Health insurance

[human1234]

 

[human1234]

Every MAGA including @Mancode should not file health insurance claims ever so that these insurance companies and executives could get huge profits/bonus and they trickle down on all of us and everyone becomes rich

[Mancode]

4 minutes ago, human1234 said:

Every MAGA including @Mancode should not file health insurance claims ever so that these insurance companies and executives could get huge profits/bonus and they trickle down on all of us and everyone becomes rich

Obama care is driving up the costs...

Check othe thread where I quoted u ,in luigi mangione thread

 

 

[Mancode]

29 minutes ago, human1234 said:

Every MAGA including @Mancode should not file health insurance claims ever so that these insurance companies and executives could get huge profits/bonus and they trickle down on all of us and everyone becomes rich

I asked GRok ai

Yes, the Affordable Care Act (ACA) effectively subsidizes some people while contributing to rising costs for others—it’s a redistribution baked into how the law works. The ACA uses a mix of subsidies and regulations to make insurance more affordable for lower- and middle-income folks, but that can shift costs onto those who don’t qualify for help or who are outside the subsidized system.

Here’s how it plays out: the ACA provides premium tax credits and cost-sharing reductions for people buying plans on the marketplace, typically those earning 100-400% of the federal poverty level (about $14,580 to $58,320 for an individual in 2025). These subsidies cap what they pay for premiums—say, 2-8.5% of their income—and lower out-of-pocket costs like deductibles. In 2023, over 90% of marketplace enrollees got subsidies, averaging around $500 a month per person, according to CMS data. Medicaid expansion, part of the ACA in many states, also covers millions at little to no cost to them, funded largely by federal dollars.

But this isn’t free money—it’s paid for through taxes and, indirectly, higher insurance costs elsewhere. For instance, the ACA funds subsidies partly via taxes on high-income earners (like the Medicare surtax), insurers, and medical device makers. More subtly, though, it shifts costs onto people with employer-sponsored insurance or non-subsidized private plans. When insurers cover sicker patients under ACA rules—like no denials for pre-existing conditions—they spread those expenses across their entire customer base, not just marketplace plans. This jacks up premiums for everyone, including the unsubsidized.

Take employer plans: they don’t get ACA subsidies, yet their costs reflect the same market dynamics—higher provider rates and richer benefit mandates driven by ACA regulations. Kaiser Family Foundation data shows family premiums for employer coverage hit $22,463 in 2024, with workers paying about $6,296 out of pocket. Part of that rise ties to hospitals charging private insurer more to offset lower Medicaid/Medicare payments, a gap the ACA widened by expanding low-reimbursement programs. Meanwhile, someone on a subsidized ACA plan might pay $50 a month for a similar policy that’d cost $500 unsubsidized.

The unsubsidized feel it too—people earning over 400% of the poverty level on the marketplace get no help, and their premiums spiked post-ACA (think 20-30% jumps in 2017-2018 before stabilizing). Off-marketplace individual plans face the same inflated baseline costs without the tax credits.

So, yeah, the ACA’s subsidies lower costs for some—especially the poor and middle-class on the marketplace—while pushing up premiums and deductibles for others, particularly those with employer plans or higher incomes. It’s not a straight “rob Peter to pay Paul” deal, but the system’s design does mean the unsubsidized are picking up part of the tab through higher market-wide costs. Does that match what you’re seeing with your own insurance?

most of us not on gc/citizen , so doesnt cover any of aca, so we are subsidizing people on ACA 

@Iriswest @CanadianMalodu @gothamprince people work in healthcare should answer

[Mancode]

trump signed a eo on drug prices transparency

biden get rid of that

[Iriswest]

4 hours ago, Mancode said:

I asked GRok ai

Yes, the Affordable Care Act (ACA) effectively subsidizes some people while contributing to rising costs for others—it’s a redistribution baked into how the law works. The ACA uses a mix of subsidies and regulations to make insurance more affordable for lower- and middle-income folks, but that can shift costs onto those who don’t qualify for help or who are outside the subsidized system.

Here’s how it plays out: the ACA provides premium tax credits and cost-sharing reductions for people buying plans on the marketplace, typically those earning 100-400% of the federal poverty level (about $14,580 to $58,320 for an individual in 2025). These subsidies cap what they pay for premiums—say, 2-8.5% of their income—and lower out-of-pocket costs like deductibles. In 2023, over 90% of marketplace enrollees got subsidies, averaging around $500 a month per person, according to CMS data. Medicaid expansion, part of the ACA in many states, also covers millions at little to no cost to them, funded largely by federal dollars.

But this isn’t free money—it’s paid for through taxes and, indirectly, higher insurance costs elsewhere. For instance, the ACA funds subsidies partly via taxes on high-income earners (like the Medicare surtax), insurers, and medical device makers. More subtly, though, it shifts costs onto people with employer-sponsored insurance or non-subsidized private plans. When insurers cover sicker patients under ACA rules—like no denials for pre-existing conditions—they spread those expenses across their entire customer base, not just marketplace plans. This jacks up premiums for everyone, including the unsubsidized.

Take employer plans: they don’t get ACA subsidies, yet their costs reflect the same market dynamics—higher provider rates and richer benefit mandates driven by ACA regulations. Kaiser Family Foundation data shows family premiums for employer coverage hit $22,463 in 2024, with workers paying about $6,296 out of pocket. Part of that rise ties to hospitals charging private insurer more to offset lower Medicaid/Medicare payments, a gap the ACA widened by expanding low-reimbursement programs. Meanwhile, someone on a subsidized ACA plan might pay $50 a month for a similar policy that’d cost $500 unsubsidized.

The unsubsidized feel it too—people earning over 400% of the poverty level on the marketplace get no help, and their premiums spiked post-ACA (think 20-30% jumps in 2017-2018 before stabilizing). Off-marketplace individual plans face the same inflated baseline costs without the tax credits.

So, yeah, the ACA’s subsidies lower costs for some—especially the poor and middle-class on the marketplace—while pushing up premiums and deductibles for others, particularly those with employer plans or higher incomes. It’s not a straight “rob Peter to pay Paul” deal, but the system’s design does mean the unsubsidized are picking up part of the tab through higher market-wide costs. Does that match what you’re seeing with your own insurance?

most of us not on gc/citizen , so doesnt cover any of aca, so we are subsidizing people on ACA 

@Iriswest @CanadianMalodu @gothamprince people work in healthcare should answer

My degree has nothing to do with my work. I am an IT girl. 

[gothamprince]

On 2/23/2025 at 6:53 AM, Mancode said:

I asked GRok ai

Yes, the Affordable Care Act (ACA) effectively subsidizes some people while contributing to rising costs for others—it’s a redistribution baked into how the law works. The ACA uses a mix of subsidies and regulations to make insurance more affordable for lower- and middle-income folks, but that can shift costs onto those who don’t qualify for help or who are outside the subsidized system.

Here’s how it plays out: the ACA provides premium tax credits and cost-sharing reductions for people buying plans on the marketplace, typically those earning 100-400% of the federal poverty level (about $14,580 to $58,320 for an individual in 2025). These subsidies cap what they pay for premiums—say, 2-8.5% of their income—and lower out-of-pocket costs like deductibles. In 2023, over 90% of marketplace enrollees got subsidies, averaging around $500 a month per person, according to CMS data. Medicaid expansion, part of the ACA in many states, also covers millions at little to no cost to them, funded largely by federal dollars.

But this isn’t free money—it’s paid for through taxes and, indirectly, higher insurance costs elsewhere. For instance, the ACA funds subsidies partly via taxes on high-income earners (like the Medicare surtax), insurers, and medical device makers. More subtly, though, it shifts costs onto people with employer-sponsored insurance or non-subsidized private plans. When insurers cover sicker patients under ACA rules—like no denials for pre-existing conditions—they spread those expenses across their entire customer base, not just marketplace plans. This jacks up premiums for everyone, including the unsubsidized.

Take employer plans: they don’t get ACA subsidies, yet their costs reflect the same market dynamics—higher provider rates and richer benefit mandates driven by ACA regulations. Kaiser Family Foundation data shows family premiums for employer coverage hit $22,463 in 2024, with workers paying about $6,296 out of pocket. Part of that rise ties to hospitals charging private insurer more to offset lower Medicaid/Medicare payments, a gap the ACA widened by expanding low-reimbursement programs. Meanwhile, someone on a subsidized ACA plan might pay $50 a month for a similar policy that’d cost $500 unsubsidized.

The unsubsidized feel it too—people earning over 400% of the poverty level on the marketplace get no help, and their premiums spiked post-ACA (think 20-30% jumps in 2017-2018 before stabilizing). Off-marketplace individual plans face the same inflated baseline costs without the tax credits.

So, yeah, the ACA’s subsidies lower costs for some—especially the poor and middle-class on the marketplace—while pushing up premiums and deductibles for others, particularly those with employer plans or higher incomes. It’s not a straight “rob Peter to pay Paul” deal, but the system’s design does mean the unsubsidized are picking up part of the tab through higher market-wide costs. Does that match what you’re seeing with your own insurance?

most of us not on gc/citizen , so doesnt cover any of aca, so we are subsidizing people on ACA 

@Iriswest @CanadianMalodu @gothamprince people work in healthcare should answer

I don't work in American health care brother, no idea about this