Unabogie
Philosopher
That hasn't been quiet. The "risk corridors" have been discussed since the beginning.
http://us.milliman.com/insight/2013/Risk-corridors-under-the-ACA/
Heeeeeeere's Obamacare!
- Thread starter MattusMaximus
- Start date
That hasn't been quiet. The "risk corridors" have been discussed since the beginning.
http://us.milliman.com/insight/2013/Risk-corridors-under-the-ACA/
Emily's Cat
Rarely prone to hissy-fits
I agree; that's a horribly terribad comment he made, with pretty much no basis in reality. I suspect he doesn't actually know what "obamacare" is...
Ampulla of Vater
Illuminator
Here's an anecdote for you:
I am a small business owner. Up until now, our premiums have been based on the average age of the group. Now, under the ACA, the premiums are determined by each individual's age. I have a 60-year old whose premium is going from $329/mo to over $800/mo. She is the oldest, but there are several others in their 50's whose premiums are also going up astronomically.
Should I can all the old people and start hiring young ones or should I just stop offering health insurance as a benefit?
I am a small business owner. Up until now, our premiums have been based on the average age of the group. Now, under the ACA, the premiums are determined by each individual's age. I have a 60-year old whose premium is going from $329/mo to over $800/mo. She is the oldest, but there are several others in their 50's whose premiums are also going up astronomically.
Should I can all the old people and start hiring young ones or should I just stop offering health insurance as a benefit?
Unabogie
Philosopher
Considering that age bands benefit older people more than younger people, I question your numbers and think that yes, you should stop offering insurance and let people who can add and subtract do the shopping.
Ampulla of Vater
Illuminator
Considering that age bands benefit older people more than younger people, I question your numbers and think that yes, you should stop offering insurance and let people who can add and subtract do the shopping.
I have the numbers right in front of me. I assure you they are correct.
Fast Eddie B
Philosopher
Considering that age bands benefit older people more than younger people, I question your numbers and think that yes, you should stop offering insurance and let people who can add and subtract do the shopping.
I see the smiley, but that was totally unresponsive to a real life effect of Obamacare.
I suppose that's one way to dismiss it, though.
I personally am taking to heart all the anecdotes from both "winners" and "losers". Others, not so much.
Unabogie
Philosopher
What I question is that you're comparing apples to apples, since as I said, prices for older people go down. I also question your desire to comparison shop.
But how about telling us a little more about your situation? What state are you in? What kind of policy did you buy that gave insurance to a 60 year old for a mere $329 a month?
Ampulla of Vater
Illuminator
Maryland. And, as I stated, it is a small group policy based on the average age of the insured employees. To renew the exact same policy this year (our renewal date is July 1) is where the new rates become effective. The new rates are directly proportional to the individual's age. There is no such thing as average age-based policies any longer. The physician's group in my same office building is dropping their group coverage and sending everyone to the exchanges when their renewal comes around.
The policy I have has a 1500/yr deductible (which I pay, in addition to the premiums) and it covers at 90%. The RX copays are $10/$30/$50. You are correct though, the new plan changes just slightly. The new out of pocket max is $6000 instead of $3000 and the coverage is at 80% instead of 90%. So not only are they at least doubling the premiums, they are cutting back on the coverage. Great.
There are cheaper alternatives I can choose from, although not by much, but the employees are going to have much higher copays on their drugs and much higher out-of-pocket expenses.
Unabogie
Philosopher
In Maryland, a 60 year old earning $35,000 a year can get a "silver" plan for $271 a month, and a "gold" plan for $336, and a "platinum" plan for $548. The platinum, even without subsidies, is just $721 (zero deductible and out of pocket max $2000). So yeah, over $800 a month is BS.
http://www.valuepenguin.com/ppaca/exchanges/md
You're welcome.
Ampulla of Vater
Illuminator
Yeah, but I can't send her, or anyone else, to the exchanges unless I drop all coverage as an employer. That has ramifications. Besides, she makes more like 50k/year or so.
If I drop the small group plan and send everyone out to the exchanges, do I give them an allotment for their health insurance and, if so, how do you suppose I make that fair across the board? I have some 20-something's who're going to pay far less than all the 50+ year olds. Should they make out just because they are young (and less experienced)? OTOH, if I subsidize the health insurance via allotments, should the 50-something's have to pay more out of pocket because of their age and experience?
I don't like this setup at all. It punishes the older, often better employee.
Unabogie
Philosopher
I was addressing your erroneous assertion that any new insurance would cost > $800. Even without subsidies, your oldest employee can find gold insurance for around $500 a month on the exchange, which is just 50 dollars a week more than what you pay now, and with lower deductibles and OOP max. So she's getting a pretty good deal. I somehow doubt you can't find a comparable rate for her in a group plan if you shop around, especially since you can deduct that cost from your business and get a tax incentive.
As for the 20 somethings, wouldn't they be making less money, and therefore qualify for subsidies? Also, you can set up a MERP:
http://www.zanebenefits.com/blog/bid/97074/What-is-a-Medical-Expense-Reimbursement-Plan-MERP
And pay a set dollar amount per person, which would probably end up about even or better than what everyone is paying now, for better coverage.
Ampulla of Vater
Illuminator
Let’s recap. I did not assert, as you state, “that any new insurance would cost >$800.”
My original post was
All of which is true. Under the ACA, small group insurance is no longer based on the average age of the employees, but rather on each individual employee’s specific age.
You then stated that:
which may be true, however such rates are not obtainable through a small group plan. Additionally, I have shopped around and compared plans and our current plan is the least expensive, unless I want to raise deductibles and other cost sharing options. The closest other option is Bluecross and Blueshield, but the deductible goes up, the out-of-pocket maximum goes up and the plan is $8.00 a month more expensive.
So please don’t deem my assertion to be erroneous. I already have an HRA, which is the method I use to cover each employee’s deductible, but thank you for the reading material on MERP’s, also known as HRA’s.
Don’t you think it is interesting that, at least in my state, it is designed to favor sending individuals employed by small groups to the exchange to obtain health insurance? I wonder if that is purposefully designed to increase the numbers of people who go to the exchange so the politicians can claim it to be a success.
As for your question about the 20-somethings, it is possible they might qualify for subsidies, although I give hefty bonuses every year which may bump people out of the subsidy range. Maybe I should do them a favor and not give bonuses anymore.
Unabogie
Philosopher
Let’s recap. I did not assert, as you state, “that any new insurance would cost >$800.”
My original post was
All of which is true. Under the ACA, small group insurance is no longer based on the average age of the employees, but rather on each individual employee’s specific age.
You then stated that:
which may be true, however such rates are not obtainable through a small group plan. Additionally, I have shopped around and compared plans and our current plan is the least expensive, unless I want to raise deductibles and other cost sharing options. The closest other option is Bluecross and Blueshield, but the deductible goes up, the out-of-pocket maximum goes up and the plan is $8.00 a month more expensive.
So please don’t deem my assertion to be erroneous. I already have an HRA, which is the method I use to cover each employee’s deductible, but thank you for the reading material on MERP’s, also known as HRA’s.
Don’t you think it is interesting that, at least in my state, it is designed to favor sending individuals employed by small groups to the exchange to obtain health insurance? I wonder if that is purposefully designed to increase the numbers of people who go to the exchange so the politicians can claim it to be a success.
As for your question about the 20-somethings, it is possible they might qualify for subsidies, although I give hefty bonuses every year which may bump people out of the subsidy range. Maybe I should do them a favor and not give bonuses anymore.
I also own a business but do not have any employees, but I did find this:
http://healthcoverageguide.org/part-one/group-coverage-costs/
It sounds like you qualify this since your employees average less than $50k a year. If so, the ACA then would pay fully HALF of your medical costs, and has been paying for 33% of your costs since 2010, which means you could easily bump up the coverage thanks to this hefty tax credit you're getting.
So YAY, it's a win for your employees. You don't need to fire them or cancel all their bonuses.
Happy day!!!
Fast Eddie B
Philosopher
Again, I just find some of the posts here dismissive whenever someone brings up a negative consequence of the ACA.
Just curious: has anyone here who owns a business actually gotten a tax credit for providing health insurance? Not sure how that would work for a business close to break even that pays little or nothing in taxes. Does the employer just pay the premiums out of pocket over the course of a year, then get a tax reduction to cover it? If that's the case, I know lots of small businesses will face cash flow problems from something like this.
Just curious: has anyone here who owns a business actually gotten a tax credit for providing health insurance? Not sure how that would work for a business close to break even that pays little or nothing in taxes. Does the employer just pay the premiums out of pocket over the course of a year, then get a tax reduction to cover it? If that's the case, I know lots of small businesses will face cash flow problems from something like this.
The tax credit calculator at the site you quoted disagrees with your assertion. Input some employees averaging $49k with $5k each in health care costs and you get a 2% credit ($100 per employee), not 50%.
Well, a lot more people have medical care, people aren't dying as much for treatable diseases, and despite 40-some attempts, the house of unrepresentatives has not succeeded in returning us to the old status quo of "if you're poor, you die".
But we're still arguing?
Yes, single-payer would be better. No doubt, but since people aren't even willing to admit Romneycare is a huge win for absolutely everyone who wasn't in a state that deliberately spiked it, well, why are we still arguing?
Yes, some state legislatures and governors need to be unelected. That's not Romneycare's fault, that's the fault of the people who hate their poor constituents, and coincidentally seem to be determined to keep them from voting via covert poll taxes like "ID cards".
But we're still arguing?
Yes, single-payer would be better. No doubt, but since people aren't even willing to admit Romneycare is a huge win for absolutely everyone who wasn't in a state that deliberately spiked it, well, why are we still arguing?
Yes, some state legislatures and governors need to be unelected. That's not Romneycare's fault, that's the fault of the people who hate their poor constituents, and coincidentally seem to be determined to keep them from voting via covert poll taxes like "ID cards".
Unabogie
Philosopher
Funny, I thought looking up actual rates and comparing them to what the poster claimed, then looking into the law and pointing out that there's a large tax credit that would apply to his situation is the exact opposite of being dismissive?
A MERP (medical expense reimbursement plan) can pay out yearly. So an employer can set up a MERP, employees can pay as they incur expenses, and an employer can pay them back at tax time. I'm not sure that's ideal for the employees. In Ampulla of Vater's case, he's already paying for their insurance on a monthly basis or whatever, so this isn't a problem for him. And as a general note, cash strapped employers probably aren't paying for health insurance anyway. The ACA just adds a hefty tax credit to help them figure out how to make it happen. But since there's no mandate on businesses with less than 50 employees, it may make more sense to decouple employment from insurance anyone and let people enter the market.
If you think about it, this is a much better way anyway. Imagine a person who has a nice corporate job, but buys her insurance on the exchange. The company downsizes and she's laid off, but she doesn't lose her insurance or her doctor, and sees no disruption in care. And finding new insurance isn't the first thing she has to worry about. She keeps her insurance, and hopefully finds another job during her six months of UEI. While she's not working, subsidies pay for part of her premiums. When she's rehired somewhere else, she still keeps the same insurance and doctor. Isn't that a better system? Isn't that a better deal for most people? Employer based insurance is an accidental norm and it's not the right way to go. Everyone used to agree on this.
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Grizzly Bear
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Yeah, we're still arguing about the bill, and it'll very likely to continue between those who don't see it as going far enough and would want a single payer system and those who believe the bill was implemented with a number of preventable flaws or everything in between. The debate's about this is going to go on for a while yet considering the bill is still relatively new and it will be ironed out for several years or more before it's fully functional.
The majority opinion anyway is that the current bill should be improved rather than repealed, and I agree with that sentiment even if I didn't support the bill's implementation to begin with. Throwing the insurance industry into another tailspin by simply repealing Obamacare would be far more damaging than either the bill as it is now or having the old status quo and I don't believe that's something that's difficult to register.
Having said that, my personal experience with the law is mixed. I benefit from the bill in that I can "afford" the healthcare, certainly... and I have coverage sure... I have a silver plan with dental coverage for $130/month. On the other hand I'm also required to have it by law or face a tax penalty and I would have preferred to have the option of holding off until my budget was not as tight as it is. I was planning to save my increased pay for a place of my own so I can be a little more independent, but now I have to allocate that extra money to the healthcare coverage I get, because my choice was to either get it or pay a tax penalty and get nothing much out of it.
It's not that I don't want the affordable coverage, but it wasn't my personal priority at this stage.
I also know it's not all Obama's fault for the flaws, but politics tends to wash out any legitimate discussion about how to fix the flaws and where the priorities are. And that works both ways
Ampulla of Vater
Illuminator
Uhoh
Well, it looks like I can't send them to the exchange after all:
http://www.nytimes.com/2014/05/26/u...mping-workers-into-health-exchanges.html?_r=0
And no, I don't qualify for the tax breaks because I pay people too much to qualify. Most of the people at my office are older, more experienced people and therefore make enough to make the average salary over 50K.
Well, it looks like I can't send them to the exchange after all:
http://www.nytimes.com/2014/05/26/u...mping-workers-into-health-exchanges.html?_r=0
And no, I don't qualify for the tax breaks because I pay people too much to qualify. Most of the people at my office are older, more experienced people and therefore make enough to make the average salary over 50K.