View Full Version : Sex Workers Embrace ObamaCare

11-02-2013, 12:48 AM
presented without additional comment, from CNN Money ...

(snip)In the all-cash, off-the-books sex industry, workers can be particularly high risk and insurance is often out of reach. Many sex workers -- a broad term that can refer to a number of services, including sexual massage, prostitution, and escort and dominatrix work -- consider themselves self-employed entrepreneurs who can't afford to purchase healthcare. But that could all change with the Affordable Care Act.

Siouxsie, 28, has shopped for plans countless times since 2008, coming up empty each time. She and her partner recently reviewed their healthcare options and found that a joint plan would have cost between $400 and $500 a month -- an unaffordably large chunk of their incomes.

"We just couldn't swing [insurance] in the Bay Area -- we're lower middle class, recent college graduates, in Startup Land trying to make our way," she said.

But come January 1, when the new law goes into effect, she and her partner will be looking at a monthly bill of between $175 and $200. They're deciding between two plans on the California exchange and will receive a tax credit of about $275 a month (without the credit it would have cost nearly $500).(snip)

(snip)Individuals making less than $46,000 are eligible for a tax credit to offset their monthly costs. Many of the sex workers at the event file W-2s for their legal work, whether it be a part-time job or sex work that falls within the law. Sex workers interviewed by CNNMoney estimated this income to be less than $45,000 a year.

The Affordable Care Act will cover contraception, screening for sexually transmitted infections, and violence counseling at no additional charge, which the sex workers said would make a big difference in their community. The legislation will also make it more difficult for insurance companies to deny coverage based on gender identity and HIV status.(snip)

12-05-2013, 11:42 PM
The Affirdable Care Act will help many people across the board, young or old, rich or poor. It's the best thing yet in producing some type of relief for people such as myself who pay ridiculous prices for medical insurance when purchasing it on your own.

Joe Redban
12-12-2013, 05:36 PM
There are certainly pros and cons to the ACA. I would strongly hesitate to label it as good or bad before we see how smoothly it will roll out. There are some promising aspects of it, but there are also folks who will be kicked off their plan or have higher premiums. So I think it would be best to wait and see. :)

12-12-2013, 06:31 PM
*raises hand*

I'm pro-obamacare to the max.

12-13-2013, 07:50 AM
So I think it would be best to wait and see

I've refrained from making additional comments for this very reason.

But one area deserving particular attention will be the future 'spending habits' of strip club and paid webcam customers, most of whom have incomes that are high enough to make them ineligible for ACA insurance premium taxpayer subsidies. If their total ( unsubsidized ) insurance premium costs go up, and their paychecks remain more or less unchanged, that extra money may have to come at the expense of some other non-essential spending ( like lap dances or paid webcam ). Only time will tell.

12-13-2013, 09:05 AM
Obamacare will benefit me (pre-existing conditions), but this isn't the case for all or even most people.

Those who are self-employed and barely getting by already who have no extra income, will be forced to pay this monthly cost or the penalty fee. Also, those who work part-time jobs (I'm talking college students and the poor) with the option to work as many hours as they want including overtime, will now no longer have that option because their full-time employment status if they work more than like 38 hours per week means that the company has to provide insurance now... which is an added unnecessary expense in their eyes. So those people get their hours get cut. Unfortunately, I know people in both situations who have told me these stories. And they are anti-Obamacare obviously, because of it.

I'm neutral about Obamacare. Its great in theory, but kind of shitty in practice. I feel like they could have developed a better plan... I think it should just be tiered based on yearly reported tax income. I also think it should be optional, but encouraging people to sign up.

12-13-2013, 02:57 PM
^I called and gave them my info and I'd be paying about 150 a month versus 350 like now. I'm worried if we get a republican president can this be taken away?

12-14-2013, 05:09 AM
^^^ trying to avoid 'pro and con' discussion at all costs, there are a number of 'question marks' that will be raised well before the next election. Probably the most significant is a US Federal court case challenging the authority of the IRS to create 'interpretations' regarding tax credits ( taxpayer subsidies ) that are arguably counter to the wording of the ACA law itself.


(snip)"The latest round of legal challenges to the Affordable Care Act, also known as "Obamacare," focuses on whether the 2010 law allows for subsidies in all states or only in states that have set up exchanges.

Only 16 states and the District of Columbia chose to set up the online marketplaces where people without private health insurance can shop for it, forcing the federal government to create them in the remaining states.

Subsidies, in the form of tax credits, are available to people with annual incomes of up to 400 percent of the federal poverty level, or $94,200 for a family of four. The Obama administration views the subsidies as essential if the law is going to work, because otherwise many people could not afford private insurance.

The suit was brought by a mix of individuals and businesses from Texas, Kansas, Missouri, Tennessee, West Virginia and Virginia. The plaintiffs argue the subsidies are unlawful and impose a burden by forcing them to purchase the insurance or else pay a penalty."(snip)

(snip)The law says subsidies may be given "through an exchange established by the state," not through one set up by the federal government, a point that the suit emphasizes.

The administration says the subsidies should be available to people in every state because Congress intended the online exchanges to be uniform.

At the core of this claim is what Congress intended when it wrote the law, not expecting that some states would fail to set up an exchange or would, as in the case of Texas and other Republican-controlled states, refuse to do so out of political opposition to Obamacare.

The case is Halbig v. Sebelius, U.S. District Court for the District of Columbia, No. 1:13-cv-623."(snip)

If this lawsuit is successful, public health exchange insurance would still be offered to residents of all 50 states. But residents of the 34 states that elected NOT to set up their own state-run insurance exchanges would not receive the taxpayer subsidy to help defer the cost of their monthly health insurance premiums. Thus all residents of those 34 states, regardless of income level ( well, above Medicaid eligibility income level, anyhow ), would wind up paying the same $300+ monthly health insurance premiums that Americans earning more than 400% of the Federal Poverty Level must pay. And as a consequence of these 34 states no longer being able to provide 'affordable' health insurance coverage ( in the absence of taxpayer subsidies to reduce net cost of health insurance premiums ), residents of those 34 states would then be automatically exempted from having to pay an IRS 'penalty' tax for failure to purchase 'affordable' health insurance.

This DC federal court case was arguably a major factor in the US Senate changing rules for political appointees last week ... see . With this additional appointment, it is now likely that this case will wind up being appealed to the US Supreme Court.

Also, remember that this year's cost for public health exchange insurance premiums, with and without subsidies, was based on a ton of assumptions regarding the number of total signups, the percentage of 'young and healthy' signups versus signups by those with expensive to treat pre-existing medical conditions, versus signups by 'older and sicker' Americans, signups by 'paying' customers vs those eligible for extended Medicaid, etc. Early signup statistics are showing that 7 out of 10 signups are in fact for extended Medicaid, and that of the remaining 3 out of 10 many have expensive to treat pre-existing conditions or are 'older and sicker'. Thus when this year's health insurance premium cost assumptions are replaced by next year's health insurance premium cost 'facts', lots of things could change. And these changes don't require any sort of legislative or executive action from Washington DC, they are based on simple math regarding the total cost of health insurance reimbursements paid out for medical treatments, versus the total amount of health insurance premium revenues taken in from 'paying' enrollees ( plus US taxpayers ).

Again, as was posted earlier, a wait and see approach is probably warranted for the next few months at least.

12-14-2013, 10:15 AM
Well there's also a thing called cost sharing. If you qualify the insurance company pays half your premium and deductible. So maybe in the states were there won't be a tax credit people can qualify for that. I hope it works! As someone who's paid put of pocket for healthcare 25 years. I've assessed I've paid over100,00 and utilized maybe 10,000 over the years I think I and all americans who paid for it deserve cheaper premiums!

12-14-2013, 11:18 PM
^^^ not wanting to dwell on peripheral aspects, but the 'heart' of any insurance plan is risk pooling and cost shifting. For such a system to work, for every person who requires a heart transplant or HIV meds costing tens of thousands or repeated cancer treatments costing hundreds of thousands, there also needs to be another 10 people who are paying in far more in premiums than they are consuming in health care costs. There is no 'free lunch'.

12-15-2013, 02:37 PM
Insurance companies are still going to be making billions! It's the damn doctors too. I looked at my claim for a doctor visit a few years ago and they did nothing and billed the company 400. I don't think they'll be allowed to anymore. Anyways the cost sharing is were if you make under as certain amount they'll pay half your premium and deductible. I've been looking at rates and plans for days and people are still going to be paying about the same if they don't qualify for any of the tax breaks or programs. I think they'll be all right. We shall see!

12-23-2013, 04:12 AM
just a reminder that, providing the rules aren't changed again at the last minute, today is the deadline if you want to sign up for Obamacare and thus avoid having to pay an IRS penalty for not having health insurance coverage.

12-23-2013, 09:39 AM
I'm not a sex worker but I support quite a few of them...

Since I live in Mass. I've had to deal with mandatory health insurance since 2006. As a self-employed individual that meant paying out of pocket since my marriage ended in 08. I am definitely saving money-about 25% with my new ACA plan. I skipped the Fed Web site and even the Mass web site and went straight to a local independent Insurance company that specializes in coverage for small business and self-employed folks. No complaints so far. The new plan has the same deductibles as my old one and I get to keep my doctor (I could have saved even more if I was willing to go with a carrier that my Doctor doesn't work with). I will say that, as with my old plan, it's going to be cheaper for me to buy my medications over the counter at Costco and pay out of pocket rather than go through my insurance and pay the monthly deductibles. This seems silly but it's reality. If, like me, you can get all the meds you need in generic form, it is often cheaper this way. A word of caution, even Costco's pricing is better if you visit your local store pharmacy rather than order on line.

12-24-2013, 07:30 AM
Yeah and you don't have to be a member to get scripts there. I save 70 on one of mine.

12-24-2013, 04:59 PM
I'm pro obama. I'm going to have better insurance for my girls and myself and save money!!! First time I ever voted in anytype of election it was for Obama so very happy I feel as if I made a difference :) Haters going to hate but Democrats look out for the little guy more!

12-24-2013, 05:00 PM
^I called and gave them my info and I'd be paying about 150 a month versus 350 like now. I'm worried if we get a republican president can this be taken away?

I worry about this too! Only like 2 years away.

12-24-2013, 05:01 PM
^I called and gave them my info and I'd be paying about 150 a month versus 350 like now. I'm worried if we get a republican president can this be taken away?

I worry about this too! Only like 2 years away.

12-25-2013, 08:30 AM
trying to avoid political opinions and stick with economic facts ...

Insurance companies are still going to be making billions!

Indeed this is true. In fact the ACA 'guarantees' health insurance company profitability via something called the 'risk corridor' ... which essentially commits US taxpayers to pay additional money directly to insurance companies to cover any unprofitable operations. See And beyond that, there have been recent 'tweaks' to the ACA, i.e. allowing certain older Americans to purchase 'catastrophic only' coverage, allowing certain Americans to keep cancelled health insurance for another year, will create additional 'losses' for health insurance companies which US taxpayers will have to cover via 'risk corridor' subsidy payments to the insurance companies. As to where all of these additional ( unbudgeted ) US taxpayer dollars are going to come from, that is a matter which hasn't been addressed yet.

I am definitely saving money-about 25% with my new ACA plan

I'm going to have better insurance for my girls and myself and save money!!!

Indeed, health insurance costs in states which had already heavily regulated their health insurance markets ( like your MA and my former NY ), and had already banned the sale of 'bare bones' health insurance, are likely to see a reduction. We can basically thank the US federal taxpayers residing in other states with less regulated health insurance markets who are indirectly subsidizing our state insurance premiums under ACA. But, at the same time, residents of other states with less regulated health insurance markets ... who were previously able to purchase very affordable but limited coverage health insurance, will now see significant increases in their health insurance costs because the ACA outlaws those very affordable but limited coverage offerings.

However, there are absolutely no guarantees that the UNSUBSIDIZED insurance premiums quoted for ACA coverage in 2014 ( in any US state ) will stay as low as they are in future years. The 2014 ACA insurance premiums were calculated based on a whole bunch of actuarial assumptions ( i.e. X percent of young and healthy people with incomes above $46k per year paying premiums which would subsidize those who are older and sicker, and those earning much less than $46k per year ) which by most reports isn't actually happening. When 2015 insurance premiums are recalculated in mid-2014 based on 'real world' actuarial data for the actual 2014 ACA customer base, these initial 'savings' could quickly disappear. Of course, at that point, there won't be any way remaining to 'return' to earlier health insurance coverage and premium costs.

Obviously, only time will tell where all of this will shake out. But, again, there is no such thing as a 'free lunch'.