Thursday, June 21, 2012

Obamacare demystified and explained in very simple language.

I was surfing over at the other day and happened across one of the best explanations of the Affordable Care Act that I have ever seen.

I thought I would repost it here, with a grateful hat tip to the originator, because I believe it could prove useful in explaining to laymen and women just how beneficial this law will be to the American people. It really is quite impressive.

Here take a look:

Already in effect: 

  • It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) 
  • It increases the rebates on drugs people get through Medicare (so drugs cost less) 
  • It establishes a non-profit group, that the government doesn't directly control, to study different kinds of treatments to see what works better and is the best use of money. 
  • It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. 
  • It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them. 
  • It renews some old policies, and calls for the appointment of various positions. 
  • It creates a new 10% tax on indoor tanning booths. 
  • It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. 
  • Kids can continue to be covered by their parents' health insurance until they're 26. 
  • No more "pre-existing conditions" for kids under the age of 19. 
  • Insurers have less ability to change the amount customers have to pay for their plans. 
  • People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend. 
  • Insurers can't just drop customers once they get sick. 
  • Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific). 
  • Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down. 
  • New ways to stop fraud are created. 
  • Medicare extends to smaller hospitals. 
  • Medicare patients with chronic illnesses must be monitored more thoroughly. 
  • Reduces the costs for some companies that handle benefits for the elderly. 
  • A new website is made to give people insurance and health information. 
  • A credit program is made that will make it easier for business to invest in new ways to treat illness. 
  • A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers. 
  • A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover. 
  • Employers need to list the benefits they provided to employees on their tax forms. 


  • Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. 


  • If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners. 


This is when a lot of the really big changes happen. 

  • No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history. 
  • If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it. 
  • Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. 
  • Make it so more poor people can get Medicaid by making the low-income cut-off higher. 
  • Small businesses get some tax credits for two years. 
  • Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty. 
  • Limits how high of an annual deductible insurers can charge customers. 
  • Cut some Medicare spending 
  • Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. 
  • Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage. 
  • Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen. 
  • A new tax on pharmaceutical companies. 
  • A new tax on the purchase of medical devices. 
  • A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed. 
  • The amount you can deduct from your taxes for medical expenses increases. 


  • Doctors' pay will be determined by the quality of their care, not how many people they treat. 


  • If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). 


  • All health care plans must now cover preventative care (not just the new ones). A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage). 


  • The elimination of the "Medicare gap" . 

Aaaaand that's it right there. 

The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it's not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury. 

Plus, as previously mentioned, it's necessary if you're doing away with "pre-existing conditions" because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance. Whew! Hope that answers the question!

Take a moment to REALLY look through this post.  I think it really does a yeoman's job of making this bill accessible to even those of us who sometimes find ourselves lost and confused when looking through government websites designed to explain this stuff to us.

I am often irritated by Right Wing pundits, but ESPECIALLY Left Wing pundits, who claim that President Obama should not have prioritized the passage of this piece of legislation, and should have instead focused on jobs, or ending the wars, or legalizing marijuana, or (insert your favorite pet peeve here.)  However I believe that this bill could possibly be one of the MOST important, and beneficial pieces of legislation passed in our lifetimes.

And what's more the Republicans KNEW IT!

That is why they have fought against it tooth and nail. They knew that once the benefits from this bill started to affect the lives of the average American that THEY would fucked!

And that is why they have been doing everything in their power to fuck US out of receiving the benefits from this extraordinarily important bill.

That is why I am very worried about what the Supreme Court decision might do to its implementation, and why I think YOU should be worried as well.


  1. Sally in MI5:37 AM

    Wait for the faux outrage from the right when refund checks start showing up in mailboxes soon from insurers who use premiums for administrative costs rather than care! "Political move!" "Obama hates the private sector!" "Socialism!" "Government overreach!:" In other words, the GOP will look stupid yet again.

  2. Anonymous5:46 AM

    I cannot imagine how the Supremes will find any of this unconstitutional. They should all have to give up all of their benefits before ruling on it.

  3. Thanks, G. Excellent points, all. I want to add a couple of points and my my thoughts because this is such a huge deal that has been under unwarranted attack from the git-go.

    Under the Affordable Care Act (ACA, aka ObamaCare), consumers will receive more value for their premium dollar because insurance companies are required to spend 80 percent (individual and small group markets) or 85 percent (large group markets) of premium dollars on medical care and health care quality improvement, rather than on administrative costs, starting in 2011. If they don’t, the insurance companies must provide a REBATE to their customers starting in 2012. Insurers will make the first round of rebates to consumers in 2012. Rebates must be paid by August 1st each year.

    Can anyone explain to me why a consumer of healthcare services (for example, ME) would prefer that MY insurance company be required to only pay out 75% of my total premium dollars in direct healthcare benefits, rather than 85% of premiums, which is required under the new ACA guidelines?

    DUH, that's right, EVEN I GET IT. No consumer wants to pay MORE FOR LESS. I want the best deal on my healthcare possible, just like every other consumer (or company) wants for their healthcare dollars spent.

    Think about it: There are only 2 outcomes from this stipulation in the coverage.

    1) If I belong to a large group health plan and actually consume the amount in annual services that my insurance covers, my insurance will actually cover an ADDITIONAL 13.33% of services for me at $0 cost to me in premiums(85%/75%) for those services. [The floor payout ratio for small group plans and individual plans is 80%.]
    2) If I consume less in medical services than the amount of my premiums, I am due a rebate or credit.
    3) Insurance companies are forced to provide information on how premium dollars are spent on administrative expenses including salaries, bonuses and other non-medical expenses on behalf of their customers (Health Plan Members).

    One big question remains: Why would the leaders in the Republican Party want EVERYONE to pay MORE for Health Care, when it is so expensive to begin with? Is it perhaps because of lobbying pressure and Campaign contributions from the Insurance Industry which can envision an end to their gravy train---padding salaries and executive bonuses via artificially high premiums, while also reducing benefits and capping coverage for services paid for consumers' health care?

    Thanks President Obama. The ACA isn't perfect yet by any means, but I appreciate you having our back here, Mr President, despite all of the lies and misrepresentations of you and your family personally by a lot of folks who don't really give a damn about me and my family, and whether or not we have healthcare coverage at all.

    Any party or individual that supports those that want me to pay more money for less healthcare is not a patriot, a "real American", or even a friend of the people. Most of all, I'm not going to support their grifting from the Insurance companies anymore as I've done UNKNOWINGLY in the past.

    We've ALL been fleeced in the past, and MY FORMER political party, the GOP--- the Party of NO!--- wants it to continue. Well, this time I am saying "Hell, NO!"

    I'm an Independent in support of Obama/Biden in 2012.

    1. Anonymous7:16 AM

      Best said by someone earlier, nothing is perfect.
      Having said that many take issue with the socialistic effect of ACA.
      Because healthcare is so very important, I think we all agree health is priority 1, it becomes a more difficult pill for the preservationists of the constitution to accept. But the truth is that this legislation does in many ways narrow the pursuit of liberty.
      You ask, "Can anyone explain to me why a consumer of healthcare services (for example, ME) would prefer that MY insurance company be required to only pay out 75% of my total premium dollars in direct healthcare benefits, rather than 85% of premiums, which is required under the new ACA guidelines?" and of course like most people I selfishly would like to retain that 10%.
      But the insurance industry in this country is private enterprise. So are hospitals, doctors offices and pharmecuetical companies. Yet this legislation, in an attempt to provide all with coverage, takes away the liberty of performing freely as a private entity. It socializes those businesses and those people.
      That's not what America is supposed to do or be.
      I personally do want everyone to have health care. I don't even mind paying the additional tax to assist Medicaid. What I mind is the continued effort by the left to undermine the American dream.

    2. Maybe "the American dream" needs to change. Maybe instead of "I get mine, and everyone else has to get theirs on their own," it could become "we all help each other get what we need, and I have a chance to get more than I need - and more than others - without leaving anybody in the dust." The scriptures remind us that "the love of money is a root of all kinds of evils," and sadly, "the American dream" has too often been used as a justification for loving money over loving one's neighbor as oneself - or even doing to others as you would have others do to you (including helping another fill an important need). We need to know that we're all in this together, and since none of us chooses the life circumstances into which we will be born, those of us who are born into better circumstances ought to give a helping hand to those who are born into worse. Otherwise, we manifest both ingratitude and pridefulness, neither of which is beneficial to us or to others.

    3. Anonymous7:20 PM

      THANK GOD that there are informed and caring people explaining this. The American dream has indeed become American greed. Hope we can turn this country around. Thanks to President Obama we are getting back on the right track.

    4. Anonymous3:51 PM

      well, fuck you and your views of obama. Because of him, my son doesn't have any benefits from DARS. because of him, my son will not get a single pair of hearing aides because he has to be completely deaf if he were to receive anything. i have no job, my wife is going to retire in 3 months, and we are struggling to pay our bills. try paying your water, electricity, and gas bill with $300 a week.

  4. Anonymous7:19 AM

    I misread this: Doctors' pay will be determined by the quality of their cars

    1. Anonymous7:47 AM

      funny. Better car = higher pay, or vice versa.

  5. Gasman8:30 AM

    Quite impressive? Not so much. Oh, it is a good start, but it does not truly address what has been chronically wrong with healthcare: the absence of any mechanism to contain cost and it does not extend full coverage to everyone.

    As to the supposed ban on insurers denying coverage for pre-existing coverage, they can still do it, they just have to change their semantics. Insurers can raise the rates on those with pre-existing conditions to the point of making coverage unaffordable, thus they are effectively STILL able to deny coverage in those situations. This is a distinction without a difference. If I need coverage, I'll not feel relieved to know that my claim was not denied, but merely made so expensive that I could not afford it.

    The mandate is also bullshit. There is no way that forcing people to buy a product from PRIVATE for profit businesses is just or can do a damn thing to contain healthcare costs. It is insane. This represents the biggest giveaway to big business in history and the only reason the GOP isn't now supporting it is because of their reflexive need to be anti-Obama in all things.

    Healthcare costs are STILL skyrocketing. Unless something can be done to contain costs, this system will collapse as well.

    The only sane solution is a single payer model similar to those in Canada or most European nations. For whatever reason, President Obama refused to even discuss this option, giving it away to the GOP before negotiations even began.

    Eventually, we WILL go the way of every other Western democracy and have some sort of nationalized single payer healthcare system, the question is merely when it will happen. As long as we have leaders who lack the political will to even talk about the shadow of a rumor of possibility of the single payer model, we will continue to have a chronically dysfunctional system that is far too expensive, can still be gamed by the insurance companies, and does not cover a huge portion of our population.

    It’s a start, but it needs to be MUCH better.

    1. Anonymous6:22 PM

      Not sure where you live but in my state it is mandatory to buy car insurance/motorcycle insurance if you drive.

    2. Anonymous9:35 PM

      But we have the option to nowt own a cr if we don't want to pay car insurance. So, should I kill myself because I don't want to pay for health insurance? Wait a minute, our constitution guarantees the right to LIFE, liberty..... I don't know a good solution, but this isn't it.

    3. Anonymous11:03 AM

      In this act you are forced to buy insurance... but it is for your own good! Its ridiculous to think that you can buy insurance on an as need basis (defeats the purpose of insurance). And even if you do decide not to get it there is a fee, BUT if you cannot afford it the gov WILL wave the fee.

  6. Anonymous8:54 AM

    Sometimes I almost hope it gets struck down,President Obama gets re elected,then he kicks ass for 4 years without worrying over re election and gets single payer passed.But then I believe in the Easter Bunny too.

  7. Anonymous9:04 AM

    I love it when I read someone's take on how this Act is not enough. As it IS, it was gutted by the Republicans, so as not to be as good as it should, and even then barely passed.

    The "forced buying" section, was demanded by the Republicans...possibly foreseeing the later Supreme Court sabotage of the whole thing.

    What kills me the most about all this is that over 70% of Americans were demanding reforms in 2007, having learned that most insurers were gouging the public for 40% profit (for doing essentially nothing more than finding ways to deny coverage).

    Flash forward a couple years, and a couple billion dollars worth of propaganda later, and now the same 70% HATE "Obamacare."

    When asked WHY, those people can never come up with a real answer. That SHOULD clue in the person that they've been punked!

    When you find yourself HATING anything, but don't know why, it means someone monkeyed with your mind (can you say "Fox?")

  8. Is there any possibility that the sole reason Republicans fought this so hard was that it would impact their OWN Bugatti-Veyron-level 100%-taxpayer-funded health insurance?

    1. Anonymous5:27 PM

      Amen to that one!!

  9. Super Fan In Atlanta6:19 PM

    Thanks for posting this Uncle Gryphen!

  10. Anita Winecooler8:42 PM

    Everything you said and then some.

    Personally, I think the GOP's outrage is basically over the ten percent tax on tanning beds. Can you imagine Boehner paying extra to look orange?

    All joking aside, the ACA will provide better health care for less across the board, and that's a giant step in comparison to what we had.

    And the Graphic is perfect!

    Obama/Biden 2012

  11. I think that if it is mandatory that we have insurance, auto, home, health, then it should be affordable for everyone. I am currently paying more for insurance than our mortgage.

    1. And just you wait, you will be paying more for it after this all kicks in. I am an insurance broker, What a lot of people have no idea about is that the cost of the gov plans and the new cost of the private plans are going to be SO high to pay for all the taxes and all of the subsidies that the poor will get

    2. I am in the insurance business and what a lot of people don't know is that the price for insurance for the average JOE is going to jump from 150 % to over 300% of what they are paying now. This is a fact. I have not seen ALL of the payment schedules but what I have seen is NOT looking good

  12. Anonymous7:25 PM

    A sad misrepresentation. Although this explaination is slightly more complicated, it is fairly unbiased, and doesnt read like the fairytale posted here. Instead of only words like "Provide, recieve, benefit" (and i'm not saying there are none to this massive power grab legislation), you will also see reality words like "mandate, require, assess, expand, subsidy, create, impose, increase tax". You could tax the entire country at 50% and it wouldn't pay for this legislation.

    Just look across the Pond to Greece, Italy and Spain... and soon to be France. Their entire population is over taxed to try and pay for their social welfare programs and they are rioting in the streets.

    I really hope this program gets repealled. But if it doesn't, I pray it is all kittens, rainbows and sunshine like this page states it to be.

  13. Anonymous10:45 AM

    Obamacare is going to fail as it stands now. It is to big of a change being forced down or throats. Obama is just trying to "make his mark" on the country, but at what cost!

  14. Anonymous2:31 PM

    although lots of folks have stated for and against comments, i have yet to see a realistic comparison of dollar amounts paid by any health care consumer; for instance, my wife and i are currently covered by her work insurance to the tune of about $550 per month and her coverage is paid by them. We are now in our early 60 s and ready to retire. Last year i had bladder cancer. what can we expect to pay for full coverage next year assuming we are retired and to whom would we pay premiums ?

    1. Anonymous3:51 PM

      My thoughts exactly..finally someone asked the question, what is this going to cost consumers? What will the ballpark premium be for specific age ranges?

    2. I am an insurance broker. Unfortunately the government has not released ALL of the plan cost to us. But from what I have read and had conversations with the insurance companies, the rates for individual insurance or going to increase by as little as 150%, if your wife's company is a small group, they have the choice to continue to pay for you or not at no penalty to them. They also have the choice to had some of the cost over to the employee. It is still VERY unclear as to any amounts that premiums will be set at for ANY of the silver bronze, gold or platinum plans as of yet.

  15. Duane9:15 AM

    My exception to this is Someone ELSE gets to say what I "can afford", regardless of the reality that I cannot. People with current coverage can lose that coverage because the Insurance company will drop those policies at their discretion. ANYONE or ANY Company that is "taxed" for particulars, will ALWAYS pass this on to Consumers. Anyone who didn't realize insurance is a money train for the insurers probably needs to be thinned from the herd. If I choose to go ahead and let whatever medical condition affects me to simply proceed, I will be penalized and forced to pay for YOUR insurance. Next time you're at the grocery store, sample this practice & pay for someone elses groceries. "Fixed Income" is exactly that, increasing taxes for insurance, lowering one's care level by "decreasing Medicare costs" is an income double whammy. If you cannot afford insurance, but are told you can, you're penalized. If you need coverage and should use it due to health issues, you'll be avoiding obtaining care till you can't function without it, due to the burdens on your income, "fixed" or not. For some reason, I am not permitted to function using "Deficit Spending" and simply forcing others to pay my way! Canada isn't that far to go for those who want Socialized Government. Feel free.

  16. Anonymous12:30 PM

    Less and less young people will choose the medical profession because of the headaches dealing with our government process to be paid. Yes you will medical insurance, but you may have a long wait to see a doctor.

    1. Anonymous10:14 AM

      Unfortunately, I graduated from my medical assistant class about a year before Obamacare was put into effect. I didn't get the chance to decide if I wanted to deal with the headache that now comes along with this profession. I now owe $25,000 in student loans for a job that, in a few years, will most likely belong in the toilet.

  17. Anonymous4:16 AM

    Businesses with over 50 employees have to offer insurance or PAY A PENALTY...explain please...
    Why wouldn't they choose to pay the penalty rather then dish out millions for their employees?? My husband chose a profession 22 years ago based on what his employer promised..i will give you THIS in exchange for your services...How is this legal?

  18. Anonymous11:00 AM

    My concern here is that if you put all of the taxes and restrictions on the Docs, and pharmacy companies, who is going to want to practice here. Let's face it they became doctors not only to help people, but because it is lucrative even after paying all of their malpractice fees etc. and my other question is; who gets to say whether I can afford health care? And why is it medicare is always being taken from rather than added to? I believe in accountability but I also believe that this nation looks to the elderly as the 'throw-a-way generation' It is disheartening to watch the grandparents of this nation struggle and worry about their health and fiscal future when they are least able to cognitively do so. (My pet peeve)

  19. Anonymous11:03 AM

    Oh and the other thing, Employers are loath to hire full-time workers due to all of the extra fees and mandates that are being demanded of them. So laying it at their feet once more, how does that help us in the workforce? We are all just stuck holding two and three partime jobs and having to buy our own insurance once again. There is cause and effect here.

  20. Anonymous5:52 PM

    A lot of valid arguments. I do ask, however, where is stated anywhere about OUR personal responsibility to take the best care of ourselves as we can so we won't need to utilize whatever system is in effect at the time? Or at least as little as we can? It seems that we've been given the "pass" to place the blame or cost without considering our own responsibility in taking care of ourselves. I do know that "things" do happen, but many experts across the board tell us that 70% of illness is lifestyle related. I believe it (consider stress levels for example). If we were just dealing with 30% of our current illnesses, we'd solve the healthcare problem not to mention lower our personal and national debt and just live better healthier lives.

    1. This interpretation is the biggest crock I have ever had the displeasure if reading. First, I went to medical school. What magazine or tv show did you get your information from? 70 percent due to lifestyle causes.. Really?!? Lol. You're ignorance makes my blood boil and we'll see how you feel about your healthy lifestyle choices brand if thinking when you develop an in curable disease, but say, "I ate my carrots and broccoli though!" Did you know most cancer patients never smoked a cigarette in their life. Some have never been within the range of smokers.
      Go visit a women's and children's hospital and blog about what you see.
      At 16 I was diagnosed with cancer... Had to succumb to chemotherapy and radiation treatments to prolong life but with a huge decline in the quality of it as the aftermath. I was born with heart diesel, a disease in my shoulders that makes other ppl believe I slouch because it looks oh so cool, have hypoglycemia, have damaged nerves, fibromyalgia, scoliosis, anxiety disorder and depression linked to my genetic heritage, ulcerative colitis, uterine prolapse forcing me to have a hysterectomy before 30, prone to infections, a brain disease I was born with.... I could go on forever! I live a healthy lifestyle but have never in my life had good health. I practically still live in hospitals and dr.'s offices. I've lost 6 friends under the age of 30 to cancer, most of my relatives, friends relatives to diabetes, cancer, and heart disease. My friend was diagnosed with diabetes at 16 months of age. He is the biggest health nut I know. He is also a body builder, and in MMA. That does not stop his sugar from getting too high or too low. So you think he can merely stop taking his shots... Insulin, glucose because he chooses to live a healthy lifestyle? Hey he wouldn't have to pay for them anymore...He'd be dead despite his "lifestyle choices."
      My grandmother can no longer get her medication for the unrelenting pain she is in because people over 60 "are going to die soon anyway." My diabetic grandfather, who just lost his foot ( no pain meds for him) .. Also has cancer and they're trying to take those meds away from him as well. *Severely disgusted*

  21. Anonymous9:06 PM

    Who determines if you can afford it and if you are determined to be unable to afford it...what do you get? Free healthcare or no healthcare? If you get it free then who pays for it? And if you can afford it by a thousand dollars or so of income then why not work less instead of paying for the mandated insurance? And if taxes only increased in Jan 2013 for those making over 200,00 a year then wht is my paycheck $23 less per week now than in dec 2012? My employer says it is from increase in ss tax and Medicare tax. Is that not related to obamacare? Is it cheaper to get 2 part time jobs and qualify for free insurance or get three part time jobs and pay for insurance? And who decides if a doctor is giving quality care? How exactly does that work? Asking because I really need to know the answers.

    1. The government has issued a formula to determine affordability. If your employer offers coverage but asks you to pay part of it, your total household income comes into play. If your portion is more that 9.5% of your household income, than it is deemed unaffordable and you can find your own coverage outside of the office. if you make too much money( another formula based on the poverty level as per the govnmnt) you will receive a smaller subsidy than the guy making less if you go through the governments exchanges.

  22. Anonymous7:21 AM

    Who determines if I can afford healthcare? I remember when $60,000 a year sounded like decent money for the area I live in. But after you take out all of our bills (house pmt, 1 car pmt, power, water...etc.) We're left with $600 for gas, groceries, and all miscellaneous expenses that come up for 2 weeks. We really have to be creative to make that last. The car we're paying on has 95,000 miles on it, our second car has 200,000 miles on it, and we're hoping these last an unnaturally long time. We don't live extravagantly (obviously) so who decides we don't have to pay this fee?

  23. Anonymous11:54 PM

    I'm a healthy American who is not so well off financially with 2 kids and one one the way, and I say this is all a load of bull. Coast have gone up, my taxes this year went up, and now I have to pay a fine because you guessed it I am opting out of a extremely overpriced service that would only bankrupt my family to help pay for insurance for the fat guy down the street that sits around looking at child porn and drinking beer. This is really stupid. The company insurance plan I was offered "thanks" to this bill was over $500 dollars 1/4 my income at the time. we calculated it out with the $500 premium a month, 2,500 dollar deductible, and only 80/20 coverage it was far more expensive to have insurance then it was to pay out of pocket and I couldn't pay the premiums anyway. Then people say what if something grave happened? good question say my wife did end up with a 100,000 dollar hospital bill at 80/20 coverage I'm still screwed that is $20,000 dollars for you who suck at math. I I can't pay that I'm going to end up in bankruptcy either way difference is if I wasn't paying for insurance I could at least feed my family tell then and if this odd and rare disaster didn't happen I would of saved several thousand dollars a year. Oh well what about the preventive medicine. Truth is it covers very little and you would be much better off just doing what your suppose to like drinking water, exercising, getting good rest, and eating right which would actually wring true with the true definition of preventive

    1. You can still opt out of the insurance, you just get a fee. The fee that you receive if you decide to opt out of insurance is significantly less than if you buy insurance. It is no different than any other tax. What this does is puts more money into the health care industry and gets rid of freeloaders (people who don't buy healthcare and only go to the emergency room and then don't pay the bill, which rises premiums for families with insurance).

    2. Anonymous11:17 AM

      You mean added a bunch of freeloaders who now have coverage and will go to the docter when they dont need to in their early 20s.

  24. Anonymous6:23 PM

    All that is listed here is all fine and good; but the reality is that those who are offered health benefits through their employers at a part time status will be hurt the most. Corporations will avoid penalties by reducing the hours of their part-time employees, less hours means less pay. In addition this act also makes it "illegal" for benefits to be offered to part time employees working less than 30 hours. Companies don't care because they can fill business demands by hiring more staff for less hours. Smaller paychecks mean out-of-pocket insurance will be harder to cover, not to mention smaller paychecks also mean its harder to survive, then when they raise minimum wage as NY is proposing, the cost of living will rise, coupled with ObamaCare will make it near impossible to keep food on the table if you are in the middle class making ANYTHING above minimum wage. I've got a bad feeling about this whole thing personally.

  25. Anonymous3:28 PM

    Here's how it hurts us though my company just took over 190 full time employees and made them part time under 28 hours a week so ok ya the bill seems great but the companies are now hurting the little Ppl because of it so i went from having 40+ hours a week to only having 28 how am i paying my bills now and taking care of my family

  26. Anonymous10:15 AM

    I've been unemployed since 2009 and have been paying for my own health insurance for the past 4 years. I am a single woman and pay $17,148 a year. This is the cheapest insurance plan for an individual. It has gone up about $200 each year to this amount. I have been paying this from my savings account all these years without any other income. I just started collecting Social Security and after paying my insurance have $520 a month to live. I have a mortgage and a ton of bills. What do I do? I have spent around $65,000 so far on health insurance. My savings are deminishing. Health Insurance is a Killer. I was told by another insurance company, Healthy New York, for New Yorkers that I can only switch if I am terminated by my previous insurance company or I would have to wait one year without insurance. Any thoughts???

  27. I have been disabled since 2000,, and used a pvt medicare complete insurance since then,, my premiums have gone up yearly,, benefits are gradually being reduced also,, and still have to co-pay each visit and use the 80/20 plan,, they all are like that sadly,,
    my wife has even worse coverage,, and has waited over 1-1/2 yrs now for a hearing on her disability acceptance,, just to be added to the dismal coverage i have.. as a veteran Union Activist ( 20yr ),, i have tried working with Congress for the rights of employees,, and seen 1st hand the the attitude of those in the political arena with the "" what can you do for me "" attitude,, with no regard for the people they (supposedly) represent.
    We need to have our voices heard in response to the political fund raisers,, bribery concealed as contributions,, Lobbying by companies of all stripes,, in all areas of legislative, judicial,, and representative arenas, Local, State and Federal.
    If our elected personnel had to fund their own campaigns,, i would think there would be a more balanced and equitable plan of action between all the concerned individuals involved,,,,,,,
    well ,, wet dreams aside,, We The American Public,, need to take off the rose colored glasses, and watch for the wolves in sheep's clothing that permeate our society.

  28. Anonymous2:22 PM

    people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them.

    I did not clearly understand this point!

    1. Anonymous3:33 PM

      That means that people with pre-existing conditions can get coverage at extremely higher rates and deductables!

  29. The grass always seems greener on the other side, and that is because the BS is more abundance. What is our country coming to our politicians only think of themselves, at least most of them?!!!

    I think we're going to be in for a rude awakening.

  30. I make less than 20g a a single mother. I cant afford the insurance i need to see my cancer doctors can some one. Please explain what happens if i dont get insurance.rather than become homeless for a second time in my life?

  31. An excellent, if biased, summary of the ignorance of this bill. Nothing "Affordable" about it other than it lowers the cost to the Federal govt by a small bit. This "savings" comes at the expense of those that pay for insurance. Much of the provisos of the bill individually raise general health insurance rates. NOTHING in the bill reduces overall health care costs with the possible exception of the preventative testing (only if done correctly, if that could actually happen.)

    It was stupid when they wrote it, Obama has administered it horribly, businesses have adjusted by firing people, reducing their hours to part-time, or taking away their benefits packages.

    Great plan...

  32. An excellent, if biased, summary of the ignorance of this bill. Nothing "Affordable" about it other than it lowers the cost to the Federal govt by a small bit. This "savings" comes at the expense of those that pay for insurance. Much of the provisos of the bill individually raise general health insurance rates. NOTHING in the bill reduces overall health care costs with the possible exception of the preventative testing (only if done correctly, if that could actually happen.)

    It was stupid when they wrote it, Obama has administered it horribly, businesses have adjusted by firing people, reducing their hours to part-time, or taking away their benefits packages.

    Great plan...

  33. Anonymous3:36 PM

    Morality was brought to man by Jesus Christ.

  34. Anonymous9:49 AM

    I'm a pre-college student with good health insurance through my employer, I'm part time in a private retail chain, but I worked hard to earn full time hours(I've been screwed out of the official promotion several times), and now that Obamacare is starting to kick in I can no longer afford the place I am renting even, at $300 a month. On top of that I'm losing the health care that is paid for me by my employer - so how am I supposed to afford a plan out of pocket?

  35. Anonymous9:36 AM

    "A new tax on pharmaceutical companies. A new tax on the purchase of medical devices. A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed."

    Who will be paying these new taxes? The companies? No. The customer/insured? YES!

    "Affordable" is a little deceiving.

  36. The Obama care will never work because they are allowing the insurance companies to run it and their God is money. There are enough health care models around the world that work I suppose it would have meant work for the government to adopt one these.
    I have experienced the UK model which in my opinion is excellent I know the US produced a lot of negative propaganda about the UK health care system.
    If the UK did not have the immigrant problem their system would work perfectly but they have half of Europe and anyone that has managed to get hold of a UK passport getting free medical.

  37. Here's the question: What about people who don't WANT health insurance? If they get sick and die, that'd be their choice, but it is a choice.
    Or what about people like the Amish?

  38. Anonymous12:52 PM

    Here's the deal, companies will only hire part-time employees and those that currently have more than 50 full-time employees will begin layoffs and reductions, this is already happening. For those millions that will not be able to afford insurance it will be provided by the taxpayers. Since our government cannot currently manage the budget for existing programs where do you think the money for this will come from? Higher taxes. The problems are huge and Obama has not been the answer for any of them, thanks libtards for electing him.

  39. You neglect to include all of the other taxes that are happening to fund this initiative, such as the sale of a home tax of 3.8%. Article would be stronger with facts.

  40. Anonymous2:37 PM

    "or ending the wars, or legalizing marijuana, or (insert your favorite pet peeve here.)"

    American citizens dying in unnecessary wars of national ego resource monopoly is a 'pet peeve'? Are you kidding?? Maybe you should think about your words a little more carefully.

  41. Anonymous1:16 AM

    If more people are working less hours how are all these new taxes going to be paid to make this afford able?

  42. Anonymous6:49 PM

    I see that a lot of people are drinking tthe kool-aid.

  43. Anonymous10:31 AM

    I dont think people look at the insurance companies point of view. Why should an insurance company have to pay millions of dollars in claims for someone who has a deadly condition and the person only has to pay a small premium? The whole point in operating a business is to make money. I dont think insurance companies are "price gouging" but mearly trying to make money, invest it wisely, and build up their business. Then it all circulates in a circle. The more doctors and hospitals charge for healthcare services, the more insurance companies have to increase there prices in order to actually profit. I mean cmon, $10,000 for a catscan! Be realistic. Medical providers need to quit billing insurance companies such outragious prices for their services.

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