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Questions, controversy permeate mandate



Published: Sun, September 22, 2013 @ 12:05 a.m.

By Burton Speakman

news@vindy.com

YOUNGSTOWN

Here’s how the Affordable Care Act works:

After Jan. 1, 2014, you either must have health insurance or you must be prepared to pay a fine when tax day comes in April 2015.

Despite a nearly three-year buildup, many people are confused about the so-called individual mandate and how the insurance exchanges will work.

Republicans in Congress have pushed for a delay in the individual mandate in the ACA to mirror the one given to businesses. On Friday, the House voted to defund the ACA altogether.

U.S. Rep. Tim Ryan of Niles, D-13th, said he doesn’t know enough about the progress that the administration is making in setting up the national insurance exchange to know if a delay in the individual mandate will be necessary.

It isn’t fair to the public that the individual mandate remains in effect while the business mandate was delayed by a year, said U.S. Rep. Bill Johnson of Marietta, R-6th. Johnson voted Friday to defund ACA.

It isn’t reasonable to expect a member of the public to understand everything included in the ACA, Johnson said. Bureaucrats in Washington are still determining elements of the law.

Though employers expressed relief that the business mandate was delayed, individuals have received no such delay and will soon be faced with a barrage of options when open enrollment in the exchanges begins Oct. 1.

A large number of people would qualify for some type of subsidy on insurance through the exchanges. Anyone who makes between 100 percent and 400 percent of the federal poverty level would qualify for a tax-credit subsidy.

The federal poverty thresholds are currently $11,490 for a single person, $15,510 for a couple, $19,530 for a family of three, and $23,550 for a family of four. This means that a single person who makes up to $45,960 or a family of four that earns up to $94,200 would receive some level of subsidy.

Those who earn less than 100 percent of the poverty level could be eligible for Medicaid — the government’s health-care program for the poor, disabled and children — if Ohio chooses to expand coverage to some 275,000 people. Until the General Assembly votes to expand the program, some of the state’s poorest will receive no help and not be eligible for subsidies on the exchanges.

Last year, the U.S. Supreme Court voted to uphold the individual mandate, but it overturned the requirement that all states expand Medicaid coverage, leaving each state to decide what was once a major provision of the law before it was struck down.

In Mahoning County, the typical family, which has just more than two people, makes $40,570, according to the U.S. Census Bureau. This family would receive a tax subsidy of $132 a month and pay an estimated $284 a month for a mid-level health insurance plan, according to information from the University of California at Berkeley Labor Center.

“Almost one-third of the population will be eligible to receive some type of discount on their health insurance,” Ryan said.

In Massachusetts, the only state that has an operating exchange, a single person who is 30 pays between $246 a month and $412 a month on the exchange. Meanwhile, 60-year-olds would pay between $436 per month and $761 a month if they make more than $34,476 per year and are not eligible for a subsidized plan. For a family of four, the income level to qualify for a subsidized plan increases to $70,656 per year. The Massachusetts plan provides subsidies only for those at 300 percent of the federal poverty levels or less. The subsidized plans range from no cost to a high of $182 per month and are dependent upon income. The numbers will be different in Ohio, and subsidy thresholds are more under the ACA.

Costs could leave some to consider paying the fine instead of buying insurance.

In the law’s first year, the fine would be about $90 and would progress from there to $695 a year when the fine is fully implemented in 2016, said George P. Millich Jr., an attorney with Harrington, Hoppe & Mitchell in Youngstown.

Things might not improve for the public in 2015 when companies with more than 50 employes have to offer insurance to employees or start paying a fine.

A number of companies are considering reducing workers’ hours to stay below the 50 full-time employee requirement to be a large employer that has to offer insurance, Millich said.

“There are also companies that are looking at it solely as a financial decision and consider the fine to be a fixed cost,” he said. “There will also be a lot of employees who currently opt out of their employers’ health insurance who will now want to opt in.”

Employees also won’t be able to rely on their employers for information because, in a lot of cases, the employers aren’t sure exactly what will happen, Millich said.

The positive aspect of the act is that it is expected to greatly increase the number of people who carry insurance, though educating them about the exchanges and what options are available remains a challenge.

The U.S. Department of Health and Human Services has estimated that the law will provide an additional 97,000 of Ohio’s young adults with health insurance.

The public also won’t be able to rely on their family doctor to tell them about how the exchanges work.

Most doctors don’t know enough about the exchanges to provide any information to the public about plans, said Dr. Dominic Conti, who practices in Youngstown.

Part of the issue is also going to be patient choice, including how long people are locked into the health plans they chose, he said

“Hopefully, there will be some option for people to change plans and maneuver within the system,” Dr. Conti said.

Navigating the exchanges could be challenging for people who are not familiar with using the Internet, Millich said.

“There are a lot of filters and other things on the side of the [web] page that could be confusing for some people,” he said.


Comments

1Ytownnative(1036 comments)posted 12 months ago

U.S. Rep. Tim Ryan of Niles, D-13th, said he doesn’t know enough about the progress that the administration is making in setting up the national insurance exchange to know if a delay in the individual mandate will be necessary.

He doesn't have a clue. It was a demoncrat plan he voted blindly for and now they are passing bills that say he doesn't fall under the plan. Its good enough for us but not good enough for him

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2bmanresident(597 comments)posted 12 months ago

It seems no one really knows how this law is supposed to be implemented. Doctors will soon be forced out of business, under employment will rise, and this country will receive the one-two knock out punch that the globalists are looking for. Obama has proven his incompetency.

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3parlayhenry(219 comments)posted 12 months ago

Most of the complaints and downright lies about the Affordable Care Act are from those on the right. They want it to fail. But I have some news for them; even if your wildest dreams come true and "Obamacare" disappears into the ether, health care exchanges, which is the basis for the plan, are here to stay.
Last week Walgreens announced that it was ending their employer-based health insurance and is sending all 160,000 of it's employees to a private health care exchange where they can choose among 60 plans. IBM put all of it's employees on health care exchanges. All the major corporations are following suit. So lunatics on the right, howl at the moon if you want, but the times they are a changing.
You right-wing "experts" out there, predict gloom and doom for a plan that you really know nothing about other than it was put through by the President that you hate for his his skin color. You will spite yourself and your children because everyone, long-term, will benefit from this plan. Is it perfect? Absolutely not. Are there things to improve? Absolutely. Will the implementation be bumpy? No doubt, but big programs like this always are. But you racists won't even give it a chance all because of Obama's "unforgivable blackness". That is not "playing the race card". That is the truth.
George Bush implemented a prescription drug plan that cost billions, took years to get right and added to our national debt tremendously. Where was the outrage then? Oh yeah, he was just a dumb white guy who was just like all the dumb white guys that voted for him, so that was fine.
Our health care system is broken. It is not anywhere near being the best in the world at providing care; but it is the most expensive in the world. The Affordable Care Act is just the first step in fixing things. The funniest thing of all, the idea for the Affordable Care Act was from the Republicans at the Heritage Foundation during the 1990's. Of course, they were all white guys, too, so no problem.
You haters keep hating; you can't win. Obama beats you right-wingers like a rented mule.

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4parlayhenry(219 comments)posted 12 months ago

Hey bmanresident, congratulations! You have managed to look like an idiot in 50 words or less. That's quite an accomplishment for you.

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5drpautot(70 comments)posted 12 months ago

Parleyhenry, your correct on so many levels. I find it staggering the level of idiocy i hear from people about the affordable care act. Never mind the fact that both times, in the last 2 elections; both candidates were running on a platform that was primarily about healthcare reform, And both times we elected the president that came up with the plan. So where are the Americans who do not want healthcare reform. Strangely, I've heard the argument to have it repealed from people who live below the poverty level, and from some seniors who are less informed than congress The bill will have virtual no effect on the healthcare that is already there except for the fact it will cut insurance corporations profit margin. And lets not forget that since we have had this bill introduced, republicans have tried to repeal it 42 times, That Is 41 long debacles of an argument that would have been better spent using that same energy fixing real problems in the country. Congress is simply acting like spoiled brat kids whose parents wont buy them candy at the store and throw themselves to the ground crying and going limp, simply because they are not getting what they want.

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6studdabubba(2 comments)posted 12 months ago

True health care reform did not have to be this difficult. This is just another hidden agenda driven towards socialism.

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7drpautot(70 comments)posted 12 months ago

Studdabubba, socialized healthcare isnt necessarily bad. Canada, as well as most of the EU have had it for years, and doctors make considerably less there, than their American counterparts. Thee services in some cases are far better too. In France for example, if you are having a stoke or heart attack, real time telemetry is sent from the ambulance to the hospital directly, so when you arrive at the ER, the room is ready for you to get the required surgery, and they do not have to page doctor so and so from his corner office at the back nine of some country club to come and do his job, saving lives. And now we have a hostage situation in Washington. I surely hope our President keeps his stance on terrorism, and refuses to negotiate with the Congressional Boehner regime. Good healthcare for everyone is not Socialism, its just common sense.

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8ricnsherri(41 comments)posted 12 months ago

Just make it fair for everyone. If businesses can wait a tear then let individuals wait a year. During that time have some educational plans for folks to learn.

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9parlayhenry(219 comments)posted 12 months ago

Hey Studadbubba!! Well if you are so afraid the Affordable Care Act will lead to "socialism" (of course you don't what socialism really is) then we need to get rid f Medicare in a hurry because that is socialized medicine provided by the government. Sure you paid some money into it, but nowhere even close to the money all of you blue-hairs in the Tea Party cost the rest of us in medical expenses.
So I agree, let's get rid of Obamacare AND Medicare, give all of you back the money you put in and then you can pay cash for your medical care. It won't last one hospital visit. The funeral directors will be millionaires!! LOL!!!!

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10Benice(4 comments)posted 12 months ago

Parlayhenry, please, your original post IS the definition of "playing the race card". Most Americans that disagree with this program could not care less which color our president is or isn't.

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11Benice(4 comments)posted 12 months ago

"'What we have now is untenable over time,' said Warren Buffett, an early supporter of President Obama. 'That kind of a cost compared to the rest of the world is really like a tapeworm eating, you know, at our economic body.'

"Buffett does not believe that providing insurance for everyone is the first step to take in correcting our nation's healthcare system.

"'Attack the costs first, and then worry about expanding coverage,' he said. 'I would much rather see another plan that really attacks costs. And I think that's what the American public wants to see. I mean, the American public is not behind this bill.'"

That is what a "dumb white guy" suggests and who IS a supporter of President Obama, who oddly enough has a different color skin pigmentation.

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12msweetwood(161 comments)posted 12 months ago

Hey everyone:

Instead of the typical back-and-forth here, I have a different idea: Read this week's newspaper and arm your self with the facts.

For the next six days, we are devoting extra space to items that you won't see here on the web. Page A9 today is a blueprint for what you need to know plus it has links to various websites for more information.

We have grown tired of the pro/con debate which does little to illuminate what the act might mean to real people in coming months. Now we want to arm you with as many facts as we can find from resources to experts, to even a glossary of ACA terms (see Monday).

For everyone posting that they don't know enough, run out and get today's newspaper and stick through the series until Friday. Then come back and share what you've learned.

Thanks,

Mark Sweetwood
Managing Editor

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13ricnsherri(41 comments)posted 12 months ago

Mark,
Will you PLEASE included a list of all the companies/groups that are exempt.

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1476Ytown(1242 comments)posted 12 months ago

Our health care costs are so far out of reach for anyone with or without insurance. Gone are the $100 deductible per person, $200 per family, 80/20 plan of years ago. Gone are employer sponsored health plans with small payroll deductions.

Fact: My individual plan has a $5,500 calendar year deductible per person, 2 family maximum That is $11,000 if 2 people have a catastrophic illness in a calendar year in addition to $508 per month/ $6096 yr for the insurance premiums for my 3 member family. The plan pays for preventive care but does not pay for any other expenses until I am out of pocket for $5500 per person at which point it will cover 100% for the remainder of the year.

According to SHRM (Society for Human Resource Management):
"For 2013, average health plan premium costs per employee are projected to jump to $11,188, of which average employee contributions to the health plan premium would be $2,385. In addition, average employee out-of-pocket costs (co-pays, co-insurance and deductibles) would be $2,429.

Over the last five years, employees’ share of health care costs—including employee premium contributions and out-of-pocket costs—have increased more than 50 percent from $3,199 in 2008 to $4,814 in 2013, according to the analysis."

http://www.shrm.org/hrdisciplines/ben...

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15southsidedave(4780 comments)posted 12 months ago

no one knows anything except that health care costs continue spiral ever higher and the average person cannot afford to become ill...

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1676Ytown(1242 comments)posted 12 months ago

“But we have to pass the [health care] bill so that you can find out what’s in it....” Nancy Pelosi (3/9/10)

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17parlayhenry(219 comments)posted 12 months ago

Bernice!!! keep trying. Actually, if you look at the polls a little more closely instead of selectively picking this or that, you will find that the MAJORITY of the American people ARE for the ACA. The polls show that only 47% support the ACA as it is, but an additional 10% are against it because they feel it doesn't go far enough. So, Bernice, if you are able to add, that is 57%, which is a pretty good majority.
As far as the "race card", that is the excuse of the racist right to blow off the real reason they hate EVERYTHING Obama. The Tea Party is just a new, more subtle, manifestation of the KKK and the John Birchers. The ONLY reason for the hue and cry against the ACA is that a black man helped usher it through.

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18Benice(4 comments)posted 12 months ago

so sad

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19parlayhenry(219 comments)posted 12 months ago

Bernice!!! Then let me ask you a few questions:
1. How and WHY did all this "birther", "muslim", "socialist" nonsense begin about Obama of not to delegitimize him? I've never in my ifetime seen a President who is more pragmatic and more middle of the road. The far left is seething at Obama. So why all of this hate?
2. Why is the Tea Party, statistically speaking, all-white?
3. Why are the white folks in rural areas and in the South so vehemently opposed to anything "Obama"?
If it smells, tastes and looks like racism, it is racism. The extreme right was not ready for a black man to be President.
That, Bernice, is what's so sad.

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20parlayhenry(219 comments)posted 12 months ago

Ted Cruz is being very selective in wanting to defund "Obamacare" and not Medicare. Both are government sponsored health care programs. End them both if you think government spending is out of control. And for all those Tea Party blue-hairs who will scream, "I paid into Medicare", we'll give you ALL the money you put into the program, with interest. That will have the added benefit of balancing the budget. Then you Tea Party idiots can pay cash for your medical services. Rand Paul is all for getting government out of your lives, so here we go! A couple days in Intensive Care or an unexpected surgery will wipe you all out instantly, then what you gonna' do???? Funeral directors will be millionaires! LOL! You see, lunatics on the right, we have had socialized medicine for quite some time now and the biggest abusers, the welfare-queens, so to speak, are the senior citizens who fill the Tea Party ranks and cost the younger, working, people in this country quite a bit as they head out the door. So you hate the ACA, then hate Medicare as much.

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2176Ytown(1242 comments)posted 12 months ago

parlayhenry: What part of out of control health care costs do you not see? Having the government take over health care is going to reduce costs? Nothing in life is Free. Those in favor of ACA seem to think that it will be.

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22parlayhenry(219 comments)posted 12 months ago

76Ytown...Here is how the ACA will reduce costs: 1.by increasing the "pool" of the insured. 2. By increasing the numbers of the insured and keeping the "uninsured" out of the Emergency Rooms and returning them to the Clinics and Doctor offices.
Right now, the uninsured are using Emergency Rooms at unsustainable levels. The cost is astronomical compared to a visit to a Doctor. And who pays for this, Einstein??? As you so smugly say, "Nothing in life is free".
You have never more clearly demonstrated how uninformed you are in any of your previous 476 posts. The idiocy that's out there on the right has no cure.
Besides, Einstein, if you are against a "government" takeover of health care, get rid of Medicare. The ACA, unlike Medicare, is ALL PRIVATE INSURANCE.
You really should just stop posting. Just go shut the lights in your bedroom and pull the covers over that dim dome of yours.

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23parlayhenry(219 comments)posted 12 months ago

One last thing; Here is how the ACA became law. First it passed congress; second it passed the Supreme Court challenge; third, the electorate voted FOR the ACA when it re-elected Obama. But I'll tell you why none of these FACTS have stopped the lunacy and rage from the right: Obama is still half-black. That didn't change through any of this. Once Obama turns 100% white, the Republicans will acquiesce. Simple enough.

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24Benice(4 comments)posted 12 months ago

You cannot defeat racism with racism.

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2576Ytown(1242 comments)posted 12 months ago

Emergency rooms have been abused by patients for years. Insured folks go there after hours and weekends when they can't visit their doctor and the uninsured go there because they know they can't be turned away. Years ago, insurance plans implemented a higher co-pay to deter ER use.

The ACA will not eliminate the uninsured population since for example, Ohio has not elected the Medicaid expansion and the undocumented won't be covered by ACA either.

A common sense approach to lower hospital costs would be for more urgent care centers to open nights and weekends for non-emergency doctor visits. They have popped up in recent years as stand-alones and even in drug stores but again, they are not always open when you need them.

Have you noticed that there is a major paradigm shift going on? Companies are reducing hours to limit benefits to employees. Yes, that would mean that the "pool" is increasing but it also means that employees are getting less hours but will be forced to pay for coverage on their own.

Lower income earners and unemployed will resort to paying the $90 penalty instead of joining the pool.

What is unsustainable is the rising cost of health care for all services not just the ER.

Medicare is for over age 65 and is paid for by FICA payroll taxes by the employee 7.65% and the employer 7.65% = 15.3% of your paycheck An additional premium deduction is paid through your monthly Social Security check.

Medicaid is for the for people with low income of all ages and is funded by the federal government and state.

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26parlayhenry(219 comments)posted 12 months ago

76Ytown...that is nonsense. What you don't know could fit in the "old" Brown's Stadium. Once again, if you want to get rid of a "socialist" program, get rid of Medicare. In fact, if a Genie appeared with a magic lamp and give me 3 wishes, I'd waste one wish on you and folks like you by giving you all "double" your Medicare taxes back and let you screwballs pay cash for your health care. You'd be standing along side the road in no time with handmade cardboard signs saying, "Will work for health care."...the ACA will not be perfect but it is first shot fired in getting costs under control. It is difficult to judge a program when it is getting "swiftboated" from the racist, lunatic right-wing before it ever gets a chance. The things that you goofs fear is that the ACA WILL work. That is why the all out effort to sabotage it. If it is so bad, then leave it alone; but you know that people will LIKE it.

Bernice...I fail to see where anything that I have stated is "racist"? Bernice, did you see social media the night Obama as elected, the first time? It was the shot heard around the RepubliKKKan world and rallied the troops to form the Tea Party.

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2776Ytown(1242 comments)posted 12 months ago

parlayhenry...Take Mr. Sweetwood's advice (#13 above). In the meantime, go for a walk and cool off before you blow a fuse!

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28parlayhenry(219 comments)posted 12 months ago

76Ytown...this stuff doesn't elevate my pressure one bit...it is sad that there is such animus and stupidity, but it is also very funny...like the following which is how you guys operate:
PITTSBURGH—After noticing a newspaper article about the implementation of the upcoming Affordable Care Act, local father Andrew Panetta, 53, made an effort Monday to explain the intricacies of Obamacare to his son, sources confirmed. “It’s bulls--t,” Panetta reportedly said, clarifying how insurance companies will comply with federal law in order to properly set up state-sponsored health care exchanges. “All of it. Complete and total bulls--t.” Panetta went on to conclude his seven-second explanation of the expansive new health care law by saying, “I’m telling you, it’s bulls--t.”

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29parlayhenry(219 comments)posted 12 months ago

Just read this; it says it all

http://www.washingtonpost.com/opinion...

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3076Ytown(1242 comments)posted 12 months ago

parlayhenry:

Canadian healthcare = single payer system paid for by taxes and free at point of use.

Obamacare = requires every to buy insurance and if you don't you pay a penalty. Govt will subsidize your premiums based on income by putting you into the Medicaid expansion.

Insurance coverage purchased can be the bronze, silver or gold plans. They pay 70%, 80% or 90% after deductible.

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31parlayhenry(219 comments)posted 11 months, 3 weeks ago

Hey wingnuts...millions of people went online to sign up today...you nuts better get in line. The ACA is here to stay!!!!

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32parlayhenry(219 comments)posted 11 months, 2 weeks ago

Over the past few years, Republicans have terrified their most fervent followers about Obamacare in order to disguise the fact that they no longer knew what to say about their old bête noir, entitlements. Now they can’t turn the temperature down.
Not so very long ago, worrying about entitlements was central to Republican identity. Then, they began to notice that the folks at their rallies looked like the audience for “Matlock” reruns. The base was aging, and didn’t want to change Social Security or Medicare. The base didn’t even want to be reminded that Social Security and Medicare were federal programs.
All over the nation, Tea Party politicians have been telling their most fervid constituents that Obamacare will bring the federal government into the nation’s health system, thus wrecking the wonderful coverage they now enjoy with Medicare. Which comes into their homes through the chimney, where it is dropped by free-enterprise storks.

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33kk80586(227 comments)posted 11 months, 2 weeks ago

henry-you posted that plagiarized drivel on another board. Why don't you quit posting other peoples opinions and come up with one of your own? OH, that's right...you are a demoKKKrat (which means your opinion is what your master tells you it is). you are a good bot :)

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