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Stethescope on top of pile of money
The primary goal of the Affordable Care Act—getting the uninsured and working poor access to health insurance—is likely to be complicated by the fact that the regular complications of life (marriage, divorce, having children, job changes, layoffs) have such a significant impact on the income of people living on the edge of poverty. Those life changes could result in interruptions not just in health insurance coverage, but in health care for these people, as they ping-pong between being eligible for subsidies versus Medicaid.
As their family incomes change, so too will their eligibility for public insurance programs. And if nothing is done, policymakers warn, many low-income patients will lose access to their doctors and medications during this massive game of health coverage pingpong.

Policymakers and healthcare industry leaders across the nation are paying close attention to the issue and working to close the coverage gaps before Jan. 1, said Alan Weil, executive director of the National Academy for State Health Policy. [...]

Nationwide, income fluctuations are estimated to interrupt coverage for as many as 28 million people expected to bounce between Medicaid and the federally subsidized health insurance exchanges that states are working to create, according to an article in the journal Health Affairs. Among those most at risk are seasonal and hourly workers and young adults who lack coverage through their parents or jobs, experts said.

Of course, the good news with Obamacare is that this group of people will at least have access to health insurance, either on the exchange or through Medicaid (if they live in a state that's implementing the Medicaid expansion), something that wouldn't have happened for most before the law. They would just be uninsured.

It's good that this is an issue policymakers are aware of and that they're trying to figure out. But the potentially larger issue that still seems to be hanging out there with no solution is what happens to all the people falling into the gap created by states that aren't expanding Medicaid. That's a problem that so far has no solution.

Originally posted to Joan McCarter on Mon May 20, 2013 at 09:39 AM PDT.

Also republished by ClassWarfare Newsletter: WallStreet VS Working Class Global Occupy movement and Daily Kos.

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Comment Preferences

  •  I my home state of Pennsylvania, Gov. Tom Corbett (11+ / 0-)

    (R) refused to expand Medicaid.  The only solution is to give these GOP Governors like Corbett the boot next year and replace them with people who will expand Medicaid.

    Funny Stuff at http://www.funnyordie.com/oresmas

    by poopdogcomedy on Mon May 20, 2013 at 09:47:09 AM PDT

  •  The reason our gov't hasn't "figured it out"... (7+ / 0-)

    ...may be summed-up in two words: Big Pharma;  and/or in a well-known quote from Upton Sinclair: "It is difficult to get a man to understand something, when his salary depends on his not understanding it."

    "I always thought if you worked hard enough and tried hard enough, things would work out. I was wrong." --Katharine Graham

    by bobswern on Mon May 20, 2013 at 10:17:52 AM PDT

    •  Big Pharma isn't the problem with this one (5+ / 0-)

      It would prefer that everyone have continuous coverage.

      •  Well, it's also not the lack of exchanges (0+ / 0-)

        in some of the states.

        If folks follow the link that Joan provided (and read the LA Times piece), it will clarify the point of her diary, which is [I believe]:

        The way that the ACA is written may cause disruptions in healthcare for folks who move from Medicaid to the Health Exchange (and in some cases, back and forth).

        That's because of the paperwork, 'yada, yada, yada' involved in applying for premium subsidies in the health exchange, and/or the process for applying to Medicaid.  Remember folks, some of this information will likely have to be verified (income, etc.).  Personally, I have no idea what the process will be, or how long that it will take.  But like most processes that the government is involved in (and this may involve federal and state governments, along with private industry/employers), the process is quite likely to take some time.

        And this is complicated by the fact that many very low income folks have a hard time (and not necessarily through any fault of their own, I might add) holding a job.  Adverse circumstances like unreliable transportation, lack of child care, etc., may cause individuals to miss work, and therefore be dismissed from work (more often than their more 'income secure' counterparts are likely to experience).

        This, in turn, may lead to them 'bouncing between' the Medicaid program and the Health Exchange, through no fault of their own.  [Just as divorce, birth of a child, etc., may also change their economic status.]

        And as the LA Times article points out, those folks will either go without healthcare, or be forced to use 'Emergency Room' care, in between their insurance plans.  And of course, the avoidance of the poor and uninsured using ER care was one of the main reasons for the implementation of the ACA.

        Personally, I think that California has the best idea (especially for the individual)--adopting a 'bridge plan.'

        Here's a short excerpt from the article, that sort of explains the gist of Joan's diary.

        Some could have gaps in medical coverage under new law

        Income fluctuations could interrupt coverage for 28 million low-income people who could bounce between Medicaid and insurance exchanges. The key will be ensuring people move smoothly between programs.

        . . . The Covered California board approved a plan in March to help patients expected to jump between the two. The "bridge plan" would enable patients now on Medi-Cal managed care whose incomes rise to continue to stay with their health plan once they move to the exchange.

        The program, which still needs federal approval and state legislation to take effect, could serve as many as 840,000 people next year. The plan should streamline the process, keep out-of-pocket premiums low and make it easier for people to keep their providers, said David Panush, external affairs director with Covered California. "It is better for their quality of care, it is better for continuity of care," he said.

        When patients bounce back and forth between plans, it leads to worse outcomes for those who are "living on the edge between working poor and just plain poor," said Howard Kahn, chief executive of the L.A. Care public health insurance plan. California's bridge program, he said, should make the transition much smoother.

        Anthony Wright, executive director for the consumer group Health Access California, said the bridge plan may be especially important for people who have chronic diseases like diabetes and asthma and whose health will be affected if they have to switch doctors every time they get more shifts at work or their seasonal work ends.

        "People don't live their lives neatly in categories above or below 138% of the federal poverty level," he said. "We are trying to create something that is more seamless."

        In a rush--hope I didn't get too redundant and 'run-on.'  ;-)

        Mollie

        "Only he who can see the invisible, can do the impossible."-- Frank L. Gaines


        hiddennplainsight

        by musiccitymollie on Mon May 20, 2013 at 03:42:38 PM PDT

        [ Parent ]

        •  medicaid for all (2+ / 0-)
          Recommended by:
          aitchdee, musiccitymollie

          Or at least medicaid on the exchanges and everyone allowed to buy in if they want to.

          I don't see any other viable alternative.

          •  seniors would be against it (1+ / 0-)
            Recommended by:
            musiccitymollie

            medicare is accepted in more places (like Visa/MasterCard)
            We'll probably lose a lot of doctors in the long run. It is going to be an interesting transition if ACA actually gets off the ground

            •  Actually, I tend to agree, for the same reasons (0+ / 0-)

              that you state.

              It will be interesting.  Who knows, it may surprise everyone, and get off to a great start.

              Even though I prefer MFA, considering that lives are 'at stake,' I hope that HHS can iron out the rough spots, so that things get off to a good start.  

              Especially since, sort of like 'first impressions of people,' it may 'poison the well' for many folks, if it doesn't.  [I know that I'll have more confidence in it, if it seems to go relatively seamlessly, from the get-go.']

              Mollie

              "Only he who can see the invisible, can do the impossible."-- Frank L. Gaines


              hiddennplainsight

              by musiccitymollie on Wed May 22, 2013 at 07:15:45 PM PDT

              [ Parent ]

          •  Well, I'd rather see Medicare-For-All, honestly. (1+ / 0-)
            Recommended by:
            ferg

            I don't know about your part of the country, but it is very hard to find doctors in the southeast and even Mid-Atlantic states to some extent, who will accept more Medicaid patients.

            And in some 'red' states, Medicaid 'medical services' are greatly restricted for adults.  And, it is my understanding that there is considerable 'leeway' in this area, written into the ACA.

            Thanks for your input.  I suppose that Medicaid would be better than remaining uninsured.

            I just keep hoping that we'll get 'MFA,' one day. ;-)

            Mollie

            "Only he who can see the invisible, can do the impossible."-- Frank L. Gaines


            hiddennplainsight

            by musiccitymollie on Wed May 22, 2013 at 07:08:55 PM PDT

            [ Parent ]

            •  oh, I agree, long term (2+ / 0-)
              Recommended by:
              musiccitymollie, Egalitare

              I just think removing the eligibility restriction of Medicaid and allowing it on the exchanges would make this problem disappear, and might also be a good choice for some people who wouldn't otherwise qualify.

              But long-term, I'd prefer a real Medicare-for-all.

              •  Great point, ferg. When I have time to do a bit (1+ / 0-)
                Recommended by:
                ferg

                of research, I'm going to post some info on the Medicaid expansion.

                An article that I read in CounterPunch was particularly concerning regarding the expansion of this program for seniors, under the ACA.

                It had to do with expanded 'powers' of 'Estate Recovery.'  I'll try to find time to poke around, and maybe post something on this soon.

                I was real disturbed about the information.  I had never heard of this process being used, unless it was upon the death of an elderly person who had been in a skilled nursing facility.

                Mollie

                "Only he who can see the invisible, can do the impossible."-- Frank L. Gaines


                hiddennplainsight

                by musiccitymollie on Wed May 22, 2013 at 07:22:22 PM PDT

                [ Parent ]

              •  Actually, Arkansas is going to do that (1+ / 0-)
                Recommended by:
                musiccitymollie

                They are going to put those that are not currently on Medicaid - adults who are poor but don't have children under 18 - into the exchanges with Medicaid picking up the premiums. There was some doubt as to whether the new Republican legislators would expand Medicaid, until Governor Beebe met with Sibelius and they came up with putting all the newly eligible people into the private exchanges.  The Republicans went for it, so they are going to do it.

                It's the only state in the South that looks like it's going to go with the expansion so far. Who would have thought it?

                Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

                by splashy on Thu May 23, 2013 at 01:07:30 AM PDT

                [ Parent ]

        •  Excellent and informative. (3+ / 0-)
          Recommended by:
          musiccitymollie, ferg, indie17

          Thanks for taking the time, Mollie.



          Denial is a drug.

          by Pluto on Wed May 22, 2013 at 06:49:13 PM PDT

          [ Parent ]

        •  This is the reality (1+ / 0-)
          Recommended by:
          musiccitymollie

          Especially for those that are self-employed:

          "People don't live their lives neatly in categories above or below 138% of the federal poverty level," he said. "We are trying to create something that is more seamless."
          It's feast or famine, unpredictably for those that sometimes get fairly large amounts, but not often.

          When they ask how much you expect to earn, it's hard not to give them a blank stare. Who knows? It's all a crap shoot.

          For those that are in the creative arts, who produce art, you never know when something will sell, or for how much, or how much will sell. A commission, or a good sale, could be the only one for the entire year.

          Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

          by splashy on Thu May 23, 2013 at 01:02:06 AM PDT

          [ Parent ]

    •  Big Pharma wins big with ACA. The current law (3+ / 0-)

      has no downside for them - just more customers and subsidies for lower income and middle income families.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Mon May 20, 2013 at 12:38:51 PM PDT

      [ Parent ]

  •  I'm working on creating a working group (6+ / 0-)

    targeted at what I'm calling Sabotage States.

    I'll post a diary about it later this week after I meet with some red state Dems about it.

    We need to get in front of this and help people in those states know that its  the GOP in their state legis and their idiot governors know it's not the ACA that's fucked up but the willful sabotage enacted by the GOP at the state level.

    People are going to die unnecessarily because the GOP hates Obama. It's our job to make sure people understand what's really going on.

    I think it could be used as a 2014 issue even in red states as people realize they could have gotten coverage were it not for  the asshole GOP in their statehouses and governor's mansions.

  •  Is it reasonable to expect ACA to address ... (0+ / 0-)

    ... and cure every variation in people's life situations?

    2014 IS COMING. Build up the Senate. Win back the House : 17 seats. Plus!

    by TRPChicago on Wed May 22, 2013 at 06:13:37 PM PDT

  •  Let's get rid of the whole pathetic mess. (4+ / 0-)
    Recommended by:
    Pale Jenova, gooderservice, jdld, kyril

    Single payer clearly won't come about in my lifetime but I hope my adult children see it before they die.
    Even then for profit medicine won't disappear. Like Europe supplements will burgeon.

    •  Single Payer easiest plan to implement for sure. (11+ / 0-)

      Obamacare is extremely complicated because it leaves most of the private insurance system intact.

      With single payer its easy: Everyone now had has Medicare. Here is the price per month. It will be assessed annually in your tax return, taken out of your check, or you can send it in.

      All other plans and systems are now defunct.

      •  Such a sad and sorry thing - that (2+ / 0-)
        Recommended by:
        jdld, kyril

        Obama and Rahm Emaneul's "Reform Efforts" basically included the very part of the problem that needed the reform. (That is, Big Pharma and Big Insurers)

        I hope we get rid of the ACA, replacing it with USPHC, and to do that, we simply must  find a way to give ourselves some decent people in office. I am so sad about what has happened to the Democratic Party's supposed leadership.

        Maybe it will take Warren/Grayson in 2016?.

        Offer your heart some Joy every day of your life, and spread it along to others.

        by Truedelphi on Wed May 22, 2013 at 06:49:54 PM PDT

        [ Parent ]

      •  And the doctors and nurses working for the (3+ / 0-)
        Recommended by:
        DSPS owl, kyril, splashy

        insurance companies can find jobs to actually deliver healthcare.  And some, not all, of the clerical people can get jobs working in Medicare.

      •  Are you proposing... (0+ / 0-)

        ...that private insurance be banned?

        I don't think that would be very popular in the United States as private insurance would be the relief valve for many middle class people to get the health care they want - esp. for non-life threatening procedures - when they want it. For example, with my current middle class level insurance, I get an MRI within hours (and an interpretation within a day) of it being prescribed for a condition which is in no possible way life threatening and where a delay, in the worst possible case, would only extend discomfort. That seems quite unlike the single payer systems I've looked at.

        I don't know how the UK is now, but when I was over there some years ago, I was talking to a middle class person who said they were going in for significant, but not emergency, surgery "next week". I commented "well, at least it doesn't cost you anything". In response I got a look of horror and a comment like "Oh, I'd never let the National Health Service do this -- that's why I have insurance".

  •  Oh, joy (3+ / 0-)
    Recommended by:
    cocinero, Pluto, Brooke In Seattle
    patients will lose access to their doctors and medications during this massive game of health coverage pingpong
    SOunds like fun: NOT.

    God bless our tinfoil hearts.

    by aitchdee on Wed May 22, 2013 at 06:16:15 PM PDT

  •  They only get "access" (5+ / 0-)
    Recommended by:
    chuckvw, ferg, Pluto, irmaly, Brooke In Seattle

    In the states that rejected the Medicaid expansion, all the uninsured can get is "access" to subsidized health insurance through exchanges.  The exchanges are conservative in nature because they extoll the role of "choice" in health insurance; however, "choice" makes no sense for something (like health insurance) where goods differ not so much in quality or character but in price.  "Choice" in such situations just means "you get only what you can afford" rather than "you get what you need."  We still have not embraced the concept of health care as a right.

  •  ..and us union guys (families) (0+ / 0-)

    are going to end up losing our cadillac plans

    I hope at least someone, somewhere says "thanks!" but I'm not counting on it.

    •  Why are you losing... (0+ / 0-)

      ...your cadillac plans?

      The administration says:

      If You Like the Insurance You Have, Keep It:

      Nothing in the proposal forces anyone to change the insurance they have.  Period.

      It shouldn't be a problem.
  •  Publicly-Funded Healthcare (2+ / 0-)
    Recommended by:
    jdld, splashy

    This is another reason we should have one, unified system of publicly-funded healthcare. Not only is it vastly cheaper and you get better care, but you don't waft in and out of coverage. The paperwork is simpler...er, non-existent.

    We need to get back on the path to a whole system paid out of a single, progressive tax. That's the only way to clean this up.

    And cleanliness is next to healthiness.

  •  Although its not as frustrating (4+ / 0-)

    as these fucking rakes that keep popping up and smacking us in the face with flaws in the ACA right now, the reality is that Democrats are going to end up owning these rakes that keep popping up and smacking everybody else in the face via the American healthcare system. That is going to suck most when it becomes obvious that the healthcare reform needs to be reformed itself and we get to do it all over again in a couple of decades.

    Medicare for All is coming. Because, at some point, there will be no other way to put it off or weasel out of it. Everything that makes our healthcare system destined to shit the bed is still there. Your health is still a product/commodity. Making money is still as big a part of the system as saving lives and preventing illness.

    At some point, we are going to be back fixing the fix,  only, on top of the burden of fixing the fix, which is going to be significant, we are going to have the additional burdens of being blamed for the things that need to be fixed while we are proposing these changes down the line.

    I understand that the sacred free market must always come first, else pants will be shat and beds will be wet and CEOs will cry like babies, but fuck.

    You can see the mess is still coming. The more complicated it is, the easier it is to fuck up. The GOP is never, ever going to stop fucking with the ACA. The same people who say they will are the same folks who said the ACA would be massively popular by now.

    They are going to call you Socialists no matter what you do. Even, as we see, if you pass THEIR fucking ideas into law. Might as well suffer the slings and arrows you are going to get shot at you anyway by going for something worthy of being slagged as a "Commie" over.

    I am a Loco-Foco. I am from the Elizabeth Warren wing of the Democratic Party.

    by LeftHandedMan on Wed May 22, 2013 at 06:40:44 PM PDT

    •  gotta agree with ya (0+ / 0-)

      probably would have been better to make sure that all the wrinkles were out prior to putting the bill out there and making it law.

      I'm a bit concerned with the expansion of the IRS in all this considering their tainted recent history but I guess we have to go with what we got and hope for the best.

    •  You can't avoid an ideological strugggle (2+ / 0-)
      Recommended by:
      LI Mike, ferg

      with Movement Conservatism. You can't. Neoliberalism is a monument to the failure of trying to beat Movement Conservatism by embracing Movement Conservatism to achieve non-Conservative outcomes.

      It never occurred to the Neoliberals that the GOP would attack their own ideas as evil. Stocked with murder boards and plans to kill conservatives and Christians and people who own guns and plaster of paris statues of Jesus and Mary. Just as the Heritage Foundation and Mitt Romney designed it, I guess.

      You can never underestimate the power of Conservative bad faith. Ever. They will call their own ideas Communism if you pass it. (D). That's all it takes. And... evil. Evil has been unleashed on the Heartland by the Democrat Party!

      Or.

      You get the Sequester. We will poison ourselves, offer to cut the social safety net, send poison pen legislation to future versions of ourselves who are still us and still the Teahadi, before we fight an ideological idea war with the GOP and the Movement Conservative Right. What does it get you? They let the Sequester happen. The thing that couldn't happen. It did. You get plans with a thousand moving parts for the GOP to fuck up, defund, refuse to participate in, delay, sabotage.  

      You can pass their ideas, and they are "Socialism".
      You can leave the free market in place, and "Communism".

      Single payer was not about pique, or liberals having to be right. The Public Option was necessary. It was a way to transition from a dying dinosaur of a for-profit system that is doomed to fail no matter how much you cater to the corporations and the rich shareholders to a universal system.

      It was simple, easy to understand, far easier to enroll in, and a lot harder for the GOP to do to it what it is doing to the ACA.

      I am a Loco-Foco. I am from the Elizabeth Warren wing of the Democratic Party.

      by LeftHandedMan on Wed May 22, 2013 at 06:52:30 PM PDT

      [ Parent ]

  •  At least when they ping pong (0+ / 0-)

    it will be between Medicaid and a highly subsidized "silver" plan, which will cover their deductibles and coinsurance much like their premiums. Don't they determine income levels during the open enrollment period around the end of the year though?

    And God said, "Let there be light"; and with a Big Bang, there was light. And God said "Ow! Ow My eyes!" and in a flash God separated light from darkness. "Whew! Now that's better. Now where was I. Oh yea . . ."

    by Pale Jenova on Wed May 22, 2013 at 06:46:56 PM PDT

    •  "Silver" is a "lose your house plan." (0+ / 0-)

      "Silver" plans only cover 70% of your costs.  You still need to pony up the other 30% of the inflated costs.  It's a  little disgusting to hear folks make blasé remarks about how this is so great.  And no one is talking about Medicaid clawback.  No the kids won't get your house when you pass on.

      •  The subsidies apply to those 30% as well (0+ / 0-)

        So you don't have to come up with all of the deductibles and copayments yourself, depending on your coverage level. If you are just above the Medicaid cutoff, you will get about 95% of these costs covered.

        This does not apply to the "bronze" or "gold" plans--over the theoretical "platinum" plan either--which no insurance company has offered anyway.

        Also, that 30% translates to a 1000 deductible and 20% copay after the deductible is met, much like a traditional plan and better than anything you can buy on the individual market today.

        Not single payer, but maybe the plans you could buy 5 years ago--and without the preexisting condition exclusion.

        And God said, "Let there be light"; and with a Big Bang, there was light. And God said "Ow! Ow My eyes!" and in a flash God separated light from darkness. "Whew! Now that's better. Now where was I. Oh yea . . ."

        by Pale Jenova on Thu May 23, 2013 at 07:22:59 AM PDT

        [ Parent ]

        •  Do you have a link? (0+ / 0-)

          Would like to view your source.  Thanks.  This is What I got.

          So it's come to this. We don't know what the policies, no matter what "metal,"** will really buy. Although they will be identical from the standpoint of AV, they will vary by health care actually delivered. (Health insurance does not mean health care. Who knew?)

          Nor can we know what the out-of-pocket costs will be. First, these "online" tools are going to work only for those who have computers (and if you're really poor, you might not), and whose computers are powerful enough to handle complex sites (more might not). And that's leaving aside issues of complexity and usability in the user experience. Second, these tools are unlikely to be built at the state level (Colorado hasn't even coded up their eligibility requirement) and from the way the Feds are talking, not there either. I mean, if the goal is to "avoid a third-world experience" an online out-of-pocket calculator isn't anywhere near the table, let alone on it.*** Third, where do these out-of-pocket online calculator tools get their price data from? The marketplace in health care is notorious for its lack of transparency and arbitrary pricing. So doesn't ObamaCare really, in the words of the old joke about economists, assume a tool for price comparison?

          In other words, citizens consumers are being asked to do what government, through single payer, can and should be doing: Force prices down through bargaining power. But ObamaCare sets citizens consumers up for failure: The exchanges cannot and and will not be able to translate AV into actual health care services delivered, nor will online calculators, even if they are implemented, be able to determine out-of-pocket costs. Ergo, citizens will not be able to bargain successfully.

          I don't like it!
          •  I'll need to check (0+ / 0-)

            to make sure I'm not repeating a state requirement rather than an ACA requirement.

            And God said, "Let there be light"; and with a Big Bang, there was light. And God said "Ow! Ow My eyes!" and in a flash God separated light from darkness. "Whew! Now that's better. Now where was I. Oh yea . . ."

            by Pale Jenova on Fri May 24, 2013 at 07:25:18 AM PDT

            [ Parent ]

          •  Section 1402 of the Affordable Care Act (0+ / 0-)

            Under PART I--Premium Tax Credits and Cost-sharing Reductions, subpart a--premium tax credits and cost-sharing reductions - Sec. 1402. Reduced cost-sharing for individuals enrolling in qualified health plans.

            A little vague, but:

            (1) REDUCTION IN OUT-OF-POCKET LIMIT-

                (A) IN GENERAL- The reduction in cost-sharing under this subsection shall first be achieved by reducing the applicable out-of pocket limit under section 1302(c)(1) in the case of--

                    (i) an eligible insured whose household income is more than 100 percent but not more than 200 percent of the poverty line for a family of the size involved, by two-thirds;

                    (ii) an eligible insured whose household income is more than 200 percent but not more than 300 percent of the poverty line for a family of the size involved, by one-half; and

                    (iii) an eligible insured whose household income is more than 300 percent but not more than 400 percent of the poverty line for a family of the size involved, by one-third.

                (B) COORDINATION WITH ACTUARIAL VALUE LIMITS-

                    (i) IN GENERAL- The Secretary shall ensure the reduction under this paragraph shall not result in an increase in the plan’s share of the total allowed costs of benefits provided under the plan above--

                        (I) 90 percent in the case of an eligible insured described in paragraph (2)(A);

                        (II) 80 percent in the case of an eligible insured described in paragraph (2)(B); and

                        (III) 70 percent in the case of an eligible insured described in clause (ii) or (iii) of subparagraph (A).

                    (ii) ADJUSTMENT- The Secretary shall adjust the out-of pocket limits under paragraph (1) if necessary to ensure that such limits do not cause the respective actuarial values to exceed the levels specified in clause (i).

            Link to searchable ACA, if you are a masochist: here.

            (I found it by search for "silver" over and over. Not as clear as in our company's demonstration, and I bet it varies from state to state. And no, not nearly as good as single payer--given all the rigamarole you have to go through just to find it!

            And God said, "Let there be light"; and with a Big Bang, there was light. And God said "Ow! Ow My eyes!" and in a flash God separated light from darkness. "Whew! Now that's better. Now where was I. Oh yea . . ."

            by Pale Jenova on Sat May 25, 2013 at 09:49:13 AM PDT

            [ Parent ]

            •  On what Planet...? (1+ / 0-)
              Recommended by:
              Pale Jenova

              I should say I live in Bellingham, WA, just 20 minutes from Canada.  Just over the border, there is universal coverage with just one good standard of care.  Everyone is covered!  Longevity and infant mortality statistics beat our performance.  No copays, deductibles, medical bankruptcy.  The cost per participant is around $3K.  Drugs cost 1/4-1/3 of costs in US.
              The "Silver" plans touted here are just pos.  No comparison.  It is a cruel joke we are even fluffing them.  For profit rentiers have no place in a rational allocation of health care spending.  We got nothing to show.

              •  Well, yes, but thanks to Baucus (0+ / 0-)

                year long dithering in the Senate, the Silver (or perhaps, Aluminum) plan is all the One Percent is willing to share with us.

                And God said, "Let there be light"; and with a Big Bang, there was light. And God said "Ow! Ow My eyes!" and in a flash God separated light from darkness. "Whew! Now that's better. Now where was I. Oh yea . . ."

                by Pale Jenova on Sun May 26, 2013 at 03:22:55 PM PDT

                [ Parent ]

  •  single payer, single payer, single payer (4+ / 0-)

    Obamacare is one step forward...hoping we'll get to single payer sooner rather than later

    The most cost-effective system right now is Medicare--a good example of how single-payer works for all.

    It's sad when just a small fraction of the population gets left out...because fewer folks have less clout.

    When everyone is in the same boat, things will get better for everyone.

  •  Who could (1+ / 0-)
    Recommended by:
    splashoil

    have foreseen this revolting development? Anybody who actually looked at what the ACA and it's connection to austerity driven economic cruelty was headed. Profit driven healthcare 'reform' that's only redeeming value was helping the poorest among us has hit the wall of bogus deficit hysteria. This bs hysteria and cooked up absurdity has spawned the by-partisan screw the people who are a profit loss. Who amongst us ordinary workers is not on the edge of poverty?  

    I got an idea, make health care actually affordable. Reign in the for profits and offer people an alternative that allows them access to health care regardless of their income. Maybe a public option or a hybrid system like France has. I'm not rich enough or poor enough to afford the ACA health care reform so I irresponsibly just try to keep on staying alive without. Come on people, profit be it for the insurance companies, or the for profit corporate hospitals and big pharma isn't the purpose of decent healthcare /medicine.

    They seem to have lost their biggest argument and bvogus talking point for this mangled farce of health care reform.  

  •  Keep trying to put that lipstick on this pig (1+ / 0-)
    Recommended by:
    splashoil

    Joan. One of these days folks, including front pagers, will realize that this awful law does us as citizens and a party more harm than good.

  •  Solution is everyone on the same thing (0+ / 0-)

    Where income is irrelevant.

    Those with more money can buy extra perks, along with things like coverage for elective cosmetic surgery (not reconstructive surgery, which should be in the basic coverage).

    Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

    by splashy on Thu May 23, 2013 at 12:57:09 AM PDT

  •  Ultimate Solution is Single Payer (0+ / 0-)

    But a temporary fix comes next year as Voters will have the opportunity to show the door to GOP Governors and State Legislatures for refusing all the Federal Dollars into their respective States.

  •  Obamacare Clusterfuck (0+ / 0-)

    Index of 100+ Articles on ACA reveals the difficulty of applying lipstick to it.  However it has been a great distraction from anything that would actually work.

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