Health Insurance in US

[Eric & Idalia 56]

How did she answer the question about having health insurance? I know for us we had to provide information about the coverage. It is 2.5% of your income or $695 whichever is less. This is for the 2016 filing year.

It is "You’ll pay whichever is higher." Not whichever is less.

Here the source: https://www.healthcare.gov/fees/fee-for-not-being-covered/

[yuna628 9,530]

ONE major illness and you could lose everything... I don't understand how anyone could live in the US without Health insurance.

Because they cannot afford it. It's not that they don't know that if they suffer one major illness and they could be flat out broke and lose everything... it's that they are nearly broke to begin with but still cannot afford health insurance. Ocare does not solve that problem, and the penalty is not high enough or enforceable enough to incentivize wealthier people to purchase coverage. The cost of this years penalty is for the majority of individuals struggling with their insurance payment the cost of one or two month premiums vs a one lump payment for an entire year. Quite a savings if you think about it, provided nothing bad happens to you.

[Ash.1101 1,755]

Because they cannot afford it. It's not that they don't know that if they suffer one major illness and they could be flat out broke and lose everything... it's that they are nearly broke to begin with but still cannot afford health insurance. Ocare does not solve that problem, and the penalty is not high enough or enforceable enough to incentivize wealthier people to purchase coverage. The cost of this years penalty is for the majority of individuals struggling with their insurance payment the cost of one or two month premiums vs a one lump payment for an entire year. Quite a savings if you think about it, provided nothing bad happens to you.

Agree'd. Had we purchased health insurance for what our income was two months ago, we would have basically been using anything we put in savings to pay for health insurance. After the last month our hours were cut down a bit, so we wouldn't be able to pay for insurance at all.

If you sit down and do the math for the health insurance, for a lot of people that DON'T qualify for medicaid in their state, they end up running into the negative.

When I was with my exhusband, we were family of three and applied for medicaid because we were afraid of the penalty, he made 22k a year and we made too much due to Texas not expanding medicaid.

Texas overall has a lower cost of living, I can't imagine what it looks like for folks in the north.

To put it in a perspective, when I went to look at costs (this was a couple of years ago) for us when we were denied, it would have been about 400$ for both of us a month, WITH a tax subsidy taking money off.

22000 is about 1833 a month.

1833

Rent - 829

Utilities - 50

car and renters insurance - 59

electric bill - 85 in the winter 135 in the summer (going with the higher number)

Cell phone - 124$ for two phones, no landline

Cable - 128 (increased to 162 but I'll use the lower number because that's what it was at the time)

---------------

508 left for the month

Insurance - 400

-------------

108 left for the MONTH (or 54$ a biweekly paycheck, 27$ a weekly paycheck) for things like food, clothing, gas, anything extra.

Some people simply either can't afford it, or would rather just have it taken out of the tax return. Again, in my current case, prior to our hours being cut, we would have afforded it by simply saving NO money. We would basically break even every month with ALL of our money we made being allocated somewhere. We were saving a little over 400$ a month, and insurance would have cost around there. We would have been insured, but would have had no savings for any emergency, like our old car breaking down, or even to put down for the deductible just to get care for that insurance we were paying for. In my prior situation attempting to buy health insurance, we would have ran into the negative every month just to eat and make sure we had gas in the car, but we made too much for medicaid.

There's a lot of confusion on the costs of insurance. I've seen people think that ALL jobs have to provide insurance, that tax subsidies make it affordable, and that if you can't afford it you can just get medicaid in your state, and none of these are true. These people are both out of the US and in the US. I've had friends tell other friends "well just get it, you don't make much, the subsidy will cover you!". Mind you, these friends I have saying this make 50k+ a year as a single person with work provided insurance, and they're saying it to a struggling family of 3 or 4.

The government totes the "WE'LL HELP YOU PAY!" or that they will make it affordable, but they don't know what affordable is when, say for USCIS, if someone makes enough to sponsor their husband with a family of 3, they actually can't afford insurance on that income if it's not provided by the job. 25200 is 2100 a month, after insurance the family would have 300$ for the entire month to make due. Again, no savings, no extra credit bills, no extra nothing, base line bills only. Some people are literally coming into the US, with the government going "you'll be fine" then the government going "WHY CAN'T YOU AFFORD INSURANCE?!". They would have to tack on another 6600 a year for a family of three to their 125% poverty limits to truly reflect what would be more affordable. (550$ insurance per month for a family of 3, times 12 months, 6600 a year)

My job, which is a very large money making company, only provides insurance to NON-Full time employees once you have worked 1500 hours in a 52 week period from start date to a year later, or October to October if you don't meet it in your first 52 weeks. Because of this, companies tend to hire more part time employees than full time, it's cheaper on them in more ways than one.

The tax subsidy for my current situation took off 97$. Which yeah, if we had to pay the extra 97$ we'd be going in the negative every month, but even with the subsidy, we had to wrestle with the idea of "Do we want to have money saved for emergencys" or "Do we want to have health insurance".

Medicaid in my state wasn't expanded, so a family of three in Texas would have to make the poverty line 20,000$ or less to qualify for it. They don't really care if you can't afford insurance if you make more than 20k a year for a family of three, but in our 22k a year situation and coming up negative every month, someone making 20,900$ a year is going to have a very bad time if they decide they want to pay for insurance.

Overall, people would rather risk the idea they'll get hit by a car and not be able to afford it, than not be able to eat or drive to work, or buy even used clothes when they're ripped. I personally get sick once a year, for the last four years. I go to urgent care, and pay 185$ for the appointment and a prescription. I have a friend whos husband needs back surgery, but insurance won't help until they pay 10k of the projected bill, the doctors think by the time they get that money in, he'll be in worse shape even with the surgery. Prior to insurance changes, their deductible was NOTHING like it is now. A lot of people can't even afford their deductibles for something big. Yeah, they can afford copay for a cold, but they can't afford what's needed for something major.

As for the OP.

The only things that exempt you are if you are exempt from filing for taxes if you're low income (less than 10,000 a year for a single filing, or 20,000 if filing jointly, or if you are unemployed for a long period of time. This year was the first year I had filed taxes in a while, due to no income. I only had insurance up until Feb 2015, so I was uninsured for most the year I wasn't fined because I only made 265$.

The fine comes out of the tax return, if you say already owe taxes, it'll just be tacked onto what is owed. If you're not getting any money back, you can make a payment plan to pay it back.

Edited December 14, 2016 by Ash.1101

[EM_Vandaveer 2,370]

Agree'd. Had we purchased health insurance for what our income was two months ago, we would have basically been using anything we put in savings to pay for health insurance. After the last month our hours were cut down a bit, so we wouldn't be able to pay for insurance at all.

If you sit down and do the math for the health insurance, for a lot of people that DON'T qualify for medicaid in their state, they end up running into the negative.

When I was with my exhusband, we were family of three and applied for medicaid because we were afraid of the penalty, he made 22k a year and we made too much due to Texas not expanding medicaid.

Texas overall has a lower cost of living, I can't imagine what it looks like for folks in the north.

To put it in a perspective, when I went to look at costs (this was a couple of years ago) for us when we were denied, it would have been about 400$ for both of us a month, WITH a tax subsidy taking money off.

22000 is about 1833 a month.

1833

Rent - 829

Utilities - 50

car and renters insurance - 59

electric bill - 85 in the winter 135 in the summer (going with the higher number)

Cell phone - 124$ for two phones, no landline

Cable - 128 (increased to 162 but I'll use the lower number because that's what it was at the time)

---------------

508 left for the month

Insurance - 400

-------------

108 left for the MONTH (or 54$ a biweekly paycheck, 27$ a weekly paycheck) for things like food, clothing, gas, anything extra.

Some people simply either can't afford it, or would rather just have it taken out of the tax return. Again, in my current case, prior to our hours being cut, we would have afforded it by simply saving NO money. We would basically break even every month with ALL of our money we made being allocated somewhere. We were saving a little over 400$ a month, and insurance would have cost around there. We would have been insured, but would have had no savings for any emergency, like our old car breaking down, or even to put down for the deductible just to get care for that insurance we were paying for. In my prior situation attempting to buy health insurance, we would have ran into the negative every month just to eat and make sure we had gas in the car, but we made too much for medicaid.

There's a lot of confusion on the costs of insurance. I've seen people think that ALL jobs have to provide insurance, that tax subsidies make it affordable, and that if you can't afford it you can just get medicaid in your state, and none of these are true. These people are both out of the US and in the US. I've had friends tell other friends "well just get it, you don't make much, the subsidy will cover you!". Mind you, these friends I have saying this make 50k+ a year as a single person with work provided insurance, and they're saying it to a struggling family of 3 or 4.

The government totes the "WE'LL HELP YOU PAY!" or that they will make it affordable, but they don't know what affordable is when, say for USCIS, if someone makes enough to sponsor their husband with a family of 3, they actually can't afford insurance on that income if it's not provided by the job. 25200 is 2100 a month, after insurance the family would have 300$ for the entire month to make due. Again, no savings, no extra credit bills, no extra nothing, base line bills only. Some people are literally coming into the US, with the government going "you'll be fine" then the government going "WHY CAN'T YOU AFFORD INSURANCE?!". They would have to tack on another 6600 a year for a family of three to their 125% poverty limits to truly reflect what would be more affordable. (550$ insurance per month for a family of 3, times 12 months, 6600 a year)

My job, which is a very large money making company, only provides insurance to NON-Full time employees once you have worked 1500 hours in a 52 week period from start date to a year later, or October to October if you don't meet it in your first 52 weeks. Because of this, companies tend to hire more part time employees than full time, it's cheaper on them in more ways than one.

The tax subsidy for my current situation took off 97$. Which yeah, if we had to pay the extra 97$ we'd be going in the negative every month, but even with the subsidy, we had to wrestle with the idea of "Do we want to have money saved for emergencys" or "Do we want to have health insurance".

Medicaid in my state wasn't expanded, so a family of three in Texas would have to make the poverty line 20,000$ or less to qualify for it. They don't really care if you can't afford insurance if you make more than 20k a year for a family of three, but in our 22k a year situation and coming up negative every month, someone making 20,900$ a year is going to have a very bad time if they decide they want to pay for insurance.

Overall, people would rather risk the idea they'll get hit by a car and not be able to afford it, than not be able to eat or drive to work, or buy even used clothes when they're ripped. I personally get sick once a year, for the last four years. I go to urgent care, and pay 185$ for the appointment and a prescription. I have a friend whos husband needs back surgery, but insurance won't help until they pay 10k of the projected bill, the doctors think by the time they get that money in, he'll be in worse shape even with the surgery. Prior to insurance changes, their deductible was NOTHING like it is now. A lot of people can't even afford their deductibles for something big. Yeah, they can afford copay for a cold, but they can't afford what's needed for something major.

As for the OP.

The only things that exempt you are if you are exempt from filing for taxes if you're low income (less than 10,000 a year for a single filing, or 20,000 if filing jointly, or if you are unemployed for a long period of time. This year was the first year I had filed taxes in a while, due to no income. I only had insurance up until Feb 2015, so I was uninsured for most the year I wasn't fined because I only made 265$.

The fine comes out of the tax return, if you say already owe taxes, it'll just be tacked onto what is owed. If you're not getting any money back, you can make a payment plan to pay it back.

I agree with so much. I also live in TX. Insurance for my husband and myself would cost $400-600/month (I believe our two kids would be included, too), but that's with like a $6-10k deductible, meaning that if anything major, requiring hospitalization were to occur, insurance would only start covering anything AFTER we paid $6-10k out of pocket.

For my previous pregnancies, our income was low enough that I could get stats coverage for prenatal care and Emergency Medicaid for labor & delivery.

I'm pregnant with our third and we are paying out of pocket this time. Prenatal care will be about $3.5k, delivery (assuming no major complications $4.5-5k if prepaid to the hospital). As you can see even if we had insurance, we wouldn't come out ahead because delivery wouldn't reach the deductible so we'd have to pay it out of pocket anyway.

Even if prenatal care was fully covered with no co-pays (unlikely), the monthly premiums we'd be paying for the insurance would be about the same as paying for prenatal care in cash.

Other than that, we are fairly young and healthy. We maybe spend $500-1000 on healthcare at most yearly (assuming I'm not pregnant that year LOL).

It makes no financial sense to get health insurance, it's anything BUT affordable.

Edited December 14, 2016 by EM_Vandaveer

[Cathi 5,610]

Because they cannot afford it. It's not that they don't know that if they suffer one major illness and they could be flat out broke and lose everything... it's that they are nearly broke to begin with but still cannot afford health insurance. Ocare does not solve that problem, and the penalty is not high enough or enforceable enough to incentivize wealthier people to purchase coverage. The cost of this years penalty is for the majority of individuals struggling with their insurance payment the cost of one or two month premiums vs a one lump payment for an entire year. Quite a savings if you think about it, provided nothing bad happens to you.

This! ^^^^

In response to David and Zoila:

After I divorced my first husband I was no longer eligible to be insured under him so for three years I went uninsured. I have two children and they were still insured but I was not able to afford insurance for myself. Being disabled(lupus and rheumatoid arthritis) it was a struggle(to say the least) to be not be insured- I did not have access to the medications I depended on to keep my diseases under control for those three years(biologics and chemotherapy-yes chemo is a treatment for autoimmune diseases), but I had two children to support on a very limited income and they came first. I had to put food on the table and a roof over their head and I simply could not afford insurance and did not qualify for Medicaid because my income(even as little as it was)was just slightly above the income level to get it. It was a miserable position to be in but my children and their needs were first and foremost. For three years my diseases spun out of control and progressed by leaps and bounds and by the time I was able to become insured again the damage was so bad that the medications that once kept them in check were no longer effective, my only option for the rest of my life is pain management and with all the government regulation of pain meds I have no access to anything that helps. (Tylenol or Motrin just doesn't cut it for the type of pain I suffer with day in and day out) My hands are so deformed I can no longer hold a pen to even print my name, let alone hold the instruments I needed to do my job(I was a dental hygienist for 20 years). My story is just like millions of others in this country, and trust me if I could have avoided all of this by having insurance, I would have. I needed emergency surgery 4 years ago, was hospitalized for 3 weeks and I did receive emergency Medicaid for the surgery and hospital stay but I feel guilty for even having to had needed it. Every uninsured person understands that a single medical emergency could bankrupt them, but insurance is not at the top of the list when you need to keep a roof over your head and take care of children. I don't know of a single person who would ever opt out of having insurance if they could afford it. Period.

Edited December 14, 2016 by mimolicious

[Ash.1101 1,755]

I agree with so much. I also live in TX. Insurance for my husband and myself would cost $400-600/month (I believe our two kids would be included, too), but that's with like a $6-10k deductible, meaning that if anything major, requiring hospitalization were to occur, insurance would only start covering anything AFTER we paid $6-10k out of pocket.

For my previous pregnancies, our income was low enough that I could get stats coverage for prenatal care and Emergency Medicaid for labor & delivery.

I'm pregnant with our third and we are paying out of pocket this time. Prenatal care will be about $3.5k, delivery (assuming no major complications $4.5-5k if prepaid to the hospital). As you can see even if we had insurance, we wouldn't come out ahead because delivery wouldn't reach the deductible so we'd have to pay it out of pocket anyway.

Even if prenatal care was fully covered with no co-pays (unlikely), the monthly premiums we'd be paying for the insurance would be about the same as paying for prenatal care in cash.

Other than that, we are fairly young and healthy. We maybe spend $500-1000 on healthcare at most yearly (assuming I'm not pregnant that year LOL).

It makes no financial sense to get health insurance, it's anything BUT affordable.

Yea ours WOULD have been like 505$ for myself and my husband, with a 97$ subsidy every month making it 408$ a month. This doesn't include my daughter, as she's disabled and has insurance through Texas. I'd imagine if she weren't and we had to pay for her insurance too, it'd be upwards to 600. And yeah our deductible for the bronze plan, cheapest per month, was 10k. I saw what they offered me, I said nope I'll eat the fee on my tax return, and I promptly closed out my application, deleted it, and haven't logged back on healthcare.gov since.

Yep! I get sick once every year between Dec and Feburary, usually Cedar Fever gone crazy. This last year was the worst with the allergies turning into a really bad sinus infection. I had to get a steroid shot and some antibiotics. Still, all under 200$ and done at an urgent care clinic.

Texas overall is getting worse when it comes to insurance. They just recently got rid of all forms of traditional Texas medicaid insurance used for children and adults with disabilities and put them in with the other Texas medicaid programs to save money. My daughter benefited GREATLY from being on the traditional medicaid plan, it allowed her to see what ever doctor she needed as long as there was a referral proving she needed it.

When she and MANY other kids at her therapy clinic were switched to regular plans, the regular plans basically made an announcement that they were cutting 30% reimbursement to all clinics in their network. It took a lot of parent letters and complaints, but we were able to keep her (and the other littles) at her speech and occupational therapy clinic and her insurance company is NOT going to cut costs for reimbursement. At least until April.

The kicker was that they said after they did this (the combining of traditional medicaid and medicaid plans), that they didn't realize the effects of what it would do to families with disabilities because they didn't do any studies or research about the effects prior to passing it. There was one boy in Houston who made the news about it. He saw 35 doctors as he has a plethora of things wrong with him, and only 19 of his doctors would take the new insurance he was forced into.

The 30% cut of reimbursements (from the combined health plans) to these places also came in response to Texas passing a 30% cut to ALL medicaid plans. Poor, disabled, doesn't matter. That was passed earlier this month and I think it goes into effect on the 15th. But any person with medicaid will suffer from it.

People are already looking into reversing these funding cuts, but it's said that it'll take 2 years before the funding would be back if they could get it back.

Either way, insurance in America is pretty awful. Some states are worse than others due to states having their own power to pick and choose what to do, if the federal government gives some states, like Texas, the option to skimp out, they usually will.

[David & Diana R 1,005]

I agree with so much. I also live in TX. Insurance for my husband and myself would cost #1: $400-600/month (I believe our two kids would be included, too), but that's with like a $6-10k deductible, meaning that if anything major, requiring hospitalization were to occur, insurance would only start covering anything AFTER we paid $6-10k out of pocket.

For my previous pregnancies, our income was low enough that I could get #2: stats coverage for prenatal care and Emergency Medicaid for labor & delivery.

#3. I'm pregnant with our third and we are paying out of pocket this time. Prenatal care will be about $3.5k, delivery (assuming no major complications $4.5-5k if prepaid to the hospital). As you can see even if we had insurance, we wouldn't come out ahead because delivery wouldn't reach the deductible so we'd have to pay it out of pocket anyway.

Even if prenatal care was fully covered with no co-pays (unlikely), the monthly premiums we'd be paying for the insurance would be about the same as paying for prenatal care in cash.

Other than that, we are fairly young and healthy. We maybe spend $500-1000 on healthcare at most yearly (assuming I'm not pregnant that year LOL).

#4: It makes no financial sense to get health insurance, it's anything BUT affordable.

With all due respect here are some comments. No judgement intended, just some thoughts.

#1: Wow, that's a bargain compared to Hawaii. My employer deducts 536.00 dollars per month from my salary and that's only 60% of the actual cost. The county pays the balance.

#2: So if I am hearing you correctly you are saying that the people (like myself) who are paying should help subsidize your cost through higher premiums and higher taxes?

#3: Family planning? (Just a thought). And again you are assuming that there will be no complications. If there is a complication taxpayers like myself will be subsidizing this birth. (Just a note: Congratulations on your pregnancy. I pray everything goes well. God Bless)

#4: I disagree, I think everyone should have insurance. The entire "Obama Care" program depends on EVERYONE having insurance. That is the main reason it is failing. Everyone does not have insurance so younger healthier people are getting off cheap by simply paying the "fine" (that Obama promised would never happen) and in the end the taxpayer ends up paying when a major illness or accident occurs. It's all about everyone participating. Without that the system will continue to fail.

And one other comment that is not based on your post: I work 40 hours per week at my "main" job. I also work 19 hours per week at my part time job. That's 59 hours per week, every week of the year. I'm 59...if I can do it these young people can do it. If they do it they can afford health insurance. P.S. My wife is pregnant and works full time while attending college to better her earnings. I have not really heard anyone mention the idea of getting a second job...??? And I don't want to hear, "Oh I can't find a job where I live" because that's baloney sausage. There are jobs all over this great country. McDonald's is always hiring.

God Bless you on your coming birth, David

Merry Christmas

[David & Diana R 1,005]

This! ^^^^

In response to David and Zoila:

After I divorced my first husband I was no longer eligible to be insured under him so for three years I went uninsured. I have two children and they were still insured but I was not able to afford insurance for myself. Being disabled(lupus and rheumatoid arthritis) it was a struggle(to say the least) to be not be insured- I did not have access to the medications I depended on to keep my diseases under control for those three years(biologics and chemotherapy-yes chemo is a treatment for autoimmune diseases), but I had two children to support on a very limited income and they came first. I had to put food on the table and a roof over their head and I simply could not afford insurance and did not qualify for Medicaid because my income(even as little as it was)was just slightly above the income level to get it. It was a miserable position to be in but my children and their needs were first and foremost. For three years my diseases spun out of control and progressed by leaps and bounds and by the time I was able to become insured again the damage was so bad that the medications that once kept them in check were no longer effective, my only option for the rest of my life is pain management and with all the government regulation of pain meds I have no access to anything that helps. (Tylenol or Motrin just doesn't cut it for the type of pain I suffer with day in and day out) My hands are so deformed I can no longer hold a pen to even print my name, let alone hold the instruments I needed to do my job(I was a dental hygienist for 20 years). My story is just like millions of others in this country, and trust me if I could have avoided all of this by having insurance, I would have. I needed emergency surgery 4 years ago, was hospitalized for 3 weeks and I did receive emergency Medicaid for the surgery and hospital stay but I feel guilty for even having to had needed it. Every uninsured person understands that a single medical emergency could bankrupt them, but insurance is not at the top of the list when you need to keep a roof over your head and take care of children. I don't know of a single person who would ever opt out of having insurance if they could afford it. Period.

And I applaud you. But your case is different. We as American's are supposed to take care of those that cannot take care of themselves. In your case you have debilitating conditions. You should be taken care of. But some of the money that would be spent taking care of you is instead being used to care for 20 year-olds because they don't have insurance. Good luck and God Bless you during this Christmas Season.

Mele kalikimaka, david

[EM_Vandaveer 2,370]

With all due respect here are some comments. No judgement intended, just some thoughts.

#1: Wow, that's a bargain compared to Hawaii. My employer deducts 536.00 dollars per month from my salary and that's only 60% of the actual cost. The county pays the balance.

#2: So if I am hearing you correctly you are saying that the people (like myself) who are paying should help subsidize your cost through higher premiums and higher taxes?

#3: Family planning? (Just a thought). And again you are assuming that there will be no complications. If there is a complication taxpayers like myself will be subsidizing this birth. (Just a note: Congratulations on your pregnancy. I pray everything goes well. God Bless)

#4: I disagree, I think everyone should have insurance. The entire "Obama Care" program depends on EVERYONE having insurance. That is the main reason it is failing. Everyone does not have insurance so younger healthier people are getting off cheap by simply paying the "fine" (that Obama promised would never happen) and in the end the taxpayer ends up paying when a major illness or accident occurs. It's all about everyone participating. Without that the system will continue to fail.

And one other comment that is not based on your post: I work 40 hours per week at my "main" job. I also work 19 hours per week at my part time job. That's 59 hours per week, every week of the year. I'm 59...if I can do it these young people can do it. If they do it they can afford health insurance. P.S. My wife is pregnant and works full time while attending college to better her earnings. I have not really heard anyone mention the idea of getting a second job...??? And I don't want to hear, "Oh I can't find a job where I live" because that's baloney sausage. There are jobs all over this great country. McDonald's is always hiring.

God Bless you on your coming birth, David

Merry Christmas

#1 I'm glad that's cheap to you. It's prohitively expensive to me.

#2 nope. Not anymore. If you actually read what I wrote, we are paying cash, out of pocket for this baby.

If you have a problem with providing Pregnancy Medicaid for low income families, write to your Congressman and tell them to scrap these programs.

#3 thank you very much for your suggestion. Never heard of that. What is family planning? (Yes, I am being sarcastic.) At least you didn't suggest abortion, that's something.

#4 We can agree to disagree, then. Health insurance is prohibitively expensive for many families. The whole healthcare system is messed up in the financial sense. I have ZERO problem paying out of pocket, if the prices are reasonable. For this reason I actually am considering having this baby in Hungary, as it's only $2.2k, even if I need a c-section.

Also you are wrong in saying that if there are complications (and I'm having the baby here in the US) you'll have to pick up the tab. You'd be wrong, as I don't qualify for Emergency Medicaid anymore (it has income requirements, naturally).

So nobody would pick up the tab, I'd either be in debt for a long time or go bankrupt.

Obviously, I'm not a fan of Obamacare. The only positives are:

cannot be denied insurance for pre existing conditions

And

originally, Obamacare was supposed to include the provision that if you had to pay the fine, you'd have received some kind of basic insurance in exchange. Now, THIS would have made too much sense, so that was scrapped before the bill was passed.

So Obamacare failing doesn't concern me. I hope it will be repealed and some other form of reform will happen.

I wouldn't mind universal healthcare. Being originally from Europe, we pay for our healthcare by paying our taxes...

Also, great suggestion on getting a job at McDonald's, that'd work out great for me as childcare for my two kids would cost more than what I'd earn and that's not taking gas, car insurance, car upkeep, etc. into account to get to and from work. Plus somebody else would raise my kids (both under-5 at the moment). Win-win all around.

Edited December 14, 2016 by EM_Vandaveer

[Ash.1101 1,755]

Some cases just aren't as easy as getting a second job, and while not all cases are the same or typical, people in the atypical situations get lumped in with those people who are seemingly "abusing" the system.

I work during the day, anywhere between 11am-7pm, my husband works 10pm-630am. We do this because my daughter has special needs and we can't afford a special needs baby sitter and any after school care has years long wait lists. We work as much as we can, while still always having one parent home with her when she's home because she can't just be with anyone.
We pay our taxes and we work in the hours we can a lot ourselves while taking care of a child that's been about 3 years old for the last 5 years (she's 8). We have no family near that can care for her, it's just us.

It's literally a case of, I come home from work, he goes to take a nap before work, he goes to work, I go to bed, I get up and take my daughter to school, he comes home from work and goes to sleep, I come home and pick up the house, I wake him up after only 4 hours of sleep to make sure he's up to pick up my daughter from school and take her to therapy while I'm at work, and then I go to work, and we repeat this process.

When we were quoted the 408$ a month, we were making 2200 a month normally. Which is fine, we were making above what USCIS likes for a family of 3. As I posted earlier, our normal outgoings WITHOUT including food, gas, anything emergency needs, is about 1359 a month. We were left with about 841$ a month, then if we took out the 400, we'd have about 400 for anything else a month, about 100$ per paycheck as we get paid weekly. That's okay, that's doable, we coulda figured it out.

I got this quote a week before our hours got cut. My husband went from 32-40 hours a week to 16-24 a week, and I still have about the same hours give or take about one 4 hour shift. His hours will be going back up soon hopefully, but not for another month or two before the extra person leaves. So now, we're making about 1800 a month. If I had accepted the insurance offer, we would have about 41$ a month to live off of. I would have ended up cancelling the insurance shortly after I received it.


As for us, I still don't think we'd qualify for emergency medicaid, as even with the current paycut, we don't qualify for regular medicaid.

Texas also has a lower cost of living, so insurance should be lower. The minimum wage here is 7.25, with no future prospects of raising it. The minimum wage in Hawaii is 8.50 and they're increasing it to 10.10 by 2018.

" As a result, Texas has the biggest coverage gap in the country, with 766,000 residents ineligible for Medicaid and also ineligible for premium subsidies to offset the cost of private coverage in the exchange.

Source: https://www.healthinsurance.org/texas-medicaid/
Follow us: @EyeOnInsurance on Twitter | healthinsurance.org on Facebook"



Remember, not all states in the US work the same. Some do things better than others because none of this is federally across the board. Each state can pick and choose what they like, when they like it. There are some states where it's beneficial to live over others, each almost has their own pros and cons.

The ones that have higher cost of living, typically have their residents making more money. Lower cost of living less money. Some have crazy child support laws (New Jersey) and some have strict divorce laws (South Carolina) and some straight up cut insurance costs by cutting 30% of funding to insurance companies (Texas). So while things may be going great for your pay, in your state, other states, may not be doing as well for the exact same topic.

Edited December 14, 2016 by Ash.1101

[EM_Vandaveer 2,370]

And I applaud you. But your case is different. We as American's are supposed to take care of those that cannot take care of themselves. In your case you have debilitating conditions. You should be taken care of. But some of the money that would be spent taking care of you is instead being used to care for 20 year-olds because they don't have insurance. Good luck and God Bless you during this Christmas Season.

Mele kalikimaka, david

If said 20-year-olds have a high enough income to actually have to pay the tax fine, nobody is subsidizing their healthcare. They don't qualify for Medicaid or Emergency Medicaid because their income is too high.

[Boiler 43,451]

What annoys me are the add ons to property tax for to pay for schools. Now that is something that could be Insured.

[Ash.1101 1,755]

What annoys me are the add ons to property tax for to pay for schools. Now that is something that could be Insured.

Lol, here in Texas... because Texas is great at this, they actually cut school funding by the state, and then raised property tax by 5% to go to the schools.

"Many lawmakers have wanted to change the “Robin Hood” plan since it was first created in the 1990s. Under the system, property-rich school districts give money to the state to help prop up poorer districts. But as each year goes by the state is relying more and more on property taxes to fund public schools.

Local property taxes used for public schools are now up 44 percent from 2008 to 2017. During that time, state funding has only increased seven percent."

- http://kxan.com/2016/08/30/texas-planning-on-5-increase-in-property-taxes-to-pay-for-schools/

[David & Diana R 1,005]

Lol, here in Texas... because Texas is great at this, they actually cut school funding by the state, and then raised property tax by 5% to go to the schools.

"Many lawmakers have wanted to change the “Robin Hood” plan since it was first created in the 1990s. Under the system, property-rich school districts give money to the state to help prop up poorer districts. But as each year goes by the state is relying more and more on property taxes to fund public schools.

Local property taxes used for public schools are now up 44 percent from 2008 to 2017. During that time, state funding has only increased seven percent."

- http://kxan.com/2016/08/30/texas-planning-on-5-increase-in-property-taxes-to-pay-for-schools/

Socialism at it's best! The Obama years...A legacy.

[yuna628 9,530]

At a younger age I gave up on many promising prospects I had future wise, and became a full time Mom... to my Mom. I was born rather late to the game you see, so that by the time I had grown up life and old age had taken it's grip on my mom's health. Dad worked full time even into his old age, and everyone else was off doing their own thing. Responsibility fell to me to care to be nurse, homemaker, and caretaker. So for a long time I didn't have insurance, and fell pretty sick myself. That was a big bill, but I paid it off slowly, through what pennies I managed to make in my spare time and savings I'd had from the past. I couldn't have afforded insurance in the past and I still really can't afford it now. Eventually I purchased it, though still not barely able to afford it. For about ten years or so, my Mom got even worse than she had ever had been before. There were a lot of fights in an attempt to kick her butt just to go seek out healthcare (afterall she did have decent insurance unlike the poor stuff I had). That's when we finally got the cancer diagnosis along with some other things. It was rough let me tell you, but after Ocare came around things didn't get any better for me insurance wise. Though 'grandfathered' the price kept going up and up and eventually BCBS did away with that coverage. For the most part it didn't matter, it's not like I could ever even afford to use the coverage offered anyway with the deductibles. The plan I had with my husband wasn't too great either. We can barely afford the premium, and once again the cost to use anything of it, makes going to see anyone pretty pointless. It's not like we don't have our own health issues either that we put off in order for other things. I say had because BCBS is pulling the plug on that coverage too and sticking us in the only other available plan. You know those gold ones that seem so sparkly and magical with what they offer, but with a premium that will make you faint. My husband will be getting a job with the state finally after being lead off in various directions for four months now. It's only conveniently part time of course, and hours that will have him working into the night. No benefits of course, but with decent pay maybe we can now afford to decide to have health insurance and eat, just slightly. Mom and Dad are on medicare+supplement now, and they can barely afford it. But it did step in to offer her great coverage for all of her cancer treatment, so that was nice.

My other sister just got her notice that the other major insurer in MD was giving her exactly one week to go find a new plan she had just signed up for. She's the sole breadwinner in her family. Working from 7-10 most days and also some weekends. Her premium was cheaper than mine, but I think the only option left for her now will be BCBS's magical gold plan of high expense now. Don't think McD's is an option for her either.