Talking to a brick wall

Obamacare questions that never get answered

I was recently reminded of how people are always claiming they don’t know something, never knew it, and still don’t understand it.

Even if you’ve told them a million times.

I’m certainly not innocent of doing this. My memory lapses are notorious in my family.

For most people we can assume that sometimes it’s forgetfulness, other times… well… let me give you an example.

This was a somewhat hilarious and simultaneously frustrating exchange on Facebook recently:

Jane: I guess I’m still somewhat confused about Obamacare.

Jane: So does this mean everyone is going to have to buy health insurance? No freebies? What about illegals?

Jane: So if I buy the “platinum” insurance and pay over $1,000.00 a month, I will have to pay 10% of my costs for health care… What happens when I need a major procedure? We’ll take child delivery which cost $20,000.00. I not only paid over $12,000.00 a year but now I have to pay $2,000.00?

Jane: So why didn’t they just change the prices associated with medical procedures? And now I won’t have to pay Medicare out of my paycheck?

Me: Yes, everyone is required to buy health insurance or face a fine from the IRS (this is called the individual mandate). Those who make too little to need to file income taxes at all will not face a fine. If you choose to not buy health insurance you will be fined $95 per person (family max $285 family) for the first year, and that amount increases annually to 2016 at which point it is $695 per person, half that for kids, up to $2,085 per family or 2.5% of household income, whichever is greater. After 2016, the number is adjusted upward to tie to inflation. (see

Me: Freebies? Well low income can qualify for medicaid, which is free’ish in the sense that you don’t pay anything in monthly costs but isn’t free in the larger sense since medicaid is tax funded by us all.

Me: Illegals do not qualify for any benefits from Obamacare.

Me: The best way to find out for sure what your out of pocket costs are is to use one of the calculators because it varies by state. (One decent one here ) At the bottom in the area where it talks about the plan types, it will talk about deductibles. The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. However, Obama delayed that part of the program in August and it won’t come into the process until 2015. ( read more here: ) so right now insurance can charge whatever they want for OOP costs.

Me: It is also important to note that for people with high deductibles and out of pocket medical costs who have filed taxes long form with itemized medical expenses, the amount of medical expenses you have to have to do that has risen from 7.5% to 10% of income. Those who are over 65 will have a phase-in period which will see it remain 7.5% until 2016 when it become the 10% rate. (see

Me: As far as changing the prices for procedures, this isn’t single-payer government healthcare like you might see in some places where the government employs doctors directly, it’s still the same healthcare system from before so since the government isn’t actually performing the medical procedures, they have no direct influence over reducing the cost of them. Those costs come from the medical and insurance industries. They can, for example, in medicaid or medicare only agree to pay a portion of the cost for something, but in that case the individual will get billed out of pocket for the rest of it.

Me: And yes, you still have medicare withdrawals from your paycheck, in fact for people at certain income levels those rates have gone up (see ).

Me: Hope this helps.


Jane: I don’t understand anything of what you just said. Joe doesn’t understand it either. Do I still have to pay medicare out of my check??!?

Me: 🙁

Talking to a brick wall
By iamjoeo, on Flickr

Leave a Reply