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ACA Calculator (Page 2)
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 2013-12-05 4:51 PM in reply to: Stuartap |
Champion  34263     Chicago |  Subject: RE: ACA CalculatorOriginally posted by Stuartap Originally posted by mr2tony Originally posted by Stuartap mr2Tony he actually doesn't have to get used to being a small employer. I have had two clients over the past two years break up their companies by division into distinct legal entities to get under 50 Employees each. Both are growing and both provide benefits. They are just not going to subject themselves to the large group penalties. We certainly agree this law is not going away. But please don't underestimate the American people in finding ways to avoid, evade or game govt regs. Not saying it is right, just a reality. Moreover, as people begin to realize the impact this is going to have on their pocketbooks, expect more to game. Most people are focused on premiums and deductibles etc. Many are not looking into the details. Generic drugs on the cheaper bronze & silver plans for instance are going to be $19.00, not the $4.00 - $10.00 they pay now. Most networks from the same insurance company you may have now will have much smaller networks with the obamacare plans. So much for keeping your doctors. Right you're referring to the people who already have insurance -- that they're going to pay more. While SOME will pay more, SOME will pay less and people who previously didn't have insurance will now have the option to buy insurance. Now, it's up to them to actually go out and buy the insurance. Instead of telling people to NOT sign up for insurance under Obamacare for political gain, people should be encouraging those who didn't have insurance before to go sign up if for no other reason than it's the fiscally responsible thing to do. Having insurance isn't a bad thing, and while it's easy for us who have good insurance and have always had good insurance to and moan and complain that it raises our rates, or in your case HYPOTHETICALLY raise your rates, people who've had zero option for health insurance in the past now have that peace of mind. Also, people who have pre-existing conditions including cancer can't be denied coverage. I know I'm a `bleeding heart' over here but I honestly can't see how that's a bad thing. You call it redistribution of wealth, but even if I paid for my healthcare under the ACA out of my pocket, it'd total less than 4% of my income, and that's without subsides. I wouldn't be too upset considering that would keep me from havnig to declare bankruptcy if I get knocked off my bike by a drunk or texting driver while hopefully providing healthcare that will keep someone else from having to declare bankruptcy if they get knocked off their bike by a drunk or texting driver. First you seem to be confused. I never said I was against anyone having insurance. I don't consider you a bleeding heart for wanting those people denied coverage in the past to be able to purchase it. Second, let's clear up any confusion between hypothetical and reality. I have had a large number of clients lose their coverage, cancelled due to ACA mandates. So far I have had exactly 1 person who will be paying a lower premium (0.9% to be exact) but for a higher deductible and higher out of pocket max so when she gets hit by that car, the small premium savings is wiped out by the $2350 higher out of pocket. FYI, over a sample of several hundred the average premium increase is running 40% and that 1 person with a lower premium leaves 99.5% paying more. Second, it is very nice that your premium driven by age or location is such a small percentage of you salary which may be a good one. However all is not so good with the rest of the world, Here are some numbers for a couple that are not so fortunate. Both age 60 living in San Jose. He makes $70k/year, she can't work due to advancing RA. At that wage he does not qualify for a subsidy. They are being forced off their old plan because of the ACA mandates. They have been paying just over $8000/year for insurance. The cheapest ACA plan for them is $12,948/year with a higher deductible and higher out of pocket. Doing some quick math that works out to a premium equal to 18.5% of their PRE-TAX income, not exactly 4%. Now if he gets hit by that car and has to pay the $12,700 out of pocket as well that totals $25,648 or almost 37% of their PRE-TAX income. Given that CA has the highest state income tax rates in the country along with the federal income tax rates that number is easily 40-45% of their take home pay. That is the reality my clients are dealing with. No subsidy, much higher rates, higher deductibles, higher out of pocket expenses, higher drug costs and fewer doctors. My problem is I am not finding anyone here in CA that is better off on the new ACA plans then they were before. That includes my 29 year old daughter. It is not an issue of 'some' paying more and some paying less. It's people who pay for their own coverage overwhelmingly paying more, people getting subsidies causing all taxpayers (the 52% that actually pay taxes) to pay still more and govt getting a shiny new entitlement program to manage badly. And before you tell me healthcare is more important than money please accept the economic reality that money is not an inexhaustible resource. People paying thousands of dollars more for healthcare premiums, even if they never go to the doctor, is money not spent on something else, slowing down our economy. The subsidies and millions moving to Medicaid are costing the govt billions. In the event you don't remember, the govt makes no money. All its 'revenue' is that it takes from its citizens. Sorry to hear about your friend, that sucks. I know of a couple people whose premiums declined due to the ACA and I know SEVERAL people who now have insurance that didn't prior to this because they couldn't afford it. And yes, of course I know people whose rates have risen, most of them by small amounts. We could go back and forth all day with this `I know a guy who ...' anecdotal evidence but that would get old quickly. So what do you think is the solution? Cheap healthcare across the board for everybody, thereby putting the insurance industry, effectively, out of business? Or would you suggest we allow people who can't afford health insurance and can't afford to pay for medical care be turned away? Or should we just do nothing and put it back to the way it was before the advent of the ACA? |
| 2013-12-05 5:28 PM in reply to: mr2tony |
Extreme Veteran 1190 Silicon Valley | Subject: RE: ACA Calculator Being in the business and having looked at hundreds of these I hope my experience is a bit more than anecdotal but your point is well taken. You are asking the right questions though. "So what do you think is the solution?" Obviously we need to find a way to offer coverage to all. Unfortunately I don't think we found a viable solution here. When you break down the uninsured numbers, despite the number of 40-50 million being thrown about, that is not there real problem number. You are counted as uninsured even if that is only for a brief while between jobs. The CBO estimated that over 20 million fell into that category (lost coverage for 90 days or less). Another 8-10 million were eligible for existing programs but did not enroll because they didn't need any healthcare services. Another 8-12 million were unemployed by choice per the census bureau. They made enough money to afford coverage, and it available and chose to not have any (young invincible). So the real number of people who actually wanted coverage and could not get it was somewhere in the 10-15 million. So let's start with right sizing the problem. A big problem yes, but easier to solve than 50 million. Most states have a high risk pool of some sort. Here in CA the cost was about $5500/enrolled. I am sure some cost the state tens of thousands and others much less than the $5500. Using that as a benchmark lets get creative with the math. If you increased every insured premium by $26.44 times the 260 million people who are insured you have the $82.5 billion required to fund the $5500/insured for 15 million people. However, that assumes that each participant pays nothing. If each of those participants could pay as little as $100/month that reduces the funding need to $64.5 billion or just $20.67/per insured/month. The direct obamacare taxes per policy are almost $60/month. Want another idea? Make people who chose to buy a brand name drug when a generic is available pay more than just the co-pay. A brand name statin costs to an insurance company runs about $75.00 and up to almost $200. If you had a $20 co-pay you stuck the insurance company with the $55/month because of your ego. Today most Anthem policies charge you the co-pay plus half the difference if you chose a brand name when a generic is available. Sales of brand name drugs that have generic equivalents runs in the tens of billions. Let's capture some of that money. There are lots of ways we could have funded good impaired risk health plans but we all need to remember that ACA was a political document not a healthcare document. I firmly believe that intelligent minds that are knowledgeable about the issues and not just politicians from one party, could have crafted a much better solution. |
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