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The new health care law will provide around $1 trillion in subsidies to low- and middle-income Americans over the next decade to help them pay for health insurance.

Johanna Humbert of Galien, Mich., was pleasantly surprised to discover that she qualifies for an insurance subsidy, since her current plan is being canceled. Humbert makes about $30,000 a year, so she'll get a subsidy of about $300 a month. The new plan is similar to her current one, but it will cost $250 — about half of what she pays now.

But where will the money come from to pay for subsidies like these?

On his show last Friday, liberal comedian Bill Maher called the Affordable Care Act a "Robin Hood" plan. "It does take from the rich to make better the poor," he said.

You can certainly make a case for that, says economist Joseph Antos of the American Enterprise Institute. "In a general sense, the rich, of course, subsidize the poor. The rich pay more income taxes," he says. "So, yes, absolutely, that's how subsidies are supposed to work."

So if you're a low-income person getting a tax credit from the U.S. Treasury to subsidize your health care, a big chunk of that credit is coming from taxes paid by the well-off.

The Cost Of Subsidies

But the authors of the Affordable Care Act didn't want the subsidies to become a drain on the Treasury and add to the deficits. So they included provisions designed to offset the cost of the subsidies.

MIT economist Jonathan Gruber, who helped develop the law, says about half the costs are offset by projected savings in Medicare payments to insurers and hospitals. Another quarter is offset by added taxes on medical-device makers and drug companies.

"The other source of revenue is a tax increase on the wealthiest Americans," he says. "Those families with incomes above $250,000 a year will now have to pay more in Medicare payroll taxes."

Those provisions actually make the bill a net positive for the federal budget, according to the nonpartisan Congressional Budget Office. By the CBO's accounting, Obamacare will produce a surplus. Gruber says the law will "actually lower the deficit by about $100 billion over the next decade and by $1 trillion in the decade after."

However, many Republicans have expressed skepticism about those findings.

New Policy, New Marketplace

The subsidies do mean some low-income people will pay almost nothing for insurance, while higher-income people will pay the full market price.

Dentist Aaron McLemore of Louisville, Ky., makes more than $100,000 a year and doesn't qualify for any subsidy on the Obamacare exchange. The 31-year-old's current policy is being canceled. A new policy from the exchange will more than double his monthly premium and nearly double his yearly out-of-pocket maximum.

One person who got a letter canceling his health insurance was Rep. Cory Gardner, R-Colo. He holds up the letter during a congressional hearing Wednesday on insurance problems. He says his family chose to buy private insurance rather than use the congressional plan.
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Notices Canceling Health Insurance Leave Many On Edge
His higher costs aren't subsidizing lower-income policyholders, whose subsidy has already been paid by the government. But he is providing a subsidy in another way: The Affordable Care Act requires him to buy a policy with features he doesn't need.

"Seeing as I'm a single male with no kids or dependents, and I'm paying for pediatric dental care and maternity care, it doesn't make a whole lot of sense to me," McLemore says.

What Obamacare is doing is moving McLemore out of the individual market — where people are sorted by age and health history and scope of coverage — to a market more like the traditional, employer-based group policy, in which young and old workers get the same coverage and pay the same premium.

It's not exactly the same. The Affordable Care Act allows insurers to charge older people up to three times more than younger people for policies.

Still, Gruber, the MIT economist, says the model reflects the basic idea of insurance. "The notion of insurance is we're protected against risk," he says. "What that means is that [during] a period of time when we're healthy, we pay more in premiums than we collect in benefits. In those periods of time we're sick — and we all go through them — we collect more in benefits than we pay in premiums."

Young, healthy people subsidize older people, who are more likely to be sick. Of course, most of those younger folks will eventually become old folks and experience the same benefit.

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Study: Some Families Could Be Forced to Repay ACA Subsidies
A new study suggests that, for many families, the Affordable Care Act (ACA) will be less affordable than they expect.

By EVI HEILBRUNN
September 20, 2013 RSS Feed  Print
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Health Insurance, Health Costs, Insurance Claim
A new study suggests that, for many families, the Affordable Care Act (ACA) will be less affordable than they expect.

[READ: How to Get the Most for Your Health Insurance Money]

The ACA, also known as Obamacare, mandates that most Americans who are currently uninsured purchase their own health insurance by Jan. 1, 2014. To make the process a little easier, state-based health insurance marketplaces will open around Oct. 1, offering plans at various price points. To make sure that plans stay affordable, individuals and families whose total annual income falls between 100 percent and 400 percent of the Federal Poverty Level (FPL) will be eligible to receive tax credits (also called subsidies) to help them pay for insurance. For most consumers, the subsidies will be paid directly to the insurance companies, to offset premiums.

[READ: The Hidden Costs of 'Affordable' Health Insurance Plans]

Since subsidies determined on a sliding scale based upon annual income, if your income changes, you may have to pay back some of that subsidy once tax time rolls around in April.

According to a recent study, funded by the California Program on Access to Care at the University of California, Berkeley, School of Public Health, up to 38 percent of families may have to repay some portion of their subsidy due to changes in income.

"Like any other tax-based program," lead author Ken Jacobs explains, subsidies are "reconciled at the end of the year when you do your taxes." But unlike other tax-based programs, consumers must report income changes directly to the Internal Revenue Service (IRS).

With companies like IBM, Home Depot, Walgreens and Time Warner pushing retirees and employees out of their companies' group insurance plans and into the state-run marketplaces, thousands of additional consumers will be expecting subsidies, unaware that they may be forced to give some of the money back to the government. Accurately reporting their income will be especially important. "The good news is that if people do make those reports, the share of the people who owe money and the amounts they owe become relatively small," Jacob says.

When signing up for insurance, if your income has changed since your last tax filing, make sure you have reported that change.Certain life events -- moving to a different region or state, marriage, divorce, birth of a child, changing jobs, or taking a child off of your health insurance plan – can affect your income. No matter if your income increases or decreases, any change must be reported online, by phone, by mail or in person to the Internal Revenue Service. Your subsidy eligibility will then be reevaluated, and the new amount will become effective on the first day of the next month.

The greatest risk is for individuals or families who are close to the 400 percent federal poverty line cut-off for subsidy eligibility. In 2013, that limit is $45,960 for individuals and $94,200 for families of four.

Under the law the highest amount you would owe back to the government for changes in your subsidy amount is capped depending on income level, according to Jacobs. If your income is between 200 and 300 percent of the Federal Poverty Level, the maximum repayment amount is $1,500 for families or $750 for individuals. (You can calculate your potential subsidy here.) If you fall between 300 percent and 400 percent of the Federal Poverty Level, the maximum repayment is $2,500 for families or $1,250 for individuals. If your income is less than 200 percent of the FPL, the maximum repayment is $600 for families and $300 for individuals. In Washington, D.C., the health insurance exchange, DC Health Link, offers subsidies that are 85 percent of what a consumer would be entitled to unless they specifically ask for the entire amount up front. The idea is to ensure that consumers will get some of the subsidy on their tax return, and not be faced with high repayment rates if their income changes.

Quoted from bumblethru

again.........the winners are the corporations........AGAIN!!
the collective government made sure the 1% got even richer!!

Quoted from Box A Rox

That's why the GOP forced the Single Payer Option out of ObamaCare.

Quoted from BuckStrider

AHAHAHAHAHA!!!!

It's the GOP fault that Obamacare is the failure it is and why Single Payer is out....Oh please, tell us more about how the GOP derailed 'Single Payer' when you had a super majority in the Senate (well not anymore since Reid lit off the nuclear option) and a majority in Congress.

Quoted from CICERO

It's box's magic bullet theory.  The republicans killed the single payer option, even though the
laws of physics say it is impossible.  

Quoted from BuckStrider

It's the GOP fault that Obamacare is the failure it is and why Single Payer is out....Oh please,
tell us more about how the GOP derailed 'Single Payer' when you had a super majority in the
Senate

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Baucus explained that he liked much about the idea of a public option but that he knew
a health care bill containing the provision would fail to win enough support in the full
Senate to overcome a Republican filibuster.
"I fear if this provision is in the bill, it will hold back meaningful reform this year," Baucus said.

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"My job is to put together a bill that will become law," said Baucus, who wrote the bill before
the committee and voted against the public option. "I can count, and no one shows me how
to get to 60 votes with a public option."

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Top Tier Hospitals Excluded from Obamacare.

The Fiscal Times
By Eric Pianin 19 hours ago



With the Dec. 23 deadline looming for signing up for health insurance under Obamacare, consumers rushing to purchase new coverage may be in for a rude shock if they focus principally on finding the least expensive premiums, according to experts.

That’s because many people buying coverage on the federal exchanges either to replace old policies or to obtain coverage for the first time could get hit with deductibles and other out-of-pocket costs much higher than is typical in employer-sponsored health plans.
Perhaps more importantly, they may find themselves excluded from some of the best hospitals in the country and their affiliated doctors.


Deductible Sticker Shock

Gail Wilensky, a senior fellow for Project HOPE and the Medicare director for the first Bush Administration, said on Monday that consumers should be as mindful of deductibles and the hospitals and doctors in network as the monthly premium costs in shopping around.

“What you’re buying is not just the benefits specified in the law but whom you will have access to in getting the service delivered,” she said in an interview. Many of the policies being offered on the federal and state exchanges carry annual deductibles that often top $5,000 for an individual and $10,000 for a couple, according to The New York Times.

“Right now, most of the focus has been on the cost of the monthly premium and occasionally people have remembered to . . .look at what the deductible and the co-insurance is, because that is as important as the premium,” she added. “Whether a hospital is in or out of network is really the third piece: don’t forget to look at what you’re buying.”


Like most insurance policies, the lower the premium the higher the deductible. For example, in El Paso, Tex., for a couple both age 35, one of the cheapest plans on the federal exchange, offered by Blue Cross and Blue Shield, has a premium of less than $300 a month but an annual deductible of more than $12,000, according to the Times. In the case of a 45-year-old couple purchasing insurance on the federal exchange in Saginaw, Mich., a policy with a premium of $515 a month carries a deductible of $10,000 a year.

Some of the Best Hospitals Are Off Limits
Americans purchasing health insurance on the federal and state exchanges may be in for an even bigger shock when they discover some of the best hospitals in the country out of reach, even when those hospitals were previously available to them under their personal policies. That’s because most of the top hospitals in the country will accept insurance from only one or two companies operating under Obamacare.

Obamacare regulations and government subsidies are likely to make insurance more affordable for millions of Americans, as President Obama and senior aides have repeatedly boasted. But many insurers have responded to Obamacare caps on premiums by offering top-tier hospitals and physicians far less money for services rendered. And they’re responding by strictly limiting the number of policies they will accept.


Watchdog.org  recently looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014 – contacting each hospital to determine their contracts and policies. The government watchdog group found that many of the best hospitals in the country were simply opting out of Obamacare – much to the detriment of people in search of the best or most specialized health care.

Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states’ premier hospitals — Cleveland Clinic and Cedars-Sinai Medical Center — have only one company in their respective networks.

A few, such as top rated Johns Hopkins in Baltimore, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers, according to Watchdog.org.

Amid a drive by insurers to limit costs, the majority of insurance plans being sold on the new health care exchanges in New York, Texas and California will not offer patients access to Memorial Sloan Kettering in New York City or MD Anderson Cancer Center in Houston, two top cancer centers, according to the Financial Times.

“We shouldn’t be surprised by this,” Wilensky said. “There was a lot of pressure that exchanges placed on insurance plans to keep premiums low, and the benefits are specified in law for each of the four levels of health care plans. If the benefits are specified and the premiums are pressed low – sometimes lower than the insurance companies thought was appropriate, a major way to try to accommodate that financial pressure is to limit the number of physicians and hospitals.”

“And by limiting the number of physicians and hospitals, you may get those that you include to accept a lower reimbursement,” she added.

Consumers have until Dec. 23 to enroll in new health insurance under Obamacare to qualify for coverage beginning Jan. 1. However, open enrollment will continue through the end of March.


http://finance.yahoo.com/news/top-tier-hospitals-excluded-obamacare-191700528.html

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On Monday, Sen. Bernie Sanders (I-VT) introduced the American Health Security Act,
which would require each state to set up a single-payer health-care system and would undo
the exchanges that have plagued Obamacare.

Meanwhile, various state-led efforts are under way that advocates hope will sweep the country
statehouse by statehouse, as soon as lawmakers see the advantage of a single-payer system.

In Vermont, for example, lawmakers have set aside the financing and are already preparing to
adopt a single-payer system when the federal government permits it, which according to provisions
of the Affordable Care Act will be in 2015. In Massachusetts, Don Berwick, a former top Obama
administration health official, is basing his campaign for governor on bringing a single-payer system
to the commonwealth.
Advocates in New York, Maryland, Oregon, and around the country say they see new energy
around their cause.

Quoted from Box A Rox

Single Payer In Our Near Future!!!