Bison Bud

I've spent some time recently trying to understand how Obama Care really works (and if it does for that matter) and the one thing that seems really counterproductive to me is the way subsidies are paid out as tax credits. Someone please correct me here if I'm wrong, but I don't see how this is very effective in helping low income folks obtain coverage as they apparently still have to pay the full premiums and then recover the subsidies on their income taxes at the end of the year. Therefore, if the policy premiums are say $1000.00 per month for a low income family and their income provides them with a $500.00/month subsidy, they still have to pay the $1000.00 per month and then recover the subsidy as a tax credit. Yes, may provide a nice refund at the end of the year, but I have to ask how that makes the insurance any more affordable during the rest of the year? To be effective, the participants should only have to pay their part of the premiums and the insurance companies should have to get the rest from the government subsidies themselves. That way, my example family only pays the $500.00 per month, which makes it far more affordable in their monthly budget and they are far more likely to get the insurance. Does this make any sense to anyone else out there or have I got something wrong here? Seems like a system set up to spend tax money before it's even available and really does little or nothing to make needed insurance easier to afford by those that the system is trying to help!

I wasn't going to mention this here, but decided to anyway. Frankly, the Obama Care policies offered here in Kentucky have very poor coverage anyway when compared to other insurance and don't seem to be a very good value even with the subsidies. It's is also danged near impossible to find a doctor that will take this insurance! I recently had to find a new Primary Family Doctor, because my previous one retired and I can't tell you how many doctor's offices I called who's first question was "What insurance do you have?" If the answer was Obama Care, they did not want me as a new patient! Has anyone else encountered this? Why do we even allow doctors and hospitals to pick and choose what insurance policies they are willing to work with anyway? This stuff is just crazy and it's high time we apply a little common sense if we are ever going to fix anything. I will look forward to your comments!

Fotoartist Loc: Detroit, Michigan

Why should the government be subsidizing this at the expense of the rest of taxpayers in the first place?

David Martin Loc: Cary, NC

It's not so much the amount ObamaCare will pay. Most doctors will accept low-paying Medicaid but refuse ObamaCare.

There is a little known provision in ObamaCare that gives patients a 2-3 month grace period to pay their premiums, during which time the insurance remains in force even though premiums are overdue. And payments continue to be made to healthcare providers.

However -- if after 3 months the premiums have not been paid, ObamaCare will cancel coverage and demand from doctors, hospitals and other healthcare facilities that all money be repaid to the government no questions asked.

So a doctor, hospital or other facility may provide up to 3 months of care, but then have to pay it all back upon demand.

And note that doctors are not permitted to declare such loss of income for services which were provided, as a loss on their income tax returns.

Not many businesses of any kind can afford to take such financial risk.

And for your information, in areas where doctors are not scarce, it is usually individual insurance companies who pick and choose who they will accept to be on their panels. Doctors' applications, especially if solo practitioner or small group practice, are often rejected.

WNYShooter Loc: WNY

The worst part of those plans is the high deductible. Some of them are as high as $10K. That's not medical insurance, it's catastrophic insurance.

Bison Bud

I don't disagree with your response, but this is what Obama got v**ed into law to try to help folks that can't afford health insurance. My point here is to try to figure out how it really helps and in my opinion paying the subsidies as tax credits is counterproductive, as pointed out in my original post. Frankly, I think this was just a way to hide the actual costs and keep them out of the budget, by spending tax money that had not even been collected yet. Frankly, a pretty stupid idea if you ask me, not to mention this approach gives them even more incentive to raise taxes on down the line, since what is coming in will be reduced by all the tax credits. It's a self eating system and I fail to understand how that helps any of us and why we even allow it to exist!

Bison Bud

Yes, I agree! Even with the highest premium plans offered on the Marketplace, the co-pays, deductibles, and other out of pocket expenses are at least double that of local PPO plans. This makes the local PPO's a much better and more affordable choice for most of us that need more than just "Catastrophic Insurance." For a few dollars more in premiums, most participants that need health care actually save money over the Obama Care plans.

Bison Bud

Interesting point here! If this is such a gamble, then why should the government be allowed to demand return payment of services rendered in good faith and as prescribed by the current law? Again, counterproductive and as you stated "Not many businesses can afford to take such a financial risk." This also affect participants choices as to whether or not to purchase an Obama Care plan. If you can't get services, then what good is the plan at any cost? Frankly, another glaring problem with the current system that really needs to be fixed if it is ever going to actually help anyone that needs it. It baffles me as to how foolish our politicians can be when creating programs like Obama Care and it's way past time that someone try to fix it!