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  • Canadian Cancer Patient Says Korean Surgery Saved His Life May 22, 2015
    Gerd Trubenbach of British Columbia was diagnosed with cancer, as a huge tumor was growing in his neck. His family doctor suggested that the tumor could not be removed and there was nothing else that could be done. The wait …
  • How to Prevent Hemorrhoids May 20, 2015
    Many people have hemorrhoids at some time, and they are a common problem. Hemorrhoids are swollen veins in the anal canal, which can be painful but not usually serious. They are caused from too much pressure on the veins in …
  • Emergency Room Visits Increase with Obamacare May 15, 2015
    Obamacare predicted that expanding health insurance coverage for the poor would reduce costly emergency room visits. A new study has found that newly insured people are actually visiting the ER more often, 40% more often than those who are uninsured. …
  • Transparency: Changing the US Healthcare System May 13, 2015
    Ralph Weber, President and CEO of MediBid, is interviewed by David Saltzman of ShiftShapers. Mr. Weber has been in the benefits business since the mid 1990s, serving clients in the US, Canada, and around the globe. A lack of information …
  • Appalachia Sees Increased Cases of Hepatitis C May 11, 2015
    Infections of Hepatitis C, a contagious liver infection spread by blood contact, has more than tripled in Appalachia – Kentucky, Tennessee, Virginia, and West Virginia – fueled by prescription drug abuse in rural areas. About 73% of patients are under …
  • An American Response to Losing ObamaCare Subsidies May 8, 2015
    by Jane Orient, MD This summer, the U.S. Supreme Court could, in King v. Burwell, uninsure 8 million Americans by finding that subsidies are illegal outside State Exchanges. Some Republicans are saying “Let it burn.” For Democrats, it’s “ObamaCare or nothing.” Can …
  • Arthritis Awareness – May Lab Specials May 6, 2015
    Nearly 53 million adults and 300,000 children in America have arthritis. By 2030, 67% of the population will suffer from one type of arthritis.  Arthritis, joint pain or joint disease, is the leading cause of disability in the United States. …
  • American Women are Drinking More Heavily May 4, 2015
    Barbara Feder Ostrov, Kaiser Health News Whether quaffing artisanal cocktails at hipster bars or knocking back no-name beers on the couch, more Americans are drinking heavily – and engaging in episodes of binge-drinking, concludes a major study of alcohol use. …
  • Shortage of Available Surgery Causes Deaths Worldwide May 1, 2015
    Millions of people die worldwide with treatable conditions because of the lack of routine surgeries, more than from malaria, AIDS, and tuberculosis combined. Five billion of the seven billion people in the world cannot get needed surgery or pay for …
  • Cleaning Tips for a Healthy Home April 29, 2015
    Cleaning your home not only makes it look and smell better, it also can improve your family’s health.  Here are some activities you may not have thought of that will make you and your home healthy and safe: Dust Everything …
  • Using Mobile Devices at Night is Bad For Your Brain April 27, 2015
    Dr. Daniel Siegel, a psychiatrist from UCLA, states that staring into a glowing screen late at night is harmful to your brain and body. Staring at any screen at bedtime, be it computer, smartphone, or ipad, is worse than previously …
  • Few Patients Use Quality, Price Information To Make Health Decisions April 24, 2015
    by Jordan Rau, Kaiser Health News Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according to a poll released Tuesday. Prices for …
  • Shopping Tools Save Patients Cash on Medical Care April 22, 2015
    Vicki Burns of New Mexico needed a total hip replacement in 2012, but could not afford the hospital’s non-negotiable cash estimate of $79,000. Within two days of placing a patient request on MediBid, she received two bids. She chose a …
  • Hysteria’s History Episode 3 April 21, 2015
  • 20th Century Experiment Attempts to Turn Back Time April 20, 2015
    Ellen Langer, a Harvard psychologist, conducted a radical experiment in 1979 – the results of which were never published. Last fall, this study was featured in the New York Times. The study examined how aging’s effects could be altered or …
  • https://youtube.com/devicesupport April 17, 2015
  • Make Spring Cleaning a Workout April 17, 2015
    Chores you do around the house and garden can burn calories and stretch and tone muscles if done correctly. Short episodes of mild exercise can improve your fitness level if done with intensity and speed. Adding 30 minutes of chores …
  • Provisioning for the Opt Out Journey April 17, 2015
    Ophthalmologist David Richardson, MD on how to prepare for opting out of Medicare. From AAPS 70th Annual Meeting, September 2013, Denver, Colorado.
  • What America’s Decline in Economic Freedom Means for Entrepreneurship and Prosperity April 16, 2015
    The United States was once considered the land of opportunity where entrepreneurs such as Henry Ford, Ray Kroc and Steve Jobs contributed to a flourishing economy by providing new products and services at prices people were happy to pay.Today America’s …
  • Obamacare Fines Debut This Tax Season April 15, 2015
    Taxes for 2014 are due this week, and your tax bill could be affected by your health insurance. If you had insurance during the entire calendar year of 2014 through an employer, a state exchange, or Medicare Part A, you …

The Cliff Effect: Obamacare Takes a Double Shot at the Economy and the American Dream

Subsidy Cliff Effect in Health Care InsuranceThe ‘cliff effect’ described here is something I’ve been worrying about for more than a year now.  Based on Kaiser’s calculator using my age, earnings and location, I’m in a spot where a tiny increase in income will have a dramatic effect on the subsidy I might get.  But what scares me is that it isn’t just me, it is that everyone like me will be faced with this, and many will be blindsided by it, which isn’t fair at all.  Like described below, a small shift of an annual income, say an additional $500 per year, or even $5 if I were that close to the marker (which shifts constantly), could push someone like me into the next bracket for subsidy, reducing the subisdy by thousands.  The situation below is extreme, but possible.  When I calculated it out (read more of my calculations here), I found that the subsidy drop off was much more drastic than the increase of income needed to produce it.  Which means someone can get a pay raise, only to find themselves without enough money to pay their health insurance premium anymore, let alone pay that and the rent.  This pay raise becomes a false sense of security, and most people celebrate getting a raise, which would only put them in debt in these cases.  I think this is horrible.  Only those who have benefits through their employer are safe from this cliff.


From the Foundry.  Click here to read the entire article.

Beginning in 2014, when the new health insurance exchanges will open for individuals and small businesses, subsidies will become available for those whose income falls between 134 percent and 400 percent of the federal poverty level (FPL). For a family of four living in a high-cost area, earning 134 percent of the FPL ($31,389 in 2014 dollars) would qualify them to receive $22,740 in assistance. A similar family earning an income at 400 percent FPL ($93,699) would qualify to receive $14,799 in subsidies.

The problem is that as income increases, families will experience large reductions in government assistance, which will discourage striving to earn a higher income. According to Kessler, “Economists call large, discontinuous changes in program benefits like this ‘notches.’ Although notches might be administratively convenient, they have terrible incentive effects.” One of these is “a substantial punishment on work effort.” If a member of a family of four living at 400 percent of FPL earns just $1 more, they would receive no subsidy at all, making the family almost $15,000 poorer. This “cliff effect” will have profound implications on the labor market. Heritage analysts Brian Blase and Paul Winfree write, “the subsidy structure creates incentives for individuals to engage in unproductive activities, such as working less and retiring early.” These income “cut-offs,” which already present issues in Medicaid, induce sharp reductions in the labor supply—not good when the economy is already struggling to recover.



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