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2012-06-29 11:51 AM
in reply to: #4286891

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Highlands Ranch, CO
Subject: RE: What happens with Health Care
trinnas - 2012-06-29 10:43 AM
sbreaux - 2012-06-29 12:38 PM
tech_geezer - 2012-06-29 10:35 AM
scoobysdad - 2012-06-29 11:58 AM
dontracy - 2012-06-29 10:51 AM
trinnas -

I thought heading into this that if you liked your insurance you could keep it.  Lot's of folks in my industry like this kind of insurance. 

We were also told that ObamaCare would not be funded by a tax increase and that if we made under $200K we wouldn't have to pay anything more.

There are fees and some bizarre stuff I was not aware of yesterday like the tax on tanning booths, but basically it is true that if you make less than $200K you will not incur any direct costs due to the ACA, unless you go to a tanning booth.  High wage earners pay more Social Security tax. Title IX of the bill deals with the revenue for all the costs of the service.  Her

Government administrative costs for administering insurance exchanges are paid for by insurance companies who particiapate in the exchange.   These are called " user fees" not "taxes" but that distinction is ignored by those who want to use more inflammatory language and call them taxes.  Users of regulatory services are frequently charged a fee for accessing the regulatory service, like you pay a fee to go in a national park.  Is that a tax to you? 

Lots of folks are grinding the numbers on revenue and the impact it might have.  What we have in this formum is a lot of people speculating without actually reading the law or doing the numbers.  I will be happy to google if for you if you can't do it yourself. 

Thanks, that was my impression too, ie no direct tax implications for those making less than $200K. 

Oh so as long as we tax somebody else it's all good!!!

Can you really get much more hypocritical than this.

I'm not being hypocritical.  I was just trying to get a simple clarification on a statement that I believed to be untrue.  I never once said "it sucks to be 1%'ers cuz they have to pay more in taxes".  Now that the legislation is moving forward, all I am trying to do is determine how it will affect ME! 



2012-06-29 11:54 AM
in reply to: #4286893

Master
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Houston, TX
Subject: RE: What happens with Health Care
pilotzs - 2012-06-29 11:45 AM
jgaither - 2012-06-29 11:29 AM
pilotzs - 2012-06-29 11:11 AM

And, to expand on the employer providing coverage above, I don't know what % they are paying now, but it's my understanding (in simple form), that employers will be required to cover 60% at a minimum of the total coverage amount.  I don't know how that plays into single vs. family coverage.

I've seen something like this too, but thought it was something to do 60% meant you got a full tax credit whereas 40% meant you got an 80% tax credit etc......  It's been a LONG while since I saw that, so I could be mixing things up.

 

Here is a diagram, interesting.  I don't know how they interpret the 60%.

http://healthreform.kff.org/the-basics/employer-penalty-flowchart.aspx

and

http://www.academyhealth.org/files/nhpc/2011/AH_2011AffordableCareReportFINAL3.pdf

yeppers.  mixed it up.  There are so many numbers and provisions flying around in this thing, one could make a career out of consulting on it.  oh look!!!!  One new job created!!!!

2012-06-29 12:01 PM
in reply to: #4286174

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Subject: RE: What happens with Health Care

For those who are speculating on the idea of only joining the plan when you discover you are ill, there will be ANNUAL OPEN ENROLLMENT PERIODS. 

 

Here is the text of the law.

(6) ENROLLMENT PERIODS

.—The Secretary shall require an Exchange to provide for—

 (A) an initial open enrollment, as determined by the Secretary (such determination to be made not later than July 1, 2012);

 (B) annual open enrollment periods, as determined by the Secretary for calendar years after the initial enrollment period;

 (C) special enrollment periods specified in section 9801 of the Internal Revenue Code of 1986 and other special enrollment periods under circumstances similar to such periods under part D of title XVIII of the Social Security Act;

 and

 (D) special monthly enrollment periods for Indians (as defined in section 4 of the Indian Health Care Improvement Act).

2012-06-29 12:06 PM
in reply to: #4286908

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Elite
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Subject: RE: What happens with Health Care
sbreaux - 2012-06-29 12:51 PM
trinnas - 2012-06-29 10:43 AM
sbreaux - 2012-06-29 12:38 PM
tech_geezer - 2012-06-29 10:35 AM
scoobysdad - 2012-06-29 11:58 AM
dontracy - 2012-06-29 10:51 AM
trinnas -

I thought heading into this that if you liked your insurance you could keep it.  Lot's of folks in my industry like this kind of insurance. 

We were also told that ObamaCare would not be funded by a tax increase and that if we made under $200K we wouldn't have to pay anything more.

There are fees and some bizarre stuff I was not aware of yesterday like the tax on tanning booths, but basically it is true that if you make less than $200K you will not incur any direct costs due to the ACA, unless you go to a tanning booth.  High wage earners pay more Social Security tax. Title IX of the bill deals with the revenue for all the costs of the service.  Her

Government administrative costs for administering insurance exchanges are paid for by insurance companies who particiapate in the exchange.   These are called " user fees" not "taxes" but that distinction is ignored by those who want to use more inflammatory language and call them taxes.  Users of regulatory services are frequently charged a fee for accessing the regulatory service, like you pay a fee to go in a national park.  Is that a tax to you? 

Lots of folks are grinding the numbers on revenue and the impact it might have.  What we have in this formum is a lot of people speculating without actually reading the law or doing the numbers.  I will be happy to google if for you if you can't do it yourself. 

Thanks, that was my impression too, ie no direct tax implications for those making less than $200K. 

Oh so as long as we tax somebody else it's all good!!!

Can you really get much more hypocritical than this.

I'm not being hypocritical.  I was just trying to get a simple clarification on a statement that I believed to be untrue.  I never once said "it sucks to be 1%'ers cuz they have to pay more in taxes".  Now that the legislation is moving forward, all I am trying to do is determine how it will affect ME! 

I am in the 1%.  I have no objection to the law.  I will pay my increased share as determined by law.

2012-06-29 12:21 PM
in reply to: #4286898

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Subject: RE: What happens with Health Care
jgaither - 2012-06-29 11:46 AM
pilotzs - 2012-06-29 10:50 AM  

My take on your second question, is that many 50+ companies are seriously thinking about dropping coverage all together and sending employees to state exchanges.  There are many reasons for this, but the ones that I've researched are following:

1) It's 1/2 the price to drop the coverage and pay the penalty, than continue to keep the insurance coverage, and the associated increases that will likely come.  MUCH cheaper to just drop insurance all together and send employees to the exchange.

A couple things you're leaving out here are that 1) it currently is more advantageous for a company to not offer heatlhcare.  Why do they not drop it today?  they would save money, would they not? 2) does this not create more competition in the health insurance market?  In order to keep participants, they can not charge too high a price.  the larger their pool of participants the more effective they can be.  I only bring these up as market conditions that effect pricing.

As it's more advantageous to not offer healthcare right now, employees have no alternative to affordable health insurance, so a company must be competitive in the market place, plus our company cares for it's employees.  That is why it's a big unknown, how companies will eventually make the decision to offer or not offer coverage.  When the exchanges open, and employees can go to the exchange and pay the same as they are paying now, and get a credit for the remainder, they now have an alternative and companies have an alternative to providing health coverage.  In our instance, it may be more affordable for them to go to the exchange anyway and leave our company with a possible penalty.  Our company set the amount they would pay a few years ago, and passed increases along to the employee (to share costs).  After the passage of ACA, our company decided to stay with a 60/40 split going forward, as we had gotten to a 55/45 split.  So, is it an easy decision, no.  Is there reason to seriously consider dropping coverage all together, yes.  I think it's a toss up on what premiums will do based on the market.  That may or may not be a risk a company wants to assume. 

2) Even though you provide coverage, does not guarantee that you will not be penalized and taxed as a company.  Employees will be free to leave your plan, and go to the exchange to purchase insurance.  For many businesses, it will be  more advantageous for the employee to go the exchange and get the subsidy, than to keep the insurance that the employer provides.  If your employee does this, the company has to subsidize the insurance up to what they would have paid anyway, and pay a penalty.  And, it's my understanding, that the employee can take the full or partial (offset by the employer subsidy) benefit of the subsidy offered via the government too (I'm a bit fuzzy about this though).

I agree this part of the law is all kinds of convoluted and whacky.

Either way, it's generally setup, where the incentive is for the employer to drop coverage, and send employees to the exchange.  Hence, the argument, that the ACA was setup as a first step to a one payer system.

Currently employees have the option to leave and get healthcare elsewhere and while it won't cost the company anything, there is a disincentive to offer healthcare as much now as in 5 years.  In fact it seems to me there is a greater incentive to offer a more affordable option so that employees DON'T go to the exchange.

Yes, employees have the option to leave now, but they don't have an affordable option.  Now, with the credits and the exchange, it becomes much more attractive as an alternative to the employer provided coverage.  Of course, the exchange may or may not offer better coverage.  That remains to be seen.  The employer may be tired of dealing with health insurance, it's costs and possible future unknowns, that now they have an option to send employees to the exchange without feeling bad about it, as they have an option now that was not presented before.  Each company will be different, based on employee makeup, etc.  I'm probably wrong about employers possibly dropping coverage, as it's all speculation right now, but it would not surprise me if they got out of the health insurance business all together, and used the ACA as the excuse.

Now, the big unknown, just as it was when employers started offering health insurance as a benefit, is how competitive companies will get to attract employees with insurance coverage.  But, that is only sustainable up to the point where the business can afford to pay for the insurance and the increases of premiums.

I agree it will be interesting to see how this one plays out.

I could be wrong on some of the above, but that is what I've gathered from the times I've looked through the information of the ACA and a couple of classes I've taken that have discussed it.    I might have misinterpreted something or multiple items.

2012-06-29 12:39 PM
in reply to: #4286907

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Subject: RE: What happens with Health Care
trinnas - 2012-06-29 12:51 PM

Left Brain - 2012-06-29 12:49 PM This thread is like a soup sandwich. Laughing

You think that's bad try the hospital Chili I had for lunch.

In what world did that even seem like a good idea?



2012-06-29 4:00 PM
in reply to: #4286174

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Champion
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Williamston, Michigan
Subject: RE: What happens with Health Care

The basic problem is that no matter what SOMEONE is going to have to pay for care.....you have a heart attack get hit by a bus....someone or some plan (car, home, health) will have to pay for care.  WHo is it....

As a physician I think that healthcare and we really are NOT talking about healthcare we are talking about INSURANCE reform, will get worse before it gets better.  Some problems as I see them

1-Exclusion for pre-existing conditions.  This needs to be fixed.  I have seen plenty of people who have something wrong that makes them uninsurable.  Often their only option is to go on medicaid.  I have seen pts who had to get divorced because their spouse made too much money to be on medicaid and it was the  only way to have costly medical problems paid for.  The other problems is if you are excluded for a heart condition you can't get insurance for ANYTHING so if you break your leg no insurance for that either.

2-My biggest fear is we are going to FORCE people to buy insurance that provides them essentially no care or cost prohibative care with huge co-pays and deductibles that bascially only cover catastrophic things.  We have been developing this for years.  CO-pays go up premiums go up and they cannot afford to get care anyway

3-Insurance costs are going to go UP UP UP.  You are kidding yourself if you think this isnt' going to happen.  Insurance is a game to NOT PAY.   For anything.  If there is any excuse to raise prices they will.  Businesses will offer plans,some will drop them and some won't be able to afford them or pass the costs onto the employees

4-They need to make costs and payments to hospitals and doctors the SAME.  How much you get paid is basically determined by your zipcode.  Why am I worth 400% more in Texas or Wisconsin than I am in Florida or New York for the SAME SERVICES?   Its totally stupid. 

5-I think the need a stop gap between medicaid and commercial insurance. Like a partially funded program or something like that.

6-Make insurance companies more accountable for their services.  They can just willy nilly refuse to pay or not pay because a pen line strays out of a box on a piece of paper.  The longer they delay the harder it is to get paid.  Then they claim its untimly filing.  There are companies who just don't pay claims for the first couple times hoping you stop filing the claim.  It makes  and their shareholders HUGE money.

Seriously I could fix this in a week if they would let me at it but there are too many special interest groups and too many people who have jobs grinding this crap out to do something sensible.  TOO MUCH MONEY

2012-06-29 4:20 PM
in reply to: #4286174

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Subject: RE: What happens with Health Care

One of my FB friends posted this video last night.  It actually does a halfway decent job of trying to explain the ACA in simple english and examples.  It's supposedly non partisan, but I'd say they generally lean towards supporting the law.

http://www.youtube.com/watch?v=3-Ilc5xK2_E&feature=player_embedded

(I do find it humorous that they have our National debt at $7 Trillion around 8 minutes into the video)  haha

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