Obamacare, the Good, the Bad, and the Wugly

The Good:
“I ventured into the ACA minefield,” my friend Fanny Guay said. “I found I can get ‘gold premium’ coverage for about what I am paying now, thanks to the subsidy.”

Enola “Fanny” Guay’s parents joined the back-to-the-land movement in Vermont at the Nearings old farm house, far from big government and rampant consumerism. Ms. Guay’s friends are now the power brokers and consumers of Montpelier but she just lost her job with a small heating assistance NGO when they lost their outreach contract with the University. I’ve known her for nearly 50 years; she was pro-Cheryl Rivers in Vermont years ago and is pro-Obamacare now.

The Bad:
The real subsidy gotcha comes when Ms. Guay discovers that her subsidy isn’t a guarantee; it is an early refund of an income tax credit. A guarantee on Obamacare that isn’t, well, guaranteed? Imagine that.

Ms. Guay hopes to find a new job next year but says, “I figured the cost on my unemployment and some part-time. I hope that’s not what really happens.”

The “subsidy” will bite many, many people who calculate it based either on a low 2012 tax return or on a calculation like Ms. Guay’s and then end up with an increase in taxable income when they file their 2014 returns.

Imagine you earned $20,000 this year. Now imagine that your $20,000 income gets bumped to $50,000 by a windfall — it could be capital gain from a stock sale, a temporary consulting job, or a gambling win.

Warning! Real Data Ahead! ACA Supporters please stop reading here!
I ran those numbers at thehealthsherpa.com and discovered that the Gold plan Ms. Guay found might have a $981.26 base monthly premium but would cost the $20K earner just $321.53 per month thanks to a $659.73 subsidy. Unfortunately, with the windfall, that single insured person would have an unexpected “extra” tax bill of $7,916.76 due April 15, 2015, because the monthly subsidy on her $50 grand income drops to $0!

Kaiser Permanente says “In determining eligibility for exchange subsidies, income will be based on your attestation of your expected income in 2014 and will be verified by the exchange with documentation from your most recent tax return, with consideration of reasonable changes you expect. Exchanges will calculate enrollees’ household incomes using Modified Adjusted Gross Income, or MAGI. The MAGI calculation includes such income sources as wages, salary, foreign income, interest, dividends, and Social Security. MAGI calculation does not include income from gifts, inheritance and some other income sources are partially excluded.” More information on MAGI is available in a report from UC-Berkeley).

We are so screwed.

The Really Bad:
I compared what I have now to a “pretty good” similar plan with the closest deductible I could find.

Here’s the BlueOptions Everyday Health 1420 “Gold” plan on the Exchange. The Annual Deductible at $2,500 for me will be $50 more than I pay now. The co-insurance at 20% will be twice as much as my current coinsurance. The premium will be $1,084.67, or $653.67 per month more than my current premium.

My Current Blue Cross Blue Shield PlanOuch.

Here’s the Blue Cross Blue Shield plan plan I currently have. The plan Mr. Obama cancelled. The Annual Deductible at $2,450 for me is $50 less than the most comparable plan I can find under ACA. The co-insurance at 10% is *half* as much the coinsurance in the most comparable plan I can find under ACA. The premium is $431/month this year. The premium for the most comparable plan I can find under ACA will be $1,084.67 or 653.67 more than my current premium.

So the ACA that Mr. Obama guaranteed to let me keep my plan and guaranteed to save me money nearly triples my cost.

I am so screwed.

The Wugly:
Forbes analyzed the data. “If you’re healthy today, you will face steeper rate increases than these figures indicate. If you have a serious medical condition, however, and haven’t been able to find affordable health coverage as a result, you will do much better under Obamacare than the average person.”

“But Dick,” Ms. Guay said, “Now I have insurance that covers my pre-existing conditions and that I can afford!”

Yeppers.

Too bad you liberals had to cover Ms. Guay by making sure young men pay thousands extra at the point of a gun. They don’t vote anyway.

Too bad you liberals had to cover Ms. Guay by making sure I pay thousands extra to change a plan I did like. Also at the point of a gun. I don’t cast enough votes to matter, either.

Too bad you liberals had to cover Ms. Guay by giving the insurance companies yet another welfare check instead of fixing the problem.

Too bad you liberals won’t guarantee the “subsidy” so Ms. Guay can afford that plan past the next election.


… BREAKING NEWS #1 …

ACA forced carriers to cancel policies for 5 million people.
Meanwhile, Reuters reported that fewer than 27,000 people signed up for plans in October. About 79,391 more signed up through state-based exchanges, 30,000 in California alone.

100,000 sucked in … 5,000,000 shafted out.
Government in action, baby. Government in action.
 
… BREAKING NEWS #2 …

Mr. Obama reversed course on Thursday and said millions of Americans should be allowed to renew individual plans and small group plans like mine just cancelled under his watch.*

Like Gov. Shumlin before him, Mr. Obama didn’t ask the insurance companies. Insurance spokesmen and state insurance commissioners immediately warned that prices will skyrocket.
* If the insurers refuse to reinstate now, of course, now they bear all responsibility for the cancellations.
Right.

 

Change Is Good

If you do not change direction, you may end up where you are heading.
Lao Tzu
To improve is to change; to be perfect is to change often.
Winston Churchill

I’ve been thinking ’bout catching a train
Leave my phone machine by the radar range
Hello, it’s me, I’m not at home
If you’d like to reach me then leave me alone.
It is fairly well known by now that Socrates hated, hated the alphabet and its portent of change. “…for this discovery of yours [writing] will create forgetfulness in the learners’ souls, because they will not use their memories; they will trust to the external written characters and not remember of themselves… You give your disciples not truth but only the semblance of truth; they will be heroes of many things, and will have learned nothing; they will appear to be omniscient and will generally know nothing,” Plato wrote, of Socrates talking to Phaedrus. Since Socrates refused to write things down, we rely on Plato as his scribe. Change is good.

On a much smaller scale, I had occasion to back a pickup truck onto a trailer tongue the other day. I’ve always preferred to do that as a two-person job, one driving the truck and Rufus making obscure hand gestures whilst standing on the tongue. The truck I used had an optional backup camera with video that swivels and points and even has range lines to guide you on far better than watching the expressions on Rufus’ face. Change is good.

Once upon a time, I wished for a (convenient) VCR for radio. See I liked to listen to Car Talk but it aired on Saturday mornings and I was often interrupted by a dump run, so I missed many of those episodes. Change is good. In 1993, Carl Malamud launched his Internet Talk Radio as the “first computer-radio talk show.” Computer users could download his audio files each week and listen at their convenience. Today I can choose from more than 115,000 English-language podcasts including reruns of Car Talk.

Change is good. Except when it isn’t.

My crew chief (not Rufus) munged the Camaro shift linkage one fine summer day and sent me out on the track with 1st gear down and to the right where 4th gear should be, 2nd in place of 3rd, but 3rd up there where 1st should be, and 4th next to 1st taking the proper 2nd slot (this was loooooong before paddle shifters). Just try going up through those gears and back down again at full chat with a horde of other pony cars around you.

“You’re the driver,” my crew chief said. “You’re supposed to be able to adapt to these little changes.”

Um, no. I have better things to do than try to learn a new shift pattern at 160 mph.

I got a new crew chief. That change bit him.

Firefox ScreenshotAnother change. Firefox decided to redo all my taskbars this morning and tell me to upgrade from version 22 (released last month) to version 25 (released the other day). It was not a clean change. I had to rebuild some of the add-ons, fix the task and menu bars, and so on. And for whatever reason the page zoom is no longer “sticky.” Page magnification used to be sticky. In addition to the UI issues, it has also fried all my protected cookies, the tab options, and some other stuff I probably haven’t found yet. Gmail, Facebook, Pandora, my credit card site, and a couple of others all thought I was logging in from a new computer. It loaded my home button page because it no longer differentiates between that and the home page and TVGuide thinks I’m in Fargo, ND, despite the fact that Cookie Culler shows explicitly that I have my location, provider, and favorite channels set. This is one of the least satisfactory single app upgrades I’ve done yet.

I told Firefox that this version may be the worst browser ever, simply because I’m spending so much more time trying to fix it than browsing.

I have better things to do than try to learn a new shift pattern or new browser tricks when I’m already trying to figure out what Facebook has screwed up this week.

I got a new crew chief. I can get a new browser.

And I managed to get through this rant without once mentioning the guy who promised to turn our world upside down and ended up simply stealing our world.

It’s past time for a change there, too. Change is good.