The Trump effect on Healthcare premiums

[Proud Tiger 4,261]

11 hours ago, Brad_ATX said:

My comment was to get you to use the correct terminology.  The ACA is a law that contains more that just the individual mandate.  You don't have insurance, which is why you paid the penalty.

 

Yes I DO have insurance. I had to attach a form to my tax return proving it. But I had to pay the penalty because my income was above some level specified in the ACA. There are some good things in ACA but also some bad ones. The individual mandate was one of the worst. For sure in hindsight it would have been better for Nancy Pelosi, et. al., to read it before they passed it. And remember the bill's principal author said it was easy to get some things in it because the public is so dumb.

[Brad_ATX 13,654]

4 hours ago, Proud Tiger said:

Yes I DO have insurance. I had to attach a form to my tax return proving it. But I had to pay the penalty because my income was above some level specified in the ACA. There are some good things in ACA but also some bad ones. The individual mandate was one of the worst. For sure in hindsight it would have been better for Nancy Pelosi, et. al., to read it before they passed it. And remember the bill's principal author said it was easy to get some things in it because the public is so dumb.

I'm really curious as to how you had to pay a fine if you have sufficient insurance.  The individual mandate is only that you carry a bare minimum amount of health insurance.  Fine is only applicable if you don't carry that minimum amount.  If you paid a fine, I suggest getting a new tax guy.

[Proud Tiger 4,261]

1 hour ago, Brad_ATX said:

I'm really curious as to how you had to pay a fine if you have sufficient insurance.  The individual mandate is only that you carry a bare minimum amount of health insurance.  Fine is only applicable if you don't carry that minimum amount.  If you paid a fine, I suggest getting a new tax guy.

I asked two different tax guys and they both told me the same thing. I'm not a tax expert or an expert on the ACA rules (1000s of pages) so I can't offer any more than I have. Next time I talk to my tax guy in Auburn I will get more details. Maybe someone else here can chime in.

[homersapien 11,453]

On 5/29/2018 at 12:31 PM, LakeBum said:

I am glad you think so.  I am sad you try to force it down the throats of those of us who do not believe that, but that seems to be the way of the world these days.

I am not trying to "force anything down your throat".  (I'm on Medicare.)

If you can't handle a civil debate, take it to the trash talk forum.

[homersapien 11,453]

20 hours ago, Proud Tiger said:

The worst part of the ACA, the individual mandate, has been removed. People no longer have to pay for not having insurance if they don't want it. Also the drug option is now much better for a lot of people..

[Brad_ATX 13,654]

And now the DOJ is arguing that the provision of the ACA covering pre-exististing conditions is unconstitutional.  This after Trump had previously said that was one part of the law he liked.  It's also a segment of the law that has widespread bi-partisan support.  Hoping like hell the DOJ loses this case.

https://www.msn.com/en-us/news/politics/‘you’ve-handed-us-an-issue’-democrats-pounce-on-trump-administration’s-health-care-move/ar-AAypwTy?ocid=spartanntp

 

[NolaAuTiger 3,295]

30 minutes ago, Brad_ATX said:

And now the DOJ is arguing that the provision of the ACA covering pre-exististing conditions is unconstitutional.  This after Trump had previously said that was one part of the law he liked.  It's also a segment of the law that has widespread bi-partisan support.  Hoping like hell the DOJ loses this case.

https://www.msn.com/en-us/news/politics/‘you’ve-handed-us-an-issue’-democrats-pounce-on-trump-administration’s-health-care-move/ar-AAypwTy?ocid=spartanntp

 

Ok so you side with Trump! Love it Brad!!!

[Brad_ATX 13,654]

25 minutes ago, NolaAuTiger said:

Ok so you side with Trump! Love it Brad!!!

Well apparently I don't. POTUS typically lays out what the DOJ will pursue/won't pursue on issues like this.  I was actually very happy initially that he at least wasn't going to touch pre-existing conditions.  Now it appears that is not the case.

[Grumps 3,704]

On 5/29/2018 at 6:03 PM, LakeBum said:

IMaybe we should just fix the prices that hospitals, clinics and doctors can charge folks for procedures and fix the price for drugs, too.  That will make everyone's healthcare costs affordable.  

THIS is what everyone (except Golf) is missing. The politicians claim to be addressing HEALTHCARE when they are really addressing HEALTH INSURANCE. They are not trying to address the COST of healthcare. The point of ACA is to raise taxes, not to make healthcare more affordable. The Obama administration wanted to raise our taxes and the Trump  administration wants to raise our taxes.

I agree that we as Americans have a moral obligation to care for the sick, but the individual mandate was wrong. Our government should not FORCE a private citizen to purchase a product they don't want or cannot afford. It is a tax on breathing, and breathing should be free.

[Grumps 3,704]

11 hours ago, Brad_ATX said:

And now the DOJ is arguing that the provision of the ACA covering pre-exististing conditions is unconstitutional.  This after Trump had previously said that was one part of the law he liked.  It's also a segment of the law that has widespread bi-partisan support.  Hoping like hell the DOJ loses this case.

https://www.msn.com/en-us/news/politics/‘you’ve-handed-us-an-issue’-democrats-pounce-on-trump-administration’s-health-care-move/ar-AAypwTy?ocid=spartanntp

 

I think that the pre-existing conditions provision is just like forcing McDonald's to give skinny people their food at half-price. It is wrong for our government to force it. We have to decide as a nation how involved our government should be in forcing us to be moral. As you can guess, I think morality should be outside the scope of our government.

[Brad_ATX 13,654]

18 minutes ago, Grumps said:

I think that the pre-existing conditions provision is just like forcing McDonald's to give skinny people their food at half-price. It is wrong for our government to force it. We have to decide as a nation how involved our government should be in forcing us to be moral. As you can guess, I think morality should be outside the scope of our government.

The problem here is that if you don't force the private industry's hand, it's already been proven that they will run away from those with pre-existing conditions.  If that part of the ACA wasn't in there, I'd be living in a box because my wife wouldn't be covered for her condition which requires a lot of doctor's visits, medications, and even procedures.  At some point we as a society have to ask what is important.  Leaving everything to a laisse-faire free market doesn't work.  That's already been shown back in the late 19th-early 20th century.  Companies will take everything, consolidate, and monopolize a market if given the opportunity which is ultimately a bad outcome for the average Joe worker and consumer.

[homersapien 11,453]

14 hours ago, Brad_ATX said:

And now the DOJ is arguing that the provision of the ACA covering pre-exististing conditions is unconstitutional.  This after Trump had previously said that was one part of the law he liked.  It's also a segment of the law that has widespread bi-partisan support.  Hoping like hell the DOJ loses this case.

https://www.msn.com/en-us/news/politics/‘you’ve-handed-us-an-issue’-democrats-pounce-on-trump-administration’s-health-care-move/ar-AAypwTy?ocid=spartanntp

 

Back to the future.  

(Or as PT would frame it, "undoing all the damage Obama did".)

[homersapien 11,453]

14 hours ago, NolaAuTiger said:

Ok so you side with Trump! Love it Brad!!!

As if Trump really held a principled position on this. 

 

[homersapien 11,453]

3 hours ago, Grumps said:

THIS is what everyone (except Golf) is missing. The politicians claim to be addressing HEALTHCARE when they are really addressing HEALTH INSURANCE. They are not trying to address the COST of healthcare. The point of ACA is to raise taxes, not to make healthcare more affordable. The Obama administration wanted to raise our taxes and the Trump  administration wants to raise our taxes.

I agree that we as Americans have a moral obligation to care for the sick, but the individual mandate was wrong. Our government should not FORCE a private citizen to purchase a product they don't want or cannot afford. It is a tax on breathing, and breathing should be free.

That moral obligation to care for the sick (and poor) will come out of everyone's pocket.  At least everyone who pays taxes.  So you might as well have a principled position that the government should not force anyone to pay taxes.

 

[Grumps 3,704]

56 minutes ago, homersapien said:

That moral obligation to care for the sick (and poor) will come out of everyone's pocket.  At least everyone who pays taxes.  So you might as well have a principled position that the government should not force anyone to pay taxes.

 

I can't think of a tax that the government forces anyone to pay now that the individual mandate is gone. Can you?

[NolaAuTiger 3,295]

3 hours ago, homersapien said:

As if Trump really held a principled position on this. 

 

Ok?

[homersapien 11,453]

2 hours ago, Grumps said:

I can't think of a tax that the government forces anyone to pay now that the individual mandate is gone. Can you?

Not sure what you are getting at, but generally speaking, citizens are required to pay their taxes or suffer legal penalties, so in that sense, the government forces everyone to pay any tax they are owed.

I happen to believe the only way to responsibly approach healthcare needs for the country is if everyone participates.  That was the intent of the required coverage position in the ACA.

And for those who now choose to op out altogether, you will pay a price in terms of the cost of the healthcare you need when you need it. And sooner or later, you will.

 

[Grumps 3,704]

2 hours ago, homersapien said:

Not sure what you are getting at, but generally speaking, citizens are required to pay their taxes or suffer legal penalties, so in that sense, the government forces everyone to pay any tax they are owed.

I happen to believe the only way to responsibly approach healthcare needs for the country is if everyone participates.  That was the intent of the required coverage position in the ACA.

And for those who now choose to op out altogether, you will pay a price in terms of the cost of the healthcare you need when you need it. And sooner or later, you will.

 

I think I can legally opt out of any tax. If I don't buy anything then no sales tax. If I don't own property then no property tax. If I don't have income, then no income tax. See how this works? We can CHOOSE to participate or not. That's why the individual mandate is different. The issue is that people who choose not to participate in healthcare insurance are given healthcare when they change their mind after getting sick. 

[homersapien 11,453]

21 hours ago, Grumps said:

I think I can legally opt out of any tax. If I don't buy anything then no sales tax. If I don't own property then no property tax. If I don't have income, then no income tax. See how this works? We can CHOOSE to participate or not. That's why the individual mandate is different. The issue is that people who choose not to participate in healthcare insurance are given healthcare when they change their mind after getting sick. 

Right.  Just like we can choose to live or not.  

By your own logic, one can CHOOSE to  avoid the individual mandate by avoiding income so as to be too poor to pay it.  The government can't - and doesn't - require blood from a turnip, right?  

So the individual mandate - using your own logic - is no different from the income tax.  Just like income and sales tax, it can be avoided.   So thanks for making my point.

And you are right about the real issue.  How do you propose to address it short of universal participation?

[Grumps 3,704]

1 hour ago, homersapien said:

Right.  Just like we can choose to live or not.  

By your own logic, one can CHOOSE to  avoid the individual mandate by avoiding income so as to be too poor to pay it.  The government can't - and doesn't - require blood from a turnip, right?  

So the individual mandate - using your own logic - is no different from the income tax.  Just like income and sales tax, it can be avoided.   So thanks for making my point.

And you are right about the real issue.  How do you propose to address it short of universal participation?

My understanding of the individual mandate is that you owe it whether you can afford it or not, so it is NOT like income taxes.

I would try to address the issue much more honestly. First, the cost of healthcare is a much bigger problem than is the cost of health insurance. I think that the politicians dealing with health insurance instead of the cost of healthcare is intentional. If healthcare costs went way down, then more people could afford it and more could afford health insurance. I believe that physicians could cut healthcare costs by 20-30% just be being honest, but that isn't going to happen unless the government forces them to be honest. For example, most x-rays that are obtained are not needed based on the patients' clinical findings. But a physician will make as much money from the x-ray as he/she does from the office visit. So physicians are incentivized to do unneeded tests AND patients think the physicians are being more thorough by doing more tests. If physicians only performed the tests that they KNEW were needed then costs would go way down. I think that if the government went to each medical specialty organization and told them that they have 6 months to present a way to cut 20% from the costs of their specialty then the organizations would do it. If the organization refuses then the government experts can do it for them.

Similarly, hospital organizations can get the same mandate and pharmaceutical companies and insurance companies the same. Just by trying to force the entities to be honest would result in real savings.

But, regarding health insurance and the uninsured. Poor people and people with pre-existing conditions need healthcare, not necessarily health insurance. Helping these people is great. THAT'S why we pay taxes. But requiring everyone to pay an individual mandate so that the poor and those with preexisting conditions is dishonest. Call it a healthcare tax and then give it to those who need it. Forcing an insurance company to take a huge loss on certain clients and then making it up on others is just silly. As I said earlier, it is no different from forcing McDonalds to give skinny people 2-3 times as much food for the same price. Why not give the poor money to pay their bills rather than require everyone to pay for insurance. The answer, in my opinion, is that people don't complain as much about paying for people with preexisting conditions as they do with paying for someone's healthcare.

Anyway, that a much longer answer than you were looking for, and I didn't really answer your question, but the short answer is 1. CUT COSTS and 2. figure out how much we need and then figure out how to honestly tax people enough to get it.

[Texan4Auburn 1,626]

4 hours ago, Grumps said:

 For example, most x-rays that are obtained are not needed based on the patients' clinical findings. But a physician will make as much money from the x-ray as he/she does from the office visit. So physicians are incentivized to do unneeded tests AND patients think the physicians are being more thorough by doing more tests. If physicians only performed the tests that they KNEW were needed then costs would go way down.

Problem with this is that is also known as defensive medicine. You are correct there are many things that doctors know they probably don't need to test for, but if there is even the .0001% chance they are going to run the test and it isn't just for profit. Today's society of sue everyone it isn't worth the risk of ignoring.

Now you also do get the idiots like the cardio surgeon, plenty of greedy dishonest doctors also, in Auburn that was stinting up everyone whether they needed it or not.

 

[Grumps 3,704]

29 minutes ago, Texan4Auburn said:

Problem with this is that is also known as defensive medicine. You are correct there are many things that doctors know they probably don't need to test for, but if there is even the .0001% chance they are going to run the test and it isn't just for profit. Today's society of sue everyone it isn't worth the risk of ignoring.

Now you also do get the idiots like the cardio surgeon, plenty of greedy dishonest doctors also, in Auburn that was stinting up everyone whether they needed it or not.

 

That's where tort reform would help, but many see that as a way to help rich physicians at the expense of the poor, mistreated patient.

[homersapien 11,453]

5 hours ago, Grumps said:

My understanding of the individual mandate is that you owe it whether you can afford it or not, so it is NOT like income taxes.

I would try to address the issue much more honestly. First, the cost of healthcare is a much bigger problem than is the cost of health insurance. I think that the politicians dealing with health insurance instead of the cost of healthcare is intentional. If healthcare costs went way down, then more people could afford it and more could afford health insurance. I believe that physicians could cut healthcare costs by 20-30% just be being honest, but that isn't going to happen unless the government forces them to be honest. For example, most x-rays that are obtained are not needed based on the patients' clinical findings. But a physician will make as much money from the x-ray as he/she does from the office visit. So physicians are incentivized to do unneeded tests AND patients think the physicians are being more thorough by doing more tests. If physicians only performed the tests that they KNEW were needed then costs would go way down. I think that if the government went to each medical specialty organization and told them that they have 6 months to present a way to cut 20% from the costs of their specialty then the organizations would do it. If the organization refuses then the government experts can do it for them.

Similarly, hospital organizations can get the same mandate and pharmaceutical companies and insurance companies the same. Just by trying to force the entities to be honest would result in real savings.

But, regarding health insurance and the uninsured. Poor people and people with pre-existing conditions need healthcare, not necessarily health insurance. Helping these people is great. THAT'S why we pay taxes. But requiring everyone to pay an individual mandate so that the poor and those with preexisting conditions is dishonest. Call it a healthcare tax and then give it to those who need it. Forcing an insurance company to take a huge loss on certain clients and then making it up on others is just silly. As I said earlier, it is no different from forcing McDonalds to give skinny people 2-3 times as much food for the same price. Why not give the poor money to pay their bills rather than require everyone to pay for insurance. The answer, in my opinion, is that people don't complain as much about paying for people with preexisting conditions as they do with paying for someone's healthcare.

Anyway, that a much longer answer than you were looking for, and I didn't really answer your question, but the short answer is 1. CUT COSTS and 2. figure out how much we need and then figure out how to honestly tax people enough to get it.

You're right.  That was a much longer answer than I was looking for.  I'll parse it later.

But you are clearly wrong in what the ACA expects of people who cannot pay into the system. You cannot legislate blood from a turnip.  But if you disagree, quote the law.  

[Grumps 3,704]

13 minutes ago, homersapien said:

You're right.  That was a much longer answer than I was looking for.  I'll parse it later.

But you are clearly wrong in what the ACA expects of people who cannot pay into the system. You cannot legislate blood from a turnip.  But if you disagree, quote the law.  

It won't be the last time I was wrong. My point was that other taxes were avoidable and this one is not. It was my understanding that everyone would be required to obtain insurance or pay a penalty. I am sure that people who cannot pay could get hardship exemptions or subsidies, but that is not the same as avoiding the tax itself. My apologies for my verbosity. I won't let it happen again!

[homersapien 11,453]

5 minutes ago, Grumps said:

It won't be the last time I was wrong. My point was that other taxes were avoidable and this one is not. It was my understanding that everyone would be required to obtain insurance or pay a penalty. I am sure that people who cannot pay could get hardship exemptions or subsidies, but that is not the same as avoiding the tax itself. My apologies for my verbosity. I won't let it happen again!

BS.  It's exactly the same as avoiding income tax by not having income as you stated.