• If you are having problems logging in please use the Contact Us in the lower right hand corner of the forum page for assistance.

THE NEXT SHOE DROPS

Tam

Well-known member
Nation's Top Hospitals Reject Obamacare Plans

Friday, 01 Nov 2013 11:11 AM

By Sandy Fitzgerald


Most of the nation's top hospitals plan to accept insurance from only a few companies participating in Obamacare, a new reports says.

Insurers participating though the Obamacare healthcare exchanges plan to offer doctors and hospitals less compensation for services so they can recoup their own losses coming from federal caps on premiums, reports U.S. News & World Report.

As a result, hospitals are rejecting many of the companies included on states' health-insurance exchanges, which typically include many low-cost options for consumers.

Urgent: ObamaCare Is About to Strike — Are You Prepared?

"This doesn't surprise me," Gail Wilensky, Medicare adviser for the second Bush Administration and senior fellow for Project HOPE, told U.S. News. "There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money."

U.S. News contacted its top 18 hospitals for this year to determine their contracts, and learned that most are opting out of Obamacare insurance companies.

Individual plans purchased outside the Obamacare regulations still will be accepted in many cases, however. The Cleveland Clinic, ranked fourth on the U.S. News list of top hospitals, responded that it accepts several insurance plans and managed-care options that are purchased individually, but accepts only Medical Mutual of Ohio from among the dozens of insurers included on Ohio's healthcare exchange.

Some top hospitals, such as the publication's top-rated facility Johns Hopkins in Baltimore, must accept all insurance companies' coverage due to state law. But 11 of the 18 hospitals on the U.S. News listings allow just one or two carriers from their state's healthcare exchanges.

"Many companies have selectively entered the exchanges because they are concerned that (the exchanges) will be dominated by risky, high-using populations who wanted insurance (before Obamacare) and couldn't afford it," said Wilensky, a member of the board of directors of UnitedHealth.

Many insurance companies declined to comment on the trade-off between price and quality of service. Critics say consumers are getting into coverage they don't understand.

"In many cases, consumers are shopping blind when it comes to what doctors and hospitals are included in their Obamacare-exchange plans," said Josh Archambault, a senior fellow with the think tank Foundation for Government Accountability. "These patients will be in for a rude awakening once they need care and get stuck with a big bill for going out-of-network without realizing it."
But even if customers don't want or need to go to a top-rated hospital, they may find that their own community hospitals also are rejecting Obamacare plans, reports CNN.

For example, residents in Concord, N.H., are learning that the city's lone hospital accepts no policies offered through the state's marketplace.

As a result, Concord residents on Obamacare plans will have to pay out-of-pocket to see a doctor, specialist or primary-care provider affiliated with the hospital or they'll have to drive at least 25 miles to the next community, Manchester, to get medical care.

Concord Hospital CEO Michael Green said the hospital isn't opting out to make a "political statement" but blamed Anthem Blue Cross Blue Shield, the state exchange's only provider, saying the company is "unwilling to negotiate sustainable contract terms" and the hospital would be "paid less than what it costs us to provide care."

Still, many consumers care more about how much their policies cost than where they're getting their services, according to a PriceWaterhouse Cooper survey, which determined 43 percent care more about policy costs than they do about where their healthcare needs are met.

Urgent: ObamaCare Is About to Strike — Are You Prepared?

Insurance companies depend on narrowing networks to keep those costs down, said Micah Weinberg, a senior policy adviser for California's Bay Area Council.

"Narrower networks is one way to keep costs (of these policies) down," said Weinberg. "Some of the networks may be too thin, at least for now anyway."
Read Latest Breaking News from Newsmax.com http://www.newsmax.com/Newsfront/Obamacare-hospitals-plans-coverage/2013/11/01/id/534327#ixzz2jTOCYZrr
Urgent: Should Obamacare Be Repealed? Vote Here Now!

If you get a Obamacare policy at a 50 to75% increase in Premium, you still may not have access to healthcare due to Hospitals and Doctors opting OUT OF OBAMACARE. :roll:
 

Faster horses

Well-known member
Our young (and healthy) friends in Oklahoma are facing policy increases that
they can't afford. They know a man who has kept really close track of what
is going on with Obamacare. He told them that if they don't have insurance,
the fine will be up to $14,000!!!! They can't afford that either. If this is true what are they to do?
 

Tam

Well-known member
Obamacare Individual Mandate

ObamaCare's Individual Mandate: What is the Tax Penalty for Not Having Health Insurance?

ObamaCare's individual mandate requires that most Americans obtain health insurance by 2014 or pay a tax penalty. The individual mandate goes into effect January 1st, 2014. The penalty will be applied to your annual taxable income for each month you don't have health insurance (although you do have a 3 month grace period hence the marketplaces being open until March 31st, 2014).

In fee for not having insurance in 2014 is $95 per adult and $47.50 per child or 1% of your taxable income (up to $285 for a family), whichever is greater.

Not sure but I think your young friends better find somebody different to explain Obamacare to them. At the highest penalty rate per month the fine doesn't come close to $14,000. it is $3420. AND from what is being reported that is only if they pay taxes as the IRS's only way of collecting the so called tax/fine is by subtracting it from your income tax return. If you don't have a return coming how are they going to get you to pay it?
 

iwannabeacowboy

Well-known member
Tam said:
Obamacare Individual Mandate

ObamaCare's Individual Mandate: What is the Tax Penalty for Not Having Health Insurance?

ObamaCare's individual mandate requires that most Americans obtain health insurance by 2014 or pay a tax penalty. The individual mandate goes into effect January 1st, 2014. The penalty will be applied to your annual taxable income for each month you don't have health insurance (although you do have a 3 month grace period hence the marketplaces being open until March 31st, 2014).

In fee for not having insurance in 2014 is $95 per adult and $47.50 per child or 1% of your taxable income (up to $285 for a family), whichever is greater.

Not sure but I think your young friends better find somebody different to explain Obamacare to them. At the highest penalty rate per month the fine doesn't come close to $14,000. it is $3420. AND from what is being reported that is only if they pay taxes as the IRS's only way of collecting the so called tax/fine is by subtracting it from your income tax return. If you don't have a return coming how are they going to get you to pay it?

One thing I saw noted in 2017 and beyond, the penalty is tied to rate of inflation. Should be exciting when the correction for all this free money hits.

I don't think we have a clue how bad the penalties will be in 5 years. What if there is more uncontested executive orders completely changing the law? Who will be king then?
 

Steve

Well-known member
Consumers don’t have to report on whether they have coverage or are exempt from the mandate until they file their 2014 income tax return, which are due April 15, 2015.

As it stands now, the individuals who don’t obtain health coverage in a given year (and are not exempt from the mandate) are subject to a fine of $95 for an individual or 1% of family income, whichever is greater. In 2015, the penalty increases to $325 per adult, or 2% of family income, whichever is greater.

130812165443-obamacare-penalties-620xa.png

For 2014, the flat fee is $95 per adult and $47.50 per child, up to $285 per family. Or the penalty could be 1% of family income, if that results in a larger fine. (Income is defined as total income above the filing threshold, which is $10,000 for an individual and $20,000 for a family in 2013.)

So a person making $50,000 would be subject to a $400 penalty, while a couple earning that amount would each pay $300.

By 2016, the flat fees grow to $695 per adult and $347.50 per child or 2.5% of family income, whichever is greater. By then, the average premium for bronze coverage is expected to hit as much as $5,000 for an individual and $12,500 for a family.

“The only way that they can collect the penalty or the fine is by taking money from your refund. If you are not owed a refund, they cannot get money from you.” If you don't get a refund next year, the “IRS could carry over the sum due and apply it against any refunds in future years.


“If you don’t pay it, all they can do is wait until they owe you some money and take that. Or probably just send you a letter every now and then reminding you that you owe money to the IRS,”

The law also prohibits the IRS from using liens or levies to collect any “payment you owe related to the law, if you, your spouse or a dependent included on your tax return does not have minimum essential coverage,” according to the IRS.

As Limbaugh explained on his show, “If you structure your taxes so that you do not get a refund, you do not have to buy insurance and you do not have to pay a fine 'cause they can't collect it from you if you don't have a refund due.

either way this will hurt enough people that it will either get fixed,.. or fail...

my advice.. shop around and avoid the exchanges as they NEED your money to make them work...
 

cowman52

Well-known member
I am a devious sort, if nobody buys insurance this pile of crap folds like a cheap card table. Why is anyone buying it? I would donate 95 bucks to see it fail, and several are going to cash only, to avoid the banks and the IRS. Sounds like the deal to me.
 

Steve

Well-known member
I am a devious sort, if nobody buys insurance this pile of crap folds like a cheap card table. Why is anyone buying it? I would donate 95 bucks to see it fail,

if those who are against obamacare can hold out at least a year or find a policy on the open market it would at least expose the cost of this boondoggle

Exemptions from the payment

Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

You may qualify for an exemption if:

You’re uninsured for less than 3 months of the year
The lowest-priced coverage available to you would cost more than 8% of your household income
You don’t have to file a tax return because your income is too low (Learn about the filing limit.)
You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
You’re a member of a recognized health care sharing ministry
You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
You’re incarcerated, and not awaiting the disposition of charges against you
You’re not lawfully present in the U.S.

Hardship exemptions

If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a “hardship” exemption:

You were homeless.
You were evicted in the past 6 months or were facing eviction or foreclosure.
You received a shut-off notice from a utility company.
You recently experienced domestic violence.
You recently experienced the death of a close family member.
You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
You filed for bankruptcy in the last 6 months.
You had medical expenses you couldn’t pay in the last 24 months.
You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.

How to apply for an exemption

If you are applying for an exemption based on: coverage being unaffordable; membership in a health care sharing ministry; membership in a federally-recognized tribe; or being incarcerated:

You have two options--

You can claim these exemptions when you fill out your 2014 federal tax return, which is due in April 2015
You can apply for the exemptions in the Health Insurance Marketplace

Note: If you get an exemption because coverage is unaffordable based on your expected income, you may also qualify to buy catastrophic coverage through the Marketplace. This may be more affordable than your other options.

If you’re applying for an exemption based on: membership in a recognized religious sect whose members object to insurance; eligibility for services through an Indian health care provider; or one of the hardships described above:

You fill out an exemption application in the Marketplace

If your income will be low enough that you will not be required to file taxes:

You don’t need to apply for an exemption. This is true even if you file a return in order to get a refund of money withheld from your paycheck. You won’t have to make the shared responsibility payment.
 
Top