AARP - under AHCA a 64-year-old with a $25,000 income, premiums could go up as much as $7,000

[legalsea]

I will toss in a worry I am starting to have, if this plan, or one similar, is passed.

As noted before, I work for the Office and Adjudication and Review (formerly Office of Hearing and Appeals) of the Social Security Administration. I am an 'attorney advisor' but basically I split my time between 1) reviewing new claims that have reached our level, for possible 'on the record' fully favorable decisions, and 2) writing decisions on behalf of an Administrative Law Judge after a hearing has been held (whether favorable, unfavorable, or partially favorable).

Some of these decisions are 'cessation' cases, wherein a claimant had been in receipt of Federal disability benefits (whether under Title II, which means the claimant had worked enough to earn insured coverage, as well as Medicare benefits) or under Title XVI (supplemental security income benefits; a 'needs' based program, in which the claimant will have Medicaid coverage), and we find (if applicable) that they are no longer disabled, and hence no longer entitled to said monthly benefits as well as Medicare or Medicaid.

Now, under Obama we had stepped up the 'cessation' cases. All well and good. At least, said claimants would then be able to obtain health insurance, due to Obamacare; i.e., the documented 'pre-existing condition' (or, the reason they got disability in the first place) would not prevent them from being insured.

I worry that, if the Republican plan goes through, some of these people will be royally screwed. I realize that the plan would still allow those with pre-existing conditions to obtain health insurance, but much depends on the various States. Before Obamacare the 'high risk' pools (at least, in Texas) was essentially a sham. There was no way that a common person could pay the premiums. Hence, people resorted (as they still do.) to the emergency rooms for everything from headaches to kidney failure.

It is a sad fact of life that most of the claimant's I see (at the hearing level) have poor earning potential. True, many are 'insured' for Title II, but the level of earnings, on an annual basis, to earn these 'quarters of credit' is pretty minimal (for 2016, total earnings of $5,000 for the year will earn you four quarters of credit). You must have 10 years (or forty quarters) of such to be 'insured'.

Believe me, most claimants I see earn maybe $15,000.00 a year, and usually less. We do get claimant's that earn in the $30s, but they are far and few between. The average claimant also has a 'limited' education (sixth through eleventh grade). The prior work usually reflects the low earnings and education.

In short, if the plan goes through as presently constructed, those on disability will be screwed if we (ODAR) find them no longer disabled. There is nice documentation for the insurance company to see exactly what 'impairments' the claimant had. When people file for disability, they do tend to list every single impairment (or illness) they have, or ever had, or even 'think' they have (like fibromyalgia).

If you, the reader, are on disability and above age 50, you are probably ok. If under that age, keep going to your doctor to have documentation in case your case is ever reviewed for cessation. One would be surprised how many, once the monthly benefit starts flowing in, neglect to return to the doctor (which we take judicial notice of).

[shooting4life]

Originally Posted by Ponderosa

The GOP has the right idea in that the cost to young people is too high and discourages them from signing up. They fix it buy raising costs for older people though. That's not really a fix and will hurt those who most need health insurance. Shifting burdens around is not going solve the problem that health care is simply too expensive for most Americans.

It wrong to shift burdens around to those that are burdoning?

Why should young pay for old? Or why should one pay for another long term?


Democrats are for people paying their fair share except when it means someone actually has to pay their fair share. When your old your share of health care costs is higher than when you are young.

[Toyman at Jewel Lake]

And...what does this do for insurance rates for younger people, just starting out, that will no longer subsidize older people as much?