As Obamacare ... evolves

[Gerry Clinchy]

Sorry Gerry your answer is not very defensible from my perspective. The article you posted does not provide any links to a "federal health insurance program", only empty rhetoric. If you have a link, please provide one.

The private insurance exchanges are being set-up for private insurers to compete for customers. A concept first promoted by conservatives. While I agree that insurance companies may decide not to participate it seems doubtful that many would not want to be part of this system that provides ready access to many more customers.

If this is a backdoor way to a single payer system, don't you find it ironic that all the conservative states that have decided to depend on the federal government to establish their exchange may then be most responsible for enabling the single payer system in the long run. Hilarious, if you ask me.

The source for the quotation cited would be the law itself, as they refer to that being where the quote is taken from?

I agree that, in theory, there is no actual "federal health insurance program" except insofar as the law stipulates what must be included in all plans to satisfy the govt minimum coverage for health insurance programs that are offered.

Yes, it would be ironic if the issue of the "exchange" concept were eventually responsible for leading to a single-payer system. However, an oversight in the law was the failure to provide for funding for a "Federal Exchange", even though it stipulates the Fed govt has the authority to establish such an exchange.

Since the law is so massively complex; and different parts could have been written by different individuals, or groups of individuals, that might be a reason for its inconsistencies.

It would seem reasonable that the insurors would want to participate to compete for a large consumer base that is mandated to purchase their product. However, if the price for these private sector plans is very expensive, then there might be a consumer demand for a govt option.

The concept of a "high risk pool" worked for auto insurance; however, even though auto insurance can be expensive, there are limits in its liability so the cost is relatively small compared to health insurance which has much higher limits of liability. And there are some insurors who do not offer products in some states. I'd have to guess that the profit margins, at a competitive price, are not attractive enough to do so.

I've never quite understood why it was not possible to cross state lines to purchase health insurance. With life and auto insurance, an insurance company gets a license to sell its products in a state, and satisfies that state's criteria for doing business in the state. The fact that Prudential had its home office in NJ doesn't prevent it from doing business in PA ... and, indeed, it (now owned by Metropolitan) sells group health insurance in PA. So, not sure what all this talk is about not being able to cross state lines for health insurance.

It is reasonable for states to have requirements, like reserves, for an insuror doing business in the state. Consumers should be assured that their insuror will have sufficient funds to actually pay their claims when they are made. However, an insuror in Iowa might have low rates, but if they sold a policy in NJ, they might actuarily have to charge nearly as much as those companies residing in NJ since the cost of care in NJ may be higher than it is in Iowa. The Iowa company might enjoy some savings by having its bricks and mortar in a place that is less expensive than residing within NJ, where the bricks and mortar are quite expensive.

We've discussed the premium increases people have seen ... but I think there was also a requirement in the law that the premiums were going to be reviewed by govt to assure that a certain percentage of premium MUST go toward benefits provided. You will recall the "refunds" that the insurors were required to issue if their prescribed ratio had been exceeded. So, the govt has provided the mandatory minimum coverage that must be offered; and also has limited/mandated how much is allowed for administration and profit on their products.

If truly the number of doctors and hospitals (per capita) decreases, that would seem to lessen competition (while demand increases) for the services of those remaining. Will prices go up even more?

[Marvin S]

Sounds like the conservative's wet dream to me, given what little respect that they have for the teaching profession.

That statement has bothered me since I saw it posted - as I believe it to be ill founded - but I'll pass this on to you & maybe you can tell me what to respect.

* Teachers in Tacoma defied a court order & went on strike to demand a raise above the $76,657 take home pay that they average plus the right to choose where they work. In the meantime students lost 8 days of school plus the additional burden already placed on parents for childcare. This is on the heels of the yearly high profile strike the WEA institutes to show the legislature they have clout.

*In the small town of Morton, in Lewis County, the state teachers union blocked the dismissal of a sexual predator charged with abusing a 16 year old girl in the school band room - & actually demanded that the school pay this creep a $12,000 severance.

Some of us in the very left leaning states don't have SD's culture, should we apply your enabling standards to these "I'm just looking out for the kid's" type of people.

One thing the article forgot to mention. Even the guy who is able to pull down 3 semesters a year will qualify to have insurance he buys on an exchange subsidized because if he has a family he is way under 400% of the poverty level. These folks are part of the 47% that Rmoney showed such respect for during the election. Too bad they can't take responsibility for their own lives. In the quote above you state: "low-paying employers, in general, are not the only ones who are cutting hours due to the new mandates of Obamacare." Hopefully now you realize that these community colleges ARE among those "low paying employers," using the exact same tactics as restaurant chains etc to save a buck.

They knew what they were getting into when they chose those professions, you need to explain in a more rational manner just what the public owes these people, if anything .

[Gerry Clinchy]

Meanwhile, the health insurance industry is already raising alarm about an ObamaCare tax on health insurers taking effect in 2014. America’s Health Insurance Plans says that cost will be passed onto the consumer, leading to another $2,000 in premium costs over the next decade for the average individual purchaser.


Read more: http://www.foxnews.com/politics/2012...#ixzz2EVyrGKfr

I hadn't even heard of a tax on health insurors before. Anybody else know anything about that?

[murral stark]

That statement has bothered me since I saw it posted - as I believe it to be ill founded - but I'll pass this on to you & maybe you can tell me what to respect.



Some of us in the very left leaning states don't have SD's culture, should we apply your enabling standards to these "I'm just looking out for the kid's" type of people.



They knew what they were getting into when they chose those professions, you need to explain in a more rational manner just what the public owes these people, if anything .

Check into the price of daycare services. $8 to $12 per hour per child and multiply that by the amount of days in a school year.

[Gerry Clinchy]

The fee will be assessed on all "major medical" insurance plans, including those provided by employers and those purchased individually by consumers. Large employers will owe the fee directly. That's because major companies usually pay upfront for most of the health care costs of their employees. It may not be apparent to workers, but the insurance company they deal with is basically an agent administering the plan for their employer.

The fee will total $12 billion in 2014, $8 billion in 2015 and $5 billion in 2016. That means the per-head assessment would be smaller each year, around $40 in 2015 instead of $63.

It will phase out completely in 2017 — unless Congress, with lawmakers searching everywhere for revenue to reduce federal deficits — decides to extend it.

This would mean that each person who has health insurance will be assessed a fee to provide for the pre-existing condition coverage that will now be mandatory.

IMO, it would be a good thing if the employers passed this fee onto the employees. This would make it clear to everyone who is insured that this new mandate did not come as a freebie. Someone has had to pay for it. Upper income employees will not miss $5.25 a month. For lower-income employees the extra deduction from their paycheck will be noticed more.

If we vote for the people who are in favor of these taxes, then it is a good thing to remind us that there is a price for these improved services. Whether we believe the services are important or not, we should at least be able to see what they are costing us.

Does anyone believe that Congress will not extend this tax when its expiration date arrives? Does anyone believe that it will remain as low as $63 when the tax is extended? Actually, it seems like $25 billion is a mere drop in the bucket when it comes to the coverage that will be required for pre-existing conditions at the same premium as those without pre-existing conditions. It won't take that many organ transplants and kidney dialysis patients to chew through that fund ... unless "the committee" decides that most of those are not merited based on likely outcomes.

This was reported by AP via Yahoo
http://news.yahoo.com/surprise-insur...185726448.html

[Gerry Clinchy]

http://www.americanthinker.com/blog/...mas_armor.html

Today [Dec. 18], a federal appeals court in Washington, D.C. handed Wheaton College and Belmont Abbey College a major victory in their challenges to the HHS mandate. Last summer, two lower courts had dismissed the Colleges' cases as premature. Today, the appellate court reinstated those cases, and ordered the Obama Administration to report back every 60 days-starting in mid-February-until the Administration makes good on its promise to issue a new rule that protects the Colleges' religious freedom. The new rule must be issued by March 31, 2013....

'This is a win not just for Belmont Abbey and Wheaton, but for all religious non-profits challenging the mandate,' said [Kyle Duncan, general counsel of The Becket Fund for Religious Liberty]. 'The government has now been forced to promise that it will never enforce the current mandate against religious employers like Wheaton and Belmont Abbey and a federal appellate court will hold the government to its word.'

[Gerry Clinchy]

I have a question, and truly don't know the answer:

If an employer of 10 employees (way below the Obamacare minimum) would like to offer health insurance benefits to their employees, do they still have to offer them the "prescribed" program mandated by Obamacare? Can they offer them less than that benefit? If they cannot afford to offer them those "full" benefits, why can they not offer them something less? SOMEthing might be better than NOTHING. Could they then allow the employees to purchase additional benefits with their own funds? If not, why not?

I'm sure that politicians would find this too simple to grasp ... if an employer is willing to expend $X for employee health insurance, but cannot afford the full amount of the Obamacare requirements, and the employees are REQUIRED by the law to have the Obamacare minimums, why not let an employer pay for part of the cost & let the employees pay for the additional coverage they need for the coverage to be in compliance to avoid the TAX for being uninsured? Keeping in mind, that an employer with this few employees is NOT required to provide ANY health insurance benefits at all. However, small businessmen/women are inclined to want to retain good employees by providing them with benefits that other employers (competing for competent employees) might not be willing to provide.

Just askin ...

[Gerry Clinchy]

Schumer, and about 15 other "influential" Dems (who voted in favor of Obamacare) are now in favor of repealing the funding portion of the law relating to the tax on medical devices. They have suddenly realized that their constituencies include companies that will be highly impacted by this tax in the law.

Duh? "We have to pass it to find out what's in it."

By the time all the special interest groups are through chopping out all the funding modes built into the law, we should have costs beyond imagination.

This was not the greatest idea for funding since the %-age of tax was on gross sales, which makes the "real" tax much higher than the 2.5% (I think that's the #) in the law. Saw an estimate of around 15% in "real" tax impact.

Of course, the device mfrs can just add 2.5% to the price of all their products ... but, no doubt, there will be a schedule of reimbursement imposed, which might not cover the 2.5% they will be adding onto the price. Depending on the profit margins of the companies, some of them could go out of business, or see their sales conspicuously decreased.