Missouri's Proposition C

Originally posted by bbarr
Yep, and it sucks. But the problem is that health care costs have so many interlocking parts that you can't increase coverage and lower costs without measures like this. If people are allowed to opt out of health insurance, then health insurers will not have the revenue base from premiums that will allow them to cover those with chronic expensive conditions. ...[text shortened]... the costs would be distributed among the citizenry. Then healthy people would cry "Theft!".

I'm not at all sure the individual mandate is necessary; how many people will actually refuse to buy health insurance when there are generous subsidies to help them pay for it? My guess is very few.

Originally posted by no1marauder
I'm not at all sure the individual mandate is necessary; how many people will actually refuse to buy health insurance when there are generous subsidies to help them pay for it? My guess is very few.

Good question. How generous are the subsidies?

Originally posted by bbarr
Good question. How generous are the subsidies?

Subsidies are available for those with incomes up to 4 times the poverty level (that would be $44,000 for a single person and $88,000 for a family of four in 2010). This is way above median income.

Subsidies would be figured on a sliding scale, with those who make less getting a bigger boost and those nearer the top getting a smaller one. As for the amounts:

The formula is pretty complicated. Basically, though, people who make three or four times the poverty level would get enough federal money so that they would not have to pay more than about 10 percent of their income for a decent health insurance package.

People who make less would have to pay a smaller slice of their income for coverage. For instance, individuals who make about $14,000, and four-person families with incomes of about $29,000, would not have to pay more than 3 to 4 percent of their incomes for insurance.

And those who make even less – under 133 percent of the federal poverty level – would be able to enroll in a newly expanded Medicaid program.

http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance


I really think the whole mandate issue is overblown.

Originally posted by no1marauder
Subsidies are available for those with incomes up to 4 times the poverty level (that would be $44,000 for a single person and $88,000 for a family of four in 2010). This is way above median income.

Subsidies would be figured on a sliding scale, with those who make less getting a bigger boost and those nearer the top getting a smaller one ...[text shortened]... s-subsidized-insurance


I really think the whole mandate issue is overblown.

O.K., but aren't the mandate and the subsidies connected? Presumably revenue from taxing the willfully uninsured will go towards paying the subsidies, and the effectiveness of the subsidies in covering health-insurance costs is contingent upon the costs as estimated on the assumption of forced compliance. So, I'm not sure that the subsidies would work as you propose in the absence of the mandate.

Originally posted by bbarr
O.K., but aren't the mandate and the subsidies connected? Presumably revenue from taxing the willfully uninsured will go towards paying the subsidies, and the effectiveness of the subsidies in covering health-insurance costs is contingent upon the costs as estimated on the assumption of forced compliance. So, I'm not sure that the subsidies would work as you propose in the absence of the mandate.

The penalties are so low that I do not think it is anticipated that they will bring in any significant revenue. Certainly such penalties will not cover anywhere near the cost of the subsidies. So I don't think the subsidies are dependant on the mandate.

EDIT: In 2016, the first year the fine is fully in place, it will be $695 a year or 2.5 percent of income, whichever is higher. That makes the mandate progressive.

And what happens if you don't buy insurance and you don't pay the penalty? Well, not much. The law specifically says that no criminal action or liens can be imposed on people who don't pay the fine. If this actually leads to a world in which large numbers of people don't buy insurance and tell the IRS to stuff it, you could see that change. But for now, the penalties are low and the enforcement is non-existent.

http://voices.washingtonpost.com/ezra-klein/2010/03/how_does_the_individual_mandat.html

Originally posted by no1marauder
The penalties are so low that I do not think it is anticipated that they will bring in any significant revenue. Certainly such penalties will not cover anywhere near the cost of the subsidies. So I don't think the subsidies are dependant on the mandate.

EDIT: In 2016, the first year the fine is fully in place, it will be $695 a year or 2.5 percent of ...[text shortened]...

http://voices.washingtonpost.com/ezra-klein/2010/03/how_does_the_individual_mandat.html

I guess. But we're not dealing with ideally rational health care consumers. I'm not sure how to best estimate whether the presence of a fine is more motivating than the availability of a subsidy. The CBO estimates that when the fines are phased in fully in 2016, the feds will collect around 4 Billion dollars annually from the fines. Admittedly, this is only about 5% of annual costs for the reform bill.