Q.  Having already gone through the horrors of one botched roll out, how can you assure us that this won’t be another complicated mess?

A.  It’s an ill wind that doesn’t blow someone some good.  By building on some things already associated with the Affordable Care Act (ACA), subsidies, the individual mandate and the IRS, we think we can convert the Affordable Care Act (ACA)  to Dave’s Plan in 2 1/2 tax filing years without too much misery.  In the first year, the IRS would change their filling forms to include the individuals Personal Benefits Accounts (PBA) information and reporting requirements by financial institutions.  More importantly they would upgrade their payment software to incorporate the appropriate income and age levels for depositing the proper Medicaid and subsidy payments to the PBAs.  Governments both Federal and State would have to determine what they are paid out in the previous year on average for subsidies and Medicaid by income and age group and get the numbers to the IRS in time to incorporate them in the following year.  This could be a little tricky as medicaid varies between the states. However, in is this age of big data this shouldn’t be a problem. They should have this information anyway.  With the IRS organized, providers and financial institutions could start gearing up for the changes.  The institutions would have to incorporate payments for the qualified Catastrophic Policy whether they sold it or the account holder bought it elsewhere. Then their medical care only credit cards would have to be coordinated with providers probably through card companies (Visa, MasterCard etc.).  Businesses would have to decide whether to drop benefits and just be responsible for payroll deductions and transfer to the employee’s PBA or go to or maintain a contractual system where they where would remain responsible for Health and retirement.  If it’s the latter, the info would be included in their W2s.  Health Insurance policies wherever purchased for the next year would be extended to Oct. 15 of the following year (Approx 18mos.) Continue reading