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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: normal"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 'Times New Roman','serif'; mso-fareast-font-family: 'Times New Roman'">Unfortunately I have read a lot of it...not fun...if you have some real time read the accompanying House Report as well...not a fun treat. The nice promise that the feds will "pick up"- 90+ percent of a state's rise in cost is only words. Like all good laws that "authorize" expenditures, there has to be the appropriations laws to follow that. This law has a lot of hollow promises because it is dependent on future Congresses to actually appropriate the funds to pay for these programs. What this law did not do is completely set up a "tight" trust fund to actually put the funds into. The law will allow the new federal bureaucracy to establish these funds, provide a tax mechanism (the tax on those who earn over $200K (individuals) and $250K (families), plus the tax on small businesses and individuals who do not participate) for revenue but the actions of this bureaucracy will be subject to the whim of the President. Congress played some nice political tricks that could hurt this effort and this reliance on future appropriations is painful to read. They needed to set up a trust fund like the DOT, SSI, FAA and others have. Unfortunately I have a strong feeling that states will be nailed with the bill especially if we keep fighting our wars.</span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: normal"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 'Times New Roman','serif'; mso-fareast-font-family: 'Times New Roman'"> </span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 6pt; LINE-HEIGHT: normal"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 'Times New Roman','serif'; mso-fareast-font-family: 'Times New Roman'">Next up...what happens to insurance agents such as those who line North Main Street? The law cuts them out of the picture real quick. My wife and I enjoyed working with Jon Kimberling buying our health insurance plans that fit our family's needs. So much of life is now so automated and out of touch, I know I miss the good old days when I would wander into his office and he would work with us to arrive at just the right coverage to fit our budget. It was nice to have someone care about you and work with you. Never once did my wife or I have problems with the coverage we had through him.<span style="mso-spacerun: yes"> </span>It was so straight forward and Gritman and the doctors we had in Moscow worked well with that coverage.<span style="mso-spacerun: yes"> </span>We had two major claims and a surgery while on that plan and we did just fine and never had issues with what was covered.<span style="mso-spacerun: yes"> </span>The first time we had trouble with medical insurance was when her and I am my children were on the damn U of <span style="mso-spacerun: yes"> </span>I plan and all of their pre-authorization of this or denial of that or heck no we can’t cover that.<span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span>Now it will be nameless bureaucrats trying to fit families into these rather odd large pools that no one really knows how they will function. The great American experiment continues....</span></p>
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<div class="gmail_quote">On Wed, Mar 24, 2010 at 6:23 PM, Andreas Schou <span dir="ltr"><<a href="mailto:ophite@gmail.com">ophite@gmail.com</a>></span> wrote:<br>
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<div class="im">> Look at FY08 Medicaid spending in Idaho... $369,000,000 for around 220,000<br>> residents or around $1670 per person. Under the new law everyone who is<br>> Medicaid eligible will be required to go on Medicaid.<br>
<br></div>This isn't true, I suspect, unless some other subsection overrules<br>this one in a way I don't understand. True, mandate requires all<br>families to maintain minimum essential coverage. However, there's an<br>
exemption in Chapter 48(e)(1)(A), which reads as follows:<br><br>"IN GENERAL- Any applicable individual for any month if the applicable<br>individual’s required contribution (determined on an annual basis) for<br>coverage for the month exceeds 8 percent of such individual’s<br>
household income for the taxable year described in section<br>1412(b)(1)(B) of the Patient Protection and Affordable Care Act. For<br>purposes of applying this subparagraph, the taxpayer’s household<br>income shall be increased by any exclusion from gross income for any<br>
portion of the required contribution made through a salary reduction<br>arrangement."<br><br>I'll admit that there's a possibility that at some point in the<br>future, that could become a problem. If the yearly cost of "minimum<br>
essential coverage" dropped below 8% of 133% of the poverty line, or<br>around $1,760 in hypothetical 2014-bucks for Donovan's two-person<br>family, then a Medicaid-eligible family would be required to go to the<br>
private market to find insurance. However, that would solve more<br>problems than it created.<br>
<div class="im"><br>> Then add in that Medicaid sucks, you have no real choice of doctors, they<br>> decide your treatment plans and options, they can deny "expensive"<br>> medications, many states drug test those who receive Medicaid, other add in<br>
> the insult of throwing in various child protective service requirements.<br><br></div>Medicaid isn't great. It does, however, receive higher marks for<br>satisfaction than America's private insurance market. See here, for<br>
instance:<br><br><a href="http://www.nationaljournal.com/njonline/mp_20090629_2600.php" target="_blank">http://www.nationaljournal.com/njonline/mp_20090629_2600.php</a><br>
<div class="im"><br>> Have any of you actually read the new law?<br><br></div>I'm not accusing you of anything, Chris, but it doesn't look like<br>you've read it either*.<br><br>-- ACS<br><br>* I haven't read the whole thing not only because it's long, but<br>
because it's got a lot of moving parts; cross-referencing 2000 pages<br>worth of legalese is roughly impossible, even for a specialist. I<br>suspect you can get a better sense of it from the chairman's draft and<br>
summaries than by reading the actual text itself. However, if you do<br>actually want to subject yourself to the whole thing, you can find it<br>here:<br><br><a href="http://www.opencongress.org/bill/111-h3590/text?version=enr&nid=t0:enr:1727" target="_blank">http://www.opencongress.org/bill/111-h3590/text?version=enr&nid=t0:enr:1727</a><br>
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