Affordable Care Act and Ramifications Discussion

<p>Another article from today’s Times - the rise in the number of part-time workers. The road to hell paved with good intentions.</p>

<p>There were a ton of articles on the part-time workers thing last weekend. There’s somewhat of a rebuttal by Rex Nutting at CBS Marketwatch - he acknowledges that there are a lot of part-time workers but that it’s not the end of full-time jobs out there.</p>

<p>Lookingforward, </p>

<p>Re: post 526</p>

<p>It was at this site that I ran into that $19,000 year silver plan before deductible and out of pocket fees for a family with hypothetical 115,000 gross wages. </p>

<p>[Washington</a> Health Benefit Exchange :: Home](<a href=“http://www.wahbexchange.org/]Washington”>http://www.wahbexchange.org/)</p>

<p>It is all to be determined and can change. Maybe higher or lower. </p>

<p>We still do not know what modified AGI is, either. I have my own business besides my part time job - will it be what income comes in before expenses or all revenue?</p>

<p>The exchanges will not benefit those in group insurance plans thru employers or those over 80,000 a year, unless they have pre-existing conditions and are uninsurable.</p>

<p>I have not been able to find the answer to this question…and maybe someone here knows…otherwise I’ll wait for the broker’s response.</p>

<p>If one qualifies for a subsidy, does this subsidy apply to ANY plan or just the ones offered thru the exchange.</p>

<p>Okay…signing off again…</p>

<p>We should be careful of attributing part time work exclusively to Obamacare. There are lots of reasons employers are using PT 'ees that have nothing to do with Obamacare. </p>

<p>And if you comment on my post, be gentle because I’m feeling pretty testy. It’s 98 degrees outside and we just lost power including Air conditioning. I am not a happy camper.</p>

<p>FWIW, according to our thermometer, we had temps of 100 degrees in HI and I don’t even OWN any A/C. I guess I’ll have to go to the mall and/or library or somewhere to cool off. Just ate an ice cream bar. Hmmm, what next.</p>

<p>Employers have been using PT employees for a long time and misclassifying employees as contractors as well. Some get caught and some get away with it for quite a while. It really is unfair for the workers, who don’t want to lose their jobs but have very little power in the matter. I’m sure the more burdens placed on employers for employees because of medical insurance increases the pressure toward PTers and contractors. <sigh></sigh></p>

<p>Department of Labor CAN levy fines and penalties against employers who misclassify people as contractors instead of employees, but historically have not prosecuted often.</p>

<p>Blue Cross has been a major user of temps, here.</p>

<p>MAGI is define in the ACA documentation and corresponding IRS docs.</p>

<p>The subsidy tiering actually goes to 158k, 8 in family. And the qualifier has to do with, eg, if your employer plan charges you more than x% of income.</p>

<p>Definitely, someone outside the tiers doesn’t want to purchase through a plan designed for low/moderate income.</p>

<p>I still wonder if an insurer could/would purposely alter a grandfathered plan to have it de-certified, pushing people to more expensive. I don’t see depth on the regs. But you know that’s becauise I think it’s too soon to expect the info.</p>

<p>Look at the Kaiser link to subsidies, from the top of the thread. You get a subsidy and it shows against one of the silvers. Go higher or lower in plan type and your net rises or lowers.</p>

<p>Have heard that Kaiser Permanente is hiring some temp MDs–pretty scary to me, as they are being trained by existing staff and then leave before they accrue benefits.</p>

<p>Himom, do you have more info on temp docs?</p>

<p>Dietz, no. Just the exchange.</p>

<p>[Subsidy</a> Calculator | The Henry J. Kaiser Family Foundation](<a href=“http://kff.org/interactive/subsidy-calculator/]Subsidy”>Health Insurance Marketplace Calculator | KFF)</p>

<p>My own quote: Definitely, someone outside the tiers doesn’t want to purchase through a plan designed for low/moderate income.</p>

<p>See, I think in the calculation from lowest tiers to each next one, they’ve got a formula or extrapolation. One you get beyond the tiers it’s designed to serve, the formula keeps on ticking. I hope that’s why it’s thrown so askew.</p>

<p>I had to research contract employee laws and they are very clear on what qualifies. </p>

<p>And, remember Married with Children, where they just went to the grocery store and sat in the produce aisle in lawn chairs, all day?</p>

<p>Sorry, Hayden. I am rather annoyed because they collected the digiplayer a full 45 minutes before landing (with 5 min to go in the movie, the second time that happened in the same movie), someone passed gas and left us all trapped in the shuttle, and I just missed my bus. But, I conceed that your misery surpasses most of ours.</p>

<p>Nevertheless, suddenly many business’s are cutting hours to less than 30 hours. If you were a small business; and your choices were to cut hours and stay in business, or pay for health insurance or fines that you couldn’t afford; what would you do? Many businesses have a very small profit margin.</p>

<p>Btw, my employer cut hours after 2008 and without discussing needs with depts. Rather large employer. Granted, it cut bloat.</p>

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<p>Some of us have been doing this for many years.</p>

<p>No, just what I have been told by KP workers, who get tired of having to train the MDs, who are just a revolving door and keep leaving because they are only hired on a temp basis (so they don’t get benefits). DISCLAIMER–I do NOT work at Kaiser and have never been a member, all I know is from newspaper articles and comments made by KP employees.</p>

<p>The other staffers I spoke with were concerned that the temp docs really are not seasoned and have to ask how things are done, slowing down care. Didn’t inquire much and don’t have details.</p>

<p>Do know that a LOT of the long-time Kaiser nurses locally were fired and replaced with cheaper employees that have less experience as well. It was pretty upsetting and the attitude there is pretty bad, especially among the unionized folks who have seniority and are mad about these changes and cost-cutting measures.</p>

<p>I know their long term MDs are treated well and get very generous pensions (have a relative working there). One of my board members retired because if she hadn’t, she would have had a huge penalty due to some federal provisions that had recently passed. She left after 29 years, even though she really didn’t want to except for the finances. She has gone on to start working for the VA & is busier than ever and likely to get benefits from them as well, plus a pension.</p>

<p>Ok thanks.</p>

<p>96 percent of businesses with more than 50 employees provide healthcare for their workers. The individual healthcare market is small. There are projections in the numbers that some employers will not provide healthcare when ACA really gets going.</p>

<p>There has been negative feedback to companies that have said they will cut hours. Check out Papa Johns and Dardens. Dardens sales were hit when they tried to cut hours.</p>

<p>Regarding UNH’s (United Healthcare) earnings - their subscriber base went up 7% which seems huge to me. I didn’t read all of the details and they might not have discussed where this 7% came from but I suspect that it’s adult children under 26. They also bought a Brazilian healthcare company so they are expanding internationally.</p>

<p>The part-time thing seems to be growing from what I’ve seen in my daughter’s job search. I see part-time/contract lawyers, doctors, programmers and all sorts of other things. There are gig websites where you list your skills and an employer will contract with you to do a piece of work over the internet. The worker might be doing this because they want to or because they have no better options.</p>

<p>BTW, I just ran 3+ miles in 93 degree. Played 50 minutes of tennis at lunch in 99 degrees, humid and sunny weather. I’m working as hard as I can so that I don’t need healthcare services.</p>

<p>Brinker is doing this too. I was at an Olive Garden this past week - third time I’ve been to a restaurant in the last year. It’s odd being served by waitstaff where you know that their employer is pulling the strings. The waitstaff have to be cheerful and friendly while they know that they aren’t making much and don’t have the benefits to make life easier. It almost seems like servitude to me - though they are free to quit if they can find something better.</p>

<p>Answer to question #584: You have to buy through the exchange to get the subsidy – at least to get in the form of an ongoing insurance rate reduction.</p>

<p>The “subsidy” is actually a tax refund, but it is set up so that it is collected in advance by the exchange in order to reduce premiums — but I am thinking that we self-employed people who are unsure about whether we qualify for subsidies might do better to waive the subsidy but collect the tax refund (if eligible).</p>

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<p>[The</a> Obamacare Subsidy You Could Be Missing - My Money (usnews.com)](<a href=“http://money.usnews.com/money/blogs/my-money/2013/05/07/the-obamacare-subsidy-you-could-be-missing]The”>http://money.usnews.com/money/blogs/my-money/2013/05/07/the-obamacare-subsidy-you-could-be-missing)</p>

<p>(A lot less angst that way for anyone with income that fluctuates up or down around the cut off point- but it will be worth double checking on the tax regs as to what types of plans will qualify for the tax refund. Plus, in year #2 we’ll have all the tax forms & will have much clearer understanding as to how to calculate our MAGI).</p>

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I think that process of getting a plan “grandfathered” pretty much locks the insurer into the plan. See – [Fact</a> Sheet: Keeping the Health Plan You Have: The Affordable Care Act and ?Grandfathered? Health Plans](<a href=“http://www.healthreform.gov/newsroom/keeping_the_health_plan_you_have.html]Fact”>http://www.healthreform.gov/newsroom/keeping_the_health_plan_you_have.html)</p>

<p>I see what you are saying about purposely making the changed to force revocation of the plan – but it wouldn’t make a lot of sense unless there is a large discrepancy in income or costs, or an insurer wants to pull out of a particular market entirely. I mean, the problem is with “pushing people to more expensive” policies is that the insurance company may be pushing those people to some other company’s more expensive policy.</p>

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This has been going for years. It was a trend already back in the 90’s when I stopped practicing law – it was a factor in my decision to go to another career. With or without ACA, professionals expect to receive benefits (health insurance, 401K, paid vacations, sick days, etc.) with their jobs – so the ACA has very little impact on those firms. They would be paying for health insurance for FT workers anyway, and their insurance rates have been rising steadily for a very long time as well. Law firms and medical providers also have to worry about malpractice insurance coverage for their FT employees – the cost of that coverage dwarves the cost of health insurance.</p>