Author Topic: Bill HR1458 and S565  (Read 30931 times)

cschwab

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Re: Bill HR1458 and S565
« Reply #15 on: May 22, 2010, 10:32:04 AM »
I was curious about what a person might be paying for health care if they make $40,000 and under, so I did some more digging around and did find a online Kaiser premium calculator and the section of the bill that limits out-of-pocket.  I thought it would be nice to figure out what is coming and I came up with the following numbers, they seem to closely jive with numbers I've seen elsewhere:

YEARLY INCOME             TOTAL EXPENSES (premiums and out-of-pocket)    PERCENT OF INCOME
$16,000                         $1557                                                                 9.7%
$20,000                         $3102                                                                15.5%
$25,000                         $4851                                                                19.4%
$30,000                         $5634                                                                18.8%
$40,000                         $7967                                                                19.9%
(corrected 7/18/2010)

Kaiser premium calculator:
http://healthreform.kff.org/Subsidycalculator.aspx

Sec. 1402. Reduced cost-sharing for individuals enrolling in qualified health plans. The standard out-of-pocket maximum limits ($5,950 for individuals and $11,900 for families) would be reduced to one-third for those between 100-200 percent of poverty, one-half for those between 200-300 percent of poverty, and to two-thirds for those between 300-400 percent of poverty.
http://dpc.senate.gov/healthreformbill/healthbill49.pdf

Cost-sharing subsidies (page 2) Provide cost-sharing subsidies to eligible individuals and families. The cost-sharing credits reduce the cost sharing amounts and annual cost-sharing limits and have the effect of increasing the actuarial value of the basic benefit plan to the following percentages of the full value of the plan for the specified income level:

100-150% FPL: 94%

150-200% FPL: 87%

200-250% FPL: 73%

250-400% FPL: 70%
http://www.kff.org/healthreform/upload/8061.pdf (added 7/18/2010)

So it looks to me someone making less than $40,000 a year is going to be asked to payout anywhere from ~10% to 20% of their income for health care (worst case) - that looks like a huge burden to me.  It sure looks like something more is needed.  And I trust private insurance only to try and keep the money; I would favor some sort of government help.

(used the example of someone 60 years old on an individual policy)
« Last Edit: July 18, 2010, 04:03:58 PM by cschwab »
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Angie

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Re: Bill HR1458 and S565
« Reply #16 on: May 22, 2010, 12:35:20 PM »
Great information Chris! :) I told the members of KK to come join up here and partake in this discussion and any feedback they have here.
 

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Reach out to celebrities and friends and family to educate about kidney disease. Don't wait for others to do that.

cschwab

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Re: Bill HR1458 and S565
« Reply #17 on: July 18, 2010, 11:27:28 AM »
I decided to have some more fun with math!  Some members of my church have been studying the new health care bill and told me about another clause in the bill that changes some of the numbers above:

Cost-sharing subsidies (page 2) Provide cost-sharing subsidies to eligible individuals and families. The cost-sharing credits reduce the cost sharing amounts and annual cost-sharing limits and have the effect of increasing the actuarial value of the basic benefit plan to the following percentages of the full value of the plan for the specified income level:

100-150% FPL: 94%

150-200% FPL: 87%

200-250% FPL: 73%

250-400% FPL: 70%
http://www.kff.org/healthreform/upload/8061.pdf

Also Kaiser updated their calculator to reflect 2014 doll.


And my church friends gave a worksheet to figure all this out.  Anyway, if anybody wants the long version of how to figure health care costs due to the new bill, here it is:
                                                                                                                           # 1                # 2
                                                                            Benefit                                      Out-of-         Out-of-
                                                        Benefit        Cost Limit               Prem Cost         Pocket           Pocket
                        Out-of-Pocket             Cost          (of $17,000)            After                Limits             Limits (b)
Ann'l Inc.           Ann'l Max (a)               Limit (%)        ($)(b)                 Credits (c)        (a) + (c)          + (c)

$16,000             $2083                         6%               $1020                 $537                $2620               $1557
$20,000             $2083                        13%              $2210                $1019               $3102               $3229
$25,000             $3125                        27%              $4590                $1726               $4851               $6316
$30,000             $3125                        30%              $5100                $2509               $5634               $7609
$40,000             $4167                        30%              $5100                $3800               $7967               $8900
------------------------------------------------------------------------------------------------------------------------

(continued)
Total est.          Health Expenses
Out-of-Pocket    % of income
Limit (Lessor      (premiums+
of #1 or #2)       out-of-pocket)
   
$1557                 9.7%
$3102               15.5%
$4851               19.4%
$5634               18.8%
$7967               19.9%

(Corrected the numbers in the May 22 post - 7/18/2010)
« Last Edit: July 18, 2010, 04:19:58 PM by cschwab »
Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years