US Health Care and Expats

I saw that the health care bill has passed in the US. I have searched everywhere for information on exemptions, but I wonder if we US expats are going to be exempt from this mandatory coverage. There are imposing a fine for people who don’t get it.

Regardless of how we feel about the bill (and personally I don’t care how anyone feels), I wonder how this is going to affect those of us here in Taiwan, if at all? Will we be able to get it when we go back?

The House of Representatives included a measure in the bill that exempts U.S. citizens living abroad from the Obama Health Care Tax. So…if you return to the U.S., you will presumably have to jump through a few hoops to be included in the system. Meanwhile, it means literally nothing to ex-pats living in Taiwan.

The “Obama Health Care Tax”? He has his own tax? Come on.

And in which bill did the reps include the exemption? If it was in the original House bill, it’s history, because it was the Senate bill that made it through. If it was in the budget reconciliation, it still needs to be approved by the Senate.

As for the expats having to either buy insurance or pay the penalty, I won’t mind, although I understand why some might. I maintain my insurance back home anyway. If you don’t get it, though, don’t cry to the US gov’t if you have a pre-existing condition when/if you move back to the US and can’t get “back into” the system.

Good to know. I was wondering if one of these “fines” for non-participants (one of the aspects of the healthcare bill that I oppose) would have been covered by the $80,000 exemption, or if we would have to pay separately.

I like Taiwan’s universal healthcare system anyway.

We all have insurance, don’t we? At least those of us living in Taiwan do. Whether international insurance counts is a good question though.
Isn’t the extra tax via a raise in Medicare taxes? I was under the impression that, as long as you don’t work for US company, you don’t have to pay that anyway.
I also maintain insurance back home, since I know I’m here for no longer than a few years and I don’t want any trouble when I go back. I’d love to be able to stop wasting that money though.

Regardless of where one happens to live at any moment in time, is it fair for a US citizen to expect to benefit from a health care system that is prohibited from denying coverage for pre-existing conditions but not have the obligation to pay into it while they are still healthy?

IMO, if you don’t participate in the program, you can’t expect to benefit from it. :2cents:


Taiwan’s NHI doesn’t cover everything. Cancer, comes to mind, and while it may cover HIV for citizens, as a foreigner we stand to not only get the NHI canceled but booted out of the country as well, should we become infected.

The expat question is interesting because many expats (from the US, anyway) question the requirement for us to file taxes too, yet I would ask those people where would they run the first time shit hits the fan, like war breaks out here or they get arrested for something (fairly or unfairly). It could be argued that if a US expat doesn’t want to be subject to US tax, then they should give up access to any protection or services the US government provides. :2cents: again

There were talks about a US$750/year excise tax penalty for Americans living abroad but the latest information I found was in November 2009. The House did eventually remove that clause though, but no word on the Senate version.

At any rate, however, the tax penalty does not include ANY healthcare benefits so if we do have to purchase US healthcare while we’re living overseas I guess we might as well consider getting one of those ultra high deductible healthcare plans.

Actually, this might be of interest to some of us:

[quote=“NYT Blog”]According to Tom Rose, chairman of the Association of Americans Resident Overseas‘ Committee on Social Security and Medicare, the legislation doesn’t have any effect on Americans abroad, except that it exempts them from the penalty for not subscribing to health insurance in the United States. “That is only logical as most Americans abroad have coverage in their country of residence,” Mr. Rose said.

Similarly, the Web site of the American Citizens Abroad organization pointed out that, as of January, neither the House nor Senate bill would tax Americans abroad for not having insurance in the United States, and both “specifically exclude overseas Americans from proposed mandatory U.S. health insurance coverage.”[/quote]

Source: … ns-abroad/

I already have affordable health insurance thanks to Taiwan’s government-run health insurance system.

[quote=“joeleitz”]Oh, that’s interesting that Americans abroad are excluded from mandatory US health insurance coverage. You would think that it might be better for Americans living abroad to be able to have coverage through US providers. I don’t think this really benefits expats. What happened to every American being able to get affordable health insurance?

That only said that Americans living abroad were exempt from a penalty for not subscribing (which is very logical esp for those in Taiwan with NHI). It didn’t say whether or not Americans abroad would qualify for affordable health insurance. And to be honest before this bill was passed I’ve carried a high deductible but high total benefit policy when I’ve been traveling or otherwise not covered under a work policy. And I didn’t think it was that expensive.

It’s understandable that someone living overseas and has insurance there wouldn’t want to pay into a system in the US. I get it, and I’m not advocating a position one way or another, but thinking out loud. Is it fair for an American to expect to benefit from a system in which they haven’t participated? Sure we have NHI here, but what if we get cancer? I’m told NHI doesn’t cover it, so we might be inclined to go back to the US where we can no longer be excluded due to it being a pre-existing condition, but we didn’t participate in the system while we were healthy.

Also just thinking out loud… You have a good point. The thing is though, there’s no one ‘system’ in the US to be participating in. If it was single payer I’d feel much better about contributing, but as it is, any premiums I pay while living here are just pure profit for an insurance company. And when I do return, it is very unlikely that I will stick with the same insurance/company. Certainly any insurance that I could afford to throw my money away on now is not one that will provide adequate coverage if I go back to the US sick.
I do have no objection to paying slightly higher taxes to fund the reform. Actually, while living abroad I would much rather pay a fine to the government than pay premiums to insurance companies. At least one will be used to fund things, the other just goes into a CEO’s pocket.

Who told you that NHI doesn’t cover cancer? I’m pretty sure they do. Chemo and radiation therapy are listed among the things that are ongoing treatments, so they must be covered.