Are the subsidies in the House Bill enough for mandating people buy insurance

[Jennicut]

I know many are against the mandates. I am torn over it. I wonder what the fine people of DU think.
The current House bill would cover 400% of the poverty line: $43,320 for an individual, $88,200 for a family of four. The Senate bill would be lower.
I will be honest and say my husband earns about $80,000 with two jobs (and we live in CT, one of the most expensive states).
The median household income in 2008 was $52,029 according to the Census Bureau. http://www.census.gov/prod/2009pubs/acsbr08-2.pdf
At the lowest income level, the subsidy would keep a family of four earning just over $29,000 a year from paying more than 1.5% of their income on insurance premiums. It reaches as far up as a family of four earning about $88,000 a year, so they would pay no more than 12% of their income toward insurance.

[Cronus Protagonist]

1. I just don't have any cash for that

I'll just have to be fined for living.

[sandnsea]

3. Then maybe you're at 150% of poverty

and will get free Medicaid which is actually very good health coverage.

[Cronus Protagonist]

5. That will be a HUGE incentive to NOT earn more money in the future

Assuming the economy picks up, where is the incentive for people with an expensive medical condition to get back to work? The entire methodology appears to me to be flawed.

[sandnsea]

6. Right, welfare queens love to sit on welfare

:eyes:

Actually, the subsidies will be an incentive for a lot of people to change jobs and move up and take more risks.

[Cronus Protagonist]

7. Really?

Do you really believe that people, faced with the prospect of a job that takes them over a ceiling, will choose to do so? I think history indicates that this will not be so.

[sandnsea]

9. Have you ever lived in poverty?

Yes. People will happily take a job that doubles their salary if they don't lose the entire increase to health care costs. People won't take the job if they have to give up their health care coverage altogether.

These arguments about low-income people have always been made by people who never lived it.

[Armstead]

15. You are assuming that health care costs will not eat up increases in income

It's not just a "welfare queen" argument.

Many working middle class people would balk if they get a raise that is all eaten up -- ir potentially makes them lose money -- by health insurance. People seldom double their income in one fell swoop. usually it is a percentage.

[sandnsea]

16. That's what I just said

Having subsidies will help enormously. Wage increases will no longer be eaten up in increased health care costs.

That's also why I've repeatedly said we've got to pay attention to the subsidies. They're the critical element of this bill, not the public option, and we have to have the House subsidies.

[ipaint]

21. With no cost controls, those generous subsidies will last about 2 years. n/t

[sandnsea]

24. And that's 2 years of lives saved n/t

[ipaint]

30. In exchange for decades of increasing losses. That's quite a bargain. n/t

[sandnsea]

32. Decades of increasing losses?

Do you mean health care is expensive and we're going to have to figure out a way to pay for it?

Yes. We will. Unfortunately the US is a live and learn country. We won't get to a different system without going through this door.

[ipaint]

34. No we are not a live and learn country.

If that was the case we would have approached this similar to the Taiwanese when they took a population of 45% uninsured to 95% insured in one year, ironically with the direct guidance from a american professional at Harvard.

We are a nation with a corrupt to the core government of lobbyists, politicians and constantly revolving doors between the two.

We haven't had a decent piece of major legislation that didn't pound the working class and poor into the ground for 30 plus years and all those promises of future fixes on shitty bills have been broken.

We didn't build medicare on a private capitalist model and we didn't build social security on one either.

This isn't the start but the finish. Some people never learn.


By increased losses I'm referring to a steady loss of life which will begin in the lower classes as soon as the mandate is passed. We will still have 18 million uninsured in the best of bills. This gives the parasite ins. companies something to build on. So reset the clock 20 years and watch the number of uninsured once again go up, the number of deaths once again rise and prices increase.

[sandnsea]

35. No, we will see more low income people with insurance

And once they become accustomed to having it, they will refuse to go back. As will all the small business people who have been paying monstrous premiums all these years.

Then we will take a second look at Medicare and Social Security and implement something sensible.

That is where we are today, I should say. The current crop of Republicans do not learn anything except when they're kicked in the head. I do believe this legislation is going to kick people in the head in about ten years. In the meantime, if we keep the House legislation, Medicaid will be changed to automatic enrollment for all adults up to 150% of poverty. That is HUGE. That, in itself, is worth passing this bill. The HOUSE subsidies, in themselves, are worth passing this bill.

This is a short term fix, so that people accept there is no other solution in the long term except a complete non-profit health system. That would be top to bottom, insurance to pharmacies to equipment.

[ipaint]

37. People at the bottom of the economic ladder have no power.

I don't care what you give them for a year or two. It can be taken away with a signature and any protest will be quelled by a veiled threat that the middle class will be next should they get any funny ideas about defending the rights of the poor and working poor.
Worked for quashing real reform, just threaten the middle class.

Besides that the lower classes are invisible and anyone without healthcare, at least for the first decade, will be considered a deadbeat. The american middle class has NEVER been known for rallying around the rights of the lower income uninsured.
The only reason a few of them empathize now is because of newly acquired first hand experience.

[sandnsea]

39. 150% of poverty will have free Medicaid

I am sorry. Your argument just doesn't wash.

And seriously, I think low income people often overlook the help they do get. Food stamps, energy assistance, lunch program, child care assistance, earned income credit, SCHIP, Pell Grants, Section 8, FHA loan guarantees, lots of programs for low income people. LOTS.

And now there is another one.

[ipaint]

40. Nice list.

Does nothing to solve the problem though. And the hoops that folks must jump through to get barely minimal aid are designed to discourage enrollment. clinton cut food stamps and welfare, energy assistance runs out way before all the people who need it get it, child care assistance, where?, section 8 is woefully inadequate, loan guarantees for folks making minimum wage?

Your list is a suave to soothe middle class angst and guilt twinges should they ever actually take a look at a life permanently lived at the bottom.

You proved my point.

[sandnsea]

41. Oh god, I have always lived at the bottom

And when I need that help, I jump a 30 minute hoop to get it. Sorry, you're bullshitting the wrong person.

[ipaint]

42. Back at ya. n/t

[ipaint]

19. What job prospects?

I'm 53 and have always been working class. The job prospects have never been good in the lower classes, now more than ever before. I intend to never make more than the cut off for medicaid should the bill go through. I can live very simply and am not invested in the consumer culture. All I really need is access to basic health care.
The bloodsucking insurance parasites who have killed over a million people in the last 20 years and have kept this country in the dark ages for decades won't see a cent of my income if I can help it.

[lumberjack_jeff]

44. Do you not understand the math or are you assuming "people" don't?

The subsidies are on a sliding scale. It doesn't discourage work.

[pnwmom]

14. Yes. One of the things that keeps people in large corporations instead of starting

more small businesses is the availability of large group health insurance. Often, that's the only way some people can be insured.

[pnwmom]

13. I can't believe I'm hearing that argument from a progressive. n/t

[busymom]

20. LOL Turn that around

When we talk about increasing taxes on people to pay for health care, everyone dismisses the idea that it is a disincentive to move up and earn more money if you are taxed and taxed and taxed. I suppose the argument is only good when it works for us? I think most people want to be self-sufficient and are more than willing to chip in and pay their share when it comes to health care. I know I am.

[uponit7771]

26. This is a bull shit right wing meme

[Cronus Protagonist]

47. Really? I know a few people on Medicare who are in exactly that position

Every dollar they earn is taken off their benefits. I, for one, am not naive enough to believe that the same will not happen with this abortion of a plan. If we can afford one billion dollar plane that we don't need, we can ALSO afford universal free health care like the REST OF THE DEVELOPED WORLD. And if, for some reason, we can't afford BOTH, you know which one we can cut the fat off to make it fit the budget.

Anyone who argues that this is a good plan isn't paying attention to the rest of the world. The British are laughing their heads off at all this crap, and for good reason. Thus is NEO-FASCISM - the further channeling of public money into the hands of bankers, corporatists and investors.

HEALTH CARE NOT BOMBS!

[frazzled]

8. What do you have the cash for?

I'm not trying to be moralistic here, nor am I trying to pry into your financial situation. I am merely curious about reasoning, because, reading over the last months, I continue to be surprised at the number of people who claim not to buy into the health insurance at work because they can't afford it, etc.

I guess we've always just considered health insurance a mandatory cost-of-living in our family. We've lived our lives adjusted to income after that money came out of the paycheck. It just never occurred to me that anyone would not carry health insurance unless they were in the private market and turned down (I've known a lot of those people.) But I've never known anyone who has chosen not to carry health insurance: they worry themselves sick trying to get it.

I guess my question would be, would you give up your monthly cable bill for health insurance? Would you give up your cellphone bill? Would you move to a less expensive residence? If your answer is that you have already done all that and still can't afford it, then you are probably in a situation where a great deal of your premium cost will be covered by a government subsidy under this bill. Or is the only acceptable cost of health insurance "free"? (Of course, it is never free: you pay into Medicare every month through payroll taxes, and if you want Medicare Part B, which covers doctor's visits, you will pay an extra premium on top of that.)

I guess a last question would be: do you have the cash in case you get hit by a bus? Because I don't have the cash to pay for your hospital stay and rehab if that does happen.

[sandnsea]

10. We have opted out of health insurance

No, I didn't cancel the $10 cable bill (at the time) to pay our $100 share of the insurance premium. We had 2 incomes, made as much in the 80s as we do now, and just could not pay all the bills and day care and feed the kids. We didn't qualify for any assistance either, although I never applied unless we were both unemployed and the cupboards were bare, which was only a couple of times. This bill would have been so helpful.

But we also didn't quit and go on welfare to get the free Medicaid either. :eyes: So ridiculous.

[Cronus Protagonist]

18. My landlord raises the rent, my income falls, food prices go up

At some point, everyone will be where I am, and then what will happen?

[sandnsea]

27. Capitalism will have collapsed

And we'll all be in third world status. It could happen. Then we'll have to figure out a new economic system or just start over.

You don't even believe that anyway.

[Lars39]

38. Becauce we're paying down huge medical bills we've already racked up.

Does this bill take that into effect? Are those bills written off? Included in the sliding scale?

[pnwmom]

11. What would you do if you ended up with the bill for even one trip to the

emergency room? My daughter broke a finger and it cost more than $8000 to get it fixed.

[Cronus Protagonist]

28. I'll be bankrupt and homeless just like everyone else

in this situation. And if the government mandates my payment of cash to a corporation, they can pay me back when the case gets to the Supreme Court.

[pnwmom]

48. How will you hire a lawyer to go to the Supreme Court?

And since you will have the option of the public plan, what will your legal argument be? No one will be forcing you to buy private insurance.

[sandnsea]

2. The House Bill is enough

The Senate Bill is awful. If we get the subsidies in the Senate Bill, I'll oppose the whole thing. People will freak out when every penny of their disposable income goes to health insurance and demand it be repealed.

I also think that family income statistic you have there is for a married couple, not all households. Median household income, which includes single moms, is around $50,000. Median individual income is down around $40,000 or maybe even less.

[Jennicut]

4. Thanks! Will change it.

[valerief]

12. Well, if not, those privatized prisons will do the trick!

:sarcasm: (I hope)

[Armstead]

17. Maybe -- but it adds a needless level and another middleman to costs

Insurance already has no role in health care other than to be a middleman. Withj subsidies, tyhe government acts as an additional middleman, thus anotehr layer of administration and expense.

That seems counterintuitive if one of the goals of reform is to streamline the system to reduce unecessary costs.

Also, subsidies change the nature of health insurance to a form of welfare, like food stamps. People who are otherwise self-sufficient would be put into the mentality of having rely on a handout. That's expanding the very thing tghat the "market based soliution" is supposed to avoid.

I would rather see peopel have the ability to choose to pay into a public system that is based on a sliding scale. Optional or not, subsidies merely divert public money into private coffers of a company you are forced to be a customer of.

[optimator]

22. subsidies aren't free money, it is shuffling the burden

it has to come from somewhere and it is a tax.
and if we are going to pool public resources then it better not be for fucking profits of a private company.
Subsidies are just as GROTESQUE as the Mandates.

[DrToast]

23. I've been concerned about the cost of living differences between states

The poverty level is wildly different if you look at individual states, but it doesn't sound like they're going to take that into account.

[sandnsea]

25. Each exchange is state run

For a variety of reasons. I think that cost of living adjustments are included in that aspect of the plan.

[DrToast]

29. Everything I've read suggests subsidies are tied to the federal poverty level

I could be wrong, but I don't recall seeing anything suggesting subsidies would be adjusted by state.

[sandnsea]

31. Even food stamps have state adjustments

Some programs have adjustments within the states. Just because the federal poverty level is used broadly, it doesn't mean they don't adjust locally as well. Frankly, there really isn't that much of a difference for most places. The high costs really come into play in wealthier areas, and most of those people aren't going to be using this program anyway. They're going to see their taxes go up to pay for it.

[Bluenorthwest]

33. It depends on what they mean by 'family'

I'm not sure if the subsidy thing is going to destroy us or give us a hugely good deal. Could be either. Not sleeping well because of it.

[sandnsea]

36. It is the most important part

The House subsidy will help a lot of people. The Senate subsidy will strangle people. We've got to get focused on the subsidies.

[lumberjack_jeff]

43. Does he make that $80k through self employment?

If not, his employer is required to provide the lion's share of your family's health insurance.

The subsidies are only really relevant for the self employed.

[Jennicut]

45. We do have health insurance through his main employer.

He is actually a church organist on the weekends and choir director. He makes quite a bit for a part time job as he has been there for 15 years.

[sandnsea]

46. And that 12% criteria

If your share is more than 12% of your agi, something along those lines, then you can go to the exchange and get the subsidies.