Tax Credits will replace Obamacare in 2020

[YULACU]

If they are not on Medicaid, it means they haven't bothered to complete their paperwork.

Prior to Obamacare, many individuals without kids were excluded from Medicaid regardless of how poor they were. After Obamacare some states didn't expand Medicaid under to include people without kids. If you don't have a kid, you're poor, and live in a state that didn't expand Medicaid, it's likely you're still uninsured. If the federal government doesn't continue to help defray some of the costs of the expanded Medicaid fee sharing, states will likely revert to only insuring people with kids.

[disneysteve]

This is NOT the situation for millions of people in our country: Folks making minimum wage aren't paying for health insurance and haven't in decades. They are on Medicaid. If they are not on Medicaid, it means they haven't bothered to complete their paperwork.

Sorry but that's not true.

Since the ACA went into effect, more than 7 million previously uninsured people got coverage largely due to the expansion of the Medicaid program. Had all 50 states expanded Medicaid as the legislation originally required, the number would have been even higher. But even with only 31 states participating, it still brought insurance coverage to over 7 million people.

Prior to the ACA, millions of lower income people were uninsured and didn't have access to Medicaid. I can tell you firsthand that our practice gained several hundred new patients because of this. So we stand to lose several hundred patients if that coverage is revoked and those people are left uninsured again.

[Outdoorsygal]

Wanted to jump in here to say

The allowed maximum for a couple for 2016-2017 is $22,107 per yr.
4o hrs wk x $10.50 hr (Min wage for Calif) is $21,840 per year.

That is ONE person working FULL TIME within a couple going OVER the alloted amout by about $730 a month.

The only way a couple might qualify for Medicaid is if one person out of two, worked less than 40 hrs per wk for minimum wage. The subsidy provided for a couple where one person made minimum wage was really good though. It was really close to medicaid in that the monthly cost was $1 (or is) for essentially the same coverage. What is the problem? Hundreds of dollars difference in cost is the problem compared to fee for service medical (or medicaid). We decided to forego it for my husband because the thought of someone else subsidizing us, was not comforting.

We've decided not to go another year so I am having enough taken out of my paycheck and he writes off alot due to owning a business that in 2018, we've decided to cover him with fee for service medical. After that, I suspect he GOP or some politician will have presented a healthcare plan which was accepted.

Medicaid expansion was great but it wasn't extended to as many people as one might think. And whether you can find a doctor that takes Medicaid, well good luck with that

[disneysteve]

Wanted to jump in here to say

The allowed maximum for a couple for 2016-2017 is $22,107 per yr.
4o hrs wk x $10.50 hr (Min wage for Calif) is $21,840 per year.

That is ONE person working FULL TIME within a couple going OVER the alloted amout by about $730 a month.

So someone who works a full time min. wage job doesn't qualify for Medicaid? That's a screwed up system, for sure.

Of course, I suspect that lots of minimum wage jobs make sure not to give employees enough hours for them to qualify for benefits so they probably aren't getting 40 hours/week anyway.

On the flipside, though, it's things like this that keep poor people poor. What incentive is there to go out and get a job if doing so will cause you to lose your health insurance and other benefits? They really need to scale those things so they phase out as income rises. So maybe if you're income tops $22,107, you keep insurance but pay a small premium for it that increases as your income rises rather than losing it entirely for being $1 over the limit.

[Outdoorsygal]

So someone who works a full time min. wage job doesn't qualify for Medicaid? That's a screwed up system, for sure.

In California, one person working 40 hr a week at min wage ($10.50 per hr) makes $21,840 per yr.
The max amount allowed to qualify for medicaid, for one person, is $16,020. So the answer is no.
In California, someone working f/t for min wage, cannot qualify for medicaid.
Same with a couple, they even make too much $$.
For a couple, at min wage, one perosn would have to scale down hours to about 36 per week while the other spouse stayed home.

The poverty levels are not adjusted for various COLA's in different areas. There are 58 counties in California, we live in the top 10 most expensive counties in California. I believe we are #8.

Of course, I suspect that lots of minimum wage jobs make sure not to give employees enough hours for them to qualify for benefits so they probably aren't getting 40 hours/week anyway.

Sounds correct. The ACA defines full time as 30 hrs a week, not 40.

On the flipside, though, it's things like this that keep poor people poor. What incentive is there to go out and get a job if doing so will cause you to lose your health insurance and other benefits?

Exacty. They are know as moochers but what if that is all you can do?
Learning disabiliteis, physical disabilities, low self esteem etc...yet you have enough financial sense to know increasing your pay = loosing medical benefits. Can't blame them.

Throughout most of life, a male who earned min wage made enough to support his entire family.
Sure they were broke but now we have two parents working f/t and they are still dirt poor.
Want more than the basic needs met? Go to college then.
Get a better job. But now you cannot even be guaranteed that. Something is wrong here in the U.S

They really need to scale those things so they phase out as income rises. So maybe if you're income tops $22,107, you keep insurance but pay a small premium for it that increases as your income rises rather than losing it entirely for being $1 over the limit.

Not really familiar with it but there is some type of cost sharing with Medicaid
I suspect it is with the traditional medicald. Meaning Medicaid before the medicaid expansion.
My guess is, those between 18 -64 cannot do this share of cost but haven't researched it.
Likely pushthem onto the ACA subsidies.
Those cost more for taxpayers which is also extremely unfair to all.
No one believed us when I said they forced our son to go onto Medicaid. We applied, he lived with us and hadn't started working for Apple yet.
A year later a card came in the mail saying he has medical (aka medicaid). ????
To try to get him off was a nightmare.
He kept calling saying he already had insurance thru work but they didnt know how to cancel him.
Rand Paul, Senator for Michigan, speaks of the same problem with his son who was the same age at the time.
They want to charge taxpayers to the hilt, no matter what it seems.
It's as if everyone is getting kickbacks from the insurance companies. Ok rant over promise

[Outdoorsygal]

Rand Paul has a killer plan for healthcare but it involves subsidies & HSA accounts.
My only concern is...can most poor people manage their $ enough not to touch the subsidy in the HSA account??
If you are poor, how tempting it would be to remove the money for non-healthcare expenses and pay the 10 or 20% penalty for doing so.

Then when everyone isn't covered, then the healthy are not balancing out the sick.
The sick will wait until they are sick to buy health insurance

[TexasHusker]

Sorry but that's not true.

Since the ACA went into effect, more than 7 million previously uninsured people got coverage largely due to the expansion of the Medicaid program. Had all 50 states expanded Medicaid as the legislation originally required, the number would have been even higher. But even with only 31 states participating, it still brought insurance coverage to over 7 million people.

Prior to the ACA, millions of lower income people were uninsured and didn't have access to Medicaid. I can tell you firsthand that our practice gained several hundred new patients because of this. So we stand to lose several hundred patients if that coverage is revoked and those people are left uninsured again.

Yes, Medicaid expanded. But minimum wage folks have always qualified for Medicaid.

[TexasHusker]

Rand Paul has a killer plan for healthcare but it involves subsidies & HSA accounts.
My only concern is...can most poor people manage their $ enough not to touch the subsidy in the HSA account??
If you are poor, how tempting it would be to remove the money for non-healthcare expenses and pay the 10 or 20% penalty for doing so.

Then when everyone isn't covered, then the healthy are not balancing out the sick.
The sick will wait until they are sick to buy health insurance

And that isn't insurance; that's welfare.

[disneysteve]

Yes, Medicaid expanded. But minimum wage folks have always qualified for Medicaid.

Millions of low income workers did not qualify until the ACA expanded coverage. Their kids may have gotten coverage but the parents often didn't. I would see that in my practice all the time. The kids had Family Care and the parents had nothing. Now the whole family is insured.

[TexasHusker]

Back in the 1990s I managed a hotel owned by a large hospital chain. We had about 40 employees at the hotel, mostly lower income hourly workers.

At that time, the hospital provided employee health insurance for about $14 per pay period, yet over half of the employees never enrolled. In fact, a higher percentage enrolled for the cancer insurance than health insurance, and the cancer insurance cost more.

I was always amazed at that.

Today, in my own business, we have about 30 employees, all hourly. While we do not offer health insurance, we do offer a medical clinic membership whereby employees can go to one of two local walkin clinics for a $15 copay. The clinics do an excellent job with cuts, sprains, stitches, etc.

The total cost for this is $22 per pay period, but we offer to pay half of that. Yet only 3 people are on the plan.

[Outdoorsygal]

Yes, Medicaid expanded. But minimum wage folks have always qualified for Medicaid.

My BIG mistake, sorry. Rand Paul's plan involves tax credits and HSA's.
Tax Credits for those who paid into the system only