quiet.american crunching the numbers looks like the poorest among us will be helped by health bill

[happy2bhere]

(reposted-too late to bump http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x6913410)

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:
H.R. 3962 Bill
2009 Federal Poverty Guidelines (scroll down to the table)
Everything You Wanted to know about HCR But...(fill in the blank)
Online Percentage Calculator

[Faygo Kid]

1. Welcome to DU. I too favor the bill.

Hope you will join us in being a long-termer, rather than someone with an agenda posting here on this only. A little more in your nonexistent profile would make me feel better about your commitment to the DU family.

[happy2bhere]

6. thanks

and thanks for the advice. I'll go back and add to my profile, I was just in a hurry to ask about this post actually. Are these numbers actually accurate? I was against this bill before I was for it. I was pretty angry about mandated insurance(which still sucks) but when I took a look at how many poor people this was going to help...I just can't imagine any progressive person being against it. It might quite possibly suck for people who make over 60,000 but sheeit there are many people doing worse than you all, have a heart. For a poor person, this is a matter of life and death.

I don't know why they keep blaming the uninsured for high insurance prices, poor uninsured people don't go to the doctor/hospital because they know the high cost will ruin their already precarious financial situation. I would rather die than make my family homeless you know. I wish they would stop blaming the unisured poor people for the ridiculous prices of health care which in turn cause insurance companies to charge so much. I wish people would stop bashing the insurance companies long enough to realize one reason insurance is so high is the absurd cost of hospital visits etc. Someone needs to stop the hospitals from charging $4,000 for an MRI. Perhaps the US government could look into the Japanese system where the government pays for the hospital equipment and then sets a limit as to what the hospital can charge. An MRI in Japan is $98

[Faygo Kid]

2. Dupe. Delete.

[DaveinJapan]

15. Just curious, who is in that picture with the First Lady and why is that one guy in shorts and crocs

?

[Faygo Kid]

17. Iron Chef America, at the White House, to air Jan. 3.

And that's Iron Chef Mario Batali, who is the best of the best.

[DaveinJapan]

18. Oh, okay. Thanks.

[ProleNoMore]

3. Maybe So - However, What Would The Coverage Actually Provide?

A big open question at this point in time.

[sandnsea]

5. What do you want it to cover?

Besides abortion, what's your list?

That's how you make sure you get the coverage you need. Fighting for it. Not sitting around with your thumb up your ass, disrupting everybody trying to do something.

[quiet.american]

12. Since you asked: HR 3962, Section 222, Page 104 - Essential Benefits Package Defined:

(b) MINIMUM SERVICES TO BE COVERED.

Subject to subsection (d), the items and services described in this subsection are the following:

(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department services.
(3) Professional services of physicians and other health professionals.
(4) Such services, equipment, and supplies incident to the services of a physician’s or a health professional’s delivery of care in institutional settings, physician offices, patients’ homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services, including behavioral health treatments.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well-baby and well-child care and oral health, vision, and hearing services, equipment, and supplies for children under 21 years of age.
(11) Durable medical equipment, prosthetics, orthotics and related supplies.

[sandnsea]

4. Yes, the bottom 50% - with the HOUSE BILL

We've got to fight for the House bill. The Senate bill won't be as helpful.

[happy2bhere]

23. the bottom 50% getting help does seem sort of important

n/t

[happy2bhere]

7. so what if you are poor and your employer offers you health care because they have to

would that then be subsidized if you have a copay every month? Is the public option only for the unemployed? Still trying to figure it out...

[quiet.american]

13. Happy, I'm not sure I can give you a definitive, or correct answer on this, but --

Take a look at this passage in the bill; this section starts on page 155, the excerpt is from page 156:

SEC. 302. EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS.

(a) ACCESS TO COVERAGE.—In accordance with this section, all individuals are eligible to obtain coverage through enrollment in an Exchange-participating health benefits plan offered through the Health Insurance Exchange unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage.

(There's also more info in this section of the bill if you have the opportunity to take a look at it.)

http://edlabor.house.gov/documents/111/pdf/publications/AHCAA-WHATYOUNEEDTOKNOW-102909.pdf">Also from this link, which would apply if you work for a small business

Employer Responsibility

If some businesses don’t provide workers health care, it forces the rest of us to pick up the tab
when their workers get sick, and gives those businesses an unfair advantage over their
competitors. That’s why, under this bill, larger businesses will be required to either offer their
workers health care coverage, or chip in to help cover the insurance costs of their workers.

Under the bill, there is a recognition that providing health care coverage is unaffordable for
many small businesses. Therefore, all businesses with payrolls of $500,000 or smaller – or 86
percent of America’s businesses – will be exempt from these requirements, and their
employees will have access to affordable plans through the Exchange and Affordability Credits
to help pay for that coverage.

[happy2bhere]

14. sounds good

thanks for the reply

[quiet.american]

8. Thanks for the shout-out, Happy! nt

[happy2bhere]

10. Thank you!

Your post made me change my mind about this bill. I think if the party put out a webpage where people could easily see the numbers, there would be more people supporting it. When I see how many people that this could potentially help...I cannot help but support it.

This doesn't mean we cannot continue to work on improving the bill, and be willing to take a look at lowering cost all around by stopping the hospitals and insurance companies from gauging the public.

[MajorChode]

9. Leave it to a newbie to actually read the bill and make some sense out of it...

Instead of slinging myths and hyperbole.

Welcome to DU, and thanks for the well thought out analysis. A plus for you.

[happy2bhere]

11. thanks for the welcome!

but it is definately quiet.american that deserves the credit. He/she needs to start talking louder hehe.

[bigwillq]

16. Hello.

Welcome to DU! :hi:

[happy2bhere]

20. thanks

:hi:

[JimWis]

19. Welcome to DU.. Thanks for sharing the info. In regards to your

mention of the $ 4,000 MRI. I just happened to be talking to a gal friend last night who works for the Mayo Clinic system. She said that the reason they charge such high prices, for example, for an MRI as you mentioned, was to make up for all the uncovered services. She said that the amount they would need to charge for staff time and to pay for the purchase of the MRI equipment over it's useful life, would probably be closer to the $ 98. Actually she used a smaller figure. So if everyone who walked into the hospital had coverage, it would seem in my humble opinion, that costs would start going down.

[happy2bhere]

21. thanks!

:hi:

I'm just still not understanding how poor people are getting free hospital care? When my husband dislocated his knee, we didn't actually have to pay the +$3,000? These people hound you demanding payment for their $300 aspirins and $1500 ambulance rides. There are that many people going in giving fake names and skipping out?

[happy2bhere]

22. kick for morning

:kick:

[happy2bhere]

24. and another

:kick: