Self-Employed Who Are Ineligible for ACA Subsidies Worry About Costs

By Steve Twedt, Pittsburgh Post-Gazette | February 12, 2016

  • February 12, 2016 at 2:14 pm
    Agent says:
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    If you like your plan, you can keep it. If you like your doctor, you can keep him. The average family of four will save $2,500 per year. BHO

    • February 12, 2016 at 6:03 pm
      County Line says:
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      As always, The Left lied and enough people believed them. Without a single conservative legislative vote, the Progressives threw under the bus the 90% of us who had coverage we liked and could afford. And all to benefit the 10% who didn’t have insurance.

      Never mind that the officially uninsured 10% had access to a great deal of healthcare at our expense anyway. They might not have had all the “whistles and bells” we have come to expect from top-grade health insurance plans, but the 10% were not completely denied care when they sought it.

      Pre-ACA, medical providers passed the cost of treating uninsured patients to carriers of those patients with health coverage. Of course that cost was factored into the insurance premiums we paid. This adequately funded the medical facility for all comers, insured or not.

      Whatever balance that existed then may not have been perfect, but it was a natural free-market equilibrium that worked more effectively, and at less cost to all. The (un)Affordable Care Act trashed that quite well balanced system, and left us with a distorted mess, all so The Left could gain the adoration (and voter block) of the 10% benefitting from the uACA.

      The media conveniently fails to report that most of the newly-covered 10% pay little or no cost for their insurance and care, and have better benefits than the 90% of us forced to fund their subsidies. Let’s face it–when you can get a Platinum or Gold benefit at zero cost, why would you sign up for Silver or Bronze plan for zero cost?

      As the feature story demonstrates, those of us in the middle class who do not qualify for a meaningful subsidy amount must buy Silver or Bronze plans because that’s all we can afford.

      Unbelievable, unaffordable and unsustainable.

    • February 20, 2016 at 3:34 pm
      UW says:
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      Nothing in the law has made people lose coverage other than outlawing some things which meant they had garbage coverage. Most of the people who lost their plans had plans that covered almost nothing, but were too uneducated on the topic to know they were getting fleeced. I have to assume the same thing happens to a lot of Agent’s clients since he borders on being literally criminally un-knowledgeable about insurance and reality.

      Their prices would have increased anyways. Undeniably insurance premiums have increased by more than they were projected to rise without Obamacare, an in fact a little less than projected even under Obamacare, and that is without the idiots in the red south expanding programs to help their people because they thought it would harm Obama.

  • February 12, 2016 at 2:22 pm
    dabear666 says:
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    The bottom line for this small, self-employed businessman is with the ACA his worst case scenario (pre-ACA) was $12,000 out of pocket annually (assuming he had $7,000 in claims) to a present case where his absolute best scenario is $13,200 out of pocket for premiums even if there are no claims.

    The comment from the representative of Arthur J. Gallagher Co. is gratuitous since most of the self-employed who earned enough to be excluded from subsidies would likely have already had A&H coverage, so being able to get it with “instant access” is a throw away line–they didn’t need instant access–they already had coverage.

    • February 12, 2016 at 4:06 pm
      Agent says:
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      Do you reckon this guy was one of the 6 million that got the plan they liked cancelled and had to go into O’Care?

  • February 12, 2016 at 3:33 pm
    Doubtful Thomas says:
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    dabear- You are so correct. The Gallagher comment was a scripted one from someone that is making a living off the confusion of O’care. If he stopped and looked at the optometrist’s situation, it is obvious that he will lose more $ with the wonderful O’care.

    • February 12, 2016 at 4:45 pm
      Agent says:
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      Hot off the press fellows. In today’s edition of Townhall.com, the story titled – Thanks Obama: North Carolina’s Largest Health Insurance Provider could leave the ACA Market.

      Blue Cross is the states largest writer and they are losing their shirt. Unbelievable what this trash law has created in this country.

  • February 13, 2016 at 10:45 am
    Yogi Polar Berra says:
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    If you like your Socialist politicians, you can keep your Socialist politicians.

    Aetna, Anthem, and UnitedHealth are all considering flying the coop. Unfortunately for US citizens, ill-constructed COOPs could not fly.

  • February 15, 2016 at 10:15 am
    Ron says:
    Hot debate. What do you think?
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    Another dilemma that Universal Health Care would solve.

  • February 17, 2016 at 11:50 am
    FFA says:
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    Everyone can take care of this problem in November. Vote to be done with it.

  • February 17, 2016 at 1:47 pm
    michael arnett says:
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    One wat to solve the problem is make a law that Legislative, Executive and Judicial employees have to accept ACA as their health insurance option. Then we will see how long it takes for them to revise the plan.

    • February 17, 2016 at 2:19 pm
      blondie2 says:
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      I wish I could “Like” your comment 1000 times!

    • February 17, 2016 at 2:56 pm
      Ron says:
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      • February 17, 2016 at 3:02 pm
        FFA says:
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        They should be required to go through the market place. They took away our options, but they still have the congressional plan. Would help lighten the load as far as the Country’s Budget.

        • February 17, 2016 at 3:22 pm
          Ron says:
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          • February 17, 2016 at 4:26 pm
            FFA says:
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            I believe in freedom of choice. If I want a $500 ded with a real stop loss, it should be available. But its not. This law pushed my med expense up to almost $40,000 including premiums.
            In the past, I knew my worst case scenario. Now, with the never ending Co Pay and the constantly changing Networks, its just a craps shoot.

            No matter who is on the rep ticket, they have my vote as I dont think its a lie when they say it will be gone. Had another Health Head Ach blow up in my agency this week. Her X Hubby cancelled his group in Oct and didnt bother to inform the mom her son was no longer covered. Open Enrollment has come and gone and there is no Special Enrollment to fall back on.

            What now? Does she let the kid go uninsured for the year and hope for the best?

            Tell a young mom she cant get health insurance on her son. another Dem just turned to the rep side.

          • February 18, 2016 at 7:31 am
            Ron says:
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          • February 18, 2016 at 10:44 am
            FFA says:
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            Well Ron, Under the old system, they would not be in this situation. They are both young and healthy, no health issues. I could have issued a BCBS Childrens Major Med on the kid. Broad Network so the son would not have victimized by obamas lie and be forced to change docs. As it shakes out, coverage ends on 2/29 so I can actually add him to moms policy.
            I am dead set against the Govt running the health care system especially after I watched the news last night, the way they take of the vets. they were reporting only 75% got the treatment they need. Not odds I am willing to take with my health. The govt has no business sticking their nose in private industry. Look what all them trade agreements have done to our jobs. Currier (HVAC Manufacturer Indiana) really took the tax payor for a ride.

            I do know they can not do away with it on their first day, but they can start working on it.

            BTW, Trump is the only one talking about bringing our jobs back. Imagine not having skilled manufacturing folks not having to flip burgers to support their family like it used to be. Teenagers would be able to get jobs and not have to work as soldiers in the gangs. The social implications of these trade agreements has been tragic. (See Chicago Violence rates).

          • February 18, 2016 at 11:26 am
            Ron says:
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          • February 18, 2016 at 12:22 pm
            FFA says:
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            Ron, last year enrollment, the Govt was not getting premium money to the carriers even though clients were paying them. People would go to doc / pharmacies and have to pay cash, then pay the same premium directly to the carrier before claims would get processed. It wasn’t till second quarter before this issue got resolved. People cant afford one months premiums not to mention paying two time because the govt cant handle premium money.

            Another reason the govt has no business sticking their nose into private business.

          • February 18, 2016 at 1:41 pm
            Ron says:
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          • February 18, 2016 at 1:54 pm
            FFA says:
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            Ron, Since day one. Its on the web site. It promts you to make the premium payment. You do and they dont send the money along. The carrier dont acknowledge payments made there until they have them.

            It is part of the system.

            Since that “flaw” came to my attention, I tell people to never send Healthcare.gov a penny. Wait for the initial billing from the carrier because their payment system has never failed. I also tell people to call their payments in and get a confirmation number because the PPACA has screwed up the health care system beyond belief. It is amazing that Obama himself cant see this.

          • February 18, 2016 at 2:31 pm
            Ron says:
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          • February 18, 2016 at 2:33 pm
            Ron says:
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          • February 19, 2016 at 11:53 am
            FFA says:
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            Ron, After I saw a piece on the news this week – ABC7 Chicago-was a report about the poor care our vets are getting from the VA. Only 75% are getting treatment they need.
            Thats what your advocating. Only 75% of people get the proper treatment. Thats your Govt at work for our Wounded Warriors. What do you think they would do for you Joe Tax Payer?
            Even if some form of Universal Health Care comes to be, I will opt for private care. Improves my odds above 75%.
            If them odds are good for you, good luck.

          • February 19, 2016 at 1:16 pm
            Ron says:
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            FFA,

            No it’s not. What I AM advocating for is allowing the Vets to go to whatever hospital they wish. If the employees at the VA want to keep their jobs, they will need to improve the care they provide our Vets. If that is not a free-market approach to improve care for our Vets, I do not know what is.

            What is your solution to providing better care for our Veterans?

            How often do seniors complain about Medicare? That is much closer to what I am advocating.

          • February 19, 2016 at 1:56 pm
            FFA says:
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            If all heath care is placed in the Govts hands, thats where it will end up at.
            They cant keep their house in order, they need to stay out of ours.

          • February 19, 2016 at 2:03 pm
            FFA says:
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            My solution to the VA is to privatize it. Take all the foreign aide being sent over seas and upgrade the entire system to private industry.
            The move to privatizing Medicare is happening already (Medicare Advantage Plans). Its like they have admitted failure with out admitting it.

          • February 19, 2016 at 2:07 pm
            FFA says:
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            Ron says”If the private insurance companies came up with their own solution, the government would not get involved. However, they were not willing to sacrifice profits for their customers.”

            Prior to the PPACA, there were no payment problems. Payment problems didn’t happen until the govt got involved. Healthcare.gov even changed my payment method – ACH – to a paper bill with no request coming from me.

          • February 19, 2016 at 2:07 pm
            Ron says:
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            FFA,

            Please clarify what you mean by “privatize”? Do you mean it should be run like a private hospital, with private sectors employees, and paid for by the government?

            That sounds awfully familiar to what I am advocating for.

          • February 19, 2016 at 2:30 pm
            Ron says:
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            FFA,

            There may not have been payment problems, but there were tens of millions of people who did not have coverage, had inadequate coverage, were going bankrupt, and/or a other problems. I will take payment problems over a lack of care any day.

          • February 19, 2016 at 3:11 pm
            FFA says:
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            Ron, Why do you keep forgetting that the Pre X Demographic had access to coverage – good quality coverage and not the crap Obama thinks is good – prior to him sticking his nose where it done belong. In Il it was called I Chip. Wi had Badger Care. Indiana had (I think) it was called Hoosier Care.

            Your in the biz, you should already know that.

            By privatize driven by profit, not budget concerns. Profit motive brings out the best.

          • February 19, 2016 at 3:26 pm
            Ron says:
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            FFA,

            The problem with a lot of the pre-x pools is the cost was prohibitive. It is pure adverse selection. No one should have to choose between care and food/rent. That is why health care costs is the #1 reason for bankruptcies. How is that good for the economy?

            Profit also breeds greed. That is why there are so many regulations. The top can never have enough and will sacrifice people to obtain it.

          • February 19, 2016 at 6:09 pm
            FFA says:
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            Ron I agree they needed help. I spent close to $40,000 last year between premiums and the never ending co pays & co insurance.

            Had I been working a regular job, I would have had to claim BK even with the health plan I had. I dont see how the PPACA has solved that issue.

            Yes, The Pre X folks needed help. I would be behind the Subsidy issue for them and them only pre ACA. Why Subsidize the entire country when only a small demographic needed it? Lets spend $1,000 instead of $1.00 is what the aca does.

            Lets not forget the lies it was sold to the American People on.

          • February 19, 2016 at 6:48 pm
            FFA says:
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            Ron – “It would come from the government to the private companies.”

            If it means money, that is what is supposed to happen but dont. Do you think it would be any different no matter whos name is on the check?

          • February 22, 2016 at 8:12 am
            Ron says:
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            FFA,

            I was not that far behind you in medical expenses last year. Not looking for sympathy, but my wife was diagnosed with breast cancer last year and is still being treated. We have already satisfied our $6,000 deductible for the year. Our spending in the private sector, outside of the medical, decreased over $10,000 last year. Please tell me how that helps the economy? For the record, we have been on a high deductible plan since 2008, before the PPACA, so don’t blame our situation on that law.

            I know that you know that I am against the PPACA. Why do you expect me to defend it?

            If you are willing to subsidize a pre-x pools, why not just include them in the same plan? That is what pooling in insurance does. The problem with the pre-x plans is that there were little to no subsidies. Meaning, again, that they were cost prohibitive for millions of our fellow citizens who were sick. That is why the #1 reason for bankruptcies were due to health expenses.

            You asked, “If it means money, that is what is supposed to happen but don’t. Do you think it would be any different no matter whose name is on the check?” I am not exactly sure what you are asking, but I was addressing that if the government was paying the premiums, an individual would not be impacted if the government did not pay the carriers.

        • February 17, 2016 at 3:24 pm
          Agent says:
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          FFA, Hi and how are you doing? Hope your wife is doing better now.

          I believe when this abysmal law was passed, the back room deals included a provision that Congress, the Supreme Court and Executive Branch would be exempted from having to take it. Why would they kill the goose that laid the golden egg. Put it on the people and let them suffer as they have for 6 years.

          • February 17, 2016 at 3:35 pm
            Ron says:
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          • February 17, 2016 at 4:21 pm
            Agent says:
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            FFA, the poster known as Ron, the gullible didn’t know that this law was passed in a totally partisan way by bribes, intimidation of Progressive Democrats, written by Ezekiel Emanuel and Jonathon Gruber, full of lies perpetuated by Nancy Pelosi, Harry Reid and our infamous President. What should we expect, he voted for Obama twice thinking he was the man for the job.

          • February 17, 2016 at 4:25 pm
            Ron says:
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          • February 17, 2016 at 4:29 pm
            FFA says:
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            She finally got to the doc this past week. Got all the tests lined up. She hasnt been sleeping as much so it appears for now moving in the right direction. Hopefully its just a fibro note.

            Anyways, I saw a report on FB that seemingly is false that Romo & Whitten came out last week and Jones traded Romo to Huston. I think its something made up, but looking to verify is Romo did indeed get traded.

          • February 17, 2016 at 4:33 pm
            FFA says:
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            Is Ezekiel Emanuel & Rahm related? Seems Teachers Union who blasted the crap out of Rahm is now siding with him as Rauner refuses to bail CPS out and suggests they go bankrupt. .

            Meanwhile, the violence in Chicago continues. Numerous free way shootings are being reported on the news. I had to go to Chicago yesterday to renew an account and found myself looking up at every bridge I went under. What a mess!

  • February 18, 2016 at 4:39 pm
    Agent says:
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    FFA, I believe Ezekiel is the nasty Progressive brother of the equally nasty Progressive Rahm. Rahm got his nickname “Dead Fish” during his stint under Obama. It was well earned.

    Glad your wife is doing better. Mine is doing better as well, but still has to use too many pain meds and keep the spine stimulator on full blast most of the time.

    • February 18, 2016 at 4:50 pm
      Agent says:
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      FFA, no truth to the rumor that Dallas traded Romo to Houston. Jones is married to Romo and thinks he can get 5 more years out of him and all that guaranteed money. They are sweating getting a capable back up since they have little cap room due to their spending ways of recent years. Many other teams have much more cap room and will spend up to $8 million to get them which Dallas doesn’t have. Jones is between a rock and a hard place of his own making. He may have to trade some higher priced players to create some room and then draft someone. Who is anybody’s guess. Manziel is not an option to sign since he can’t stay out of trouble. He may have to go to Canada or the Arena league to play since the NFL has written him off at least for now.

      • February 19, 2016 at 11:56 am
        FFA says:
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        With his boozing, I doubt any one would sign him. Its a shame. Kid has all the talent in the world. Only one he exploits is drinking like a fish.

        • February 19, 2016 at 4:32 pm
          Agent says:
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          Manziel was an entitled kid who was spoiled rotten by his parents. They had to transfer the kid out of his high school because of trouble and send him to another part of the state to finish up. A&M also spoiled him and he often didn’t attend meetings or practice, but he was a star and the coach didn’t want to suspend his meal ticket.

          By the way, on another subject, you mentioned the wonderful VA and the poor treatment vets receive. A story on Townhall today was on the so called Suicide Hot Line set up by the VA for vets. The line often sent a vet to voice mail and the calls have not been getting returned. There is no telling how many suicides have happened as a result of “no service”. This is the kind of government healthcare that Ron wants so desperately.

          • February 19, 2016 at 6:04 pm
            FFA says:
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            They talked about that on the new piece I saw last week. I Team Investigates. Thats what you get when the govt “takes care” of health issues.

  • February 22, 2016 at 11:24 am
    Agent says:
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    FFA, why do you think very few administrators have been fired over their actions/inactions since the VA scandal happened? Perhaps Obama’s promise to get to the bottom of the problem was another empty promise. Say what you want about Trump, but I do believe he would clean up the VA mess and send a lot of bureaucrats packing. He just raised $5 million when he boycotted the debate in Iowa to help veterans.

    • February 22, 2016 at 11:38 am
      Ron says:
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      Agent,

      You do realize that the president cannot just go around firing people, right?

      Has Donald Trump presented his plan to clean up anything or is he just going to keep selling snake oil?

      • February 22, 2016 at 4:06 pm
        Agent says:
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        He fired the top guy, you nimwit. Sure he can fire the head of any agency or department that is not doing their job. Reagan fired the Air Traffic Controllers for not coming to work on a union issue. If you want to be polite about it, he can ask for their resignation on his desk by 8:00 AM. Same thing as firing them.



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