# How is Obamacare going to work for families that have expensive workplace health insurance? **URL:** \ **Category:** Factual Questions\ **Created:** [January 29, 2013, 7:55pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737 "2013-01-29T19:55:26Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![actualliberalnotoneofthose](https://avatars.discourse-cdn.com/v4/letter/a/e79b87/32.png) [@actualliberalnotoneofthose](https://boards.straightdope.com/u/actualliberalnotoneofthose)\ **Post date:** [January 31, 2013, 5:49am UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/21 "2013-01-31T05:49:08Z")
I think in my state Medicaid is for like up to 200% of the poverty line for families. I assumed they would force people into that if they want to avoid paying the high premiums and are eligible. Or is that still just going to be on a state by state basis and some states will not be expanding that at all (as far as adding adults and increasing income limits)? ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 31, 2013, 8:50am UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/22 "2013-01-31T08:50:07Z")
That was the one part the SCOTUS partly struck down, saying states could not be forced to join the Medicaid expansion. Some stubborn red states are refusing to, even though the federal government is paying over 90% of the tab. But it only raises the threshold to 138% of FPL, and we are at 200%. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [January 31, 2013, 9:18am UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/23 "2013-01-31T09:18:56Z")
This just in! Article in New York Times yesterday (Jan. 30): [Federal Rule Limits Aid to Families Who Can’t Afford Employers’ Health Coverage](http://www.nytimes.com/2013/01/31/us/politics/irs-to-base-insurance-affordability-on-single-coverage.html) > [@](#): > > WASHINGTON — The Obama administration adopted a strict definition of affordable health insurance on Wednesday that will deny federal financial assistance to millions of Americans with modest incomes who cannot afford family coverage offered by employers. > > In deciding whether an employer’s health plan is affordable, the Internal Revenue Service said it would look at the cost of coverage only for an individual employee, not for a family. Family coverage might be prohibitively expensive, but federal subsidies would not be available to help buy insurance for children in the family. Family-friendly, my ass. ---
**Author:** ![PandaBear77](https://avatars.discourse-cdn.com/v4/letter/p/edb3f5/32.png) [@PandaBear77](https://boards.straightdope.com/u/PandaBear77)\ **Post date:** [January 31, 2013, 11:02am UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/24 "2013-01-31T11:02:06Z")
> [@Senegoid](#): > > This just in! > > Article in New York Times yesterday (Jan. 30): > [Federal Rule Limits Aid to Families Who Can’t Afford Employers’ Health Coverage](http://www.nytimes.com/2013/01/31/us/politics/irs-to-base-insurance-affordability-on-single-coverage.html) > Family-friendly, my ass. In-fucking-deed. I can feel my BP going up already and it’s not even 6:30am. ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 31, 2013, 8:06pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/25 "2013-01-31T20:06:20Z")
Ugh. Ugggghhhhh. UGH! WTF–this is seriously disheartening, not just personally (though it certainly is that) but it is so asinine from a policy perspective. I really can’t believe this. ETA: PandaBear, you seem to have not wanted Obama to be president, is that right? This rule shouldn’t really bother you then because the subsidy is not there but neither, if you read the whole article, is the penalty for not buying insurance. So it’s status quo all the way. I hate the status quo, but if you didn’t, what’s the problem? ---
**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\ **Post date:** [January 31, 2013, 8:10pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/26 "2013-01-31T20:10:29Z")
Democrats had better be careful. It looks like the Pubs might be right on what a clusterfuck this will be. So in my case: Me: $0 Me+spouse: $400 Me+family: $900 So consider me screwed by the Federal rule. This was my favorite: > [@](#): > > Under the law, people who go without insurance will generally be subject to tax penalties. In a separate proposed regulation issued on Wednesday, the Internal Revenue Service said that the uninsured children and spouse of an employee would be exempt from the penalties if the cost of coverage for the entire family under an employer’s plan was more than 8 percent of household income. So rather than helping me get my family covered, you just won’t punish us because we can’t afford it? Thank you Obama. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [January 31, 2013, 8:41pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/27 "2013-01-31T20:41:29Z")
> [@Saint\_Cad](#): > > Democrats had better be careful. It looks like the Pubs might be right on what a clusterfuck this will be. They should know, they proposed it first - back in 1993. [This](http://www.kaiserhealthnews.org/graphics/2010/022310-bill-comparison.aspx) shows that much of the current bill is identical to a proposal from Republican senators to counter the Clinton era reforms which would have mandated employer coverage for all. I think Obamacare is good improvement for a first step, but some are going to be very disappointed because it does not guarantee low cost coverage for all. It does make it possible to get insurance. However the cost can be quite a shock since employers have not usually let employees know how much insurance actually costs. ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 31, 2013, 8:53pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/28 "2013-01-31T20:53:46Z")
But why, WHY, would they ever think of making it more expensive to get covered if someone in the family has an employer that picks up part of the tab, than if you have the identical household income but no one in the household works for an entity that provides any coverage? It is beyond ridiculous and just makes NO sense at such an elemental level, I don’t know whether to laugh or cry (though obviously I’m leaning toward the latter). ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [January 31, 2013, 9:31pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/29 "2013-01-31T21:31:02Z")
> [@SlackerInc](#): > > But why, WHY, would they ever think of making it more expensive to get covered if someone in the family has an employer that picks up part of the tab, than if you have the identical household income but no one in the household works for an entity that provides any coverage? It is beyond ridiculous and just makes NO sense at such an elemental level, I don’t know whether to laugh or cry (though obviously I’m leaning toward the latter). If that happens - and we won’t really know until the exchanges open on 1 October, it is an indefensible flaw that should be corrected by legislation that clears things up. As it is, it leaves the IRS on the hook for an unpleasant decision. But… with congress the way it is, don’t hold your breath for adjustments to the ACA (except repealing it of course). I wonder how things would look if the ACA forced every employer to drop health insurance and simply gave everyone a raise. Everyone would have to use the exchanges on a level field then. As it is, we have people with ‘Cadilliac’ employer plans getting taxed and people with ‘Scrooge’ plans getting screwed with the possibility of no subsidies. ---
**Author:** ![snowthx](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowthx/32/10660_2.png) [@snowthx](https://boards.straightdope.com/u/snowthx)\ **Post date:** [January 31, 2013, 9:38pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/30 "2013-01-31T21:38:46Z")
> [@SlackerInc](#): > > But why, WHY, would they ever think of making it more expensive to get covered if someone in the family has an employer that picks up part of the tab, than if you have the identical household income but no one in the household works for an entity that provides any coverage? It is beyond ridiculous and just makes NO sense at such an elemental level, I don’t know whether to laugh or cry (though obviously I’m leaning toward the latter). I do not know the answer, but perhaps it was to put pressure on employers to extend coverage to an employee’s family and not just cover the employee alone. Maybe they figure those that offer better benefits will be more attractive to prospective employees, and companies would want to retain their good employees and not have them leaving for better benefits. Just speculating. The outcome here so far does seem disappointing. I would have expected better. ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 31, 2013, 9:47pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/31 "2013-01-31T21:47:29Z")
> [@](#): > > But… with congress the way it is, don’t hold your breath for adjustments to the ACA (except repealing it of course). Exactly. I am \*seriously _thinking I may actually have to divorce my wife_ so I can get affordable coverage through the exchanges! And how fucked up is that–good grief. Talk about the law of unforeseen consequences…but they should have seen this one coming. \*Would this be like an immigration case, where someone from the IRS will sniff around to see if we are still living and sleeping together? Gaaahhhhh… ---
**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\ **Post date:** [February 1, 2013, 2:44pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/32 "2013-02-01T14:44:11Z")
> [@jasg](#): > > They should know, they proposed it first - back in 1993. [This](http://www.kaiserhealthnews.org/graphics/2010/022310-bill-comparison.aspx) shows that much of the current bill is identical to a proposal from Republican senators to counter the Clinton era reforms which would have mandated employer coverage for all. But the point of the OP was that Family insurance coverage will be cost out at the individual rate for subsidy eligibility and thus most middle-class familys will still not be able to afford coverage. Are you saying the Republicans had that as part of their plan? ---
**Author:** ![ralph124c](https://avatars.discourse-cdn.com/v4/letter/r/8797f3/32.png) [@ralph124c](https://boards.straightdope.com/u/ralph124c)\ **Post date:** [February 1, 2013, 3:57pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/33 "2013-02-01T15:57:04Z")
I have a different question: when those 11-12 million illegal aliens become US citizens, they wil be eligible for Obamacare. Suppose they have zero taxable earnings (they work in the cash-underground economy)-who will pay for their health coverage? ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [February 1, 2013, 4:56pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/34 "2013-02-01T16:56:01Z")
> [@ralph124c](#): > > I have a different question: when those 11-12 million illegal aliens become US citizens, they wil be eligible for Obamacare. Suppose they have zero taxable earnings (they work in the cash-underground economy)-who will pay for their health coverage? 😕 I don’t see a smiley-face on this question, so I’ll ask the obvious: who will pay for the health coverage of legal non-aliens who have zero taxable earnings (they work in the cash-underground economy) ? One argument in favor of legitimizing aliens is so they won’t work underground. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [February 1, 2013, 5:33pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/35 "2013-02-01T17:33:11Z")
Maybe I am misunderstanding, but it seems as if an employee is generally better off if his employer does NOT offer health insurance under the new law. But the new law then penalizes the employer if it doesn’t offer health insurance creating a tension between the two. Again, if I understand, say I make $1000/mo (for simplicity, ignore the poverty level) As long as an employer makes my health care available for $95/mo, then it is good, right? But it could say that coverage for my spouse or child is $1500/mo and STILL be in compliance with the law? And I don’t get a subsidy for the exchange? ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [February 1, 2013, 6:02pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/36 "2013-02-01T18:02:27Z")
The fact that affordability will be based on single coverage has been expected for well over a year, based on preliminary regs, and the recent guidance just makes it official. Also worth noting is the potential income gap in states which do not elect expanded Medicaid coverage. This is about people who are not eligible for Medicaid under current rules but are eligible under ACA expanded Medicaid rules (income up to 138% of FPL). Since under the ACA these people were assumed to qualify for Medicaid, they are not eligible for subsidized coverage on exchanges. But if a state does not expand Medicaid - as allowed under the USSC ruling - then these people will also not qualify for Medicaid, and are SOL unless they get raises (or pay cuts). A whole lot of states are apparently electing not to expand Medicaid, so this could be a big issue. In other ACA news, a lot of unions are apparently having second thoughts about the ACA, having belatedly realized that their own health plans are going to be undercut by ACA, and that having a plan is a big part of the reason the unions exist in the first place. [Link](http://online.wsj.com/article/SB10001424127887323854904578260313912570432.html) And what about Obama’s promise that "“If you like your health-care plan, you can keep your health-care plan”? [More bad news](http://www.economist.com/news/business/21570756-will-obamacare-spur-firms-drop-workers-health-cover-insured-and-unsure). ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [February 1, 2013, 6:25pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/37 "2013-02-01T18:25:27Z")
> [@Saint\_Cad](#): > > But the point of the OP was that Family insurance coverage will be cost out at the individual rate for subsidy eligibility and thus most middle-class familys will still not be able to afford coverage. Are you saying the Republicans had that as part of their plan? Of course not. Their plan never got implemented. I do find Republican objections to Obamacare rather disingenuous. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [February 1, 2013, 6:49pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/38 "2013-02-01T18:49:23Z")
My guess - none of the articles, none of the IRS press releases, and probably not even the IRS themselves have figured out what the real rules are. The ruling was imply to make it so that if Dick and Jane got married, or Jane had triplets, or the other Dick in the household got laid off, the employer was not suddenly hit with an unforseen penalty. The obvious cheat is simple - 0 for the employee's coverage, (the roof) for any dependants. Nobody signs up their dependants, they use the exchange, but the employer does not get penalized. The employer no longer has to voucher for what the employee’s in-house plan would cost. Drive as many employees as possible to choose the exchange while avoiding fines. I bet nobody in the IRS wants to stick their neck out to make a decision on this so - is an employee getting the subsidy if the cost structure is such that the employer aviods a fine? Leave it to the politicians to decide the issue when the noise gets louder. The various articles most likely quote those with an agenda putting their own interpretation on ambiguity. ---
**Author:** ![moriah](https://avatars.discourse-cdn.com/v4/letter/m/b2d939/32.png) [@moriah](https://boards.straightdope.com/u/moriah)\ **Post date:** [February 1, 2013, 7:57pm UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/39 "2013-02-01T19:57:33Z")
> [@Fotheringay-Phipps](#): > > And what about Obama’s promise that "“If you like your health-care plan, you can keep your health-care plan”? [More bad news](http://www.economist.com/news/business/21570756-will-obamacare-spur-firms-drop-workers-health-cover-insured-and-unsure). Well, that’s a rather disingenuous set-up for that link. You make it sound that current plans will be taken away from you be _force_ because the promise is a lie!. But the link says _maybe_ some _employers_ will drop insurance plans. And maybe they won’t. Just like all those ‘job creators’ said they’ll fire huge numbers of employers if the tax rate went up on the top tier taxpayers. How did that pan out? ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [February 3, 2013, 5:43am UTC](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737/40 "2013-02-03T05:43:25Z")
> [@Senegoid](#): > > This just in! > > Article in New York Times yesterday (Jan. 30): > [Federal Rule Limits Aid to Families Who Can’t Afford Employers’ Health Coverage](http://www.nytimes.com/2013/01/31/us/politics/irs-to-base-insurance-affordability-on-single-coverage.html) > > [Excerpt from that article quoted here] > Family-friendly, my ass. Follow-up: Editorial in NYT today (Feb. 2) [here](http://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html?ref=opinion). [Previous page](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737.md?page=1) [Next page](https://boards.straightdope.com/t/how-is-obamacare-going-to-work-for-families-that-have-expensive-workplace-health-insurance/648737.md?page=3)