Healthcare Reform is a win for SouthWalton

I know so many people in their late 50's or early 60's who'd like to retire (many to the beach) but have to keep working because of health insurance issues. I confess I haven't read even the Cliffs notes to this bill yet, and I'm not necessarily saying I support it overall, but it seems to me that South Walton is a winner economically if this passes for 2 main reasons.

First, the aforementioned 58 year old who would be able to semi-retire in any other country on the planet, except the U.S., now may have affordable coverage (or at least, no worry about being dropped etc), therefore hastening the retirement to places like South Walton

Second, most people of working age in South Walton are not employed by the kind of large corporations (GE, Bank of America, Boeing, Exxon) that provide juicy benefits etc... this Bill mainly will benefit small/medium sized businesses, and their employees - which South Walton is heavy on as opposed to the large corporate employers.

Depends. If these businesses don't have profit margins large enough to pay for the health insurance they will be forced to provide starting in 2014, it may well put them out of business. The bill tries to limit the costs through the exchanges, but it's yet to be determinded how effrective that will be. Time will tell. I hope if small businesses get slammed and start failing, congress will change the law.

Depends. If these businesses don't have profit margins large enough to pay for the health insurance they will be forced to provide starting in 2014, it may well put them out of business. The bill tries to limit the costs through the exchanges, but it's yet to be determinded how effrective that will be. Time will tell. I hope if small businesses get slammed and start failing, congress will change the law.

This seems to be one of those cases where the slippery slope arguments seem to ring true... i.e. that basically companies are going to drop benefits, and everyone is going to be forced to pick up a public option of some sort, so basically it will all be socialized soon. I think we've reached the diminishing return limits of scientific progress on healthcare for the purpose of extending life meaningfully - so I think the whole thing ought to be socialized now.

If they have under 50, they are excluded. Their employees will have insurance and they will not have to pay for it.

Depends. If these businesses don't have profit margins large enough to pay for the health insurance they will be forced to provide starting in 2014, it may well put them out of business. The bill tries to limit the costs through the exchanges, but it's yet to be determinded how effrective that will be. Time will tell. I hope if small businesses get slammed and start failing, congress will change the law.

My understanding is that these businesses can pay a fine instead of providing coverage. That fine starts out at 750 per year and then increases to 2k per year per employee for businesses with greater than 50 employees, which is a lot less than they would pay towards most employees' coverage.

Then I assume the employees, much like they do now, will go shop for insurance (on the exchange), except in the new system they will be subsidized and will have a market with greater risk sharing pools from which to purchase.

My prediction is that the GOP will dust off the bible of Rove in October, we'll see a huge take over by them in Congress, and they will purposely eff the whole thing up just to make a political point.

My understanding is that these businesses can pay a fine instead of providing coverage. That fine starts out at 750 per year and then increases to 2k per year per employee for businesses with greater than 50 employees, which is a lot less than they would pay towards most employees' coverage.

Then I assume the employees, much like they do now, will go shop for insurance (on the exchange), except in the new system they will be subsidized and will have a market with greater risk sharing pools from which to purchase.

There has to be some sort of limit or restriction on that, otherwise firms would have no reason to provide coverage and would just pay the 2K healthcare tax and be done with it. Or maybe that's what the authors wanted, in an effort to funnel more people through the exchange as individuals? Seems rather odd that the punishment is only 2k per employee.

Hmm, can't seem to find anything other than the 2K tax for 50 or more employees. That's really interesting, I guess employer coverage for smaller firms will basically come to an end. I wonder why they designed the bill that way?

Hmm, can't seem to find anything other than the 2K tax for 50 or more employees. That's really interesting, I guess employer coverage for smaller firms will basically come to an end. I wonder why they designed the bill that way?

To support small business and take a major burden off the backs of small business owners?

It's even less than that, the first 30 employees are excluded, and businesses only have to pay fines if one of their employees qualifies for government subsidies based on income. Wacky stuff!

To support small business and take a major burden off the backs of small business owners?

Basically, yes. Offload the cost onto retirees and people who make over 200K a year. A strange mix of progressivism and pro-small business. This one aspect of the bill seems very bipartisan.

How does the bill work for businesses?

Here’s how that works: If you are a firm with more than 50 employees, and do not offer health insurance as a benefit, and at least one of your full-time employees gets a subsidy from the federal government to purchase health insurance on his or her own, you would have to pay Washington a fee of $2,000 for every one of your full-time workers. (Company accountants take note: you could subtract the first 30 of your employees from that assessment.)
Got that?
Also, even if you do offer coverage, you might have to take some extra action to help any of your low- or middle-income workers who want to buy insurance on their own.
Take an employee who makes less than 400 percent of the federal poverty level, which today is about $10,800 for an individual, or $22,000 for a family of four.
Perhaps that employee is finding firm-offered insurance expensive. If their share of health premiums is more than 8 percent of their income (but less than 9.8 percent), they would have the option of going out and buying insurance on their own through the new-fangled “exchange” marketplaces the health care reform bill would establish.
And you, as an employer, would have to help them. You’d have to provide them a “free choice voucher” equal to what the firm would have kicked in to provide coverage in the company plan.
When do the changes take effect?

All of the above changes would take effect beginning on Jan. 1, 2014.
One final item: if you’re a firm with more than 200 employees, and you do offer health insurance, you would have to automatically enroll your workers in the plan.
They could opt out of the coverage. But they are the ones that would have to make that decision.
Join the healthcare reform discussion on Facebook
Health Care Reform Bill 101:
Introduction: What the bill means to you
Part 1: Who must buy insurance?
Part 2: Who gets subsidized insurance?
Part 3: What's a health 'exchange'?
Part 4: How long will reform take?
Part 5: Who will pay for reform?
Part 6: What will it mean for business?
Part 7: What does it mean for kids and families?
Part 8: What does it mean for seniors?

Thanks for the link aleonard.

Just to be clear on that. Even a restaurant with waiters, who make a far lower base pay, wouldn't be affected by the poverty line issue as a full time waiter making the Federal minimum wage would bring home just over $10,500 per year. That's before any tips and in Florida we have an additional $1 per hour. Unless it defines full time employment as 32 hours or more per week it's not the looming monster people are trying to make it out to be.

In the end the only thing this bill will do is provide ins for anyone who wants to buy it regardless of health. nobody has been succesful at slowing down the price increases of ins so what makes you believe the bubbling gov't can? think about the millions of sick people who will flock to this and cause huge claims. think about the massive shortage of dr's and hospitals we'll have with 30 mil new patients.THIS WILL ACTUALLY SKY PREMIUMS OVER TIME.the us is already techinally insolvent so who foots the bill for this?this could cost 100's of billions

The idea of these "exchanges" is not necessarily new fangled. Though I live here, I own an Ohio company that employs 10 people and provides full ins. coverage for them. The reason we are able to do this is because we are members of the Ohio Counsel of Smaller Enterprises (COSE). It functions very much like these proposed exchanges, at least as I understand them. Without it, we never would have been able to offer the type of ins coverage that we do. For companies employing less than 50 people, I dont see how this reform is a negative in any way. In fact, when combined with the credits we just found out we are receiving from the Obama stimulus plan, we are going to be able to create 2, and maybe 3, new positions this year...

Just how Im seeing the real effects of things......not judging it one way or the other...

My understanding is that these businesses can pay a fine instead of providing coverage.

Along those same lines the following scenario is being tossed around a lot. The bill madates that everybody, by law, has to have insurance. It also states that nobody can be excluded for any pre-existing conditions. Many young people who are generally healthy will find it cheaper not to buy insurance. When the need it, they will pony up the fine which is cheaper than having paid insurance to that point and will get treated because they cannot be denied.

Would preventative visits prevent a lot of these potential illnesses? Maybe.
Will the added costs of, now, having to treat somebody who is needlessly ill going to drive up costs? Maybe

It's an interesting scenario...

Along those same lines the following scenario is being tossed around a lot. The bill madates that everybody, by law, has to have insurance. It also states that nobody can be excluded for any pre-existing conditions. Many young people who are generally healthy will find it cheaper not to buy insurance. When the need it, they will pony up the fine which is cheaper than having paid insurance to that point and will get treated because they cannot be denied.

Would preventative visits prevent a lot of these potential illnesses? Maybe.
Will the added costs of, now, having to treat somebody who is needlessly ill going to drive up costs? Maybe

It's an interesting scenario...

I think in this case what we need to look at are the subsidies that will be available. So a young person who needs/wants coverage in your above example will 1) be able to use the exchanges and 2) will have access to a subsidy possibly. I can tell you from experience that for a young healthy person the cost for what would be considered a "cadillac plan" is about 100/month give or take. Also, as I understand it, if this person is making less than 45K, they will be eligible for a subsidy to offset the cost. So Id guess that many of these folks will in fact choose to be covered..

Again, this is my understanding, and I am not stating this as fact....

I think in this case what we need to look at are the subsidies that will be available. So a young person who needs/wants coverage in your above example will 1) be able to use the exchanges and 2) will have access to a subsidy possibly. I can tell you from experience that for a young healthy person the cost for what would be considered a "cadillac plan" is about 100/month give or take. Also, as I understand it, if this person is making less than 45K, they will be eligible for a subsidy to offset the cost. So Id guess that many of these folks will in fact choose to be covered..

Again, this is my understanding, and I am not stating this as fact....

Depends. The subsidy kicks in if they don't qualify for Medicaid. Since Medicaid is cheap or free I imagine they would just sign up for that and get the taxpayers to cover all their medical. For a single individual, the cut off for expanded medicaid coverage is now around 14K a year. So that covers all the waiters and artists.

For everyone else above the poverty line, the fine is $2000.00 a year or 2.5% of income. So I think folks over the poverty line will pony up for private plans, which I imagine are going to be a lot cheaper than the fine.

The subsidy applies if the cost of the plan is more than a percentage of income. (4% at the low end, 10% at the top end) A majority of the subsidies will be going to the folks at the very low end of the scale. Healthy youngsters won't even qualify, their plans will be too cheap.

For example:

income: 20K, coverage limit: 4% ($800.00) plan for a healthy individual: $1500.00, taxpayers pickup $700.00.

income: 40K, coverage limit: 10% ($4000.00) plan for a healthy individual: $1500.00, taxpayers pickup $0.00.

Now if they are in bad health, obviously the subsidies / limits will be a big help.

Considering how unhealthy a lot of youngsters are these dyas, I think we should add additional restrictions to this bill for people receivng help - for example, they should be punished for living non-healthy life styles. Drug tests and regular fitness exams should be mandatory.

This bill lacks any incentive to live a healthy lifestyle. For example, an extremely obese person with Diabetes, and other medical problems, will pay the same amount, maybe less if they cannot work due to their obesity, than a healthy person who chooses to eat right, not smoke, not drink, exercises, etc. Seems to me that as Americans get more and more overweight and we as a nation, exercise even less, costs of healthcare will increase accordingly. Obviously, many people choose their lifestyle, and they have no incentive to eat well and exercise regularly. I think if the gov't is going to shake things up with this Health Care law, they should give incentives ($$$) to people who don't have claims, as in the form of a rebate. If I knew that I could get paid to be more healthy, I would do so. Perhaps make it enough of a rebate to cover gym membership or fitness classes, or buy a nice bicycle. In this bill, I see no rewards for those who choose the healthy lifestyle. I was always taught that the best way to enforce a good habit is to reward it.

I know in Holland they charge based on weight, smoking and age. I wouldn't go as far as age here, but if they charged by kilo here, problem is healthcare would be completely unaffordable. The people who have gym memberships and home exercise equipment do so for themselves, and I do not see a rebate as being motivational for an obese population. I think the most we can hope for is the obese, or people who lacked insurance before, to go for regular check ups and hope that associated diseases are caught early in treatment stages.

Murray, I agree with much of the point you made about the bill lacking incentive for people to become more healthy. But i suspect that very few unhealthy folks would make lifestyle changes because of any incentives if they were in there. Case in point- a pack a day smoker would save about $2400 a year if they kicked their habit. If that isn't enough financial incentive then how would a reduction in the cost of their health care that is less than that convince them? There are many more compelling reasons than a few hundred or a few thousand dollars to make healthy choices. You either do it or you don't...

This bill lacks any incentive to live a healthy lifestyle. For example, an extremely obese person with Diabetes, and other medical problems, will pay the same amount, maybe less if they cannot work due to their obesity, than a healthy person who chooses to eat right, not smoke, not drink, exercises, etc. Seems to me that as Americans get more and more overweight and we as a nation, exercise even less, costs of healthcare will increase accordingly. Obviously, many people choose their lifestyle, and they have no incentive to eat well and exercise regularly. I think if the gov't is going to shake things up with this Health Care law, they should give incentives ($$$) to people who don't have claims, as in the form of a rebate. If I knew that I could get paid to be more healthy, I would do so. Perhaps make it enough of a rebate to cover gym membership or fitness classes, or buy a nice bicycle. In this bill, I see no rewards for those who choose the healthy lifestyle. I was always taught that the best way to enforce a good habit is to reward it.

The libertarians should be thrilled. Otherwise the government would be legislating choice.

Murray, I agree with much of the point you made about the bill lacking incentive for people to become more healthy. But i suspect that very few unhealthy folks would make lifestyle changes because of any incentives if they were in there. Case in point- a pack a day smoker would save about $2400 a year if they kicked their habit. If that isn't enough financial incentive then how would a reduction in the cost of their health care that is less than that convince them? There are many more compelling reasons than a few hundred or a few thousand dollars to make healthy choices. You either do it or you don't...

Really? Some people have been known to have babies, just to collect welfare checks, even though they cannot apparently do the math to know that they have to feed, cloth and house the children.

In the case you mention, you are talking about drug addiction (nicotine), so perhaps that was a bad example by me. However, if a non-smoker saves the gov't money by not having claims of lung cancer, why shouldn't that person be rewarded for not costing everyone extra money? I hear that part of this bill also includes a tanning tax. That's right, for people who go to tanning salons to tan. If they are willing to tax the people with bad habits, I guess fast food tax is coming next. My point is that all research shows that rewarding good behavior provides more good behavior than does penalizing bad behavior. If I can save everyone money by living a healthy lifestyle, why shouldn't I be somewhat rewarded? Instead, I would be penalized in a sense for other people's choices to live unhealthy lifestyles, as those choices are proven to cost more in health care.

SWGB, I'm not sure what your comment be. Are you saying we should legislate choice?

Really? Some people have been known to have babies, just to collect welfare checks, even though they cannot apparently do the math to know that they have to feed, cloth and house the children.

In the case you mention, you are talking about drug addiction (nicotine), so perhaps that was a bad example by me. However, if a non-smoker saves the gov't money by not having claims of lung cancer, why shouldn't that person be rewarded for not costing everyone extra money? I hear that part of this bill also includes a tanning tax. That's right, for people who go to tanning salons to tan. If they are willing to tax the people with bad habits, I guess fast food tax is coming next. My point is that all research shows that rewarding good behavior provides more good behavior than does penalizing bad behavior. If I can save everyone money by living a healthy lifestyle, why shouldn't I be somewhat rewarded? Instead, I would be penalized in a sense for other people's choices to live unhealthy lifestyles, as those choices are proven to cost more in health care.

SWGB, I'm not sure what your comment be. Are you saying we should legislate choice?

Yes, 10% and I believe it kicks in around 2054.