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Topic: ACA and the Middle Class< Next Oldest | Next Newest >
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PostIcon Posted on: Jul. 09 2013, 3:05 pm  Skip to the next post in this topic. Ignore posts   QUOTE

Run the numbers yourself to see….Just how much it will “save” the middle class family?

http://laborcenter.berkeley.edu/healthpolicy/calculator/

I ran some numbers on a middle income nuclear family, and they got NUKED by the ACA.

Great news for the poor….0% of income up to 20K

Good news for the lower middle class….2% of income 20-39K

Not so good for those in the middle quintile……7.8% of income 40-69K

Pretty bleak for the upper middle….14.5% of income 70-109K

Starts bad for the top……13%  at 110K…. but gets much better as you make further up to the top

Those with employer sponsored coverage can even opt for these savings…..if it exceeds 9.5% of income.

Great for the poor, and the rich might even get another bargain, but the middle class keeps carrying the yoke.
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PostIcon Posted on: Jul. 09 2013, 3:28 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I ran the numbers based on my own family (two adults and two children under 21).  
If you have a combined income less than $42K/yr then the government plan is less than my employer-subsidized health plan.  I did not compare benefits between the two plans.

If your income is higher than that, the cost goes up quickly.
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PostIcon Posted on: Jul. 09 2013, 3:47 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Since the ACA wasn't targeted at "the middle class family" (whatever that may be) I'd be suspicious of whatever irrelevant numbers got cranked to bend to the agenda.

Though I definitely could see how gaining access to, and thus having to pay for, healthcare insurance a family was previously barred from purchasing through for profit health insurance company pre-existing conditions bans etc. would see a dramatic rise in costs: from ZERO most of anything is big eh?

As for myself? Employer provided so not an issue. Just like for all the other people the ACA and it's accompanying legislation wasn't really intended for. Note the opening paragraph of that page.

OTOH as fewer and fewer people get a free ride and more and more people pay for their medical care (via insurance coverage) and thus reduce the burden of unpaid bills often made larger by delay to seek care, the cost to everyone will be better controlled. Also the two bills were far more than simply the exchanges, which is all that webpage "calculator" involves.
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PostIcon Posted on: Jul. 09 2013, 4:08 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Here is a discussion on this topic between Avik Roy(of the conservative Manhattan institute)
and Ezra Klein a progressive

http://www.youtube.com/watch?v=xchlKt1--rk&feature=youtube_gdata


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PostIcon Posted on: Jul. 09 2013, 4:12 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(High_Sierra_Fan @ Jul. 09 2013, 3:47 pm)
QUOTE
Since the ACA wasn't targeted at "the middle class family" (whatever that may be) I'd be suspicious of whatever irrelevant numbers got cranked to bend to the agenda.

Though I definitely could see how gaining access to, and thus having to pay for, healthcare insurance a family was previously barred from purchasing through for profit health insurance company pre-existing conditions bans etc. would see a dramatic rise in costs: from ZERO most of anything is big eh?

As for myself? Employer provided so not an issue. Just like for all the other people the ACA and it's accompanying legislation wasn't really intended for. Note the opening paragraph of that page.

OTOH as fewer and fewer people get a free ride and more and more people pay for their medical care (via insurance coverage) and thus reduce the burden of unpaid bills often made larger by delay to seek care, the cost to everyone will be better controlled. Also the two bills were far more than simply the exchanges, which is all that webpage "calculator" involves.

I personally believe that the middle class is an important segment of the US, and the impact on that segment should be taken into consideration when evaluating health care reform.

Further, with the accelerating demise of employer sponsored coverage, it may soon become an issue for a larger segment of the population.

I have employer sponsored coverage, never been happy with the coverage, and was envious of those deemed eligible for the exchange…until I realized that the middle class has been means-tested out of any real benefits.
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PostIcon Posted on: Jul. 09 2013, 4:21 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

"the impact on that segment should be taken into consideration when evaluating health care reform."

I agree and that means the entire two bill's provisions, not simply a portion, the marketplaces, that most explicitly wasn't written for "the middle class" but rather for the currently uninsured, a very different segment.

Means tested out of coverage because the coverage wasn't intended for that economic segment. But from that I would judge you're for single payer universal coverage provided by the government and many are. I'm not as I see many potential inefficiencies in that sort of socialist system.
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PostIcon Posted on: Jul. 09 2013, 4:53 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Admittedly, I’m not very knowledgeable about the ACA and the health care cost monster in general. You seem much more knowledgeable.

I can also see the potential inefficiencies in a socialist system, but I would prefer it to the current situation.

However, it seems like there has to be a third option. Government program available to all capped at the regional median price point? That is, a government run program that could incentivize competition and savings. Probably a naive idea, but I just don’t see the situation improving for the middle class under the ACA.
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PostIcon Posted on: Jul. 09 2013, 5:02 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(markinOhio @ Jul. 09 2013, 2:53 pm)
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However, it seems like there has to be a third option. Government program available to all capped at the regional median price point? That is, a government run program that could incentivize competition and savings. Probably a naive idea, but I just don’t see the situation improving for the middle class under the ACA.

A large part of the ACA (and these Exchanges in general) is that it forces companies to clearly explain what the benefits of their programs are--along with the exceptions and exclusions--on a simple line-item sheet (not hidden in chapters of legal-eze as before) in order to be part of the Exchanges.  These companies the post their plans to the exchanges and people get to choose between them.

Clear competition drives down prices, eventually.  That's not what goes on in our current health-care system, much to the detriment of consumers who see nothing but skyrocketing costs for minimal (or negative) improvements in care.  True competition got tossed aside somewhere in our current mix.  The costs in the link in the OP estimate the exchange rates based on current insurance costs.  It doesn't include any future benefit from competition-driven decreases.

How much will it work?  I dunno yet.  But I welcome the idea of finally giving it a shot.


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PostIcon Posted on: Jul. 09 2013, 5:59 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I expect we'll be finding out that there's a very solid floor below which it's going to be very difficult to get because the insurance aspect of healthcare isn't in reality what drives the costs, that's the medical services industry and our population's overall health.

That 70% of our deaths are chronic disease related, often lifestyle associated illnesses bodes ill for the effort to reduce costs of American health services consumed in this country below a certain point. In many ways, I suspect, we are just that much sicker....

There's a lot that can be done to be sure, that National Institute of Medicine report To Err is Human has a very nice listing, but without more of an effort at prevention from the population the chronic diseases will still be there...

http://iom.edu/~....ief.pdf

http://www.cdc.gov/chronicdisease/overview/index.htm
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PostIcon Posted on: Jul. 10 2013, 8:35 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Did you ever stop to think that Obama's goal might be the elimination of the middle class?

After all, communist countries don't really have a large middle class do they?


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PostIcon Posted on: Jul. 10 2013, 8:51 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

He must be incredibly devious as the middle class has been in decline for at least a decade….maybe Bush was just another Obama puppet?

Both sides like to preach about “helping” the middle class to get elected, but then concentrate efforts on either extreme of the economic scale….prosperity on the backs of the middle class.
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PostIcon Posted on: Jul. 10 2013, 9:57 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(gunslinger @ Jul. 10 2013, 7:35 am)
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Did you ever stop to think that Obama's goal might be the elimination of the middle class?

After all, communist countries don't really have a large middle class do they?

Did you ever stop to think ...

... or are you just doing a parody of the type Jim Wright was talking about?


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PostIcon Posted on: Jul. 10 2013, 11:57 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Drift Woody @ Jul. 10 2013, 9:57 am)
QUOTE

(gunslinger @ Jul. 10 2013, 7:35 am)
QUOTE
Did you ever stop to think that Obama's goal might be the elimination of the middle class?

After all, communist countries don't really have a large middle class do they?

Did you ever stop to think ...

... or are you just doing a parody of the type Jim Wright was talking about?

Or, "Have the chickens come home to roost"?

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PostIcon Posted on: Jul. 10 2013, 1:26 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(gunslinger @ Jul. 10 2013, 10:57 am)
QUOTE

(Drift Woody @ Jul. 10 2013, 9:57 am)
QUOTE

(gunslinger @ Jul. 10 2013, 7:35 am)
QUOTE
Did you ever stop to think that Obama's goal might be the elimination of the middle class?

After all, communist countries don't really have a large middle class do they?

Did you ever stop to think ...

... or are you just doing a parody of the type Jim Wright was talking about?

Or, "Have the chickens come home to roost"?

Oh, the chickens most definitely have a habit of coming home to roost. The problem is, you don't know what chickens look like or where they roost (not talking about barnyard fowl in Tennessee).

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PostIcon Posted on: Jul. 11 2013, 7:36 am Skip to the previous post in this topic.  Ignore posts   QUOTE

GoBlueHiker
QUOTE
A large part of the ACA (and these Exchanges in general) is that it forces companies to clearly explain what the benefits of their programs are--along with the exceptions and exclusions--on a simple line-item sheet (not hidden in chapters of legal-eze as before) in order to be part of the Exchanges.  These companies the post their plans to the exchanges and people get to choose between them.

Clear competition drives down prices, eventually.  That's not what goes on in our current health-care system, much to the detriment of consumers who see nothing but skyrocketing costs for minimal (or negative) improvements in care.  True competition got tossed aside somewhere in our current mix.  The costs in the link in the OP estimate the exchange rates based on current insurance costs.  It doesn't include any future benefit from competition-driven decreases.

How much will it work?  I dunno yet.  But I welcome the idea of finally giving it a shot.


Exactly!....+1!

The ACA, Obamacare, also mandates that health insurance companies must spend at least 80% of their contract revenue ( 85% for group policies) on items related to medical care. That is a response to the $300 million dollar stock option packages being granted to health insurance company executives and board members. This goes a long ways toward reducing the health insurance premiums charged too.

There are a lot of other provisions in the 2000 plus pages to provide private sector incentives to increase the supply of health care providers and increase the efficiency of medical treatment by putting medical records on computer, etc.

In my opinion, the ACA is about dismantling many of the barriers to free market competition in health care. But it is not perfect.

Health insurance companies are already undermining the 80% rule by, for example, claiming that the cost of "medical management training facilities" ( with includes apartments, meals, etc for executives ) in Hawaii are part of the 80%.

I am sure that a lot of other ways will be found to undermine the provisions designed to promote free market competition. There is a lot of money being spent lobbying for new laws and regulations by the insurance companies and medical organizations to erect new barriers to competition as a response to Obamacare.
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