The Affordable Care act is not a “mandate.” It’s government paying for your private insurance when your employer doesn’t.

What’s a synonym for “mandate plus a subsidy”? Government buys you insurance, with a small contribution. Let’s put it the second way.

My post on why the ACA will become popular was too long and confusing.  Shorter me:

The phrase “individual mandate,” though it explained to wonks how we were going to achieve near-universal coverage, was always bound to make for atrocious framing.  Pairing it with a subsidy is great policy but possibly even worse framing.  Now one thing people don’t like—being told by the government what to do—is supposed to be made better by another thing they don’t like—admitting they need government help.

Here is another way of describing ACA that’s completely accurate but explains the point much better:

“If you or your family aren’t getting health insurance through your job, the government will pay to get you private insurance coverage, just as an employer would.  You’ll have to contribute something—but the law guarantees, with specific numbers, that it will be no more than you can afford. It’ll be less than three percent of your paycheck if your family makes $33,000 a year, less than ten percent if you make as much as $88,000.  Pre-existing conditions won’t matter.  The government will still pay for your insurance, with the same affordable contribution from you.”

The bill has lots more—things that make it even better.  But that, it seems to me, is the basic idea.  And if we drill it in, people (Fox News junkies aside) will stop imagining that the bill is somehow about government telling people without insurance that they have to get it because the government won’t help them.  It’s the opposite.  Under ACA, it’s the government’s job to get you insurance, and to pay for almost all of it if you can’t afford it.  Before, you were on your own.

Objections?  Can we sink the “mandate” language once and for all?  And can anyone explain to me whether (or why) anybody ever though “individual mandate” sounded good politically?

Author: Andrew Sabl

Andrew Sabl, a political theorist, is Associate Professor of Political Science at the University of Toronto. He is the author of Ruling Passions: Political Offices and Democratic Ethics and Hume’s Politics: Coordination and Crisis in the History of England, both from Princeton University Press. His research interests include political ethics, liberal and democratic theory, toleration, the work of David Hume, and the realist school of contemporary political thought. He is currently finishing a book for Harvard University Press titled The Uses of Hypocrisy: An Essay on Toleration. He divides his time between Toronto and Brooklyn.

65 thoughts on “The Affordable Care act is not a “mandate.” It’s government paying for your private insurance when your employer doesn’t.”

  1. Andrew, that's LOOKS good, but it doesn't match the facts on the ground:

    1) I'm paying $550/month for one unemployed 55-year old under CALCOBRA – the actual check goes to Anthem and the rate increase is still in effect. I have a slightly low blood count that I've had all my life and that didn't prevent me from getting private ins. when I was in my 40s. Now there is no company that will issue me a policy because of this "pre-existing condition" so I've been paying these obscene COBRA and CALCOBRA rates. I haven't had to use the doctor but I have to have insurance to protect my savings and house.

    2) The CALCOBRA runs out soon, after which all that's left is HIPAA which is over $800/month

    3) As far as I can tell, none of this changes until after 2014.

    In '08, I donated $3,000 to dems and worked long hours in campaign offices, but I guarantee that I won't donate to, work for, or vote for another democrat until I have affordable health care.

  2. Obsessed,

    If they had never passed healthcare at all you would be far worse off – yet you're withholding support because the full changes do not come into effect until 2014? They passed the unpassable and yet you're almost defecting because there's a four-year delay? I don't really understand how people can take this sort of stand. They got it done – likely at a great political cost – and they passed it for people in your situation. Seems a touch irrational to punish them for a delay of effect.

  3. Obsessed,

    I'm not inclined to get angry at you. You're sick, you ought to have had access to insurance long ago, and I'll admit that the ACA doesn't fully kick in until 2014. Even the catastrophic insurance for high-risk patience that's been set up as a stopgap requires a gap in coverage of six months before it kicks in, I think–which means you're left high and dry for those six months.

    However, I wonder whether this particular criticism–the delay involved, not the eventual result–wouldn't have applied to any possible alternative as well. I support the public option. In fact, I support single-payer (with caveats: I think hypochondriacs or people who like swish hospital rooms ought to be able to by supplementary coverage). But given that the insurance exchanges under ABA will take years to set up, doesn't it seem likely that the public option would have taken a while to set up too? I don't think any country has achieved universal coverage at a stroke.

  4. Question: I am an Obama supporter and in favor of the healthcare reforms in this bill. While I think your point is important, isn't it also true that individuals who can afford health insurance and choose not to obtain it are subject to fines? So, I think we have to keep "mandate" in the healthcare lexicon, because it does have requirements for people who would not qualify for government assistance.

  5. "And can anyone explain to me whether (or why) anybody ever though “individual mandate” sounded good politically?"

    I don't think anyone ever did. People supporting the mandate always referred to those provisions using language like "individual responsibility".

  6. They didn't think it sounded good politically. They inadvertently forgot to use Orwellian doubletalk. What's the definition of a "Gaff"? A politician inadvertently telling the truth.

  7. Andrew,

    If you're using my health as a reason no to get mad at me, the irony is that I'm not sick. I'm 55. I go to the doctor once a year for a physical. I've never had any disease and when I was in my 40s, the insurance company took me willingly, knowing about my slightly low blood count. They don't people over 50, period. I don't smoke, I'm not overweight, bla bla bla. If you're 55, they will dump you for any reason they can. Just you wait, as Eliza Doolittle would say, just you wait.


    If they had passed nothing I would NOT be far worse off. I'd be right where I am. As a matter of fact, I'm getting screwed a lot worse now than I was under Bush because my rapidly-expiring CALCOBRA is affected by the Anthem rate increase that Obama used to collect donations and then did absolutely nothing about.

    I spent my life buying a house and trying (unsuccessfully) to save enough for a comfortable retirement. I cannot afford to leave those assets uninsured, so I'm going to have to pay over $800/mo (maybe a lot more) for the rest of the Obama presidency to protect against the chance that I will get sick. As Andrew says, the bogus "high risk pool" is completely worthless. I'd no sooner go naked 6 months than jump out of a plane without a parachute.

    Obama made the cynical calculation to screw me and the other baby-boomers in my position instead of laying down the law to the health insurers. We'll see how smart that turns out to be. Maybe it was smart, in which case, I'm just acceptable collateral damage, but by stabbing me in the back Obama turned a $3,000 donor and campaign worker into a very angry, very cynical enemy. You people simply aren't old enough or un/self-employed enough to have been affected by this, so you can sit in your ivory towers and gloat about the great progressive success of it all. Those of us who live in the real world know that it's pure BS.

    re: "mandates"

    Since I want to buy a policy and can't get one, this BS about mandates just makes more steam come out of my ears. So if I go naked for 6 months to try to get into the "high risk pool" I have to pay a fine for not staying on HIPAA? The whole thing is cruel, ridiculous and deeply corrupt.

  8. obsessed, I really have no idea what you're talking about. Using words like "cynical calculation" to describe a person you claim to have campaigned for under the theme of "hope!" is a dead give away.

    Be a man, and quit hiding behind lies.

    Because ultimately, that's what you're doing. The funny thing is, you're pretty effective at hiding behind these rationalizations to hate the president just like the rest of the so called "teabagger" movement.

    Even though the media and others are baffled by the confusing nature of the things you folks are "angry" about and think that most of you are just confused; I see your game.

    It's clear, just as Bush discovered while President, it's extremely difficult to make sense when you're trying to spew lies that you didn't even think up on your own!

    If you actually thought about the issues, did some research (no this does not mean reading DRUGDE), and decided what is really important to YOU; I BET YOU WOULDN'T SOUND LIKE A GUY JUST OUT OF A PSYCH WARD!

    Until that time, you're a pawn in a game that always ends with you losing.

  9. I'm in agreement with Obsessed, but I will stay with the Dems – to have some sort of win situation.

    I'm 61, and can't buy insurance due to "pre-existing conditions". I have house equity which is totally vulnerable – my life's total monitary accumulation. Completely at risk.

    A while back, I was laid off, and went on the COBRA extension. CAL-COBRA is a second 18 month extension, but – my insurance and place of employment was headquartered in Massachusetts, and the CAL-part didn't apply! I couldn't have the extension. So much for selling policies across state lines as the Republicans think is a solution.

  10. I'm curious about how big the population of "young invincibles" is. I saw somewhere that about 25 percent of the uninsured young invincibles can afford health insurance, at least on paper, but choose not to. I was in this group when I tended bar for periods in my 20s. My brother in law, a contractor, held out well into his 30s, and would have continued had not my sister put him on her plan (she was a teacher). About 40 percent of the uninsured earn at least 2.5 times poverty level ($55,000) for a family of four– I don't know what the scale is here, but even $3000 is a lot of cash for such a family. Some portion of the insured young invincibles have coverage through their employers, but if they all got an offer to drop their health insurance and buy a new Silverado, well, it'd be agood time to pick up a little GM stock.

    So if you are young and healthy and living month to month, it's not hard to understand the willingness to take the risk, and the resentment in being forced not to . . . by the nanny government. This "young invincible" demographic is also a big, and noisy in the blogoshpere, part of the FOX news audience.

  11. i am 58 years old and without insurance for three years when my cobra coverage ran out. I immediately applied for and was declined coverage by both Blue Cross and Kaiser due to pre-existing conditions. I have been un-insurable since high school but eventually everyone become un-insurable so

    When I called Senators Boxers office to find out how to apply for coverage under the guaranteed issue rules just past I almost broke down and cried when I was told that I had to wait till 2014 to buy insurance.

    The more I think about it the madder and madder I get. Obama went to the mat for non-productive children and young adults with little or no economic value to their families and turned his back on us baby boomers. Folks with families and responsibilites he fucked. But for sentimental reasons he fought hard for those with little or nothtng to lose.

    Yea I'm pissed. I feel betrayed, stabbed in the back. I've voted democrat all my life and I never got a single benefit for doing so. I supported civil rights for blacks, I've supported equal pay for women, I've supported gay rights, I've supported every liberal cause you can think of and I've never looked for anything for myself. Now that I finally could look forward to a real concrete improvement in my life I am told to forget it, later, kids are more important. KIDS???? What the fuck have they ever done for the democratic party?

  12. Richard Crew,

    The company that laid me off was out of New York. They tried to cut off my cobra at 18 months but I called my California legislative rep.( a republican) and they escalated the issue to Sacremento where some State Agency made sure that the New York company abided by California rules. That is the law. I had to pay all the back premiums for the months that we were disputing the issue but eventually I got my cobra coverage extended for the 36 months guaranteed to everyone in California.

    I know how you feel. Unless someone with a family and assets and responsibilities goes without health insurance they have no clue how at risk you feel.

    Call your state representative and ask for help.

  13. Hey Ken,

    Let me understand, you feel stabbed in the back because kids were insured first? Wow. You are a true example of a man of virtue (like you said: "unless someone with a family and assets and responsibilities goes without health insurance they have no clue how at risk you feel")!

    I wonder how you would feel if you voted for the other guy in 2008 and nothing happened for the next 4 years?! I guess when you consider it a great sacrifice to vote for people who consider women, minorities and children as equals it must be very difficult for you.

    Poor sad little Ken.

    By the way, my newborn baby girl? I feel really good knowing that no matter what happens to me and my job, she won't die because I can't get her insured.

    That's my number one worry. But you're a family man, I'm sure you understand.

  14. Dear Obsessed,

    That's just what insurance COSTS for people our age. It is a lot, indeed, but the only thing that would have changed that is single payer, and there wasn't an ice cube's chance in hell that we were going to get single payer at this stage.

    People our age have to be altruistic and realize this bill won't help us very much, but is a first step toward more affordable health care for generations to come.

    And it will eventually, we can hope, lead to a public option, that by it's popularity will eventually become de facto single payer.

    Obama did not stab you, personally, in the back. Nor did he stab Baby Boomers in the back. You know who did that? Joe Lieberman did that, by sinking the almost sure thing "let seniors buy into Medicare" solution, just because Wiener liked it.

    Blame him.

    The ONLY chance to get this bill passed was for the House to pass the Senate bill, as they did.

    Please, take a few deep breaths. I KNOW it's expensive. BTW, I think the "high-risk pool" will cost approximately what HIPAA does, as that's what HIPAA coverage IS.

    And I don't see how you would have been better under Bush. At least you got an extension on your COBRA, didn't you?

    Finally, a word of advice from someone in almost exactly your position: apply for the Kaiser MRMIPs coverage if you can. It is MUCH cheaper than the Anthem plan here in California. And apply for it now for a starting date when your CALCOBRA actually runs out. That will move you up the waiting list.

  15. Sorry, Obsessed.

    It's not HIPAA that is analogous to the high-risk pool, it is the California MRMIPs program (Major Risk Medical Insurance Program) that is our local high-risk program. When I priced it, Kaiser's plan was about what you're paying for CALCOBRA.

  16. Ken, you, too, should look into MRMIPs.

    California DOES have a high-risk medical insurance program. The main problem with it is that it fills up, so apply ASAP to get yourself on its waiting list. You can, in fact, apply for it before your other coverage runs out, which is a great idea, as you assure your place on the waiting list so that you might have no lapse in coverage.

  17. yeah bubbly, I feel betrayed. Obama spent his political capital going to bat for the least needy (and worthy) cohort of Americans you can imagine. If you are going to dole out coverage in dribs and drabs who should be first in line? A group with little or no responsibility or economic value to anyone? Or a group with large responsibilities and economic value to their families and to society?

    I feel especially bitter because I know that this chance will never come around again and all my loyalty to the democratic party was for nothing.In time a great need millions of folks like me were shoved aside for a political show instead of a solid health reform. Just compare it to past liberal programs like Medicare and Social Security that target the most vunerable members of society. You didn't have Johnson or Roosevelt wasting effort on enrolling the least likely to need the protection of their programs, did you? NO! They took a simple direct approach to cover folks who needed it and when the legislation was signed into law you didn't see a less needy or worthy cohort step in line ahead of those who truly needed or deserves the protections.

    And fuck you with your snot nosed attitude you little prick. Really, fuck you.

    There was never was a crisis of uninsured little girls in this country, asshole. The crisis is with aging baby boomers left high and dry without insurance, with families and responsibilities and with pre-existing conditions developed over a lifetime of hard work.

  18. So, let me get this straight: after 40 if not 100 years, on a legislative battle field littered with the inglorious remains of previous failed efforts from Presidents and majority leaders of both parties, against the odds, despite a great deal of "helpful advice", and at some considerable political risk, Obama manages what no previous administration has done and enacts legislation that for the first time will ensure that the vast majority of American citizens and legally documented immigrants will have affordable, reliable health insurance — and obsessed and ken are consumed with a sense of betrayal because the law will take time to go into full effect?

    And ken in particular is getting all vituperative about how some kids (and other groups he isn't interested in) don't have to wait as long, and is willfully and entirely ignoring the benefits that will be coming online within a couple of years?

    You'll perhaps pardon me if I suspect the sincerity of their disappointment – I think that, at best, they were eagerly waiting for their chance to become disappointed. In a similar vein, is commenter "ken" the same blog commenter "ken" who was such a vehement PUMA back in 2008?

  19. @Warren Terra

    The irony is that Ken & Obsessed are upset because they'll be close to 65 and thus receiving single-payer healthcare benefits from Medicare before ACA takes full effect. I can't say I'm that empathetic. In either case the government is paying their healthcare costs.

    Yes, I too wish that this bill was enacted more quickly, but if we want to make big changes it is important that we don't act hastily. Better that this legislation is carefully implemented over a longer timeframe so that it is done right and lasts a long time.

  20. ACA is a framework not a monument. It will need continuous tweaks, especially on cost control, as Ezra Klein keeps saying; so why not on coverage? If the economy improves – and it surely will – bringing forward the big changes is going to look more affordable. I´m sorry too tor Obsessed and Ken, but you are now part of a single lobby for public health care – the whole American people. Just keep campaigning for your rights. The RBC will I think still be on your side.

  21. I may be a snot nosed little prick, but I know for sure, I don't think I've even met a person let alone a self-described Democrat who refers to children as "A group with little or no responsibility or economic value to anyone."

    Wow. I think you've confused page with the one titled Lie-Based Consortium.

    You should check here for information less confusing:
    I think they're more your speed.

  22. I think the mandate language is important, and captures a key feature, because 10% of $66000 is more than twice what currently-available insurance costs IF you are healthy. And most people are healthy.

  23. ken you do realize that without the young paying into the system nothing else is financially possible don't you? How do you think we get $143 billion deficit reduction the first 10 years and $1.2 trillion the next 10 years without it? It sure isn't because we cover everyone from the start.

    As for what this group "with little or no responsibility or economic value to anyone" did for the Democratic party and Obama they came out in droves to not only vote but volunteer for him during the election. In particular if it hadn't been for young people in IA and those who came to IA to put him over the top there would be no Obama presidency at all. Without them IA caucus goers would have given us a "safe" choice, Hillary who already failed at passing health care reform, ran a lousy campaign, and was the only candidate on either side who could fire up the Republican base, or John Edwards who we all know in hindsight would have been an utter disaster.

    Yeah this bill isn't perfect. But it's not for lack of trying on Obama's part. He spent last summer making 62 townhall meetings answering questions from all comers. If you have a beef with anyone take it up with the leaders in the house and senate. Why weren't they on teevee all summer long being interviewed on MSNBC and CNN selling the benefits of passing good legislation to counter the nonsense?

    I'm 54 years old and don't even own a home anymore. I haven't had any insurance since 2002 when my ex lost her job. I'm a pretty lucky guy as I have no health problems I know of though I haven't had a physical since the 1990s.

    Cal Gal is right, if you want to blame anyone blame Joe Lieberman, he's the guy who shot down Medicare buy-in which would have helped you (but not me, at least for another year). But I ask you what would that cost? My guess is it would have killed any deficit reduction in the first 10 years. And again, I bring up cost because in case you haven't noticed the Republicans whom you seem all too willing to concede the next election to spent your health care dollars in Iraq. And if they had their way they'd spend your Social Security and Medicare too.

  24. The problem is NOT the mandate to purchase. Its the definition of acceptable insurance. There are so many mandates on what an acceptable policy is.

    That along with mandiator acceptance makes everyone market like New York State's Market.… put in a NYS zip code like 10023 then try to find a plan that

    meets the required standard of the bronze required plan. IE. total coverage for drugs, low co-pay for "preventative care".

    For a man and wife. $1,668.02 to $2,456.40 a month. Note even theses have illegal drug cost deductibles.

    which is $20,016 to 29,472 a year.

    Now please note this 20k to 30k is STILL NOT tax deductible. So a couple making 100k a year will be be required

    to spend 20% to 30% of their pre tax income on health insurance.

    Now assuming they only paid federal tax of $12,000 and no state or local tax.

    Their post tax income 88k so they will be required to pay up to 34% of post tax

    income on health insurance.

    Of course the sad thing is that a person with $100k can currently afford $400 month For

    hospital or high deductible policy and maybe $2000 to $3000 in cash a year. to pay for their

    doctors and preventive care.

    You can continue to dream that the opposition is wrong. But you need to look at the numbers.

    They don't work. The bill does NOT make insurance affordable.

    read my post about other problems with the bill

    25% equals Fail : Understanding The health Care Bill

    25% equals Fail : Understanding The health Care Bill

    Please talk to you congress critters and tell them that the plan they are voting on is critically flawed.

    #1 It more tightly ties health insurance to employment. Since the average time any American spends on a job is only 4 years there is no benefit for health insurance to keep the person healthy for a lifetime, which is the only hope to reduce cost in the long term and improve service (like in the VA)

    #2 In a world where the median healthcare spending is about $700 per person (that means 50% of the people in the country use less than $700 of medical services a year). Its unconscionable that everyone will be required by law to spend 8 to 12% of their income on health insurance before they get government help to purchase health insurance.

    #3 It unconscionable that the federal government will pass an unfunded mandate by increasing the number of people on Medicaid without having long term federal funding solution to this huge increase for state's budgets.

    #4 But the biggest fail of this monstrosity is that after all of this spending. 18 million American still wont have health insurance. Since they say 40 million don't have insurance now. Only 22 million will get insurance (mainly because of mandate details below)
    As you can see 17% of the uninsured are 400% of more of the poverty level who wont get any government aid to purchase insurance. So the mandate alone adds 10 million more insured. So everything else only insures 12 million more people. At a cost of about 200 billion a year. Which is $16,666. per extra insured person per year.

    (Just to clarify it doesn't cost $16,666 a year to purchase health insurance of a person in the individual market).

    10 million extra insured out of 40 million uninsured today is 25% more insured. 25% by any measure is failure.

    Tell congress to try again.

  25. Dennis the Peasant aka Kenton Kelly the third doesn't know squat about health care or policy in general. Citing wingnut teabaggers with anger issues like him doesn't help your case.

  26. I'm still ticked that the People are paying for uncontrolled insurance rates. I agree it is imperative for all people to have health care when needed.

    I think it's bad fiduciary management and a ridiculous shell game to continue to pick up the inflated and abusive costs through taxes on the back end. Cut out the middle men!

  27. why in the hell would you buy different health insurance if you and your wife make 100k? Keep the insurance you've got, duh.

    My wife pays for health insurance from her job. This bill doesn't do much of anything for her at the moment accept provide reassurance that if she is ever let go, she'll still be insured through the govt.

    If you are already insured, why would you care at all what this bill says?

    If you are working and not insured or get a better insurance deal privately without the government, THEN KEEP YOUR CURRENT INSURANCE PLAN, duh.

    Just throwing some numbers around may confuse most folks but these arguements are worse than the ones that blame children for getting too much attentino.

    What a bunch of crazies.

  28. Bubbly – you're a troll. You can champion the health care system all you want, but it will catch up to you. It's like Vegas. You've been winning at roulette. Don't count on it lasting.

    CalGal – Thanks for all the ideas. Unfortunately:

    1) Neither the COBRA extension nor the COBRA subsidy applied to me – laid off in May '08

    2) Kaiser won't take me because I live too far from the nearest facility.

  29. So let me get this straight…

    Sure, you're being forced to do something against your will (buy health care), but it's good for you, and we're paying some of the expense, so it's OK?

    Wasn't that a line of reasoning that caused that big kerfuffle about 150 years ago?

    Plus, there's basically no effort to control costs in this thing, so insurance premiums are going to skyrocket. The fix to that, of course, is for government to step in and fix prices, which will drive innovation out of the drug and medical device industries (the US consumer pays for R&D for most of the world, because (most of) the rest of the world implements price controls)

    What's the solution then? Government funding of R&D? That'll save money, for sure.

    My first child's due in a couple of months, and I'm saddened that we, selfishly, have mortgaged her future, or more accurately sold her into indentured servitude for a progressive experiment we simply can't afford. And it's even more sad, because I KNOW it's happening.


    If it's the sort of plan our lords and masters in Washington just outlawed, WE CAN'T, duh. I've got high deductible plan with my employer contributing to my FSA. They can't continue offering that, never mind that it's a great plan.

  31. Okay let me help you: It's been well known for AT LEAST the last three decades that this country was going to run into problems with health care. People are living longer, and science and medicine is coming together to create opportunities for surviving previously fatal conditions and diseases. In the 70's, rather than solve the problem, Nixon's Administration crafted an idea for profit oriented health organizations.

    How's that working out for you?

    Guess who spends millions of dollars so they don't have to make insurance better and cheaper?

    Guess who is motivated the most to not give health insurance to children or those with pre-existing conditions?

    AS A FIRST STEP, government is creating a market for health insurance to help stem the costs for those that cannot get health insurance. This market will have access to 32 million potential customers BUT only for those companies that are not retaliating against the bill by raising their prices.

    B. Health industry is based on profit. Government is not. Government is not an alien force trying to eat your head (maybe I shouldn't speak for you). Unless you let it become that by voting people into office who privatize the government.

    Them's the facts. BTW facts, are not too tough to find unless you try really hard to avoid them.

  32. Oh and Brian Bellmore, please show me the part of the this bill, or back up your weird out-of-space allegation of no longer being able to keep your employer's insurance. Or, are you like the only one this has happened to? Are you a real person or a HMO shill who spends his time spreading misinformation to keep people confused?

    I think you're telling a, how do we say? LIE.

    If you've got to make up stories to make a point, you're probably on the wrong side of the debate.

  33. somebody above says "Dennis the Peasant aka Kenton Kelly the third doesn’t know squat about health care or policy in general".

    Maybe, but he knows a lot about tax laws and accounting, which were the subjects of the post in question.

    Lefties can stamp their little sandal-shod feet as much as they want but it will not make the unpleasant consequences of Obamacare go away.

  34. Person of Choler what unpleasant consequences are you referring to? How has this affected your life personally? Please show us the trauma that's unfolded in your life since the passing of the bill.

  35. Bubbly, I can keep health insurance, if the various provisions of this law don't drive my employer to drop it. I can't keep my current policy. Certain features of it are illegal.

    Section 2711: No lifetime or annual limits on coverage. It's a very high limit, but it's there.

    Section 1302 (c) (2) (A) I have an illegally high deductible. Which doesn't bother me one bit, because my employer contributes to my FSA.

    Section 9005 (i) Only the amount of the FSA has just been considerably limited.

    I suspect there are probably other features of the police which we will be legally mandated to change, but those are the ones I know about.

    Look, you just don't get to mandate, (There's that word again.) the features insurance policies may not, or must, have, and claim that people get to keep their current coverage. Not if you're not grandfathering us in, and you're not. You can claim I should prefer the new policy to the old, and I can tell you you're delusional about that, but you can't claim I get to keep it.

  36. And let me point out that there are perfectly rational reasons to find a high deductible policy, with employer contributions to the FSA, preferable to a low deductible policy without. I cancould spend the FSA on anything medical I wanted, regardless of whether the insurance covered it. Lasik. Cialis. OTC drugs. My employer found the net cost lower this way, I find the benefits better.

    And you freaks just over-rode both our judgments on this.

  37. So are these things true of the loopholes left in the bill? If not prove it. "-No meaningful restrictions on claims denials insurers don't want to pay for. Proponents cite a review process on denials, but the "internal review process" remains in the hands of the insurers, and the "external" review will be up to the states, many of which have systems now in place that are dominated by the insurance industry with little enforcement mechanism. -Significant loopholes in the much touted insurance reforms: 1. Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions. 2. Permitting insurers to sell policies "across state lines", exempting patient protections passed in other states. Insurers will likely set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states. 3. Allowing insurers to charge three times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees. 4. Insurers may continue to rescind policies, drop coverage, for "fraud or intentional misrepresentation" – the main pretext insurance companies now use." — Rose Ann DeMoro National Nurses United.

  38. Are you saying you're frustrated because they can't limit the amount of care they give you? I'm sorry that doesn't sound like a bad thing to me.

    R_Helferding; here's the whole article and so people can understand what the hell you're trying to say:
    It basically says what people who care about this country already know: The bill ain't perfect but the plan is to get better over time. As one can plainly see in the comments of this form, there's some misinformed folks folks and some people paid to keep them that way.

  39. "Are you saying you’re frustrated because they can’t limit the amount of care they give you? I’m sorry that doesn’t sound like a bad thing to me."

    You know what? It's a trade off. You limit the payout here, you get lower premiums there. So, yeah, I'm frustrated that my health insurance premiums are going to go up, to give me something I was just fine with not having. I'm frustrated that my FSA is suddenly going to become a lot less useful, (No more buying OTC medications and vitamins with it. Even if my doctor is telling me to take them!) and that my employer is probably going to stop contributing to it, to handle the higher premiums having to go to a low deductible policy will result in.

    But the point here is: You can advance arguments as to why it's a good thing that a great many people are going to be forced to change their coverage. But you can't claim they AREN'T going to be forced to change their coverage. The former is a matter of opinion. The latter is objectively false. Remember which you're entitled to, per the slogan at the top of the page?

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