Cash Costs for Able Bodied Adults Without Dependents
When the Affordable Care Act mandated healthcare for Able Bodied Adults without Dependents, all hell broke loose among young US Citizens from all walks of life. Talks emerged of the following topics all over the internet:
- Boston Tea Party.
- Nazi Medical Experimentation.
- Forced participation in creation of genetic drugs and gene therapy.
- The social security account being empty and Baby Boomers using ACA to fund their retirement.
- The ridiculous costs for someone without any medical issues which is most of the 20 to 40 population.
- At the time many 40 to 75 year olds did not require any type of ongoing monthly care, just yearly physicals, so they were on board with us mainly due to the Nazi Experimentation theories.
We discovered that the Affordable Care Act provided exemptions for both affordability and hardship, with homelessness being one of the hardships. Homelessness is defined in U.S. Code Title 42, Chapter 119, Subsection 11302 5(b) as
- Staying in a hotel and lacking resources to stay for more than 14 days (#TryTheRitzCarlton)
- No subsequent address identified (they were using intrusive credit reports)
- No resources to obtain permanent housing (at the time, permanent housing was defined as a 2 year residence)
And so our journey began.
Many people began online travel blogs like these The Nomadic Vegan, Vegan Travel, Forums Posts on Moving Every 6 Months, Living in a New City Every 6 Months, 6 Month Financial Planning, How to Start Over in a New City,
Our new lifestyle spurred questions from narq informant recruiters who needed people with no criminal record, an 800 credit score and a 2 year permanent residence as a minimum for consideration. Many people bought expensive items, sold them on craigslist for half price and skipped all the payments then watched their credit score drop to the 600 level when they found out about the narq informant recruiter requirements to be a qualified narq.
So what does this have to do with Healthcare?
Since non of us had permanent residence, we were considered difficult to insure but we found out the cash price for doctor visits often times ended up being less expensive than paying an insurance premium every month and so our peaceful protest continued, and in some cases intensified.
Here were my healthcare costs between 2011 and and 2019. The individual mandate of the Affordable Care Act was repealed by President Donald J. Trump through the Tax Cuts and Jobs Act of 2017 and is documented as Public Law 115-97 on Congress.gov (search for “PART VIII–INDIVIDUAL MANDATE”)
|Physical with Urine Sample||Pico Rivera, California||2016||$50|
|Physical||Sioux Falls, South Dakota||2017||$102|
|Dental Exam and Teeth Whitening||Sioux Falls, South Dakota||2017||$400|
|Dental Exam and Cleaning||London, England||2018||£40|
|Eye Exam with Contact Fitting||London England||2018||£40|
|Teeth Cleaning||Sioux Falls, South Dakota||2019||$75|
|Eye Exam for glasses and contacts||Sioux Falls, South Dakota||2019||$85|
|Physical||Sioux Falls, South Dakota||2019||$102|
|Teeth Cleaning||Alhambra, California||2019||$60|
|Urgent Care Visit for Dog Bite||Pico Rivera, California||2019||$40|
Back in 2011, the cheapest Bronze plan was over $300 a month although the costs have come down now to about $260 for a 36 year old single making $45,000 a year living in the 90017 zip code. Even at $260/mo. for 8 years that represents $24,960. The ridiculous amount of these insurance costs compared to actual costs brought up the conversation of having insurance companies act like more of an escrow company in the future where you pay into it until you meet the state minimums and stop paying when you have sufficient funds to cover medical expenses. This escrow type insurance would apply to health, car, home and accident insurance. We also discussed making an HSA plan available for anybody not just people with high deductibles and to be able to use it as your primary and only insurance. We also wondered why is a health plan “tax favored” . Escrow Type Insurance and HSA Plans were our favorite options for paying medical, dental and vision costs. Having to go to a religious institution for a few meetings and signing up for their religions healthcare plan to reduce the penalties (forced insurance is a penalty) or get a waiver was the worst. Even at $45 a month, that is $540 on top of your actual medical bills we were paying cash for. Note, being homeless per the Federal Definition worked out better but the Healthcare “Ministry” was an eye opener into the US Economy. The $45 plan is going up to $78 on 4/1/2020.
I was not able to obtain any information regarding health care coverage. I was advised to apply for healthcare through coveredca.com which also does the medi-cal, medic-aid applications. Honestly, subsidized healthcare should be based on the $52 per month healthcare allowance and tax deductions based on income. Search for health on this IRS Webpage to get started on those policies. I’m a big fan of the HSA account for all that should function as an escrow account that can be cashed out at end of life and given tax free to offspring. The IRS is also currently allowing people to deduct medical expenses in excess of 7.5% of “adjusted” gross income. This would be equivalent to making $8320 per year and being able to “deduct” any medical expenses in excess of $624. Note that EVERY tax deductions comes from the general funds account of the US Treasury so there needs to be a better way to manage health costs of people that have excess medical costs. If I’m making $45k a year or $200k a year and my health costs are less than $1,000 a year (regardless of how much money I make), why should someone that makes $90k a year and has $17,000 in yearly medical costs be able to deduct $10,250 of their medical expenses to the US Treasury medical fund every year for the rest of their lives?
In conclusion, in addition to expanding qualifications of an HSA account to everybody regardless of whether they have insurance or not and treating all insurance as an escrow account for future payments and liabilities; I am a supporter of allocating a set amount out of the US Treasuries previous years taxes to go towards providing treatment for those with excess medical costs. Lets say 4% of the US Budget is set towards healthcare for those that can’t afford it and an additional 2% allocated towards research and treatment for those with terminally illness.
Everyone else, should exercise regularly, eat healthy and drink lots of water.
P.S. For those that live in California it would be a good idea to argue in court that an individual mandate is a violation of Public Law 115-97 Part VIII and that since Public Health has already been delegated to Congress through Title 42 of the US Code, that a State level individual mandate is unconstitutional and in conflict with Federal Law. The US Constitution Article I, Section I and the 10th Amendment give all legislative powers to Congress. All State Laws need to be in compliance with and not in conflict with the US Code since administration of the US Code is a power delegated to Congress through the US Constitution. Any conflict between State and Federal Law is also a violation of Title 28 of the UN’s Universal Declaration of Human Rights.