All of us who buy insurance have been paying for the uninsured and underinsured all along. This is passed on to us through rising medical costs, reflected in our premiums. </p>
<p>Also, keep in mind that employer-provided insurance has been subsidized all along – subsidized by both the employer (which pays all or some of the premium) and by the government by exempting those employer payments from taxation. </p>
<p>ACA shifts the burden of medical costs that previously went unreimbursed from hospitals to insurance companies, and it fills the gap by providing a direct government subsidy to those who don’t have the good fortune of an employer willing to subsidize their insurance. </p>
<p>I just want to note that our conversation here seem to suggest somehow that by the end of march we can extrapolate or in some way fathom the efficacy of ACA.</p>
<p>However, ACA will not be implemented as intended until the employer mandate and compliance kicks in in 2015. I will predict that many small business employers will move to the SHOP exchange, and that will be a good thing for their employees overall, since there’s a wide variance of circumstances and wage. Larger employers who retain insurance that is newly compliant will continue the trend of not covering spouses, etc. </p>
<p>Over time, I predict the pools will equalize, and oversight will have some bearing ultimately on costs.</p>
<p>So a good time to evaluate the efficacy of ACA might be 2020
We’ve only just started down this road, IMHO.</p>
<p>kmcmom - My non-profit policies (I manage finances for them) just came up for renewal with a 15% increase in price tags (11k for the year). I was googling SHOP and it says we can go to an agent and file for a subsidy through a tax return (we have not filed one in a while but if there is money coming…). Do you think it is worth going through this effort?</p>
<p>It’s not just about young people chasing their dreams. Some of the biggest beneficiaries of the ACA so far are aging boomers who lost their jobs and employer-sponsored health insurance during the recent recession, but are not yet eligible for Medicare. Many were unable to buy insurance on the pre-ACA private market due to pre-existing conditions or unaffordable costs. For them, the ACA is a Godsend, and they’re apparently signing up in droves, as this AP story indicates:</p>
<p>Texaspg, what would be the disadvantages of going through an agent and getting the SHOP subsidies? You would still be able to buy the same plan as last year, if you chose, wouldn’t you?</p>
<p>If your insurance cost is 73K, and you can get, say, a 25% rebate, that surely would be worth it, I should think.</p>
<p>CF - Not sure at this point whether our current agent even knows about SHOP. Checking on it now. Since kmcmom and I have discussed this in the past, I wanted to see if she has some ideas about whether it is worth it. She does have other ideas. :D</p>
<p>texaspg, I hope you get back to us with what you learn. On the face of it, a nonprofit with a small number of employees, which is not in a position to pay high salaries, ought to be the very kind of organization that the SHOP subsidies are targeted at. If you learn that the SHOP subsidies are not worth it for your organization, that would be an interesting fact to know.</p>
<p>It’s been floated numerous times that insurers judged the mix well enough that the shortfall of young invincibles wasn’t going to be a problem. That premiums were priced right.</p>
<p>If this turns out to be true, wouldn’t today’s premiums necessarily be priced under-market?:</p>
<p>I am deleting the original post. I cant have another person’s work listed here without a source.
A source that used real numbers. Real facts and then based projections on those facts. </p>
<p>The article that catahoula initially posted pointed to another article claiming that the administration is floating the idea of extending the right to buy non-compliant health insurance plans for three more years. In response, insurance companies are saying if non-compliant plans are extended for three more years, the risk corridors should also be extended for three more years. The entire story came from unnamed industry executives. It might be true, or it might be jockeying in the press.</p>
<p>And, other than explaining why non-compliant plans would get another three years, an official extension of the risk corridors past statutory date would validate almost all of it.</p>
<p>Hey, Texas, if your agent isn’t well-versed in Shop subsidy, also speak with your accountant, who by now should be Our agent admitted he was a bit behind me on shop info but our accountant was very up to speed. That was how I learned about the two-year sunset.</p>
<p>“unnamed” isn’t authoritative. We had another unnamed a few weeks ago and some digging pointed to one exec at some meeting, speaking roughly about some lunch chat with peers. </p>
Even partial subsidies at 35% are typically “worth it” if the company meets the criteria. The issue is whether gross pooled salaries meet the criteria or not. If the average salary of all W2 workers is under 50k, a company is eligible. But of course, in two years, the “actual” cost of premium effectively doubles So an owner would want to plan for that.</p>
<p>I understood there were several qualifications: the average salary of full-timers has to be under $50K, the company has to have under a certain number of workers, the employer has to pay over half of the insurance premiums. And then the subsidies are phased out as the number of workers gets bigger and as their salary gets bigger. </p>
<p>If texaspg’s nonprofit is at the edge of the subsidy level, so the entire company subsidy is tiny (say $500 or something) then it might not even be worthwhile to apply for subsidies. I’m interested to know how it works out, in practice, for this nonprofit.</p>
Our agent admitted he was a bit behind me on shop info but our accountant was very up to speed. That was how I learned about the two-year sunset.</p>
So an owner would want to plan for that.</p>