There seems to be some confusion over the new health exchanges set up under the federal Affordable Care Act.
The exchange is not for everyone.
In fact, even if you are uninsured, you do not have to go to the exchange to get coverage. You can go directly to an insurance company, but you might miss out on some benefits if you do.
Be careful not to get snookered. Beware of private companies not informing you of potential subsidies.
There is no harm in going to the exchange first.
To qualify for subsidies available under the law you must go to the exchange. Fill out the application at healthcare.gov. It will tell you whether you qualify. Hopefully the site’s problems will be worked out soon but there is a paper application process. And remember, before blaming the glitches on Obamacare, remember that Michigan could have set up its own exchange instead of relying on the federal government. States that set up their own exchanges are experiencing far fewer problems than states that failed to do so.
Also, to apply for Medicaid, go to the Michigan Department of Human Services website, not the health exchange, although the exchange will tell you if you qualify.
Medicare recipients do not need to go to the exchange. They can apply at Medicare.gov.
The exchange is mostly for the uninsured, but others may benefit as well, according to information provided by Kaiser Health News and Cosmopolitan. If you have employer-based coverage, you may have no need to go on the exchange. But if your share of the premium costs more than 9.5 percent of your annual gross income, you may qualify for a subsidy. If you currently have an individual policy that you bought for yourself, you may find a better deal on the exchange because it offers subsidies that could lower your costs.
Roughly 80 percent of people who buy exchange plans will qualify for premium tax credits, according to Avalere Health. The credits, available to people with incomes up to 400 percent of the federal poverty level ($45,960 for an individual or $94,200 for a family of four in 2013) will be based on your projected income for next year.
Altruis Benefit Counseling supplied the following figures:
•Single Person - $45,960 per year
•Couple - $62,040 per year
•Family - $94,200 per year
Subsidies can be sent directly to the insurer, reducing your monthly premium. If your income estimate is too low, however, you could have to repay at tax time any excess amounts you received.
Families USA crunched the numbers for a few different scenarios. By its estimates, a family of four earning $94,200 and purchasing a silver-level plan carrying a $12,500 annual premium will get a subsidy worth $3,550, which limits the cost of the premium to 9.5% of the family's income.
The government hasn't yet released its own estimates on how many Americans will be eligible for the subsidies, but Families USA believes that up to 26 million citizens will meet the criteria.
Not everyone eligible for those subsidies will actually sign up, though. The Congressional Budget Office is forecasting that only 6 million people will receive subsidized coverage through an exchange next year. It expects that number to grow to 22 million by 2017.
There are really just two important dates to keep in mind, according to a National Public Radio report. The first is Dec. 15. That's the date by which you need to be signed up if you want your coverage to begin Jan. 1, 2014 — the earliest any of these plans will take effect. The other date is Feb. 15, 2014. That's the last day you can get coverage and avoid being liable for a penalty for not having insurance. The maximum penalty if you don't have coverage for the entire year is $95 or one percent of your taxable income, whichever is bigger. It will go up in future years.
One thing is certain: There is no need to make the process more complicated than it needs to be. The resources for understanding the program are virtually endless.
Monday, October 14, 2013
Thursday, October 10, 2013
What do “shutdown” and “default” really mean?
There would be one reason to prolong the government shutdown and fail to raise the debt ceiling.
Perhaps Americans could learn more about what “shutdown” and “default” really mean.
Obviously “shutdown” does not mean the government isn’t functioning. Let a country attack us and see how quickly we will respond. Plus, it seems the only programs affected are survivor benefits for widows of veterans and food programs for poor children.
Also, failure to raise the debt ceiling by Oct. 17 is not synonymous with “default.”
“Default” would mean the country failed to paying its creditors on time. But how can that happen if daily the government receives 70 percent of the revenue it needs to function from tax revenue pouring into the Treasury?
Wall Street may caution us about turmoil in the markets, but we know that if stocks go down, they will also come back.
“The federal government keeps stumbling from one budget crisis to another, but the damage never sticks,” Bernard Condon wrote for the Associated Press.
“Global investors still see it as the world's best place to park their money. Even the threat of an unprecedented government default doesn't seem to have dulled the allure of Teflon America,” Condon wrote.
Maybe we should test this out so we can all learn about real consequences.
If the Republicans are right about anything — and they are — it is that Congress and President Obama have not seriously addressed the issue of the national debt. Maybe we should see if we can make do with just 70 percent of the revenue we have been spending. Then start setting priorities as we restore the funding.
This is what our government should be doing — scrutinizing and debating all expenses. And yes, if we like the programs, raise taxes to pay for them.
Social Security is the best example. While solid now, long-term adjustments need to be made to maintain the integrity of its trust fund. One thing our leaders could do is stop raiding the trust fund to pay for other parts of the government. But other, common-sense suggestions were made by the National Commission on Fiscal Responsibility and Reform. Use of the so-called “chained” Consumer Price Index to figure increases in Social Security benefits would relatively slightly slow the outflow from the trust fund. Raising payroll taxes on wealthier individuals or reducing benefits of rich retirees also could lead to significant savings.
These are things responsible lawmakers should insist upon if they are to raise the debt ceiling.
Perhaps Americans could learn more about what “shutdown” and “default” really mean.
Obviously “shutdown” does not mean the government isn’t functioning. Let a country attack us and see how quickly we will respond. Plus, it seems the only programs affected are survivor benefits for widows of veterans and food programs for poor children.
Also, failure to raise the debt ceiling by Oct. 17 is not synonymous with “default.”
“Default” would mean the country failed to paying its creditors on time. But how can that happen if daily the government receives 70 percent of the revenue it needs to function from tax revenue pouring into the Treasury?
Wall Street may caution us about turmoil in the markets, but we know that if stocks go down, they will also come back.
“The federal government keeps stumbling from one budget crisis to another, but the damage never sticks,” Bernard Condon wrote for the Associated Press.
“Global investors still see it as the world's best place to park their money. Even the threat of an unprecedented government default doesn't seem to have dulled the allure of Teflon America,” Condon wrote.
Maybe we should test this out so we can all learn about real consequences.
If the Republicans are right about anything — and they are — it is that Congress and President Obama have not seriously addressed the issue of the national debt. Maybe we should see if we can make do with just 70 percent of the revenue we have been spending. Then start setting priorities as we restore the funding.
This is what our government should be doing — scrutinizing and debating all expenses. And yes, if we like the programs, raise taxes to pay for them.
Social Security is the best example. While solid now, long-term adjustments need to be made to maintain the integrity of its trust fund. One thing our leaders could do is stop raiding the trust fund to pay for other parts of the government. But other, common-sense suggestions were made by the National Commission on Fiscal Responsibility and Reform. Use of the so-called “chained” Consumer Price Index to figure increases in Social Security benefits would relatively slightly slow the outflow from the trust fund. Raising payroll taxes on wealthier individuals or reducing benefits of rich retirees also could lead to significant savings.
These are things responsible lawmakers should insist upon if they are to raise the debt ceiling.
Wednesday, October 9, 2013
Four branches of government?
Rep. Markwayne Mullin of Oklahoma is being ridiculed because he said there are four branches of government. Well, he is probably right, but not for the reasons he attempted to enunciate.
We were taught in civics that there are three branches: executive, judicial and legislative. But a fourth — and one that the public connects with — could be the administrative or bureaucratic portion.
It is true that it is an arm of the executive branch but it has a life all of its own.
The public most commonly deals with the bureaucracy — at least on the federal level — on matters of Social Security and taxation. The fact is, the bureaucracy — and that word is not used in a derogatory fashion — is critical. For instance, a new report details its incompetence in the area of Social Security disability.
You can see some of this in action. The Obama Administration, in unilaterally postponing the employer mandate portion of the Affordable Care Act, without congressional approval, successfully ordered the bureaucracy do something it was not authorized to do by Congress — which it did, by the way.
Think of this too. The Congress can propose all the laws it wants to, say, in the environmental realm. But if it does not give the federal Environmental Protection Agency sufficient staffing to enforce the law, what good is the law?
Similarly, the executive branch can direct agencies to enforce or not enforce certain laws. For instance, the federal ban on mere possession of marijuana is generally not enforced.
If you understand the functioning of the bureaucracy (James Q. Wilson wrote a brilliant book on it) you could take some of these sequences to frightening, albeit logical, lengths. For instance, if the Congress fails to raise the debt ceiling could the president order the Federal Reserve to issue and sell bonds to finance the government? Ah, you say: this is illegal. And there is one of the other branches of government would come into play — the judiciary.
Some legal scholars have argued, however, that in this instance the courts could rule that the Congress was legally bound to fund the programs it created. Is that outrageous?
If it happened, one of our federal branches, the Congress, would suddenly seem irrelevant. Would the public care?
That would make the bureaucracy much more relevant. And it would initiate something that down through the ages has come to have an ignominious reputation — a dictatorship.
Scoff if you will, but a country that no longer cares about genocide in Syria (and elsewhere) may someday become callous toward democracy itself — especially when it conducts itself in the sordid way we are witnessing.
We were taught in civics that there are three branches: executive, judicial and legislative. But a fourth — and one that the public connects with — could be the administrative or bureaucratic portion.
It is true that it is an arm of the executive branch but it has a life all of its own.
The public most commonly deals with the bureaucracy — at least on the federal level — on matters of Social Security and taxation. The fact is, the bureaucracy — and that word is not used in a derogatory fashion — is critical. For instance, a new report details its incompetence in the area of Social Security disability.
You can see some of this in action. The Obama Administration, in unilaterally postponing the employer mandate portion of the Affordable Care Act, without congressional approval, successfully ordered the bureaucracy do something it was not authorized to do by Congress — which it did, by the way.
Think of this too. The Congress can propose all the laws it wants to, say, in the environmental realm. But if it does not give the federal Environmental Protection Agency sufficient staffing to enforce the law, what good is the law?
Similarly, the executive branch can direct agencies to enforce or not enforce certain laws. For instance, the federal ban on mere possession of marijuana is generally not enforced.
If you understand the functioning of the bureaucracy (James Q. Wilson wrote a brilliant book on it) you could take some of these sequences to frightening, albeit logical, lengths. For instance, if the Congress fails to raise the debt ceiling could the president order the Federal Reserve to issue and sell bonds to finance the government? Ah, you say: this is illegal. And there is one of the other branches of government would come into play — the judiciary.
Some legal scholars have argued, however, that in this instance the courts could rule that the Congress was legally bound to fund the programs it created. Is that outrageous?
If it happened, one of our federal branches, the Congress, would suddenly seem irrelevant. Would the public care?
That would make the bureaucracy much more relevant. And it would initiate something that down through the ages has come to have an ignominious reputation — a dictatorship.
Scoff if you will, but a country that no longer cares about genocide in Syria (and elsewhere) may someday become callous toward democracy itself — especially when it conducts itself in the sordid way we are witnessing.
Tuesday, October 8, 2013
The tea party and fiscal responsibility
Rep. Lloyd Doggett of Texas had the observation of the month, if not the year.
“Of all the bizarre moments,” he said, “this may be the most bizarre — that we will pay people not to work.”
Doggett, a Democrat, called it “the new tea party sense of fiscal responsibility.”
Have we lost sight of some of the real issues here — the main one being that Congress spends too much money?
When the automakers furlough workers they force workers to use their vacation time.
Republicans used to say there was no such thing as a free lunch. Now they look less intelligent with each passing day of the government shutdown. There is an array of government economies they could be suggesting. Instead, they are endangering the sequester they forced Democrats to agree to earlier in the year.
The sequester imposed up to 10 percent reductions in government spending, the only economies the Congress has agreed to in recent memory. It is set to save the country billions of dollars in the coming years.
Now that was a real achievement.
Why can’t we just agree to fund government at the level called for by the sequester?
Remember, we do have a national debt totaling over $16.7 trillion.
“Of all the bizarre moments,” he said, “this may be the most bizarre — that we will pay people not to work.”
Doggett, a Democrat, called it “the new tea party sense of fiscal responsibility.”
Have we lost sight of some of the real issues here — the main one being that Congress spends too much money?
When the automakers furlough workers they force workers to use their vacation time.
Republicans used to say there was no such thing as a free lunch. Now they look less intelligent with each passing day of the government shutdown. There is an array of government economies they could be suggesting. Instead, they are endangering the sequester they forced Democrats to agree to earlier in the year.
The sequester imposed up to 10 percent reductions in government spending, the only economies the Congress has agreed to in recent memory. It is set to save the country billions of dollars in the coming years.
Now that was a real achievement.
Why can’t we just agree to fund government at the level called for by the sequester?
Remember, we do have a national debt totaling over $16.7 trillion.
Friday, October 4, 2013
Medical devices and the deficit
You’re hearing a lot of talk from Republicans about repealing the medical device tax that is helping fund Obamacare. But repealing the tax without repealing the Affordable Care Act would increase the federal budget deficit and the national debt.
Why can’t we all at least agree that we need to pay for the programs Congress enacts? Very simply, why shouldn’t taxpayers foot the bill for these programs?
If they don’t want the taxes, do away with the programs. Enacting programs without paying for them adds to the national debt.
And the Grand Canyon is deep. Isn't it obvious?
The medical device tax would raise $30 billion over 10 years to pay for the subsidies and free care guaranteed by ACA to pay for health insurance for lower income people. How would we replace the $30 billion?
Meanwhile, delaying the ACA’s individual mandate would reduce federal spending because fewer people would purchase insurance. Thus fewer would receive free care — i.e., Medicaid — or insurance subsidies from the government.
However, insurance premiums would rise for everyone else because healthier people would not be purchasing insurance, thereby leaving only a less healthy crowd for insurers to cover.
Is there somehow a difference between the dollars we spend on health insurance premiums and the dollars we spend on taxes?
These are not complex questions. Our lawmakers are taking simple issues and making them difficult through distortion.
Why can’t we all at least agree that we need to pay for the programs Congress enacts? Very simply, why shouldn’t taxpayers foot the bill for these programs?
If they don’t want the taxes, do away with the programs. Enacting programs without paying for them adds to the national debt.
And the Grand Canyon is deep. Isn't it obvious?
The medical device tax would raise $30 billion over 10 years to pay for the subsidies and free care guaranteed by ACA to pay for health insurance for lower income people. How would we replace the $30 billion?
Meanwhile, delaying the ACA’s individual mandate would reduce federal spending because fewer people would purchase insurance. Thus fewer would receive free care — i.e., Medicaid — or insurance subsidies from the government.
However, insurance premiums would rise for everyone else because healthier people would not be purchasing insurance, thereby leaving only a less healthy crowd for insurers to cover.
Is there somehow a difference between the dollars we spend on health insurance premiums and the dollars we spend on taxes?
These are not complex questions. Our lawmakers are taking simple issues and making them difficult through distortion.
Thursday, October 3, 2013
What if Obamacare Works?
If you read nothing else, take a look at Wall Street Journalist columnist’s David Wessel’s piece entitled “What If Obamacare Works?”
It reports what free enterprise advocates ought to know: competition drives down prices.
If the Affordable Care Act is so bad, why do insurance companies want to compete in the markets it has created?
For the first time in recent memory, Blue Cross Blue Shield of Michigan seems to be running scared. Thirteen companies are competing against it in Michigan’s health exchange. Have you noticed BCBSM’s ads?
And in spite of what the president promised — you can keep your health insurance if you want it — employers will have a big voice in that, as Wessel points out.
Think of this: Why should employers have all the health insurance burden placed on them? It’s time for individuals to learn how much it costs businesses, and why they need to share the burden.
This will potentially revolutionize our health-care system. How can it possibly get worse? What it needs — and what Obamacare provides, in spite of what Republicans are saying — is a strong dose of competition.
It reports what free enterprise advocates ought to know: competition drives down prices.
If the Affordable Care Act is so bad, why do insurance companies want to compete in the markets it has created?
For the first time in recent memory, Blue Cross Blue Shield of Michigan seems to be running scared. Thirteen companies are competing against it in Michigan’s health exchange. Have you noticed BCBSM’s ads?
And in spite of what the president promised — you can keep your health insurance if you want it — employers will have a big voice in that, as Wessel points out.
Think of this: Why should employers have all the health insurance burden placed on them? It’s time for individuals to learn how much it costs businesses, and why they need to share the burden.
This will potentially revolutionize our health-care system. How can it possibly get worse? What it needs — and what Obamacare provides, in spite of what Republicans are saying — is a strong dose of competition.
Tuesday, October 1, 2013
Obamacare unaffected by shutdown
Republicans in Congress miscalculated on their way to acquiescing in a federal government shutdown.
Failure to reach a budget has indeed halted non-essential government functions. But the object of the GOP’s scorn, the Affordable Care Act — Obamacare — is exempt from the shutdown.
Surely they knew better, but why not mislead the public if you can get away with it?
It is a little-reported fact that “a shutdown per se doesn’t stop the Affordable Care Act,” said Doug Holtz-Eakin, a former director of the Congressional Budget Office who now leads the American Action Forum, a Washington advocacy group opposed to the health law.
Bloomberg pointed out that the 2010 law relies primarily on mandatory spending, which congressional inaction can’t stop. It’s the same budget category used for benefits such as Medicare and Social Security.
Turns out the Democrats who passed the law had their thinking caps on by ensuring the funding.
Clearly, the Republicans knew the significance of the Oct. 1 effective date for the opening of Obamacare health exchanges throughout the country. They must be afraid that as the uninsured sign up for health insurance and see the price breaks they are getting, the law may suddenly gain in popularity.
Merits of the law aside, if they wanted so desperately to rescind it, they should have elected a Republican president and Congress last year. That’s the way we should be settling political disputes in this country — at the ballot box, not by the Congress reneging on its constitutional duties.
Perhaps lawmakers should be jailed for violating their oaths of office.
Failure to reach a budget has indeed halted non-essential government functions. But the object of the GOP’s scorn, the Affordable Care Act — Obamacare — is exempt from the shutdown.
Surely they knew better, but why not mislead the public if you can get away with it?
It is a little-reported fact that “a shutdown per se doesn’t stop the Affordable Care Act,” said Doug Holtz-Eakin, a former director of the Congressional Budget Office who now leads the American Action Forum, a Washington advocacy group opposed to the health law.
Bloomberg pointed out that the 2010 law relies primarily on mandatory spending, which congressional inaction can’t stop. It’s the same budget category used for benefits such as Medicare and Social Security.
Turns out the Democrats who passed the law had their thinking caps on by ensuring the funding.
Clearly, the Republicans knew the significance of the Oct. 1 effective date for the opening of Obamacare health exchanges throughout the country. They must be afraid that as the uninsured sign up for health insurance and see the price breaks they are getting, the law may suddenly gain in popularity.
Merits of the law aside, if they wanted so desperately to rescind it, they should have elected a Republican president and Congress last year. That’s the way we should be settling political disputes in this country — at the ballot box, not by the Congress reneging on its constitutional duties.
Perhaps lawmakers should be jailed for violating their oaths of office.
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