What is your ongoing opinion of the Affordable Care Act? (Title Edited)

Politics & Elections
221

It can more easily be lied about when it’s not in effect. Delaying implemention is a clear sign that the opponents weren’t lying, but were telling the truth.

In regards to the employer mandate, I don’t think there can be any doubt that the critics of ACA were 100% right. It’s unworkable, it will cost tons of jobs, and it will be a millstone around Democrats’ necks in 2014. Well, it would have been.

This administration sure likes to delay ACA implementation until non-election years. They did the same thing with the Medicare Advantage cuts that were supposed to go into effect in October 2012. There’s nothing these guys won’t politicize.

222

Alright, so after stewing on this for a day - and after having read quite a lot of commentary about the delay in the interim - let me take this time to refine the reservations of my earlier post.

Now, I’m not as upset about the delay as I was yesterday, which basically amounted to a knee-jerk response of deep disappointment. That said, I’m still unhappy that the employer mandate has been postponed for two reasons: (1) on a purely practical level, delaying the mandate is going to make the ACA more expensive (apparently, about $4 billion in revenue is going to be lost next year now), and the last thing I want to see is a bunch of spineless GOPers hoo’ing and ha’ing about the ACA driving up the deficit due to the delay even though it’s STILL going to massively lower the deficit in spite of everything else; more importantly, however, is reason (2), which is that delaying the mandate plays into the GOP fear mongering that the administration is unable to implement the law on time and that it’s doomed to fail and yadda yadda yadda.

The former concern can be assuaged if the mandate is actually imposed next year as planned - and if it isn’t delayed again or otherwise discarded - while the latter worry will only be addressed if (1) the marketplaces roll out ON TIME on October 1st and (2) if the administration doesn’t delay the individual mandate, which, unlike the delay of the employer mandate, would be a devastating blow to the ACA.

Thankfully, neither of those possibilities is seemingly on the table.

And Hell, there ARE benefits to delaying the employer mandate, both practical and political. On the practical side, lifting the employer mandate for a year will insure that more individuals actually INTERACT with the ACA and the exchanges, now that some employers might feel free to offload their employees onto the marketplaces. Consequently, more people will be in the pool and this should mitigate all this stupid talk of “rate shock” that the GOP has resorted to now that the meat of the ACA is only a few months away. Fuck, if I were in charge of everything, I would have every damn employer in this country offload their workers onto the exchanges, given that that would probably be the only fucking way to disengage us all from our stupid employer-sponsored health insurance system.

As has been said already, though, in political terms the delay robs the GOP morons of one of what was surely going to be their major talking points in next year’s election: “Oh NOES! Teh Obummers has forced ur job to give you teh benef!ts. Elect us so we can take those benies away!!111”

I can’t believe I just typed that. :stuck_out_tongue:

223

The individual mandate going away wouldn’t be devastating at all. It was never much of an incentive to get people to get insurance. It’s not enforceable and it’s designed to not be enforced.

Plus, candidate Obama had it right the first time: people don’t need to be forced to get health insurance.

As for the employer mandate, Ezra Klein had it right. It’s never going to be implemented because it can’t work. The delay is for election year purposes. If they killed it, Republicans could crow that it failed. If they implemented it, it would cost a lot of jobs. Delay is how the President plans to muddle through until the 2014 elections are past.

224

Today’s NYT editorial commented on the low Impact of the 1 year delay.

It went on to say

which is amply proven in this thread.

The editorial closed with

225

If the impact of the employer mandate is so low, then repealing it altogether wouldn’t be so bad, no? It only affects companies with more than 50 full time employees who don’t currently provide health insurance.

Side question, and hopefully not a hijack. I was looking for individual policies on the web and found several that were high deductible, HSA eligible, no maternity coverage, no mental health coverage, background check for pre-existing conditions. Don’t all of the previous things go away when Jan 1 rolls around?

226

For companies? Probably not. But it would be a disaster for the uninsured, and higher premiums for the everyone else.

227

Not for the companies, no, but you seem to be forgetting the employees, hmm?

If, as you say, the impact is so low, then why don’t the companies just go ahead and do it? :dubious:

228

As I understand it, the last three go away, but HDHP and HSA plans will stay around as long as they meet other ACA requirements.

Wife and I have HDHP/HSA plans and have been told we can keep them next year.

229

Thanks. I understand that there are “minimum standards” for a plan to be ACA compliant. If a plan is HSA eligible it has a high deductible. I envision a scenario where a company can offer a high deductible plan for 10% of an employee’s salary and really not offer a whole hell of a lot. What is the maximum deductible? I see $10k in my searches.

A young, healthy minimum wage worker can afford a $10k deductible HSA eligible policy for less than 10% of his wage on the free market. If his employer offered that deal (10% for a HD/HSA policy), he would be a fool to take it, but it seems that the ACA mandates it nonetheless.

230

IIRC, any HDHP plan will have meet at least Bronze level standards for OOP
costs.

231

On the bright side, this now puts the lie to the idea that the IRS is “independent”, an early talking point in the IRS scandal. The law states that the IRS is supposed to enforce the employer mandate, but the administration claims the power to stop the IRS from enforcing the mandate. Thus, the IRS does take direct orders from the administration and it not actually independent.

Another issue which they may or may not have thought through: if employers don’t have to report whether they are providing affordable health insurance, how do people qualify for the exchanges? Only people who cannot get affordable health insurance from their employers are allowed to receive subsidies for the exchanges. And that’s not a law the administration can just wave away.

232

To this old boy (kidney failure + osteoarthritis), who is paying 1/4 of his income for not-so-great insurance (advice from a competitor last time I tried to buy insurance: “Whatever you do, don’t let anything happen to that insurance!”), I am desperately hoping it works - the “Silver Plan” is quoted at 1/3 of current premiums.
Even if (as the GOP is darkly hinting) rates skyrocket in 2015, if I can’t afford it, I’ll punt and just buy medicare - I’ll be 65.
Medicare says it covers “end stage renal failure” - that apparently means dialysis - I don’t know about erythropoiesis stimulating agents - the $2500/week drugs to prevent complete shutdown of hemoglobin. Google “epogen” - best known of the three.

233

Where are the retired “rust belt” workers who were promised health insurance for life along with their (generous) pensions?
GM gave the UAW a few billion and told them - they’re your people - you pay their medical bills.

The big problem is getting enough people is the exchanges that the exchanges can absorb the massive cost of those 70-90 year-olds who built all those crappy cars in the 60’s-80’s.
First, destroy the American economy by producing crap, then ruin the health insurance system.
Ta-daaaa!
Not bad for a single generation, eh?

234

The 70-90 year olds already get Medicare. The ACA was written to help those under 65 who were too poor to qualify for Medicaid under the old system or who were too sick to get private health insurance.

235

So just to follow up, what can I expect to happen to the policy that was quoted at $400/month for my daughter and I that excludes maternity, mental health, and a screen for pre-existing conditions? Surely that number cannot remain the same if the company is now covering the above three on January 1. (Not trying to start a new debate, just stating a fact. Extra coverage is an extra cost, right?)

Is there any benefit to signing up now or come January 1 will the company just say, sorry, that’s $700/month now, or alternatively, we are cancelling this policy, go to the federal exchange for coverage.*

*I will be offered insurance through my employer, but damn it is expensive and my employer will pay me cash in lieu of premiums. I always liked the HSA plan I had before and being relatively young and healthy, it is a better deal for me, especially with the tax advantages. I don’t go bankrupt from an unforeseen emergency, but I can use market forces to lower costs for routine medicine.

236

From what I understand, you have to have qualifying health insurance or pay a tax. If your employer offers qualifying insurance, then you have to take it, you aren’t eligible for exchange subsidies.

237

What they qualify for and what they were promised are two VERY different things.
As I understand it, their retirement health care was promised to be EVERYTHING FREE!
Medicare ain’t close.

238

True, but that promise came from a private company that promised more than it could deliver.

239

Well, I don’t want, nor will I qualify for a subsidy. And I will have health insurance to protect my assets, so the penalty/tax won’t be an issue.

I’m just wondering if anyone in the know will predict what will happen on January 1 to the rates of these policies and those like it that quote things that will no longer be permissible on January 1. Will they not be offered, or only offered at a higher (and how much higher?) rate?

The problem I am facing is that the firm I will be working for in August will pay my premiums at 100%, but I would have to pay sticker price for my daughter. My ex-wife’s employer will pay her premiums (mostly) but she would have to pay sticker price for our daughter.

I think that both prices are outrageous, but I can’t buy a single policy only for my daughter. Since my employer will pay me cash if I opt out of his health insurance coverage, I really like this HSA plan (as I have had similar ones in the past).

The problem is that nobody with knowledge can tell me what will happen on January 1, and I am simply trying to provide for my family here. If I am going to have a huge increase in a private plan premium on January 1, then it might be better to go through my employer. But nobody seems to know what the ACA will cause, even though it’s been law for 4 years.

240

Why would anyone be able to predict what every private insurer will do? That presumes they always make the most cost effective decision, which based on the past, we know is not true. Some will raise rates, some will reduce rates. Some will prosper as a result, others will wither. That is the nature of competition in the free market. In the long run, I believe it will reduce rates for everyone, but I can’t guarantee it. If that is what you are waiting for before making a decision, I am afrad you are in for a long wait.