<p>[Delay</a> in Obamacare - what you need to know - Jul. 3, 2013](<a href=“http://money.cnn.com/2013/07/03/smallbusiness/obamacare-employer-mandate/index.html]Delay”>Delay in Obamacare - what you need to know)</p>
<p>Sorry, I was referring to this. I have no agenda. It’s in the law and it was delayed. That was my only point.</p>
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<p>I’m not hiding, and the analysis is simple. What part of it do you dispute? Is the private insurance risk pool healthier than the employer insurance pool, less healthy, or about the same?</p>
<p>Should people who buy private insurance get to be in a risk pool that is considerably healthier than the employer insurance pool, as they heretofore have been? We who contribute to employer insurance have been covering unhealthy subscribers for decades.</p>
<p>Actingmt Lol… </p>
<p>CF… Do you have the link from the Kaiser Foundation that discusses what is causing the premium increases and by how much? </p>
<p>That is my last request… For now. :)</p>
<p>I see. When you said “small business mandate” you actually meant “mandate that covers all businesses except small businesses.” How could I possibly have been confused?</p>
<p>It is confusing, but yes that is what I meant. Smaller than very small but not very large because they are largely unaffected, so far.</p>
<p>CF, lol.</p>
<p>“The uninsured population is in worse health than the privately insured population. Uninsured adults are almost twice as likely to report being in fair or poor health as those with private insurance.9 Almost a third of all uninsured nonelderly adults have a chronic condition.10 People who have chronic conditions or poor health and who do not have access to employer-sponsored coverage may find non-group coverage to be unavailable or unaffordable. The ACA addresses this issue by imposing new regulations that will prevent health insurers from denying coverage to people for any reason, including health status, and from charging higher premiums based on health status or gender.”</p>
<p>This is from the Kaiser link.</p>
<p>Hmmm… The population of the uninsured is sicker than the insured, but are the sick going on medicaid? Interesting bet, CF.</p>
<p>I can’t find a Kaiser report that talks about premium increases.</p>
<p>There is a Forbes report, based on a “study” by the innumerate Avik Roy. I’m not going to link to it, because if you look deep into the weeds, you discover how the “study” made its conclusions. They needed to come up with an average premium for all the people in the private insurance market, including people who were denied private insurance and people who didn’t try to buy insurance. </p>
<p>But what premium can you impute to people who tried to buy insurance, but were denied? The obvious number would be infinity, but if you average infinity with other numbers, you get infinity, so that won’t work for their purposes. So for the people who were denied, the study just blandly imputed a premium three times the premium of the insured people. As far as I can tell, they just made that number up. They certainly don’t provide any justification for it. </p>
<p>The entire result of the study is based on a number they just made up.</p>
<p>"People who post that the ACA clearly says something should link to the part of the ACA that clearly says it. Otherwise, we might think that those people are spreading falsehoods to support an agenda.:</p>
<p>Re: congressional staff and ACA:</p>
<p>The provision is in Section 1312 of ACA. </p>
<p>“The Affordable Care Act includes a provision that Members of Congress and
congressional staff employed by the official office of a Member of Congress must obtain
coverage from health plans created under the Act or coverage offered via an Affordable
Insurance Exchange (Exchanges).” </p>
<p>services/publications-forms/benefits-administration-letters/2013/13-204attachment2.pdf</p>
<p>“That is not a small business mandate.”</p>
<p>Ok. But I was thinking acting meant the businesses which are small in relation to large companies who now have to offer health insurance or pay a penalty.</p>
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<p>Yes yes yes, we know that, but that’s not the question. If we add the people who are uninsured and who are subject to the mandate to buy insurance, to the people who previously had private insurance, how healthy is that group? Because that is the group that GP, romani and calmom now have to cover.</p>
<p>Iglooo has been complaining that the people in the private insurance market are now subject to a burden that the people in the employer insurance market are not subject to. “…limited number of people share the burden of insuring the previously uninsured at a greater cost…” is the quote. </p>
<p>The people with employer insurance are already covering some sick people. And employer insurance is very expensive. Now, people in the private insurance market are also having to cover sick people, and for that reason their premiums are going up. But are they covering sicker people than the employer group, or are they just covering a proportionate number of sick people? If they’re just covering a proportionate number, then they are not subject to a unique burden.</p>
<p>CF, with all due respect, the FAFSA has defined “small business” as one with less than 100 employees for about 10 years now. Now, I personally have a hard time seeing that as “small”-- but I can see where someone posting on a college-focused board can be confused about the definition. </p>
<p>The letters SHOP in the employer exchange stand for “Small Business Health Options” and that exchange is geared to businesses with 50 employees or less - specifically the business that will not otherwise be required to provide insurance under the law. </p>
<p>The requirement that employers provide insurance for all full time workers applies to businesses with 50 or more employees. However, the law will probably tend to have greater impact on businesses that are on the smaller end of the scale (closer to 50 than, say, 50,000) simply because almost all of the largest businesses already provide insurance. So I can see how someone who hasn’t committed the exact wording of the law to memory could be confused into thinking that there is a “small business” (as opposed to “all” business" mandate).</p>
<p>OK, fine, whatever, when actingmt talked about “small business mandate”, actually it was supposed to mean “employer mandate.”</p>
<p>My apologies. It was really about parts of the law not being implemented even though they are in the law since that’s what was being discussed when I posted. Calmom’s explanation of my wacky thinking process is excellent!</p>
<p>CF, I understand your argument. You may be right. I am in the GP, romani, Calmom group too. I hope you are right. You make a good argument and I didnt give it much thought until today. </p>
<p>My thought process has gone from the opposite point of view compared to what you are articulating to neutral. I might flip all the way with more information.</p>
<p>See texaspg, I am changing my opinion. ;)</p>
<p>Calmom, do you have that info that explains the causes of rate increases?</p>
<p>Here is the text of the law which applies to health insurance for Congress members and their staffs: </p>
<p>Link: [42</a> USC § 18032 - Consumer choice | Title 42 - The Public Health and Welfare | U.S. Code | LII / Legal Information Institute](<a href=“http://www.law.cornell.edu/uscode/text/42/18032]42”>42 U.S. Code § 18032 - Consumer choice | U.S. Code | US Law | LII / Legal Information Institute)
<a href=“D”>quote</a> Members of Congress in the Exchange</p>
<p>(i) Requirement Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are</p>
<p>(I) created under this Act (or an amendment made by this Act); or</p>
<p>(II) offered through an Exchange established under this Act (or an amendment made by this Act).</p>
<p>(ii) Definitions In this section:</p>
<p>(I) Member of Congress The term Member of Congress means any member of the House of Representatives or the Senate.</p>
<p>(II) Congressional staff The term congressional staff means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.
[/quote]
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<p>A lot of people don’t realize how expensive employer insurance is now, because they don’t have to pay the premiums. It’s expensive. Those who have employer insurance, look at your W2 and be amazed.</p>
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<p>There already is a LAW in Texas governing navigators – what is under discussion are regulations to be issued under the terms of the law. The law requires:</p>
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[quote]
If the commissioner determines that the standards provided by regulations enacted under 42 U.S.C. Section 18031 are insufficient to ensure that navigators can perform the required duties, the commissioner shall make a good faith effort to work in cooperation with the United States Department of Health and Human Services and to propose improvements to those standards. If after a reasonable interval the commissioner determines that the standards remain insufficient, the commissioner by rule shall establish standards and qualifications to ensure that navigators in this state can perform the required duties.<a href=“my%20emphasis%20added”>/quote</a></p>
<p>Here’s a link to the full text of the law as enacted:
<a href=“http://www.capitol.state.tx.us/tlodocs/83R/billtext/pdf/SB01795F.pdf[/url]”>http://www.capitol.state.tx.us/tlodocs/83R/billtext/pdf/SB01795F.pdf</a></p>
<p>It is unlikely that there will be any changes to that law in the near term because the Texas legislature meets in alternate years, and would ordinarily not be in session again until 2015. </p>
<p>In case anyone in interested, here is a link to the full text of the REGULATIONS under proposal:
<a href=“https://www.tdi.state.tx.us/rules/2013/documents/navproposal.pdf[/url]”>https://www.tdi.state.tx.us/rules/2013/documents/navproposal.pdf</a></p>
<p>**I am posting this only for informational reasons – NOT for discussion, as TexasPG has made it clear that further discussion, commentary or debate on this topic is not appropriate for this thread. ** </p>
<p>I don’t know the procedure for approval and finalization of administrative regulations in Texas. But if anyone wants to find out, here’s a place to start:
[GOVERNMENT</a> CODE CHAPTER 2001. ADMINISTRATIVE PROCEDURE](<a href=“http://www.statutes.legis.state.tx.us/Docs/GV/htm/GV.2001.htm]GOVERNMENT”>GOVERNMENT CODE CHAPTER 2001. ADMINISTRATIVE PROCEDURE)</p>
<p>In general (not specific to Texas), there usually is a process where draft regulations are published for public comment prior to final regulations being adopted. If you live in Texas or know someone who does, the first step to figuring out how to be heard on this would probably be to contact the Department of Insurance.</p>
<p>thanks calmom. I was reading the story and thinking there is legislation pending. </p>
<p>I have no problem if people discussed what the law says. </p>
<p>Unissued regulations are not up for discussion until they are issued.</p>
<p>I am only following TOS about political posts and trying to limit it to what is the law.</p>
<p>One more note to add to my last post – again, as food for thought, NOT for discussion in this thread:</p>
<p>If you do read the proposed regulations, keep in mind that aside from the politics pro and con about implementation of ACA, there is another stakeholder involved: licensed insurance agents or brokers. I think you may get a more nuanced understanding of the issue if you keep those interests in mind, and consider the role they may play in advocating for restrictions on the role of navigators.</p>
<p>No offense intended, calmom, but I’ll leave it up to texaspg to tell us what is up for discussion on this thread.</p>