ACA subsidy expiration: what it means and to whom

Trade said:
The only viable solution is Universal single payer. We already have that for people over 65 and the disabled. It's called Medicare. Just extend that to everyone and the problem is solved. And it would cost less to implement than all these subsidies. As for private insurance companies they are nothing more than an expensive for profit middleman. Kick them to the curb. Let them go out and find a way to make an honest living for a change.
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I agree with you 100%, but it's not going to happen as long as politicians are controlled by corporations.

The first thing we need to do is get big money out of politics, and we could do that with publicly funded elections, but that's not going to happen, either. Corporations like the current system because they've been given the power to author legislation. That's supposed to be the responsibility of legislators, but the way things are now, corporate lobbyists write laws, legislators simply format them so they can vote on them, and then they become law.

Politicians benefit from the current system because they're able to get filthy rich by not doing anything other than helping corporations increase their profits.

We're supposed to have a government that's for, by, and of the people. Instead it's one that's for, by, and of corporations.
 

Trade said:
The only viable solution is Universal single payer. We already have that for people over 65 and the disabled. It's called Medicare. Just extend that to everyone and the problem is solved. And it would cost less to implement than all these subsidies. As for private insurance companies they are nothing more than an expensive for profit middleman. Kick them to the curb. Let them go out and find a way to make an honest living for a change.
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Sounds like a plan.

What percent of tax on a persons wages would be reasonable to deduct?
Would the soc sec. tax be a model for implementation?
What about those on government programs? Not morally right to deny medical.

New Report Shows More Americans Dependent on Welfare Checks, at the Expense of Work
January 08, 2025
WASHINGTON, D.C. – Buying Americans out of poverty is undermining incentives to work, with families living in poverty relying more on taxpayer-funded welfare checks than income from work, according to a newly released report from the Congressional Budget Office (CBO). Costing well over $1 trillion, America’s social safety net encompasses more than 80 federal programs, and is discouraging beneficiaries from seeking income from work.

New Report Shows More Americans Dependent on Welfare Checks, at the Expense of Work - Ways and Means

Not being argumentative just think it's not easy or simple to implement.
 
againstthegrain said:
^^^Why would you restrict taxes for health care to wages?

One might ask those high net worth individuals that don't earn "wages" to pay in as well.
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Not restricting to wage earners thus the question
Would the soc sec. tax be a model for implementation?

That plan has employers contributing

As for high net worth individuals seriously doubt they would need a universal health care plan. But if you think they should contribute to a health care plan what amount would you consider as fair?

Now that you mention that. It would be another problem that makes conversion not so simple.
 
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Knight said:
Not restricting to wage earners thus the question
Would the soc sec. tax be a model for implementation?

That plan has employers contributing

As for high net worth individuals seriously doubt they would need a universal health care plan. But if you think they should contribute to a health care plan what amount would you consider as fair?

Now that you mention that. It would be another problem that makes conversion not so simple.
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How much do you think they should contribute?
 
againstthegrain said:
more than they are now
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Why? Do you think they would be getting better care?
I'll go back to my original thought. I doubt they would sign up for care under the ACA
Why do you think high net worth individuals would sign up for care under the ACA
 
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againstthegrain said:
Oh please, stop. You're going in circles chasing your tail.
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Not really. Just trying to get you to explain your thinking. I've responded to what you've asked. You have no answer for

Why? Do you think they are getting better care?

Why do you think high net worth individuals would sign up for care under the ACA?

Considering the lack of response on your part to my questions, I don't see a reason to keep trying to get answers from you.
 
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Knight said:
Sounds like a plan.

What percent of tax on a persons wages would be reasonable to deduct?
Would the soc sec. tax be a model for implementation?
What about those on government programs? Not morally right to deny medical.

New Report Shows More Americans Dependent on Welfare Checks, at the Expense of Work
January 08, 2025
WASHINGTON, D.C. – Buying Americans out of poverty is undermining incentives to work, with families living in poverty relying more on taxpayer-funded welfare checks than income from work, according to a newly released report from the Congressional Budget Office (CBO). Costing well over $1 trillion, America’s social safety net encompasses more than 80 federal programs, and is discouraging beneficiaries from seeking income from work.

New Report Shows More Americans Dependent on Welfare Checks, at the Expense of Work - Ways and Means

Not being argumentative just think it's not easy or simple to implement.
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Here's my take on Medicare for all. This is based on the latest data that I have been able to find. There are currently 68 million people on Medicare and the total cost is $1.1 Trillion. The total cost of Health care in the US is 4.8 trillion. The current population of the US is 342 million. So assumimg that the cost per individual would be the same if we expanded Medicare to all 342 million we can calculate an estimated total cost of 342/68 X 1.1 = $5.53 Trillion.

However studies have shown that medical care costs are much higher for the population currently on Medicare (over 65, or disabled.) It's about 5 times as high as it is for children, and about 2 and 1/2 times as much for adults from 18-64. So to be conservative I'll just use the 2 and 1/2 figure. That would mean that the cost of expanding Medicare to everyone would be $1.77 Trillion additional or $2.87 Trillion. That's a savings of about $2 Trillion a year over what healthcare is costing us now under the system we have.
 
Trade said:
It will be really bad for a while but I think that will get us to Medicare for All faster which is the only real solution to fixing our broken health care system.
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The prices you see now on ACA will be like Medicare for all. Where exactly will the money come from ? And if the Government administers it, what a mess. Right now the insurance Companies are making bank thanks to ACA.
 
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DonnyO said:
The prices you see now on ACA will be like Medicare for all. Where exactly will the money come from ? And if the Government administers it, what a mess. Right now the insurance Companies are making bank thanks to ACA.
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We are already paying more than it would cost for the system we have now. As for this staement of yours:
And if the Government administers it, what a mess.
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Medicare which is administered by the government has an overhead of 2% while private insurance companies have an overhead that runs anywhere from 12 to 18%. Hows that for a mess?
 
Government run health care for all using Medicare as guideline per Trade sounds really doable.

Maybe not if this becomes a reality.

In recent years, physician groups and some policymakers have raised concerns that physicians would opt out of Medicare due to reductions in Medicare payments for many Part B services, potentially leading to a shortage of physicians willing to treat people with Medicare. Medicare payments are lower, on average, than payments from private insurers and are not automatically indexed to keep pace with inflation in medical practice costs. Every year, as required by law, the Centers for Medicare & Medicaid Services (CMS) updates Medicare payments to physicians under the physician fee schedule through rulemaking. Since 2021, Congress has enacted four temporary, one-year increases to physician payment rates to soften scheduled cuts. However, Congress has not enacted a payment increase for 2025, and a 2.93% drop in average Medicare payments to physicians went into effect on January 1.
How Many Physicians Have Opted Out of the Medicare Program? | KFF

I wonder what the impact would be if all the US population of approximately 342.8 million as of November 22, 2025, would suddenly need care provided under government controlled health care. Would doctors opt out if their wages were lowered? Would hospitals, nurses, and every aspect of the health care system as it is now be willing to earn less?

Really no way to know now. Closest to having an understanding would be for the impact the wage freeze by Nixon in 1971 felt. Government control over wages back then not a happy time.
 
Knight said:
Not really. Just trying to get you to explain your thinking. I've responded to what you've asked. You have no answer for

Why? Do you think they are getting better care?

Why do you think high net worth individuals would sign up for care under the ACA?
to follow you down
Considering the lack of response on your part to my questions, I don't see a reason to keep trying to get answers from you.
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Your questions are irrelevant and only serve to amuse you. It's not my responsibility to follow you down your rabbit holes, by replying to your dumb questions and providing "answers" so you can further lecture us on the waste, what-ifs, but, but, but, etc.

We get it - you've got yours, you did it w/out the help of society, and you're taking your SS, Medicare, and other programs that lessen the burden on you, only to put that burden on the backs of the wage earners that can't afford health insurance because they are paying for your retirement and health care.
 
Trade said:
s


We are already paying more than it would cost for the system we have now. As for this staement of yours:


Medicare which is administered by the government has an overhead of 2% while private insurance companies have an overhead that runs anywhere from 12 to 18%. Hows that for a mess?
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Actually my Medicare is run by UHC? What Goverment Health plan do you have. Even Obamacare was turned over to private health insurers.
 
againstthegrain said:
Your questions are irrelevant and only serve to amuse you. It's not my responsibility to follow you down your rabbit holes, by replying to your dumb questions and providing "answers" so you can further lecture us on the waste, what-ifs, but, but, but, etc.

We get it - you've got yours, you did it w/out the help of society, and you're taking your SS, Medicare, and other programs that lessen the burden on you, only to put that burden on the backs of the wage earners that can't afford health insurance because they are paying for your retirement and health care.
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Your posts are interesting.

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"We get it - you've got yours, you did it w/out the help of society."

That was something that began with my legally blind father. If he could do it then for sure I could.

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"and you're taking your SS, Medicare, and other programs that lessen the burden on you,"

Paid for over the years just like others are doing now.

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"only to put that burden on the backs of the wage earners that can't afford health insurance because they are paying for your retirement and health care."

The "burden" was pre paid because we both worked & contributed to the system, still do. Our retirement for 30 years now due to excellent planning doesn't depend on our Soc. Sec. benefit. As for health care that benefit is the same as everyone gets.

I understand you don't want to reply to questions on points you brought up but here goes questions anyway.

I don't know if you already draw on your benefits but if you aren't.

Do you plan on drawing on your Soc. Sec. & Medicare benefits? Or are you going to reject those because you don't want to as you say.

"to put that burden on the backs of the wage earners that can't afford health insurance because they are paying for your retirement and health care."

If you are already drawing on your benefits do you plan on asking the government to stop your benefits?
 
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againstthegrain said:
Can't make this stuff up............this morning's reports indicate reversal on Obamacare subsidies could happen.
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Unfortunately, Obamacare just drove up prices for everyone. I just retired after 30 plus years in the medical field and all my colleagues took forced pay cuts and the Hospital is failing. So why is UHC making record profits?
 
DonnyO said:
Unfortunately, Obamacare just drove up prices for everyone. I just retired after 30 plus years in the medical field and all my colleagues took forced pay cuts and the Hospital is failing. So why is UHC making record profits?
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Good questions.
I think this may help answer.

My input isn't about eliminating ACA subsidies it's about my opinion that review and restructuring for the benefit of even those that don't need subsidized.

Because most don't like long boring input I've reduced this report to the ways & means committee that was generated back in 2023. It outlines the expected impact of subsidies. The full report look up is included.

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$50,923 in 2023.22 A benchmark plan covers 70 percent of a household’s expected health care expenses on average. Of note, the fact that the exchange plan for a family of five can be more than $50,000 a year suggests serious underlying problems with the program.
• If that family made $150,000, they would qualify for a subsidy of $38,173.
• If that family made $350,000, they would qualify for a subsidy of $21,173.
• If that family made $500,000, they would qualify for a subsidy of $8,423.
• This family does not lose subsidy eligibility until they make more than $ 599,000.

Second, the subsidies go directly to health insurance companies, subsidizing their profits even though enrollees may place low value on the coverage and would prefer different health care and health coverage products.

Third, if the subsidies are extended, millions of people will likely lose workplace coverage. This will be especially true of employees at smaller firms since these firms are not subject to tax penalties from the ACA’s employer mandate. In fact, CBO projects that about 3.1 million people will replace private UNSUBSIDIZED individual market insurance or employer-provided insurance with subsidized exchange coverage.

Fourth, the subsidies are inflationary in their design and will drive up health care prices and health spending, as well as prices throughout the economy.

https://waysandmeans.house.gov/wp-c...Ways-and-Means-testimony-3.21-FINAL-Blase.pdf

Since implementation I don't think it's reasonable to subsidize up to $599,000.00 & for sure government subsidies have made insurance companies profits explode.
 
againstthegrain said:
Doesn't it stand to reason that if health care insurers have -20 million new customers that they would be more profitable than before they had those 20 million new customers?
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Absolutely right more people signing up translates to more profit.

The difference from my perspective more tax dollars are used to generate that profit. Benefit of health care instead of paid by companies are paid from tax dollars.

Toss in tax dollars from high income earners with income up to $599,000.00 that are eligible to be subsidized are the ones that burden the wage earners.

Still have the opinion that subitizing health care for low income & no income due to circumstances beyond their control should be done. Just need to review & tweek what is in place.
 

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