Supreme Court Upholds Health Care Mandate

[alumni]

Just for the record, I don't believe the "insurance lobbies" fought this legislation at all. Based on what I've read and heard, they basically wrote it.
The health insurers are going to potentially add 30-35 million new customers (read: premium revenue) through the state insurance exchanges.
That is the primary reason they agreed so quickly upfront to eliminate pre-existing condition exceptions and lifetime reimbursement maximums, allow state-to-state portability, provide dependent coverage to age 26, etc.
I think the average US citizen will learn soon about the negative consequences of this legislation on their personal healthcare circumstances.
It appears to me that the ACA will turn the entire US health insurance system upside down in an effort to provide some level of coverage for less than 10% of the population. Along with tax increases and very, very vague promises about, in theory, somehow lowering healthcare expenses.

[Kellison]

I don't get why 'America' is making this Affordable Health Care Act/Obamacare such a huge deal.
1. The individual mandate is a 'conservative' idea...why in the hell are Republicans throwing this on their number 1 hit list?? I would think forcing insurance companies to allow anybody with ANY condition(s) to be covered with health insurance would be the kicker for them.
2. This individual mandate is so freaking watered down that it means nothing whether you purchase health insurance or not. It states that the IRS can assign this penalty/tax...yet that aren't able to pursue it if you don't want to pay it. Pretty much the govt saying 'oh hey, you didn't buy health insurance(even though you could afford it). Can you pretty please pay this small small small penalty? No? Ok, no biggy. '.
3. Its amazing how many people that bitch about Obamacare and the Individual Mandate have actually no idea what the individual mandate/AHA is or its purpose. They massively confuse it with 'Medicare'. Which are completely separate entities.

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woops. I meant 'MedicAid'.

[DreamOn]

Just for the record, I don't believe the "insurance lobbies" fought this legislation at all. Based on what I've read and heard, they basically wrote it.

You are right. The earlier poster who said that the big Pharma and Insurance lobbies worked hard against this legislation had it wrong. Sometimes I wonder how someone can be so sure about something when their facts are totally inaccurate.

[barkingmad]

I formed my opinions based on several sources including Wendell Potters book Deadly Spin. You are correct that for-profit medical and insurance firs got involved and were instrumental in the framework, but I believe (not a fact, my opinion) that there is less profit in ACA than theyd like. I dont think hospitals should be for profit anyway. No ones life blongs on a balance sheet.

[alumni]

@barkingmad Basically forcing millions of new customers (the majority of whom will be young and healthy) into paying premiums to private health insurers won't be as profitable as they'd like? Possible, I guess, but highly unlikely. All depends on how efficient the state "insurance exchanges" are in practice when they become operational. Given the frightful financial budget mess that exists in almost every state, I'll believe that when I see it.
Also, most hospitals, for-profit or non-profit, are probably going to be delighted that they now have some ability to receive insurance reimbursements for patient care rather than currently being required to treat everyone regardless of having insurance or not.
I personally believe hospitals, health insurers and pharmaceutical companues are all going to be very happy with the eventual results from this legislation. But the huge majority of employers and those people currently covered by private insurance, MediCare and MedicAid may very well not be so happy. Time will tell.

[Kellison]

I formed my opinions based on several sources including Wendell Potters book Deadly Spin. You are correct that for-profit medical and insurance firs got involved and were instrumental in the framework, but I believe (not a fact, my opinion) that there is less profit in ACA than theyd like. I dont think hospitals should be for profit anyway. No ones life blongs on a balance sheet.

This is a tough call either way. America is a free-market economy(at least we like to pretend). So it would be nice that these hospitals could be self-sustaining without heavy government carry.

Yet none of us like to pay for other people's mishaps or misfortunes.

The system we have currently will at least accommodate you in an emergency if you have health insurance or not.

If we Americans don't want government assisted healthcare(canada/uk loose example) then where are you willing to draw the line?
-If a person has been shot, will you turn them away if they don't have health insurance?
-We've drawn a line when it comes to whether you qualify for Medicaid or not. Should people that chose not to purchase health insurance(that could afford it), be turned away if they get cancer?
-Why should your premiums be the same as Joe Schmo if he is always in the hospital(along with his family) when you only have to see a doctor a few times in your life for maybe a check-up?

Is asking you to pay your fair share into the 'private' insurance system really that horrible? Are you willing to sign over a waiver that hospitals can turn you away and let you die an undesirable event happens?

Agreeing with some previous post....i think the only answer is middle-ground. Which no one will ever like.

[Roswell1947]

IMO I think it's GREAT!
Now finally I can see a PCP for free and not have to pay BCBS $1200.00
per month. Yes there will be small taxes starting in 2014 but mostly for the Rich earning $250K+.
I'm still 61 yrs old but I feel confident that since I'm under 70yrs old
I still have a fighting chance.
I'm sorry for the grandmothers out there who are 70yrs who will be put out to pasture but times have changed
and no worries about Romney.
He was the mastermind of the plan so he'll look stupid trying to rail against it.
Big victory for the regular folks!! Woot.

[Roswell1947]

In addition, we have many members from the UK, Canada & Australia
who post regularly on this forum and I don't hear them complaining..
So personally I'm relieved this saga is over. Yes Romney will "say" he
will repeal it but he lies like most politicians and once elected he will
roll over and try to fix the economy.

[alumni]

In addition, we have many members from the UK, Canada & Australia
who post regularly on this forum and I don't hear them complaining.

Seriously?
I've read many complaints from posters who live in these countries all over this discussion board.
Loads of them.

[Jeremy Fisher]

I'm very torn.. A lot of good but a lot of bad. It's 6 of one half dozen of the others..

I hope it helps but my uncle's boss already told him he'll be dropping insurance and pay the fine for not providing rather than the cost and save $2,000 per employee..

I know i can't afford it and Im very scared about being forced and it bankrupting me.

I think it's well intentioned and has great attributes- but isn't what we need completely. It's a very touchy subject but complicated and not fully understood by most American's including me..

Wow jcorisg, that just does not seem right for an employer to do but I know there are many employers who may go the same route. Americans who provide insurance for Americans should get some kind of tax break which will equal the benefit of saving $2K per employee when one drops employee insurance! Otherwise seems like a big backfire to me.

I need to read the rest of the thread and may edit this post to add some more thoughts. Wish there was a New Healthcare Law for Dummies book ...

[billyboy1965]

I just hope you are all aware of the tax implications, the hiring decisions, the impact on small companies, and especially the implications for the economy when unemployment is factored in.

If you have unusual medical expenses, such as hearing aids or other health care items not covered by Medicare or private insurance, and if you itemize and write these off as deductions, PLEASE do it for the 2012 tax year.

You may not meet the AGI deduction requirements for the 2013 tax year.

Also comforting to know, penalties are taxes.

EDIT ~ If I have 45 employees and planned on hiring 10 more, somebody's going to pay. It's going to be the 45 currently employed. What to do? I'm going to hire a "contract employee." I'm not required to pay their benefits (up for interpretation?) So contract employees, and there are going to be far more now than before, best start looking for your own coverage now ~ especially if you're 27. You get a nice tax penalty if you don't.

While I'm at it, I'm taking away my employees' group life insurance coverage. They can buy their own.

[1991cs]

@billyboy1965 - I enjoyed reading your post and it resonated with me.

If we take your example of an employer with 45 people, just assume that the cost of health insurance per month, per employee is $200 (this is obviously conservative). That is $9000/month. Now multiple that by 12- $108,000/ year. Now look at our current economic climate. Assuming that the economy doesn't make a remarkable recovery, this has the potential to hurt a lot of employers, which in turn, hurts the employees. If the employer chooses to just pay the penalty, now the employees are required by law to pay for their own health insurance (which was deemed a tax by the Supreme Court). If the insurance companies are forced to cover pre-existing conditions, won't this significantly increase the premiums that are forced on the citizens?

I understand that a lot of people are struggling and I have been blessed with good coverage for a long time, but I just don't see how this can work financially for businesses, individuals, and our country. It's tough though to find a good solution; I just hope we find the best one before we jump into this.

OK, I'm done.

[billyboy1965]

OK, I'm done.

Please go on. You are making perfect sense.

I've also decided that 2 weeks vacation for new hourly workers is too much. They can earn 1 vacation day for every 6 months they've worked after a 2 year vesting schedule. And screw my 3% 401K plan match for those people. I need that money for me. The government can make me pay health insurance coverage for my employees, but they can't make me pay a penny more for anything else that I used to. No more sick time.

[1991cs]

Please go on. You are making perfect sense.

I've also decided that 2 weeks vacation for new hourly workers is too much. They can earn 1 vacation day for every 6 months they've worked after a 2 year vesting schedule. And screw my 3% 401K plan match for those people. I need that money for me. The government can make me pay health insurance coverage for my employees, but they can't make me pay a penny more for anything else that I used to. No more sick time.

These are the consequences that I don't believe some people think through. Allowing new hourly employees 2 weeks of vacation is a great benefit, as well as the 3% match (I started with the same employer with the same benefits and they are both supposed to continue to increase). However, if employers are being force into allocating their money somewhere else, they will be forced make cuts to remain profitable and in business. I certainly hope that employees understand this, especially those that support this bill.

As far as the sick days are concerned, hopefully they can make a quicker recovery with their new insurance

For those other than @billyboy1965 reading this, I don't intend to come off as cold-hearted. I am just trying to be objective about a potential turning point in our country.

[sambob]

Please go on. You are making perfect sense.

I've also decided that 2 weeks vacation for new hourly workers is too much. They can earn 1 vacation day for every 6 months they've worked after a 2 year vesting schedule. And screw my 3% 401K plan match for those people. I need that money for me. The government can make me pay health insurance coverage for my employees, but they can't make me pay a penny more for anything else that I used to. No more sick time.

I don't wanna work for you, that's for sure!

[billyboy1965]

I don't wanna work for you, that's for sure!

I'm guessing you're being sarcastic.

You might, because regardless of my online persona, I am a nice guy and so is my business partner. We have operating expenses. We've been meeting with our CPA's and tax accountants trying to figure this out. We are looking for every loophole we can find.

I don't have an employee I don't like. We are a tight knit family and my newest hire has been there 6 years.

We've kept them in the loop and they understand. Some are carrying their spouses/domestic partner's coverage. If I let them go, they have COBRA but then what? Who's going to hire them in this depressed city?

Small business owners' hands are tied. This is serious shit.

[IGoeOn]

If you want to legally drive a car (in America) you have to have car insurance. I believe that the general population should have health insurance mandated. As a fiscal conservative this goes against my grain but I believe that ultimately, government intervention will manage down spending.

And yes. I do own my own business and employ 9 people in my office. I also employ over 25 sub-contractors. At this time all of our employees are given the option to carry benefits - not all choose to do so. We pay 50% of health - none of dental but they get the group rate - all done with pre-tax dollars. Because I am an incredibly selfish person I worry that one of my employees will get hurt/sick and - not that they will be ill but how their illness will affect my business.

If a person doesn't want to have health insurance and WANT care when they are sick they are essentially saying that they want someone else to pay for their care. I have a big problem with this concept.

IG

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I just hope you are all aware of the tax
While I'm at it, I'm taking away my employees' group life insurance coverage. They can buy their own.

Hmmm. . .we don't offer this. Very ritzy of you - do you have group disability, too? Pre-tax? I sit for my disability next week.

[billyboy1965]

If you want to legally drive a car (in America) you have to have car insurance.
And yes. I do own my own business and employ 9 people in my office. I also employ over 25 sub-contractors. At this time all of our employees are given the option to carry benefits - not all choose to do so. We pay 50% of health - none of dental but they get the group rate - all done with pre-tax dollars. Because I am an incredibly selfish person I worry that one of my employees will get hurt/sick and - not that they will be ill but how their illness will affect my business.

If a person doesn't want to have health insurance and WANT care when they are sick they are essentially saying that they want someone else to pay for their care. I have a big problem with this concept.

Your employees will need to now. Either through your or on their own.



Hmmm. . .we don't offer this. Very ritzy of you - do you have group disability, too? Pre-tax? I sit for my disability next week.

As for the auto and homeowner's insurance requirements, that is more bank/lease/collateral driven than state driven especially with car leases replacing auto financing.

Yes, I provide short term disability benefits. Now. Most likely not after January 1.

[IGoeOn]

Right - but what about liability and medical - not comprehensive? That's more of what this analogy is referring to @billyboy1965.

Yeah - we will never get to offering those benefits now to our employees - I imagine that that entire sector will disappear. We don't hire high talent/rich benefit people - it's basically the owners (3) and the others. I am a big believer in keeping my employees happy and offering them "out of the box" benefits: gas cards, EZ pass, etc. . .

It ain't easy to make these decisions. . .

[Jeremy Fisher]

@billyboy1965, please don't get annoyed w/me for being slow about this topic.

So I guess you are saying that your group health insurance for your employees will be more expensive and that will drive you to consider dropping the health insurance and pay the penalty instead? Like @jcorsig's uncle may choose to do.

If that assumption on my part is right, how can you know that your group health insurance is going up? Common sense? Have the insurance companies stated this is so, primarily due to the pre-existing rejection being disallowed? I would think that would be balanced out by the ins. companies having so many new members. Unless everyone chooses to pay the penalty instead.

What IS the penalty for an individual who does not have group (through work) or individual insurance. Is it a sliding scale based on income?

Anyone who can this, please do. Just very interesting in this topic. @IGoeOn, I would appreciate your take on my questions above, as it sounds like you are in a similar position as Billy.

Small business owners are so critical to America. I have a lot of respect for you guys/gals. @1991cs, you seem to know this topic well too - so really educate me if you have time. That is meant seriously.