear the worshippers now.

[L0oniX]

30. +1

[Dragonfli]

34. Mandated home ownership! What could go wrong?

Why I bet there will be a subsidy that will pay $100 a month for a mortgage for part time workers at McDonald's. We should let subprime mortgage companies write the legislation, that will make it perfect and affordable

(disclaimer: copays to enter the home will be required upon each use of the front door, also bathroom privileges may not be covered under most plans, a deductible of $50,000 will be required before taking possession)

[Yo_Mama]

37. You made me laugh on a grim topic

This is all sad, and indeed I think you've summed up the mindset.

Don't get the $5 charge for three sheets of toilet paper! Collected by the IRS!

What blows my mind are the copays that the people are expected to cough up. A lot of poorer people might be able to buy the insurance, but not to get medical care!

[L0oniX]

40. "buy the insurance, but not to get medical care" sounds like that's the plan.

Isn't that what insurance corporations do? Collect premiums and make it so they don't have to pay out?

[Yo_Mama]

41. I'm starting to think that was the plan

It's not going to cut medical costs! Not for those people.

[L0oniX]

45. It may be considered to be a subsidy or welfare for insurance corporations...

...if they get to collect premiums from poor people who can't afford any co-pay or prescriptions.

[Yo_Mama]

47. Sadly, that is true, and that should anger us the most

(Unless we are in the bracket that is supposed to buy, but still won't be able to afford to see a doctor or get medicine).

If you pull back and think about this, the taxpayer is paying subsidies that won't end up helping many of these people.

I think taxpayers would be MORE willing to pay a higher tax if it meant that people actually got medical care. Even if you are doing well now, someday you may be in that boat, and you probably have a friend or family member who already is in that boat.

[tridim]

52. Well that post is a bunch of crap.

None of it's true in the least.

Congrats!

[cbdo2007]

36. You aren't getting the ACA rate, those don't become available until October 1.

In the mean time, the insurance companies are still trying to get as many people as possible signed up at the current rates and then hope they don't change plans when the rates go down.

Check again in a few months and let us know how much it's changed.

[Schema Thing]

50. Take a look at Costco

I recently did an online quote with them and was impressed with their offering.



It was fairly close to what will be available in 2014 (which I may just wait for).

[L0oniX]

29. My bet is that ACA will be unaffordable for anyone making under $15 a year.

[HiPointDem]

32. I have a plan to cut 1/3 of the cost: get rid of private insurers.

[Dragonfli]

35. Private insurers are who this law was written for/by. good luck with that.

[Comrade Grumpy]

39. Aren't those the ones who need it?

Fuck this profit-driven health insurance bullshit.

This country needs national, taxpayer-funded health care. Not health insurance. Those parasites should rot in hell. Along with all the others who are profiting from illness. (Which is not to say that health care providers should not be adequately compensated.)

[kenny blankenship]

43. If they can't afford the nosebleed prices for under-insurance

they can always cut back their hours to the point that they qualify for Medicaid's 3rd world level of care.

[bvar22]

44. Its "The Uniquely American SOLUTION!!!!"

New Rule (Passed by Congress and signed by President Obama) signals Kiss of Death for Pensions
http://www.cnbc.com/id/100694955

Wealthy win lion's share of major tax breaks
http://www.boston.com/business/news/2013/05/29/wealthy-win-lion-share-major-tax-breaks/Ua0UyYle21EUXub7g1suCI/story.html

Half of America is in poverty, and its creeping toward 75%
http://www.alternet.org/economy/real-numbers-half-america-poverty-and-its-creeping-toward-75-0

Wealth gap widens as labor's share of income falls
http://www.nbcnews.com/business/wealth-gap-widens-labors-share-income-falls-1B6097385

As the Economy Recovers, the Wealth Gap Widens
http://www.usnews.com/news/blogs/rick-newman/2013/03/11/as-the-economy-recovers-the-wealth-gap-widens

Top One Percent Captured 121 Percent Of All Income Gains
http://www.huffingtonpost.com/2013/02/12/top-one-percent-income-gains_n_2670455.html

Corporate Profits Hit Record High While Worker Wages Hit Record Low
http://thinkprogress.org/economy/2012/12/03/1270541/corporate-profits-wages-record/?mobile=nc


These things ^ do NOT happen by accident.
They take careful planning, preparation, marketing, and buying the right politicians.

This trend is ALSO Unsustainable.
The RICH KNOW that,
and are grabbing everything that isn't nailed down,
and pulling up the ladders.

...because something is gonna break,
and when it does, it won't be pretty.
THAT is WHY the 1% is busy militarizing the Police Forces,
and building a mammoth Security/Surveillance State.

Lindsey Graham and Dianne Feinstien were on TV yesterday saying they are just fine with the NSA Spying on Americans.
I thought to myself,
"Well, they would be."
Any Old, Extra White, Extra RICH 1%er WOULD be.
"They" are going to need them to protect their loot when the peasants realize they've been screwed.

2014 could be the breaking point when MILLIONS of already hard pressed Working Class Americans realize they have to BUY Junk ("Bronze&quot Insurance that they can't afford to use
from RICH, For Profit Corporations,
with the IRS serving as the Enforcers.

The photos of the CEOs and Upper Managers of the parasitic Insurance Cartels buying new private jets, yachts, and new Summer Homes in Aspen won't help.
I KNOW these photos will be all over The WEB,
because I will be posting them.

VIVA Democracy!
Our neighbors in Latin America have given us the Blue Print for "change".
I pray we get some here soon.

[zeemike]

59. Exactly

This is the oath to neo feudalism
When the1% own it all, (and that is inevitable if you do the math) the rest of us will be their serfs hoping to one day become a vassal to serve them...the best we can hope for.

[dreamnightwind]

62. Wow, great post

Way to lay it out there, and I agree that the real change these days is happening in Latin America, hopefully we'll wake up and learn how to get power back in the hands of the people.

Different circumstances for sure, the corporations have latched on to the U.S. taxpayers as the funders of their international resource security force (our military), so they'll do everything in their power to maintain control here. Clearly real change won't happen by voting for the least evil candidate presented to us by our two corporate parties.

[Hydra]

48. I posted about this during the debate

And the cheerleaders assured me everything would be just peachy, everyone would be covered and everyone would get subsidies.

Personally, this would have killed me if I hadn't gotten the job I currently have. Nice to know my survival and the survival of my household came down to pure luck while the WH gave out a HUGE handout to big insurance.

[Proud Liberal Dem]

49. and a huge ginormous asteroid MAY crash into the Earth!

Seriously, I think that it's ridiculous to be putting all of these stories out there until after PPACA is FULLY implemented next year. We won't know how much of a success and/or failure it's going to be until we get there but, honestly, I can't imagine it being WORSE than the system we've had for practically forever in this country and I suspect that it will be quite an improvement. Any big change is going to hit a few speed bumps and need some tweaking but I personally like to deal in facts and those won't be available until everything is in place. Engaging in rempant speculation will get us nowhere.

[eridani]

65. Of course we know. Just look at Massachusetts

Four years after implementation of Romneycare/Obamacare, medical bankruptcies are still 50% of all bankruptcies.

[Skeeter Barnes]

51. People need healthcare. They get an insurance mandate instead.

[leftstreet]

58. +1

USA! USA! USA!

Welcome to DU

[Babel_17]

53. We need to work on deductibles and copays and out of pocket expenses

Being in poverty means you learn to fear what might take away the little you have. When people in poverty associate seeing a doctor with not having money for the rest of the family then they will avoid seeing the doctor.

Afaik, the most affordable plans have deductibles and copays and out of pocket expenses.

[Skeeter Barnes]

61. Low income workers can't afford to take time off to see a doctor in the first place.

When money is that tight, you can forget about co pays or deductibles. Stuff like that is out of the question. We're talking about people who barely have enough money left over to buy gas to get back and forth to work and now they're supposed to cough up more? If they do get some kind of coverage, they won't be able to use it because they don't have the fucking money! I'm tired of the class warfare waged on workers by both parties. They are corporate owned and operated.

God damn the corporate owned United States.