Since it's ACA it'll probably be D&D anyways, but my question is have we thought through potential gaming of the ACA? This question stems from the thought that since the current insurance plans are mostly voluntary AND insurance companies CAN deny you coverage, there are less incentives/abilities to game the system. Since I'm no expert in this field, I'm wondering if there's anyone on this board that can help. Example 1: What if someone just stop paying premiums. Can you be dropped from coverage and are you still going to face the tax penalties if involuntarily dropped? If you're dropped for not making payments, at what point can you be insured again? Are you going to have to go without insurance for X months till the following enrollment year before you can get affordable health insurance? Example 2: Would people start gaming life changing events? I.E. Go with the lowest coverage till they really need the higher coverage, then "life change"? Are you able to both scale up or down the plan? I.E. I can only afford the second tier now, but now I got a better job, can I scale up due to life change? I'm sure there are more nuance to this law I just don't know. I'm covered through my work and as far as I know, we're compliant. The rates have gone up though it wasn't significant enough for me to notice it right now.
Will people cheat on their taxes always? Sure. Will people cheat on their taxes and risk their own/families lives to save 95 bucks? I don't think so.
My questions is more around the law though? If the law is very stringent, then the people that don't intend to cheat will be hurt quite a bit. I.E. some one legitimately was unable to pay for health care due to cash constraints/poor decisions, do they get locked out of health care for a year? If the law is not very stringent, people illegitimately decides to stop paying for health care, then only pick it up when they really need it.
If you're very poor you're exempt anyway. So basically we're down to the scenario of people getting insurance then opting out of it (and willfully committing tax fraud) to save a pretty trivial amount of cash and risking their families health in the process. You'll find very few people who affirmatively pursue that courses, other than maybe a few tea party morons.
You do not understand the law. It's ok. Insurance companies can still rescind coverage for: 1) Material fraud (which makes up almost all rescissions right now) 2) Non-payment of premium If you are dropped for non-payment, you can always buy insurance again at any point you are willing to pay the premium. If however you are a subsidy recipient, you will be restricted to open enrollment periods only if you want to continue with the subsidy. Failure to pay premium is not a qualify life event. As for gaming life events, proof is required. You can't scale up and down just because you want better coverage. It works just like group open enrollment does now. Life events create a new enrollment opportunity for you, but you'll need to be able to prove the life event occurred. The above only applies if you get a subsidy. If you are a non subsidy recipient you will be able to continue doing what you do now. Shop for better or worse coverage to impact your premiums whenever you want. Edit: Life changes are not something you decide. They are predetermined events that create an enrollment opportunity. Marriage, divorce, adoption, birth of a child, loss of employment, gain of employment, loss of employer sponsored insurance, gain of employer sponsored insurance, salary change that would impact your subsidy eligibility, death or failure of your plan to comply with the law's requirement.
I think the optimum strategy might be to just pay the taxes for no insurance and when you have something like cancer or some other expensive issue get the insurance. This is why we should have a single payer systems.
The best thing for America would be to strip away a sector of employment that has hundreds of thousands of jobs throughout the United States through various tiers of employment. Kick them all to the unemployment line, many of them in their 40s with a set of experience that would be useless.
That's great if it's a long-term issue like cancer. You're pretty much screwed if you get in a car wreck or a heart attack or anything else that demands immediate attention. That's no different than now - if you're willing to risk bankruptcy, go for it. The idea of the law is to help take that stress off of people. And the penalty increases in a few years - up to 2.5% of income, I believe. So if you make $50k per year, you can either pay $100/mo for nothing or, say, $300/mo for health insurance. It almost works like a subsidy-to-yourself in that you're only paying a net additional $200 for your $300 insurance plan.
If you go in for regular checkups and cancer screenings with your insurance, you will be more likely to catch it sooner when it's more treatable. I don't think I'd take a chance on that one.
Exactly. I'm inclined to believe most folks understand that the difference between a treatable cancer and a terminal cancer is a little bit of money in addition to the penalty. If Americans are so willing to pour money into increasing a miniscule chance of survival during end-of-life, why not a little extra today in exchange for a substantially better chance? Quite literally investing for the future.
I think the tax penalty needs to be super punitive to push enrollment in. One of my clients lacks health insurance and needed surgery that she was pushing off for months. A few weeks ago she tried to get coverage through ACA and we explained to her that it wasn't going to start until the new year. Doc said that the surgery couldn't wait any longer so she had to stroke a check for $100K. I'm not well versed at the ACA, but some of my employees are...I'll ask them what happens in the future in these scenarios. Anyhow, even rich people can penny pinchers when it comes to their health care. If you want them to voluntarily enroll (the rich and uninsured...usually self-employed), you probably need to make the penalties stiff and spread the word.
The typewriter, cathode ray tube TV, and microfiche industries thank you for your support by using this throwaway line of argument. If there's substantial net efficiency gains from switching to single payer from private insurance then we should do it.
Furthermore, there would be this big shiny brand new government agency. With, a rightfully so, huge budget and the need for a skilled workforce with a particular skill set. A skill set that a ton of soon to be unemployed citizens will possess. So, what shall we do? Spoiler
What if you're in a cash intensive business and sometime you just can't make the $300 payment. You get dropped from the plan. Do you get to get back on it at any point? Are taxed if you're dropped from the plan?
Since Sammy here refuses full disclosure on this failed product, let me remind him that for the first year, its 1% or $95.00, whichever is greater. The $95.00 will apply to few, since most people qualify for subsides.
