Crunched the #s, & it looks like by Jan/2010 I'll have health insurance for $80 or less/month.

[quiet.american]

Thought I'd take a look at the numbers to get an idea of just how "affordable" this would be in the real world. Hopefully, I've interepreted the legalese and summaries correctly -- has anyone else tried this?

Downloaded the bill and combed through the Affordability Credits section, as well as various summaries; here's what I'm basing my conclusion on:

Eligibility

HCR 3962:

Page 16:
TITLE I—IMMEDIATE REFORMS
SEC. 101. NATIONAL HIGH-RISK POOL PROGRAM.
(a) IN GENERAL.—The Secretary of Health and Human Services (in this section referred to as the ‘‘Secretary’’) shall establish a temporary national high-risk pool program (in this section referred to as the ‘‘program’’) to provide health benefits to eligible individuals during the period beginning on January 1, 2010, and, subject to subsection (h)(3)(B), ending on the date on which the Health Insurance Exchange is established.

(c) ELIGIBILITY.—For purposes of this section, the term ‘‘eligible individual’’ means an individual—

(there's more at the link - skipping to what would be applicable in my case) --

Page 18: -- who has not had health insurance coverage or coverage under an employment-based health plan for at least the 6-month period immediately preceding the date of the individual’s application for high-risk pool coverage under this section.

The numbers:

According to the table on Page 252:

The percentage of the affordability credit I'd qualify for, according to my modified adjusted gross income (expressed as a percentage above the Federal Poverty Level -- the table ranges from 133% to 400% -- my income falls in the 250%-300% category) is a percentage credit of 78% towards my premium. The percentage of my income I would be charged as an annual premium would begin at 8% and on a sliding scale, increase to 10% *after* the first year. (I used the 10% number for my figures.)

(The premium range may end up being less because I've used my gross income as a basis for the figure -- that was easier to figure out since my income this year is very different from what was on my tax return last year).

Okay, for the purpose of how I arrived at my figures -- let's use a household income of $40,000/ 2 people and this would be for an individual policy for one person --

Gross income, $40,000 is 275% of the FPL (2009 Federal Poverty Level, $14,570); which would place one in the "250%-300%" category for the purpose of determining what percentage of the affordability credit one is eligible for.

If one calculates according to 2010-Year 1/ 8% "initial premium percentage":

8% of $40,000 = $320/month

The affordability credit = 78% of $320 = $249.60

$320-$249= $71/month


After Y1, sliding scale to:

10% "final premium percentage" of $40,000 = $400/month

The affordability credit = 78% of $400 = $312

$400-$312=$88/month;

Additionally, maximum out-of-pocket for Year 1 is: $4,000.

Through all the noise, and the "best of intentions" passionate criticisms -- this is something that would truly be welcome to me - namely, premiums I can afford that are vastly lower than anything I could get now.


Links used:
http://docs.house.gov/rules/health/111_ahcaa.pdf">H.R. 3962 Bill
http://aspe.hhs.gov/poverty/09poverty.shtml">2009 Federal Poverty Guidelines (scroll down to the table)
http://edlabor.house.gov/blog/2009/10/affordable-health-care.shtml">Everything You Wanted to know about HCR But...(fill in the blank)
http://www.onlineconversion.com/percentcalc.htm">Online Percentage Calculator

[TexasObserver]

1. Recommend

[sandnsea]

2. The House bill is more generous than the Senate

Which is why we really need to get focused on the subsidies.

[xchrom]

3. lot of hoops to jump throguh to ge to that number.

are you responsible for those hoops?

i find simpler solutions to be the most effective.

[mzmolly]

4. K and R.

I hope you will Q.E. :hi:

[rosesaylavee]

5. That would be most helpful

as I am near that category myself. Paying 8,000/year now and not sure how long we can hold at that level. If it goes up not sure what we will do as maintaining the monthly payments is killing us.

[HughMoran]

6. I'm recommending this just based on the links at the bottom

Holy crap - there is a plethora of information available at the house Education & Labor site. Somebody's done their homework on this one.

[ProleNoMore]

7. Thanks For Sharing Your Analysis

eom

[PHIMG]

8. Willful obfuscation in this bill = FAILURE

Why on earth do you want to right a bill so complex even highly motivated people have great difficulty coming up with the answers?

Laws should be easy to understand. They would be if sold-out legislators didn't need to hide the fact that they aren't representing the will of the people but rather the wealthy special interests who fill their campaign coffers.

MEDICARE FOR ALL = HR676 = 27 pages.

Simple elegant and easy. It was never on the table. Why? Money in politics.

[quiet.american]

14. Amazingly enough, even putting "failure" in ALL CAPS has not swayed me.

Come on. You have to know the final product is not going to make consumers wade through the actual legislation in order to ascertain eligibility/plan details.

At the link I posted titled "Everything You Wanted To Know...." there are bullet points that clearly explain what steps are being taken so that consumers will be able to understand "in plain English" what is available to them, as well many more intiatives that are being designed to cope with providing consumers clear information on their inquiries.

[quiet.american]

9. Turning in -- thanks everyone, for taking a look.

:hi:

[eridani]

10. Bully for you. I'll have to pay $450/month

And good luck making them pay if you ever have to file a claim.

[quiet.american]

12. Telling us based on what would be helpful.

I'm not worried about "making them pay," Medicare seems to be handling things just fine.

[eridani]

25. Based on the Kaiser Famliy Foundation online calculator

Age discrimination and subsidies are supposedly figured in. KFF is supposed to be updating it with changes in the legislation, but I have no way of knowing for sure if that's true.

[eridani]

11. It would also be nice if you could get your claims paid

Given that 85% of the population will never get expensively sick, you'll probably luck out and never have to find out whether, though.

[quiet.american]

13. Now that's what I call a weighty response -- not. nt

[eridani]

26. You have some evidence that insurance companies who profit now by denying care--

--are going to stop doing that?

[Phoebe Loosinhouse]

15. Very compelling post. This is EXACTLY the kind of real world synopsis

that the Dems should be doing all day every day to demonstrate that their bill DOES make healthcare affordable.

[quiet.american]

17. Thanks for the shout-out, Phoebe.

:hi:

I'm not a "numbers cruncher" by profession, and so, can't quite tell if I've missed something important to add to the numbers, but according to the table, this is the premium I'd be looking at.

I would be very interested to hear if others come to the same conclusion as I did by running the numbers included in the table on page 252 of the bill. If you do it, too, please let us know!

[Egnever]

16. Great stuff!

This is the kind of stuff I come to DU for!
K%R

[quiet.american]

18. Thanks, Egnever --

If you do the numbers for yourself, would be very interested to hear feedback on your results!

[Egnever]

23. I will try to as soon as i get some time to sit and look at it

Thanks for laying out you went about it I am interested to see what my family would work out at.

[lumberjack_jeff]

19. I support this bill, but I'm not sure you're reading it right.

Do affordability credits apply to the (short term) high risk pool? I don't think they do, but I could be wrong.

[quiet.american]

20. Excellent question. Starting on page 23, the bill talks about the HRP premiums --

-- here's an excerpt (at a glance, it seems to me it would be) -- and yes, the 8%-10% is indeed the affordability credit for the income category of 250%-300% -- the credit varies according to how high above the Federal Poverty Level one's income is -- page 252 of the bill is where the table can be found):

(1) PREMIUM.—The monthly premium charged to eligible individuals for coverage under the program—

(A) may vary by age so long as the ratio of the highest such premium to the lowest such
premium does not exceed the ratio of 2 to 1;

(B) shall be set at a level that does not exceed 125 percent of the prevailing standard rate for comparable coverage in the individual market; and

(C) shall be adjusted for geographic variation in costs.

Health insurance issuers shall provide such information as the Secretary may require to determine prevailing standard rates under this paragraph. The Secretary shall establish standard rates in consultation with the National Association of Insurance Commissioners.

(2) COVERED BENEFITS.— Covered benefits under the program shall be determined by the Secretary and shall be consistent with the basic categories in the essential benefits package described in section 222. Under such benefits package—

(A) the annual deductible for such benefits may not be higher than $1,500 for an individual or such higher amount for a family as determined by the Secretary;

(B) there may not be annual or lifetime limits; and

(C) the maximum cost-sharing with respect to an individual (or family) for a year shall not exceed $5,000 for an individual (or $10,000 for a family).

(3) NO PREEXISTING CONDITION EXCLUSION PERIODS.—
No preexisting condition exclusion period shall be imposed on coverage under the program.

[quiet.american]

21. A correction to my post above --

The "78%" is the credit -- the 8%-10% is the amount of my income on which the premium would be based, and then subsidized by 78%.

[mimitabby]

22. that looks good!

[DarleenMB]

24. So if I'm reading this right

because I've been shelling out $317 a month for basically NOTHING ($10,000 deductible, no drug benefit) I won't qualify for this because I've had "coverage?"