Health Care Thoughts: Employer PPACA Options, More Analysis
by Tom aka Rusty Rustbelt
Health Care Thoughts: Employer PPACA Options, More Analysis
One of the more suspenseful issues of PPACA (aka Obamacare) is the question of employer conduct in 2014 and after.
Question is, will employers drop health insurance and punt workers into the state exchange system? Some new perspectives have been added to the debate. (Both assume PPACA will not be repealed or materially altered before 2014, an issue to be settled by the 2012 election).
The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) have weighed in on the question (https://www.cbo.gov/publication/43082) . (Warning, very long) This report tries to cover multiple options and scenarios, but I think it comes to a Goldilocks conclusion, not to hot and not too cold, but something in the middle of the range of possibilities.
A McKinsey and Company (MC) study (http://www.mckinseyquarterly.com/How_US_health_care_reform_will_affect_employee_benefits_2813) reaches much different conclusions. McKinsey sees up to 30% of employers dropping employer–sponsored insurance (ESI), and perhaps more as awareness spreads and 2014 approaches. MC also suggests exploration of any number of employer options, some good for employees, some not.
My spin? If the labor market remains weak, and underemployment and limited employee options continue, more employers will drop ESI and employees will have little so say or do about it. There is a lot to digest here. More analysis required.
Interestingly, the subsidies
http://healthreform.kff.org/SubsidyCalculator.aspx
end at $46,000 income for single people.
At $47,000, I’d get nothing (no fine either since the cost would be greater than 8% of income).
A family of 4 however at $47,000 gets a $11,000/yr subsidy ($250/mo net cost).
At $93,000, this family gets a $5000/yr subsidy, but at $94,000, $0.
Brilliant law-writing, guys.
Note that this is the backdoor to Wyden Bennett. Many have the objective of de-linking employment and health care, If they had passed Wyden Bennett, then everyone would have been put on the exchanges.
Was it not the plan for everybody to be dropped? Of course it was….how can you get to Single Payer when employers cover basic health insurance? After all….the people who wrote this debacle have clearly stated publically many times that the single payer system is the end game.
The fuuny part will be, when the people who cried for single payer the most actually have to live within it’s grip. Just relax, sit back and let the comedy begin.
Ken, as far as I know every American will eventually have to live within the grip of single payer. It’s called Medicare. And if you’re 65 or older, it’s the law. And if you propose eliminating that eeeevil soshalist Medicare, I suggest you do *not* mention your proposal to your 70 year old granny or mother (depending on your generation), because she’ll whack you over the head with her walking cane until you are seeing stars and have to test the current U.S. healthcare system up front and personal when you wake up in the ER.
In Massachusetts, employers have not stopped obtaining insurance through the preexisting channels in favor of the connector. If anything I think the takeup on the connector is lower than expected because they have been advertising it on the radio as a solution for small businesses.
There must be some difference in there, but I’m not the expert. I’ve pretty much been working on the assumption that in MA, the way we do insurance isn’t changed by the federal law, the main impact is on the regulatory side (what insurance means and what the general boundaries are for qualification and so forth).
Conspiracy theorists think this is a back door to a major public option or even single payer. Time will tell.
Of course the other possibility is that the court invalidates the act leaving us on square one.