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1 of 22 Dr. John Gallucci, center, pediatric surgeon, performs exploratory laparotomy, stoma closure surgery on 6 month old, Bryson Abbott at St. Peter's University Hospital in New Brunswick. Monday August, 12, 2013

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Print (http://blog.nj.com/ledgerupdates_impact/print.html?entry=/2013/09 /obamacare_affordable_care_act_explained.html) (http://connect.nj.com/user/dgoldberg/index.html) By Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg/posts.html) Email the author | Follow on Twitter (https://twitter.com/DanGoldbergSL) on September 27, 2013 at 6:15 AM, updated September 30, 2013 at 2:24 PM

Signed into law three years ago, the Patient Protection and Affordable Care Act — one of the most sweeping laws in the nation's history — has been debated, scrutinized, lauded and criticized. It has been the subject of a controversial U.S. Supreme Court decision and subjected to dozens of repeal votes in the U.S. House of Representatives. Now "Obamacare" is moving into the hands of Americans across the country. The new health care exchanges open Tuesday, allowing millions of Americans the opportunity to sign up for health insurance or enroll in an expanded Medicaid program for coverage next year. For many, it may be the first time they will have access to

OBAMACARE IN NEW JERSEY Obama's growing credibility gap: Editorial (http://blog.nj.com /njv_editorial_page/2013/11 /obamas_growing_credibility_gap.html Letter: Why does Obamacare make guys buy women's coverage? (http://www.nj.com/south-jerseyvoices/index.ssf/2013/11 /letter_why_does_obamacare_make.html Letter: Obamacare's goal is health care subsidy for immigrants (http://www.nj.com/south-jerseyvoices/index.ssf/2013/11 /letter_obamacares_goal_is_heal.html Letter: Obama has to face up to his scandals (http://www.nj.com/southjersey-voices/index.ssf/2013/11 /letter_obama_has_to_face_up_to.html

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Though many of the Affordable Care Act’s key provisions begin Jan. 1, polls continue to show most Americans know little about the new law — or how it may impact them and their families.

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Most directly affected are the 48 million uninsured Americans, 15 percent of the nation. In New Jersey, about 1.2 million residents — 15 percent of the state’s population, to U.S. Census data — will have new access to health insurance. The majority 2according of 22 will be eligible for federal subsidies as a tax credit to help pay their premiums.

Trending 11/6/13, 12:17 PM V


Ready for Obamacare? Many Americans struggling to understa...

http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... However, the uninsured are not

the only ones affected by the new law. There are provisions that impact even those who have insurance through their employer, including the opportunity to keep adult children on a parent’s plan until age 26. Eventually, free preventive care will be available On Tuesday, Oct. 1, open enrollment begins for the health insurance exchanges created through the Affordable Care Act. About 1.2 million New Jerseyans who are uninsured will be able to sign up for private health insurance on the exchange or for Medicaid. Coverage becomes effective starting on Jan. 1. Patti Sapone/The Star-Ledger

through all insurance plans. Starting in 2014, an insurance company can’t turn you down or charge you more because of a pre-existing condition.

One of the law’s most controversial provisions, the individual mandate, will take effect in January. “Whether the average person feels it immediately or not, there are going to be shifts,” said Elizabeth Litten, who represents insurers and physicians as a partner at the law firm Fox Rothschild in Princeton. “Whether you are at the older, more expensive end or younger, there are going to be changes, but the takeaway is individuals are going to be paying a lot more attention to how they use care and how they decide to be covered. I think it’s going to be the rare person who can go along blindly and assume their health care is going to be covered the way it always was.” THE INDIVIDUAL MANDATE The cornerstone of the new law, and one of its least popular provisions, is the individual mandate. Everyone is responsible for having health insurance or a penalty will be assessed by the IRS on the following year’s tax return. In 2014, the fine is $95 or 1 percent of taxable income, whichever is higher. In addition, there is a $47.50 penalty per child with a family cap of $285. The fine for an individual increases to $325 or 2 percent of income in 2015, with a penalty of 162.50 per child and a family cap of $975. In 2016, it increases to 2.5 percent of income or $695 for an individual and $347.50 for each child with a family cap of $2,085. There is a loophole in the law that would allow anyone to avoid the penalty. Under the 3law, of 22the IRS has no power to garnish wages. The only power the IRS has is to reduce the refund one receives after filing the previous year’s tax return. If a person does not have

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Chris Christie ar

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they can avoid paying the penalty even though technically they would still be breaking the law. Supporters of the law argue the individual mandate is necessary

Chuck Bachi, a physical therapist and interim director of Saint Peter's Sports Medicine Institute, works with patient Alex Nicholson of Somerset.

to reduce the amount the federal and state governments

Patti Sapone/The Star-Ledger

pay hospitals in charity care and to lower everyone’s premiums. “If all we had is sick people who enrolled, (the system) wouldn’t be able to support itself,” said Jeffrey Hall, a spokesman for this region’s Centers for Medicare & Medicaid

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Services. “It’s the same as any kind of insurance.” Supporters and detractors agree that for the law to work as intended, millions of

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uninsured Americans must enroll, especially those who are young and healthy.

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“What’s more important than the number is the mix,” said Joel Cantor, director of the Center for State Health Policy at Rutgers University. Younger, healthy people must

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Open enrollment for the new health care exchanges, the marketplace where people can shop for health insurance, begins Tuesday and ends March 31. You must be enrolled by Dec. 15 if you want coverage to begin Jan. 1. U.S. Secretary of Health and Human Services Kathleen Sebelius said she expects 7 million people to sign up on the health exchanges in the law’s first year, but to keep premiums low, about 2.7 million must be between the ages of 18 and 35. That’s a daunting task, said Raymond Castro, senior policy analyst at New Jersey Policy Perspective. “It’s very high risk,” he said. “There is a lot of potential for problems.” One of the main components of the law is free preventive care, which covers things such

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as female contraception, mammograms and colonoscopies. However, these benefits do not apply to all employer-based coverage, particularly for large employers. It also does

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grandfathered plans. Even if an employee joins a plan after that date, the plan may still be grandfathered because the status depends on when the plan was created, not when an employee is hired.

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Dr. Robert Berger checks x-rays at the Princeton Radiology center in

The federal government plans

11/6/13, 12:17 PM


Monroe Middlesex County. struggling to understa... Ready forTownship, Obamacare? Many Americans Patti Sapone/The Star-Ledger

http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... to spend $1.8 trillion during the

next 10 years subsidizing

premiums to help people purchase health coverage from the exchanges, which will offer a choice of private insurance companies. Each company on an exchange will offer plans based on metallic tiers: platinum, gold, silver, bronze. Those earning less than 400 percent of the poverty level — $45,960 for an individual and $94,200 for a family of four — are eligible for subsidies. The Affordable Care Act states you will not have to spend more than 9.5 percent of your income on premiums. The government will subsidize the remaining portion of your premium if you purchase a silver plan from the exchange. If you choose more expensive gold or platinum plan, you are responsible for paying the difference. The U.S. Department of Health and Human Services on Tuesday released the first information about the price and availability of health insurance through the federally run exchanges set to launch this week. It showed the weighted average price of insurance on New Jersey’s exchange will be above the national average, and the state won’t have nearly as many plans available as other states. For the second lowest-cost silver plan, the weighted average premium will be $385 per month. Depending on income level, subsidies could significantly lower the premium, however. For example, a 27-year-old with an income of $25,000 could pay roughly $145 a month for that same plan. For a family of four earning $50,000, the premium will be $282 a month. NEW OPPORTUNITIES Tonisha Burnett, 30, of Irvington, said she has been waiting for a chance to buy affordable health insurance since she lost her job two years ago. A diabetic, Burnett said she had to skip doctor appointments and rely on samples for medications. “I haven’t been steady on my medication,” she said. “I’ve had to ration it out so I don’t take it every day like I’m supposed to.” Burnett has no children and said she has not been able to qualify for the state’s Medicaid program. The Affordable Care Act expands the Medicaid program and Burnett believes 5 of 22 she will now be eligible.

Dr.Ashwin Jadhav, a maternal fetal medicine specialist, performs an ultrasound of Maria Holiguin, 32, at Somerset Medical Center in Somerville. Holiguin, who is five months' pregnant, is expecting her fifth child. Patti Sapone/The Star-Ledger

11/6/13, 12:17 PM


Ready Obamacare? “I’m for very excited,”Many saidAmericans Burnett.struggling to understa...

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More than 300,000 New Jerseyans will qualify for the expanded Medicaid, according to the Urban Institute. An individual earning up to $15,282 and a family of four earning up to $31,322 will be eligible. The Affordable Care Act has also altered the health care landscape by encouraging the formations of Accountable Care Organizations — groups of doctors, hospitals and other health care providers who work under one umbrella. The Affordable Care Act provides financial incentives for ACOs to cover Medicare patients, said Alper Ozinal, spokesman for the Centers for Medicare & Medicaid Services in Washington, D.C. The idea is that pooling doctors and hospitals into one network will increase efficiency while reducing redundancy and cost, he said. The federal government estimates ACOs could save Medicare up to $940 million in the first four years, he added. “Taken to its logical extreme, it will change the paradigm of health in America,” said Tom Considine, former commissioner of the state’s Department of Banking and Insurance and now chief operating officer of MagnaCare, a health benefits manager. THE FUTURE Experts across many fields believe New Jersey, and the nation, is likely to see a continuation of a trend that has employers self-funding insurance plans. Instead of paying premiums to a private insurance company, such as Horizon or Aetna, employees will pay premiums directly to their company, which will be responsible for reimbursements. That gives employers a bit more flexibility when it comes to controlling costs and premiums, said Litten of Fox Rothschild. “Some of the very large employers have been doing this for a couple years, but now it’s all employers trying to modify the coverage they offer or to purchase it differently,” Litten said. The Affordable Care Act may also make it easier and more attractive for employers to divorce themselves from health coverage, said Barry Ostrowsky, president and CEO of Barnabas Health. He compared it to retirement plans. It used to be that many companies offered a pension plan, but now employees rely on 401k plans. Health insurance, he said, could follow the same path with employers providing a match or stipend to their employees, who will then choose their own plan. “The move will be gradual,” he said. “Industries are going to look at this and talk out loud because the encouragement is there.” He predicts companies will create their own

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11/6/13, 12:17 PM


Ready forinsurance Obamacare? exchanges Many Americans to understa...a menu ofhttp://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... health andstruggling offer employees health insurance options.

Employees, he said, would then become accustomed to picking their own plan, one that suits their family’s needs as opposed to a one-size-fits-all for the company. “The next step is now that you have bought insurance without necessarily doing it in a herd mentality with all of our employees, we think it is smarter for us to give you more compensation and allow you to use this additional compensation to purchase health insurance,” Ostrowsky said. The lasting legacy of the Affordable Care Act is likely to be its effect on how the nation purchases and utilizes health insurance. The federal government, employers and individuals will pay closer attention to what their coverage plan costs and offers, Litten said. “In the past, I don’t think anyone had a reason to know what it cost to get an X-ray,” Litten said. “Now, people are going to pay more attention to the value. They’re going to also get a lot smarter and demand to know what they are purchasing.” On Tuesday, Americans will be able to take the first step.

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/index.ssf/2013/11 /letter_why_does_obamacare_make.html) Letter: Why does Obamacare make guys buy women's coverage? (http://www.nj.com/south-jersey-voices /index.ssf/2013/11 /letter_why_does_obamacare_make.html)

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HR Ken (http://connect.nj.com/user/kenlieberman/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-30/1380570569-217-566.html)

What I find amazing is that NO ONE is talking about the fact that we all will be paying $5.25 per month per covered member to pay for this. It is a tax that will begin on January 1st. That is $63 per person per cover individual. If you have 4 in your family, that is $252.00 in health tax per year. Most people don't know this. (http://nj.com/)

mdonaldcant (http://connect.nj.com/user/mdonaldcant/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380300086-81-516.html)

Here's the thing, I've been trying to get to the "bottom line" here to find out exactly what this forced insurance will cost me on a monthly basis. Based on everything I've found so far, it appears that I will be socked for hundreds of dollars a month in exchange for fairly lousy insurance that I don't want and don't need. I keep reading a lot of gobbeldygook about "marketplaces" and "subsidies" but I cannot find a clear answer on what it will cost me per month...if I comply. When does this state intend to make this information available? (http://nj.com/)

Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg /index.html) last month (http://nj.com/news/index.ssf/2013/09

8 of 22

/obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380306132-840-657.html)

11/6/13, 12:17 PM


Ready for Obamacare? Many Americans struggling to understa... I'll help

http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab...

First, i assume you are currently uninsured. Is that correct? If so, use this handy calculator to get best guess http://kff.org/interactive /subsidy-calculator/ (http://kff.org/interactive/subsidy-calculator/) Actual numbers will be available on Tuesday at healthcare.gov. If you are already insured, you don't need to do anything. Any other questions - shoot me an email at dgoldberg@starledger.com

Subsidy Calculator (http://kff.org/interactive/subsidycalculator/) http://kff.org/interactive/subsidy-calculator/ (http://kff.org /interactive/subsidy-calculator/) Where can I go for help understanding how the health reform law will affect me? If you have questions about how the health reform law will affect you and your insurance options, please go to Healthcare.gov, or contact their Help Center if you have qu... (http://nj.com/)

nc002 (http://connect.nj.com/user/nc002/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380308262-748-4.html)

McDonald, if you are uninsured and "don 't want and don't need" insurance, what happens if you do have an accident and need to be hospitalized? Are you going to pay the entire hospital bill out of your savings? (http://nj.com/)

mdonaldcant (http://connect.nj.com/user/mdonaldcant/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380329173-829-993.html)

What if I never have an accident and never need insurance, will I be eligible for a refund? Hypothetical questions avoid the issue which is that the government is forcing people to purchase a service from a privately-owned business whose only goal is to make a profit for its owners and shareholders. Stop pretending we're all going to be helped by the kind-hearted insurance industry. (http://nj.com/)

9 of 22

11/6/13, 12:17 PM


paisley214 (http://connect.nj.com/user/paisley1/index.html) Ready for Obamacare? Many Americans struggling to understa... http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... (http://c

last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380292299-522-255.html)

I understand ACOs would be formed and given incentives to cover Medicare patients -- but the article doesn't mention Medicaid patients. It does say, however, that more people will qualify for Medicaid. However, adults receiving straight, Series-G Medicaid coverage now have access to very basic care, but they can't find needed specialists (including dentists, but also cardiologists, oththopedists, rheumatologists, general surgeons, etc.) who accept Medicaid. Small wonder, since it's much more of a hassle and less profitable for healthcare providers to treat Medicaid patients. So with many more joining the Medicaid ranks, how does it help anyone when there are no Medicaid doctors -- particularly in wealthier counties -- who will treat them under the NJ Medicaid plan? (http://nj.com/)

Dan Goldberg/The Star-Ledger (https://api.embarke.com/v1/contacts /6797) last month (https://api.embarke.com/v1/messages/2224736)

That's an excellent point and one we touched on in our story about doctor shortages. I plan to return to the Medicaid g problem in the coming weeks once I get a handle on how many people sign up for the program. But I think your hunch is correct. Though it is worth mentioning Medicaid rates were bumped up for two years to sweeten the deal. Many docs however say that is not enough of an incentive.

rikky1 (http://connect.nj.com/user/rikky1/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380289186-240-191.html)

what i don't see mentioned is the network of doctors that will be part of these plans. each healthcare provider has numerous plans with their own negotiating rates and participating doctors. has anyone looked into what doctors will be part of the plans in NJ? we talk about getting healthcare coverage like the only thing that matters is the cost than everything else is the same when the network of doctors is extremely important as well. (http://nj.com/)

Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg /index.html) 10 of 22

last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380289368-73-570.html)

11/6/13, 12:17 PM


We weretojust talking about thishttp://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... in the office yesterday. The Ready for Obamacare?Great Many question Americans-struggling understa... networks have not been announced yet. I wonder that too. Say I live in Hunterdon and Warren and sign up for the cheapest Bronze plan, will I be able to find a doctor in my area? I really don't know. How to use insurance once you have it is something not talked about enough. I completely agree. (http://nj.com/)

lawman75 (http://connect.nj.com/user/lawman75/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380297824-718-636.html)

It appears from some of your answers there's an awful lot not know about this Bill. They postponed it for Big Business and small business and certain union constituents. Don't you agree they should postpone it for the average middle class citizen until we fully know what we're dealing with under this law. The Bill was passed in 2009. It's implementation was postponed until for four years to occur after Obama's reelection. So why not give the same postponement to middle class America. What's the rush. (http://nj.com/)

Baby Doc (http://connect.nj.com/user/hoffmth/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380287670-631-783.html)

I currently work for a Fortune 500 company here in NJ and through their health coverage plan contribute about $250 month to cover my family of 4. I have no deductible and the plan covers anywhere from 60-100% depending on whether I go to in plan doctors/hospitals or not. I would argue that within the next 3-5 years, this company will drop all employee health care coverage and require everyone to purchase plans at the health care exchanges. After all, why should they now continue to incur any health insurance related costs? According to this article the average cost for Silver grade coverage is $385 per month per person. Extending that to a family of 4 drives the monthly cost of this coverage to over $1000 per month. My salary would not allow for any government subsidies so I would have to bear the full brunt of this increase. This is socialism at it's worst. So Dan, explain to me how I benefit from the AHCA beyond the tingle I'm told I should get for supporting the health care needs of drop outs and immigrants? (http://nj.com/)

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rikky1 (http://connect.nj.com/user/rikky1/index.html) 11 of 22

last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27

11/6/13, 12:17 PM


/1380288802-228-880.html) Ready for Obamacare? Many Americans struggling to understa...

http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab...

baby doc, that is some excellent health care. i also work for a fortune 500 in NJ and i currently pay $405 a month to cover my family of 4 with a $375 deductible for each person before they cover 70%. next year due to obamacare my premiums are going up $100 a month and the deductible another $100 a person. i believe my company will continue to offer healtcare as part of attracting good talent but it will continue to increase in cost/burden on the employee which will force more people somewhere else. we are also pushing Health Savings Accounts which is cheaper for the employer and limits their payouts. (http://nj.com/)

Dan Goldberg/The Star-Ledger (http://connect.nj.com /user/dgoldberg/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380288973-233-322.html)

That is a good point -- the cost of premiums to larger companies may rise to help subsidize all these costs. That will get passed on to the employees. It's too soon to tell how much this will hurt. I think you'd need a real 5 year look because premiums always rise -- the question is how quickly. Insurers may load up the front end b/c they aren't convinced the exchanges will work. If they do, premiums might level off for everyone; if they don't premiums could rise for those like yourself. I just don't know the answer to that one (http://nj.com/)

Baby Doc (http://connect.nj.com/user/hoffmth/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380290377-27-317.html)

Rikky - Agreed, premiums always rise but don't think the cost of the government health care will remain stable either. (http://nj.com/)

Baby Doc (http://connect.nj.com/user/hoffmth/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380290092-374-404.html)

Dan/rikky1: 1.) You guys are delusional if you think that over time all companies aren't going to be dropping their health care coverage all together or only providing it for the 12 of 22

employee and not the family. With the AHCA this particular benefit will disappear

11/6/13, 12:17 PM


andMany it willAmericans not longer be a competitive The AHCA now gives Ready for Obamacare? struggling to understa...feature for hiring. http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... them an excuse. 2.) Dan - The example you mention is simply a different aspect of socialism. This one goes "you make too much money so you have to pay disproportionately high fees for health care to cover those who make less. Many of their own choosing." This one is just as bad. 3.) Dan - My current plan already provides me with preventative health care, though not completely free it only requires a co-pay. Also we already had a means to cover people that lose their jobs and have no money, Medicaid. (http://nj.com/)

1

(http://connect.nj.com/user/jacknabes/index.html)

Baby Doc (http://connect.nj.com/user/hoffmth/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380290217-801-930.html)

You also fail to address the 400% increase in my monthly health care costs. (http://nj.com/)

Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg /index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380286710-320-383.html)

Hey everybody -- I know the comments here are going to get intense and I'll try to respond to every legit question I can. But for a bit of levity on a Friday morning ... I'm also sharing this. http://www.theonion.com/articles/man-who-understan... (http://www.theonion.com/articles/man-who-understands-8-of-obamacarevigorously-defe,34022/) Man Who Understands 8% Of Obamacare Vigorously Defends It From Man Who Understands 5% (http://www.theonion.com/articles /man-who-understands-8-of-obamacare-vigorously-defe,34022/) http://www.theonion.com/articles/man-who-understan... (http://www.theonion.com/articles/man-who-understands8-of-obamacare-vigorously-defe,34022/) SEATTLE-As debate continues in Washington over the funding of President Obama's health care initiative, sources confirmed Thursday that 39-year-old Daniel Seaver, a man who understands a total of 8 percent of the Affordable Care Act, offered a veheme... (http://nj.com/)

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nc002 (http://connect.nj.com/user/nc002/index.html) Ready for Obamacare? Many Americans struggling to understa... http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... (http://c

last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380286580-423-523.html)

I also love the observation by Sebelius that they need about 2.7 million people under 35 to enroll to keep costs down. For anyone who missed the point, they need 2.7 million suckers under the age of 35 who are willing to be overcharged so other people can get their insurance cheaper. It is not a good sign that the success of obamacare depends on finding enough people who are ignorant enough to make a poor economic decision. (http://nj.com/)

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Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg /index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380289060-511-21.html)

I apologize -- I mistyped -- I'm going to pull my comment down --- my fingers were working faster than my brain. (http://nj.com/)

spanneta (http://connect.nj.com/user/spanneta/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380333739-996-185.html)

"The rates are (should be) based on the risk, not arbitrary political issues." I've got no problem with that statement, that's always been the basis of insurance. But under Obamacare, we're still charging for one risk factor (age), but removing other risk factors (like serious pre-existing conditions) from the premium calculation. Would be fairer to treat them all the same. (http://nj.com/)

spanneta (http://connect.nj.com/user/spanneta/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380285594-669-557.html)

"The Affordable Care Act states you will not have to spend more than 9.5 percent of your income on premiums." That's not quite correct. The Affordable Care Act states that if you don't have to spend 14 of 22

more than 9.5% on INDIVIDUAL coverage offered by an employer, then you're deemed to have affordable coverage. If that's the case, even if the family coverage offered by

11/6/13, 12:17 PM


your employer might cost you 10%, 20%, 30% of your http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... income or MORE and you Ready for Obamacare? Many Americans struggling to understa... can't afford it, you're still deemed to have affordable coverage and your family is ineligible for subsidies should you wish to purchase family coverage on the exchange.

I personally know a few low-moderate income couples affected by this "family glitch", One example, family of five, the wife works a nurse's aide and gets very low cost individual coverage from her job. However the family or spouse coverage offered is not subsidized by the employer and is beyond their means. Family coverage and would cost more than $13,000/year, greater than 20% of their gross income, which is just shy of $60,000/year. The husband is a machine operator, and gets no coverage from his job. Under Obamacare's "you'll get the details after you pass it" definition of "affordable", this family is deemed to have affordable coverage, and gets no subsidies. Bottom line, Obamacare does nothing for this family. They can't afford the employers family coverage, so don't buy it. The wife is and will continue to be covered because of the employer's low cost individual coverage... more (http://nj.com/)

Patrick Cowher (http://twitter.com/PatrickCowher/) last month This comment was posted on another article. This story is being discussed in the comments here: Stocial - The Stock Network (http://stocial.com/site-ticker/)

Patrick Cowher (/#/profile/twitter/PatrickCowher) read: Ready for Obamacare? Many Americans struggling to understand new health care law | NJ.com (http://www.nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html)

farwestnj (http://connect.nj.com/user/wanker47/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380284163-270-115.html)

And in other news, the US senate and house of non_ representatives have carefully left themselves and certain others exempt from obama care, one would think if it was such a wonderful thing, they would have been first in line to sign on, lead by example? They of course being unwilling to give up their luxury lifetime health care, the best the tax paying citizens can afford I believe. (http://nj.com/)

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Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg /index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27

11/6/13, 12:17 PM


Ready for Obamacare?/1380286970-852-760.html) Many Americans struggling to understa...

http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab...

I do this on every Obamacare story. That is not true. Congress must purchase health insurance from the exchange. They just get a much larger subsidy than everyone else because they are employed by the federal government. http://www.reuters.com/article/2013/08/07/usa-heal... (http://www.reuters.com/article/2013/08/07/usa-health-congressidUSL1N0G820F20130807) UPDATE 1-U.S. Congress wins relief on Obamacare health plan subsidies (http://www.reuters.com/article/2013/08/07/usa-health-congressidUSL1N0G820F20130807) http://www.reuters.com/article/2013/08/07/usa-heal... (http://www.reuters.com /article/2013/08/07/usa-health-congress-idUSL1N0G820F20130807) Ruling aimed at avoiding "brain drain" on Capitol Hill (Adds comments from Republicans, Pelosi, edits) By David Lawder WASHINGTON, Aug 7 (Reuters) Congress has won some partial relief for lawmakers and their staffs from the "Obamacare" health refor... (http://nj.com/)

lawman75 (http://connect.nj.com/user/lawman75/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380297381-934-699.html)

Not everybody employed by the federal Government are getting these "much larger" subsides ( which is code for full payment). It's members of Congress, the Administration and their families and staffs. Their Platinum Plans will cost them nothing. See how much the same plan cost the average citizen. The subsidies under Obamacare are supposed to be for people of lower incomes that can't afford the mandated payment. If elected officials are not getting insurance under the same provisions as the average citizen they are perpetrating a fraud. The only thing worse than that is defending it. (http://nj.com/)

ThisIsIt (http://connect.nj.com/user/rightherenow123/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380281506-2-176.html)

I am from the government, and I am here to help.... (http://nj.com/)

ThisIsIt (http://connect.nj.com/user/rightherenow123/index.html) 16 of 22

last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380281485-288-751.html)

11/6/13, 12:17 PM


@Dan Many Americans struggling to understa... Ready for Obamacare?

http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab...

I am looking forward to the story on the avg deductible of $2550 a year, as well as copays, split percents between the insurer /uninsured. max out of pocket expenses as well. (http://nj.com/)

jack300 (http://connect.nj.com/user/jacknabes/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380283816-954-229.html)

$2500 deductible is per person for in-network; 70% coinsurance. Out-of-network (doctors whose names contain vowels) deductible is $7500; 50% coinsurance. (http://nj.com/)

Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg /index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380287272-8-22.html)

Believe me, me too. The real unknown is will any of this be affordable, and what kind of benefits and network will exist. As soon as I know, you will know. My guess is we will be writing these stories in October. But here is my point -- lets say you are relatively healthy and shopping on the exchange. You buy a silver plan that covers 70 percent of your costs for $145 per month. (after subsidies) Now because you will get checkups and other preventive measures like flu shots for free, your out of pockets costs remain low. There will be copays for certain things and you might be in trouble if you need an MRI or X-Ray but most people don't in a year. Now, at the same time, they are protected from huge medical bills. I know that sounds a bit too rah rah and believe me I'm not trying to defend Obamacare. i am. just playing Devil's Advocate to your question. just playing Devil's Advocate to your question. (http://nj.com/)

nj4sure (http://connect.nj.com/user/nj4shore/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380280881-206-617.html)

"Most directly affected are the 48 million uninsured Americans, 15 percent of the nation." Oh really, what about the 85% that already have insurance that will pay more, 17 of 22

in some cases a lot more. Liberals don't like to talk about that, they think all money is free. Nice going Obama voters, hope this one is painful.

11/6/13, 12:17 PM


Ready for Obamacare? Many Americans struggling to understa...

http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab...

http://www.forbes.com/sites/theapothecary/2013/09/... (http://www.forbes.com /sites/theapothecary/2013/09/25/double-down-obamacare-will-increaseavg-individual-market-insurance-premiums-by-99-for-men-62-for-women/) Double Down: Obamacare Will Increase Avg. Individual-Market Insurance Premiums By 99% For Men, 62% For Women (http://www.forbes.com/sites /theapothecary/2013/09/25/double-down-obamacare-will-increaseavg-individual-market-insurance-premiums-by-99-for-men-62-for-women/) http://www.forbes.com/sites/theapothecary/2013/09/... (http://www.forbes.com/sites/theapothecary/2013/09/25/doubledown-obamacare-will-increase-avg-individual-market-insurance-premiumsby-99-for-men-62-for-women/) For months now, we've been waiting to hear how much Obamacare will drive up the cost of health insurance for people who purchase coverage on their own. Last night, the U.S. Department of Health and Human Services finally began to provide some data on...

2 (http://connect.nj.com/user/sylin/index.html) (http://connect.nj.com/user/GFGNJ/index.html) (http://nj.com/)

Adam (http://connect.nj.com/user/aselver/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380284931-687-400.html)

Liberals? I must remind you that this plan was created by the Heritage Foundation, proposed by Newt, and first executed by Mitt Romney. (http://nj.com/)

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spanneta (http://connect.nj.com/user/spanneta/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380286484-884-643.html)

"...and first executed by Mitt Romney." So if it's good for the State of Massachusetts, it must be good for the whole country? Using that logic, the very liberal gun ownership, possession and carry laws that work fine for the State of Vermont must be good for the whole country too, right? (http://nj.com/)

nj4sure (http://connect.nj.com/user/nj4shore/index.html) last month (http://nj.com/news/index.ssf/2013/09

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Sorry no adam, the Heritage Foundation washttp://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... to cover catastrophic Ready for Obamacare? Many Americans struggling to understa... insurance only. There is another story in the SL this morning discussing this. But I guess in the land of intellectuals reading isn't required. (http://nj.com/)

lawman75 (http://connect.nj.com/user/lawman75/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27/1380280281-68-499.html)

One correction. There are no fines. These were changed to taxes when Chief Justice Roberts illegally rewrote the Bill. Secondly you failed to mention the out of pocket expenses most Americans will face under the law. The law was created to be intentionally impossible to understand. That's why it was orchestrated behind closed doors without a glimmer of transparency. And Tom, nobody one the Ledger's staff has addressed the question that if this is such a great law why did those who create it exempt themselves? (http://nj.com/)

jack300 (http://connect.nj.com/user/jacknabes/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380283922-409-844.html)

lawman - Didn't you watch the negotiations televised on C-SPAN for all to see? Neither did I, that was just another O lie. 1

(http://nj.com/)

(http://connect.nj.com/user/lawman75/index.html)

Dan Goldberg/The Star-Ledger (http://connect.nj.com/user/dgoldberg /index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_affordable_care_act_explained.html/post/2013-09-27 /1380287400-134-321.html)

We went back and forth on whether to call these fines or taxes or penalties. The truth is we decided that calling it a tax is too confusing. Yes, that is what Justice Roberts ruled when justifying the government's power to enforce the individual mandate, but that was more for legal purposes. In reality, it's a fine. If I get a speeding ticket because I broke the law, I call that a fine, not a tax. 1

(http://connect.nj.com/user/lawman75/index.html)

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lawman75 (http://connect.nj.com/user/lawman75/index.html) last month (http://nj.com/news/index.ssf/2013/09

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Ready for Obamacare? Many Americans struggling to understa... http://www.nj.com/news/index.ssf/2013/09/obamacare_affordab... I fully agree. Calling it a 'Tax" was a lie to the American people to justify the

law under the Constitution. You can't Constitutionally penalize a person for not buying a product your forcing them to buy. (http://nj.com/)

nc002 (http://connect.nj.com/user/nc002/index.html) last month (http://nj.com/news/index.ssf/2013/09 /obamacare_aordable_care_act_explained.html/post/2013-09-27/1380280223-993-413.html)

Look at the comment by the Medicare/Medicaid guy, that if the only people who enrolled were sick, the system would collapse, just like any insurance business. But this is exactly what the government did to the existing system. When someone doesn't carry insurance but we force hospitals to treat them, that is exactly what we did: Someone who did not contribute but is using the resources. When someone one doesn't carry insurance but is guaranteed coverage when they apply after getting sick (pre-existing conditions), the same thing applies. The government has consistently screwed up the system but now we are supposed to believe they will get it right (http://nj.com/)

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