Can someone break "Obamacare" & alternatives down in an easy to understand why?

[DevotedDemocrat]

Back during the debates over what would become known as "Obamacare" in 2009 and 2010, there were numerous ideas about what shape the reforms would take; what parts of the program might be accepted, what other parts might be scrapped or sized down in compromise.

But I've found the final law, with it's grand scope and different parts coming into effect at different times, can someone break down Obamacare into simple terms and lay out for me exactly what it does, how it reforms the healthcare industry, and when each part will go into effect, and if with the GOP now starting in again, is it dead in the water?

The only parts I am truly clear on are the individual mandate (but I'm not sure how it would work once put into effect) and children being able to stay under their parents' insurance plans until age 24.

And also, what are some alternative plans which could provide Universal Healthcare--by which I mean affordable, easy to access, high quality care, that would cover all--or an overwhelming majority of Americans? What are some alternative ideas? It's obvious that our healthcare system needs a lot of tweaking, and a lot of fixing, and I believe even our existing programs such as Medicare and Medicaid could use reform--only to cleanse the abuse from those programs, not change or gut them.

But I'm not sure if Obamacare is the right route to go in fixing our healthcare system, so if someone could break Obamacare and what it would do down simply, it'd make it easier to understand, and perhaps if I understand it better, I could better support it, and defend it against my Republican peers.

[King]

1. It is mandated that every American purchase health insurance or pay a fee.

2. To assist in this, the state and/or federal government sets up health care exchanges with Bronze/Silver/Gold/Platinum plans offered by the government.  The plans are not run by the government, but contracted to private insurers in each state depending on who bidded the lowest price to be the official bronze, silver, gold, or platinum plan in each state. 

3. If you can still not afford the lowest price of these four plans, the government will also be providing tax subsidies depending on your distance from the poverty line--above 100%, 200%, 300%, or 400% to assist you in this payment.

4. Note the subsidies are only for above the poverty line.  If you are below it, you receive an even greater subsidy: the ability to now join Medicaid through a state run Medicaid expansion, paid fully by the federal government.  That's right--free health insurance for the poor at not cost to the state government.  Unfortunately, many states run by anti-Obamacare governors and legislatures have decided against expanding Medicaid, leaving millions of below poverty line Americans with no insurance and no subsidy.  Meaning, the poorest Texans, Alabamans, North Dakotans, etc. will be forced to pay fees for no insurance because the state government refuses to accept free money to give them insurance. On the bright side, the emergency room costs, costs to employers of low income earners, and loss of income by Medicaid institutions is economic damnation for these states and competition between states will eventually require them to file suit.

That, my friends, is Obamacare in four points.  Note how the longest, most convoluted point of the four is the only one where anti-Obamacare influences have tried to meddle in.

[Blue3]

children being able to stay under their parents' insurance plans until age 24.

Age 26, actually.

[DevotedDemocrat]

1. It is mandated that every American purchase health insurance or pay a fee.

2. To assist in this, the state and/or federal government sets up health care exchanges with Bronze/Silver/Gold/Platinum plans offered by the government.  The plans are not run by the government, but contracted to private insurers in each state depending on who bidded the lowest price to be the official bronze, silver, gold, or platinum plan in each state. 

3. If you can still not afford the lowest price of these four plans, the government will also be providing tax subsidies depending on your distance from the poverty line--above 100%, 200%, 300%, or 400% to assist you in this payment.

4. Note the subsidies are only for above the poverty line.  If you are below it, you receive an even greater subsidy: the ability to now join Medicaid through a state run Medicaid expansion, paid fully by the federal government.  That's right--free health insurance for the poor at not cost to the state government.  Unfortunately, many states run by anti-Obamacare governors and legislatures have decided against expanding Medicaid, leaving millions of below poverty line Americans with no insurance and no subsidy.  Meaning, the poorest Texans, Alabamans, North Dakotans, etc. will be forced to pay fees for no insurance because the state government refuses to accept free money to give them insurance. On the bright side, the emergency room costs, costs to employers of low income earners, and loss of income by Medicaid institutions is economic damnation for these states and competition between states will eventually require them to file suit.

That, my friends, is Obamacare in four points.  Note how the longest, most convoluted point of the four is the only one where anti-Obamacare influences have tried to meddle in.

It doesn't sound nearly as bad as the right wing media made it sound (not surprisingly) but it also sounds much more simple than the the way the Administration/Dem supporters sold it. Both sides, thus, have kind of done the program an injustice in either purposely misleading, or badly advertising, what would seem to be a good set of reforms, to the American public.

And just to bring the point home:

How would Obamacare affect a 23 year old minimum wage (part time) worker in New Jersey? If that person has no real savings or assets and only lives on that minimum wage? Would they be able to get reasonable health coverage (IE dental, emergency care, vision)? Or would a good chunk of their paycheck go toward covering said insurance?

And what if said person moved to Texas, as you mentioned them in your post?

[King]

It doesn't sound nearly as bad as the right wing media made it sound (not surprisingly) but it also sounds much more simple than the the way the Administration/Dem supporters sold it.

I don't think a lot of Democrats are bothering to understand it in simplistic terms either.  Most of the 2500 pages of this bill is simply citations to previous legislation.  Most of the rules are rules against insurers that the consumer does not have to decide upon.

How would Obamacare affect a 23 year old minimum wage (part time) worker in New Jersey? If that person has no real savings or assets and only lives on that minimum wage? Would they be able to get reasonable health coverage (IE dental, emergency care, vision)? Or would a good chunk of their paycheck go toward covering said insurance?

And what if said person moved to Texas, as you mentioned them in your post?

Assuming their parents are not dead, said 23 year old should be allowed to be insurance dependents for the next three years on their parents' healthcare plan.  At that point, their salary will determine whether they are subsidized or Medicaid (or if they really hit it rich are paying their own way).

If they turned 27 today, Medicaid would be available for them in NJ but not TX.  Hopefully by 2016-17, that person will be able to find Medicaid wherever he goes.

[7,052,770]

In addition, insurance companies cannot deny people for any reason during the Open Enrollment periods, nor can they charge extra for people with pre-existing conditions (or for issues such as obesity).  In fact, the price of the insurance can ONLY vary by age, tobacco status, and location, and for family plans, the number of people in the family.

In addition, there are a lot of transfer payments between insurance companies to iron out the effect of coincidentally high or low claims to keep the prices more consistent from year to year and from company to company.

[Lief 🗽]

There's also a kitchen sink's worth of cost-saving rules, incentives and taxes in the bill, which will hopefully continue to decrease the rate of yearly growth in healthcare costs.

[Indy Texas]

Obamacare = Socialism, Communism, Fascism, Death, Tyranny

The Alternative (Nothing) = Freedom, 'Merica, Protecting Babies From Getting Aborted

[🐒Gods of Prosperity🔱🐲💸]

4. Note the subsidies are only for above the poverty line.  If you are below it, you receive an even greater subsidy: the ability to now join Medicaid through a state run Medicaid expansion, paid fully by the federal government.  That's right--free health insurance for the poor at not cost to the state government.  Unfortunately, many states run by anti-Obamacare governors and legislatures have decided against expanding Medicaid, leaving millions of below poverty line Americans with no insurance and no subsidy.  Meaning, the poorest Texans, Alabamans, North Dakotans, etc. will be forced to pay fees for no insurance because the state government refuses to accept free money to give them insurance. On the bright side, the emergency room costs, costs to employers of low income earners, and loss of income by Medicaid institutions is economic damnation for these states and competition between states will eventually require them to file suit.

That, my friends, is Obamacare in four points.  Note how the longest, most convoluted point of the four is the only one where anti-Obamacare influences have tried to meddle in.

It's not quite true that the Medicaid expansions won't cost the state governments.  Each state will pay something like 10% of the expansion.  It's true the net cost may be close to zero given the reduction in uncompensated care, though Medicaid doesn't have the best track record when it comes to paying out to health care providers anyway and so a lot of people on Medicaid have trouble being seen.

Another important component of Obamacare is the employer mandate, which is that employers with 50 or more employees must provide health insurance to those who work more than 30 hours or face a penalty.  A lot of employers have been reducing hours in order to get around this.

There's also a kitchen sink's worth of cost-saving rules, incentives and taxes in the bill, which will hopefully continue to decrease the rate of yearly growth in healthcare costs.

I haven't seen anything that suggests there's anything that will make a difference.  And I don't understand how adding a tax on top of something is supposed to make it cost less in any practical sense.

[memphis]

No employer has cut anybody's hours because of the healthcare law.  The employer mandate doesn't even begin until 2015.

[All Along The Watchtower]

No employer has cut anybody's hours because of the healthcare law.  The employer mandate doesn't even begin until 2015.

Employers will generally use any excuse to cut hours these days.

[🐒Gods of Prosperity🔱🐲💸]

No employer has cut anybody's hours because of the healthcare law.  The employer mandate doesn't even begin until 2015.

Did you not notice that whole thing about the mandate being delayed? It was going to be much sooner, and employers actually prepare for things ahead of time when something is coming down the pipe. If you want to believe that the fact that there have been many employers cutting people to 29 hours is just a coincidence, I suppose you can do that.

[t_host1]

1. It is mandated that every American purchase health insurance or pay a fee.

2. To assist in this, the state and/or federal government sets up health care exchanges with Bronze/Silver/Gold/Platinum plans offered by the government.  The plans are not run by the government, but contracted to private insurers in each state depending on who bidded the lowest price to be the official bronze, silver, gold, or platinum plan in each state. 

3. If you can still not afford the lowest price of these four plans, the government will also be providing tax subsidies depending on your distance from the poverty line--above 100%, 200%, 300%, or 400% to assist you in this payment.

4. Note the subsidies are only for above the poverty line.  If you are below it, you receive an even greater subsidy: the ability to now join Medicaid through a state run Medicaid expansion, paid fully by the federal government.  That's right--free health insurance for the poor at not cost to the state government.  Unfortunately, many states run by anti-Obamacare governors and legislatures have decided against expanding Medicaid, leaving millions of below poverty line Americans with no insurance and no subsidy.  Meaning, the poorest Texans, Alabamans, North Dakotans, etc. will be forced to pay fees for no insurance because the state government refuses to accept free money to give them insurance. On the bright side, the emergency room costs, costs to employers of low income earners, and loss of income by Medicaid institutions is economic damnation for these states and competition between states will eventually require them to file suit.

That, my friends, is Obamacare in four points.  Note how the longest, most convoluted point of the four is the only one where anti-Obamacare influences have tried to meddle in.

It doesn't sound nearly as bad as the right wing media made it sound (not surprisingly) but it also sounds much more simple than the the way the Administration/Dem supporters sold it. Both sides, thus, have kind of done the program an injustice in either purposely misleading, or badly advertising, what would seem to be a good set of reforms, to the American public.

And just to bring the point home:

How would Obamacare affect a 23 year old minimum wage (part time) worker in New Jersey? If that person has no real savings or assets and only lives on that minimum wage? Would they be able to get reasonable health coverage (IE dental, emergency care, vision)? Or would a good chunk of their paycheck go toward covering said insurance?

And what if said person moved to Texas, as you mentioned them in your post?

Why would you want to work?
 You wouldn't have to be concerned about what it cost.
Say, where is thread of past health care insurance policy holders, so we compare 07- 08 - 09 -10 - 11 and 2012 rates and what the policies paid for with the deductible? Who here has employees that your paying their healthcare premiums, Obama says you're cost should be 25% less now.

[memphis]

No employer has cut anybody's hours because of the healthcare law.  The employer mandate doesn't even begin until 2015.

Did you not notice that whole thing about the mandate being delayed? It was going to be much sooner, and employers actually prepare for things ahead of time when something is coming down the pipe. If you want to believe that the fact that there have been many employers cutting people to 29 hours is just a coincidence, I suppose you can do that.

I've heard a lot of speculation and hysteria. Precious few actual examples. Hiring and training new people to cover shifts is a very expensive, troublesome thing as well. Not nearly as easy as the rightwing scaremongers want us to believe. We'll see what happens. No system is going to be 100% air tight.

[🐒Gods of Prosperity🔱🐲💸]

No employer has cut anybody's hours because of the healthcare law.  The employer mandate doesn't even begin until 2015.

Did you not notice that whole thing about the mandate being delayed? It was going to be much sooner, and employers actually prepare for things ahead of time when something is coming down the pipe. If you want to believe that the fact that there have been many employers cutting people to 29 hours is just a coincidence, I suppose you can do that.

I've heard a lot of speculation and hysteria. Precious few actual examples. Hiring and training new people to cover shifts is a very expensive, troublesome thing as well. Not nearly as easy as the rightwing scaremongers want us to believe. We'll see what happens. No system is going to be 100% air tight.

There have been threads on this in the past.  Here is the latest example.  Adjunct faculty in Virginia public colleges and elsewhere is another.