Another thing to consider is that "means testing" for subsidies is not so simple as it sounds. Many people have irregular income year-year, even month to month. Your official IRS total AGI 2014 income will not be officially documented and added up until as late as April 2015, so I am not sure what is used to document annual income, and what happens if you estimate it wrong. Lots of fun ahead!

Amazing how having kids will motivate you to get the will done in a hurry! I've always had insurance coverage because it's dumb to think that a serious accident can't happen to you at any moment at any age.

The question I have is, isn't the point of this bill to lower the exorbitant feedback loop of costs that's been occurring back and forth between insurance companies and providers (doctors/hospitals/etc) and those who haven't had insurance and the tab's been picked up by the taxpayer anyway? Every system is going to cost us all, the question is which one will be managed better (and no, I don't know the answer to that, I just know that the system we have is not optimal, effective, or desirable). If the penalty needs to be adjusted in the future because that many are opting out, then it needs to be adjusted, or the kids left to bleed and suffer, or pay full-price for their repair/rehabilitation. There has to be accountability, checks and balances, and smart management.

Income eligibility for advance tax credit payments may be determined using income as reported on the most recent tax return available. Under the law, individuals eligible for premium tax credits can apply for advance payments of the credits, which will be paid directly to their insurer. This is important for helping to make coverage affordable at the time it is needed. The ACA provides that income eligibility for advance payments may be determined using income as reported on the most recent tax return available, which for many people may reflect income for two years prior to the year for which assistance is being requested. The law also requires that procedures be in place to collect more current income information from people who experience a change in their financial situations or family circumstances since filing a return, or do not file a tax return. Income eligibility for premium tax credits ultimately will be based on an individual’s annual income for the year in which credits were received. At the end of the year, any advance premium credit payments received will be reconciled against the credits for which individuals are eligible based on their annual income that year, which will be determined based on their annual MAGI as reported on the tax return. If the advance payments exceed the amount of credit for which individuals are ultimately eligible, some or all of the overpayment must be repaid.1 This could cause a financial burden for families and discourage some individuals from applying to receive advance payments of the subsidy.

I agree SC, but when in the history of this country has the government bureaucracy been able to wisely manage tax revenue? I understand the problem of rising health insurance, but I also understand that the actual cost of medical care is the driving force in rising costs. how will the government control these costs if it can't seem to control the costs of every other government run program? I guess we'll be paying for thousands of new government employees to fix the problem.

[The fundamental problem is that it comes down to flawed humans running the show, and disengaged humans not minding the store, doesn't matter whether they are in government or the private sector.

rofllol LOL! No, my dear, you're turning into a logical, big-picture, realist scientist.

But gee thanks for saying I'm gonna croak ...

Fundamentally, I don't know the answers to your question of how the gov't can control the medical costs (it's probably too simplistic to assume that correcting one side would balance the other). But when in the history of this country have corporations been able to be counted on to do the right thing, rather than maximizing their profits at the expense of the public? The fundamental problem is that it comes down to flawed humans running the show, and disengaged humans not minding the store, doesn't matter whether they are in government or the private sector.

Okay, all my thoughts from here just go pessimistic so I obviously need to stop now before I proclaim us all doomed. I'm gonna go polish my zombie apocalypse cache of weapons (or do invoices and stare depressingly at my to-do list).
Need chocolate and wine...