I’ve had this article in mind for well over a week now. I’ve completely chocked the open “Tabs” bar in my web browser with websites I have held onto during my research. There’s still more I ought to delve into, perhaps, but on the other hand I feel I am already suffering “paralysis by analysis”. There’s only one cure, Dave, write the damn thing already.
So What Am I Dragging My Feet On?
Simple, a nifty little literacy number out there that’s currently on many best seller lists, the Patient Protection and Affordable Care Act (PPACA). I’m sure most of you out there have read it by now, haven’t you?
No? Well perhaps you better get busy and check into it further, it’s going to quite possibly change your life starting 1 January 2014, (only a little over 120 days from now, (as I write this) unless you learn about it now.
Even more time critical is the fact that some of you reading this article are going to need to take actual “fill up forms and write checks” type action a lot sooner … as early as 1 October 2013 .. 30 something days from now.
I Think Most Of You Have Heard About This Monster, After All
But very likely you only know it by it’s “pet” name, Obamacare. Yeah, that plan.
Now that I have kicked over the can of gas onto the smoldering bonfire, let me set a couple rules here before I actually get into the article. They will be simple:
- No “I hate Obama messages, please. Not a one. It doesn’t matter if you like the guy, hate the guy or if you thought that Ronal Reagan was still president until I jogged your memory on this, this article Is not about US politics and I, for sure, am not going to engage in debate. It is the law of the land, and it was even challenged in the US Supreme Court where 9 predominately Republican justices ruled the law was constitutional) … so “It II What It Is”. We have to learn to live with it.
- In spirit of helping everyone whose blood pressure is now creeping into the read zone, I am not going to mention that “O”-word again. Let’s call this juggernaut the “ACA” (which is, after all part of its “long form” name and besides it is much easier for me to type.
Fair Enough? Thanks for your help on this.
Let me also add a disclaimer. several, actually.
- I am not a lawyer, tax accountant, Immigration consultant or any other form of professionally certified advisor. This is my personal opinion only. Take it as such.
- Any other person, even if they ARE a professional of some ilk should be taken with a huge grain of salt on these issues, because the ACA itself is completely “silent” (as in they didn’t write any sections for that, yet) on a number of questions involving US citizens and LPR’s living overseas. Things may very well change in the future.
Who Is Affected By The ACA?
That is both simple and difficult to answer. The simplest answer is, EVERY US citizen and a huge majority of US Permanent Legal Residents (Green Card holders), world-wide. The US citizens are simpler to deal with, so that is where I am going to focus first. The LPR (Green Card) folks, as in the spouses of many of you reading this article, have a lot more exceptions and “but if’s” involved, so I am only going to briefly mention parts of the ACA which seem to directly affect LPR’s living in the USA or living with their American spouses here in the Philippines.
Any Good News in the ACA?
Yep, there is. And in addition to the well-known provisions of offering allegedly affordable health insurance to those of you who don’t have it/can’t afford it now, there are two big provisions that will wipe this off the radar for many of you who have been reading along, waiting for me to drop the shoe.
Those Of You Who Already Have Insurance Are Not really Affected:
At least for now, anyway. Types of insurance coverage which are clearly acceptable are:
- Existing commercial US policies: whether paid for by you personally, or by your employer/former employer.
- Medicare: Which means the majority (but certainly not all) US citizens over age 65, and some (but again, not all LPR/Green Card holder over age 65.
- TRICARE: The medical insurance coverage extend to most active duty US military retirees. (there is TRICARE for some Reservists also), see: US Military TRICARE
- VA Medical Care: It wasn’t until I was reading this that I discovered how extensive US veterans (not only retirees, and not only disabled vets) are provided. See: VA Medical Benefits
- US Citizens Who reside Overseas: Yep, there’s a very convenient loophole for those of us reading here who live full-time in the Philippines.
So I Can Escape the Whole ACA Mess by Living Overseas?
Yes, you can. The ACA specifically exempts US citizens (and LPR’s) who reside outside the USA. So really, I could close the article right here and call this whole ACA issue yet another reason in favor of living in the Philippines … especially for a segment of my audience here who I have been talking to a lot. That is, US military retirees who don’t stay in the US upon retirement, but move to the Philippines so they can actually live on their retirement pay … and who are far short of the age 65 “gate” for Medicare and many of the other “escape clauses”.
But most of you are old enough to understand the old saying, the bold print giveth and the fine print taketh away.
You can’t just “say” you’re Living in the Philippines
The ACA defaults to the rules of the IRS in determining foreign residency of US citizens. These rules are already complex and there are some prohibitions and provisions that will make life a little difficult for many readers here. You can find out the “real rules” for determining overseas residence here. But it’s not always simple.
To try to make a complex issue easier, let me summarize by saying it mostly all depends on actually being outside the USA. And, in particular, not being inside the USA for 30 days or more within your “tax year” (1 Jan through 31 December for most tax payers.
In general, if you don’t meet this test, you are not a non-resident, even if you own property in the Philippines, have a permanent visa for the Philippines, have dual US/Philippine citizenship, etc.
Since I know that there are many of you out there who already divide your time between the Philippines and the USA, and who certainly spend more than 30 days, total, in the USA per year, you’re Philippine “connection” doesn’t count for anything with the ACA. Buy insurance or start paying a fine if you don’t have insurance determined as adequate by the ACA by 1 January 2014.
That’s why I put some emphasis on time urgency here. From what I hear, especially from the overseas American community, a lot of folks are still in ostrich mode. Waiting for some sort of formal notice from “Uncle Sam”? Hoping the whole ACA mess goes away? Waiting for a different president to be elected?
Well none of that is happening before 1 January 2014, so you have a little over 90 days to do some serious thinking … because on 1 January 2014, the US government is going to make up your mind for you.
I May Have To Buy Insurance Then, What Can I do?
Just to make a bad situation worse, the ACA leaves the actual sale and certification of the insurance up to the individual states. That means there are 51 different places to visit to learn about what’s available. As you can see, the various states are not exactly leaping ahead with their plans. Hope yours is more forthcoming than some.
Some of you may not have a “State of Residence”. It is not required anywhere that a US citizen _be_ a resident of any state. Also, if you do claim a state of residence, that state my be way behind the “power curve” in getting their state ACA program going.
The US Government, specifically Health and Human services, is required to et up a clearing house and default plan. I can’t find out a lot, yet. about their program, but this is the best Federal ACA Compliance information I have found so far.
Wish I Had Some More Definitive Answers
But I don’t. Sorry. We’re all in the same leaky boat here, and the water is really going to start pouring in come 1 October, so forewarned is forearmed as “they” say (Whomever that “they” was, s/he was pretty smart, eh?)
“It was even challenged in the US Supreme Court where 9 predominately Republican justices ruled the law was constitutional”
This article lost a lot of credibility with that quote. Are you serious? There are four supreme court justices who are about as left-wing as you could possibly get. Their votes where never seriously in question. Everyone knew which way they’d vote. The only real surprise in the supreme court outcome was John Robert’s vote. The opinion of the justices who voted against the bill was scathing. It’s a great read.
Informative article Dave. Good to know that as I am on Medicare I will not be affected (immediately at least) by the ACA.
Dave could have worded that part better. I think that he meant that the nine-justice supreme court was comprised of mostly Republicans (actually five of the nine); you sure cannot say that the court is predominantly Democrat. But no, not all nine justices are predominantly Republican.
Personally, I would say that at this time the court is divided almost exactly equally. You have 4 very liberal justices. Three very conservative justices. Two (if you include Roberts, who went off the reservation this time) who will swing either way. It doesn’t get too much more equal than that.
I agree Bob, in terms of liberal and conservative the court was pretty evenly divided. But, I believe it did have slightly more self-identified Republicans than Democrats (which are not necessarily the same thing as liberal and conservatives).
Yeah, for me, the party identification means little, it is the philosophy that is important in my book. For example, look at Warren Burger, a Nixon appointee. He was a republican, but one of the most liberal justices in his time. So, I personally believe that the philosophy is more important than the party ID.
Really no reason to debate you, anyhow who a quote like this ““It was even challenged in the US Supreme Court where 9 predominately Republican justices ruled the law was constitutional”” is well to lost to debate with.
Thanks again Dave! I haven’t been able to get any non politicized info on this at all until now. The main thing I was hearing was that Tricare and Medicare didn’t qualify and I was going to be up the creek. The only other effect we’ve experienced has been positive. We were able to keep our son on our Tricare policy until he got his own coverage. He had to go overseas to get it. But, ain’t that sort of what we’ve done? Anyway, good news to our family so far……
Take care,
Pete
Hi Pete,
Glad the article was of some help. .
I knew there would be some some political debate here, which is always dabgeroius ground, but I really am chuckling as the first 6 or 7 comments came in.
So far only one comment addresses what the article is about. Oh well, my fault for treading on thin ice. mea culpa. My apologies.
As was mentioned my wording was clumsy in one way. The US Supreme court does not vote strictly along party lines. What I should have said, though is fact.
Five of the nine justices were appointed by Republican presidents … which _IF_ the court _did_ vote along party lines would have been enough to block the ACA.
But whatever the reason, the politics, the religion, or the fact that one too many justices was playing golf rather than “Justicing”, the act is now the law of the land,
Hence the “Cowboy Up” reference, Red ot Blue, Republican or Democrat no longer matters regarding the law itself. it’s time to stop debating it and start figuring out exactly how it affects us, because right or wrong it is now the horse we have to ride.
it takes effect very soon, it affects virtually all Americans, and you can’r necessarily hide from it by living in the Philippines.
Ya’ll have a happy day if you can … again, sorry for the clumsy wording.
I always enjoy your informative articles Dave. Already have insurance, so I’m not affected. Won’t get into politics because that is not what I use this forum for. Thanks a lot Dave!
Don’t feel bad Dave, because you cant provide more definitive answers. It appears as though there are non, or if there are, no one can find the answers. I have asked my accountant quite a few questions and she hasn’t been able to get most of them answered, but she is going to a 2 day seminar late in Sept. and is hoping to get answers then. NBC news, has said they will be doing stories about the ACA program once they can find the answers to the questions people here need too know about, so apparently they aren’t having much luck either.
I have been a member of the pre-existing Condition Insurance Program (PCIP)ever since I found out about it, shortly after it was started close to 2 years ago, it was one of the first parts that went into effect a few months after Obama signed the ACA into law, along with a few other provisions that started at that time also. I am self-employed and had insurance through the COBRA law, because my insurance co. canceled my policy soon after I was diagnosed with high blood pressure, and I contested it with my state, and they sided with the insurance co. so I was able for a 1 time only application to go to a different insurance co. and they had to take me, but at a very premium rate, almost 3 times what I was paying the other co. Upon finally being able to get rid of the Blue Cross Blue Shield after having it for almost 9 years, my monthly premium was, $1,333.50, that was just for myself only, I was paying a higher premium than a family plan even, with much less benefits also, (wont bore you with all those details, as this is probably boring enough). Am currently paying $242.00 per month, with better benefits than I had, but far short of what our Congress is currently getting, which is what Obama kept using as a selling point to the public. I called PCIP about 2 weeks ago to ask them a bunch of questions pertaining to the ACA Program, and she said that they are still waiting for answers also, and that they are almost as in the dark as I was (to paraphrase). She did say that once the new plan was “finalized” that they would be sending out a mailing to attempt to answer the questions that almost everyone has.
It seems pretty unapplicable to me at age 70 soon to be 71. It is also interesting that it takes effect on Jan. 1 2014, when my asawa turns 65 on Dec. 4, 2013, and gets eligable for Medicare. Interesting timing. We’ve been struggling along with a limited insurance coverage for years since I lost my last job in 2004, at age 61; and couldn’t afford anything like a regular health insurance policy. Now they fix it. There were several years that we had no health insurance at all. We are glad that is coming to an end. We got my asawa’s Feb. 2013 shoulder surgery partially paid for by the charity of a surgery team, and negotiated discounts, etc. Some of the bills are still on our credit card balances. Viewpoints thus vary on the whole plan.
Hi Dave,
Glad to see that your living up to your reputation for taking on real issues. Great article to start the conversation and also as a prelude to future articles….which I am sure you already have taking on draft mode in your head.
FYI on one item. Even those of us that have insurance WILL be affected. As you know, I am on the national bargaining committee for the Teamsters Aircraft Mechanics at United Airlines. We are currently still in the muddy waters of trying to price out health benefits going forward from 2014. One thing we do know as fact….everyone’s plans are going to be more expensive as a result of the ACA, but no one knows by how much just yet.
Will be happy to share more insights as I get them going forward. We are saddling back up and going to Chicago for a new round of bargaining near the end of September.
Be well my friend and keep on keeping it real.
Dave,
I won’t get into the political aspects of this issue either. That would mostly be nonproductive dwelling on the past. We can’t change what happened. It could be reversed but I’m not seeing any will to do so among America’s leaders. I will say this. The PPACA has produced nothing but negative fallout in the healthcare industry and the economy overall since enactment. Brace for the worst. We have not yet begun to see the extent of the damage this legislation will bring.
No comment-if one can not say something good one should say nothing. Hmmm, the second part of the statement could be total BS.