It looks like big business won the fight over Obamacare or so it seems. The original plan was to mandate any business with over 50 employees to offer health insurance to their employees or face a $2,000 a year penalty for each employee. But businesses have a one year extension. It was the ACA (Affordable Care Act) bureaucrats who put the brakes on because they were getting so many calls from businesses complaining that the law was confusing and they threatened to stop hiring and cut current employees hours to under 30 a week, to circumvent the law. However, all the places I shop at tell me, all their employees are working part-time anyway and have been for awhile. So technically, those businesses, like Target, The Dollar Store and Ralph’s won’t have to pay anything, but their employees will.
It is my understanding that the individual mandate will still be in effect though. This October those without health insurance will be able to buy health insurance through the health care exchange. At least that is the plan — but I am guessing that since we will be dealing with a bureaucracy, it will still be confusing to people shopping for insurance.
It is my understanding that most Americans are currently living paycheck-to-paycheck. Where will they come up with the extra cash to pay for health insurance premiums? Most HMOs require co-pays as well, which are expected to go up — if someone already has trouble paying their bills and manages to buy the cheapest policy available, how will they come up their co-pay? The majority of healthcare providers expect payment immediately. Will they rack up credit card debt to pay their medical bills? Also, since this is a Federal law, how will the share-of-cost be calculated? It costs a great deal more to live in Orange County than, let’s say, Desoto County, Mississippi. A family of four with an income of $30,000 annually ( that’s gross income) can buy a lot more in Mississippi than Anaheim.
Another question is — how will people applying for help with coverage be expected to show proof they can’t afford it and what kind insurance will they be offered? Have you ever tried to get Medi Cal, or even food stamps? The paperwork is endless. Will those with pre-existing conditions be able to get treated for their illness immediately or have to wait a full year? The original law gave insurance companies a pass on the pre-existing part of the plan — they do have to cover people with pre-existing conditions but not for the first year. In other words, a person will be covered if they break their leg, but not if they have heart disease at the time they buy a policy. There is a lot of “fine print” hidden in those 1500 pages of the ACA handbook.
I think the real reason the ACA is pushed back another year is because, back in April of this year, Congress was trying to get their staff exempted from the mandate. The problem stems from whether members and aides set to enter the exchanges would have their health insurance premiums subsidized by their employer — in this case, the federal government. If not, aides and lawmakers in both parties fear that staffers — especially low-paid junior aides — could be hit with thousands of dollars in new health care costs, prompting them to seek jobs elsewhere. Older, more senior staffers could also retire or jump to the private sector rather than face a big financial penalty. If they think staffers will have trouble coming up with money to buy health insurance, what about the guy working at Target or Marie Callenders?
Allowing businesses to get an extension will cause the government to lose out on the expected 10 million in revenue that they hoped to get from businesses who opted to pay the fine. But our leaders just hate living under the same rules they create for you and me. In fact, they exempt themselves from all laws they implement, that’s why they don’t want to go back to the private sector.
I completely understand the need to make sure people get the healthcare they need but this sounds like a train wreck. The ACA does nothing to deal with rising healthcare costs and health insurance costs. I am suspicious when it was the health insurance companies that helped write this law. Very suspicious indeed.
*Inge…..the actual number is 10,000. That is the number of small businesses that will be impacted because they would be forced to alter their businesses with over 50 employees. This amounts to almost 8% of the total number covered in the ACA. You of course are right about much of what you said however. There are serious issues regarding “who is covered” and “who gets help” and “who qualifies when they don’t have Medicaid”?
Not to worry……”Dam the torpedoes…..full speed ahead!” It is guaranteed ot drive every Republican partisan into a Pizza Parlor of their own choice! No beer however!
Inge — people who can’t afford it will get waivers.
Employers are using Obamacare as an excuse to justify what they are doing anyway. We should not let them get away with that BS.
As for “the ACA does nothing to deal with rising healthcare costs and health insurance costs,” that is at best premature and more likely plain false. We have a good progressive insurance commissioner in this state, Dave Jones. He’s the guy who has tried to roll back insurance rates and is using insurer access to the exchanges as a sledgehammer to get concessions. You should check out what he has to say about it.
Greg, who decides what people can afford? I deal with the state all the time. Have you personally had too? I get conflicting letters from their agencies on a regular basis. One says yes, I qualify. Another says no. I disagree with you…employers should not have to foot the bill for health insurance. We need National healthcare. It is unreasonable to expect employers to come up with x amount of dollars to cover employees.
Let’s say Bob employs 51 people. His annual premium per employee will be ($5,000) that’s low balling it. His total annual extra bill = at least $50,000 a year. Its easy to tell someone else to pay that amount of money. What if it were you?
And when an employee leaves his/her job, they will lose their coverage. Its not as easy as you might believe and it sounds to me like the insurance will be minimum coverage…what about those who get cancer? heart disease, etc???? How will they be able to afford it?
I have great doctors where I am at BUT I am well aware that if I didn’t have money to pay them, I am ass out. Insurance companies have all the power. No authorization = no test or procedure. Its ALL about money and you watch Congress will exempt their employees.
The standard is right there in the legislation, Inge.
National healthcare would be better. We don’t have an electorate, or a political structure (given the use of the filibuster in the small-state-dominated U.S. Senate), that will allow those who opposed it to be punished. So this is what we could get.
If Bob is now providing health insurance he may reduce salaries to account for it — and Bob’s employees still come out ahead because of the value of having health insurance rather than hospital emergency room treatment.
As for your other questions, you have to read the bill. These are good questions and there are answers out there.
This cuts into the power of insurers — who recognize that, if they blow it, we will before long see a “public option” that will hand them their asses.
*Great Ones…..the number of changes implemented before ACA becomes fully functional will be amazing to all. Inge – your point on cost is very important. If the government subsidizes too high…in order to please the Insurance Companies…the cost will rise geometrically for all of us that make premium payments through our work or independently. If the Government pays too low…….the exact same thing will happen. Without a doubt, the pharmaceutical payouts need to be controlled first. Then the youngest applicates second. Then the Pre-Existing Conditions Third. Additionally, family Insurance program need to be required. Let’s say that the family has six members. The father only gets Insurance for himself…so he won’t be penalized on his tax form. What happens to the other five members of the family…
without coverage?
Lot’s of unanswered questions to be sure.
Hey, y’all — read this story in Slate by Dave Weigel — a longtime blogger who’s critical of both parties and not iconoclastic just for the hell of it — on the topic that Inge introduced. Good stuff.
good find Greg…how many hours do you spend online? Reading…reading…reading… I am critical of both parties too
…
I still say it’s not the employers responsibility to pay healthcare premiums. I want single-payer or Medicare for everyone.
Carl, it isn’t as easy as you claim “just do responsible thing”…if someone earns $11 – $15 an hour…and has to go to private market to buy insurance they get a choice of (if they have pre-existing condition, which majority do) to spend $500 a month, with $5,000 annual deductible or $1500 a mth premium with $1500 deductible. Doctors expect payment immediately.
Insurance companies raise premiums whenever they want even w/o ACA…because they can. I know many people who were dropped from their insurance when they got seriously ill.
I get e-mail alerts, Inge. Plus, my Facebook page is Hall of Fame-level. People clue me in on what I need to know.
First off, the entire Obummercare fiasco needs to be trashed, period. It’s the single largest corporate welfare package in history. NOBODY knew what the entire mess consisted of when they passed it, which should be illegal to begin with.
Second, it’s insane albeit legal, per SCOTUS, which I still don’t really understand but so be it. It’s still crazy to burden the poor and the young as it does.
Third, the ramifications of it will cripple the health care system as we now know it. It will reduce the amount of coverage granted to those of us who were responsible and have good insurance, that we are now paying a shitload more for. Affordable Care Act, MY ASS! Our premiums at work have nearly doubled!
If anyone thinks that trivial, then you haven’t seen the lack of raises that goes along with reduced profits and increased cost of business since the mortgage industry collapse. Now this increase in cost without a benefit increase…Oh that’s going to fix the “healthcare crisis” for all of us…BS!!
Energy costs, healthcare costs and tax increases, all lead to a less than ideal marketplace for small business in this state and the nation overall.
Way to help the economic recovery to ALL the elected’s that think somehow government is the answer. Central planning has been and will be, a folly of failure. Didn’t any of you dolts learn from history? When Pravda gives US lessons in history and freedom, you know things have gone terribly wrong.
*Commandante Carlo – The OLD SYSTEM was totally broken. The Cost of Coverage was on the verge of doubling every other year! That is what they call UNSUSTAINABLE. So, using the broadest brush in the artist bag….they came up with something that would not upset the Insurance Companies. (make everyone pay) and the Doctor’s and Healthcare Professionals who always find a way to work around any system.
Little doubt this will not be like spreading smooth peanut butter on a soda cracker, but if you want the reward….you need to do the deed!
Yet, more importantly – give us YOUR BEST SOLUTION scenario. Single Payer perhaps? Make every person with a Social Security Card get a bill in the mail every month? Make everyone drop their current coverage and start all over again? Allow no one with a Pre-Existing Condition to ever get Health Coverage ever again? Make poor people and the young pay double what old folks pay?
We are just saying……..Come up with some alternative measures which the Loyal Opposition of Rand Paul, Ted Cruz and Mitch McConnell will buy off on.
Single payer, THE PATIENT.
When you could negotiate with the doctor directly and were responsible for the bill, directly it was much better. You only needed to buy catastrophic insurance and/or major medical, had a regular doctor and an ER visit for a broken bone, including x-rays cost less than $500 for the most part. (at least most of mine were)
I had loads of them when I was young and couldn’t afford them, but paid them anyway because I was responsible. I think Anaheim Memorial had me in there files as a “regular” back in those days! They all knew me by first name at least. That was before the days when they couldn’t refuse a patient too, as I remember it.
The drug companies couldn’t advertise on TV or print and deduct it from their bottom lines, which has increased the costs of medicines exponentially.
It was also prior to the days when lawyers would descend on doctors like flies on dog excrement. Today nearly 50% of a doctors income is paid to malpractice insurance. It was also unheard of to sign a arbitration agreement prior to treatment.
The medical community could lower their staff and overhead without the medically unproductive baggage of insurance companies and lawyers and lower the price to consumers as well.
The entire process has been greatly inflated with the increased payload of carrying all the dead weight of the non medical requirements of the current system.
*You have it right sir! We have deduced the problems exactly. Now for the solutions……the big one being rejecting Pharaceutical TV……to start!
no kidding…I have seen so many commercials for erectile dysfunction…I think I have it!… probably because I had chicken pox as a kid.
“It was also prior to the days when lawyers would descend on doctors like flies on dog excrement. Today nearly 50% of a doctors income is paid to malpractice insurance.”
Uh, if, just hypothetically, that’s not true, then how much does that change your mind?
Greg,
I know several Dr’s who pay MORE than they take as gross wages, on a yearly basis to their insurance providers, they are in several different specialties. One recently decided to close his obstetrics practice and return to Singapore directly because of the legal climate here. Not one thing hypothetical about it.
They should join HMOs then. No lawsuits for negligence.
What’s your understanding of the burden that Obamacare places on the poor, Carl? (Admittedly, that burden would be lower if certain Republican Governors would not veto Medicaid expansion in hopes of seeing the program fail. Ethically, that’s criminal.)
“Ethically, that’s criminal.”
In a legal sense that comment is illogical.
Implicitly asserting that the adjective “criminal” is never used outside of a formal law and justice context is a criminal waste of people’s time.
Greg,
I need you to define your understanding of “poor” before I can even begin to answer your question coherently.
My major concern is the damage to the over all medical system that this bill has and will cause.
The effect on those who have been responsible with the way they have approached and managed their own medical care, costs and planning is being turned on it’s head with the revised regulations of the Affordable Care Act being finally put into place so we can see the effects, have been startling and expensive.
Once again, as a society, we seem to reward those who didn’t act and punished those who are responsible.
Somehow this doesn’t seem real intelligent to me.
The definitions of who would receive income-based exemptions and subsidies are in the bleeding law itself, Carl. Read it.
One definition of poverty is provided by the Health and Human Services Department. Their definition is based on data provided by the Census Bureau.
https://www.federalregister.gov/articles/2013/01/24/2013-01422/annual-update-of-the-hhs-poverty-guidelines
http://www.census.gov/hhes/www/poverty/methods/definitions.html
As I recall, subsidies were provided for people up to something like 200% of those figures, but I’m sure that Carl can look it up for us.
Greg,
Please Greg, your definition vs what’s in the Bill might be two different things and certainly would be debatable among folks generally overall.
Since you already know the answers to your own question, one frankly that I did not address in my earlier comment, I will leave the education to you.
My issues with the “Affordable Care Act” are simply founded on the pure fact, that there is no clearly defined “right” to healthcare and as such it’s simply not a matter that federal govt has the authority to be engaged in to begin with. Please show me, if you will, where it is clearly defined anywhere as a right, further that Congress has the legal authority to do so?
How we got there is another point as well and we did so progressively …
As Justice Roberts pointed out, Congress is empowered by the Taxing and Spending Clause in Article I, Section 8, clause 1 of the Constitution to levy taxes to promote the general welfare.
For economic reasons (even if nothing else like saving lives), providing health insurance to people can be construed to serve the General Welfare. (That’s Congress’s call, unless it’s really, completely, obviously, madly out of line.) So there’s the basis of Congress’s legal authority to do this.
I’ll admit that this was somewhat confusing because the Obama Administration was adamant that the imposition of mandates was not a tax. I was one of those progressives who argued — at one point even creating a very long piece of doggerel to make the argument — that “of course it’s a tax and you’re not fooling anyone.” I appreciate that Roberts pulled Obama & Co’s chestnuts out of the fire by just ignoring their argument.
I was following this extensively from 4.5 to 3 years ago; I just can’t recall the specifics of it. It was something like 200% of the poverty line.
Carl, If I understand you correctly…if someone cannot afford to buy health insurance and/or buy health care services, then they are out of luck and should just croak. Is that about right?
no exemptions for anyone, not POTUS, not congress, not favored unions. all in or scrap it. what’s good for me is good for obama
Inge,
Medicaid is the United States health program for families and individuals with low income and resources. The Health Insurance Association of America describes Medicaid as a “government insurance program for persons of all ages whose income and resources are insufficient to pay for health care.” (HIAA, pg. 232). Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States. It is a means-tested program.
I like this headline better:
Obamacare Postponed One Year Due To Un-workability Program and the Incompetence of POTUS
California’s plan under the ACA/Obamacare health reform is called Covered California. Its website is http://www.coveredca.com. To avoid some of the paperwork that Inge mentions when applying for Medi-Cal and Food Stamps, there is an online application system: http://www.mybenefits calwin.org.
Do they still call themselves the Compassionate Conservatives? Pennsylvania Gov. says poor children, pregnant women & breast cancer patients should pay more for health care http://thkpr.gs/12VG2IL