Disqus - Latest Comments for TV107

Re: New York: Effectuated enrollment down ~7% so far this year; will likely skyrocket this summer, but...

TV107 — Mon, 11 May 2026 13:23:28 -0000

this will all be reversed in 3 years time

Re: District of Columbia: Coverage up to 200% FPL is dead. Long live coverage up to 200% FPL!

TV107 — Sat, 11 Oct 2025 00:47:35 -0000

Do you have a column where you predict how this shutdown will ultimately be resolved in terms of subsidies in your opinion? or are sticking to facts and not speculation / hope cause it seems to be way too premature?

Re: New York: 450,000 to lose Essential Plan eligibility as state is forced to end expansion due to GOP's #BigUglyBill

TV107 — Tue, 30 Sep 2025 12:56:47 -0000

Summary on the Impact of OBBBA on NYS Healthcare
As of September 30, 2025, the "One Big Beautiful Bill Act" (OBBBA) is an enacted federal law that has created a two-front crisis for New York's low-income healthcare system. It attacks both Medicaid and the Essential Plan, but in very different ways.

1. The Primary Threat: A Catastrophic Cut to NYS Medicaid

The biggest and most immediate blow from OBBBA is a direct 12% cut to the federal funding for New York's Medicaid program.

The Math: New York receives roughly $60 billion in federal Medicaid funds annually. A 12% cut creates a $7.2 billion hole in the state budget.

Compounding the Problem: When combined with other OBBBA provisions that shift costs for SNAP and other programs to the state, New York is facing a total annual budget deficit of approximately $8.5 billion.

This massive shortfall is a crisis for the entire state, forcing lawmakers into a desperate, zero-sum game. To balance the budget, they must consider deep cuts to every public service, including schools, transportation, and healthcare.

2. The Secondary Threat: A Direct Cut to the Essential Plan

The Essential Plan's funding is separate from Medicaid's and was hit by a smaller, more technical cut.

The Cause: OBBBA changed a federal formula (called "PAPI") which made the underlying ACA tax credits less generous. Since the Essential Plan is funded by these tax credits, the amount of money the federal government sends to New York was automatically reduced.

The Math: This results in a direct federal funding cut to the Essential Plan of $210 million to $350 million per year.

Conclusion: Why the Medicaid Cut is the Real Danger to the Essential Plan

While the Essential Plan faces its own direct cut of around $300 million, that problem is completely overshadowed by the $8.5 billion budget crisis caused by the Medicaid cuts.

The state must fill that $8.5 billion hole. A huge portion will be filled by making painful cuts to the Medicaid program itself (slashing payments to doctors and eliminating benefits like dental care). But that won't be enough. Lawmakers will then be forced to take money from other programs.

The Essential Plan, being a multi-billion dollar program, becomes a prime target. To help close the massive deficit, the state will be forced to consider cutting the Essential Plan by imposing new monthly premiums or lowering the income limit to kick hundreds of thousands of New Yorkers out of the program.

In short, the direct cut to the Essential Plan is a serious problem, but the colossal Medicaid crisis is the true existential threat that could force New York State to dismantle the program.

Re: New York: 450,000 to lose Essential Plan eligibility as state is forced to end expansion due to GOP's #BigUglyBill

TV107 — Tue, 30 Sep 2025 12:30:47 -0000

For anyone wondering how these improvements happened, it all goes back to the American Rescue Plan (ARPA). This was the major 2021 federal law that, among other things, temporarily made ACA health insurance much cheaper across the country by boosting tax credits. This move created a pool of federal funding that New York was able to use to significantly upgrade its state-run Essential Plan.

Two Phases of Improvement, One Source of Funding
New York used this ARPA money in two main phases:

The 2021 Upgrades: This is when the big benefit improvements happened. Before this, people in Essential Plan 1 (those with incomes 150-200% of the poverty level) had to pay a $20/month premium. The ARPA funding allowed NY to get rid of that premium completely, making all tiers of the plan free. At the same time, the state added comprehensive dental and vision coverage for everyone in Essential Plans 1 and 2.

The 2024 Expansion: With the funding stream secure, New York then expanded eligibility on April 1, 2024, to a whole new group of people—those with incomes between 200-250% of the Federal Poverty Level.

The Devastating Rollback
The bill this article warns about would repeal the ARPA's enhanced funding. This single federal action would pull the rug out from under both phases of New York's improvements.

The roughly 100,000 New Yorkers in the new 200-250% FPL group would lose their eligibility and coverage entirely.

The hundreds of thousands of people in Essential Plans 1 and 2 would see their benefits stripped away—they would lose their dental and vision coverage, and the state would likely be forced to bring back the $20 monthly premium for those in Essential Plan 1.

Re: How full of shit is this "Americans for Prosperity" Op Ed in The Hill? Let me count the ways.

TV107 — Tue, 30 Sep 2025 12:20:46 -0000

Thank you to the AI that helped me break this down! After reading through this excellent analysis, here’s my takeaway on why the Hill op-ed is so misleading. The author, Charles Gaba, does a fantastic job dismantling it point by point.

Claim 1: ACA subsidies are "extremely generous."
This is the first and most misleading claim. The op-ed conveniently ignores the massive tax break for employer-sponsored insurance, which is far more generous to high-income folks.

For Lower-Income People (<200% of poverty level):

The average ACA subsidy is $6,420/year.

The average employer tax break is $1,650/year.

For Higher-Income People (>800% of poverty level):

The average ACA subsidy is only $730/year.

The average employer tax break is $2,580/year (over 3x more!).

So, complaining about "generous" ACA subsidies while ignoring the much larger tax break for the wealthy is incredibly hypocritical.

Claim 2: They were "temporary" and "millionaires get subsidies."
The "Temporary" Lie: The op-ed claims the subsidies should end because they were for the "temporary" COVID crisis. As Gaba points out, the tax break for employer insurance also started as a "temporary" workaround during WWII. It's a total double standard.

The "Millionaire" Exaggeration: The idea that millionaires are getting big subsidies is basically a fantasy. It would only happen in an absurdly rare and specific scenario, and even then, the subsidy would be tiny (like $1/month).

Claim 3: Letting subsidies expire is no big deal.
This is a "flat-out lie." If the enhanced subsidies expire, the old "subsidy cliff" comes back. That means anyone earning just over 400% of the poverty level loses all help and could see their insurance premiums jump to 25-30% of their income. That's a devastating financial hit.

Claim 4: "Phantom enrollees" prove fraud. 👻
The op-ed claims millions of "phantom enrollees" who don't see a doctor are driving up costs. This is wrong for a few key reasons:

That's How Insurance Works: You want healthy people in the insurance pool. Their premiums help pay for the sick people. It's "Insurance 101."

The Data is Flawed: The report this claim is based on is full of bad data—it double-counts people and uses mismatched sources. It's essentially "Phantom Data."

Insurers Can't Just Pocket the Money: The ACA's 80/20 rule forces insurers to spend at least 80% of premiums on actual healthcare or issue rebates.

In short, the op-ed is a masterclass in using half-truths and flawed data to attack a program that helps millions. Great job to the author for laying it all out so clearly!

Re: Warning: 2026 ACA net rate hikes will be even worse than I thought.

TV107 — Tue, 30 Sep 2025 10:23:27 -0000

i'm slow had to use gemini to understand .... told me: Of course. Let's simplify it with an analogy.

Imagine your parents agree to help you pay for your hobbies.

The Old Way เก่า
Your parents only looked at how much the price of your comic books went up each year. Since comic book prices only rose a little bit, they gave you a little extra money to cover it. Simple.

This is like the old PAPI formula, which only looked at the slow price growth of employer-sponsored insurance.

The New Way ✨
Now, your parents have a new rule. They will average the price increase of your comic books with the price increase of concert tickets.

Concert ticket prices have been shooting up like a rocket! 🚀

When you average a small price increase (comics) with a huge price increase (concerts), the official "average increase" is much higher than before.

This is like the new PAPI formula, which now averages the slow growth of employer insurance with the much faster growth of individual ACA insurance.

Why You Pay More
Here's the final catch. Because the new "average increase" (the PAPI) is so much higher, the government's formula says you are now responsible for covering a bigger percentage of the total cost yourself.

So, by changing what they measure, the formula makes the subsidies a little less helpful, and you have to pay more out of your own pocket.

Re: As the guy who's been shouting the loudest about enhanced tax credits expiring, DO NOT settle for a short-term extension!

TV107 — Sat, 20 Sep 2025 17:13:44 -0000

I don't understand how you have only 1 comment to this article before myself .... do u make any money from this site? for all the work you have done on this topic for years

Re: New York: New data shows massive increases to premiums if GOP's #OneBigUglyBill becomes law

TV107 — Sat, 28 Jun 2025 13:59:50 -0000

How is Essential Plan going to be affected?

Re: New York: Gov. Hochul on the impact of the #MedicaidMassacre bill on New York's healthcare economy

TV107 — Thu, 22 May 2025 23:42:18 -0000

Why is Essential Plan being targeted especially hard?

Re: PredictIt | Who will win the 2024 US presidential election? Archive 2

TV107 — Thu, 18 Apr 2024 16:32:53 -0000

Why is Trump losing here significantly but gambling oddsmakers still have him a slight favorite?

Re: BOOM: Inflation Reduction Act (IRA) passes House, on to President Biden's desk for signing!

TV107 — Sat, 13 Aug 2022 13:54:03 -0000

I think the $2,000 out of cap limit is by far the biggest underreported thing ...seniors that take biologics like Humira with just original Medicare don't have to worry now (as much) ... is this cap number adjusted for inflation?

Re: NEW:FIND YOUR STATE: How much more will YOU pay if #AmRescuePlan subsidies AREN'T extended?

TV107 — Sun, 29 May 2022 19:07:22 -0000

when do you predict state of emergency so no one has to reapply for medicaid will ultimately end?

Re: New: How much will YOU pay with expanded subsidies under the #AmRescuePlan?

TV107 — Mon, 15 Mar 2021 13:38:44 -0000

Charles, have you heard anywhere online how new 0% APTC rate @ 133-150% and lower rates @ 150%-200% might affect the Essential Plans?

Re: New: How much will YOU pay with expanded subsidies under the #AmRescuePlan?

TV107 — Mon, 15 Mar 2021 13:13:31 -0000

Great News! Great Article! Good to know if I ever leave NYS, I might be able to afford healthcare

Re: PredictIt | Who will win the 2020 U.S. presidential election?

TV107 — Wed, 20 May 2020 22:32:34 -0000

how does Trump have a 3 pt lead in this poll (and recently been much bigger) but ON THE SAME SITE have him losing Penn and all the Midwestern states he won in 2016 .... can someone explain this to me?

Re: PredictIt | Who will win the 2020 U.S. presidential election?

TV107 — Tue, 19 May 2020 23:08:11 -0000

how does Trump have a 7 pt lead in this poll but ON THE SAME SITE have him losing Penn and all the Midwestern states he won in 2016 .... can someone explain this to me?

Re: PredictIt | Who will win the 2020 U.S. presidential election?

TV107 — Sun, 29 Mar 2020 18:03:20 -0000

can someone explain to me how trump is leaving so much when biden had a 47-46 lead before the virus hit usa big?....i thought overwhelming opinion is he's doing a poor job....has there been polls in the swing states?

Re: PredictIt | Which party will win the 2020 U.S. presidential election?

TV107 — Tue, 10 Mar 2020 15:03:50 -0000

doesn't make sense why demcoratic is 53 and biden is 45...spread is way too wide

Re: PredictIt | Who will win the 2020 U.S. presidential election?

TV107 — Wed, 04 Mar 2020 08:14:46 -0000

can someone explain to me how trump is still over 50 percent ... biden is now the likely nominee not bernie, and how exact is trump going to win the midwest and Pennsylvania?

Re: PredictIt | Who will win the 2020 U.S. presidential election?

TV107 — Sun, 01 Mar 2020 08:10:07 -0000

can someone explain to be why bloomberg collapsed or is the truth he should have never rose to 25-33....everyone knew Biden would have a strong SC performance even when he was losing Iowa ... was it just the first debate that sunk the ship?

Re: PredictIt | Who will win the 2020 U.S. presidential election?

TV107 — Fri, 21 Feb 2020 07:05:30 -0000

can someone explain to me how Trump is at 55 cents when Sanders is likely nominee and leading Pennsylvania big and all the national polls with 4 percent at least?

Re: Rep Peter King: I Am Voting No on Tax Bill If State Taxes Not Deductible

TV107 — Mon, 06 Nov 2017 00:07:48 -0000

believe it or not, might be cheaper to divorce your wife and live it up solo in one of those cheaper states

Re: And here...we...go...

TV107 — Thu, 22 Jun 2017 18:39:26 -0000

in last paragraph "somewhat less" should be "significantly less"

Re: If I Ran The Zoo

TV107 — Wed, 29 Mar 2017 00:20:13 -0000

"The other thing I would say is that, from what I can tell, restricting CSR assistance to Silver plans has backfired from a strategic POV" makes absolutely no sense ... im surprised cause u IMO are the authority on the ACA ...haven't u seen any SBCs that show the CSR deductible?...it makes no sense to include bronze as an option cause there you would be lowering from 60 levels....CSR lowers silver deductible and OOP max from standard silver at 70 to 73 or 87 or 94.... A CSR plan keeps the same silver co-pays but lowers deductible and OOP max ... doesn't affect premium (which is covered by APTC) ... in 2014, CSR 94 lowered silver deductible to 0 and OOP max to 1000 in NY .... in 2016 BHP equivalent was 200 OOP max.

Re: TV Ratings Tuesday: 'Selfie' & 'Manhattan Love Story' Premiere Low, 'MARVEL's Agents of S.H.I.E.L.D.' & 'Forever' Drop, 'Person of Interest' & 'The Mindy Project' Up

TV107 — Wed, 01 Oct 2014 12:26:30 -0000

Manhattan Love Story was the best 30 min pilot I've seen since I started
ranking shows 10 years ago (and I watch 50-60 shows a year). Better
than Dance Academy, Worst Week....Reminds me a lot of Love Bites.
True gem, but I gotta enjoy it while it lasts.