The Obama administration adopted a strict definition of affordable health insurance on Wednesday
Post ReplyPost New TopicPosted 1/31/2013 by nicegirl in NSBR Board
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nicegirl
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Posted: 1/31/2013 7:57:49 PM
I thought this was to help the working poor?

I linked to the NY Times so you know it isn't biased.
NY Times article

WASHINGTON The Obama administration adopted a strict definition of affordable health insurance on Wednesday that will deny federal financial assistance to millions of Americans with modest incomes who cannot afford family coverage offered by employers.

In deciding whether an employer's health plan is affordable, the Internal Revenue Service said it would look at the cost of coverage only for an individual employee, not for a family.Family coverage might be prohibitively expensive, but federal subsidies would not be available to help buy insurance for children in the family.

The policy decision came in a final regulation interpreting ambiguous language in the 2010 health care law.





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lucyg819
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Posted: 1/31/2013 8:04:05 PM
One step at a time.

I think Republicans would pitch a fit if the Feds spent a lot more money helping families pay for health insurance.


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beachgurl
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Posted: 1/31/2013 8:04:19 PM
I hope you were not one of the families counting on insurance becoming affordable for themselves.




nicegirl
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Posted: 1/31/2013 8:08:13 PM
So you can find a way to blame this on Republicans? The Republicans didn't want the thing passed in the first place. Now you are worried about making them mad? Talk about deflecting blame.



One step at a time.

I think Republicans would pitch a fit if the Feds spent a lot more money helping families pay for health insurance.


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mopah
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Posted: 1/31/2013 8:09:16 PM
Everything comes with a price somewhere.

Me GOP
Movin On Pea

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Posted: 1/31/2013 8:16:47 PM
At some point, will Obama/Democrats actually own the realities of what the ACA actually does negatively?

Such as, how it effects rural community hospitals?

ETA: And yes, everything does come with a price. It would be nice for the realistic price to be recognized that there will be fellow Americans, many who will get insurance coverage, but then face availability issues.



Tracey

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Posted: 1/31/2013 9:31:52 PM
Actually I don't have a problem with this. I saw too many women who were carrying their husband and children on their employer-provided health insurance because the husband was self-employed. It was a good deal for the women and a very bad deal for our employer. In fact several young, single people were hired just because it would be cheaper for the employer.

Even if it only covers the employee and not the employee's family too, the ACA is a step forward.



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Posted: 1/31/2013 9:34:58 PM

I saw too many women who were carrying their husband and children on their employer-provided health insurance because the husband was self-employed.


Yeah, because the men in the family never carry all the family insurance because the wife stays home and raises the kids...

SweetPeasMom
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Posted: 1/31/2013 9:39:53 PM

I saw too many women who were carrying their husband and children on their employer-provided health insurance because the husband was self-employed. It was a good deal for the women and a very bad deal for our employer. In fact several young, single people were hired just because it would be cheaper for the employer.


What the hell difference does it make who's on who's insurance? If a family can make it work for their budget better by using the wife's insurance, so be it. So you think it's better that the husband is uninsured because he has a different way of earning income than his wife? If they can afford her policy, go for it.


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simplekelly
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Posted: 1/31/2013 10:01:30 PM

Actually I don't have a problem with this. I saw too many women who were carrying their husband and children on their employer-provided health insurance because the husband was self-employed. It was a good deal for the women and a very bad deal for our employer.
WTF? That makes NO sense. LMAO. Like husbands do for their wives who stay home and raise their children or decide the wife wouldn't work because that was best for their family??

You must be joking.


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Posted: 1/31/2013 10:07:46 PM
Interesting that the federal government is making all kinds of requirements employers must make. Yet, my dh is a federal government employee and autism therapy is denied.

MochasMom
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Posted: 2/1/2013 1:23:33 AM

Even if it only covers the employee and not the employee's family too, the ACA is a step forward.
Great! The employee's family gets dropped but the employee will get to help pay to insure those currently not insured while his/her own family becomes uninsured. Just where is the logic?

ePEAcenter
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Posted: 2/1/2013 2:09:05 AM
Add to that the fact that the IRS's published estimate of the lowest cost plan under ACA will be $20,000 per family of 4 per year.

Where's all that "affordable" stuff?

link

momofkandn
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Posted: 2/1/2013 6:53:40 AM

At some point, will Obama/Democrats actually own the realities of what the ACA actually does negatively?


And how much it is costing employers to comply. My clients have had to hire a full time person just to sort through it all, do the auditing necessary and manage the changes they have to put in place. And these aren't large companies. Someone else in HR is probably losing their job to make room for the ACA compliance person. Just calculating who is a "variable" employee and who isn't will be a full time job going forward. Companies will make adjustments to the hours they offer their employees in order to work the system and side step some of the regulations.

Now it's a boon to brokers, payroll companies, and companies like mine that offer benefits administration. We are getting lots of extra business. But it's being paid for somewhere. I just hope the trade off helps the economy in the long run.

There are huge changes coming starting in 2014. We are only seeing the tip of the iceberg right now.

Nancie52
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Posted: 2/1/2013 7:17:26 AM

I saw too many women who were carrying their husband and children on their employer-provided health insurance because the husband was self-employed
HUH????



scary.... the whole thing is scary...

lynlam
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Posted: 2/1/2013 10:30:09 AM

Just where is the logic?


Logic was thrown out the window sometime mid-2008. I fear it is gone forever, dead and buried by the progressive liberal mentality that has infected untold millions of human beings world wide.

Common sense and personal responsibility are also buried in shallow unmarked graves nearby.





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beachgurl
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Posted: 2/1/2013 10:53:15 AM

Where's all that "affordable" stuff?



It's right over there, next to the "hope".




purpledaisy
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Posted: 2/1/2013 11:08:04 AM

I saw too many women who were carrying their husband and children on their employer-provided health insurance because the husband was self-employed. It was a good deal for the women and a very bad deal for our employer.
And the problem with this is...? Isn't this exactly like a husband who carries the policy for his SAHM wife and children?


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Posted: 2/1/2013 11:08:21 AM

In fact several young, single people were hired just because it would be cheaper for the employer.



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doesitmatter?
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Posted: 2/1/2013 11:37:19 AM
So millions of children will take the brunt of this and go completely uninsured. I am beyond livid.

Please - Obama supporters - explain why this is ok? Because the more research I do the angrier I'm getting. Please tell me I'm misunderstanding this - please.


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Posted: 2/1/2013 11:46:33 AM

Actually I don't have a problem with this. I saw too many women who were carrying their husband and children on their employer-provided health insurance because the husband was self-employed. It was a good deal for the women and a very bad deal for our employer.
WTF? That makes NO sense. LMAO. Like husbands do for their wives who stay home and raise their children or decide the wife wouldn't work because that was best for their family??

You must be joking.


Goodness gracious -- another epidemic of intentionally ignoring facts so as to make a point. Badly.

No where in my post did I say anything about SAHMs. I said that co-workers, meaning someone who works, carry the insurance for their husbands who are self-employed, meaning they work, and children. No one was satisfied and they let everyone know how much they hated their jobs and would quit if their husbands only had health insurance. Not the same situation at all as the SAHM, without an income, whose husband carries them on his policy. There is a huge, huge difference in cost between a single policy and a family policy.

IMO, every worker should buy coverage for themselves and put the kids on CHIPS. Of course the best solution is single payor. It's a shame that the lackeys for the private insurance companies bought enough senators off so they could continue their lavish salaries and lifestyles.



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maddiesmum
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Posted: 2/1/2013 11:51:11 AM


Logic was thrown out the window sometime mid-2008.


Obama didn't become president until January 20, 2009.

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Posted: 2/1/2013 11:51:19 AM
Wait, wait, wait, wait...I thought the main purpose of Obamacare was to ensure that EVERYONE, especially children, would be insured.

Please explain...



Logic was thrown out the window sometime mid-2008.
I respectfully disagree, logic has been extinct in politics for several decades.



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blondiek237
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Posted: 2/1/2013 11:56:25 AM
So am I reading this correctly. The government is MAKING you buy insurance. Your spouses employer offers insurance, but the family plan is too expensive (like if the employers cover the cost of the employee and for a family you pay the difference)so you cannot do that--then the government is not going to give you the subsidy because the employer single plan is considered affordable. But you HAVE to buy insurance even if you can't afford it. So does this family go homeless, or hungary??

PunchPrincess

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Posted: 2/1/2013 12:11:59 PM

DH has employer provided insurance and so do I. I cover the family since its $200 a month less than having DH cover it. Do the smart thing and don't worry about the "gender role". If DH wants to be self employed and I cover the insurance through my work, it shouldn't bother anyone.


My God, Mrs_T, has that cold weather frozen your brain cell? It should bother every one in your school district whose taxes pay for that insurance. Oh, there will be one employer who is very happy -- your husband's employer whose incentive to keep his premium just a bit higher than yours. There is no gender difference in my complaint. I would not be pleased to see a male worker carrying insurance on his wife/husband and children if he had a spouse who declined insurance because it would have cost them $200.

Someday your union may do what a friend of ours did -- if the spouse has insurance available at his work place, the teacher cannot carry them. End of story.



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Enough
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Posted: 2/1/2013 12:12:12 PM
Punch Princess, what country are you in?

blondiek237
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Posted: 2/1/2013 12:20:40 PM
So Punch Princess--you have an issue because my husband is self employed and I carry the insurance through my employer???

purpledaisy
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Posted: 2/1/2013 12:30:55 PM

Goodness gracious -- another epidemic of intentionally ignoring facts so as to make a point. Badly.

No where in my post did I say anything about SAHMs. I said that co-workers, meaning someone who works, carry the insurance for their husbands who are self-employed, meaning they work, and children. No one was satisfied and they let everyone know how much they hated their jobs and would quit if their husbands only had health insurance. Not the same situation at all as the SAHM, without an income, whose husband carries them on his policy. There is a huge, huge difference in cost between a single policy and a family policy.

I don't believe anyone who read your first post is ignoring any facts, badly or otherwise. Actually, I don't see any actual facts in your post to ignore. More like your opinion on a situation at your work place.

And as someone who has first hand knowledge and experience with how self-employed people pay through the nose for their health insurance, I can totally understand where those women are coming from. And unless their "hatred" of their jobs in any ways affects their work performance, I don't see where the employer has any beef.


Becca

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Posted: 2/1/2013 12:37:05 PM

My God, Mrs_T, has that cold weather frozen your brain cell? It should bother every one in your school district whose taxes pay for that insurance. Oh, there will be one employer who is very happy -- your husband's employer whose incentive to keep his premium just a bit higher than yours. There is no gender difference in my complaint. I would not be pleased to see a male worker carrying insurance on his wife/husband and children if he had a spouse who declined insurance because it would have cost them $200.

Someday your union may do what a friend of ours did -- if the spouse has insurance available at his work place, the teacher cannot carry them. End of story.


I really never agree with Mrs T BUT I do here. I know numerous families that have insurance available to them but since they are married they get the family coverage through one of the jobs. Please do not bring in Unions and Teachers into this conversation. It has nothing to do with those two things.

MochasMom
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Posted: 2/1/2013 12:37:56 PM

Punch Princess, what country are you in?
Forget what country she is in; there is an obvious disconnect going on.

MochasMom
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Posted: 2/1/2013 12:41:47 PM

know numerous families that have insurance available to them but since they are married they get the family coverage through one of the jobs. Please do not bring in Unions and Teachers into this conversation. It has nothing to do with those two things
Exactly. Why would a family decide to pay $200 more per month for insurance? What financial sense would that make. They are doing the right thing providing insurance for their family now we have someone saying they should spend $200 more per month to do that? The dumbing down of American has been successful.

ePEAcenter
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Posted: 2/1/2013 12:54:19 PM

It should bother every one in your school district whose taxes pay for that insurance.


Her employer offers both a single and family policy coverage. She opts for the family coverage and has the appropriate deductions from her paycheck to cover her portion of it. I really don't understand what your issue is.

PEArfect
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Posted: 2/1/2013 1:16:00 PM

It's right over there, next to the "hope".


This topic is definitely not funny, but this statement is.


Jen


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StuckOnPeas

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Posted: 2/1/2013 1:22:41 PM
scrappower

I live in WI, the "evil Act 10 " state" (gasp) and work in schools. Guess what? I , as a new employee, get 10 fully paid sick days, 3 personal days, and we can choose to carry the insurance if we so desire... and WE DON"T HAVE A UNION... YEP... no union representation at all. Still have 18 kids per class... sick days, insurance, long term care (fully funded) , HSA, and insurance..


I hate to rain on the Walker Sucks parade, but other than MPS, our schools are great, teachers aren't getting laid off or ripped off.

Care to tell me how the community is being gipped because of the gender taking the insurance? If my husband taught and I didn't , we'd take his insurance. You cannot make the case that a man should insure the family instead of the woman.

If you claim it's a rip off, who cares? The school board, approved by the community, doesn't have a problem with it.

scrappower
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Posted: 2/1/2013 1:24:05 PM

In a perfect world - if both spouses are working - each 'employee' would get insurance from their employer and the kids on one of the plans.


Yes, but the companies don't set up the plans like this. Usually it is either a single plan or a family plan which includes a spouse and up to so many kids. So they are the ones setting themselves up for this.



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StuckOnPeas

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Posted: 2/1/2013 1:24:27 PM
so each person should have their own insurance , how should kids be assigned to insurances.. rock paper scissors?

scrappower
Allons-y Alonso

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Posted: 2/1/2013 1:25:00 PM

scrappower

I live in WI, the "evil Act 10 " state" (gasp) and work in schools. Guess what? I , as a new employee, get 10 fully paid sick days, 3 personal days, and we can choose to carry the insurance if we so desire... and WE DON"T HAVE A UNION... YEP... no union representation at all. Still have 18 kids per class... sick days, insurance, long term care (fully funded) , HSA, and insurance..


I hate to rain on the Walker Sucks parade, but other than MPS, our schools are great, teachers aren't getting laid off or ripped off.

Care to tell me how the community is being gipped because of the gender taking the insurance? If my husband taught and I didn't , we'd take his insurance. You cannot make the case that a man should insure the family instead of the woman.

If you claim it's a rip off, who cares? The school board, approved by the community, doesn't have a problem with it.


Umm, I didn't write anything on this thread until AFTER your post. You are responding to Punch Princess, not me.



purpledaisy
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Posted: 2/1/2013 1:27:09 PM

In a perfect world - if both spouses are working - each 'employee' would get insurance from their employer and the kids on one of the plans.


Yes, but the companies don't set up the plans like this. Usually it is either a single plan or a family plan which includes a spouse and up to so many kids. So they are the ones setting themselves up for this.
That is what I started to say, but you said it better.


Becca

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anmore
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Posted: 2/1/2013 1:33:33 PM
Is the assumption that employers are picking up the full tab here?

My employer pays $3000/ year towards my health insurance - I pay the other $10000 to cover my husband and kids. He (DH) is self employed. BCBS here does not base their pricing on the number of kids....just family or single.
So who cares if I carry the insurance for them if I am paying 70% of it?



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Posted: 2/1/2013 1:45:32 PM

Yes, but the companies don't set up the plans like this. Usually it is either a single plan or a family plan which includes a spouse and up to so many kids.

The employers I have had set up at as employee only, employee and spouse, employee and children, employee and family. With my current employer, if I want to cover DH, I have to pay an extra $60 a month because he has the option of insurance at his job. DH's employer does something very similar but when it comes to children it is split by 1 child, 2 childre, or 3+ children.

As for Obamacare, I suspect that over the next year, before many of the provisions are started, there will be many things like this that will come out. And, as for PP and her comments, I really wish people would quit quoting her.





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StuckOnPeas

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Posted: 2/1/2013 1:56:51 PM
sorry. I apologize. M ean for punch princess.

lynlam
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Posted: 2/1/2013 2:04:43 PM
"Obama didn't become president until January 20, 2009. "
-----------

And he became the rock star nominee mid2008...that is when this country lost its ever lovin mind, going ga-ga over a community organizer turned junior senator with zero experience and a plethora of unanswered questions swirling around him. Logic was abandoned in favor of a toothy grin and a smooth speech delivery.





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scrappower
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Posted: 2/1/2013 2:08:01 PM

And he became the rock star nominee mid2008...that is when this country lost its ever lovin mind, going ga-ga over a community organizer turned junior senator with zero experience and a plethora of unanswered questions swirling around him. Logic was abandoned in favor of a toothy grin and a smooth speech delivery.







bridgyree
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Posted: 2/1/2013 2:15:52 PM

I know numerous families that have insurance available to them but since they are married they get the family coverage through one of the jobs.


We do! No kids here, just the two of us, but I opt out of my insurance and my husband pays to cover me on his insurance because it's cheaper. I get paid by my company to not use their insurance benefits and we save some money. We have practically the same insurance at our company though his is a little better (almost comparable to our premium plan) and we come out in the end. I can also use his FSA and enroll in AFLAC (which my company does not offer) by doing this. I'd be stupid not to.

If a company offers it they obviously know that people are going to advantage of the family plan. It's not like we lie about me not having the option to have insurance. They are well aware and it's totally legal.

blondiek237
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Posted: 2/1/2013 2:29:20 PM
Many small companies do not have the employee plus 1 option. My company doesn't and when I asked about, I was told that when a company adds this tier it increases the family plan. Mynowner had a family so no plus 1 for us.

anmore
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Posted: 2/1/2013 2:43:41 PM

It does matter. I isn't necessarily BCBS paying all your claims. Many employers are self employed. BCBS can be the plan administrator.

It also matters when it comes to renegotiating contracts for following years. Claim/cost history does play a role in the pricing of plans


Do you mean many employers are self insured? That is generally only the case for the municipalities and large companies. I work for a company with 10 employees. Our rates are approved by the state. BCBS definitely pays the claims.

And I can definitely see my employer paying the fine as opposed to their current contribution. It would save them money. And lord knows NYS has cadillac medicaid plans - CHP here is fantastic. Can't buy insurance like that anymore.


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Posted: 2/1/2013 5:47:53 PM
Single. Payer.

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Posted: 2/1/2013 6:20:37 PM

Her employer offers both a single and family policy coverage. She opts for the family coverage and has the appropriate deductions from her paycheck to cover her portion of it. I really don't understand what your issue is.


My issue is that the "appropriate deductions" Mrs T pays is probably around 20% of the actual cost of the coverage the rest of which is being paid by the homeowners in the district. Many school districts in Ohio are paying their teachers to take the family members off their plans and put them on the family plan of the spouse. If her district gave her the $200 per month she is saving, they would be ahead a ton and, surprise, could make that money available for salaries or equipment. Some districts refuse to cover the spouse and children if the spouse's birthday comes before the employee. Whatever way they choose to determine who pays for the family plan, as long as it is non-discriminatory, should decrease the number of people who are taking unfair advantage of an employer.

When DH started teaching, the single plan was 100% paid for by the district and we paid for the family plan for the children and me. It was quite expensive and didn't even cover office calls or immunizations.


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PunchPrincess ( def. A long, long time ago when I first started scrapping I discovered punches -- round, square, squiggles, cars, etc. You name it. Like coat hangers they multiplied, under the bed I think until they were threatening to take over that precious space that we all covet and refuse to cede to other family members. Thus I became PunchPrincess. )


raindancer
Capt. Sparrow's Pirate Wench

PeaNut 217,886
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Posted: 2/1/2013 7:03:44 PM

So am I reading this correctly. The government is MAKING you buy insurance. Your spouses employer offers insurance, but the family plan is too expensive (like if the employers cover the cost of the employee and for a family you pay the difference)so you cannot do that--then the government is not going to give you the subsidy because the employer single plan is considered affordable. But you HAVE to buy insurance even if you can't afford it. So does this family go homeless, or hungry??


I'm wondering the same. It seems entirely illogical. I feel like I'm surely misunderstanding something somewhere.

I also am failing to see how the term "affordable" is being used here.

It's a whole round of "I don't think that word means what you think it means".


~Heidi~



"You can make excuses or you can make progress but you can't make both."

MochasMom
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PeaNut 146,383
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Posted: 2/1/2013 7:17:38 PM

When DH started teaching, the single plan was 100% paid for by the district and we paid for the family plan for the children and me. It was quite expensive and didn't even cover office calls or immunizations
OK so?? What does that have to do with someone not spending $200.00 more per month than necessary by simply availing themselves of insurance through their employer? Are you going to attempt to tell us that you were employed and had insurance available but paid 100% of the family plan coverage through your DH's plan. Most people would call BS on that and then question the financial sense to that one.
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