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Tags Affordable Care Act , AHCA , donald trump , health care issues , health insurance issues , obamacare , Trumpcare

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Old 27th June 2017, 03:24 PM   #81
CapelDodger
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Originally Posted by lomiller View Post
Make America sick again!
If the sick no longer linger the population gets healthier. It's a one-off boost, but can be entered on the Win List.
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Old 27th June 2017, 03:25 PM   #82
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Originally Posted by xjx388 View Post
I don't think it's magic but I do believe that, generally speaking, less regulation/taxation means lower prices and more choice.
What do you base this belief on?

In my experience, going for the lower price has not always meant a lower cost. In many cases, quite the opposite.

So is the mere fact it is done in the name of "lower prices" an argument in favor of something? I mean shipping all of our manufacturing jobs abroad to exploit 3rd world labor sure has lowered prices, too.

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To head off the army of strawmen that are surely coming my way, note that I did not say zero regulation/taxation. What we need is smarter policy.
Wonderful slogan.

Quote:
That's the problem: Define effective regulation/taxation. Beyond hardcore Libertarians, you aren't going to find many people that want absolutely nothing.
Correct, certainly for those in power who use that slogan you just used. They don't want nothing, they want campaign war-chest contributions and a nice retirement gig on a few charitable boards. We get lower prices, maybe a funny aftertaste in the water, too.

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Right. Rent-seeking is a problem in the business world in general. That's a problem we have to fight. ETA: A high-regulation atmosphere contributes to rent-seeking.
If the regulations protect an entrenched interest such that it can be that comfortable and complacent, sure.

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Why wouldn't we want to have as small a government as possible? Do we need them to do everything?
Same straw man you claimed you just had to shield yourself from.

Wanting a government that is active and responsive to commercial abuses (as if the idea that people will do anything for a buck is so outlandish) is not the same as saying you "need them to do everything."

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Old 27th June 2017, 03:27 PM   #83
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Originally Posted by Darat View Post
I can imagine the job adverts, 15hr a week and we cover one kidney.
Which always turns out to be the other one if the evil day arrives.
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Old 27th June 2017, 03:35 PM   #84
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Originally Posted by Dr. Keith View Post
Our exceptionalism keeps us from considering good ideas from other countries. This should be changed. Good beer does not have to served ice cold.
You guys are making some fabulous craft beers these days, and thanks to globalisation I can enjoy them right here in Cardiff. What an amazing world we live in.
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Last edited by CapelDodger; 27th June 2017 at 03:50 PM.
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Old 27th June 2017, 03:50 PM   #85
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Originally Posted by Skeptic Ginger View Post
Good news, sort of. The delay says they can't pass it. The delay might just be waiting for less attention on the issue so they can get it passed like the House did.
That can't be it. All the secrecy and short deadlines was about bouncing a measure through because they knew it would be toxic. The more time passes the worse it gets. This is them throwing their hands up and enjoying summer, because who knows what the political landscape will be like come fall? Who knew it would be like this in spring?
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Old 27th June 2017, 03:58 PM   #86
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Originally Posted by Bob001 View Post
That sounds like a reason to expand or redraw the boundary lines. If people can't get insurance because of the county they live in, and in the next county over they can, that's a problem. This stuff isn't carved in stone; it can be revised. And maybe those customers would choose a longer drive to a specialist rather than no coverage at all.
https://en.wikipedia.org/wiki/Redlining

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In the United States, redlining is the practice of denying services, either directly or through selectively raising prices, to residents of certain areas based on the racial or ethnic composition of those areas.
That was deemed unacceptable enough to be made illegal. Perhaps it should be extended to economic class as well.
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Old 27th June 2017, 04:09 PM   #87
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Originally Posted by Kestrel View Post
IRS Publication 974 covers the Premium Tax Credit. The income range is specified on page 4:



There are however other factors besides income that could make one ineligible for a Premium Tax Credit.

I was wrong in my earlier post, the Medicaid income cutoff is 138%, not 133%.
Here in Texas, we don't have expanded medicaid. If your income falls between 100% and 138% (?) you don't qualify for medicaid or Obamacare, basically just forget about having health insurance.
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Old 27th June 2017, 04:13 PM   #88
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Originally Posted by CapelDodger View Post
You guys are making some fabulous craft beers these days, and thanks to globalisation I can enjoy them right here in Cardiff. What an amazing world we live in.
It is a pretty good time to be alive. I hope we don't wreck all the things that make it so.
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Old 27th June 2017, 04:28 PM   #89
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Fortunately my income is not low enough to fall into the hole, where you make too much for medicaid and not enough to qualify for Obamacare, but I know a number of artists who do. The limit is only 12k for an individual but that is deceiving, when you are self employed lots of things are expenses, even a large bit of mortgage, utilities, etc., so that by the time you get to net income there is not much left.
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Old 27th June 2017, 06:29 PM   #90
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Originally Posted by Bob001 View Post
That sounds like a reason to expand or redraw the boundary lines. If people can't get insurance because of the county they live in, and in the next county over they can, that's a problem. This stuff isn't carved in stone; it can be revised. And maybe those customers would choose a longer drive to a specialist rather than no coverage at all.
Region boundaries can be altered to fix problems. Or the state can work harder to convince an insurance company to serve and underserved region. Assuming of course that the state is interested in making the ACA work instead of making Obamacare fail for political reasons.

A list of where the 42 counties are might tell us a lot about the cause of the problem.
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Old 27th June 2017, 06:38 PM   #91
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Originally Posted by Marcus View Post
Here in Texas, we don't have expanded medicaid. If your income falls between 100% and 138% (?) you don't qualify for medicaid or Obamacare, basically just forget about having health insurance.
The Kaiser subsidy calculator is probably the best place to explore options.

A 45 year old person living in Austin, Texas with income of 115% of FPL would qualify for an enhanced Silver plan with a 94% actuarial value for $23 a month. A Bronze plan would have a $0 monthly premium.

With an income below the FPL this person would be screwed because Texas didn't expand Medicaid.

Last edited by Kestrel; 27th June 2017 at 06:49 PM. Reason: Add example
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Old 27th June 2017, 06:49 PM   #92
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What are people meaning when they say they "can't qualify for Obamacare?"

The ACA isn't a health coverage plan in and of itself.

If they mean they don't qualify for subsidies, that's a different matter.

Just one of many ways to subtly use language to make something that needs tweaking and adjusting into a condemnation of the entire system and that we simply have to abandon the whole thing.

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Old 27th June 2017, 07:38 PM   #93
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Originally Posted by Delphic Oracle View Post
What are people meaning when they say they "can't qualify for Obamacare?"

The ACA isn't a health coverage plan in and of itself.

If they mean they don't qualify for subsidies, that's a different matter.

Just one of many ways to subtly use language to make something that needs tweaking and adjusting into a condemnation of the entire system and that we simply have to abandon the whole thing.

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Obamacare is almost synonymous with the subsidies. There are people who buy on the exchange who don't qualify for subsidies but they are in the minority.

ETA: I'm very much in favor of keeping the system.
ETA2: The biggest mistake I see was making medicaid expansion optional.

Last edited by Marcus; 27th June 2017 at 07:51 PM.
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Old 27th June 2017, 07:41 PM   #94
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Originally Posted by Kestrel View Post
The Kaiser subsidy calculator is probably the best place to explore options.

A 45 year old person living in Austin, Texas with income of 115% of FPL would qualify for an enhanced Silver plan with a 94% actuarial value for $23 a month. A Bronze plan would have a $0 monthly premium.

With an income below the FPL this person would be screwed because Texas didn't expand Medicaid.
My bad, it's people who make below the FPL but not low enough to qualify for medicaid that are screwed then.
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Old 27th June 2017, 08:10 PM   #95
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Trump wants the government to pay for peoples' healthcare, and that is where he and congressional republicans differ.
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Old 27th June 2017, 11:26 PM   #96
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Originally Posted by Marcus View Post
Obamacare is almost synonymous with the subsidies. There are people who buy on the exchange who don't qualify for subsidies but they are in the minority.

ETA: I'm very much in favor of keeping the system.
ETA2: The biggest mistake I see was making medicaid expansion optional.
I seem to recall that the feds had no real shot at forcing states to expand medicaid, and trying to do so would have lost in the Supreme Court.
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Old 28th June 2017, 12:11 AM   #97
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Originally Posted by BobTheCoward View Post
Well it's not killing, so I guess we are fine then?
Sorry, wasn't sure if your statement was meant to be sarcastic or not.

I am assuming that you realize that kicking 22 million people off of insurance, and charging over 5 times more would result in a very large number of unnecessary deaths.

Based on the culmination of over 130 studies on the subject, the historical data shows that 1,300 people would die every year for every 1 million people without health insurance. In other words, the GOP "healthcare" plan would result in 28,600 unnecessary deaths every year for the 22 million uninsured.

Health Care Cuts Will Increase Odds Of Dying For The Uninsured, Medical Review Predicts



Pointlessly killing off Americans is bad enough, but what's worse is the blood money is not even going to really help any other Americans besides the super rich.

You can literally measure the number of people killed (mostly elderly, children, and the disadvantaged) that would be used to buy each new sports car from the extra money given to the super rich as a result of this bill.

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Old 28th June 2017, 02:28 AM   #98
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Originally Posted by xjx388 View Post
Resources are limited and hard decisions have to be made.
But they're not really that limited in truth, are they? The trouble really isn't resource, it's allocation.

https://qzprod.files.wordpress.com/2...ng?w=700&h=394



http://i.huffpost.com/gen/1258895/original.jpg
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Old 28th June 2017, 02:33 AM   #99
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Originally Posted by 3point14 View Post
But they're not really that limited in truth, are they? The trouble really isn't resource, it's allocation.

https://qzprod.files.wordpress.com/2...ng?w=700&h=394



http://i.huffpost.com/gen/1258895/original.jpg
Exactly. Capitalism is not being checked therefore most of the resources are going right to a few people and corporations.
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Old 28th June 2017, 03:24 AM   #100
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Originally Posted by xjx388 View Post
To head off the army of strawmen that are surely coming my way, note that I did not say zero regulation/taxation...

Why wouldn't we want to have as small a government as possible?
Not zero, just 'as small as possible', huh?

Typical republican mantra.

"We tried cutting taxes and removing regulations, and things just got worse. So obviously we need more tax cuts and deregulation!"

"Eventually we will reach that magic spot where government is as small as possible but not quite zero, and everything will come up roses!".
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Old 28th June 2017, 03:30 AM   #101
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The Constitution never mentions a state-funded military: only militias.
So if you want to have a Small Government the way the Founding Fathers envisioned, get rid of the entire defense budget.
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Old 28th June 2017, 03:56 AM   #102
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Originally Posted by The Great Zaganza View Post
The Constitution never mentions a state-funded military: only militias.
So if you want to have a Small Government the way the Founding Fathers envisioned, get rid of the entire defense budget.
Likely just the army and airforce. A standing Navy was always understood to be of necessary to keep piracy under control.
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Old 28th June 2017, 03:58 AM   #103
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Originally Posted by ponderingturtle View Post
Likely just the army and airforce. A standing Navy was always understood to be of necessary to keep piracy under control.
And a strong nuclear arsenal was part of the founder's plan as well.
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Old 28th June 2017, 04:04 AM   #104
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Originally Posted by CapelDodger View Post
Which always turns out to be the other one if the evil day arrives.
I was assuming they'd already have had to sell a kidney to pay for their kid's leukemia treatment...
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Old 28th June 2017, 04:05 AM   #105
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Originally Posted by ponderingturtle View Post
Likely just the army and airforce. A standing Navy was always understood to be of necessary to keep piracy under control.
That is the job of the Coast Guard, not a navy.
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Old 28th June 2017, 04:07 AM   #106
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Originally Posted by The Great Zaganza View Post
That is the job of the Coast Guard, not a navy.
The coast guard was never expected to act overseas. Look at the Tripolitan wars for how the navy was expected to operate
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Old 28th June 2017, 04:29 AM   #107
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Originally Posted by ponderingturtle View Post
The coast guard was never expected to act overseas. Look at the Tripolitan wars for how the navy was expected to operate
and neither did the Founding Fathers think that they would build a navy to rival England. That was inconceivable.
At most, they wanted to curtail smuggling and have early warnings on enemy ships.
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Old 28th June 2017, 05:15 AM   #108
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Originally Posted by Roger Ramjets View Post
Not zero, just 'as small as possible', huh?

Typical republican mantra.

"We tried cutting taxes and removing regulations, and things just got worse. So obviously we need more tax cuts and deregulation!"

"Eventually we will reach that magic spot where government is as small as possible but not quite zero, and everything will come up roses!".

Repeating the same action, expecting a different result.
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Old 28th June 2017, 05:37 AM   #109
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Originally Posted by The Great Zaganza View Post
and neither did the Founding Fathers think that they would build a navy to rival England. That was inconceivable.
At most, they wanted to curtail smuggling and have early warnings on enemy ships.
And protect commerce in foreign seas. See the Tripolitan wars.
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Old 28th June 2017, 05:40 AM   #110
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Originally Posted by quadraginta View Post
Repeating the same action, expecting a different result.
I'm not sure that the objective is wider success for the economy as a whole (though if it happens to come about then that's no bad thing), but instead the success for the individuals who are paying the piper.
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Old 28th June 2017, 05:41 AM   #111
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Originally Posted by The Don View Post
I'm not sure that the objective is wider success for the economy as a whole (though if it happens to come about then that's no bad thing), but instead the success for the individuals who are paying the piper.
The claims being made is broader success, despite the stagnation of the middle class for the past 35 years.
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Old 28th June 2017, 06:57 AM   #112
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Originally Posted by CapelDodger View Post
That can't be it. All the secrecy and short deadlines was about bouncing a measure through because they knew it would be toxic. The more time passes the worse it gets. This is them throwing their hands up and enjoying summer, because who knows what the political landscape will be like come fall? Who knew it would be like this in spring?
It's complicated. Trump has to launder the Russian money he is donating to the future campaigns of the 5 hold out Republican senators.
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Old 28th June 2017, 07:39 AM   #113
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Originally Posted by quadraginta View Post
Repeating the same action, expecting a different result.
Exactly: there are all those examples historically and even present day in the USA and other countries where cutting to the bone regulations, government, and safety nets has worked really well for the vast majority of the citizens. Well I can't think of one right now but I am certain that there are many! Whereas countries that are the opposite are horrible failures with horrible qualities of life. Right?
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Old 28th June 2017, 12:48 PM   #114
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Originally Posted by Bob001 View Post
Gee, maybe it's time to change them. Both the ACA and the AHCA are massive federal bills. County lines shouldn't carry much weight.
Go for it.

It might present a problem for regionally located staff-model systems though. Where would you define the boundaries?
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Old 28th June 2017, 01:43 PM   #115
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Re dying without insurance, just found out today that one of the drugs I may need to take costs $10,000/month. Were I on Medicare (I'm not there yet) my share would be 33%, so $3,300/month for years or more.

A low income elderly person needing this drug would essentially be unable to buy it. Inadequate insurance coverage can indeed be a death sentence.
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Old 28th June 2017, 02:19 PM   #116
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Originally Posted by Skeptic Ginger View Post
Re dying without insurance, just found out today that one of the drugs I may need to take costs $10,000/month. Were I on Medicare (I'm not there yet) my share would be 33%, so $3,300/month for years or more.

A low income elderly person needing this drug would essentially be unable to buy it. Inadequate insurance coverage can indeed be a death sentence.
Low income elderly people can qualify for subsidies, as well as potentially qualifying or Medicaid that coordinates with Medicare.

Also, Drug coverage under Medicare varies by carrier, the 33% may be a good ballpark estimate, but many PDPs use copays rather than coinsurances.
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Old 28th June 2017, 03:09 PM   #117
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Originally Posted by Emily's Cat View Post
Low income elderly people can qualify for subsidies, as well as potentially qualifying or Medicaid that coordinates with Medicare.

Also, Drug coverage under Medicare varies by carrier, the 33% may be a good ballpark estimate, but many PDPs use copays rather than coinsurances.
Yes, and the key points are "can" which usually means maybe depending on the program and the details, and the definition of "low income." I would be exactly in this situation if not for having a good insurance plan through my employer ( the drug pricing is very similar). I am by no means low income and justifiably I am not eligible for subsidies form the drug manufacturer or state. I am a senior citizen. Yet there is no way I could afford $120,000 for one drug.

We've got to do a lot better than this as a society, rather than worse as the Trumpcare bills seek .
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Old 28th June 2017, 04:39 PM   #118
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Originally Posted by Emily's Cat View Post
Low income elderly people can qualify for subsidies, as well as potentially qualifying or Medicaid that coordinates with Medicare.

Also, Drug coverage under Medicare varies by carrier, the 33% may be a good ballpark estimate, but many PDPs use copays rather than coinsurances.
Subsidies? Do you mean from the drug manufacturer? To qualify for Medicaid you have to have a low income, in Texas below $23,522. Also. you must be pregnant,disabled or caretaker of someone with a disability, or over 65. https://www.benefits.gov/benefits/benefit-details/1640

ETA: Or a parent of a dependent child under 19.

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Old 28th June 2017, 04:56 PM   #119
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Originally Posted by Marcus View Post
Subsidies? Do you mean from the drug manufacturer?
By subsidies, I mean Medicare Savings Program, Low Income Subsidies, and a couple of others.
https://www.medicare.gov/your-medica...ing-costs.html
https://www.ehealthmedicare.com/medi...ncome-subsidy/

Originally Posted by Marcus View Post
To qualify for Medicaid you have to have a low income, in Texas below $23,522. Also. you must be pregnant,disabled or caretaker of someone with a disability, or over 65. https://www.benefits.gov/benefits/benefit-details/1640

ETA: Or a parent of a dependent child under 19.
I don't know what the rules are for Medicare/Medicaid dual eligible. I believe they are different than for Non-Medicare-Eligible folks, but I'm fairly unfamiliar with them.
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Old 28th June 2017, 05:05 PM   #120
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The BBC says that nine republican (at least, that's presumably what they mean) senators have said they will not support the Senate bill, but that Trump is optmisitic that they'll "get over the line". They also report a survey by USA Today saying that only 12% of Americans support the bill. (Most don't know, rather than opposing it.) I wonder what the chances of the Senate passing some version of it are!
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