{"id":346,"date":"2013-04-04T11:24:15","date_gmt":"2013-04-04T15:24:15","guid":{"rendered":"http:\/\/www.dougsbriefcase.com\/blog\/?p=346"},"modified":"2013-04-04T12:02:16","modified_gmt":"2013-04-04T16:02:16","slug":"52-a-month-for-health-insurance-sounds-like-a-great-deal-but-maybe-not","status":"publish","type":"post","link":"https:\/\/www.dougsbriefcase.com\/blog\/52-a-month-for-health-insurance-sounds-like-a-great-deal-but-maybe-not\/","title":{"rendered":"$52 a month for health insurance sounds like a great deal. But maybe not."},"content":{"rendered":"

 <\/p>\n

\"Maybe<\/a>

Maybe Kevin Cost\u00adner should build the new health exchanges.<\/p><\/div>\n

Would you pay $52 per month for health insur\u00adance cov\u00ader\u00adage?<\/span>  <\/span><\/span><\/span><\/p>\n

Palm Beach Coun\u00adty offi\u00adcials thought peo\u00adple would.<\/span>  <\/span>They were wrong<\/a>. <\/span><\/span><\/p>\n

The coun\u00adty estab\u00adlished its pro\u00adgram in 2006 to cov\u00ader peo\u00adple who did not qual\u00adi\u00adfy for Med\u00adic\u00adaid despite low incomes.<\/span>  <\/span>With an esti\u00admat\u00aded 250,000 unin\u00adsured peo\u00adple out of a pop\u00adu\u00adla\u00adtion of 1.3 mil\u00adlion, coun\u00adty offi\u00adcials were sur\u00adprised that so few eli\u00adgi\u00adble unin\u00adsured peo\u00adple (indi\u00advid\u00adu\u00adals with incomes below $34,470 or three times the fed\u00ader\u00adal pover\u00adty guide\u00adlines) snapped up their gen\u00ader\u00adous offer.<\/span><\/span>  <\/span>By the end of the first year, few\u00ader than 500 had enrolled.<\/span><\/span>  <\/span>In the pro\u00adgram\u2019s sev\u00adenth year, that num\u00adber has grown to 11,000, still just a frac\u00adtion of those eligible.<\/span><\/span><\/span><\/p>\n

What went wrong?<\/span><\/span><\/p>\n

Accord\u00ading to those involved with the pro\u00adgram, the prob\u00adlem wasn\u2019t price.<\/span>  <\/span>Focus group research con\u00advinced offi\u00adcials that low income peo\u00adple would glad\u00adly shell out $52 a month for cov\u00ader\u00adage.<\/span><\/span>  <\/span>Sev\u00aden years into the exper\u00adi\u00adment, they still think they got the price right.<\/span><\/span>  <\/span>So why have so few peo\u00adple signed up?<\/span><\/span><\/span><\/p>\n

\u201c<\/span>A lot of peo\u00adple who are unin\u00adsured and can afford it, don\u2019t buy it because they aren\u2019t sick,\u201d <\/span> <\/span>Paul Gion\u00adfrid\u00addo, a con\u00adsul\u00adtant who worked to enroll peo\u00adple in the pro\u00adgram, told the <\/span><\/span>Tam\u00adpa Tribune.<\/span><\/i><\/p>\n

In Wash\u00ading\u00adton health pol\u00adi\u00adcy cir\u00adcles, Gion\u00adfrid\u00addo would be con\u00adsid\u00adered a heretic.<\/span>  <\/span>One of the under\u00adly\u00ading prin\u00adci\u00adples of the President\u2019s \u201cPatient Pro\u00adtec\u00adtion and Afford\u00adable Care Act\u201d (PPACA<\/span>) is that if insur\u00adance is made more afford\u00adable, peo\u00adple will buy it.<\/span><\/span>   <\/span>They point to Mass\u00ada\u00adchu\u00adsetts, which has achieved vir\u00adtu\u00adal\u00adly uni\u00adver\u00adsal cov\u00ader\u00adage, as a model.<\/span><\/span><\/span><\/p>\n

But that mod\u00adel may not work so well else\u00adwhere.<\/span>  <\/span>It hasn\u2019t in Palm Beach or in Jack\u00adsonville, Flori\u00adda, which runs a sim\u00adi\u00adlar\u00adly unsuc\u00adcess\u00adful pro\u00adgram for small busi\u00adness\u00ades with low-income workers.<\/span><\/span><\/span><\/p>\n

Wash\u00ading\u00adton pol\u00adi\u00adcy\u00admak\u00aders expect that the pub\u00adlic response will look more like Mass\u00ada\u00adchu\u00adsetts than Flori\u00adda.<\/span>  <\/span>One rea\u00adson, they say, is that peo\u00adple who buy cov\u00ader\u00adage will receive sub\u00adsi\u00addies that will make care more afford\u00adable, while peo\u00adple who don\u2019t buy cov\u00ader\u00adage will have to pay penal\u00adties<\/a>.<\/span><\/span>  <\/span>The sub\u00adsi\u00addies essen\u00adtial\u00adly cap pre\u00admi\u00adums that indi\u00advid\u00adu\u00adals will pay at a per\u00adcent\u00adage of their pre-tax income.<\/span><\/span>  <\/span>The table below shows, for exam\u00adple, that an indi\u00advid\u00adual who earns $28,725 will pay no more than $2,312.36 annu\u00adal\u00adly for cov\u00ader\u00adage, rep\u00adre\u00adsent\u00ading 8.05 per\u00adcent of her income.<\/span><\/span>  <\/span>Some\u00adone earn\u00ading $40,215 would pay no more than $3,820 for that same cov\u00ader\u00adage, or 9.5 per\u00adcent of wages.<\/span><\/span>  <\/span>But as this chart shows, not only will the sub\u00adsi\u00addized pre\u00admi\u00adums be much high\u00ader than Palm Beach County\u2019s $52 per month, but those pre\u00admi\u00adums will be 8 or 9 times as large as poten\u00adtial penalties.<\/span><\/span><\/span><\/p>\n

\n\n\n\n\n\n\n\n\n\n\n\n
\n

Sub\u00adsi\u00addized Pre\u00admi\u00adums and Penal\u00adties Under Health Care Law<\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n

Indi\u00advid\u00adual Income<\/span><\/strong><\/td>\n\n

Annu\u00adal Premiums<\/span><\/strong><\/p>\n<\/td>\n

\n

Penal\u00adties<\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n

$28,725 (250% FPL<\/span>)<\/span><\/td>\n\n

$2312.36<\/span><\/p>\n<\/td>\n

\n

$287.25<\/span><\/p>\n<\/td>\n<\/tr>\n

$34,470 (300% FPL<\/span>)<\/span><\/td>\n\n

$3274.65<\/span><\/p>\n<\/td>\n

\n

$344.70<\/span><\/p>\n<\/td>\n<\/tr>\n

$40,215 (350% FPL<\/span>)<\/span><\/td>\n\n

$3820.43<\/span><\/p>\n<\/td>\n

\n

$402.15<\/span><\/p>\n<\/td>\n<\/tr>\n

Fam\u00adi\u00adly of 4 Income<\/span><\/strong><\/td>\n\n

 <\/span><\/p>\n<\/td>\n

\n

 <\/span><\/p>\n<\/td>\n<\/tr>\n

$58,875 (250% FPL<\/span>)<\/span><\/td>\n\n

$4739.44<\/span><\/p>\n<\/td>\n

\n

$588.75<\/span><\/p>\n<\/td>\n<\/tr>\n

$70,650 (300% FPL<\/span>)<\/span><\/td>\n\n

$6711.75<\/span><\/p>\n<\/td>\n

\n

$706.50<\/span><\/p>\n<\/td>\n<\/tr>\n

$82,425 (350% FPL<\/span>)<\/span><\/td>\n\n

$7830.38<\/span><\/p>\n<\/td>\n

\n

$824.25<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

 <\/span><\/p>\n

The IRS<\/span> will have a tough time assess\u00ading those penal\u00adties.<\/span>  <\/span>Unlike with oth\u00ader tax\u00ades, the IRS<\/span> can\u2019t use its usu\u00adal tools to enforce the new levy on the unin\u00adsured.<\/span><\/span>  <\/span>They can\u2019t gar\u00adnish their wages, for exam\u00adple, or put them in jail.<\/span><\/span>  <\/span>If you\u2019re unin\u00adsured and the gov\u00adern\u00adment catch\u00ades you, the most IRS<\/span> can do is with\u00adhold the penal\u00adty from your income tax refund.<\/span><\/span><\/span><\/p>\n

The health care law also elim\u00adi\u00adnates much of the risk of remain\u00ading unin\u00adsured.<\/span>  <\/span>Con\u00adsid\u00ader a 27-year-old who decides not to buy insur\u00adance for a few years, pays the penal\u00adty (or not), then signs up at age 33 after hurt\u00ading her knee while play\u00ading vol\u00adley\u00adball.<\/span><\/span>  <\/span>She can get cov\u00ader\u00adage at the sub\u00adsi\u00addized rate dur\u00ading the annu\u00adal open sea\u00adson and her insur\u00adance will pay for treat\u00adment of her pre-exist\u00ading knee injury. <\/span><\/span> <\/span>Once she recov\u00aders, she can drop her insur\u00adance, stop pay\u00ading her pre\u00admi\u00adums and wait to re-enroll when she needs med\u00adical care again. <\/span><\/span><\/span><\/p>\n

Per\u00adhaps social pres\u00adsures can bend the young and healthy to the government\u2019s will.<\/span>  <\/span>Not buy\u00ading health insur\u00adance will be por\u00adtrayed as self\u00adish, irre\u00adspon\u00adsi\u00adble and boor\u00adish behav\u00adior, akin to oppos\u00ading same-sex mar\u00adriage or vot\u00ading Repub\u00adli\u00adcan.<\/span><\/span>  <\/span>That\u2019s one tool that Palm Beach Coun\u00adty offi\u00adcials didn\u2019t have.<\/span><\/span>  <\/span>The gov\u00adern\u00adment will dri\u00adve that mes\u00adsage through tele\u00advi\u00adsion, text mes\u00adsages and social media.<\/span><\/span>  <\/span> <\/span>The President\u2019s mas\u00adtery of Twit\u00adter and Face\u00adbook and his capac\u00adi\u00adty to deploy cul\u00adtur\u00adal icons to press his mes\u00adsage proved enor\u00admous\u00adly suc\u00adcess\u00adful in the recent elec\u00adtion.<\/span><\/span>  <\/span>But it\u2019s one thing to con\u00advince a young per\u00adson to vote for you or re-tweet your lat\u00adest meme on gun con\u00adtrol and quite anoth\u00ader to get him to part with 9.5 per\u00adcent of his pre-tax income for some\u00adthing he doesn\u2019t want or need.<\/span><\/span><\/span><\/p>\n

Mil\u00adlions of old\u00ader and sick\u00ader peo\u00adple have been shut out of the health insur\u00adance mar\u00adket because their med\u00adical costs are like\u00adly to great\u00adly exceed what\u00adev\u00ader pre\u00admi\u00adums they pay.<\/span>  <\/span>They can be expect\u00aded to flock to health insur\u00adance exchanges to buy cov\u00ader\u00adage once they open for busi\u00adness on Octo\u00adber 1.<\/span><\/span>  <\/span>In order for the sys\u00adtem to work, mil\u00adlions of young and healthy peo\u00adple will have to buy a prod\u00aduct they don\u2019t expect to use.<\/span><\/span>  <\/span>If the Palm Beach expe\u00adri\u00adence is any indi\u00adca\u00adtion, it will take more than sub\u00adsi\u00addized pre\u00admi\u00adums and sim\u00adpli\u00adfied enroll\u00adment to succeed.<\/span><\/span><\/span><\/p>\n

As Lin\u00adda Quick, pres\u00adi\u00addent of the South Flori\u00adda Hos\u00adpi\u00adtal and Health Care Asso\u00adci\u00ada\u00adtion, put it, <\/span>\u201c<\/span>The \u2018if you build it, they will come\u2019 phi\u00adlos\u00ado\u00adphy doesn\u2019t work in health care.\u201d<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Would you pay $52 per month for health insur\u00adance cov\u00ader\u00adage? Palm Beach Coun\u00adty offi\u00adcials thought peo\u00adple would. They were wrong. Con\u00adtin\u00adue read\u00ading \u2192<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":347,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","wp_typography_post_enhancements_disabled":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"nfd_image_url":"","nfd_onboarding_generated":"","footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[18,17,16],"tags":[62,57,58,61,54,56,53,55,1184,63,59],"class_list":["post-346","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-economy","category-entitlements","category-health-care","tag-affordable-care-act","tag-florida","tag-gionfriddo","tag-heath-insurance","tag-irs","tag-jacksonville","tag-linda-quick","tag-massachusetts","tag-medicaid","tag-palm-beach","tag-uninsured"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t