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

[windeguy]

US Health Care plan should be approved soon

It appears very likely that the US House and Senate will reconcile their different versions of the US Health Care plan just after the New Year begins.
Headache or a blessing? You decide.

There are two possibilities I see for US Expats:

1) The plan could include an exemption for Expats who spend less than about one month in the US per year. Expats could always return to the US and pay for a plan if they need special care.

2) If there is no exemption for living out of the US, then "almost everyone", which means it will include Expats, must be in an approved plan in the US or face a fine each year. You could pay the fine and only sign up for a plan when you need it. Or you could sign up for a plan that you could use only in the US. Decisions would have to be made based upon the fine amount versus a plan's cost and coverages.

It remains to be seen if any of these approved plans would cover a US citizen outside of the US. I very much doubt it.

Let's see how it goes. We should know the final outcome in a few months.

 

[ctrob]

It appears very likely that the US House and Senate will reconcile their different versions of the US Health Care plan just after the New Year begins.
Headache or a blessing? You decide.

While you may be right, there are still a few hurdles. The reconciliation between the Senate and House bill must take place next. If the deal-making that took place in the senate also happens in the House, then yeah, it might go to final vote and pass.

BUT THEN, after a succesful House/Senate vote it appears very likely that there are going to be constitutional challenges. I could see this potentially being a long process. Once the lawsuits start flying, it's anybody's guess where it could end.

And also, while a lot of the taxing for the new plan starts in 2010, I believe the actual benefits/procedures don't start till 2013 or 2014 if I remember correctly. That it is how the Senate bill works, not sure if the same holds true for the House version, and then once the two are "merged", I'm not sure if those timelines still hold.

AND THEN - the 2010 elections, AND THEN the 2012 election......it ain't over till the fat lady sings!

Not trying to turn the thread into a political discussion at all, cause it's an interesting topic for those of us that this will affect. But I think it's gonna be a LONG thread due to the ongoing political process.

 

[windeguy]

US Health Care Reform, Yes or No - we will know by Monday - what do you think?

After a long and arduous battle, Obama's health care reform comes down to a vote this weekend. Will it pass or not?

 

[bienamor]

After a long and arduous battle, Obama's health care reform comes down to a vote this weekend. Will it pass or not?

Short of some kind of miracle yes. whether the public wants it or not. Your going to get it.

 

[Bob K]

Short of some kind of miracle yes. whether the public wants it or not. Your going to get it.

Sort of like the BOHICA taxes here and at home (Bend Over Here It Comes Again).

I could not find anything in the bill (but did not read the thousands of pages) that deals with living abroad. Anyone??

Bob K

 

[windeguy]

Implications for those living abroad - not sure yet

Sort of like the BOHICA taxes here and at home (Bend Over Here It Comes Again).

I could not find anything in the bill (but did not read the thousands of pages) that deals with living abroad. Anyone??

Bob K

It is not clear what will happen regarding Expats and what we are forced to do until the smoke clears. I did see one plan a while back that included wording that exempted those living out of the country for a minimum period of time each year.

Most likely we will either have to sign up for a US government approved plan or pay an annual fine for not signing up.

I wrote a letter to Nancy Pelosi's office about this and got the generic answer back that she and her people were doing what was right for America. Bend over here it comes again...

 

[ExtremeR]

I think it will pass, yes it will be expensive, and there will be some who will be affected, but I think the good outweigh the bad in this bill. For example my wife's friend who is a graduated Chef is not getting enough hours at work for the insurance to cover her. She had a really nasty stomach pain and made an appointment with a Dr. which she paid normally. After the Doctor saw her symptoms he admitted her in the hospital right away, started doing her a lot of tests and after 3 days they discharge her saying they didn't have a clue what she had (they were suspecting Colitis), but before sending her home they gave her a US$11,000.00 bill for the 3 days she spent there plus tests. That is downright completely wrong and it shouldn't happen in the country with the biggest GDP in the world. I'll pay more taxes if that's the issue that's going to be fixed.

 

[pedrochemical]

I'll pay more taxes if that's the issue that's going to be fixed.

That is so refreshing to hear.

 

[windeguy]

I'll pay more taxes if that's the issue that's going to be fixed.

Spoken like a true Democrat. There is no question that taxes will go up if it passes. It is likely that I will be paying a "fine".

 

[ExtremeR]

Spoken like a true Democrat. There is no question that taxes will go up if it passes. It is likely that I will be paying a "fine".

Why do I have to think for only me and me only?? There's more people living in this country aside from me, which may have more pressing needs that I do regarding health care, or simply cannot afford (or is denied) a health insurance plan in the US. If my contribution is paying more taxes in order for this country to have healthcare for everyone (including those who can and can't afford it, or are denied) then so be it.

More on topic on your worry, I believe Expats should be exempt of obtaining a mandatory US health insurance plan. They no longer live in the US and they should not pay for a service they will use maybe once a year or less. So I don't support you paying a "fine".

 

[windeguy]

More on topic on your worry, I believe Expats should be exempt of obtaining a mandatory US health insurance plan. They no longer live in the US and they should not pay for a service they will use maybe once a year or less. So I don't support you paying a "fine".

I take it back then, a true Democrat would not have that opinion. It is one that makes complete sense.

 

[PeterInBrat]

Health care costs in the US are simply stupid. The last time I had to go to the emergency room was in VT where they are already far ahead of the national plan. I was in and out under an hour with a severe nose bleed(drowning in blood is not much fun) and the bill was over $800. But with the VT state plan I paid nothing, not even a co-pay. Hawaii also has a more progressive system than anything in the proposed national plan and they aren't complaining.

I would be more interested in the opposing views if they were not almost entirely hyperbola and straw man arguments. A fairly significant portion of the US population believes this man is actually loony tunes:

YouTube - GlennBeck Eugenics part1 Short History

 

[cobraboy]

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.

I would think your legal residence is the one you use to file your IRS return every year.

You DO file US taxes, correct? Even non-citizen U.S. legal residents have to do so if they obtain a Social Security number and are not a legal dependant.

 

[windeguy]

I would think your legal residence is the one you use to file your IRS return every year.

You DO file US taxes, correct? Even non-citizen U.S. legal residents have to do so if they obtain a Social Security number and are not a legal dependant.

I did find out additional information that the last place voted in before one leaves the US and becomes an Expat is where your representatives are still located. Hence my email to Nancy Pelosi.

In response to your question: Absolutely I do file my taxes every year. And if required to by US law, I will also pay a fine for not having a US qualified health care plan. But do you think a PO Box with EPS qualifies as a legal residence? If it did, my wife would not have had to trade in her US Residency for a 10 year renewable visitor's visa. It was just too hard for her to fit into that PO Box in Miami.

 

[cobraboy]

Spoken like a true Democrat. There is no question that taxes will go up if it passes. It is likely that I will be paying a "fine".

Taxes WILL be going up for any legal U.S. resident or citizen who is not a dependant on someone elses IRS filings: increase in Medicare taxes, increases in capital gains, etc., as well as the actual cost of mandated insurance.

The "fine" is a minimum of $695 per year, per person up to $2000 per family (i.e. Joint IRS return.)

However, one will not be able to purchase insurance from one of the "exchanges" cheeky until 2014. You will be paying taxes but not enjoy ObamaCare insurance for 3 years, until 2014, one slick trick the politicians pulled to make the deal look like it made financial sense when it doesn't. Sweet. Like a mandatory non-refundable Christmas Club account you can't use for three years and still have to keep paying into it..

Should this pass, my personal strategery will be to pay the fine until such time I get really sick with something that requires the services of the US healthcare system. Then I shop around for the best deal for my expensive pre-existing condition. Net/net, far less expensive.

BTW-one can opt for SS and Medicare at age 62.5. With the current future insolvency problems (2010 in the first year outgo exceeds income, and SS IOU's are being cashed) might want to consider getting a pile earlier.

 

[AlterEgo]

BTW-one can opt for SS and Medicare at age 62.5. With the current future insolvency problems (2010 in the first year outgo exceeds income, and SS IOU's are being cashed) might want to consider getting a pile earlier.

CB, Is this something new and part of Obama's health plan? As it stands now you can get SS at 62, but you have to be 65 for Medicare..... [unless you're on SS Disability, of course]

And I've been looking at Supplemental plans for Medicare - AARP's Plan C includes foreign emergencies..... makes me wonder if Medicare does too?

AE

 

[cobraboy]

CB, Is this something new and part of Obama's health plan? As it stands now you can get SS at 62, but you have to be 65 for Medicare..... [unless you're on SS Disability, of course]

And I've been looking at Supplemental plans for Medicare - AARP's Plan C includes foreign emergencies..... makes me wonder if Medicare does too?

AE

I stand corrected. Yes, SS @ 62.5, MC @ 65.

Thank you.

 

[bienamor]

I stand corrected. Yes, SS @ 62.5, MC @ 65.

Thank you.

Medicare provides NADA outside the borders of the USA, except in very detailed exceptions. This was discussed before don't remember the thread. links to government sites were provided, also links to AARP sites.

The original House bill had a provision for Expat exemptions, the Senate bill does not! The senate bill is the one the house wants to use deem and pass, without voting on it. Then they will vote on the fixes they want to make. They have to do this or the Senate cannot use referendum on the fixes. They would need 61 votes which they can't get.

Last CBO score with the medical reimbursements in it, shows that this increased the debt instead of decreasing it.

 

[cobraboy]

Medicare provides NADA outside the borders of the USA, except in very detailed exceptions.

True. The irony is that most medical procedures in the DR are around the same price as the co-pay and deductible for Medicare.

I had a procedure done at HOMS that cost under US$600 and would have been, at minimum, $4500 in the US. And the experience was every bit First World as anything I could have gotten in the U.S.

 

[windeguy]

It will be interesting to see if I have to pay a higher fine because I can declare my wife legally as a dependent on my tax return, but she isn't a US resident.