Question -- and this may be a topic for its own thread: Frequently during the course of the discussion about Obamacare and its unintended consequences, the concept of employers reducing workers' hours below 32 so they don't have to offer them insurance, most recently by bugatti. While I don't disagree that this will happen as a result of businesses tightening their belts, but isn't this something that's been going on for a decade or more? I recall lots of news stories about this happening about 10 years ago, during the time of the big spike in insurance rates.

 

I'm not doubting that some businesses that operate close to the margins will be adversely affected. But I'm also betting a lot will use the "let no good crisis/tragedy go to waste" theory and take advantage of the uproar over Obamacare and use it as an excuse to trim payroll when they don't really need to.

While companies have cut back for various reasons (insurance, technology, other overhead, etc.), I look at it from a potential growth standpoint. If you have a newer, thriving business and looking to expand operations, once you hit certain thresholds a business owner must really question their course of action. Will it be advantageous to expand to over 50 or 100 full time employees if we have these new requirements associated with it? Not saying that is a good or a bad thing, just another consideration for employers.

Baloney . No one is arguing companies haven't down sized in the past. But there is to much evidence showing a direct link between Obamacare and part time workers and layoffs. It is your fault if you choose to ignore the examples provided that's on you.

 

Again, I see a lot of problems with Obamacare. I'm not disputing that. I'm also not disputing that some companies are cutting back (or maybe more appropriately, accelerating those cutbacks) because of the legislation. I'm not choosing to ignore anything, I tend to look at everything. It seems like those who vehemently oppose this are so laser focused on hating everything about the bill (and the President) are the ones who are ignoring any example that the current landscape is not all the different (and I do concede that it is somewhat different) from what really, has been going on for years. The "direct links" I've been shown are mostly one sided in their presentation, and based on an end of the world assumption, mostly because they hate the bill. When you let someone go, or have to raise premium costs, it sure is nice to have something to blame it on......It's a convenient scapegoat. In some cases, it may be true. But I'm not convinced it's true in all cases. Again, I've been involved with benefits management for a long time. What is going on now is NOT all that different from what has been happening for most of the last 20 years.

formerly cheap generics are skyrocketing , going up 200-2000 % I could name a bunch . All the folk in the industry say its bc of " Obamacare" I'll throw out a few .. Gen zpacs are OOS ( out of stock ) at my primary wholesaler as of today .. Gen Zantac ( Ranitidine) went up 300% . All generic eyedrops are exploding up . Prednisone , Pravastatin , Generic depakote went up 1500% . Enalapril . I could keep going on and on . We could live with 10-20% increases ... Thank the wonderful community organizer.

and the post above mine from rjs is crapola . ( the part about this not being different from the previous 20 years)

and the post above mine from rjs is crapola . ( the part about this not being different from the previous 20 years)

 

 

I love the intelligent debate ;-). Until I see something that is radically different, I'll stand by my comments. My costs, my companies costs, costs of my/my families medication have not changed dramatically. And I'm not saying some haven't been affected. But the whole sky is falling argument is just over the top.

I love the intelligent debate ;-). Until I see something that is radically different, I'll stand by my comments. My costs, my companies costs, costs of my/my families medication have not changed dramatically. And I'm not saying some haven't been affected. But the whole sky is falling argument is just over the top.

Give it time, trust me, it will. I could have said the same 2 days ago, but that has changed DRASTICALLY!

Folks, ObamaCare as it is currently designed, is designed to fail purposely.

Give it time, trust me, it will. I could have said the same 2 days ago, but that has changed DRASTICALLY!

From UPI story about a week ago:

"Annual premiums for employer-sponsored family health insurance coverage rose by 4 percent from last year, the 15th annual Kaiser/HRET survey indicates. ... Since 2003, premiums have increased 80 percent, nearly three times as fast as wages, which increased 31 percent and inflation, which increase by 27 percent. In the 2000s annually rate increases were often in double digits."

 

The key numbers are "since 2003" and "80 percent."

There is a lot to discuss and I suspect that for someone everything that has been said will be true. The question is, what are the results overall. For example, the article that started this thread made the shocking point that if you didn't have insurance before and now you have to buy insurance, that insurance will cost you money. While that is true, it will be up to the individual to decide if they think that on balance, having insurance is worth the cost.

 

For businesses it will depend on the type of business you have. If you are a small business (under fifty employees) and have always offered high quality insurance, my guess is that access to the exchanges will help control your rate increases and may well result in an initial decrease in rates, depending on the makeup of your employees. That is the group my company is in. Our plan year starts March 1, so we'll see how the next negotiation goes in a few months. If you are a small business with less than fifty employees and have never offered insurance or only low quality insurance, the law doesn't apply to you, but now your employees will have access to insurance. Some companies in this group may elect to take steps to stay below 50. We'll hear a lot about them in the next few months. If you are a larger company (more than fifty employees) and have always offered high quality insurance, I expect you to see the least impact. I hope there will be some downward pressure on rates from the exchanges, but that remains to be seen. If you are a company with more than fifty employees and have never offered insurance or only low quality insurance, your costs are going up. You will have to start paying for a portion of the insurance costs for your employees or pay the fine.

 

I wish that the ACA had started to sever the ties between employers and health insurance. It would have been very unpopular, but I think we will end up there eventually. The reasons for employer based health insurance are favorable group rates and favorable tax treatment. The exchanges will provide the group rates and the law could have equalized the tax treatment of individual and employer based plans. With the exchanges individuals will have access to high quality insurance at large group rates. Indivduals could shop on the exchanges for the insurance plan that best fits their needs and not have to go with the plan that the HR department thinks best fits the most employees.

Serious question because this passive aggressive approach is very similar to most posts defending obamacare. Have you studied the impact of pricing ? Obamacare was originally marketed as a way to fix sky rocketing health care costs. But the law itself ignored key problems to cost of health care and whether intended or unintended created problems that caused pricing to rise at a higher rate. The bill is bad and we as a nation will suffer because of it for decades . There is no way around it , this is the worst piece of legislation in at least 75 years.

 

I think my post was straightforward. The meat of the article is that uninsured, pre-Medicare 60-somethings might be less likely to purchase insurance than their uninsured 20-something counterparts once the law goes into effect. I’m not sure if the vitriol in this thread is angled toward that the uninsured will be required to purchase insurance or if the cost of insurance for them will be higher compared to now. Considering some of the triumphant posts made here about these findings and the sample costs highlighted in the first post, I think it would be relevant to consider the differences between what the exchange plans will offer and cost and what is available now.

 

Most of the “cost saving” components of the bill attempt to flatten the overall cost curve over the long term through things like allowing Medicare actuaries to negotiate pricing like insurance companies do, asking Medicare to pay for outcomes instead of volume (there’s already been a substantial reduction in hospitals’ reporting readmissions and hospital related infections to Medicare since the law was passed), creating a patient database, requiring insurance companies to offer preventive care, requiring insurance companies to spend at least 85% of expenditures on actual care rather than ancillary costs like advertising, etc.

 

For individuals, the poor are given subsidies to afford purchasing insurance; Medicaid is expanded in states willing to go along with it so more people have coverage and raise the incentive to take jobs/hours without fear of losing benefits; pre-existing conditions can’t be used to deny coverage, which means that coverage is accessible for those who fall into that category; out of pocket expenditures are capped so people with severe illnesses are less likely to be forced into bankruptcy; etc.

 

So, under the law the costs savings of premiums are mainly directed at the poor and the uninsured and the law seeks to contain costs in other ways. Even if I disagree with much of the law, I don’t find those entirely unreasonable.

 

This law isn’t my preferred healthcare policy; I find the individual mandate too much to bear and a boon to insurance companies; I do not think this law is any kind of panacea; but, I find that a lot of the criticisms are hyperbolic or disconnected. I think the convoluted and insulated system of care we have in this country is the problem and I would like to see criticisms and solutions aimed at fixing it rather than at a law that keeps it in place and merely tinkers with it on the fringes. I think we would be a lot better off if we actually did overhaul this system, particularly getting away from employer-centered insurance and insurance itself.

 

I believe criticisms of this law (death panels, socialism, etc.) have been framed to intentionally distract from those arguments. I believe the insurance industry supported these measures not as a matter of principle, but as a matter of self-preservation, and I believe much of the attacks have been in the service of preserving the current system. What fundamental alternatives have been offered but “get rid of Obamacare” and to keep the same system? There simply haven’t been any.

 

I think this law has become a talisman for both sides: One side believes it fixes the healthcare problems in this country and the other believes it is an underhanded form of socialism. I believe this law perpetuates the glaring problems of this system under the veil of alleviating them and I believe that critics are refusing to deal with the glaring problems of our system under the veil that this law is all that is wrong with the system. Let’s have a real discussion about how to fix health care in this country.

First, the health care exchanges haven't even opened for enrollment, so it's premature to talk about the effects on particular groups, IMO.

 

Secondly, this whole idea was not marketed on the premise of cutting the costs of providing care, but in broadening the ACCESS to quality care by providing a way for people to purchase affordable insurance.

 

Thirdly, some feel health care isn't a "right", and maybe that's debatable. But with insurance people are able to access a broader platform of preventative care services in an affordable manner. Preventative care is critical to preventing life threatening disease requiring higher cost, longer term care.

 

The AHCA has already had much positive impact, not the least of which is eliminating the preexisting condition barrier. And as Habib pointed out, the outcome vs volume change is a positive. Why should providers be rewarded for high volume shoddy care?

 

I spoke with someone in the healthcare administration industry that pointed out that the charting and coding requirements have improved patient documentation, making complete treatment plans by multiple physicians able to be coordinated with less margin of error, as well as easier to accurately process for payment. They also pointed out that although some hospitals are making staffing cuts they blame on AHCA, technology is making some jobs redundant. He pointed out that while some hospitals are making staffing cuts, other hospitals have been able to streamline and avoid staffing cuts by not filling open positions if there was away to spread responsibilities over a number of existing staff.

 

The AHCA also provides that young adults are able to have access through their parents policies for longer, increasing the chances they will be able to advance in their careers long enough to be more able to afford their own care eventually. It lessens the chance that entry level employees have to make the choice of health care OR rent. There is always the option for parents to ask their children to pay for the difference it costs to keep them on the policy. That's what one family I know does.

 

As to the effects that AHCA has on staffing, especially full time vs part time, health care benefits have long been used as a competitive tool. But for many employers, they staffed primarily full time staff with benefits which is crippling as business cycles shift. From a business perspective, in this day and age, the model has to be nimble to adapt. The AHCA makes it possible to do that more effectively but allowing employees to still have the ability to have health insurance even if not employer sponsored.

 

An employee can work no more than 1540 hours in a 1 year period, if not being provided benefits by an employer. An employer working their employee more than that must make the decision to place a person at that threshold onto their plan, or stop working that employee until the 1 year evaluation period renews. 1540 hours is 38.5 40-hour weeks. It is 51.33 30-hour weeks. There is ample opportunity for employers to manage their staffing and avoid the cost of providing benefits without negatively impacting hiring. It's just changed the model of staffing.

 

The most damning part of the AHCA is the new tax on the medical device manufacturing industry. They now are taxed on their gross sales. That is wrong. They should be taxed on profits, not gross sales. One company I am familiar with is a privately held company doing ~20B in business worldwide annually. They will pay ~18M in taxes before the end of this year.

 

All in all, there are changes to be made and areas to be tweaked. But the answers to those problem areas is NOT to repeal the entire AHCA, especially when there is not one idea forthcoming as an alternative. There is no reason this can't be improved AND the area of the costs of providing care addressed as well, AND businesses still provide jobs.

I found it interesting Teamsters airing ad that is anti obamacare.

Bottomline: most things the Gov't gets involved with turn to :poop:

First, the health care exchanges haven't even opened for enrollment, so it's premature to talk about the effects on particular groups, IMO.

 

Secondly, this whole idea was not marketed on the premise of cutting the costs of providing care, but in broadening the ACCESS to quality care by providing a way for people to purchase affordable insurance.

 

Thirdly, some feel health care isn't a "right", and maybe that's debatable. But with insurance people are able to access a broader platform of preventative care services in an affordable manner. Preventative care is critical to preventing life threatening disease requiring higher cost, longer term care.

 

The AHCA has already had much positive impact, not the least of which is eliminating the preexisting condition barrier. And as Habib pointed out, the outcome vs volume change is a positive. Why should providers be rewarded for high volume shoddy care?

 

I spoke with someone in the healthcare administration industry that pointed out that the charting and coding requirements have improved patient documentation, making complete treatment plans by multiple physicians able to be coordinated with less margin of error, as well as easier to accurately process for payment. They also pointed out that although some hospitals are making staffing cuts they blame on AHCA, technology is making some jobs redundant. He pointed out that while some hospitals are making staffing cuts, other hospitals have been able to streamline and avoid staffing cuts by not filling open positions if there was away to spread responsibilities over a number of existing staff.

 

The AHCA also provides that young adults are able to have access through their parents policies for longer, increasing the chances they will be able to advance in their careers long enough to be more able to afford their own care eventually. It lessens the chance that entry level employees have to make the choice of health care OR rent. There is always the option for parents to ask their children to pay for the difference it costs to keep them on the policy. That's what one family I know does.

 

As to the effects that AHCA has on staffing, especially full time vs part time, health care benefits have long been used as a competitive tool. But for many employers, they staffed primarily full time staff with benefits which is crippling as business cycles shift. From a business perspective, in this day and age, the model has to be nimble to adapt. The AHCA makes it possible to do that more effectively but allowing employees to still have the ability to have health insurance even if not employer sponsored.

 

An employee can work no more than 1540 hours in a 1 year period, if not being provided benefits by an employer. An employer working their employee more than that must make the decision to place a person at that threshold onto their plan, or stop working that employee until the 1 year evaluation period renews. 1540 hours is 38.5 40-hour weeks. It is 51.33 30-hour weeks. There is ample opportunity for employers to manage their staffing and avoid the cost of providing benefits without negatively impacting hiring. It's just changed the model of staffing.

 

The most damning part of the AHCA is the new tax on the medical device manufacturing industry. They now are taxed on their gross sales. That is wrong. They should be taxed on profits, not gross sales. One company I am familiar with is a privately held company doing ~20B in business worldwide annually. They will pay ~18M in taxes before the end of this year.

 

All in all, there are changes to be made and areas to be tweaked. But the answers to those problem areas is NOT to repeal the entire AHCA, especially when there is not one idea forthcoming as an alternative. There is no reason this can't be improved AND the area of the costs of providing care addressed as well, AND businesses still provide jobs.

Rockmom I respect you. But this entire bill was sold as cheaper health care . To say other wise is dishonest .

Rockmom I respect you. But this entire bill was sold as cheaper health care . To say other wise is dishonest .

 

No...it is about access to affordable health care by creating access to insurance. The actual costs of providing care weren't the goal. Previously, without access to the more affordable employer sponsored health care, or if one couldn't pay for that even if offered, there were no alternatives if one didn't qualify for government healthcare programs.