<p>My best friend’s employer dropped her insurance (and that of the only other full time employee) LAST YEAR and blamed it on Obamacare. It’s impossible to tell if he was using ACA as an excuse or he really doesn’t understand it. Not that anyone understands it fully.</p>
<p>FWIW, the ACA thus far had been adding jobs - it mandates a whole new infrastructure with the exchanges, and new people have to be hired to make it happen. See: [Technology</a> Firms Staff up to Build Health Insurance Exchanges - The Daily Beast](<a href=“Technology Firms Staff up to Build Health Insurance Exchanges”>Technology Firms Staff up to Build Health Insurance Exchanges)</p>
<p>While it is also true that jobs may be lost due to the employer mandate, those are anticipated future losses --while the firms who are ramping up for the implementation of Obamacare are hiring now – so if there is any uptick in unemployment, it is highly unlikely to be a reflection of ACA.</p>
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<p>Maybe, busdriver. But that’s also not the reason they gave. </p>
<p>tom1944, I think you’re right.</p>
<p>I think companies are opportunistic about cutting when they can, and more opportunity comes from blaming on the ACA. I don’t know how accurate those unemployment numbers are. I hope they’re wrong, because it worries me.</p>
<p>That size jump in unemployment in one month would be quite bizarre. It’s quite unlikely.</p>
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<p>Busdriver and I often disagree, but this statement is one I agree with 100%.</p>
<p>I actually think (and probably busdriver would agree with me) that companies should be opportunistic about cutting costs. I abhor liars, though; if they want to cut costs, fine, but they shouldn’t pretend that they have to cut costs because the ACA is increasing their costs if they are actually cutting costs because they think that the spouses can get insured elsewhere so why should they pay.</p>
<p>My husband just got a mailing today. One of his specialist doctors is going to the “Concierge” type of service where you pay an annual membership fee for the privilege to have him be your doctor. You still have to have insurance and you still pay any deductibles and co-insurance. It’s being marketed that you then get to spend more time with your doctor because they limit the number patients that have a membership. ugh. He sees two other doctors for other things and they too are considering doing the same thing. WHY? They have told him it’s because of Obama care and all the regulations. By doing this they are also able to avoid rules on how many patients on medicaid they have to see.</p>
<p>Concierge care is a solution to the problem of having too much money and wanting to pay more to your doctor. You buy regular insurance, you pay regular copays AND you pay an annual fee to your doctor, and in exchange you get longer doctor visits. Typically, concierge patients are limited in how many times a year they can see their doctors, though the limits are big enough that they would make no difference to most patients.</p>
<p>^^Concierge and off shore medical tourism will increase…for those that can afford it.</p>
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<p>Or simply working smartly within the inherent weaknesses of the ACA system…</p>
<p>Concierge practices will by definition be out of network. Therefore they will not be covered by the EPO HMO and limited PPO plans offered through the exchanges - speaking for CA only…not sure about the rest of the country.</p>
<p>If one can figure out how to be subsidized through an exchange plan and subsequently afford a concierge practice…it is the best of both worlds. And since the ACA does not take assets (only 1040 income) into account it is quite doable to be paper poor but have ‘too much money’ which one can throw at a concierge practice… Those willing to work the system to make this work will no doubt increase in number. More power to them</p>
<p>If you have assets that you are selling off to live on, you can get subsidies for health insurance, and also sell off some more assets to pay for concierge care. The group of people who have assets which do not produce income, and who don’t have other streams of income, and who are selling off those assets to live, and who are under 65, and who are willing to use some of their assets to pay for concierge care, is probably not empty, but I’m just guessing it’s also probably not big enough that I care about it.</p>
<p>Michigangeorgia - how much are they charging the members?</p>
<p>I got a mailing at one time long before ACA (2010-11) asking us to decide if we wanted to be members of such a practice from someone we randomly went to for care once.</p>
<p>Instead of saying this how much they will charge you, it was a survey saying how much is it worth to you and the lowest mentioned was 1000 per year. I saw that survey and went may be I should get paid to give you my business instead.</p>
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<p>What they have told him is baloney. Concierge medicine was around before Obamacare was ever thought of. Just one more example of people using ACA as an excuse to do something they wanted to do anyway. In this case, they think it will be to their financial benefit but don’t want to say so.</p>
<p>It seems to me that one thing ACA may be doing (whether it means to or not) is shining a light in the hull of the good ship “EmployerBenefits” and revealing rats in the belly 
The shenanigans are astounding to me!</p>
<p>At the same time, if there had been a company policy to subsidize family benefits at UPS, and the cost hikes insurers are blaming on ACA are passed on to UPS, it may well be true that ACA was a precipitating factor in the decision to change the coverage because ethically speaking, said families can now access healthcare, and likely comparable healthcare, without the subsidization of the company or large plan economy of scale. </p>
<p>I know in our case we made a conscious decision to offer and subsidize family benefits due to concern for the employees family. But I cannot warrant just how much more we’re willing to spend to do so, frankly, when healthcare costs outstrip earnings growth by an astronomical ratio :)</p>
<p>If all care is one of the metallic plans, has removed caps, and has reasonable out-of-pocket limits, and is transparent in pricing, and access despite preexisting conditions, plus operates on pooled care, I wonder if it wouldn’t make more sense to do away with traditional employer plans entirely and instead offer a “health supplement” payment to a salary (or allow companies to buy blocks or care on the exchange) and then perhaps offer ancillary employee benefits such as vision, dental, group disability, accident insurance, etc. I realize that’s the opposite of ACA in a way, but in actual effect the uniformity should level the playing field and reduce the shenanigans-factor.</p>
<p>(Texas, since I’ve run afoul of the no-single-payer posting before, allow me to make clear I’m not referring to single payer approach in this instance. :)</p>
<p>Historically, employers offered benefits to attract employees. Nowadays, we have a sellers market, not a buyers market, and consequently employers don’t have to compete much - if at all - with each other to attract workers. Cutting health benefits to employees and their families isn’t about ACA.</p>
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I will be looking into just this scenario in the next few months (once the exchange rates are out).</p>
<p>Texaspg - $1650 per year. Too much for us even though their practice is one for the best in their field in the Atlanta area. My husband believes that a lot of the other patients will pay the money because they are highly regarded and unlike my husband a lot of the patients require lots of visits to them because of their health issues. My husband only goes there maybe 2 to 3 times a year. So he will need to find another specialist. I have to say though if it was our asthma doctor we would probably find a way to pay since all 5 of us have asthma…</p>
<p>If someone doesn’t have a big income (including investment income and working income), so that their total income is substantially less than 400% of poverty, and they don’t get insurance through their employer, then they get meaningful subsidies to buy insurance. If that person wants to in addition spend $1650 per year per person on concierge health care, who am I to complain how they spend their money?</p>
<p>Concierge care doesn’t cover the expensive stuff: it doesn’t cover hospitalization, it doesn’t cover drugs, it doesn’t cover rehab or mental health care or ambulances or medical devices or specialists or lots of other things you’d need if you were seriously ill. If someone wants to spend $1650/year so their doctor visits are more pleasant, what the heck. </p>
<p>I do wonder, however, how concierge doctors think they will get around the health care death spiral. Concierge service will obviously be more attractive to people who have serious conditions and think they will need long office visits every week. How will concierge doctors get around eventually having practices full of sick people who demand lots of care?</p>
<p>Read a news article about U Va dropping spousal coverage when the spouse could get insurance at his/her job. They say it’s due to the fact that the ACA will cost them an additional $7,000,000 per year in insurance costs. So they are looking for other ways to save. UPS could be doing the same thing. The additional coverage mandates aren’t free.</p>
<p>The IRS is tasked with levying penalties against those who do not purchase insurance. However, the IRS has no authority to take action and collect these penalties. They can not attach wages, put a lien against a home or garnish other assets. What’s the point? At this stage of the game one can simply accrue penalties with no fear of collection.</p>
<p>They can’t take the fines out of your refund, if any?</p>