Shut Down Optics

[Paul158]

40 minutes ago, Viratas said:

Of course not. You and I probably agree on one thing: we would like to see quality, affordable care for ALL Americans, not just the rich or the poor. At least we would agree, I do not want to make assumptions, but I am guessing we are on the same page. 

Yes, AI, but it can also provide you with resources.

Here’s a breakdown of what happened:

1. Premium Costs

• From 2013 to 2019, premiums for individual (non-group) plans roughly doubled nationally, though rate growth slowed after 2020.

• Subsidy-eligible enrollees (lower income) were largely insulated, but middle-class families earning above roughly 400% of the federal poverty level (around $120k for a family of four in 2025) often paid full price.

• Many in this bracket saw monthly premiums exceeding $1,000–$1,500 per household for silver-tier plans.

2. Out-of-Pocket Costs

• ACA-compliant plans introduced minimum essential coverage and no annual/lifetime limits, but to balance risk, insurers increased deductibles and coinsurance.

• The average deductible for a silver plan is now over $5,000 per person, compared to about $2,500 before 2014.

• Cost-sharing reductions only apply to lower-income enrollees, so middle-income households pay the full deductible and out-of-pocket max (often $8,000+).

3. Net Benefits and Coverage Networks

• Mandated “essential health benefits” added coverage categories (mental health, maternity, etc.), but insurers offset costs by narrowing provider networks.

• Many middle-class self-employed workers or early retirees now find fewer doctors in-network and limited plan options.

4. Winners vs. Losers

• Winners: Low-income, previously uninsured Americans and people with preexisting conditions.

• Losers: Middle-income individuals and small business owners not receiving subsidies.

• Neutral: Large-employer plans have changed less, though cost-sharing has still trended upward due to general healthcare inflation.

If you’d like, I can show you a chart comparing average premiums and out-of-pocket maximums from 2013 to 2025 for single vs. family coverage to visually summarize the change. Would you like that?

 

 

 

Excellent. We are going to rename the Affordable Care Act. New name. The Affordable Care for a Few/ The Non-Affordable Care Act for Most Americans.

Edited October 28, 2025 by Paul158
missed a word

[Caveira]

17 minutes ago, Paul158 said:

Excellent. We are going to rename the Affordable Care Act. New name. The Affordable Care for a Few/ The Non-Affordable Care Act for Most Americans.

Or just another political lie in a sea of never ending political lies ?

[JimmySpeaks]

3 hours ago, fishbane said:

Probably?  This is the definition for that field

"Total Consumers Who Have Selected a Marketplace Plan: represents consumers who selected or were automatically reenrolled into a Marketplace medical plan (regardless of whether the consumer paid the premium) as of the end of the open enrollment period."

So all, some, many, a few, could still be on Medicare too but they’re capable of paying for an additional plan to help offset out of pocket costs?  I’m just trying to understand who’s using only the marketplace medical plan.  Im curious if you came across anything that breaks it out that way?   

[Wrestleknownothing]

Not to worry after four years as president, and another four years where he could really buckle down and think about it, and another 10 months as president, Trump has the concepts of a plan to replace the ACA. By his fourth term he hopes to have a plan. By his sixth term he hopes to have the concepts of a plan to pass his plan. And by his eighth term he plans to have a plan to pass his plan. By his tenth term he plans to pass his plan.

That is if everything goes according to plan.

[Caveira]

13 minutes ago, Wrestleknownothing said:

Not to worry after four years as president, and another four years where he could really buckle down and think about it, and another 10 months as president, Trump has the concepts of a plan to replace the ACA. By his fourth term he hopes to have a plan. By his sixth term he hopes to have the concepts of a plan to pass his plan. And by his eighth term he plans to have a plan to pass his plan. By his tenth term he plans to pass his plan.

That is if everything goes according to plan.

Maybe they just want to go back to the old plan?  As they were cool with that and didn’t want the new plan?

Edited October 28, 2025 by Caveira

[Scouts Honor]

16 hours ago, ThreePointTakedown said:

I don’t think I ever said it fixed anything. Tried to fix things sure. But half measures rarely work. As we’re seeing now. 
 

So unless you can point out where I made that comment, please go ahead and connect the dots for your theory. 

so like i said

replace a fire with what

[Scouts Honor]

13 hours ago, Wrestleknownothing said:

Not to worry after four years as president, and another four years where he could really buckle down and think about it, and another 10 months as president, Trump has the concepts of a plan to replace the ACA. By his fourth term he hopes to have a plan. By his sixth term he hopes to have the concepts of a plan to pass his plan. And by his eighth term he plans to have a plan to pass his plan. By his tenth term he plans to pass his plan.

That is if everything goes according to plan.

he saw the logic of not replacing a fire with another fire? 

[Caveira]

13 hours ago, Wrestleknownothing said:

Not to worry after four years as president, and another four years where he could really buckle down and think about it, and another 10 months as president, Trump has the concepts of a plan to replace the ACA. By his fourth term he hopes to have a plan. By his sixth term he hopes to have the concepts of a plan to pass his plan. And by his eighth term he plans to have a plan to pass his plan. By his tenth term he plans to pass his plan.

That is if everything goes according to plan.

He prolly can’t can’t find his autopen 

[fishbane]

17 hours ago, JimmySpeaks said:

So all, some, many, a few, could still be on Medicare too but they’re capable of paying for an additional plan to help offset out of pocket costs?  I’m just trying to understand who’s using only the marketplace medical plan.  Im curious if you came across anything that breaks it out that way?   

I don't think one can be on Medicare and have an ACA plan.  Quoting from Medicare.gov

"Can I get a Marketplace plan in addition to Medicare?

No. It’s against the law for someone who knows you have Medicare to sell you a Marketplace plan. This is true even if you have only Medicare Part A (Hospital Insurance) or only Part B (Medical Insurance)."

Supplemental plans are available in the marketplace for those not on Medicare.  Vision and dental plans can be purchased as stand alone plans for adults.  I don't have the breakout of who only has those and not medical.

My main point is that I think it is likely that Republicans extend the enhanced credits in some form.  Of that list I gave 9 of the top 11 states in participants are either red states or swing states.  This map shows where the greatest growth in enrollments has been since the enhanced credits came into effect.  Voters in red states have disproportionately benefited from the enhanced credits which has doubled enrollments overall since being enacted.

Open enrollment for the ACA starts Nov 1.  Any decision on the enhanced credit should be made before then and definitely before it ends on 1/15. People need this information to make a decision. Estimates are without the enhanced credit the average premium for someone currently with a marketplace plan will increase by 75%.  Those currently with an ACA plan may opt to get coverage elsewhere or go without, so the actual increase seen by those that remain would be less.

The optics of the shutdown could pivot on what happens with the enhanced credits.  If they ultimately get extended I am sure Republicans will try and argue that the Democrats shut down the government for nothing and that this was always going to happen. Democrats will try and say that the shutdown was effective in forcing their Republicans to agree to extend the enhanced credits and the shutdown was the Republicans fault for not coming to the table before the start of open enrollment.

In the situation that the enhanced credits are not extended in any form the Republicans would have won the shutdown.  The Democrats would have shut down the government to gain nothing and only wasted money in the process.  They will have to pay the political price for that.  But Republicans will have to pay the price for millions of voters disproportionately in states they represent either facing increased healthcare costs or losing coverage all together.  

[Caveira]

 

[red viking]

ACA is a red herring. You really think healthcare costs are gonna drop if we get rid of ACA? And the cow jumped over the moon. 

Here's a reality check for you. As long as we continue to fund every medical procedure technologically available for every single person, healthcare costs will continue to skyrocket. It's that simple. Doesn't matter what else you do. That's going to override everything. 

Maybe you like this or maybe you don't. That's another subject. But there's a price to pay for providing high tech healthcare for everybody. 

[Caveira]

3 minutes ago, red viking said:

ACA is a red herring. You really think healthcare costs are gonna drop if we get rid of ACA? And the cow jumped over the moon. 

Here's a reality check for you. As long as we continue to fund every medical procedure technologically available for every single person, healthcare costs will continue to skyrocket. It's that simple. Doesn't matter what else you do. That's going to override everything. 

Maybe you like this or maybe you don't. That's another subject. But there's a price to pay for providing high tech healthcare for everybody. 

Deporting illegals in large volume sure will help 

[Scouts Honor]

10 hours ago, red viking said:

ACA is a red herring. You really think healthcare costs are gonna drop if we get rid of ACA? And the cow jumped over the moon. 

Here's a reality check for you. As long as we continue to fund every medical procedure technologically available for every single person, healthcare costs will continue to skyrocket. It's that simple. Doesn't matter what else you do. That's going to override everything. 

Maybe you like this or maybe you don't. That's another subject. But there's a price to pay for providing high tech healthcare for everybody. 

who gets to choose who lives and dies?

i was told there were no death panels.

[fishbane]

11 hours ago, Caveira said:

Deporting illegals in large volume sure will help 

Will it though?  Not all illegal aliens are eligible for coverage.  Only those that are lawfully present.  A list of immigration statuses that are potentially eligible can be found here. I think those with such immigration statuses would not be subject to immediate deportation, so they might not get caught up in the Trump deportation push.   If I am wrong and they are subject to deportation then Republicans have less reason to fight over health care coverage for them.  ICE is geared up to deport 1 million illegal immigrants per year they could have all those with ACA marketplace plans out by the end of 2026.  Why shut the government down over something that can be fixed through ice enforcement?

Only about 1.2 million lawfully present immigrants have health plans through the ACA marketplace.  The increase in US citizens with plans through the market place since the enhanced credits were enacted in 2021 is nearly 10x that.  In terms of shutdown optics have Republicans offered to extend the enhanced credits without the provision that makes lawfully present immigrants eligible?  You know extend the enhanced credits for the 11 million citizens and cut them for 1.2 million lawfully present immigrants?  
 

Looking more long term if all or even a significant portion of the 10-14 million illegal immigrants are deported then that will leave vacancies in the jobs they used to do.  These jobs are disproportionately low paying often seasonal or short term or contract work.  If they are filled by US citizens then even more of those employed in these positions will be eligible for ACA plans since all citizens are eligible.  Also upward pressure on wages created by the deportations might not be enough to keep ACA enrollments down.  The income limit for lawfully present immigrants under the enhanced credits is capped at 100% of the poverty line whereas the income limit for citizens even before the 2021 enhancement was 400% of the poverty line.  Wages would have to more than 4x to make a position currently filled by an immigrant and replaced by a citizen above the income limit.  

[Scouts Honor]

they use emergency rooms

[Caveira]

Just now, Scouts Honor said:

they use emergency rooms

Not when they’re deported they don’t.  They use the emergency room where ever they get deported to.   And they pay for it 

[Caveira]

Pretty classy of the democrats to play chicken with SNAP and what not over this.   Stay classy boys.  

[Caveira]

This wasn’t that long ago 

 

[Scouts Honor]

new twist

it's not happening!!

oh wait, it's happening and it's not good...

but oh yeah.. it really is

 

[Viratas]

Around 9:30 PM EST the Dems will vote for a Clear CR then..

"We believe we made our point, and now we have saved Food Stamps"... 

They will take a victory lap and try to hang their hat on it for the elections.

A political Ploy, a sad one.

[red viking]

[Interviewed_at_Weehawken]

14 minutes ago, red viking said:

Wow! An asteroid named after her!!!

Guess what?  There is also an asteroid named after the dark lord Sauron!

Another amazing fact: Sauron's eye is less crazy than AOCs.

Edited October 31, 2025 by Interviewed_at_Weehawken

[Viratas]

21 minutes ago, red viking said:

So she is proof our education system is, well, broken.

She worked for one of the most corrupt senators in our history

Imagine a debate between her and Kamala... Instant Classic....

M

 

[Gene Mills Fan]

7 minutes ago, Viratas said:

So she is proof our education system is, well, broken.

She worked for one of the most corrupt senators in our history

Imagine a debate between her and Kamala... Instant Classic....

M

 

She has an economics degree? and thinks tax breaks are cash payments to corporations?

[Caveira]

1 hour ago, Viratas said:

Around 9:30 PM EST the Dems will vote for a Clear CR then..

"We believe we made our point, and now we have saved Food Stamps"... 

They will take a victory lap and try to hang their hat on it for the elections.

A political Ploy, a sad one.

Unfortunately.   I think your right.