February 10th, 2013

A Few Remarks about the Affordable Care Act

Taken from this:

www.fas.org/sgp/crs/misc/R41137.pdf

This is current, from June of last year. It's written by Bernadette Fernandez and and Thomas Gabe for the "Congressional Research Service". This is the Library of Congress' description of the "Congressional Research Service": http://www.loc.gov/crsinfo/

You should know, if you googled in here, that when I say "A Few", I'm usually lying. And when I say "Remarks", it's code for, "Expect frequent updates until I tire of the subject".

Beginning in 2014, there will be Federal tax credits available to make health care premiums more affordable for "people" (individuals, families, "Tax Reporting Units", wtf) who are between 133% and 400% of the Federal Poverty Level. The people who find themselves unluckily below 133% have another path to health care provided. This is the "carrot" to go get some health care (which your employer is not providing). The "stick" is tax penalties if you _don't_ go get some health care. This post is an assessment of the crunchiness, juiciness, color and palatability of the carrot. It is NOT about the stick.

First, observe that companies which already offer health care coverage, unless that coverage is unusually expensive to the employee and/or unusually crappy, will feel no particular change under the law. Very small companies (fewer than 50 Full Time Equivalent employees) will also experience no effect. The FTE rule is AWESOME. It should prevent companies from trying to dodge the effects of the law by making everyone go part time. Making full time people go "part time" for insurance avoidance purposes would be incredibly lame, since history suggests that companies which pull that kind of crap also engage in labor law violations associated with reporting overtime and so forth.

To assess the quality of the health insurance on offer, "levels" of insurance have been devised (bronze, silver, gold, platinum) that represent an actuarial assessment of the value -- that is, what fraction of the customers health care costs are covered under the plan (60-70-80-90). "Unusually crappy" health care from an employer = worse than silver.

To deal with the "unusually expensive" part of the health care issue, there are fractions of AGI levels that self-only coverage can cost depending on AGI vs. FPL. Sorry about that. I'm going to try English. There's a sliding scale of what your health care premium can cost, whether you get it from your employer or an exchange. If you make between 133% and 300% of the Federal Poverty Level, self-only premium for Silver (see above) is supposed to run between 3% and I forget. Between 300% and 400% of FPL, it goes up to 9.5%. But when assessing employer provided insurance for "affordability" that's _self-only_ -- a family of 4 making just under 400% of the Federal Poverty Level could still be paying decent chunk for the whole family if they get their health care through their employer. OTOH, they _are_ making $70K+, so on the scale of People We Worry About, they rank lower than people who are making ... a lot less. (And I believe they retain the option to get the earner's health insurance through the employer and a family plan on the exchanges, which should at least cap things at, worst case, 2x 9.5%, but I'm speculating here. There may be a hole that will require some rule making to deal with.)

See Figure 2 in the above referenced article.

If you have to go buy insurance yourself, the same levels apply, but they apply on the family/Tax Reporting Unit. (Does this make working for a small -- <50FTE -- company that doesn't offer health insurance a better deal for a family of 4 making less than 400% of the FPL than working for a large company that offers health insurance that squeaks in at 9.5% self-only, and charges the same for each additional family member? Maybe! Assuming you can afford to front the cash to the health insurance company and wait for your tax credit, or assuming the withholding calculation accounts for it.).

And remember, the credits that make up the difference between what you have to pay and what the formula says you should have to pay apply to _silver_ plans. You buy a Platinum Plan, we're not going to help you with the difference between silver and platinum.

Table 4 shows how the reality of what you pay for annual health care premiums interacts with what the IRS kicks back to you in a tax credit.

For a family of four, making 350% of the Federal Poverty Level, or $78,225 (48 contiguous states -- it's higher in Alaska and Hawaii), the maximum premium contribution as a percentage of income is 9.5%. If the actual premium paid is $13,500, then subtracting 9.5% (or $7,431) gets you a credit on your tax return of $6,069, assuming I understood the table and transcribed things correctly. (Again, this is the you-bought-it-option, not the your-employer-provided-it option.)

What do you get for this? A silver plan is supposed to cover 70% of your health care costs. But there will be all kinds of "silver" plans with costs all over the place. So the ACA and/or associated rule making has designated the "second lowest-cost silver plan" as the reference plan. Silver health plans will likely exist in a variety of structures (some with high deductibles, some with higher co-pays, etc.), which should give consumers the ability to pick one that lets them get a little bit better deal but stay close to the "reference plan" cost and value. (<-- That is my speculation.) There is a bunch of rule making associated with what plans _must_ cover.

The ACA recognizes that insurers charge more for people who are older than people who are younger and sets limits on the differential. The ACA recognizes that some geographical areas are more expensive (beyond the contiguous states thing) than others and that insurers charge more for people in those areas than in others. I believe the ACA limits that, but I'm not so sure.

If you make more than 400% of the Federal Poverty Line, congratulations! Also, you're going to get jack in terms of credits from the IRS. You'll keep paying what you pay. Sorry.

There's a marriage penalty, and it gets worse the more your premium exceeds the 9.5% cap (this is only for people below 400% of FPL, obvs, and again, only those buying for themselves, not getting it through an employer). Life sucks if you are old. Once people adjust to this, efforts to raise the age of eligibility for Medicare are going to result in, erm, verbal if not physical violence, because we'll have this huge group of people who vote regularly, who are below 400% of FPL, who have insurance premiums that substantially exceed the 9.5% can -- and who are married. They will be pissy, and they will be looking at Medicare as an opportunity to get out from under a substantial burden that they feel is disproportionately on them. (And the pissy group will include some people whose employer provided coverage is "affordable" at 9.5% self-only, but charges a gargantuan amount for family members.)

Read the whole thing; my summary is quite pathetic by comparison.

Signs of Life, Retail Therapy (Indoor edition)

Roche Bros. opened at the regular time today and I got in and out in a half hour (ketchup! tea! muffins! cake! Yay! Also bananas and some other marginally more like real food. But only marginally). The motion sensors on their exterior doors are not working, so they've set the inbound pair of doors to be open so you can get in and out. They have the usual New England airlock setup, so while it's a bit chillier than usual it isn't terrible.

The bakery department was behind, but they did have fresh baked bread and muffins (needed to restock the bags, but did so promptly); they are behind on a lot of the rest (whoopie pies, cakes, etc. notably). They'd done a good enough job plowing that you could see pavement and what else was there was slush rather than snow.

R. and A. are out because A. saw a box and thus wanted "Presents!". They are going to run errands, find a drive thru and buy her some toys. Or at least replacement white board markers in the color she used up.

Meanwhile, I've been sitting around buying crap on eBay, in between putting chairs on top of tables so the Roomba can run and thus entertain hippity hoppity'ing children. I don't like auctions, but succumbed to one for a set of Northern Lites Backcountry snow shoes. My Quicksilvers are from many pounds ago, and do not have as much flotation as I would like. I didn't really care for years, because I didn't really have an opportunity to use them, but 2 feet of snow = opportunity. I also bought T.'s snow pants and snow boots for next year (next size up, in other words), so he'll have backup pants and boots for here at home. His regular setup lives as school and does not typically come home, unlike A.'s, thus leaving us with a bit of a conundrum for dressing him yesterday. Also, the pants at least are on their 3rd year and getting a bit small anyway.

As long as I'm buying footwear for children in the next-size-up, I went through some of the existing footwear to see what we should be passing along to some other youngster.

Helping People Do the Right Thing: prescription drug edition (and guns)

I finally gave in and gave the Boston Globe money so I could access all of their articles. I do sometimes wonder just how much I'm ultimately going to wind up forking over per year for digital access to things. Then I remember back in the 1990s, when I used to actually subscribe to paper magazines, newspapers, journals, blah, blah, bleeping blah. That was _really_ expensive. Also, created an enormous pile of stuff to dispose of.

So this is okay.

In the Boston Globe, there is very minimal coverage of a western Mass effort by police to help people dispose of their non-liquid, non-sharp, not-chemotherapy prescription medications. This is great! People always complain about how we shouldn't throw them away or flush them down the toilet and we're poisoning our waterways and our fish aren't reproducing and the frogs are switching gender and so forth -- but they don't give us a positive option. I'm a huge believer in positive choices (that is, tell me what _to_ do, rather than what _not_ to do, or, ideally, tell me why some choices are better than others, type of thing) ever since, well, why go there. I just am.

Is this a Thing? This is a Thing!

[ETA: Predictably, Bay Area is thinking about making Big Pharma pay for disposing of unused meds. More power to them. http://www.sfgate.com/health/article/Alameda-County-to-vote-on-drug-disposal-3726864.php]

San Diego's program, with a picture, from the Sheriff's website:

http://www.sdsheriff.net/oxycontin/dropbox.html

In Benton County, Arkansas:

http://www.bentoncountysheriff.org/Prescription.aspx

I will say one thing. If libraries every go all-virtual, at least the people who make a living designing media return boxes will have a line of business that lasts ... well, a lot longer.

There's an advocacy group:

http://rxdrugdropbox.org/

National Association of Drug Diversion Investigators (NADDI)

Or perhaps two!

http://www.takebacknetwork.com/about.html

Mt Pleasant, Michigan:

http://www.mlive.com/news/saginaw/index.ssf/2013/01/prescription_drug_drop-off_box.html

I already grow tired of picking links off of google. Feel free to play along on your own time:

drug drop off box prescription

was my search string (not in quotes).

The NADDI site has a search box you can type a zip code into.

Savage, Minnesota (great name!) doesn't want your sharps, but you can turn in illegal drugs in their drug turn-in box:

http://www.cityofsavage.com/for-residents/take-it-to-the-box

They'll even take liquids, if they are sealed up, and they don't say anything about no chemo meds.

This may be a state-wide program, branded "take it to the box":

http://www.co.scott.mn.us/CountyGov/News/PressReleases/Pages/PrescriptionDrugDrop-OffProgram.aspx

These programs are often the result of multiple agencies/advocacy organizations cooperating. The ones run by/focused on the environment are, frankly, the most useless (as near as I can tell, some of those don't even take prescription pain meds). The ones that involve meth lab task forces (in part) seem really cool -- but may not work in all areas, if the box itself risks becoming a target of theft (so you can let people turn in illegal drugs in a box in Minnesota, but perhaps not in Chicago).

I've been listening to various advocates of gun buyback programs, and then reading coverage in which people line up around the block and they run out of gift cards or whatever, and I can't help but feel like there ought to be programs for turning in your unwanted guns without pay -- sort of like hazardous waste disposal day programs that some towns run. Maybe I'll search on that next.

ETA:

Aha! Private gun buyers surf lines for buy-back programs to "save" guns that will otherwise be destroyed. And there's a bit of a movement to ban buyback programs that promise destruction as well. There are some interesting tradeoffs here. Roman property law let you use the thing (rape your servant), the fruits of the thing (take the resulting baby away from her and sell it separately) and abuse the thing (beat up the servant, right up to killing the servant). We don't do things that way; we respect some limitations on what you can do with your property (also, you don't get to own people, even if they are female, and increasingly, we are not treating children as if they are property either, altho we have a ways to go on that). We designate some things "historic", type of thing. But generally speaking, we let you destroy something if you own it, even if we complain about it endlessly (people breaking up ancient books of maps and selling the individual pages, etc.).

While I find it entertaining when a right-winger wants to prevent someone from destroying their property, it's not _that_ entertaining, because it's too easy to find libertarians who want to limit speech and/or access to contraception and so forth. Fish. Barrel. Blah, blah, bleeping, blah. I was very happy to find this:

http://mynorthwest.com/11/2178106/Gun-turnin-not-buyback-in-Olympia-Saturday

Which in classic, Olympia, Washington style, has tried to be all things to all people. Want to get rid of an unwanted gun? We'll designate a day. Want it destroyed? Just tell us that. Don't care/don't want it destroyed? We'll give it to an FFL in exchange for much-needed ammo for the department.

Reuse. Recycle. (Use the proceeds for the benefit of the public.) Respect property. Sounds like where I came from.

ETA: Less an event, more a policy. Advocacy organization in Oregon acting as a connection point to law enforcement for year round turn-in.

http://www.ceasefireoregon.org/coef/yearroundturnin.html

Part of NJ has an amnesty program:

http://www.nj.com/middlesex/index.ssf/2013/01/south_brunswick_cops_you_can_t.html

You don't get a gift card -- but they don't use it as evidence to prosecute you, either.

Albuquerque will return stolen guns to owners; doesn't otherwise specify. Every Saturday in January, ongoing alternate Saturdays thereafter. No additional incentives.

Chicago is Short and Sweet:

http://www.cityofchicago.org/city/en/depts/cpd/provdrs/police_services/svcs/gun_turn-in.html

"Turn in a gun.

No questions asked.

Don't Kill a Dream, Save a Life."

And then a link to a find-a-turn-in-location. Which when I tried it, didn't work. Ouch. Looks like the domain is available.

Greensboro, NC has arranged to have gun turn ins at _churches_. 18 and older only. It's hard to know where to start, but there is this mysterious statement: "The weapons will not be returned." Any ideas what that means?

To be fair, there was a church-located turn-in event on Cape Cod, too:

http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20130203/NEWS/302030344/-1/NEWS07

I mention that, even tho it is a buyback, because Northeast, church and I was kinda shocked by the Greensboro church thing (looks like it's another grocery card, sponsored by Shaw's).

And I've now lost interesting. It's nice to see the buyback excitement start to turn into something that's less of a one-off event (which has zero chance of really impacting the prevalence of inadequately maintained and unsafely stored guns in our society) and more of an ongoing solution of what-the-heck-do-I-do-with-this, which is really what we need.

My last remark is that apparently King County's destruction program intends to use the metal as rebar in construction projects.

Nice.

I really hate auctions

I did in fact win the Backcountry auction, but in the last two or three seconds, someone who had not previously bid at all swooped in and drove my price up another $40.

I freaking hate that.

However, it's still (barely) less than I would have paid for the Quicksilvers, so as long as they show up and are in the as-described condition, I'm happy.

Retail Therapy: Not Having to Create an Account edition

PayPal just gets more and more interesting the more I use it. When I used PayPal at Land's End a couple days ago, I noticed that the PayPal receipt had item level detail (!!). Then today, when I ordered from ShoeBuy, where I had not previously ordered, I realized that I didn't have to enter _anything_ in the checkout process (LastPass supplied the PayPal info and PayPal told Shoebuy where to send the stuff).

_This_ has got to be the future of online retail. This whole must create a new account every time you buy from someone, with a username, password, shipping address, billing address, payment information, phone number, email address and whatever else they ask for, PLUS having to dig around to say _NOT_ do not send me random emails trying to sell me more stuff, has got to end.

And if the price of having it end is PayPal, I can definitely cope with that. I may change my mind some day, if I have a particularly bad experience that I've never before experienced with other payment methods, but at least at the moment, I Am a Fan.

Roomba Review. Sort of.

We got our first roomba a few years ago: a cheap model from Target that wasn't safe for area rugs. It was a huge project to arrange things so it could do the job -- so huge, it wasn't worth it (not to me, anyway). Fast forward slightly, and I gave in and we hired a cleaning service.

The cleaning service is not without its issues. There has been mission creep, partly our fault, partly miscommunication between the woman who spec-ed the job and the woman who actually does the work. However, I didn't put my foot down and define the task until T., who does the work, was sick for months, missing about a quarter (what _is_ it with me and a 25% absenteeism rate?) of her weekly visits. I didn't doubt that she was sick, but I asked for a replacement. I _loved_ the replacement, but the service fired her for failing to show up on the Wednesday before T-weekend for clients she says she didn't even know about. *shrug* I gave T. another try, and to make it work better for all of us, I sat down and worked out the actual job details with R. This reduced the amount of work dramatically and focused it on the things we cared about but did not want to do ourselves (kitchen, bathrooms, vacuuming). Side effects include: the vacuuming is actually reliably completed; the hours billed has dropped by 1; T. is out before noon consistently.

Then for Xmas, I asked for one of the Roombas which is safe to use on tassel-ed area rugs. It took us a while to get it up and running (nothing against Roomba, we're just not that Quick in some ways). Then there were scheduling issues (R. set it to go off at 10 a.m., and that's when I walk with M. and often her dog P. Neither is okay with the robot, so once we get back, it has to be shut off, limiting its utility; the solution was to schedule it to 11 a.m., which R. did). Finally, this long weekend of Nemo, the kids became obsessed with the Robot Vacuum (previously, they were freaked out by it), and I figured out the right amount of furniture to get out of its way and we've been running it a ton.

(1) Initially, its ability to clean is limited by the size of its bin. You have to run it often, and clean it out often, until you hit some kind of homeostasis. We don't have pets, so it isn't too bad. If you had a big house and/or big shedding issues, you might want to get more than one of these.

(2) You do have to watch where it gets into trouble, to figure out which furniture you need to move and which you can safely leave alone. I do what restaurants do at night: pick up the chairs and turn them over seat down onto the table surface. Oooops. Should clean that surface first. Right. Along with a couple of footstools, a dollhouse and a couple other odds and ends, that's about it. The worst is the kitchen stools, because they are really heavy and they have swivels. Gotta be careful.

(3) The whole picking up process will encourage you not to leave things lying about. This is a good thing.

I've become convinced that once you catch up, this thing is actually better than a "regular" vacuum, and by better, I mean the 7 series is better than a mid-range Miele. There are corners that the Roomba doesn't reach; I've taken to using one of the extendo dry swiffer devices to get those, because it's faster than getting out the canister and attachments. I also think the swiffer is more comprehensive in a small area.

This leaves me with an interesting problem. I think I could replace the vacuuming portion of the cleaning service with the Roomba, with the exception of the kitchen/hall/downstairs lav, which we also have her mop. You have to vac before mopping, otherwise it's just a pointless exercise in frustration. But I'm now thinking I'll rework the task list, and have T. switch over to doing dusting (which I've been doing when I feel like it, which isn't very often), rather than vacuuming the rest of the house. The downside to having T. do the dusting is that she tends to use papertowels. I'm going to have really insist on swiffer, because I fucking _hate_ having to go around the house and pick bits of stuck paper towel off the corners of all the picture frames. Which often still have dust on them anyway.

If you're sitting there going, hey, why don't you get a [insert green tech of choice] duster instead, I'm working on it. I can't tolerate feather dusters, and using rags is less effective than swiffer on delicate/ridged/complex surfaces and it is disruptive on movable surfaces (hanging pictures).

For Freezing Rain?!?

I love our little town. I love its sidewalks. I love that the schools and the sidewalks work out so that many, many, many kids can walk to school. That is fantastic.

What I don't love is that the town did not clear the sidewalks after this storm. (Probably a bit overwhelmed. They usually clear them almost immediately. Altho to be fair, when we first looked at this house, before we bought it, we looked at it right after a snowstorm in February and the sidewalks weren't cleared for that, either. Hmmmm.) And between that and freezing rain, my town decided to close schools on Monday. Yes. For rain.

*sigh*

Fingers crossed that the next town over doesn't close. If they stay open, T. can still go to his class if we drive him in (CASE transport doesn't go out if Acton is closed).

Either way, it looks like we might have some help. Our regular babysitter works for the town schools and thus is not working tomorrow. She was supposed to work Saturday, but that, along with the rest of life, was canceled.