What US Health Care Reform could mean to US Citizens living in the DR

windeguy

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It appears that US Health Care reform is likely to go ahead. What I saw as having little chance to happen 6 months ago now seems to have about a 50/50 chance to happen. Despite not being passed yet, I wanted to start a discussion on the implications for US Citizens living in the DR. This is likely to have an impact on ALL US citizens regardless of where they live.

Here is what I am finding about likely scenarios:

All US Citizens and qualified family members will be required to have a government qualified health care plan in the US. I do not expect that Expatriates will be excluded from this. We are not a factor in their equations.

If you do not join a qualified plan, you will pay a special tax at a rate of about 2.5% of your gross income annually or there could be severe penalties.

Qualified plans will cost somewhere between 15 and 20 percent of your gross income for coverage you would receive in the US.
 

mountainannie

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what a can of worms that would be....

more just would be a bill that simply says if you are planning to move abroad and wish a refund on the money that you paid into Medicare, fill out these forms.. then wait.. then fill out these other forms... then wait... by the time they got through with it most of the people would be dead..

also, of course, it would take away funding from their sisters, and cousins, and uncles, etc etc--

EVERYONE on Medicare is receiving more than they paid into it.

Lifetime Social Security and Medicare Benefits

and note that that table was made a long time ago before the HUGE boondoggle for the drug industry in the drugs for seniors.. in which Medicare can not even negotiate for a better rate...

costs have skyrocketed
 
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Chirimoya

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Dec 9, 2002
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We've tried this several times and it has always ended up in a discussion of the merits/evils of public health systems in general.

Please, if this thread is to remain open, keep strictly to the topic as set out by the OP - What US Health Care Reform could mean to US Citizens living in the DR.

Bolding mine.
 

windeguy

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I don't have a Senator to whom to write


Correct that this is not about the merits of such health care, it is to point out the consequences of what looks like will be happening soon.

I don't have a Senator or Congressman to whom to write. I live in the DR and do not have a residence in the US. To have a Senator or Congressman that represents me, I would have to have a home state and I do not have one. Expats matter very little to those in power and are not likely to have any say in this. It will likely be taxation without representation nor benefit.

I am simply trying to point out that those that don't sign up for this if it goes as planned will risk major penalties.
 
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bienamor

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Apr 23, 2004
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Correct that this is not about the merits of such health care, it is to point out the consequences of what looks like will be happening soon.

I don't have a Senator or Congressman to whom to write. I live in the DR and do not have a residence in the US. To have a Senator or Congressman that represents me, I would have to have a home state and I do not have one. Expats matter very little to those in power and are not likely to have any say in this. It will likely be taxation without representation nor benefit.

I am simply trying to point out that those that don't sign up for this if it goes as planned will risk major penalties.

Well if your retired and 65 or older then you will not be fined as your automatically enrolled in Medicare part A, and I would hope that its a qualified plan. Don't think they can mandate Part B or Part D coverage. And your Medicare Part A is not any use at this time outside the USA, PR, or Guam except under very special circumstances as was pointed out in another thread.

Not retired and like in your case, not sure how they find you, to levy the fine unless your filling IRS, as according to the bill they will be the ones in charge of ensuring that every one has qualified coverage.
 

windeguy

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Regarding Medicare: I am not saying that this topic is completely unrelated to Medicare, but Medicare only applies to people 65 and over or those with special disabilities. As we have discovered from other threads, in order to be covered under Medicare you have to be treated in the US with rare exceptions. I see no problem in discussing the implications of the proposed health care plan those that do qualify for Medicare as well.

The current thread is primarily about what we as Expats under "normal" retirement age or not retired yet will have to do in order to not be subject to criminal charges or additional penalties.
 

Bob K

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Aug 16, 2004
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I wonder if an international plan such as clements (which uses Health one in the US) would qualify as a plan acceptable to the lords that be.

Bob K
 

windeguy

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I don't expect International plans will be acceptable

I wonder if an international plan such as clements (which uses Health one in the US) would qualify as a plan acceptable to the lords that be.

Bob K

While it makes perfect sense that such a plan could be accepted, I seriously doubt they are considering them to be a part of the accepted plans. It is a good question and will be a good point to watch as this unfolds.

What I expect to happen is that the International plans will modify their products so that they are accepted. Expect a dramatic increase in premiums for accepted plans.
 

tflea

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Everyone has a congressional rep in the US if you ever voted there. Your home district is where you last voted, so you do still have representation and a voice while living abroad.
That's a reason to vote absentee if you so choose.
 

windeguy

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I can't complain about having no representation...

Everyone has a congressional rep in the US if you ever voted there. Your home district is where you last voted, so you do still have representation and a voice while living abroad.
That's a reason to vote absentee if you so choose.

Thank you for that information. I had no idea that was true. I can't complain about having no representation.

The problem is I have no idea in where I last voted. Being a Libertarian, I never had a vote that mattered, so I usually abstained, voted for a Libertarian candidate if they existed or voted against the incumbent. I did vote a few times in local elections, but I am not sure in which of the last 7 locations I lived where that could have been since it was so long ago.
 

Lambada

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Thank you for that information. I had no idea that was true. I can't complain about having no representation.

The problem is I have no idea in where I last voted. Being a Libertarian, I never had a vote that mattered, so I usually abstained, voted for a Libertarian candidate if they existed or voted against the incumbent. I did vote a few times in local elections, but I am not sure in which of the last 7 locations I lived where that could have been since it was so long ago.

I was going to tell you but paused because...........well, what is a mere Brit. doing telling a US citizen about their US rights :cheeky:. And I couldn't believe you didn't know so I thought maybe something had changed since the days years ago when we contacted the US Senator and Congressman concerned for a US citizen unfairly jailed here.

There are well known organisations which have masses of info for US expats, so you could contact them over your inability to remember where you voted:
Frontpage | Democrats Abroad

Republicans Abroad

https://www.overseasvotefoundation.org/overseas/home.htm

Libertarians abroad

I'm afraid the last one is under construction! But the first two are extremely well known.

Which state do I vote in?
https://vhd.overseasvotefoundation.org/unified/index.php?_m=knowledgebase&_a=viewarticle&kbarticleid=1239&nav=0,43
 

windeguy

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Thanks for the additional links Lambada. For me personally, I had no idea of this simply because I became completely disenchanted with the US political system. My concepts of limited government and freedom have been put aside by both parties that are in charge. I simply gave up on them.

In regards to how the new US Healthcare plan can be dealt with, here are some initial thoughts if a US Resident/Citizen does not want to pay for a plan. This is actually part of the package being passed, so nothing illegal is being suggested:

1) Pay the annual "fine" of 2.5% of gross income for refusing to enroll in a health care plan
2) If you need health care not available to you in the DR, then go to the US and enroll in a plan when you need it. There will be no basis for them to refuse you since you played by the rules and complied by paying the fine all along without any benefits.

Also note that this change will probably make the current EXPAT medical plans a thing of the past for US Residents. Those are the type of plans that cover you if you spend at least 6 months out of the US. The problem with them is that have great restrictions on pre-existing conditions if they qualify or not under the new law.
 
It appears that US Health Care reform is likely to go ahead. What I saw as having little chance to happen 6 months ago now seems to have about a 50/50 chance to happen. Despite not being passed yet, I wanted to start a discussion on the implications for US Citizens living in the DR. This is likely to have an impact on ALL US citizens regardless of where they live.

Here is what I am finding about likely scenarios:

All US Citizens and qualified family members will be required to have a government qualified health care plan in the US. I do not expect that Expatriates will be excluded from this. We are not a factor in their equations.

If you do not join a qualified plan, you will pay a special tax at a rate of about 2.5% of your gross income annually or there could be severe penalties.

Qualified plans will cost somewhere between 15 and 20 percent of your gross income for coverage you would receive in the US.

Get ready to pay taxes thru your a$$ and you might as well go out and buy a Dominican Medical insurance policy now,because you will not be able to travel to the states as most of you probably do to seek treatments from specialists on a as needed basis with little to no waiting. Get ready to wait 6-12 months to see a specialist or needed surgery. This is the change most of you people voted for so I hope your all happy.
 
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yeah, I just don't see them enforcing the case of the expat. If this is tied to federal and state wages, then that's your answer. If you have declared external income (allowed to exempt up to about 92K if you lived abroad for more than 333 consecutive days - I think), then there you have it as well.

If it's 1040-based, then there you go as well.

So, I am trying to see this "Killer App" of a new HC system, all of it's administrative and electronic components, checks and balances, etc. I just don't see it being until YEARS before they can get a handle on it.

I mean, the IRS and Treasury Dept. still can't find the billions sitting in undeclared offshore accounts. How many years has that gem been in effect?

Long and the short: I'm "almost" certain that US citizens in DR (also other foreign sovereigns) will have to meet a part of this requirement, BUT this is already starting to shape up like all of our other IRS, Treasury, etc. requirements on reporting and submission.
 

mountainannie

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exempt expatriates

In part (quoted from text of bill):
from the House bill...
(c) Exceptions.?

?(1) Dependents.?Subsection (a) shall not apply to any individual for any taxable year if a deduction is allowable under section 151 with respect to such individual to another taxpayer for any taxable year beginning in the same calendar year as such taxable year.

`(2) Nonresident aliens.?Subsection (a) shall not apply to any individual who is a nonresident alien.

?(3) Individuals residing outside united states.?Any qualified individual (as defined in section 911(d)) (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during the period described in subparagraph (A) or (B) of section 911(d)(1), whichever is applicable.

?(4) Individuals residing in possessions of the united states.?Any individual who is a bona fide resident of any possession of the United States (as determined under section 937(a)) for any taxable year (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during such taxable year.

?(5) Religious conscience exemption.?

?(A) In general.?Subsection (a) shall not apply to any individual (and any qualifying child residing with such individual) for any period if such individual has in effect an exemption which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.

?(B) Exemption.?An application for the exemption described in subparagraph (A) shall be filed with the Secretary at such time and in such form and manner as the Secretary may prescribe. Any such exemption granted by the Secretary shall be effective for such period as the Secretary determines appropriate.
 

bob saunders

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Does this mean there's going to be new Republican Religious sects blooming all over America. How will this new bill affect people that are receiving government pensions, such as SS.