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 Post subject: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu May 16, 2013 1:39 pm 
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http://www.kaiserhealthnews.org/Stories/2013/April/24/maryland-aca-premiums-carefirst-blue-cross.aspx


Maryland Offers Glimpse At Obamacare Insurance Math

KHN Staff Writer
Apr 24, 2013

In the latest preview of prices for health coverage under the Affordable Care Act, Maryland’s dominant insurer says proposed premiums for new policies for individuals will rise by 25 percent on average next year.

That’s lower than what some had predicted. Just three weeks ago, the insurer, CareFirst BlueCross BlueShield, had been looking at a proposed 50 percent increase. But the company revised that initial estimate, citing worries about affordability for consumers.

“Not only were we concerned about a potential hit to subscribers, but we were also concerned about price levels that were unattractive” to young customers seen as an important stabilizing force for the market, CareFirst CEO Chet Burrell said in an interview Wednesday.

Late Tuesday Maryland regulators posted proposed rates and benefits for health plans to be sold through an online exchange, a step required under the health act, known as the Maryland Health Connection.

Maryland is an important state to watch because it has embraced Obamacare’s insurance reforms, setting up its own marketplace. But there have been serious concerns that the insurance offered there — and on every other exchange across the country — might be too expensive for people to buy.

While most Marylanders younger than 65 have health plans through employers, the exchange’s plans for individuals and small employers are expected to play a key role in bringing coverage to the state’s 700,000 uninsured. That’s about 12 percent of the state’s population.

Many have warned that guaranteeing coverage at regulated prices for sick people would drive up the cost of insurance in the individual market. The ACA prohibits charging sicker members substantially more but allows plans to adjust premiums for age and other factors, within strict limits.

Taking those factors into account, CareFirst premiums for individual plans could rise as high as 150 percent next year for healthy young men and decrease slightly for someone older and sicker, Burrell said.

One current popular CareFirst plan with a $2,700 deductible costs “less than $115 per month” for men under 30, said Mark Hammett, a broker at Kelly & Associates Insurance Group in Hunt Valley, Md.

Consumer advocates were reluctant to draw conclusions from the raw rate filings for the exchange, which make it difficult to quote proposed prices for specific individuals. And they cautioned that filings by CareFirst and other carriers are only preliminary.

“Now the regulators take a look and say, ‘How do you justify these increases?’” said Kathleen Stoll, director of health policy for the pro-ACA consumer group Families USA. “That often results in a reduction to the proposed charges.”

Although prices may rise for some, benefits may be better and many will receive federal subsidies to pay the premiums, she said. Families USA estimates that some 361,000 Marylanders will be eligible for tax credits to pay insurance costs.

“Some people may actually spend much less out of pocket… and end up with a much better product and a much better situation to protect their family from financial devastation from illness,” she said.

That distinction may be initially lost on those focusing only on the premiums, however.

“To the average consumer who has insurance now, the rates will feel every bit like a rate increase,” said Joseph Antos, a health economist at the right-leaning American Enterprise Institute.

CareFirst owns about 70 percent of Maryland’s individual insurance market, with about 120,000 members. Even most of them — 60 percent — won’t see the kind of increases CareFirst proposes because they’re in older, “grandfathered” plans that don’t have to comply with some requirements of the health law yet, Burrell said.

CareFirst and other carriers also filed plans for small employers, but because Maryland had already implemented small-group reforms similar to those that are included in the ACA, those prices weren’t expected to change much. For years Maryland has prohibited insurers from charging substantially more to small employers with sicker and older workforces.

Premiums for CareFirst’s small employer plans to be offered on the exchange next year are proposed to rise about 15 percent, Burrell said, mainly because of the rising cost of health care.

Burrell dismissed a reporter’s suggestion that Democratic Gov. Martin O’Malley, who has much riding on the success of the ACA in Maryland, might have pressured CareFirst to lower its initial filing premiums.

“Nobody asked,” he said. “We did it of our own volition.”

Maryland law requires the nonprofit CareFirst to promote health care affordability and accessibility. With the new, lower projected premiums, Burrell said, “we’re not expecting to make money. We’re expecting to lose money. If we’re going to lose it we’re going to lose it on behalf of subscribers and the community.”

Besides CareFirst, Kaiser Permanente, Aetna, UnitedHealthcare, Coventry Health and Evergreen Health Cooperative all filed to offer about 50 individual or small group plans on the exchange.

An Aetna spokesman said proposed premiums for Maryland small group plans would rise between 12 and 16 percent next year. United proposed average small group increases of from 15 to 28 percent, but premium changes could vary widely depending on the plan, said company spokesman Matt Stearns.

Aetna didn’t say what the average increase for individual plans would be. United hasn’t filed applications yet for Maryland individual plans.

“We currently offer individual coverage in Maryland, and we expect to do so next year,” United's Stearns said.

The O’Malley administration also stressed that the filings are not the final word on insurance prices under the health law.

“It is premature to reach any judgment or conclusion based on the rates as proposed,” said Carolyn Quattrocki, director of the Governor’s Office of Health Care Reform. “In the meantime, we are pleased that the filings confirm there will be robust participation in the Maryland Health Connection.”




I am all for a federal law that mandates health insurers be non-profit, non-publicly traded businesses, but sounds straight out of Atlas Shrugged. Private businesses that intentionally lose money under government pressure won't be private businesses for very long.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu May 16, 2013 3:17 pm 
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broken iris wrote:
Private businesses that intentionally lose money under government pressure won't be private businesses for very long.


Many people, myself included believe that's been the idea all along, that the ACA is just a step towards single payer universal care.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu May 16, 2013 4:53 pm 
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vegman wrote:
broken iris wrote:
Private businesses that intentionally lose money under government pressure won't be private businesses for very long.


Many people, myself included believe that's been the idea all along, that the ACA is just a step towards single payer universal care.


...much like how the Enola Gay contributed to the Hiroshima Revitalization Project back in '45.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu May 23, 2013 5:48 pm 
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nypost wrote:
Another enormous ObamaCare ‘Oops’
By MICHAEL BARONE

Would you like to have a “skinny” health insurance policy? Probably not. But if you’re employed by a large company, you may get one, thanks to ObamaCare.

That’s the conclusion of Wall Street Journal reporters Christopher Weaver and Anna Wilde Mathews, who report that insurance brokers are pitching and selling “low-benefit” policies across the country.

Wonder what a “skinny” or “low-benefit” insurance plan is? The terms may vary, but the basic idea is that policies would cover preventive care, a limited number of doctor visits and perhaps generic drugs. They wouldn’t cover things such as surgery, hospital stays or prenatal care.

That sounds similar to an auto-insurance policy that reimburses you when you change the oil but not when your car gets totaled.

You might ask how ObamaCare could encourage the proliferation of such policies. It was sold as a way to provide more coverage for more people, after all. And people were told they could keep the health insurance they had.

As Weaver and Mathews explain, ObamaCare’s requirement that insurance policies include “essential” benefits such as mental-health services apply only to small businesses with fewer than 50 employees. But larger employers “need only cover preventive service, without a lifetime or annual dollar-value limit, in order to avoid the across-the-workforce penalty.”

Low-benefit plans may cost an employer only $40 to $100 a month per employee. That’s less than the $2,000-per-employee penalty for providing no insurance.

“We wouldn’t have anticipated that there’d be demand for these type of Band-Aid plans in 2014,” the Journal quotes former White House health adviser Robert Kocher. “Our expectation was that employers would offer high-quality insurance.”

Oops.

It’s probably true that businesses trying to attract and retain high-skill employees for long-term positions have an economic incentive to offer generous and attractive health insurance. Otherwise they’d lose good people to competitors.

But the kind of businesses mentioned in the Journal story — restaurants, retailers, assisted-living chains — tend to employ lower-skill workers who typically work there only temporarily.

In a high-unemployment economy, they may not need to offer gold-plated health insurance to get the workforce they need.

Such employers would have to pay a $3,000 penalty for each employee who buys insurance on ObamaCare’s health-insurance exchanges. But it seems likely that many workers, especially young ones, would opt not to pay the hefty premiums for that.

The problem here is that ObamaCare’s architects seem to misunderstand the concept of insurance.

People buy insurance to pay for low-probability, high-cost and undesirable events. It doesn’t make sense to hold onto enough cash to replace your house if it burns when you can buy an insurance policy that will cover that unlikely disaster.

But Health and Human Services Secretary Kathleen Sebelius has a different idea of what insurance is. In response to an American Society of Actuaries report that health premiums would rise 32 percent under ObamaCare, she said, “Some of these folks have very high catastrophic plans that don’t pay for anything unless you get hit by a bus.”

Her idea apparently is that insurance should pay for just about every health-care procedure.

In her defense, the World War II decision to make the cost of health insurance deductible for employers and nontaxable for employees has moved things in that direction. Many people have come to expect that.

But as the Daily Beast’s Megan McArdle commented, “Coverage of routine, predictable services is not insurance at all; it’s a spectacularly inefficient prepayment plan.”

If large numbers of employees are enrolled in “skinny” health insurance plans, as the Journal article suggests, ObamaCare will have produced an unanticipated outcome no one wants.

People stuck with these policies will have insurance that pays for the equivalent of oil changes (up to six a year!) but not for the equivalent of wrecked car. Just the opposite of real insurance.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu June 13, 2013 1:25 pm 
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http://www.politico.com/story/2013/06/obamacare-lawmakers-health-insurance-92691.html?hp=f2


Obamacare? We were just leaving …
By ANNA PALMER and JAKE SHERMAN | 6/13/13 5:13 AM EDT

Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting.

The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive.

Democratic and Republican leaders are taking the issue seriously, but first they need more specifics from the Office of Personnel Management on how the new rule should take effect — a decision that Capitol Hill sources expect by fall, at the latest. The administration has clammed up in advance of a ruling, sources on both sides of the aisle said.

If the issue isn’t resolved, and massive numbers of lawmakers and aides bolt, many on Capitol Hill fear it could lead to a brain drain just as Congress tackles a slew of weighty issues — like fights over the Tax Code and immigration reform.

The problem is far more acute in the House, where lawmakers and aides are generally younger and less wealthy. Sources said several aides have already given lawmakers notice that they’ll be leaving over concerns about Obamacare. Republican and Democratic lawmakers said the chatter about retiring now, to remain on the current health care plan, is constant.

Rep. John Larson, a Connecticut Democrat in leadership when the law passed, said he thinks the problem will be resolved.

“If not, I think we should begin an immediate amicus brief to say, ‘Listen this is simply not fair to these employees,’” Larson told POLITICO. “They are federal employees.”

Republicans, never a fan of Democratic health care reform, are more vocal about the potential adverse effects of the provision.

“It’s a reality,” said Rep. Pete Sessions (R-Texas). “This is the law. … It’s going to hinder our ability with retention of members, it’s going to hinder our ability for members to take care of their families.” He said his fellow lawmakers are having “quiet conversations” about the threat.

(Also on POLITICO: TOP 5 complaints about Obamacare)

Alabama Rep. Jo Bonner said the threat is already real, especially for veteran lawmakers and staff. If they leave this year, they think they can continue to be covered under the current health care plan.

“I’ve lost one staffer who told me in confidence that he had been here for a number of years and the thought of losing the opportunity to keep his health insurance on Dec. 31 [forced him to leave]. He could keep what he had and on Jan. 1 he would go into that big black hole,” said Bonner, who had already planned his resignation from Congress. “And then I’ve got another staff member that I think it will be a factor as she’s contemplating her future.”

Lawmakers and aides on both sides of the aisle are acutely aware of the problems with the provision. Speaker John Boehner (R-Ohio) and Senate Majority Leader Harry Reid (D-Nev.) have discussed fixes to the provision. Boehner, according to House GOP sources, believes that Reid must take the lead on crafting a solution. Since Republicans opposed the bill, Boehner does not feel responsible to lead the effort to make changes.

The Affordable Care Act — signed into law in 2010 — contained a provision known as the Grassley Amendment, which said the government can only offer members of Congress and their staff plans that are “created” in the bill or “offered through an exchange” — unless the bill is amended.

Currently, aides and lawmakers receive their health care under the generous Federal Employee Health Benefits Program. The government subsidizes upward of 75 percent of the premiums for the health insurance plans. In 2014, most Capitol Hill aides and lawmakers are expected to be put onto the exchanges, and there has been no guidance whether the government will subsidize those premiums. This is expected to cause a steep spike in health insurance costs.

There have been many options for fixing the problem discussed throughout the year, including administrative fixes and legislative tweaks. One scenario seen as likely on Capitol Hill would have OPM simply decide that the government could still subsidize insurance on the exchanges.

House Democratic leadership says the issue must be resolved.

“The leadership has assured members that fixing this issue is a top priority,” said one Democratic leadership aide. “This issue must be fixed by administrative action in order that the flawed Grassley Amendment’s spirit is honored and all staff and members are treated the same.”

It could be politically difficult to change this provision. The provision was put in the bill in the first place on the theory that if Congress was going to make the country live under the provisions of Obamacare, the members and staff should have to as well.

The uncertainty has created a growing furor on Capitol Hill with aides young and old worried about skyrocketing health care premiums cutting deeply into their already small paychecks. Some longtime aides and members of Congress, who previously had government subsidized health care for life, are concerned that their premiums will now come out of their pension.

If their fears are borne out, the results could be twofold. Some junior staff will head for the private sector early while more seasoned aides and lawmakers could leave before the end of the year so they can continue under the old plan.

Several lawmakers said departures could run the gamut from low-level staff to legislative aides, to senior aides and lawmakers. Capitol Hill is an attractive workplace for politically ambitious college graduates, but a core of Capitol Hill aides stick around for decades, serving as institutional knowledge, and earning prized retirement packages.

OPM, which administers benefits for federal employees, is expected to rule in the coming months on how congressional health care is to be administered. OPM did not respond to a request for comment.

More than a dozen senior aides interviewed by POLITICO about the issue declined to be named out of fear for future job prospects. The problem is most acutely felt at the staff level, where aides make between $35,000 and roughly $170,000 and budgetary problems have all but stopped pay increases and bonuses. Lawmakers have questioned leadership aides about the future of their health care.

“Between the constant uncertainty surrounding sequestration, and the likelihood aides will soon be paying for the subsidy portion of their health care coverage, congressional office budgets are being squeezed once again, and it’s causing a lot of concern amongst chiefs of staff regarding how to best handle the situation,” said one chief of staff to a senior Democratic member of the House. “Do we give raises to junior level aides so they can afford to pay for their higher health care costs, and if so, where do we find the funds to do so? Additionally, leadership has been relatively silent in terms of providing guidance to offices, which is frustrating.”

There are other ways that aides can fully avoid this problem. If they’re married, they can join their spouse’s health care plan. If they are 65, they can go on Medicare.

But the focus right now is centered on lawmakers trying to figure out how to offset potential increases in premiums.

“I know other members are doing the same thing in terms of what we can do to offset [premiums],” Rep. Tom Cole (R-Okla.) said. “You are particularly limited now because of course we’ve had the cuts in the [member office allowances] on top of this. You just don’t have a lot of options.”

Cole added, “A lot of the staff stays on largely because of the benefit levels and particularly if you’ve got people with families and it’s extraordinarily important to them … it’s just not right.”


***************


Just in case you thought that the same rules should apply to the federal government that they apply to you...

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu June 13, 2013 5:35 pm 
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The healthcare system that we have sucks the above indicates, that it is only being made worse by the people that have given this wretched system to us in the first place.

So, we have a legal system a government and a healthcare system that don't work for the majority of us.

The more we can avoid any and all government interaction in our lives, the better we all are...you know unless you work for big brother.


Maybe we can just go Ayotollah style and just give ourselves completely to the supreme leader.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Wed June 19, 2013 2:28 pm 
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http://news.investors.com/061913-660419 ... andate.htm
Quote:
Local Governments Reeling Under ObamaCare Costs

By JOHN MERLINE, INVESTOR'S BUSINESS DAILY


When Regal Entertainment Group (RGC) in April blamed ObamaCare for the fact that it was cutting some of its workers' hours, backers of the law mounted a furious backlash against the theater chain, among other things filling its Facebook page with boycott threats.

"Greed and selfishness make me sick," one of them said.

Darden Restaurants (DRI) felt this intense heat last year after suggesting it might shift to more part-time work to minimize the cost of the law's mandate that companies offer coverage to all their full-time workers. CEO Clarence Otis even blamed its lowered outlook for 2013 in part on "recent negative media coverage" over "how we might accommodate health care reform."

Yet while private companies are getting all this unwelcome and hostile attention, local governments across the country have been quietly doing exactly the same thing — cutting part-time hours specifically so they can skirt ObamaCare's costly employer mandate, while complaining about the law in some of the harshest terms anyone has uttered in public.

The result is that part-time government workers — many of them low-income — face pay cuts that can top $3,000 a year, and yet will still be left without employer-provided benefits.

Here is just a small sampling of local news reports about what local government officials are saying about ObamaCare, and the steps they're taking to avoid or minimize its costs:

Phillipsburg, Kan.: "School administrators here say they are alarmed and confounded by the looming new costs they face with the implementation of the Affordable Care Act," according to the Kaiser Health Institute News Service. Chris Hipp, director of a Kansas special education cooperative, warned that ObamaCare's costs "could put us all out of business or change significantly how we do business," adding that "we are not built to pay full health benefits for noncertified folks who work a little more than 1,000 hours a year."

Dearborn, Mich.: "If we had to provide health care and other benefits to all of our employees, the burden on the city would be tremendous," said Mayor John O'Reilly, explaining why the city is cutting its more than 700 part-time and seasonal workers down to 28 hours a week. "The city is like any private or public employer having to adjust to changes in the law."

Indiana: "What I'm seeing across the state is school districts, unfortunately, having to reduce the hours that they are having some of their folks work, primarily so they don't have to worry about the (ObamaCare) penalties, or they don't have to provide them health insurance, which would be very, very costly," said Dennis Costerison, executive director of the Indiana Association of School Business Officials. Ft. Wayne Community Schools, for example, are cutting yours for nearly three-quarters of its part-time aides.

Omaha, Neb.: "The biggest problem is everyone said that ObamaCare is only going to help cut costs. Nothing could be further from the truth," said Mike Kennedy , who serves on the board of Millard Public Schools, just outside the city, and figures ObamaCare will raise its costs by $400,000. A neighboring school district is reducing hours for up to 281 part-time employees to avoid $2.5 million in new costs, which will result in pay cuts of up to $3,300.

Long Beach, Calif.: "We are in the same boat as many employers," said Tom Modica, Long Beach's director of government affairs. "We need to maintain the programs and service levels we have now." So the city is going to cut hours for 200 part-time workers so it doesn't have to pay $2 million to provide health benefits.

Salt Lake City: "With new provisions in the Affordable Care Act, there was going to be a significant burden upon Granite School District and our taxpayers to offset the cost of benefits," said spokesman Ben Horsley. He says covering the district's part-time workers would cost about $14 million, and so about 1,000 will have their hours cut to 29 a week.

Cape May County, N.J.: "A number of people in the nation who read it are recognizing how detrimental (ObamaCare is) to government and private employers out there," said Gerald Thornton, the county's finance director who is trying to figure out how to budget for the law.

Virginia: "The Commonwealth of Virginia is grappling with the same issues that many businesses in the private sector are as they struggle to deal with the costs imposed by the Affordable Care Act," Paul Logan, a spokesman for Gov. McDonnell, said. The state is requiring that about 7,000 part-time government workers put in no more than 29 hours a week.

Texas: "The Affordable Care Act has added so much complexity and administrative burden that there is nothing affordable about it," said Jared Pope, who is consulting with Texas municipal governments on ObamaCare. Dallas expects its health costs to climb $2.1 million next year. Plano is cutting hours to avoid $1 million in new costs.

Kern County, Calif.: "It will affect multiple departments, a majority of departments," said the county's deputy administrative officer Eric Nisbett, explaining that unless the county cut worker hours for 800 employees, ObamaCare would cost it up to $8 million a year.

Allegheny County, Pa.: "There's frustration and anger and sadness and resentment, you know, but you don't have a voice," said adjunct English professor Clint Benjamin in the wake of the Community College of Allegheny County's decision to cut hours for about 400 adjunct faculty and other employees so it wouldn't have to pay $6 million in ObamaCare-related fees next year.

Medina, Ohio: "We feel bad as a city administration and as a council in having to cut hours from 35 to 29," Medina Mayor Dennis Hanwell said. "We have the budget to pay the people, but we do not have the budget to pay for the health care." If they hadn't made that cut, the city faced up to $1 million in new health costs courtesy of ObamaCare.

Birmingham, Mich. Commissioner Gordon Rinschler may have summed up best the reaction that countless businesses and governments are having to ObamaCare, saying: "We simply can't afford the Affordable Care Act."




I have no idea if these are Republican areas being obstinate, counties in financial trouble looking for an excuse, or if the reality of the ACA is starting to peak through.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon June 24, 2013 6:15 pm 
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According to Peter Schaeffer:

Quote:
"Yet another nail for the coffin. U.S. health care expenditures are around $12 per hour for the entire economy. The minimum wage is $7.25 per hour. If a minimum wage worker paid 100% of his income in taxes (or health care premiums), America would still lose $4.75 on health care costs alone."



And moar scary pictures:

http://www.forbes.com/sites/danmunro/2012/12/30/2012-the-year-in-healthcare-charts/

Image



Image

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Wed July 03, 2013 10:46 am 
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Quote:
http://www.dailymail.co.uk/news/article-2354135/Treasury-Department-source-Obamacare-employer-mandate-wait-2015-Democrats-breathing-room-2014-midterm-elections.html

Obamacare employer mandate delayed until 2015 to give Democrats breathing room until after 2014 midterm elections, says Treasury source


The revised timetable, the source added, will also push back the final implementation of Obamacare's penalties past the 2014 midterm elections, providing Republicans fewer chances to highlight the law's potentially harmful effects on businesses' bottom lines.


:shake:

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Wed July 03, 2013 2:24 pm 
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It's real bullshit if they delay the employer mandate but not the individual mandate. That would really be an excellent example of the government giving management a break and stiffing labor.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Wed July 03, 2013 5:35 pm 
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Green Habit wrote:
It's real bullshit if they delay the employer mandate but not the individual mandate. That would really be an excellent example of the government giving management a break and stiffing labor.


The exchanges are still a mess so they could very easily justify delaying that as well. Why they wouldn't decided and announce that at the same time I'm not sure.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu July 04, 2013 2:46 pm 
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Quote:
http://online.wsj.com/article/SB10001424127887323899704578583493972896364.html

Employer Mandate? Never Mind
Obama decides not to enforce the heart of his health-care law.

These columns fought the Affordable Care Act from start to passage, and we'd now like to apologize to our readers. It turns out we weren't nearly critical enough. The law's implementation is turning into a fiasco for the ages, and this week's version is the lawless White House decision to delay the law's insurance mandate for businesses, though not for individuals.

The employer mandate is central to ObamaCare's claim of providing universal coverage. Companies with 50 or more "employee equivalents" must pay a $2,000 penalty per full-time employee if they don't provide government-approved health insurance. The provision was supposed to start in January, and delaying it is like Ford saying its electric car is ready to go, except the electric battery doesn't work.

But all of a sudden on Tuesday evening Mark Mazur—you know him as the deputy assistant Treasury secretary for tax policy—published a blog post canceling the insurance reporting rules and tax enforcement until 2015 as Washington began to evacuate for the long Independence Day weekend. Enjoy the holiday, mate.

White House fixer Valerie Jarrett tried to contain the fallout with a separate blog post promising that ObamaCare is otherwise "staying the course." That's true only if she's referring to the carelessness and improvisation that have defined the law so far.

Mr. Mazur cited the "complexity of the requirements" as the reason for the delay. He isn't talking about business confusion and uncertainty, as damaging as those are. This is probably an admission that Treasury's information technology isn't ready to process and cross-check paperwork across the 5.7 million businesses in America, especially the pass-through S-corps and partnerships that file under the individual tax code.

This is more than a typical government snafu. It relates directly to the design of the law, which was thoughtlessly written and rammed through Congress with instructions for the bureaucracy to figure it all out.

And, lo, over eight interim final rules, three final rules, 20 requests for comment, 21 proposed rules, one information collection request, two amendments to the interim final rules, six requests for information and one frequently-asked-questions document, the Administration has created an employer-mandate system that, for example, requires business to track and report every full-time employee's hours of service on a monthly basis.

Meanwhile, the law stipulates that a full-time workweek for the purposes of the mandate is 30 hours, when general business practice is at least 35. The result is that businesses have been scrambling to insulate themselves from higher labor costs by hiring part-time workers, or splitting shifts, or in some industries like fast food even sharing workers. Small firms trying to expand while avoiding the 50-worker trigger have come to be known as 49ers.


The delay will help these and other employers avoid immediately higher costs, which is why the main business lobbies endorsed it. But the decision will continue to dampen overall job creation because businesses know they'll still be whacked in a year. Businesses don't hire workers with the intention of sacking them later.

The Administration's media cheerleaders are nonetheless portraying this as a stroke of political genius to push all the pain past the 2014 elections. But if that's the goal, it is too clever by half. If Republicans have any sense, they will move immediately to delay the rest of the bill for at least a year too. They should start with the individual mandate to buy insurance or pay a tax.

Individuals are only supposed to be eligible for ObamaCare's subsidies if their employer doesn't offer the right benefits. But how will the Treasury know who qualifies in 2014 if they lack the information that businesses are supposed to provide? Citizens must also pay the individual mandate-tax if they decline coverage from their employer. How will the Treasury verify these offers?

Which brings us to the dubious legality of this delay. The Affordable Care Act's Section 1513 states in black-letter law that "(d) Effective Date.—The amendments made by this section shall apply to months beginning after December 31, 2013." It does not say the Administration can impose the mandate whenever it feels it is politically convenient.

This selective enforcement of laws has become an Administration habit. From immigration (the Dream Act by fiat) to easing welfare reform's work requirements to selective waivers for No Child Left Behind, the Obama Administration routinely suspends enforcement of or unilaterally rewrites via regulation the laws it dislikes. Now it is doing it again on health care, without any consultation from, much less the approval of, Congress. President Obama probably figures business and Republicans won't object because they don't like the law anyway.

But Republicans should give Mr. Obama the legal authority to suspend the mandate—in return for other concessions. In addition to forcing votes on suspending the individual mandate-tax, this could include repealing the medical device tax and other harmful provisions. Democrats will find it hard to defend an individual mandate-tax now that businesses are spared. And a delay of one year can easily become two, then three, and then past the next Presidential election.

ObamaCare has become a rolling "train wreck," in Senator Max Baucus's memorable phrase, and it gets worse the more of it the public sees. The employer mandate is terrible policy, as the law's critics said before it passed. Now the Administration is all but admitting it can't implement it properly, and the task for opponents is to press the concession and begin to delay the rest of the law and dismantle it piece by piece.


Singler payer would have been easier.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Fri July 05, 2013 4:25 pm 
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broken iris wrote:
Singler payer would have been easier.


:thumbsup:

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Wed August 21, 2013 4:15 pm 
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Quote:
http://www.bizjournals.com/atlanta/morning_call/2013/08/ups-to-drop-15000-spouses-from.html?ana=RSS&s=article_search&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+bizj_atlanta+%28Atlanta+Business+Chronicle%29

UPS to drop 15,000 spouses from insurance, cites Obamacare

United Parcel Service Inc. plans to remove thousands of spouses from its medical plan because they are eligible for coverage elsewhere. The Atlanta-based logistics company points to the Affordable Care Act, or Obamacare, as a big reason for the decision, reports Kaiser Health News.

The decision comes as many analysts are downplaying the Affordable Care Act's effect on companies such as UPS, noting that the move reflects a long-term trend of shrinking corporate medical benefits, Kaiser Health News reports. But UPS repeatedly cites Obamacare to explain the decision, adding fuel to the debate over whether it erodes traditional employer coverage, Kaiser says.

Rising medical costs, “combined with the costs associated with the Affordable Care Act, have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost,” UPS said in a memo to employees.

According to Kaiser, UPS told white-collar workers two months ago that 15,000 working spouses eligible for coverage by their own employers would be excluded from the UPS plan in 2014.

UPS expects the move, which applies to non-union U.S. workers only, to save about $60 million a year, company spokesman Andy McGowan said.

The health law requires large employers to cover employees and dependent children, but not spouses or domestic partners, Kaiser adds.

Kaiser said the Obama administration would not respond directly to UPS' statements, but said that employer coverage increased when Massachusetts implemented its own version of the health overhaul.

"The health care law will make health insurance more affordable, strengthen small businesses and make it easier for employers to provide coverage to their workers," said Joanne Peters, spokeswoman for the U.S. Department of Health and Human Services.


*Except in a place we call reality.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu August 22, 2013 5:22 am 
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B wrote:
broken iris wrote:
Singler payer would have been easier.


:thumbsup:


Some think that a total failure of Obamacare is just another step towards the endgame of single payer. While I don't find it desirable, it might very well be compared to the effects on the ground of the ACA.

What happens when all those 26-30 somethings (and under 26s not covered by parents) decide its cheaper to pay the penaltax rather than the coverage level that they don't require (as basic catastrophic coverage is no longer basic and therefore approaching 'bronze' levels of cost). If you have a job with coverage and have the gall to cover your family, be prepared to pay a penalty. If you are young and employed without coverage and want to buy it individually, you get the double whammy of subsidizing the elderly through your social security taxes, as well as the insured older echelon through your increased individual healthcare premiums.

This news of UPS corresponds with reports from the food service industry and others pushing towards more part time work that falls under the healthcare mandate.

I can't imagine a fix for this until we find a way for basic healthcare to be a reasonable out of pocket expense with catastrophic coverage as a backup. Please see any other sort of insurance (without heavy governmental involvement) for an example.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Sat August 24, 2013 12:35 am 
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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Sat August 24, 2013 3:43 pm 
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B wrote:



:thumbsup: Frankly the best argument for single payer. Probably the only way we are ever going to control the crushing costs in this county.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Sun August 25, 2013 1:18 am 
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vegman wrote:
broken iris wrote:
Private businesses that intentionally lose money under government pressure won't be private businesses for very long.


Many people, myself included believe that's been the idea all along, that the ACA is just a step towards single payer universal care.


This is almost certainly not the case. I'm not saying this won't someday happen, mind you, but Obamacare BARELY passed Congress. It took monumental efforts to get even this passed, and the administration gave up on it until Nancy Pelosi resurrected it (it really should be named after her, for better or worse). This was not a calculated first move in a larger plan. It is likely the case that the administration hopes that once a law is on the books that it'll evolve over time (a la social security, which was deeply compromised in its first iteration, but again--the best the administration could do) but I would be shocked to discover that this was a calculated step towards a single payer end game.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Sun August 25, 2013 1:22 am 
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broken iris wrote:
nypost wrote:
Another enormous ObamaCare ‘Oops’
By MICHAEL BARONE

Would you like to have a “skinny” health insurance policy? Probably not. But if you’re employed by a large company, you may get one, thanks to ObamaCare.

That’s the conclusion of Wall Street Journal reporters Christopher Weaver and Anna Wilde Mathews, who report that insurance brokers are pitching and selling “low-benefit” policies across the country.

Wonder what a “skinny” or “low-benefit” insurance plan is? The terms may vary, but the basic idea is that policies would cover preventive care, a limited number of doctor visits and perhaps generic drugs. They wouldn’t cover things such as surgery, hospital stays or prenatal care.

That sounds similar to an auto-insurance policy that reimburses you when you change the oil but not when your car gets totaled.

You might ask how ObamaCare could encourage the proliferation of such policies. It was sold as a way to provide more coverage for more people, after all. And people were told they could keep the health insurance they had.

As Weaver and Mathews explain, ObamaCare’s requirement that insurance policies include “essential” benefits such as mental-health services apply only to small businesses with fewer than 50 employees. But larger employers “need only cover preventive service, without a lifetime or annual dollar-value limit, in order to avoid the across-the-workforce penalty.”

Low-benefit plans may cost an employer only $40 to $100 a month per employee. That’s less than the $2,000-per-employee penalty for providing no insurance.

“We wouldn’t have anticipated that there’d be demand for these type of Band-Aid plans in 2014,” the Journal quotes former White House health adviser Robert Kocher. “Our expectation was that employers would offer high-quality insurance.”

Oops.

It’s probably true that businesses trying to attract and retain high-skill employees for long-term positions have an economic incentive to offer generous and attractive health insurance. Otherwise they’d lose good people to competitors.

But the kind of businesses mentioned in the Journal story — restaurants, retailers, assisted-living chains — tend to employ lower-skill workers who typically work there only temporarily.

In a high-unemployment economy, they may not need to offer gold-plated health insurance to get the workforce they need.

Such employers would have to pay a $3,000 penalty for each employee who buys insurance on ObamaCare’s health-insurance exchanges. But it seems likely that many workers, especially young ones, would opt not to pay the hefty premiums for that.

The problem here is that ObamaCare’s architects seem to misunderstand the concept of insurance.

People buy insurance to pay for low-probability, high-cost and undesirable events. It doesn’t make sense to hold onto enough cash to replace your house if it burns when you can buy an insurance policy that will cover that unlikely disaster.

But Health and Human Services Secretary Kathleen Sebelius has a different idea of what insurance is. In response to an American Society of Actuaries report that health premiums would rise 32 percent under ObamaCare, she said, “Some of these folks have very high catastrophic plans that don’t pay for anything unless you get hit by a bus.”

Her idea apparently is that insurance should pay for just about every health-care procedure.

In her defense, the World War II decision to make the cost of health insurance deductible for employers and nontaxable for employees has moved things in that direction. Many people have come to expect that.

But as the Daily Beast’s Megan McArdle commented, “Coverage of routine, predictable services is not insurance at all; it’s a spectacularly inefficient prepayment plan.”

If large numbers of employees are enrolled in “skinny” health insurance plans, as the Journal article suggests, ObamaCare will have produced an unanticipated outcome no one wants.

People stuck with these policies will have insurance that pays for the equivalent of oil changes (up to six a year!) but not for the equivalent of wrecked car. Just the opposite of real insurance.


I'm not sure what the argument being made here is (was this a national review piece? I know this guy writes for them). Is he saying that employers already providing insurance are providing cheaper policies due to some obamacare mandate? if so I'm not sure what the causal mechanism is? or is his complaint that the insurance that people without insurance are going to be provided with is inferior to no insurance at all?

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Sun August 25, 2013 1:26 am 
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broken iris wrote:
http://www.politico.com/story/2013/06/obamacare-lawmakers-health-insurance-92691.html?hp=f2


Obamacare? We were just leaving …
By ANNA PALMER and JAKE SHERMAN | 6/13/13 5:13 AM EDT

Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting.

The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive.

Democratic and Republican leaders are taking the issue seriously, but first they need more specifics from the Office of Personnel Management on how the new rule should take effect — a decision that Capitol Hill sources expect by fall, at the latest. The administration has clammed up in advance of a ruling, sources on both sides of the aisle said.

If the issue isn’t resolved, and massive numbers of lawmakers and aides bolt, many on Capitol Hill fear it could lead to a brain drain just as Congress tackles a slew of weighty issues — like fights over the Tax Code and immigration reform.

The problem is far more acute in the House, where lawmakers and aides are generally younger and less wealthy. Sources said several aides have already given lawmakers notice that they’ll be leaving over concerns about Obamacare. Republican and Democratic lawmakers said the chatter about retiring now, to remain on the current health care plan, is constant.

Rep. John Larson, a Connecticut Democrat in leadership when the law passed, said he thinks the problem will be resolved.

“If not, I think we should begin an immediate amicus brief to say, ‘Listen this is simply not fair to these employees,’” Larson told POLITICO. “They are federal employees.”

Republicans, never a fan of Democratic health care reform, are more vocal about the potential adverse effects of the provision.

“It’s a reality,” said Rep. Pete Sessions (R-Texas). “This is the law. … It’s going to hinder our ability with retention of members, it’s going to hinder our ability for members to take care of their families.” He said his fellow lawmakers are having “quiet conversations” about the threat.

(Also on POLITICO: TOP 5 complaints about Obamacare)

Alabama Rep. Jo Bonner said the threat is already real, especially for veteran lawmakers and staff. If they leave this year, they think they can continue to be covered under the current health care plan.

“I’ve lost one staffer who told me in confidence that he had been here for a number of years and the thought of losing the opportunity to keep his health insurance on Dec. 31 [forced him to leave]. He could keep what he had and on Jan. 1 he would go into that big black hole,” said Bonner, who had already planned his resignation from Congress. “And then I’ve got another staff member that I think it will be a factor as she’s contemplating her future.”

Lawmakers and aides on both sides of the aisle are acutely aware of the problems with the provision. Speaker John Boehner (R-Ohio) and Senate Majority Leader Harry Reid (D-Nev.) have discussed fixes to the provision. Boehner, according to House GOP sources, believes that Reid must take the lead on crafting a solution. Since Republicans opposed the bill, Boehner does not feel responsible to lead the effort to make changes.

The Affordable Care Act — signed into law in 2010 — contained a provision known as the Grassley Amendment, which said the government can only offer members of Congress and their staff plans that are “created” in the bill or “offered through an exchange” — unless the bill is amended.

Currently, aides and lawmakers receive their health care under the generous Federal Employee Health Benefits Program. The government subsidizes upward of 75 percent of the premiums for the health insurance plans. In 2014, most Capitol Hill aides and lawmakers are expected to be put onto the exchanges, and there has been no guidance whether the government will subsidize those premiums. This is expected to cause a steep spike in health insurance costs.

There have been many options for fixing the problem discussed throughout the year, including administrative fixes and legislative tweaks. One scenario seen as likely on Capitol Hill would have OPM simply decide that the government could still subsidize insurance on the exchanges.

House Democratic leadership says the issue must be resolved.

“The leadership has assured members that fixing this issue is a top priority,” said one Democratic leadership aide. “This issue must be fixed by administrative action in order that the flawed Grassley Amendment’s spirit is honored and all staff and members are treated the same.”

It could be politically difficult to change this provision. The provision was put in the bill in the first place on the theory that if Congress was going to make the country live under the provisions of Obamacare, the members and staff should have to as well.

The uncertainty has created a growing furor on Capitol Hill with aides young and old worried about skyrocketing health care premiums cutting deeply into their already small paychecks. Some longtime aides and members of Congress, who previously had government subsidized health care for life, are concerned that their premiums will now come out of their pension.

If their fears are borne out, the results could be twofold. Some junior staff will head for the private sector early while more seasoned aides and lawmakers could leave before the end of the year so they can continue under the old plan.

Several lawmakers said departures could run the gamut from low-level staff to legislative aides, to senior aides and lawmakers. Capitol Hill is an attractive workplace for politically ambitious college graduates, but a core of Capitol Hill aides stick around for decades, serving as institutional knowledge, and earning prized retirement packages.

OPM, which administers benefits for federal employees, is expected to rule in the coming months on how congressional health care is to be administered. OPM did not respond to a request for comment.

More than a dozen senior aides interviewed by POLITICO about the issue declined to be named out of fear for future job prospects. The problem is most acutely felt at the staff level, where aides make between $35,000 and roughly $170,000 and budgetary problems have all but stopped pay increases and bonuses. Lawmakers have questioned leadership aides about the future of their health care.

“Between the constant uncertainty surrounding sequestration, and the likelihood aides will soon be paying for the subsidy portion of their health care coverage, congressional office budgets are being squeezed once again, and it’s causing a lot of concern amongst chiefs of staff regarding how to best handle the situation,” said one chief of staff to a senior Democratic member of the House. “Do we give raises to junior level aides so they can afford to pay for their higher health care costs, and if so, where do we find the funds to do so? Additionally, leadership has been relatively silent in terms of providing guidance to offices, which is frustrating.”

There are other ways that aides can fully avoid this problem. If they’re married, they can join their spouse’s health care plan. If they are 65, they can go on Medicare.

But the focus right now is centered on lawmakers trying to figure out how to offset potential increases in premiums.

“I know other members are doing the same thing in terms of what we can do to offset [premiums],” Rep. Tom Cole (R-Okla.) said. “You are particularly limited now because of course we’ve had the cuts in the [member office allowances] on top of this. You just don’t have a lot of options.”

Cole added, “A lot of the staff stays on largely because of the benefit levels and particularly if you’ve got people with families and it’s extraordinarily important to them … it’s just not right.”


***************


Just in case you thought that the same rules should apply to the federal government that they apply to you...



this is probably a good thing :) Ralph Nader proposed in 2000 that members of Congress (i guess this could apply to staffers as well) be paid the average salary of the people they represent so that they are more sympathetic to the circumstances of their lives. If the people writing the laws are struggling with the same plans as everyone else that takes us one step closer to single payer.

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