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Old 11-11-2012, 22:15   #301
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Re: Obamacare = early retirement anyone?

In responce to the OP, I found the following.

Obama Care and Expats with link to full text below. What it doesn't say is how you prove to the IRS that you live outside the US. All I can think of for proof is you need to use you Mexican address on your 1040 instead of some US address.

CHAPTER 48—MAINTENANCE OF MINIMUM ESSENTIAL COVERAGE

(a) Requirement to maintain minimum essential coverage
An applicable individual shall for each month beginning after 2013 ensure that the individual, and any dependent of the individual who is an applicable individual, is covered under minimum essential coverage for such month.

------------------------------------

(f) Minimum essential coverage
For purposes of this section—

(1) In general
The term “minimum essential coverage” means any of the following:

-----------------------------------------------

(4) Individuals residing outside United States or residents of territories
Any applicable individual shall be treated as having minimum essential coverage for any month—

(A) if such month occurs during any period described in subparagraph (A) or (B) of section 911(d)(1) which is applicable to the individual, or

(B) if such individual is a bona fide resident of any possession of the United States (as determined under section 937(a)) for such month

U.S.C. Title 26 - INTERNAL REVENUE CODE



In other words if you are a bonified expat then you do not need to have any health insurance. It's up to you as to wether you want it anyway.
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Old 11-11-2012, 22:23   #302
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Re: Obamacare = early retirement anyone?

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Originally Posted by jahillsr View Post
There is a reason the Senate, the Congress and the Executive Office have exempted themselves from Obamacare. I am willing to bet it isn't because they think they "deserve" less then those who can't exempt themselves. As always, follow the money ... or in this case, the health coverage. It is telling that Obama has exempted himself from "Obamacare" isn't it?
I have often seen and heard people make this statement, but it appears to be entirely without any basis in truth. As far as I know, there is no special exemption for government employees or Congress from the individual mandate. Furthermore, under Obamacare, any insurance plan that meets or exceeds the Minimum Essential Coverage standard is sufficient to satisfy the individual mandate. The plans offered to the government and members of Congress easily exceed the Minimum Essential Coverage.
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Old 11-11-2012, 22:27   #303
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Re: Obamacare = early retirement anyone?

See these links for a summary of the individual mandate provisions of Obamacare:
1. http://www.ncsl.org/documents/health..._PPACA_pdf.pdf
2. https://www.bcbsri.com/BCBSRIWeb/pdf...Fact_Sheet.pdf
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Old 11-11-2012, 23:36   #304
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Re: Obamacare = early retirement anyone?

In NZ we have no fault accident compensation to exclude litigation over accidents.
The system has its faults but is one hell of lot more effective in getting solutions to the victims problems. The USA's destructive litigation process sounds like madness to us. Jesus said 2000 years ago "make friends quickly with your accuser while you are going with him to court...." The injustice and procrastination of litigation is not new and those defending it should wake up. If the spilt coffee thing happened in NZ the victim would have been looked after quickly and at no cost, and, the negligent company taken to court by ACC (the Accident Compensation Corporation) and fined. Insurance is not a barrier for NZ'ers who want to go cruising.
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Old 11-11-2012, 23:41   #305
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Re: Obamacare = early retirement anyone?

To bring the subject back around to cruising folks I can see that there are probably three categories into which these folk fit.

First is the full time live aboard folk cruising inside the territorial waters of the USA. These cruisers still need to have an "address of record" on land (like maybe St. Brendan's Isle mail service) so that they can have drivers license, vote, pay taxes, have boat insurance, have a banking account and credit cards, etc., etc. This address would then constitute their residence in a State of the USA. I can see very young, healthy cruisers without children in this category who cruise part of the year and find local work to replenish their cruising kitty during the rest of the year.

Secondly, there are full time live aboard cruisers who cruise both inside and outside USA territorial waters for part of the year and work inside the USA to replenish their cruising kitty. Same thing, they need an address of record and that would be their residence in the USA.

They would need have a minimum essential coverage medical plan or be in one of the exempt categories. Without this coverage their medical needs would have to be taken care of by Medicaid or various free clinics. Either way they are getting medical services paid for by other citizens.

Third, would be full time cruisers who cruise outside USA territorial waters and do not maintain any ties like an address of record inside the USA. These folks would NOT be able to get drivers licenses, banking accounts, credit cards, boat insurance, etc. and receive any money from investment accounts. And if they had any income from any activity such as "under the counter jobs" they would be avoiding filing any tax returns - sort of, living outside the laws of the USA.

Probably they would use foreign medical services and pay in cash. Since they are "outlaws" anyway, and the various government agencies do not know they exist, the PPACA requirements would be just one more thing they ignore. However, WHEN they return to inside the USA they would have a world of hurt officially and PPACA would be only a minor factor. Note I didn't say "If" as every 10 years they need to renew their passport and for that you need an address. . . "gotcha."

I didn't list full time live aboards with residence outside the USA since they by the nature of having an address of record outside the USA are in the exempt category for PPACA.
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Old 12-11-2012, 00:14   #306
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Re: Obamacare = early retirement anyone?

I don't know where you are getting info about addresses of record and not being able to have US accounts. I didn't see anything like that in the bill. It just says living in another country.
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Old 12-11-2012, 00:21   #307
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Re: Obamacare = early retirement anyone?

There is also a small issue of honor and pride. People who have made a lot of money in the United States and then threaten to leave because of this "socialist" scheme really bug me.

The Other Day J.K. Rowling was on the Daily Show, and her attitude really struck a cord with me. She'd been on the British version of Welfare while writing much of her first book, and she made the comment that she could easily move to Monoco or some other tax haven but that she felt an obligation to pay her (massive) taxes to her sovereign nation.

There are indeed givers and takers, but most often people are both, The people that usually protest too loudly are not the one they think they are, and I am grateful for all that my country has given me.
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Old 12-11-2012, 05:52   #308
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Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by David M View Post
Others, is it time to close this thread?
I don't think we are going to suddenly discover any new info here about the effect to a cruiser.

On the other hand I don't understand why people would e complaining when they could just skip the political and what is wrong with the USA posts!
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Old 12-11-2012, 06:07   #309
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Re: Obamacare = early retirement anyone?

This has all been rather beat to death but:

In New Zealand, they have no civil litigation for damages as another poster implies. This does save cost, but in practice encourages others to act carelessly. Unless you are found to be CRIMINALLY liable, you can harm others to a great extent and simply say "I'm sorry" and that's it.

In the US we do perhaps have a lawsuit problem, but having lived many places, I personally like the idea I will be compensated if I'm harmed by others.

BTW, the estimate cost of tort cases on healthcare is 2-6% of the overall healthcare spending. The high side includes defensive medicine adjustments.

At the end of the day, insurers have no real interest in TORT reform as they will, have to charge less in premiums. Wether health, home, business, etc. Less gross income= Less Net profit

I raced with an insurance agent in NZ. He moved to Fiji as Fiji was developing under the US model where insurance was the key to any business venture. He hated the "no lawsuit" deal in NZ.

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Old 12-11-2012, 06:26   #310
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Re: Obamacare = early retirement anyone?

well I guess I'll join going off topic:

I don't really believe that the insurance companies care anything what so ever about costs as long as they can pass them on to insures! So the problem isn't with the insurance companies, it's with the health care industry itself
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Old 12-11-2012, 06:49   #311
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I guess it is impossible to escape the rediculous political banter. This IS NOT the place to discuss the pros and Cons of Obamacare. Try Fox or MSNBC and leave those of us looking to exchange ideas about cruising alone.
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Old 12-11-2012, 07:02   #312
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Re: Obamacare = early retirement anyone?

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Originally Posted by osirissail View Post
I don't know where you got your CT scan, but it must have been in some swanky, fur lined, gold-plated clinic. I have had a half dozen CT scans in the last 1.5 years here in Central Florida at both hospitals and dedicated imaging clinics. The "retail" price** for the CT scan was US$726 (chest) and US$800 (abdominal). The "wholesale" price** was US$218 and US$154. And with AARP supplemental coverage my out of pocket was US$0 (zero).

** For the last decade or more the U.S. medical system has instituted a dual pricing system. "Retail" is what the medical provider bills for a procedure/process and "Wholesale" is what they will accept as full payment from insurance companies for that procedure/process. With most insurance policies you pay about 20% of "wholesale" (after meeting the deductible) and the rest is paid by the insurance provider. With "Supplemental" insurance the 20% you have to pay is paid by your "Supplemental" carrier.
I am concerned that there are different prices for different people as well. Those with private health insurance pay a lot, those who are able to pay cash pay even more, and the Medicare patients are subsidized...

The other concern I had is: Can the hospital write-off the loss of $3,000 ($4k quoted price, and $1k insurance paid) on their taxes...

I don't think anyone is saying that Obamacare will fix everything wrong with the system, and if we stop talking about it, then we will never come up with ideas on how to improve the system.

I'm only halfway to retirement age, but I would like there to be some way for me to take a few years off in my 30s or 40s, yet not have to pay thousands in healthcare premiums (I would rather have thousands in a HSA account), and if I am going to be a traveling nomad either in the US or abroad, I think we need information on how that works.

I have been a poor college student before who got sick with Bronchitis. I'm not sure how communicable it is, but since I didn't want any healthcare bills, and I had no idea how much it would cost to treat, I didn't go to the doctor for 3 weeks. It got pretty bad, and I'm sure I came in contact with thousands of people. People who didn't want to get sick. And if a bunch of them had to go see the doctor and get the medicine there would be no finacial incentive for the medical industry to treat me early for cheap, yet it would have saved a lot of people getting an unnecessary illness. Maybe it would have prevented me from getting sick in the first place too. And since I didn't want to go bankrupt, I didn't go to the ER to get 'free' care. But I think Obamacare might fix that situation where you have hourly part-time employees that might get sick, and have no options for treatment since they can't declare bankruptcy to use the ER, and even clinics cost months of savings. Having a path to get treatment is an improvement, but there should be a minimum level of health insurance that is under $20/month that just covers the basic and common health problems...
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Old 12-11-2012, 07:08   #313
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Smile Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by SailorBill1954 View Post
I guess it is impossible to escape the rediculous political banter. This IS NOT the place to discuss the pros and Cons of Obamacare. Try Fox or MSNBC and leave those of us looking to exchange ideas about cruising alone.
If anyone on this site wish to be left alone I think it is quite easy to fix.

All you have to do is not read the thread that offends or bother you. Only read the subject thread you wish to read.

The vast majority of posts in this thread has been both polite, civil and informative.

Exchanging information is always beneficial if you have an open mind.
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Old 12-11-2012, 07:13   #314
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Re: Obamacare = early retirement anyone?

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Originally Posted by SunDevil View Post
Having a path to get treatment is an improvement, but there should be a minimum level of health insurance that is under $20/month that just covers the basic and common health problems...
If each person sees a doctor at least once per year (a physical?) and one in 10 need some sort of complicated treatment once every five years. That is, 30 minutes in the emergency room is $3000.00, how far do you think $20.00 per month will go. You are talking about $240 per year.

I read that in the last two years of a persons life the average person will rack up $200,000.00 in medical treatment. If you work forty years you will have paid in 10 grand in your working life at that rate. I don't think Canada can even do it that cheep.
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Old 12-11-2012, 07:16   #315
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Re: Obamacare = early retirement anyone?

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Please quote a part of the bill/law that says this. Because so far we have seen that there is a minimum amont or percentage of your income, whichever is larger.
Rule 42 CFR Parts 431, 433, 435, and 457
"Medicaid Program: Eligibility Changes Under the Affordable Care Act of 2010" ➥ http://www.gpo.gov/fdsys/pkg/FR-2011...2011-20756.pdf

Beginning in 2014, the Affordable Care Act extends Medicaid coverage to all individuals between ages 19 and 64 with incomes up to 133 percent of the federal poverty level, or $14,856 for an individual and $30,656 for a family of four (based on the 2012 federal poverty level).
Children are currently and will remain eligible for either Medicaid or CHIP at higher income levels based on the eligibility standards already in effect in their State.
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