USA topic -- Expat specific issues regarding repeal and replace of Obamacare

[Jingthing]

This is NOT a political debate thread!

For hot comments as above, such as the comments saying government has no business in health care, there are always other active WORLD NEWS threads.

There was some on topic content in that post though, in the sense that if you're covered by your employer you are generally off the radar of both ACA and whatever replacement is coming.

I will add this though. 

The initial republican change proposal said that large employers (I think it's over 50 employees) will NOT be required to provide employer paid health coverage at all (with cost sharing or not) as they were (still are) in ACA.

It's certainly unknown to me what percentage of large employers now required to provide the health cover would stop offering it if the law said they didn't need to anymore. 

So in that sense people secure with employment that usually provides such cover MAY not be as secure in that presumption in future. 

Edited March 20, 2017 by Jingthing

[Jingthing]

Where this is at now.

Currently the trumpcare bill has been revised in congress and there is a push to pass it in the house.

The original plan was revised somewhat.

It's not so easy to get details on what the revisions actually are so far. 

Here are some details in this article.

 

https://trumpcare.com/

Updated March 21st, 2017

 

Quote

Trumpcare (AHCA) Is Revised In An Attempt To Compromise With Conservative Members of GOP

According to recent CBO estimates, the 50 to 64 demographic will be the group most hurt by the repeal and quick replacement of Obamacare. Some will see their premiums increase from an average cost of $200 month to more than $1,200, in large part because the AHCA doesn’t prevent insurance carriers from pricing plans to reflect the increased risk that older individuals represent, as compared to a younger and more active demographic.

 

 

There has been news that they are aware that millions of Americans would be in that demographic and they're trying to soften it. How much softer nobody says but it's fair to assume it won't be anything like the ACA program which had significant subsidies for lower income people and also a limit of 3x more for older people, rather then the current, before possible revision, of 5x more. 

Edited March 21, 2017 by Jingthing

[CaptHaddock]

The Repubs don't have the votes in the House.  They have pushed off the scheduled Thursday vote.  Maybe there will be a vote on Friday, maybe not.

 

The Dems spent 14 months on hearing, etc. building a coalition to pass Obamacare.  The Repubs can't be bothered.  Any bill that could pas the House would fail in the Senate.  

 

So, "repeal and replace" looks to be DOA.  Nevertheless, they can and will strangle Obamacare by withdrawing funding to the extent that they can and changing regulations which they can do without Congressional approval.  When Obamacare collapses they will blame the Dems.

[Ramen087]

1 hour ago, CaptHaddock said:

The Repubs don't have the votes in the House.  They have pushed off the scheduled Thursday vote.  Maybe there will be a vote on Friday, maybe not.

 

The Dems spent 14 months on hearing, etc. building a coalition to pass Obamacare.  The Repubs can't be bothered.  Any bill that could pas the House would fail in the Senate.  

 

So, "repeal and replace" looks to be DOA.  Nevertheless, they can and will strangle Obamacare by withdrawing funding to the extent that they can and changing regulations which they can do without Congressional approval.  When Obamacare collapses they will blame the Dems.

The ACA worked in the first few years because the subsidies to the insurance companies provided economic feasibility.  In 2016 it became apparent a reworking would be needed because the system without the subsidies could not be sustained with people dropping out, or choosing to pay the IRS fine in the face of the larger non-subsidized premiums.  Gutting it isn't the answer, reworking it is. Maybe it'll be better the second time around. This isn't an easy policy to adjust, to say the least.  Give 'em a chance to maybe get it done better after tweaking it. 

[Jingthing]

This is not a political debate thread.

It's about practical issues for people dealing with the new law, or if there isn't a new law right away, dealing with the transition period where the old law is technically in effect.

If at least temporarily the old law is in effect there will likely be real life practical changes during that period as well.

Currently, there is a massive amount of uncertainty for all.

Moving target. 

Political news that impacts on practical issues is relevant here. But debate is not. 
For that, please post on the related WORLD NEWS forum topics. 

Edited March 24, 2017 by Jingthing

[NanLaew]

Just heard that Trump has warned fellow Republicans that if the current proposals submitted to repeal the ACA are not passed today, he will leave Obamacare in place and move on to other matters.

Edited March 24, 2017 by NanLaew

[Langsuan Man]

1 minute ago, NanLaew said:

Just heard that Trump has warned fellow Republicans that if the current proposals submitted to repeal the ACA are not passed today, he will leave Obamacare in place and move on to other matters.

I think everyone knew the local bully who,  if you didn't follow his rules,  would take their ball back and go home

 

Trump,  the man child,  is doing the same thing, only problem is that his fellow Republicans did not run on the repeal the ACA platform and don't have four years left for their constituents to forget what they do today

 

He also has not figured out that in Washington he has already squandered any "good will" he may have had by making enemies out of almost everyone.  With an approval rating of 37% I doubt if many in Congress are worried about not getting endorsed by Trump come the mid term elections 

[Jingthing]

Hot political comments elsewhere please.

It's impossible to castrate this topic 100 percent from politics but I think a practical discussion of impact is still possible in theory.

[Jingthing]

Just heard that Trump has warned fellow Republicans that if the current proposals submitted to repeal the ACA are not passed today, he will leave Obamacare in place and move on to other matters.

Yes he has forced a vote without assurance of passage. High drama that. If it passes the next test will be the Senate. If not then we'll have to wait and see about the next steps and impact. I think it's fair and unbiased to assume if ACA stands that the Republicans won't be supporting it strongly as far as implementing and fixing so that is a potential huge impact issue going forward.

 

One step at a time.

 

[Jingthing]

The trumpcare bill was pulled.

For now, the ACA law stands as is.

As far as expat planning, I still think there is a great deal of uncertainly.

For current expats that may have issues with still being under the ACA mandate because of too much time in the U.S., that obligation stands.

For expats considering repatriation, for now you can assume that ACA stands as is, but for how long is unknowable now. 

[beachproperty]

Not one to say "I told you so"....BUT Trumps Bill wasn't law so it wasn't worth discussing!

Waste of Time!

 

[Jingthing]

Not one to say "I told you so"....BUT Trumps Bill wasn't law so it wasn't worth discussing!
Waste of Time!
 

Ha ha. Yes you are.

[Ramen087]

Given the title, would it not be appropriate to close the thread!!??

[Jingthing]

1 hour ago, Ramen087 said:

Given the title, would it not be appropriate to close the thread!!??

If going by the literal thread title, then, yes, probably.

But the story has now changed from the original to any possible impact in the wake of the pulled bill that are expat related.

 

For examples --

 

Mandate enforcement

As stated some expats spend enough time in the U.S. in some years that they are still subject to the ACA insurance mandate (or fine).

An obvious question now is whether the government in power (trump and the republicans) will actually continue to enforce the mandate and fines.

trump early on signed an executive order signaling a softening on such enforcement, but it held no weight without legislative action.

 

But it seems to me that they could still soften enforcement and whether they do or not, does impact some expats.

 

Changes in the wake of ACA still existing with a government that doesn't support it and a presidential leadership predicting it's death spiral. 

 

Some of these potential changes could still impact some repatriating expats.

For example some states that previously did not pursue expanded Medicaid in expectation of ACA ending and to oppose it, may decide ACA is here to stay and start in the expanded Medicaid.

 

ACA in some states does have serious problems that are very real even without a non-supportive federal government. Changes for the worse (or better) going forward with ACA staying may impact on decision making for some returning expats. For example, there may be decent ACA options in California but not Arizona.  

 

Therefore, even though the trumpcare bill did not pass or even come up for one vote, the details of the now still existing ACA are STILL a moving target, and potential changes may still have a major impact on some expats and repatriating expats.

 

---

Because of all that, I as the OP won't be requesting the closure of this thread because the bill was withdrawn. If it is closed though for that or other reasons, new topic(s) can be started later to address the kinds of issues I mention in this post as they come up.

 

Cheers. 

Edited March 25, 2017 by Jingthing

[namasata]

Lol .. it didn't pass .. and won't be brought up again for years .. yeah obamacare

[Ramen087]

2 hours ago, Jingthing said:

If going by the literal thread title, then, yes, probably.

---

Because of all that, I as the OP won't be requesting the closure of this thread because the bill was withdrawn. If it is closed though for that or other reasons, new topic(s) can be started later to address the kinds of issues I mention in this post as they come up.

 

Cheers. 

Just a suggestion --> Start the new thread with an improved title, and put the link in the final post of this thread. Sort of like the honda pcx 300 thread turned into the honda forza thread.

[Jingthing]

7 minutes ago, Ramen087 said:

Just a suggestion --> Start the new thread with an improved title, and put the link in the final post of this thread. Sort of like the honda pcx 300 thread turned into the honda forza thread.

Not bad, but I think it's premature to start a new thread. Let's see how things go.

[Ramen087]

4 minutes ago, Jingthing said:

Not bad, but I think it's premature to start a new thread. Let's see how things go.

UP2U. Hope it works out. Choke Dee Khrap.

[Jingthing]

OK, I've already got something.

Expats are exempt from the ACA mandate but based on the number of days visiting the U.S. that exemption goes away.

I'm sure lots of Americans that consider themselves expats fall into the mandate zone. 

When file your federal tax return as an expat, either you claim the exemption, or if you don't quality, you're in the same boat as everyone else.

Well perhaps there is already a change in that and I do know taxact.com is a very popular way for expats to file.

So called "silent returns" on the coverage issue previously instantly rejected, but maybe not anymore --

Quote

 

The mandate requires Americans to have a minimum level of health insurance, qualify for one of myriad exemptions or pay a penalty known as the “individual shared responsibility payment” when they file their return. Taxpayers must indicate on their tax returns whether each person included on the return had insurance for the full year, qualified for an exemption or owed the penalty. Returns that don’t provide this information are known as silent.

In a Feb. 3 meeting with tax-preparation software companies, the IRS said it would not reject silent returns this filing season, according to Andrew Townsend, tax analyst for software maker TaxAct. The decision, which took effect Feb. 6, was not announced publicly and Townsend said he has not seen it in writing.

 

http://www.sfchronicle.com/business/networth/article/Quiet-IRS-change-could-undermine-Obamacare-10932798.php?cmpid=premartcl

[Jingthing]

This article has a lot of political content but I think reading it provides a good framework for questions about what happens next.

Relevant to returning expats that may be hoping some kind of decent ACA related coverage will be possible in this phase of uncertainty.

 

Health & Science

 

Affordable Care Act remains ‘law of the land,’ but Trump vows to explode it

 

 

 

 

https://www.washingtonpost.com/national/health-science/affordable-care-act-remains-law-of-the-land-but-trump-vows-to-explode-it/2017/03/24/4b7a2530-10c3-11e7-ab07-07d9f521f6b5_story.html

 

 

[kowpot]

Until and Only when, Congress has to also come under the same plan as the rest of America. The ACA and any other piece of crap healthcare bill is not worth the paper it is written on. 

 Dems and Republicans alike in the House and Senate make me sick.  

[Jingthing]

Please avoid hot political comments here. There are other threads for that. 

This thread is about discussion of practical information impacting or potentially impacting either expats or repatriating expats related to the uncertainties in the U.S. health care system. 

[Jingthing]

I am seeing some potential expat impact in this article.

The larger story is that even though ACA remains the law of the land, things are still in flux. For potential repatriating expats needing some kind of ACA coverage, the uncertainty continues.

 

Shorter sign up period?

If you repatriate outside that period, then you would need to get an exception based on living abroad to enroll outside that period.

I don't know how easy or hard that was before, but it could become harder, or I suppose maybe not even possible. 

 

 

http://www.sfgate.com/news/medical/article/Insurers-say-Trump-must-do-more-to-stabilize-11072947.php

 

Quote

 

The changes announced Thursday include:

—A shortened sign-up window of 45 days, starting with coverage for 2018. That's about half as long as the current open enrollment season.

—Curbs on "special enrollment periods" that allow consumers to sign up outside the normal open enrollment window. Insurers say these have been too easily granted, allowing some people to sign up only when they need costly treatment.

 

 

 

 

 

[Gary A]

Since I have no intention of ever repatriating, none of this will likely affect me. However, I do have my opinions. People who are unfortunate to have pre-existing conditions should in no way be excluded from the program. They are the ones who need coverage the most. This entire program is and will be a huge can of worms. No one will be totally satisfied. How do they manage to get professional welfare clients to pay their share? At the very least the welfare professionals should have their benefits cut at least proportional to working taxpayers. Why should citizens pay for the coverage of illegals? It will be important to enforce the immigration laws. Why should government employees have better coverage than Joe Public? They need to have the same plan as Joe Public. It is also easy for me to see that very wealthy people should pay more, they can afford it. Everyone should pay something. Any plan is going to be very expensive and everyone needs to contribute their share. No free rides.

[Jingthing]

An interesting development.

 

https://www.washingtonpost.com/news/wonk/wp/2017/05/18/states-get-involved-in-lawsuit-to-shield-obamacare-saying-trump-cant-be-trusted/

 

Probably too technical though except for those of us that have been following the details.

[jmd8800]

Being in California at present to deal with health care issues I pay attention to a lot of the media. I came across this post and my understanding is there will be a more complete disclosure of the plan in a few days.

 

http://mattbruenig.com/2017/05/22/californias-surprisingly-cheap-single-payer-plan/

 

I am trying to find ways to feel 'covered' while living in Thailand with pre-existing conditions that Thai insurance won't cover. My best solution so far is ACA in USA plan, a relatively cheap Thai plan and repatriation to USA if needed. This is pretty expensive though.

[Jingthing]

The potential "trumpcare" changes seem to be in limbo.

The house passed something but the senate is working on something very different.

I don't think anyone can predict what the end result will be from that process yet.

Something that is happening that is real is massive uncertainty in the insurance industry because they can't predict either, and of course it's no secret the white house is hostile to the status quo and ACA. 

So with that introduction of where we're at now roughly, I saw this item which was quite interesting. 

Of course it doesn't mean it will actually happen in Nevada, but still, interesting.

 

https://www.vox.com/policy-and-politics/2017/6/6/15731622/nevada-medicaid-for-all

 

 

Quote

 

Nevada's legislature just passed a radical plan to let anybody sign up for Medicaid

Nevada, with little fanfare or notice, is inching toward a massive health insurance expansion — one that would give the state’s 2.8 million residents access to a public health insurance option.

 

The Nevada legislature passed a bill Friday that would allow anyone to buy into Medicaid, the public program that covers low-income Americans. It would be the first state to open the government-run program to all residents, regardless of their income or health status.

 

 

[Gumballl]

On 3/7/2017 at 10:15 AM, Jingthing said:

This is NOT a political debate thread. 

I suppose I need to be more explicit now.

It can not be a political debate thread.

It is not allowed for members to start political debate threads on this HOME COUNTRY forum.

I did not start one but if members insist on trying to hijack this thread by insisting on making it a political debate thread, the potential PRACTICAL value this thread may have for real life issues for expats and returning expats will be over as the thread will be toast.

Clear enough now?

Change your avatar/pic into a pig's face, and then you might get the objective discussion that you seek.

[Jingthing]

1 hour ago, Gumballl said:

Change your avatar/pic into a pig's face, and then you might get the objective discussion that you seek.

Useless post. 

[tomwct]

As an American Expat, I would just let Obama Care die and offer a second market based alternative to the folks managed by

the states. Obama spent billions advertising ObamaCare because it was a terrible product. 50% of folks who signed up for

ObamaCare pay Zero $0 and many of these folks can work, but don't! So, no more advertising, no more mandates, no more taxes

and ObamaCare will die on it's own.