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    Default Health insurance

    When you get married, when is the last time you can use your 'single' healthcare plan? There will be a gap in coverage between the marriage and when I can get onto his plan. Can I still use mine in the mean time?

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    Default Re: Health insurance

    I don't know of any reason why you wouldn't be able to stay on your own plan. Have you asked your insurance company?

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    Default Re: Health insurance

    I'm still on my dad's plan

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    Default Re: Health insurance

    ^^^ usually 30 days is the limit for an employer's health plan coverage for a 'dependent' of an employee ( i.e. your father ) who is no longer eligible for 'dependent' status ( i.e. your upcoming marriage ). And there is usually a waiting period, typically 90 days, when you're first signed up on a different employer's health plan coverage for a 'dependent' of an employee ( your soon to be husband ). So yes you are likely to have a 'gap' in health insurance coverage.

    However, some employer health plans make specific waiting period exceptions for existing employees adding spouses or children as new 'dependents' on employer provided health insurance coverage ... so your soon to be husband needs to check this out with his employer.

    If it turns out that you will indeed experience a 'gap' in health insurance coverage, and you wish to CYA, you can always sign up for Public Exchange ACA health insurance coverage based on your own ( low ? ) income, and simply stop making the monthly payments after your soon to be husband's health insurance coverage kicks in. In point of fact, you actually only need to make one Public Exchange ACA payment ... because there is 'trailing' 60 day coverage ! However, going this route may mess up your taxes next April 15th since, based on joint income, you'll wind up having to pay back to the IRS the 'taxpayer subsidized' portion of your Public Exchange ACA monthly premium that you won't actually be 'eligible' to receive. See .

    DO NOT go this route if Public Exchange ACA attempts to sign you up for ( Expanded ) Medicaid health insurance ... because ( Expanded ) Medicaid can eventually back-bill for their 'services' - potentially waiting until you reach age 55 to actually bill you ... with 30 years worth of interest charges tacked on ... and potentially placing a lein on your house as a means of eventually getting 'repaid'. This doesn't matter much for people who are likely to have low incomes for their entire lives, who are not likely to ever afford owning a home. However, it may matter a lot for a high earning couple who do own a nice home 30 years from now !!! See . The potential financial 'surprises' involved simply makes ( Expanded ) Medicaid coverage too huge of a risk to consider.
    Last edited by Melonie; 05-23-2014 at 02:48 AM.

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    Default Re: Health insurance

    Are you under 26 years old? If you are, you can stay on your dad's plan, even if you're married.

    https://www.healthcare.gov/can-i-kee...-until-age-26/

    If a plan covers children, they can be added to or kept on a parent's health insurance policy until they turn 26 years old.

    Children can join or remain on a parent's plan even if they are:

    married
    not living with their parents
    attending school
    not financially dependent on their parents
    eligible to enroll in their employer’s plan

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    Default Re: Health insurance

    ^^^ eagle2 is in fact correct about this - as the result of a very recent 'change' in regulations. Since January 2014, employer sponsored health plans are no longer permitted to drop under age 26 'dependent' coverage even if that under age 26 'dependent' becomes eligible for OTHER employer sponsored health insurance. Prior to last January, if an under age 26 'dependent' were to get married, and thus become eligible for other employer sponsored 'dependent' coverage as the spouse of a different employee ( her husband ), then the original ( father's ) employer sponsored health insurance could drop coverage. This recent change now also applies to under age 26 'dependents' who also took jobs themselves and thus became eligible for THEIR OWN employer sponsored health insurance coverage, who prior to January 2014 could also be dropped by the parent's employer sponsored health insurance.

    My bad !!! However, it's difficult to keep track of which ObamaCare provisions are actually being implemented as scheduled, which are being delayed, and which are being 'made up as they go along'. I asked a business acquaintance about this, and this resulted in a 'caution' ... based on the new regulations which replace 'their own' with 'other'.

    There is now a corresponding 'flip side' to this new situation which bears checking out with the new husband's employer sponsored health insurance provider. As employer sponsored health insurers have been forced to provide coverage for a larger number of 'dependents' under a wider set of circumstances, those employer sponsored health insurers have also gone through the regulations with a 'fine tooth comb' to reduce their exposure in other ways. One of those ways is employer sponsored health plans now refusing to cover spouses of employees if those spouses are eligible for 'other' employer sponsored health insurance coverage.

    Thus the same new regulation that now prevents the father's employer sponsored health insurance from dropping 'dependent' coverage upon marriage of the daughter may also now allow the new husband's employer sponsored health insurer to refuse 'spousal' coverage because the wife / daughter is eligible for 'other' employer sponsored insurance coverage ( i.e. her father's ). Not all employer sponsored health insurers are refusing to cover spouses who are eligible for other employer sponsored health insurance coverage, but an increasing number of them apparently are. Thus it's now very important for the soon to be husband to check out these details with his employer's health insurance provider PRIOR to making any changes in 'dependent' coverage under her father's employer sponsored health plan. The new regs say 'eligible' not 'covered', thus it's possible that the new husband's employer sponsored health insurance could still refuse to sign up the new wife for 'spousal' health insurance coverage after she voluntarily drops 'dependent' coverage under her father's employer sponsored health insurance plan because, as long as she is under age 26, she is now still 'eligible' for coverage under her father's employer sponsored health plan !!!

    A few high profile employers ... most notably UPS ... were already doing this prior to 2014, based on the spouse having their own job thus the option to sign up for 'their own' employer sponsored health insurance. See . However, the new regulations apparently now allow the new 'interpretation' to be extended from spouses eligible for 'their own' employer sponsored health insurance to spouses eligible for 'other' employer sponsored health insurance ... including the new 'unconditional' under age 26 'dependent' coverage by a parent's employer sponsored health insurance. The main complaints about this situation are that the husband's insurance coverage, and the spouse's insurance coverage, may not share participating doctors, hospitals, etc. ... as well as a high probability that the combined cost of the two separate insurance premiums may be higher than the cost of a single premium for 'family' coverage to be paid by the husband.

    So if this is now the case, the 'real world' result could be that, instead of experiencing a 'gap' in health insurance coverage now, the OP will in fact experience a 'gap' in health insurance coverage when she reaches her 26th birthday ... at which point her father's employer sponsored health insurance coverage can drop her. Upon losing 'eligibility' for dependent coverage under the father's employer sponsored health insurance plan due to reaching age 26, the husband's employer sponsored health insurance also loses their 'excuse' to deny spousal coverage thus must allow her to sign up ... unless, of course, she takes a job which makes her 'eligible' to purchase her own employer sponsored health insurance via her own employer, in which case the husband's employer sponsored health plan could still refuse 'spousal' coverage.
    Last edited by Melonie; 05-24-2014 at 12:51 AM.

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    Default Re: Health insurance

    Not that it has any effect on me (I'm a resident of Canada covered under a provincial health insurance plan), but I read this thread out of interest.

    It seems that the situation is beyond messy, and into incomprehensible/incoherent / need specialised expertise not to get messed up.

    It's interesting that "ObamaCare" has on the surface many similarities to how the health system works in Switzerland (for example: there are other similar ones), and that there it works quite well, but that in the U.S., it seems to be a disaster-in-the-making. My guess is that it's the cultural/vested interests/economic factors that are slightly different and lead to the vastly different outcome. As an outside observer, it seems to me that ObamaCare is leading to a situation where for *most* people, they have the disadvantages of BOTH a private AND a public system.

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    Default Re: Health insurance

    As an outside observer, it seems to me that ObamaCare is leading to a situation where for *most* people, they have the disadvantages of BOTH a private AND a public system.
    Not wanting to dwell on the political aspects of ObamaCare, the following does seem to be the case factually speaking ...

    - the actual 'rules' of the program are constantly changing
    - the 'unintended consequences' of the program changes haven't been thoroughly researched, thus are popping up as 'unwelcome surprises'
    - many aspects of the program have yet to be 'rolled out' ( from effects on next year's tax returns to age 55 'repayment' measures )
    - the costs of the program, to both insured individuals and to US taxpayers in general, are unknown

    As above, personal research is required regarding every aspect of the program ... because 'signing up' today has the potential to create long lasting future consequences.

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    Default Re: Health insurance

    I must say, I'm glad I don't have to deal with this!

    As an aside, I just came across this:

    http://apps.who.int/gho/data/node.main.688?lang=en

    Lebanon now has a better life expectancy than the U.S., according to the WHO. Yes, Lebanon, that "messed up" country in the Middle East. Scary! Glad I don't live there, though :-).

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    Default Re: Health insurance

    Quote Originally Posted by Clara_M View Post
    Not that it has any effect on me (I'm a resident of Canada covered under a provincial health insurance plan), but I read this thread out of interest.

    It seems that the situation is beyond messy, and into incomprehensible/incoherent / need specialised expertise not to get messed up.
    There were a lot of technical problems with the insurance exchanges when they were first launched, but they seem to be stable now, at least at the national level. Some of the states exchanges worked very well, while others didn't.

    Quote Originally Posted by Clara_M View Post
    It's interesting that "ObamaCare" has on the surface many similarities to how the health system works in Switzerland (for example: there are other similar ones), and that there it works quite well, but that in the U.S., it seems to be a disaster-in-the-making. My guess is that it's the cultural/vested interests/economic factors that are slightly different and lead to the vastly different outcome. As an outside observer, it seems to me that ObamaCare is leading to a situation where for *most* people, they have the disadvantages of BOTH a private AND a public system.
    I see 'Obamacare' more as having the advantages of both a private and public system. It has the advantages of a private system in that most people will get their insurance through private insurers, so they will have many different options, and it has the advantage of a public system in that if you cannot afford health insurance on your own, there are subsidies available. People getting their insurance through the Medicaid expansion will have less options.

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    Default Re: Health insurance

    Quote Originally Posted by eagle2 View Post
    I see 'Obamacare' more as having the advantages of both a private and public system. It has the advantages of a private system in that most people will get their insurance through private insurers, so they will have many different options, and it has the advantage of a public system in that if you cannot afford health insurance on your own, there are subsidies available. People getting their insurance through the Medicaid expansion will have less options.
    Maybe we're too cynical and the kinks will eventually get worked out, and it'll work out better than what happens now, because it does seem (from afar) like there is a lot of room for improvement, in that the current scheme seems to result in high expenses without very good results.

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    Dizzy Re: Health insurance

    ^^^ from a purely financial standpoint, that remains to be seen.

    One of the major issues being raised by certain elements of US media is that, during this first year of signups, actual eligibility for taxpayer subsidized discounted monthly health insurance premium costs cannot be verified. This may result in millions of Americans being forced to pay additional taxes next April if their total 2014 income level disqualifies them for the discounted health insurance premiums they are currently paying.

    Also those same certain elements of US media are raising the issue that, as a result of the composition of the insured 'base' having few young and healthy people, but lots of older unhealthy people plus people with pre-existing, expensive to treat, medical conditions, the subsidized and unsubsidized public health exchange insurance premium costs for 2015 must be set at significantly higher price levels than they were for 2014. This bad 'mix' of insured was also aggravated by the granting of waivers which allowed lots of Americans to stay on their own 'non-compliant' private health insurance for another year instead of being 'forced' to purchase public health exchange insurance.

    The insurance companies will be announcing 2015 premium costs over the course of the next couple of months, which will take these factors into account, so we'll see. Also, US taxpayers already owe these insurance companies billions of additional 'subsidy' dollars because their first year monthly premium price levels vastly understated the actual costs to those insurance companies of providing the required health care during 2014. The legality of 'deliberate' back door taxpayer 'subsidy' dollars being paid directly to the insurance companies, versus increasing public health exchange insurance premium prices, to cover shortfalls in public health insurance revenues versus actual costs of prviding the health care, is already being challenged. See

    Again, my point is strictly financial ... in that the true costs of this program are unknown, and that the present 'apparent' costs significantly understate the real costs.

    Allow me to to offer a theoretical example, based on regulations and actions which have already been noted ...

    - OP turns 26 this month, and is thus dropped by her father's employee sponsored health insurance as the result of being rendered 'ineligible' due to her age.

    - to prevent a 'gap' in coverage, the OP decides to buy public health exchange insurance coverage. Based on her own $2000 per month current income level, she finds she is eligible for a ( taxpayer subsidized ) premium cost of about $140 per month. The unsubsidized cost of this coverage is actually $290 per month, but taxpayer funded subsidies effectively pay $150 of that amount. However, this subsidy transaction is not actually 'seen' by the OP or anybody else signing up for taxpayer subsidized public health exchange insurance coverage ... they just see a ( subsidized, discounted ) monthly premium price.

    - The OP then gets married ... and discovers that 'this year's update' on her husband's employee sponsored health insurance decides NOT to cover spouses ( spousal coverage isn't mandated under the ACA, only employees and children of employees ) as a cost saving measure by her husband's employer. See . So she continues to pay the $140 per month public exchange health insurance premium for herself.

    - When the new year rolls around next January, the IRS and ACA discover via W2 and 1099 income reports that, with her husband's $4000 per month income plus her own $2000 per month income, she wasn't actually eligible for subsidized premiums because the 'family's' combined income exceeds the eligibility threshold. Thus her 2015 monthly health insurance premiums not only lose subsidies, but also are priced at higher levels based on too few young and healthy Americans signing up in 2014. Thus the $140 per month now becomes the 2014 $290 unsubsidized monthly premium cost + 20% 2015 premium cost increase, thus perhaps $350 per month.

    - When the OP and her new husband file their joint tax return next April, they also discover that, because the 'family's' combined income exceeded the 2014 eligibility threshold, the OP and her new husband must also 'pay back' 7 months worth of 2014 taxpayer subsidies which the OP had already received, but actually lost eligibility for the minute she got married. This increases their joint tax bill by $ 1050 or so !!!

    The underlying point, of course, is that all of these 'under the surface' financial details are being overlooked by the public health exchanges, by most US media, as well as by most Americans. This is likely to change early in 2015, when Americans actually start filing their tax returns and see their customary tax refunds 'disappear' as they are forced to repay erroneous taxpayer subsidies they have already received on their 2014 public health exchange insurance premiums, and at the same time they are hit with significantly increased 2015 prices for monthly public health exchange insurance coverage.

    As the result of these 'under the surface' financial details 'rearing their ugly heads' next year, it's also likely that the new husband will wind up researching how much extra money he can wind up with in his take home paycheck if he drops his employer sponsored health insurance coverage entirely ... in favor of signing up the entire family for public health exchange 'family' coverage. It's very possible that the future cost of a single 'family' coverage monthly premium for ACA insurance will wind up being lower than the total combined cost of the OP's individual coverage monthly premium for ACA insurance, plus the husband's paycheck 'contributions' toward employer sponsored health insurance coverage, plus the husband's employer's avoided additional 'contributions' towards the husband's employer sponsored health insurance premium cost - part of which may be added to the husband's paycheck if he opts to drop employer sponsored health insurance coverage altogether. This 'extra money' will come from the husband sparing the employer the applicable per capita ACA employer taxes as well as the additional ( some estimates state $10,000 per year ) employer costs to provide 'ACA compliant' employer sponsored health care for the husband with 'reasonable' employee paycheck contributions and copays ( versus a potential $3000 max annual ACA penalty being leveed on the husband's employer if the husband / family seek coverage through the public health exchange ).

    And yes, before you ask, the regulations and eligibility thresholds involving ACA taxpayer subsidized health premiums for unmarried individuals versus married persons does instate a 'marriage penalty' ... in this particular case something on the order of $1800 for 2014, and rising in future years !

    And now we get to the 'weird' stuff. The OP's / 'family's ineligibility for public health exchange insurance premium subsidies was due to the fact that their annual income was ( $2000+$4000 ) * 12 or $72k per year ... versus an eligibility cutoff of around $62k per year for a married couple with no children. The unsubsidized 'family' coverage monthly premium under public health exchange insurance coverage would be something on the order of $700 per month or $8,400 per year ... maybe $10k with 2015 premium increases, but we'll ignore that for now. These premiums must be paid with after-tax money, meaning that some $12,000 in pre-tax earnings is necessary to cover the cost of unsubsidized monthly public health exchange insurance premiums. This effectively leaves the family with $72k - $12k = $60k in de-facto pre-tax income ex health insurance. Granted that the ~$700 per month may still be lower than the wife paying an unsubsidized ~$350 public health insurance exchange premium for her own coverage, plus the husband and husband's employer together paying ~$ 800 a month ( seen or unseen ) for the husband's employer sponsored health insurance coverage, but we'll leave that aside for the moment as well.

    However, if the OP voluntarily limits her earnings to $1000 per month instead of $2000 per month, all of a sudden the 'family' becomes eligible for subsidized public health exchange insurance premiums, which effectively drops the unsubsidized $700 per month unsubsidized 'family' coverage premium cost down to $280 per month or $3,400 per year. And that amount only requires say $4,500 in pre-tax earnings to cover. So by voluntarily reducing the OP's income by $10,000 per year, she only 'loses' something like $2,500 per year in actual net after-tax income via lower income taxes + subsidized versus unsubsidized public health exchange insurance premium costs !!! This sort of math is something that every married couple is going to need to perform very soon !!! For a fact, the ACA also creates a huge 'earnings barrier' at the 400% of Federal Poverty Level eligibility standard, where a few extra dollars worth of combined earnings winds up costing hundreds of extra dollars per month in the form of unsubsidized versus taxpayer subsidized public exchange health insurance premium price levels.

    Secondary issue ... if the OP and the soon to be husband are both capable of high earnings potential, the $62k eligibility limit which applies to them as a married couple remains at $92k or $46k each if they choose NOT to get married !!! In other words, even if both choose to purchase public health exchange insurance coverage, if they do NOT get married they can both earn $46k each and still be eligible for $140 each $280 total monthly taxpayer subsidized public health insurance premiums. However, getting to this position might force the husband to work fewer hours to cut his present $4000 per month earnings level to $3,800 per month = $46k per year ... but in the process he could potentially save much more than that in the form of current employer sponsored health insurance vs $140 per month subsidized public health exchange insurance premium costs. Being married and having a first child raises the eligibility threshold to $78k in combined income. However, being unmarried and having a first child raises the father's eligibility threshold to $62k while leaving the mother's eligibility threshold at $46k ... which would essentially leave both the father and the mother free to 'maximize' their earnings, while both still enjoying the heavily discounted taxpayer subsidized public health insurance monthly premium prices, as long as they don't get married !!!

    In other words, there are additional aspects to the ACA 'marriage penalty' that also require calculation ... because they can mean a large difference in money remaining at the end of the month !!! And as is already the case with the IRS and income taxes, future divorces for the purpose of 'saving money' on public health exchange insurance costs are also likely to be ruled 'illegal'. Thus IMHO there is no way I can recommend that anyone get married in the near future, until all of these ACA 'gray areas' are given a chance to be resolved into 'black and white' via court challenges, additional gov't rulings, etc. ... thus making the actual cost of the ACA 'marriage penalty' quantifiable at $2000 per year or $4000 per year or whatever it actually turns out to be.

    Waiting a year will also give employer sponsored health insurance plans a chance to decide on whether or not they are going to continue to incur high costs for continuing to provide spousal health insurance coverage for employees which they are NOT mandated to provide under the ACA ( with spousal insurance coverage presently being one of the major 'pros' to getting married ). At the moment, many employers are 'hanging back' on making decisions about employee spousal health insurance coverage, both to avoid the bad mainstream media publicity that UPS and other early adopter employers received last year, as well to see how much the 2015 costs of providing '100% ACA compliant' employee health care benefits via an employer sponsored health care plan are going to increase as the 2014 one year ACA 'waivers' expire. However, once a few more employers start discontinuing spousal health insurance coverage for employees, an avalanche of additional companies are likely to 'follow suit'.
    Last edited by Melonie; 05-25-2014 at 01:15 PM.

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    Default Re: Health insurance

    ^^^ Melonie: Once again, although it has no effect on me, I read and am impressed with the analysis, which begins to show the unbelievable complexity of the situation.

    One third-party outside takeaway that I can't help but saying is that one good thing that may come of this is a detachment of "health insurance" from "employer". In a "must insure everyone" and "must have insurance" scenario, employer involvement just seems like a needless hassle for everyone, without even getting into what must be "change job, change doctors" scenarios, which I imagine occur as the result of various "networks". I'm just really glad I *don't* have to deal with this!

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    Default Re: Health insurance

    ^^^ ironically, the IRS has just issued an ACA related new ruling which on the surface, amounts to just the opposite ... see

    According to a business acquaintance, this latest IRS ruling basically boils down to a requirement that SOMEBODY must pay income taxes on the money used to pay for public health exchange health exchange insurance premiums. The effect is to leave employer contributions toward their own employer sponsored employee health insurance tax free, but to require that the employer and/or employee pay income taxes on moneys destined to pay public health exchange insurance premiums. The stated IRS intention was to provide a dis-incentive for employers who sponsor employee health care plans to simply discontinue those plans, hand the former employer's contribution to the cost of employer sponsored employee health care to the employee ( tax free ), and allow that employee to then purchase public health exchange health insurance coverage as the employer sponsored health care plan is terminated. Until this latest IRS ruling, this technique was arguably legal.

    Arguably, these ongoing changes to the ACA program, and thus to it's economic realities, incentives, and dis-incentives, certainly complicates decision making. And to make matters even worse, my business acquaintance suspects that this IRS ruling, in combination with an already approved 'Cadillac' employee sponsored health plan tax on plans which provide great benefit levels that is scheduled to take effect 2 years from now, will lead to even more future changes via court challenges on 'equal treatment' grounds. My business acquaintance points out that the actual goal here may be to prompt future court rulings which make ALL payments toward ALL health insurance taxable ... which, besides resulting in higher tax revenues being collected by the IRS, would also effectively raise net costs for employers and employees with employer sponsored health insurance plans - thus creating a stronger future incentive to discontinue those plans altogether in favor of public health exchange insurance for employees ( with all payments subject to taxes, of course ).

    Again, putting non-economic issues aside, the root problem here appears to be that the gov't / courts / IRS are free to make future changes to the ACA program that can significantly affect the net costs involved, while Americans who sign up for the program based on 'what they know right now' will be bound by those future changes no matter what the cost or consequence. This makes intelligent decision making extremely difficult. And the 'scope' of material decisions is rather wide already ... whether it's 'worth it' to earn more than X dollars per year, whether people can 'afford' to get married, etc.
    Last edited by Melonie; 05-26-2014 at 02:47 AM.

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    Default Re: Health insurance

    I have the feeling that between this and non-dischargeable student loans a lot of people in the U.S. are eventually going to wake up to an "effective" tax rate that is a lot higher than the "official" one.

    If I were an American, I'd be looking at expatriating too!

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    Default Re: Health insurance

    ^^^ again trying to avoid non-economic aspects, I will say this. Per the old adage, the 'devil is in the details' ... and WAY too many Americans aren't paying enough attention to those details. As I posted earlier, when 2015 tax time arrives, and 2015 public health exchange insurance premium price increases take effect, many Americans will be FORCED to notice those details !!!

    In regard to the topic of expatriation, I would point out that the IRS, in conjunction with the US State Dep't, has also enacted recent changes that now require 'advance tax withholding' on US assets as a condition of being allowed to remove yourself and your assets from the country. For an American with say $100,000 worth of stock shares, this now means that either the stockholder must place 30% or $30,000 in 'escrow' with the IRS to be allowed to transfer those stock shares out of their US brokerage account, or to actually sell those shares and pay the 20% or whatever capital gains tax plus 3.9% new ACA tax on the proceeds. This was prompted by a record number of US citizens leaving the country, taking their 'assets' with them, and then renouncing US citizenship thus allowing them to escape US taxes on their assets entirely.

    (snip)"IRC 877A imposes a mark-to-market regime, which generally means that all property of a covered expatriate is deemed sold for its fair market value on the day before the expatriation date. Any gain arising from the deemed sale is taken into account for the tax year of the deemed sale notwithstanding any other provisions of the Code. Any loss from the deemed sale is taken into account for the tax year of the deemed sale to the extent otherwise provided in the Code(snip)
    Last edited by Melonie; 05-26-2014 at 08:08 AM.

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    Default Re: Health insurance

    This doesn't sound massively different from how Revenue Canada does things, with a deemed disposition upon becoming a non-resident, and either having to pay the tax or put up collateral for it.

    I think that the major difference is that non-resident Canadians don't get taxed based on citizenship alone. This being said, unless going to a high-tax "treaty" country, they've fixed the residence rules in such a way that it's almost impossible to effectively become a non-resident, it seems to me :-( - though the focus of enforcement is probably on the high-value people in reality.

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    Default Re: Health insurance

    ^^^ again not wanting to drift toward the political, or to stray too far off the issue of health insurance, but Canada has had a much longer history of truly high effective tax rates, thus high numbers of 'rich' tax-paying Canadians looking to expatriate for tax avoidance purposes, than the USA has. In the past the USA has had some high 'official' tax rates, but between ( formerly ) allowable tax deductions, ( formerly ) legal tax 'shelters', etc. no Americans actually had to pay anything near those 'official' tax rates. Obviously, this has been changing over the course of the past several years ... as well as the US gov't having learned that raising official income tax rates draws lots of opposition while enacting new, separate taxes hardly gets noticed. As touched on above, the ACA enacts a whole bunch of new taxes ... with the new 3.9% ACA tax on capital gains / investment income probably being the best example regarding the issue of increased US expatriations at least .

    Circling back on topic, the taxpayer subsidized public health exchange insurance premium structure being used, and the 'penalties' being collected by the IRS on individuals and businesses who do not choose to purchase / provide '100% compliant' health insurance, aren't officially called taxes ... but they function just like taxes. 'Means testing' ( i.e. using total income to determine net cost ), marital 'status' ( i.e. very different net costs for a married couple vs two unmarried individuals ) etc. now factor into the net costs of public health exchange insurance coverage in a similar manner to the way they already factored into the net costs of income taxes.

    And, as such, a similar degree of calculation and 'planning' is now required regarding public health exchange insurance costs as has been the case for income taxes !!! As touched on above, earning a few hundred dollars 'too many' can now wind up costing thousands of extra dollars per year in higher health insurance premium costs ... and getting married can now wind up costing thousands of extra dollars in higher net annual health care costs ( net of monthly premiums plus deductibles ) ... under certain circumstances. With these magnitudes of net cost differences potentially at stake, calculation and 'planning' may now indicate that some US couples cannot 'afford' to get married, that some US workers cannot 'afford' to accept pay increases or promotions, etc., if their primary health care option is public health exchange insurance.

    And a huge unknown in this regard will be future actions by employers regarding currently available employer sponsored health insurance ... i.e. dropping spousal coverage, dropping employer sponsored health insurance for employees altogether, raising employer sponsored health insurance premiums charged to employees by large amounts due to '100% ACA compliance' waivers expiring, etc. Couples deciding to get married this year, or employees accepting pay raises and promotions this year, based on the assumption that the absence of negative health insurance cost side-effects made possible by existing employer sponsored health insurance will continue in the future, may be UNpleasantly surprised next year ( or the year after ) to the tune of several thousand dollars per year.
    Last edited by Melonie; 05-27-2014 at 03:27 AM.

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    Default Re: Health insurance

    This is a perfect example of the type of thread in which I just simply choose not to participate. It is inherently "political " and can't be intelligently discussed without at least some political content. Even the most strictly factual posts technically come close to violating the politics ban. That being said, the posts have been uniformly informative.

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    Default Re: Health insurance

    Quote Originally Posted by eagle2 View Post
    There were a lot of technical problems with the insurance exchanges when they were first launched, but they seem to be stable now, at least at the national level. Some of the states exchanges worked very well, while others didn't.



    I see 'Obamacare' more as having the advantages of both a private and public system. It has the advantages of a private system in that most people will get their insurance through private insurers, so they will have many different options, and it has the advantage of a public system in that if you cannot afford health insurance on your own, there are subsidies available. People getting their insurance through the Medicaid expansion will have less options.
    The politics ban is keeping me from filling in the blanks.

    The only thing I will say is that based on the rollout alone with all its glitches and "surprises " nobody knows what Obamacare will bring next year or the year after that. Melonie has only hit SOME of the highlights.

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    Default Re: Health insurance

    nobody knows what Obamacare will bring next year or the year after that. Melonie has only hit SOME of the highlights.
    Well, to try and answer the OP's question, I couldn't really come right out and say A. stay on your father's employer sponsored health insurance plan for as long as the employer / the ACA will allow, and B. seriously consider postponing your wedding until you can determine if getting married is going to cost you and your new husband thousands of extra dollars per year which you may or may NOT actually be able to 'afford', without providing some sort of 'background' explanation !
    Last edited by Melonie; 05-27-2014 at 08:29 AM.

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    Default Re: Health insurance

    ... trying very hard to stay on the strictly financial side of this ... from

    (snip) a top federal appeals court Tuesday said that billions of dollars worth of government subsidies that helped nearly 5 million people buy insurance on HealthCare.gov are illegal.

    A judicial panel in a 2-1 ruling said such subsidies can be granted only to those people who bought insurance in an Obamacare exchange run by an individual state or the District of Columbia — not on the federally run exchange HealthCare.gov.

    The decision threatens to unleash a cascade of effects that could seriously compromise Obamacare's goals of compelling people to get health insurance, and helping them afford it.

    The Obama Administration is certain to seek a reversal of the decision by the U.S. Court of Appeals for the District of Columbia Circuit, which does not immediately have the effect of law.

    The ruling endorsed a controversial interpretation of the Affordable Care Act that argues that the HealthCare.gov subsidies are illegal because ACA does not explicitly empower a federal exchange to offer subsidized coverage, as it does in the case of state-created exchanges. Subsidies for more than 2 million people who bought coverage on state exchanges would not be affected by Tuesday's ruling if it is upheld.

    HealthCare.gov serves residents of the 36 states that did not create their own health insurance marketplace. About 4.7 million people, or 86 percent of all HealthCare.gov enrollees, qualified for a subsidy to offset the cost of their coverage this year because they had low or moderate incomes.

    If upheld, the ruling could lead many, if not most of those subsidized customers to abandon their health plans sold on HealthCare.gov because they no longer would find them affordable without the often-lucrative tax credits. And if that coverage then is not affordable for them as defined by the Obamacare law, those people will no longer be bound by the law's mandate to have health insurance by this year or pay a fine next year.

    If there were to be a large exodus of subsidized customers from the HealthCare.gov plans, it would in turn likely lead to much higher premium rates for non-subsidized people who would remain in those plans, who are apt as a group to be in worse health than all original enrollees.(snip)


    If this federal court ruling 'sticks' ... and it is likely to given the very specific wording of the ADA ... it probably will have the following effects on dancers and camgirls -





    - If you live in one of the 'blue' states, if you purchased ACA health insurance and your income qualified you for 'discounted' insurance premiums, you'll continue to receive the 'discount'. However, if you live in one of the 'blue' states, if you did NOT purchase public health exchange or have other 'ACA qualified' health insurance you will ( still ) be subject to the new IRS penalty tax.

    - If you DON'T live in one of the 'blue' states, if you purchased ACA health insurance and your ( less than $46,000 per year ) income qualified you for 'discounted' insurance premiums, that discount has been ruled illegal thus you'll wind up having to pay the full price for public health exchange insurance premiums no matter what your income level. Absent new legislation, you will also be required to pay back to the IRS the 'difference' between your 2014 unsubsidized versus subsidized public health exchange premium cost when you file your 2014 tax return. However, since unsubsidized premium costs for persons earning less than $46k per year fall under the ACA definition of 'unaffordable', you will NOT be required to pay the new IRS tax penalty if you do not have 'ACA qualified' health insurance coverage.

    The important point to consider is that if you are a dancer or camgirl who does NOT live in one of the 'blue' states, and if your income level originally qualified you for discounted monthly premiums which you are now ineligible for, every month that you continue to pay $200 or whatever per month for ongoing discounted public health insurance coverage also means an extra $200 or whatever per month ( the difference between the unsubsidized and subsidized premium cost ) will also be added to your 2014 tax bill.

    Granted that the federal gov't will appeal this federal court decision ( again - today's ruling was an appeal of an earlier court decision ) ... probably all the way to the US Supreme Court. However, regardless of the personal position of any given judge, the wording of the ACA law is arguably very clear and hard to disregard. These appeals may delay the IRS 'collection' of the difference between subsidized and unsubsidized health insurance premium prices, but absent new legislation that difference will eventually have to be 'paid back' to the IRS.
    Last edited by Melonie; 07-22-2014 at 08:29 AM.

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    Default Re: Health insurance

    another late update ... a second federal appeals court panel, hearing a separate but related case, has contradicted the first appeals court's decision. See . And there are two more separate but related cases yet to be ruled on. Arguably, this means that the entire issue is now one step closer to the US Supreme Court. Hopefully this will be settled before the end of 2014 so that the IRS can finalize tax returns for 2014 and avoid another several months worth of delays on Americans actually receiving tax refund money !!! However, if the IRS must indeed 'claw back' ACA insurance premium subsidies, there may not be very many tax refunds !!!

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    Default Re: Health insurance

    also, another update based on the IRS release of a 'draft' 1040 tax return for filing by next April 15th -





    Thus it would appear that the new 'tax' for Americans who do not have 'qualified' health insurance coverage will start to be collected as part of this year's annual tax return ( which is payable by next April 15th )

    If you have not purchased public health exchange insurance coverage, and if you are not covered as a dependent under someone else's insurance ( parent, husband ), a tax penalty calculator can be found at

    For a 'typical' unmarried dancer or camgirl with no children, earning $1000 per week, the calculated additional new 'tax' will be $399 in 2014, $794 in 2015, and $986 in 2016 and beyond if you did not have 'qualified' health insurance coverage for the entire year. If you had 'qualified' health insurance coverage for part of the year, the new 'tax' is pro-rated on a months uninsured basis.

    Or, stated in a more 'official' manner by US News ... from

    (snip)The penalties for individuals are expected to increase each year, and the uninsured will have to pay either a fee or percent of household income (whichever is greater).

    In 2014, the fee is $95 per adult or 1 percent of household income.

    In 2015, the fee is $325 per adult or 2 percent of household income.

    In 2016, the fee is $695 per adult or 2.5 percent of household income.

    The penalties for children are half that for adults. And there is a cap on the penalties, regardless of income, which is the annual cost of a basic health insurance policy on a state health insurance exchange. That ceiling is not likely to be a factor this year, but it could come into play when the penalties get steeper(snip)

    As detailed from other news sources, the 'cap' on maximum penalty 'tax' is the NATIONAL average cost of unsubsidized Bronze health care coverage through public health exchanges.

    Also, you don't have to pay this new penalty 'tax' if you fall under an exemption. One such 'exemption' is the unavailability of 'affordable' health insurance. Thus the pending court cases may in fact provide an exemption from the new penalty 'tax' for uninsured residents of the 36 states that operate under the federal exchange ( who may lose their premium subsidies ).
    Last edited by Melonie; 07-26-2014 at 08:20 AM. Reason: e

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    Default Re: Health insurance

    yet another important update ... from

    (snip)"U.S. District Judge Ronald White concluded Tuesday that the IRS rule altering the Obamacare law and providing billions in subsidies is "arbitrary, capricious and abuse of discretion":

    "The court holds that the IRS rule is arbitrary, capricious, and abuse of discretion or otherwise not in accordance with law, pursuant to 5 U.S.C.706(2)(A), in excess of summary jurisdiction, authority or limitation, or short of statutory right, pursuant to 5 U.S.C. 706(2)(C), or otherwise is an invalidation of the ACA [Affordable Care Act], and is hereby vacated. The court's order of vacatur is stayed, however, pending resolution of any appeal from this order."(snip)


    The effect of this court ruling is that it concurs with a previous legal interpretation that the ACA law only authorizes new tax credits for ACA public health exchange insurance coverage if the state in which the person resides in one of the 14 states which actually established their own state run health care exchanges. For the other 36 states, the IRS had taken it upon itself to authorize such tax credits ... in order for the IRS to be allowed to pay out 'cash advances' against future tax credits to health insurance companies so that state residents whose incomes are below 400% of the Federal Poverty Level would only be required to pay the 'difference' between the actual cost of the health insurance premiums and the amount of the expected new tax credits.

    What will this mean in 'real world' terms ? Well, for the residents of those 36 states who have been allowed to pay $100-$200 or whatever per month in 'difference', versus the actual $400-$500+ per month cost of the unsubsidized health insurance premiums, it means that when next April 15th rolls around they will be expected to repay the IRS for the 'cash advances' the IRS did not have the legal authority to make. In other words, 2014 tax refunds will be far smaller, or large cash payments to the IRS will be necessary. After all, 12 months worth of $200-$300+ per month IRS 'cash advances' to the health insurance companies adds up to serious money.

    If this is allowed to stand, it will obviously affect dancers, camgirls, and 'customers' who have been receiving 'subsidized' ACA health insurance discount premiums during 2014. As of next January, keeping this insurance coverage could result in their $100-200 per month subsidized insurance premium cost rising to the $400-$500 per month unsubsidized insurance premium cost. Additionally, when 2014 tax returns are filed, the 12 months * $200-300+ per month worth of IRS 'cash advances' already paid to the insurance companies will have to be repaid to the IRS. This obviously has the potential to create a major 'cash crunch' for affected dancers, camgirls, and 'customers'.

    At this point, additional legal appeals are expected which could delay this outcome. However, additional delays will arguably make the end result even worse if, for example, 'subsidized' ACA health insurance enrollees will be required to repay 24 months * $200-300 per month worth of IRS 'cash advances' a year from April instead of 12 months * $200-300 per month of IRS 'cash advances' having to be repaid this April.

    Also, as of January, for any dancers and camgirls who did NOT purchase ACA health insurance, and who are not covered under 'qualifying' health insurance from other sources, the IRS 'penalty tax' increases from 1% to 2%. Stated another way, for dancers or camgirls earning $1000 per week, the $500 in 1% 'penalty tax' in effect this year will increase to $1000. However, if this latest court ruling is upheld, only residents of the 14 states which established their own ACA health care exchanges will actually be required to pay the 'penalty tax'. For residents of the other 36 states, having their ACA tax credits ruled to be illegal may also allow them to invoke an exemption from the 'penalty tax' on the basis that 'affordable' health insurance coverage is not actually available in their state.

    All in all, this makes for a big potential 'mess' when filing 2014 tax returns ... as well as the potential for unexpected IRS liabilities amounting to several thousand dollars per affected tax return filer.
    Last edited by Melonie; 10-03-2014 at 08:10 AM.

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