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Dr. Faustus
Feb 18, 2001

Grimey Drawer
I was waiting for Indigofreak and OneEightHundred to come instruct me on my faulty logic, but maybe I haven't waited long enough, yet.

(USER WAS PUT ON PROBATION FOR THIS POST)

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Volmarias
Dec 31, 2002

EMAIL... THE INTERNET... SEARCH ENGINES...

Pohl posted:

bitched and moaned about everything that wasn't done, and how we were going to fail the surprise audit scheduled the next day.

Telling people about surprise audits seems like an excellent way to assess quality.

Typical Pubbie
May 10, 2011

gently caress the ROW posted:

It'll increase under employment, the 29 hours is a pretty hard limit. And not very tough to juggle schedules in a low skill position, you've got a bunch of part timers anyway.

How will it increase underemployment? The number of hours that must be worked will remain the same, otherwise businesses will be unable to meet demand. What you'll have is more people working multiple jobs. And why do you think it's easy to juggle schedules for low skill positions? Getting people to COVER shifts is usually easy, because you're giving them more hours. If a business caps its hours at 29 a week, what will happen is that the best workers will max out their hours quickly, which will force managers to lean heavily on their less reliable B Team, or cast a line out for new, unknown employees to come in ASAP. The end result of this will be more missed shifts, lower productivity, lower customer satisfaction, and stressed out employees.

Of course, none of these factors will prevent corporate America from trying to cap hours anyway, since the majority of executives are the sort of loving morons who think that all "low skill" employees are interchangeable drones.

Pohl
Jan 28, 2005




In the future, please post shit with the sole purpose of antagonizing the person running this site. Thank you.

Jealous Cow posted:

Running a business like this is sort of like coasting downhill with the engine off and the headlights out. Eventually you sell the engine, the brakes, and the headlights because "I've made it this far and haven't needed them!" when suddenly there's stopped traffic ahead and you plow into someone. You can run a retail business (particularly grocery) in the grey like that for quite a while, but boy when customers get fed up it'll be a ghost town.

All I know is that I got to work at 6 pm that night after school, and there were 4 huge pallets of toilet paper in back because my order clerk is an idiot. I was looking at them and devising ways to murder him with the soft rolls of tissue when my Store Director tore into the back room and asked if I had seen Jeff.

I was like, Jeff? The manager Jeff?

Yeah, yeah, Jeff.

At that point I knew something was seriously crazy, and I felt instant empathy for my boss Jeff, because he gets to work at 6 am, so why would he still be there at 6 pm?
I looked at my store Director, and I told him I hadn't seen Jeff since I just got to work; but drat, that is a LOT of toilet paper.

He was confused.

I had a good night after that.



Volmarias posted:

Telling people about surprise audits seems like an excellent way to assess quality.

Welcome to retail. And we still can't pass. :sparkles:

I think I just totally hijacked this thread, sorry.

Pohl fucked around with this message at 00:10 on Sep 26, 2013

Lycus
Aug 5, 2008

Half the posters in this forum have been made up. This website is a goddamn ghost town.

Ravenfood posted:

What? No. They're forced onto the exchanges, thanks to a stupid stunt by Sen. Grassley.

Here's a decent summary. http://maddowblog.msnbc.com/_news/2013/08/14/20021898-congress-isnt-exempt-from-obamacare?lite
So anytime someone says something about how "Congress exempted themselves from Obamacare!" I know it's completely meaningless made-up bullshit. I suspected that. Thank you.

mastershakeman
Oct 28, 2008

by vyelkin

gohuskies posted:

Seems like a lot of the ACA naysayers have stopped posting in this thread ever since the premium prices have been coming in so low.

Honestly, the prices seem so incredibly low that they're just too good to be true. The premium prices are the costs before even having subsidies kick in, right? And suddenly they're much lower than what businesses are able to provide despite being able to deduct the health care premium against taxes? I'll be flabbergasted if this holds up.

Nonsense
Jan 26, 2007
Probation
Can't post for 16 hours!

mastershakeman posted:

Honestly, the prices seem so incredibly low that they're just too good to be true. The premium prices are the costs before even having subsidies kick in, right? And suddenly they're much lower than what businesses are able to provide despite being able to deduct the health care premium against taxes? I'll be flabbergasted if this holds up.

Would health insurance companies be able to raise their prices high enough to get people angry enough to affect the law?

I don't mean get it scrapped, but altered by Congress thus making it poo poo?

It sounds conspiratorial, but they're kinda trying to do that it seems what with that horseshit map I posted earlier, and pretty much every opinion column in business mainstream saying: leave america its over.

greatn
Nov 15, 2006

by Lowtax

mastershakeman posted:

Honestly, the prices seem so incredibly low that they're just too good to be true. The premium prices are the costs before even having subsidies kick in, right? And suddenly they're much lower than what businesses are able to provide despite being able to deduct the health care premium against taxes? I'll be flabbergasted if this holds up.

Well we don't know about deductibles or copays quite yet, just the premiums and percent covered.

Dr. Faustus
Feb 18, 2001

Grimey Drawer
Would someone please step back in here and remind everyone that hiring two or three part time employees counts towards the employment mandate, so it doesn't even benefit employers to hire PT instead of FT?

greatn
Nov 15, 2006

by Lowtax

Dr. Faustus posted:

Would someone please step back in here and remind everyone that hiring two or three part time employees counts towards the employment mandate, so it doesn't even benefit employers to hire PT instead of FT?

Right, but they will only have to provide healthcare to the FT workers. If they have 50 PT workers and one FT manager, they only have to provie one healthcare package. Also said manager will have to watch his back walking to his car at night.

esquilax
Jan 3, 2003

mastershakeman posted:

Honestly, the prices seem so incredibly low that they're just too good to be true. The premium prices are the costs before even having subsidies kick in, right? And suddenly they're much lower than what businesses are able to provide despite being able to deduct the health care premium against taxes? I'll be flabbergasted if this holds up.

1) There are major hidden subsidies as well. There's a $12 billion pot of "Transitional Reinsurance" that's doled out to the plans by the gov't and is effectively lowering the premium rates. When you divide that by the CBO estimated 6 million on the exchange in 2014 the premium rates are lowered by $166 per person per month. There aren't a lot of specifics on how this program is handled, but that's huge, and that subsidy is phased out by 2017. The math is fuzzy though, I'm not sure the process of how they apply and receive funds.

2) Keep in mind a lot of the numbers being shown are "lowest available rate". Some people may choose a plan on a basis other than what's the lowest premium rate. The lowest cost plan may not necessarily include, say, the teaching hospital in your area.

Dr. Faustus posted:

Would someone please step back in here and remind everyone that hiring two or three part time employees counts towards the employment mandate, so it doesn't even benefit employers to hire PT instead of FT?

The requirement doesn't affect employers below 50 full-time equivalents, and the calculation of full time equivalents includes part timers. The mandate itself is only for full time employees. By hiring part time folks you still avoid the mandate. Having 200 part timers avoids the mandate. Having 29 full timers and 100 part timers makes the mandate apply but the penalty $0. Having 49 full timers and 100 part timers means you pay the penalty on 19 (49-30=19) people.

esquilax fucked around with this message at 00:46 on Sep 26, 2013

Lycus
Aug 5, 2008

Half the posters in this forum have been made up. This website is a goddamn ghost town.

Nonsense posted:

Would health insurance companies be able to raise their prices high enough to get people angry enough to affect the law?

I don't mean get it scrapped, but altered by Congress thus making it poo poo?

It sounds conspiratorial, but they're kinda trying to do that it seems what with that horseshit map I posted earlier, and pretty much every opinion column in business mainstream saying: leave america its over.
I was under the impression that the insurance industry was generally happy with the law because of all the money they stand make through the individual mandate and the subsidies. I would assume they would just continue to go with the flow instead of instead of doing anything to make people angry.

Lycus fucked around with this message at 00:48 on Sep 26, 2013

FAUXTON
Jun 2, 2005

spero che tu stia bene

gohuskies posted:

Seems like a lot of the ACA naysayers have stopped posting in this thread ever since the premium prices have been coming in so low.

E: aww, okay.

FAUXTON fucked around with this message at 01:37 on Sep 26, 2013

evilweasel
Aug 24, 2002

gohuskies posted:

Seems like a lot of the ACA naysayers have stopped posting in this thread ever since the premium prices have been coming in so low.

Please don't do this.

Kalman
Jan 17, 2010

Lycus posted:

So anytime someone says something about how "Congress exempted themselves from Obamacare!" I know it's completely meaningless made-up bullshit. I suspected that. Thank you.

Anytime someone says "Congress exempted themselves from X", it's going to be completely meaningless made up bullshit. With one major exception (Speech and Debate Clause) and a couple minor historical exceptions (workplace regulations til the early 1990s, Social Security until 1984 because they had a parallel system which was basically identical) Congress doesn't exempt itself.

FAUXTON
Jun 2, 2005

spero che tu stia bene

esquilax posted:

1) There are major hidden subsidies as well. There's a $12 billion pot of "Transitional Reinsurance" that's doled out to the plans by the gov't and is effectively lowering the premium rates. When you divide that by the CBO estimated 6 million on the exchange in 2014 the premium rates are lowered by $166 per person per month. There aren't a lot of specifics on how this program is handled, but that's huge, and that subsidy is phased out by 2017. The math is fuzzy though, I'm not sure the process of how they apply and receive funds.

2) Keep in mind a lot of the numbers being shown are "lowest available rate". Some people may choose a plan on a basis other than what's the lowest premium rate. The lowest cost plan may not necessarily include, say, the teaching hospital in your area.


The requirement doesn't affect employers below 50 full-time equivalents, and the calculation of full time equivalents includes part timers. The mandate itself is only for full time employees. By hiring part time folks you still avoid the mandate. Having 200 part timers avoids the mandate. Having 29 full timers and 100 part timers makes the mandate apply but the penalty $0. Having 49 full timers and 100 part timers means you pay the penalty on 19 (49-30=19) people.

The term 'transitional' gives away the basis of it as being a temporary grant to eat a bit of the cost of insuring everyone until everyone gets insured/paying premiums and the actuarial pools are adjusted and costs properly projected with actual health info. The idea is that the scale and not the subsidies will be the driver of savings by 2017.

Or that the pols in office by that time see the writing on the wall and pass more subsidies.

DrPlump
Oct 5, 2004

by Jeffrey of YOSPOS
The whole reason Obamacare works is because of some crazy formula that was created to explain and calculate risk pools for exchanges. Insurance companies don't like to compete with each other directly. It is the same reason mattress companies make 12 different lines with different names and trademarked features. They want to obscure the actual price and quality ratio between brands.

The reason they don't like to compete is because it fucks with their risk pools. If they calculate the risk of a certain population they are assuming everyone will be purchasing a plan and entering the pool even the healthy members. When there is another company entering the mix they are STEALING people from your risk pool maybe they have a lower cost plan that is more appealing to the hipster youths and you get stuck with all the disgusting olds!

The exchanges work by making the risk pool so large that imbalance of age and other issues that result from competition becomes less of a factor. Also by being forced to offer standardized plans with direct comparisons between all their competition. The end result is pretty much a petting zoo version of the original it is much easier to understand all of the gimmicks have been removed just animals and petting for a flat rate.

The insurance companies are of course completely fine with this because they in fact do not do a god drat thing. They are useless the entire industry could be replaced by a vault that the government just stuck all the money in and periodically withdrew from as needed to pay doctors and stuff. It is not magic they are doing (for the most part). They are going along with it because they have no other choice. The old formulas and rituals are no longer working. People do not make enough money to pay that amount they calculate they need for it to work. As much as they enjoy the result of rising healthcare cost they know it will only accelerate the race towards the “final solution”.

Enter a government by the people for the people that looks at this problem from the macro perspective. There is a total amount of cost for all healthcare in the country if you collect some amount of money from the population equal to or greater than than amount you can do this thing forever. Since they are a large government instead of a small puny useless sore of a company they do not need some fancy magic formula to get rich. They can also borrow against this entire population and collect the amount after the fact by force of police and military if necessary. However usually it isn’t in every place they have done it so far the people seem to quite like NOT DYING OF TREATABLE AILMENTS.

OneEightHundred
Feb 28, 2008

Soon, we will be unstoppable!

Nonsense posted:

This is making the rounds.
I'm shocked that my state has the second-highest premium increase after turning down Medicaid bucks and letting everyone else eat the uncompensated care expenses.

Dr. Faustus posted:

Would someone please step back in here and remind everyone that hiring two or three part time employees counts towards the employment mandate, so it doesn't even benefit employers to hire PT instead of FT?
The businesses that want to cut FT to PT are the ones that are too far past 50 for that to be a viable option, so that doesn't say much.

OneEightHundred fucked around with this message at 04:32 on Sep 26, 2013

miscellaneous14
Mar 27, 2010

neat
It's not really any different from the government healthcare information site, but TurboTax also has an interactive guide to finding out what you'll end up paying for a plan based on your age, state, income, etc. For me it says I'll be covered by the state so my cost would apparently be $0, though I'm not sure what sort of plan that would cover and if it means I don't have to pay anything in order to get healthcare.

Even with this information, I'm still not sure what all this really means for me, and I imagine it's the same for loads of other people. Which is probably where most of the public skepticism of the ACA stems from.

mastershakeman
Oct 28, 2008

by vyelkin

miscellaneous14 posted:

It's not really any different from the government healthcare information site, but TurboTax also has an interactive guide to finding out what you'll end up paying for a plan based on your age, state, income, etc. For me it says I'll be covered by the state so my cost would apparently be $0, though I'm not sure what sort of plan that would cover and if it means I don't have to pay anything in order to get healthcare.

Even with this information, I'm still not sure what all this really means for me, and I imagine it's the same for loads of other people. Which is probably where most of the public skepticism of the ACA stems from.

Th at's a weird site. I'm a early 30s male in Illinois, not married and no kids, and last year with a 5k deductible plan (100% coverage after it) I was paying $125 or so a month. According to Turbotax, the cheapest possible plan I can get is $312/mo, but it doesn't mention deductibles/copays/etc.

Amused to Death
Aug 10, 2009

google "The Night Witches", and prepare for :stare:

miscellaneous14 posted:

It's not really any different from the government healthcare information site, but TurboTax also has an interactive guide to finding out what you'll end up paying for a plan based on your age, state, income, etc. For me it says I'll be covered by the state so my cost would apparently be $0, though I'm not sure what sort of plan that would cover and if it means I don't have to pay anything in order to get healthcare.

If it says no costs it probably means you or you and your family qualify for Medicaid.(unless your state is run by assholes who didn't expand it)

esquilax
Jan 3, 2003

The Entire Universe posted:

The term 'transitional' gives away the basis of it as being a temporary grant to eat a bit of the cost of insuring everyone until everyone gets insured/paying premiums and the actuarial pools are adjusted and costs properly projected with actual health info. The idea is that the scale and not the subsidies will be the driver of savings by 2017.

Or that the pols in office by that time see the writing on the wall and pass more subsidies.

Except in this case "eat a bit of the cost of insuring everyone" is equivalent to doing a literal giveaway in order to lower premiums. It was specifically designed to lower premiums in 2014 to make them more favorable than they otherwise would be. It appears to be a big reason why the premiums on the exchange are lower than you would otherwise expect. Employer plans are being forced to pay the transitional reinsurance fee into the fund to make the exchanges look better.

Ceiling fan
Dec 26, 2003

I really like ceilings.
Dead Man’s Band

Nonsense posted:

Would health insurance companies be able to raise their prices high enough to get people angry enough to affect the law?

I don't mean get it scrapped, but altered by Congress thus making it poo poo?

It sounds conspiratorial, but they're kinda trying to do that it seems what with that horseshit map I posted earlier, and pretty much every opinion column in business mainstream saying: leave america its over.

Health insurance companies will have a hard time jacking up rates quickly. Their biggest problem is the rule that no more than 20% of gross income can be attributable to administrative costs and profits. After posting rates like this, they are going to have to claim losses to justify jacking up rates. And that will kill their stock prices.

But keep in mind, insurance companies are one of the few industries still comfortable playing the long con. They will be content compounding percentages, subverting regulatory bodies to create exceptions, and gathering in increasing profits year after year instead of trying to cash in all at once. In the end, what they pull in will be hard to tease out of the overall growing gap between the rich and the poor. They resent propaganda like that map, because it can only draw attention to what they are doing.

I'm far more worried about what the rates will be 10 years from now rather than next year.

FAUXTON
Jun 2, 2005

spero che tu stia bene

For anyone wondering, the assistance subsidies top out at levels above what you may think. That Turbo Tax website says I (29, male, no kids, unmarried) stopped qualifying for some kind of assistance at $43-44k (qualified at $43k, not at $44k) and in my state the cheapest plan is $295 (because Nebraska votes straight-ticket shitlords like Deb 'my hometown fits in a walmart' Fischer) so it's definitely a major expense but affordable.

menino
Jul 27, 2006

Pon De Floor

The Entire Universe posted:

For anyone wondering, the assistance subsidies top out at levels above what you may think. That Turbo Tax website says I (29, male, no kids, unmarried) stopped qualifying for some kind of assistance at $43-44k (qualified at $43k, not at $44k) and in my state the cheapest plan is $295 (because Nebraska votes straight-ticket shitlords like Deb 'my hometown fits in a walmart' Fischer) so it's definitely a major expense but affordable.

So will these subsidy plans actually work like most people think taxes work? If you make $43900, you get a subsidy and take home more than if you make $44000?

Indigofreak
Jul 30, 2013

:siren:BAD POSTER ALERT!:siren:

Put this loser on ignore immediately!

Ceiling fan posted:

Health insurance companies will have a hard time jacking up rates quickly. Their biggest problem is the rule that no more than 20% of gross income can be attributable to administrative costs and profits. After posting rates like this, they are going to have to claim losses to justify jacking up rates. And that will kill their stock prices.

But keep in mind, insurance companies are one of the few industries still comfortable playing the long con. They will be content compounding percentages, subverting regulatory bodies to create exceptions, and gathering in increasing profits year after year instead of trying to cash in all at once. In the end, what they pull in will be hard to tease out of the overall growing gap between the rich and the poor. They resent propaganda like that map, because it can only draw attention to what they are doing.

I'm far more worried about what the rates will be 10 years from now rather than next year.

I've only seen them jack of the pricing if you compare old lowest price to new lowest price. Those plans are radically different though in what they offer. Like my plan has completely changed. Yes, the price goes up overall. Have the prices of the same plan gone up? I may have missed the graphs of that.

Insurance companies are loving this. The other people that are loving this are hospitals.

Insurance companies like this because they are getting millions of new people, and the rules on rates, while different, really don't mean much. For instance since you can only charge an older person 2? 3x? as much as a younger person, all you have to do is raise the rates on the younger group. You also can't charge women more, normally done due to pregnancy costs, so you just charge the men the same as the women.

Hospitals are loving this because the bill doesn't address cost. They can continue to rake people, and insurance companies over the coals. Thanks to the daily show I heard about a rather long, but really good Times article. It's from back in march so maybe you guys know of it already.

Bitter Pill

It pretty much goes over how hospitals are jacking up prices to insane amounts. Medicare pays 17 dollars for a test, but average joe gets charged 200 dollars. And that recently insurance companies aren't getting deals like the used to either. Non-profit hospitals pull down hundreds of millions of dollars in profits, sometimes around 25% of their sales. The company I work at is retail and our managers orgasm over making 5 cents on the dollar(or 5%) as profit. Medicare has laws where pricing is set at a certain amount above cost, so they can't get raked over the coals. What should be done is a law that does this for all customers at a hospital and not just for government. Clearly the hospitals aren't losing money on illegals and uninsured not being able to pay. They are so scared of losing money they overcharge to an insane amount.

Even though I don't like it, PPACA isn't going to get repealed or defunded. Might as well double down and add more laws. Half assed approaches never work.

Bizarro Kanyon
Jan 3, 2007

Something Awful, so easy even a spaceman can do it!


Under the PPACA, what happens if a family of four (2 adults, 2 kids and one on the way)has the father who receives insurance through his school which covers him and his wife (and one on the way), but the other two kids are on high deductible insurance plans(the family received a letter stating that their kids insurance does not "meet standards of PPACA")?

I was wondering, what is the best path for this family to take? (Illinois, father is an assistant principal, mother is stay at home/norwex seller and both in their 30s) Would the father be able to stay on his work insurance (which is completely covered for him but really high rates for the rest of the family) and the rest of his family get on the health care exchanges (while still getting a subsidy)?

I am asking for a friend who hates "Obamacare" but I still want her to get the best options possible.

FAUXTON
Jun 2, 2005

spero che tu stia bene

Bizarro Kanyon posted:

Under the PPACA, what happens if a family of four (2 adults, 2 kids and one on the way)has the father who receives insurance through his school which covers him and his wife (and one on the way), but the other two kids are on high deductible insurance plans(the family received a letter stating that their kids insurance does not "meet standards of PPACA")?

I was wondering, what is the best path for this family to take? (Illinois, father is an assistant principal, mother is stay at home/norwex seller and both in their 30s) Would the father be able to stay on his work insurance (which is completely covered for him but really high rates for the rest of the family) and the rest of his family get on the health care exchanges (while still getting a subsidy)?

I am asking for a friend who hates "Obamacare" but I still want her to get the best options possible.

It's probably heavily dependent on income at that point. With that drat many kids the cutoff income is substantial.

And of course your friend hates obamacare, she put her own kids on goddamn catastrophic coverage. I think people with that type of mentality on insurance - 'why would I ever need a specialist outside the ER' type thinking - are going to be shedding the lion's share of tears mainly because they're being awakened to the reality that they have basically been paying for nothing. They might mask it under 'ughh premium hike' but a) our bullshit system makes actual coverage cost actual money and b) if you're putting your kids on fake insurance (to be perfectly honest here about what it is) to save money you need elsewhere (as in not on buying red soles and monograms) chances are you will get a subsidy to some degree.

Indigofreak
Jul 30, 2013

:siren:BAD POSTER ALERT!:siren:

Put this loser on ignore immediately!
I've checked further into my situation. I can't get subsidies. If your work offers health care, you pretty much are forced to go with that(provided you qualify for your work's.) So I wonder if they will just have to put the entire family on the the fathers work plan.

I am not sure why you would put your kids on a catastrophic plan? Kids get sick constantly. I guess they are just able to absorb the cost themselves. Or, since they were kids maybe they were using coverage that doesn't cover pregnancy and mental health? Really would be interesting to see what plan they had for their kids.

Also, if they were going to put the kids on a separate plan wouldn't there be a government option like CHIP or medicaid?

Ceiling fan
Dec 26, 2003

I really like ceilings.
Dead Man’s Band

Indigofreak posted:

I've only seen them jack of the pricing if you compare old lowest price to new lowest price. Those plans are radically different though in what they offer. Like my plan has completely changed. Yes, the price goes up overall. Have the prices of the same plan gone up? I may have missed the graphs of that.

Insurance companies are loving this. The other people that are loving this are hospitals.

Insurance companies like this because they are getting millions of new people, and the rules on rates, while different, really don't mean much. For instance since you can only charge an older person 2? 3x? as much as a younger person, all you have to do is raise the rates on the younger group. You also can't charge women more, normally done due to pregnancy costs, so you just charge the men the same as the women.

Hospitals are loving this because the bill doesn't address cost. They can continue to rake people, and insurance companies over the coals. Thanks to the daily show I heard about a rather long, but really good Times article. It's from back in march so maybe you guys know of it already.

Bitter Pill

It pretty much goes over how hospitals are jacking up prices to insane amounts. Medicare pays 17 dollars for a test, but average joe gets charged 200 dollars. And that recently insurance companies aren't getting deals like the used to either. Non-profit hospitals pull down hundreds of millions of dollars in profits, sometimes around 25% of their sales. The company I work at is retail and our managers orgasm over making 5 cents on the dollar(or 5%) as profit. Medicare has laws where pricing is set at a certain amount above cost, so they can't get raked over the coals. What should be done is a law that does this for all customers at a hospital and not just for government. Clearly the hospitals aren't losing money on illegals and uninsured not being able to pay. They are so scared of losing money they overcharge to an insane amount.

Even though I don't like it, PPACA isn't going to get repealed or defunded. Might as well double down and add more laws. Half assed approaches never work.

I purposely spent 8 years working in military health care, because I wanted to work in socialized healthcare and did not want to spend my career wrestling with insurance companies over reimbursement rates. I had an inkling something had changed whenever I walked into a civilian hospital and saw the décor laid out like an investment bank. But Brill's article really astounded me on how the center of power in healthcare had switched from insurance companies to providers.

Change over such a short time frame causes a huge problem for people studying an industry. When people wait five years to turn in bills, much less write them off, or to validate other data, you can't make declarative statements about what's wrong right now with the healthcare system. When the PPACA of 2008 was passed, it used data from 2003. That's the only data people could defend, and it said insurance companies ruled the roost.

Now there's a huge disconnect, because most of the law addresses health insurance. Health insurance is the lesser problem now. The half assed fix to health insurance is showing benefits, but only because the system was so broken before. Unfortunately, the marketplaces only fix very little. (Universal Health Care carries $5,000 deductibles per year? Seriously? :wtf:)

The PPACA did include health care improvement provisions, but they were mostly afterthoughts. Still the Accountable Care Organizations give incentives to reduce costs, and the Medicare readmission penalties are a stick against hospitals providing lousy care.

Unfortunately several efforts to re-focus health reform on providers were sabotaged. The whole Independent Payment Advisory Board = Death Panel fiasco was the most obvious one. HHS also turned in several legislative proposals that died, because Republicans took a stand of repeal or nothing. Another big defeat was the Senate refusing to consider Dr. Berwick as CMS Administrator. Just because he said Britain's NHS achieved better heath care outcomes at a cheaper price than the US system, and maybe we could learn something from them. Of course, he lost some popularity helping author the To Err Is Human report that pissed off every physician in the country who wasn't a medical school professor.

Ceiling fan
Dec 26, 2003

I really like ceilings.
Dead Man’s Band
DP, but what the hell.

Bizarro Kanyon posted:

Under the PPACA, what happens if a family of four (2 adults, 2 kids and one on the way)has the father who receives insurance through his school which covers him and his wife (and one on the way), but the other two kids are on high deductible insurance plans(the family received a letter stating that their kids insurance does not "meet standards of PPACA")?

I was wondering, what is the best path for this family to take? (Illinois, father is an assistant principal, mother is stay at home/norwex seller and both in their 30s) Would the father be able to stay on his work insurance (which is completely covered for him but really high rates for the rest of the family) and the rest of his family get on the health care exchanges (while still getting a subsidy)?

I am asking for a friend who hates "Obamacare" but I still want her to get the best options possible.

If the insurance policies for the kids do not meet the standards, you can use the marketplace and qualify for subsidies/tax credits for them. That letter is more than enough proof.

Indigofreak posted:

I've checked further into my situation. I can't get subsidies. If your work offers health care, you pretty much are forced to go with that(provided you qualify for your work's.) So I wonder if they will just have to put the entire family on the the fathers work plan.

I am not sure why you would put your kids on a catastrophic plan? Kids get sick constantly. I guess they are just able to absorb the cost themselves. Or, since they were kids maybe they were using coverage that doesn't cover pregnancy and mental health? Really would be interesting to see what plan they had for their kids.

Also, if they were going to put the kids on a separate plan wouldn't there be a government option like CHIP or medicaid?

Your situation is a little more complicated.

When your employer offers family coverage, and you accept it, and it qualifies as affordable, your family does not qualify for subsidies/tax credits.

When your employer offers family coverage, and you accept it, and it does not qualify as affordable, your family does qualify for subsidies/tax credits.

When your employer offers family coverage, and you only accept self coverage, your family might qualify for subsidies/tax credits. (This hasn't been tested yet. Wait and see if someone else makes this work first.)

The controlling information on whether your policy qualifies is your policy number and what it covers. Don't assume what your employer/insurance company told you about affordability and qualification is correct.

This is all new, and I can't say things will work out the way they should. But you have until March 31st to get on the exchanges. Make an application next week using your current policy. If you don't like the answer, call the number for appeals. If you still don't like the answer, ask what you need to change about your insurance to qualify for subsidies/tax credits. Then re apply.

Ardennes
May 12, 2002
Arguably it does improve the system in some ways for certain people, but there are plenty of gaps and one of them is making over 300% of the poverty line (which isn't that much) and having the subsidies decline rapidly, which is especially difficult in some states that didn't see much savings from the exchanges.

Bizarro Kanyon
Jan 3, 2007

Something Awful, so easy even a spaceman can do it!


My favorite part is how her insurance salesman/agent says that this will not provide the coverage they want and will cost more than what they pay now. ($800)

In my mind, it clicks that the insurance agent gets paid on commission and he has an incentive to keep people off the exchange.

Condiv
May 7, 2008

Sorry to undo the effort of paying a domestic abuser $10 to own this poster, but I am going to lose my dang mind if I keep seeing multiple posters who appear to be Baloogan.

With love,
a mod


I'm a student/worker living in france full time now, and I was wondering how the mandate affects me, if at all?

evilweasel
Aug 24, 2002

Indigofreak posted:


Hospitals are loving this because the bill doesn't address cost. They can continue to rake people, and insurance companies over the coals. Thanks to the daily show I heard about a rather long, but really good Times article. It's from back in march so maybe you guys know of it already.

Bitter Pill

This is not true. A huge portion of the bill is addressing cost in numerous ways, which have dropped the rate of medical inflation to the lowest rate in 50 years.

EugeneJ
Feb 5, 2012

by FactsAreUseless
I still can't find an answer for this, regarding if my employer's plan is considered "unaffordable" -

http://www.buckconsultants.com/port...under-PPACA.pdf

quote:

Coverage is considered “unaffordable” if the required employee contribution towards the cost of self-only coverage exceeds 9.5% of the employee’s household income.

Is my household income in the above calculation considered:

-9.5% of my base wage (my hourly rate x 40 hours/week x 52 weeks/year)?
-9.5% of my Net Income as shown on my tax return?
-9.5% of my Adjusted Gross Income as shown on my tax return?

If it's either of the latter two - how can I possibly signup for the Exchange before January/February since I won't have my taxes done before then and won't know my total income?

evilweasel
Aug 24, 2002

EugeneJ posted:

If it's either of the latter two - how can I possibly signup for the Exchange before January/February since I won't have my taxes done before then and won't know my total income?

Still reading through the actual regulation to determine what household income means, but the answer to this question is here:

quote:

Under the proposed regulations, an employer-sponsored plan is not affordable for an employee or family member for a plan year if, when the employee or family member enrolls in a qualified health plan, an Exchange determines that the eligible employer-sponsored plan is not affordable.

The exchange determines your eligibility when you enroll, so if you then do your taxes and something changed you still are eligible for the rest of the year.

edit: Household income definition:

quote:

(e) Household income—(1) In general.
Household income means the sum of—
(i) A taxpayer’s modified adjusted gross income; plus
(ii) The aggregate modified adjusted gross income of all other individuals who—
(A) Are included in the taxpayer’s family under paragraph (d) of this section; and
(B) Are required to file a return of tax imposed by section 1 for the taxable year (determined without regard to the exception under section (1)(g)(7) to the requirement to file a return).
http://www.gpo.gov/fdsys/pkg/FR-2012-05-23/pdf/2012-12421.pdf

evilweasel fucked around with this message at 15:55 on Sep 26, 2013

BexGu
Jan 9, 2004

This fucking day....

EugeneJ posted:

I still can't find an answer for this, regarding if my employer's plan is considered "unaffordable" -

http://www.buckconsultants.com/port...under-PPACA.pdf


Is my household income in the above calculation considered:

-9.5% of my base wage (my hourly rate x 40 hours/week x 52 weeks/year)?
-9.5% of my Net Income as shown on my tax return?
-9.5% of my Adjusted Gross Income as shown on my tax return?

If it's either of the latter two - how can I possibly signup for the Exchange before January/February since I won't have my taxes done before then and won't know my total income?

Open Enrollment ends March 31st 2014: https://www.healthcare.gov/what-key-dates-do-i-need-to-know/#part=1

EugeneJ
Feb 5, 2012

by FactsAreUseless

Ok, but what about next year:

https://www.healthcare.gov/glossary/open-enrollment-period/

quote:

The period of time during which individuals who are eligible to enroll in a Qualified Health Plan can enroll in a plan in the Marketplace. For 2014, the Open Enrollment Period is October 1, 2013–March 31, 2014. For 2015 and later years, the Open Enrollment Period is October 15 to December 7 of the previous year

Sounds like a clusterfuck waiting to happen. My employer usually releases their rates in late November, so having 1 week to choose a plan without my AGI next year is going to be fun!

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greatn
Nov 15, 2006

by Lowtax

EugeneJ posted:

Ok, but what about next year:

https://www.healthcare.gov/glossary/open-enrollment-period/


Sounds like a clusterfuck waiting to happen. My employer usually releases their rates in late November, so having 1 week to choose a plan without my AGI next year is going to be fun!

What do you mean one week? October 15 to December 7 is nearly two months.

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