New Health Law Frustrates Many in Middle Class | Hacker News Reader

New Health Law Frustrates Many in Middle Class

nytimes.com

34 pointskareemm97 comments

New trick I just learned for 2014 (and maybe 2015): you can get 12 month "short term health insurance") for about $50/yr. This isn't great coverage, but does have a $750k lifetime limit, which is probably enough for a single year. Short term insurance is not covered by ACA; it's more like disability insurance in that it's an indemnity.

You basically keep the plan for catastrophic insurance, and use it if necessary. If you get sick in 2014 and need more medical care in 2015, you switch in the next open enrollment period to an ACA compatible plan. You have to pay the penalty due to not being covered by an approved plan, but $95 and $695/yr isn't huge compared to the premium increase. (in extremis, you can also engineer a qualifying event for enrollment; if I discovered I had cancer of the soul or something in mid-2014, I'd move states, and as a new resident, be eligible for an ACA Gold plan...or get a job at a bigco, of course.)

I'm looking at doing this for 2014; $41/mo vs. $250/mo would be nice, even with a penalty.

Extra bonus: if you had an individual plan in 2013 (like I did) which got cancelled due to ACA, you don't have to pay the penalty in 2014, either.

This is one of the reasons that I'm not optimistic that AHA will work. It makes gaming the system too tempting.

And because it's a national system it's quite likely that as loopholes are found the knowledge will spread and undermine the whole thing.

EDIT: And because it's hitting middle to upper middle class folks it seems likely that they'll have the time and knowledge to successfully perform said gaming. All the more reason to build in some kind of gentle transition from full to some to zero help.

The AHA bill is 1,990 pages long [0]. From what I can tell, there are anywhere between 10,000 and 30,000 pages of regulations.

The Tax code had about 400 pages in 1913, about 19500 pages in 1974, and about 74000 pages today.

A lot of people complain about tax loopholes. I wonder how long it will take for the AHA regulations to double. There sure is a lot of room for loopholes and exceptions to hide in there.

[0] http://docs.house.gov/rules/health/111_ahcaa.pdf (3.3 MB)

There's also a lot of allied stuff, e.g. the stimulus bill is requiring doctors to move to electronic record keeping. And it has two crucial words, they must make "meaningful use" of the systems. According to a friend in the field, those two words blossomed into about 700 pages of regulations, and small fortunes are being made by consultants who give advice on this.

And I'd read of abd implementation where as the doctor fills in more info, more lights on the UI turn green. That one quit, judging the government was inserting itself a little too strongly in the doctor-patient relationship.

I'm having trouble interpreting your numbers; is the short-term insurance $50/year or $50/month? (Looking on ehealthinsurance.com, I don't see any short-term plans under $100/month, but that might be my age/zip.)

And why is $95 your estimate for the penalty? Won't most people with non-poverty incomes be paying the larger, 1%-of-income-over-the-filing-threshold, penalty?

$50/month. It is actually $30-50 one time and then $40-80/mo which is what I meant by $50/yr. plans are 6 or 12 months max duration depending on state.

$95 or 1%. I don't have to worry about the penalty in 2014 since my plan was cancelled in 2013. I didn't look into it enough to see it was the greater of $95 or 1%.

I'm not certain, but I see another alternative for those that find themselves screwed by the cliff and are self employed is to form an LLC and pay themselves a salary that keeps them at the ideal salary and keep balance in the company for future years. This has the added benefit of helping minimize tax obligations over the long term.

There are potentially dragons if you artificially reduce salary and retain earnings, but if you have a business justified way, it is possible. The other weirdness is that a lot of this is income based, not assets, so a rich "retired" person could get subsidies.

I bought cheap, catastrophic health insurance during my past year of funemployment. I eventually got a letter that the plan would not be offered in the future because it does not meet all provisions of the Affordable Care Act. Personally, it doesn't matter because I've got insurance through a job again, but it struck me as funny (or sad) that the law was strangling the cheapest plans. I have friends who are basically going without insurance now because the cheap bare-bone plans are drying up.

The thing about cheap catastrophic plans is that that is the price point where a lot of lousy plans would hang out. Lousy meaning, you get sick and all of a sudden find out that costs you thought were covered aren't actually covered. Or you get kicked off due to rescission. Or, the first $x is covered and then you're told you're on your own due to some fine print somewhere.

A lot of plans relied on that, which is what made them cheap, and customers would regularly get screwed by it, and Obamacare makes all that illegal now.

The downside for Obama is that if someone gets sick, and goes to the hospital and actually has their costs covered, they're not exactly going to be amazed that the plan works exactly as they would have expected. So in that sense, the law might never really get the appreciation it deserves.

I've heard this argument before, and I dislike the paternalism of it. I read the fine print and made tradeoffs that I thought were appropriate for my situation at the time.

I agree that it has the feel of paternalism, but I think there's another way to look at it.I think, that all things considered, obamacare makes society as a whole a better place.

Paternalism and consumer protections are two sides of the same coin. The fact is that without some protections, you could wind up signing your life away due to some sleazy fine print.

Dealing with insurance companies is asymmetric warfare. There's an entire industry built around maximizing the profits it makes on customers. The surest way to boost profits is to make people think they're buying more protection than they are. Charge more for less. That's one of the many reasons consumer protections exist.

This. I'm extremely good with legalese, regulations, fine print, etc. More so than 99% of my peers, even some that have law degrees, and I have spent a lot of time explaining all the ways in with a specific contract might be trying to screw them. Most people simply aren't equipped to make those decisions. In fact, I'd go farther to say that the overwhelming majority are ill-equipped. A comprehensive cost-benefits analysis is hard enough for most people without also requiring them to sift through impenetrable legalese to figure out what the costs really are and what benefits they will actually get.

Do you have stats on how customers were "regularly" screwed by it? My understanding is that "rescission" was extremely rare.

Rare doesn't mean acceptable. It happened more than a small handful of times and was deeply unfair, particularly since it tended to happen to people that were deeply in need of coverage at the time - which by itself is a rare event when compared to how many people are living healthy day-to-day lives.

Besides, while rescission was rare, annual maximums and lifetime maximums were not. Bumping up against those maximums (now illegal) was rare, but see above - they happened at the worst times, oftentimes to people who weren't expecting it.

As I understand it, the new plans are expensive because they cover all sorts of things regardless of whether you want them or not. You might never want kids, but that's covered. Also you may not believe in acupuncture or aromatherapy, but they're covered. Of course the real problem is that Obama stood up and said "you can keep your existing plans" and people believed him, and now the chickens are coming home to roost.

You point out some of the ridiculous things they cover, which isn't wrong. However, these plans ALSO don't have lifetime benefit caps, are available whether or not you have pre-existing conditions, and offer (almost always) much better preventive care coverage. I don't think many people realize just how bad the old, cancelled, catastrophic care plans were/are.

There must be some kind of Yogi Berra-ism to describe "how bad" the insurance is that so many people wish they could still buy.

Insurance against a condition that already exists is not insurance.

Preventive care should not be something you look to insurance to pay for. Do you expect to be insured against your weekly grocery shopping bill? Your utilities? Your rent?

"Preventive care should not be something you look to insurance to pay for. Do you expect to be insured against your weekly grocery shopping bill? Your utilities? Your rent?"

In fact, Obamacare mandates that much preventive care be provided for free. Health insurance is different from many kinds of insurance, which you hope never to collect on. With healthcare insurance you're very likely to use at least some covered services every year. Preventive care is the kind of care everyone should have every year, and it is the kind of care that best reduces health costs, making it best for patients and for nation as a whole. That's why Obamacare requires that it be covered 100%, even in least expensive bronze plans. This encourages people to get preventive care and prevents bigger expenses for them later on. I'm not knocking Obamacare. Hardly, I'm a proponent of it. It makes sense.

"Preventive care is the kind of care everyone should have every year, and it is the kind of care that best reduces health costs...."

BZZZT.

As I understand it, study after study shows preventive case does not result in cost reductions. E.g. look at the controversial mammogram screening recommendations that came out a while ago. There are many other mechanisms where not immediately obvious things come into play.

That's not to say we shouldn't do it, look at the backlash to those mammogram recommendations, which would have killed a friend of mine in her early 40s if she and her doctor had followed them, just that they will overall cost more.

BZZZT. Preventive care in general is cheapest and study after study shows that it is. That doesn't mean that certain kinds of preventive care might not work. Of course if they don't work then they're not cost effective. But the fact that smart, simple tests to catch diseases or conditions before they've progressed is most cost effective method has been established for a long time. Heck, just having patients get in for an annual physical and quick look over from a doctor is cost-effective form of preventive care. That's why ACA requires it to be covered.

I do agree that unwise or poorly designed preventive care, usually in the form of excessive and expensive testing that is poorly chosen and often has too many false positives, is one of the big problems running up medical costs. That does not change the fact that proper preventive care is most cost-effective form of healthcare.

The famously biased in the other direction PolitiFact says otherwise and goes into some detail: http://www.politifact.com/truth-o-meter/statements/2012/feb/...

"Preventative care does not result in cost reductions" is a rather contentless argument - it has to be broken down into exactly what people are trying to talk about. For instance, while there may be mammogram-related arguments on one side, it's also obvious that it costs less to take care of a small medical condition that, left untreated, would result in an expensive trip to the emergency room.

Well, I don't really want to claim on my car insurance either, but it would be pretty unusual if the insurance company covered my MOT.

What sort of insurance are you thinking of that you do plan to collect on?

Don't most car insurance policies pay for repair of window chips on the very rational basis that a chip can turn into a much more expensive window replacement if not treated?

Right, but that's repairing damage that has happened. Preventative means something else. It means taking preemptive action. Preventative healthcare would be something like paying for your vitamins and gym membership.

Preventative means more like having a physical where you discover an easily treated cancerous mole.

"Insurance against a condition that already exists is not insurance," but I've twice had coverage for other unrelated conditions (rehab for a broken leg, and treatment for severe pneumonia) denied because I was hospitalized years earlier for a chronic illness having to do with the digestive tract.

Sounds like you're extending intent of quote to be about "pre-existing conditions". Obamacare requires that health insurance policies cover pre-existing conditions, which is another difference from other types of insurance. The only way this could reasonably be required would be if all individuals are required to always carry insurance, which is what gives rise to the much-debated "individual mandate". All of this makes good sense, in my mind.

You don't say why you were denied coverage for broken leg rehab and pneumonia treatment. It seems a stretch for it to have been denied as pre-existing condition, but one of the problems when insurance companies were allowed to deny for pre-existing conditions was that they did often make non-sensical stretches to deny. I think reason for denial in your case was probably for something else, perhaps something like an insurer's "annual cap" on coverage (but not that b/c your previous coverage was years earlier), another thing that now is gone thanks to Obamacare.

Yes, I was straight up denied coverage for broken leg rehab and pneumonia coverage for having the intestinal issues, and only through fighting it was it covered. It was not anything other than insurance companies being dickish, hadn't reached the annual cap or anything like that. Other friends of mine with chronic illnesses have had similar issues.

Needless to say, I'm looking forward to that provision of obamacare.

Call it what you will, but health insurance that doesn't cover preventive care and pre-existing conditions would be all but useless to me, personally, due to expensive ($15,000/month, give or take) preventive treatment necessary to properly treat severe hemophilia.

With that said, hard cases make bad law, and the argument against immediate coverage of pre-existing conditions — healthy people will rationally choose to remain un- or underinsured, then seek more comprehensive coverage when diagnosed with something that requires expensive treatment — is reasonable.

It's also a decent argument for universal health care at a reasonable minimum standard.

They also redistribute a LOT of money to the age 50-64 bracket. And the money for the subsidies has to come from somewhere, TANSTAAFL. Also look at the banding system.

I don't know about Jayschwa, but __xtrimsky elsewhere in this discussion is one of the "young invincibles" who's buying of very expensive insurance is essential for the economics to work out; well, such as they were before 14 and counting last minute changes.

This is exactly how National Insurance works in the UK. It isn't really insurance per se; money coming in is paid straight out again.

My HSA-compatible HDHP which I had from 2010-2013 had no lifetime cap or annual cap, and since I'd had employer coverage before, no exclusion on pre-existing conditions. They actually reduced some benefits (for out of network providers) from 2013 to 2014, and the price went from $81 (2010) to $90 (2011) to $102 (2012) to $120 (2013). HSA Bronze HSA, the nearest equivalent, is $214 from another provider, or $250 from this provider. So I switched to a $41/mo short term plan for 2014.

Not all of them were bad. Health insurance varies wildly by state, which is another topic that's being ignored, and we had a reasonable catastrophic plan that covered all preventative care visits with just a small copay.

The problem with the new plans is the same as the problem with the old plans: there's no free market. People don't have any "choices" except what's forced onto them in a "market" where everything is all sewn up vertically. The insurance companies are writing the legislation. They were writing it before Obamacare, and they're writing it now. The only difference is, now they are writing more of it.

We're sort of in that boat. I've been grandfathered into my plan for some time now, but we switched over my wife from a $7500 deductible plan to a $3500 deductible plan in 2011 and that plan is going away. Only plans that were you were enrolled in prior to March 23, 2010 can be kept under Obamacare, which is unfortunate because a lot can change in 3-4 years, particularly when most people were unaware of the actual implications of the law.

Anytime there is a strict cutoff rather than a gradual roll-off there will be people who are artificially disadvantaged.

That tends to create a substantial income cliff which people have to climb in order to actually benefit from their increased income. If you're a salaried employee it might matter little, but if you're self-employed or a small business owner it's a billboard saying "don't work too much harder unless you're willing to work MUCH harder" to overcome the income cliff.

I don't have even a clue as to how many small business owners this will affect, but it seems likely that it will be more than a few hundred thousand. I'd guess millions. It's really unfortunate.

I'm a small business owner. Small business owners were screwed by the previous health care regime. Individual plans are hella expensive. Small group plans are also expensive, and extremely sensitive to the health issues of who you had on staff. Both were going up by double-digit percentages every year.

My income is over the subsidy limit, but with careful shopping, I've found a plan (with the same carrier as before) that's substantially cheaper and has better coverage.

Of course, when my carrier cancelled my plan, they "recommended" a much more expensive one. If I hadn't shopped around, I would have thought that the ACA was causing my premiums to skyrocket, but the opposite is actually true.

Bottom line: don't believe everything you read about the costs of ACA.

Can employers/employees work around this stupid cliffing kind regulation with optional deferred compensation?

Let's say the cliff is 50k. You earn 55k/year. So you get paid 50k and opt to keep 5k in a deferred compensation stash that gets paid out sometime in the future (maybe when your baseline is sufficiently higher than 50k that's worth it?).

Yes, it's apparently possible:

http://www.irs.gov/Businesses/Corporations/Nonqualified-Defe...

Interestingly enough, the employer is required to withhold FICA taxes as soon as the deferral is made, if it's truly guaranteed future income.

Well. Under the old regime, my family was paying about $2000 a month for premium blue shield/cross for three. 44, 46, and 17 years old. BUT, my work was subsidizing my insurance so I only paid $800/month. Without subsidy, $1000, in fact, costs the family more.

So, my partner and I "split up". We stopped filing a domestic partnership in California and now, I pay 175$ a month. She pays $100 a month. And her son pays nothing (Medical).

By breaking up the logical family unit, we saved over $500 a month because my partner makes around $20K a year.

I'm not so sure this is working out.

Yes, people have run the simulations and the ones I read said they could find absolutely no scenario where being married doesn't cost more. Often a LOT more, as you're found out.

"I'm not so sure this is working out."

Well, that might depend on your objectives. E.g. many can't help but notice that in general married women vote Republican, single Democrat.

What I'm specifically pointing out is that, if my partner is officially married to me, her 20K is added to my salary (let's say 100K for arguments sake) And now, according to the government, we make 120K. We are placed in that 120K married bracket which is NOT a whole lot different that say someone making 80-100K individually. But, if you divide by two: 120 becomes 60K each. Being married in the USA has very little financial advantage.

>The cheapest insurance plan they can find through the new federal marketplace in New Hampshire will cost their family of four about $1,000 a month, 12 percent of their annual income of around $100,000 and more than they have ever paid before. Even more striking, for the Chapmans, is this fact: If they made just a few thousand dollars less a year — below $94,200 — their costs would be cut in half, because a family like theirs could qualify for federal subsidies.

Is this accurate? It sounds like bad math on the part of NYT similar to people who believe that make a few hundred dollars more and shifting to a higher marginal tax bracket means less net income. Aren't taxes & subsidies normally structured to avoid these sort of discontinuities?

I kinda hesitate to link here, it seems like a pretty non-authoritative site, but it does point out that this law did a bad job of that standard gradation [1]. They wrote in 'cliffs'. Justified in the article ridiculously:

>To avoid creating such steep cliffs, federal officials would have had to spend more money on the subsidies, said Larry Levitt, an executive with the Kaiser Family Foundation, a nonprofit research group that is closely following the health care law. Subsidies would have been higher, and could have been more gradually phased out, he said. The design “was largely driven by budgetary decisions,” Mr. Levitt said.

[1] http://obamacarecliff.com/Index.html

I went to site you link and see it purports to use the Berkeley calculator to calculate the "cliff" amounts. When I put numbers into Berkeley calculator (http://laborcenter.berkeley.edu/healthpolicy/calculator/ ) I see values that are similar to those I got from Kaiser calculator (in post I made in this same subthread). The way data is presented in your linked article seems intended to be misleading. E.g., they talk about raw dollar amounts, not percentages. I don't know whether there is some case in which the dollar amounts could come out to those in their charts, but if there is it's not for the usual "silver" policy. Maybe the percentage subsidy for a whacky expensive gold policy could get you to those dollar values for the cliff, but I doubt even that.

Don't know about the site, but the Kaiser Family Foundation has been one of the best and most solid sources of info on Obamacare. E.g. see their subsidies calculator: http://kff.org/interactive/subsidy-calculator/

Definitely a much better resource. Kinda weird - I really didn't know how to find such a resource. After the weird link above, I actually spent a good bit of effort digging around. It's not easy.

And as others noted as well, it looks like there is a fair bit of a slope to the phase-out of the subsidies, and not an (obvious) cliff.

I wonder if there may be a perception cliff: https://news.ycombinator.com/item?id=6947928

Using the Kaiser calculator linked on that site, it looks like the subsidies are properly phased out. Increasing my income causes the subside to gradually go down and I don't see any major inversion in that calculator. There might be some slight inversion when accounting for the marginal state & federal tax brackets, but the calculator doesn't support the math for those cases.

I think there must be some mistake. The author seems to have no idea of how the subsidy amounts are rolled back as a participant's income grows.

You can use something like the Kaiser calculator to do a quick check: http://kff.org/interactive/subsidy-calculator/

In Kaiser calculator I put a family of 4 in Concord, NH (zip 03303), making $100k a year, adults 40 and 42, 2 kids under 20, and get annual premium of $10,522.

With income of $90k/year they get a subsidy of $1,972, or 19% of the premium.

With income of $80k/year they get a subsidy of $2,922, or 28% of the premium.

With income of $70k/year they get a subsidy of $3,928, or 37% of the premium.

With income of $60k/year they get a subsidy of $5,609, or 53% of the premium.

And so on. You get a larger subsidy the closer you are to poverty level.

Quick question, I'm in the same middle class, and am self employed. I'm thinking of not having an insurance at all, and if I get really sick long term, I'll switch to an Obama care insurance. Is this something possible ? (now that they can't check for preexisting conditions). Or will I get screwed somehow.

I'm 26 so I went to the doctor maybe twice in 6 years, I only want coverage in case of emergency.

PS: I can pay 5000$ out of pocket if needed.

If you find out you have cancer or kidney failure or whatever, you may not be able to enroll immediately depending on "open enrollment periods". (If you can move to another state that might count as a "qualifying event" and let you enroll faster.)

I do think people in the USA are overwrought about going without health insurance. It's a risk, but so is driving a car. If you do end up with a big medical bill, medical debt is (at least in my experience) more manageable that other kinds of debt.

This sounds insane. Medical bills can go into the millions, and typically hundreds of thousands, if you get a serious condition.

Medical bills can go into the millions, but this is very rare. I quite doubt hundreds of thousands is something that could reasonably be described as typical.

I had surgery with anesthesia (kidney stones) for less than $10K.

I might be wrong--but I'd want to see data based on actual people actually treated.

Well it's called insurance for a reason. For a healthy person under 40 or so, you're paying to insure against rare events that would be very expensive. What if you get cancer, or a serious bone fracture requiring steel implants or leg braces, or any number of other serious conditions? Insuring against rare but disastrous financial burdens is the whole point at that level.

I had a kidney stone too (age 35, 190lb) this year in July.

All said and done, my medical bills would have hit $54,000.

> Is this something possible ? (now that they can't check for preexisting conditions). Or will I get screwed somehow.

There's a fine for doing this, precisely to stop people from doing what you're suggesting. But I think the fine is so small that it's actually worth doing it (rather than having insurance).

It's $95, $325 the second, and $695 the third, and for every year after.

For what it's worth, the penalties, as currently planned out, are only 'paid' by capturing tax returns. One could effectively, and legally avoid paying those penalties by changing their tax documents such that no returns are expected, or so that they would owe each year.

The IRS currently cannot demand payment on those penalties, but if you were due $1000 refund, they can withhold the $95 from it. If, however, you owe $10 in taxes, they cannot make you pay $105, as you might otherwise suspect.

yes, I think its less than 100$.

If I take a plan for me and my wife, the cheapest plan is 660$, which makes it 7920$ a year.

I also have a child, but I can take a plan just for her, which would be 280$.

A new insurance plan won't retroactively cover the costs of some emergency hospitalization.

At 26 you should be able to limit your out of pocket to less than $20,000 for a few grand a year, you have to compare that to what it would cost you to declare bankruptcy.

You can only sign up for ACA plans during the so called, "Open season" which is a limited time each year. So if you find out you have an expensive illness you could be paying for treatment out of your pocket for a while before you can sign up for a plan during open season. You might be able to get around that by manufacturing a "life event" ie get married or have a kid etc... And there by be able to get an ACA plan immediately. Defiantly risky though.

Defiantly risky

That's a species of risk that is admirable and patriotic!

A safer plan might be to buy non-qualifying catastrophic coverage in case you get in an accident or develop a serious illness outside the open enrollment period. Safer, but more expensive, than relying on hacking the system to bail you out if shit happens.

Coverage in case of emergency is called "catastrophic coverage." If that's what you want, it's available on the health insurance exchanges for anyone under 30. In my zip code, plans start at $90/mo for a 26yo with no family. (In comparison, bronze plans start at $133/mo.)

If you'd rather bet that you won't get an expensive injury (a dangerous idea, in my opinion—emergency health care is expensive in the US), you can just pay the no-insurance fine. But it's not the way I would go.

Look here (recommended by an insurance broker or the like): http://insurance.answers.com/health-insurance/aca-basics-ope... at Special Election Periods for the officially allowed criteria.

I'd get a cheap short term policy to cover you for major accidents or sudden illness, then move states and enter ACA if necessary (i.e. if you have discovered a serious medical condition).

Can you remind me again, why did you vote for Obama second time?

Because despite the Affordable Care Act being a long way from a proper first-world system, people realize that it's miles better than what we had previously on the whole.

Without this turning into a long diatribe, one of the major problems I have is that the general assertion that the ACA is "better than nothing / better than what we had before" is that it is only true in some states. Yes, many states were doing a poor job of regulating health insurers, but in my state (Washington), the ACA offers few new benefits. Whereas previously high-deductable / catastrophic plans were available cheaply for those who were willing to pay cash for the bulk of their health needs, now everybody is pushed to plans that don't do enough for preventative care and will cost ~$1000/month for a typical family. I think we are all thankful to see people with long-term chronic illness finally able to buy health insurance regardless of their state, but for those states that already had functioning marketplaces for family/individual insurance, the ACA smacks of unnecessary federal meddling that, IMHO, fixes the market rather than leading to the competitive market that was a claimed benefit. Background: I've been a buyer/selector of health insurance as both an individual and employer since 2006, so have been through this a couple times now.

How can a system that costs more for less coverage and poorer access to treatment be better than what we had before? RTFA!

What we had before had plenty of problems, but Obamacare is a failure from the get-go, leaving aside the $600+m web site debacle.

"and poorer access to treatment"

One critical thing about what I gather is the vast majority of plans is that their provider networks are narrow since the insurance companies were pressured hard to lower costs (we've all read about how many quality hospitals have been outright excluded). So narrow that routine medicine outside of your county or local area is out-of-network and entirely uncovered.

This is going to have some serious effects on those who've retired but have not yet reached the 65 year old threshold for Medicare and have a second home, e.g. snowbirds who want to avoid harsh northern winters: http://www.americanthinker.com/2013/12/more_obamacare_devast...

Because he was the best available candidate by far.

Yes, ACA has problems. We would have been better with a system modeled after that of Britain or Germany or Japan (or pretty much any other first world country...). Republicans, however, made sure that nothing like that could come about, leaving the only choices ACA or nothing. Going with ACA gives us something that can at least be tweaked up to first world standards.

The other candidates and their party platforms were also terrible on science, terrible on the environment, and clueless on economics.

Finally, many of us figured that if we elected him again, maybe Republicans would get it through their heads that the first time was not a fluke, and we elected him because we actually WANTED the things he had campaigned on the first time, and stop basing their ENTIRE strategy around "do the opposite of whatever Obama says".

because the other side was a joke,and between 2 evils one should always chose the lesser.

How about they don't choose either? I chose to not be involved in a sham of a process that purports to give "two" options.

That's a tactical mistake. You are throwing away your vote.

I'm a libertarian. But I almost never vote Losertarian, because I want to influence the outcome. So, I generally hold my nose and vote Republican, the Democrat Party being the party of Big Government, the enemy of Liberty!

That's a miscalculation of opportunity costs. You are throwing away the time you could have spent doing better things than voting. How many times have you cast the deciding vote in an election?

The opportunity cost of at most a few hours? Every two to four years?

Sure. You could spend that time writing posts on Hacker News that influence more than one voter.

oof, long shot...

It's not wasting my vote if I don't want either the Democrat or the Republican. By your logic, the vote is equally wasted if I vote Republican and the Democrats win, because I "didn't influence the outcome". Voting isn't a lottery game, you're not trying to use your vote to predict the outcome. You use it to voice your opinion. My opinion is that the two candidates provided are neither adequate, therefore I will not endorse either.

EDIT: And in parliamentary procedure, abstaining from voting is a valid option, and it is not a waste of a vote. You are specifically going on record as not approving of the choice being provided.

>Voting isn't a lottery game, you're not trying to use your vote to predict the outcome. You use it to voice your opinion.

No, it's not a lottery game. But it's nevertheless desirable to have the best possible ball park estimate of the situation before voting.

E.g., if the candidates of the major parties are Bad and Worse, and you are certain that Worse is going to win, then you vote Libertarian (or for whatever your favorite third party). Worse wins, but at least you will have contributed to the protest vote total. However, if you are not certain, then you'd better vote for Bad, because voting for the Losertarian is only going to help elect Worse! That's what I mean by "influence the outcome".

>And in parliamentary procedure, abstaining from voting is a valid option, and it is not a waste of a vote. You are specifically going on record as not approving of the choice being provided.

A parliamentary body is a totally different situation. Many fewer voters. Much more frequent votes. And the votes are on the record, the voters having advocated their positions as effectively as they can.

what possible purpose could there be to knowing the outcome of an election before voting? The likelihood that one person can impact the vote is so slim that it does not make sense for the individual to strategize for the best outcome of their personal choice. They must strategize based on aggregate choice, which favors sticking to principles, as, you know, they are principle.

It's not like the Republicans are the party of small government, nor have they functionally been so in any time in the last 20 years. This is what I'm talking about, people do not actually vote towards their conscience, they vote towards a lottery game.

Hopefully not too many people follow your example.

Neither Mitt Romney or Barack Obama were good choices for President, regardless of their comparison to each other. If more people refused to vote for a bad candidate, then the margin to win would be much smaller.

Egads, if people voted for who they actually wanted, rather than vote against who they want the least, then maybe we'd get someone who actually, you know, represents the people!

The only reason you can be upset about me not voting against my principles is that I'm not helping your favored candidate over your disfavored candidate.

I disagree that both main candidates were not good.

The winning presidential candidate does roughly represent the majority preference of the people. You make it sound like everyone is being disenfranchised. If you support proportional representation, or ranked voting, or some other change, I'd agree to that.

If you went around telling everyone that would vote for my preferred candidate to vote for candidate X that has no chance of winning, I might be annoyed if you succeeded. Unless I liked candidate X even more and knew you could succeed with everyone (or a majority anyways); but that's very unlikely.

our disagreement on the suitability of the candidates is the entire point of voting. and I think it is important to note: of the people who could have voted, only 28% chose to vote and vote for Obama. and going around, telling people to not vote for your preferred candidate, that is the entire point of campaigning.

I'm not saying you shouldn't campaign. You just read way too much into my initial "Hopefully not too many people follow your example" statement. But then you made some contentious statements so I felt I had to reply. Like saying the two main candidates were not good, stated as fact. Something clearly many people disagree with you on.

having to preface every sentence with "in my opinion" is a waste of text. I am speaking it, of course it is my opinion. It is only fact insofar as it can be recognized as so. I did not explicitly state "it's a fact". Don't be pedantic.

It's not that simple, since you followed with:

"If more people refused to vote for a bad candidate, then the margin to win would be much smaller.

Egads, if people voted for who they actually wanted, rather than vote against who they want the least, then maybe we'd get someone who actually, you know, represents the people!"

So you're using "the main candidates are bad" as the basis for how the population should vote. It was more a bad assumption than an opinion.

Assumes facts not in evidence.

Did anyone do the math here? If a family making 100K pays 12K for insurance, and a family making 94K pays 6K for insurance, that is the exact same amount at the end of the year. Wonder how long they had to search to find this clean of an example. Seems the best solution for the family is to either ask for a raise (all take home profit) or take a sabbatical every year (more time to enjoy life).

And just how many 100K earning families will think that's "fair"?

Sure, this is insult vs. injury, but perceptions count for a lot. And perhaps there's some minimally objective measure of pain in writing checks twice as large, even if the end result is the same....

I've never found much to like about policies pitched by any of our leaders left or right, but ObamaCare surprisingly seems to be something that is positive.

It may not be much different for single people or those under 30, but if you have a family, keeping them in an acceptable PPO was running $1200-$1500/month (total corporate or individual) - and for individual, that's if you don't get rejected for something as ridiculous as someone having been treated for allergies.

Plugging in some numbers on healthcare.gov, I'm seeing comparable PPO's for $700/month and if you play with the numbers you can see that the tax credit drops the plan cost as income drops below 4x the poverty level, so for example a family making $50K/yr would only pay $200/mo for the same plan.

This seems like a step in the right direction in so many ways.

I think most negative publicity is coming from polarized sources who would reject anything, and their paid media outlets.

Are you factoring in the mid-4/low-5 figure deductibles and total out-of-pocket caps?

You think that famous Albuquerque artist couple making 24K a year with 100% subsidized premiums are going to be able to afford to pay their caps, which could be up to $12,700, if something really bad happens one year? (http://www.nytimes.com/2013/11/04/business/under-health-care...).

From what I've seen, corporate plans are becoming more and more like what was once called major medical insurance.

So yes, coverage for anything below a small crisis is non-existent under these new plans, but it's about the same under the old plans. I'd rather bank the 50% monthly savings and know that my family can stay insured no matter what comes along.

As for the artist couple, they've got to be better off than having no insurance at all under the previous situation.

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