The Affordable Care Act doesn’t fully implement until 2014, and in the meantime, health care costs will rise. In fact, costs for employers, among the more stable in the broken insurance market, are expected to jump 9% in 2011, according to a study by Pricewaterhouse Coopers. And the only reason the overall cost increase is this low is because employers plan to shift costs to their workers. So the total increase to the employer and employee is easily into the double digits. And that will continue at least until full implementation. The study hopes that some of these costs hikes are due to provider consolidation and capital expenditures, which should ease in the medium term, but given the trajectory of health care costs in America over time, that looks like wishful thinking.
But clearly, the biggest fear is that employers make their coverage crappier and crappier, offloading these increased costs onto their workforce. The Obama Administration is actually writing rules designed to put a stop to that.
The White House on Monday will issue new rules that strongly discourage employers from cutting health insurance benefits or increasing the costs of coverage to employees, administration officials say.
The rules limit the changes that employers can make if they want to be exempt from certain provisions of the health care law passed by Congress in March. Many employers want the exemption because it allows them to keep their existing health plans intact with a minimum of changes. More than 170 million Americans have employer-sponsored insurance.
The administration said the rules would allow a smooth transition to a new, more competitive insurance market that works better for consumers. But in some respects, the rules appear to fall short of the sweeping commitments President Obama made while trying to reassure the public in the fight over health legislation.
Specifically, certain plans in place on the day of the signing of the ACA are grandfathered in, and under this rule, those plans would lose that exemption if they “make significant changes in deductibles, co-payments or benefits.” The PWC study shows that we know employers are already doing this. Here are some of the metrics:
Under the rules, a health insurance plan can lose its exemption if it eliminates all benefits for a particular condition or if it increases deductibles or co-payments by more than the rate of medical inflation plus 15 percentage points.
Likewise, a health plan loses its exemption if an employer reduces its contribution so that its share of the total cost of coverage declines by more than 5 percentage points. If, for example, an employer is paying 60 percent of the cost of family coverage, it would run afoul of the rules if it cut its share to 50 percent.
An employer would also lose its exempt status if it increased co-payments for doctor’s visits to $45, from $30 — a 50 percent increase — while medical inflation was 8 percent.
Some health plans require consumers to pay a percentage of the bill, rather than a fixed dollar amount. An insurer loses its special protection if it makes any increase in this percentage — if, for example, it requires patients to pay 25 percent of the bill for surgery, rather than the 20 percent charged in the past.
Obviously this does little for the 2010-2014 period, but it could be a major boost to the quality of employer-based insurance after that. They need to leverage whatever exemptions that are out there, if they’re going with a large employer-based system, to ensure that system is sustainable and provides half-decent coverage. I don’t think the Rube Goldberg solution for health care was the best practice, but at the very least, the government was put on the hook for the nation’s health care, in certain ways, which means they need to use tactics like this to ensure the best coverage possible in these markets.




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I automatically assume that Obama does something like this for show with an already prearranged agreement with one of his oh-so-precious rotating blue dog villains to transform it into yet another corporate giveaway. I don’t even bother to pay attention until his yapping blue dogs reduce it to what he intended all along.
Next.
I’m skeptical. Do the new rules allow employers to shift premium expenses to workers, and saddle workers with junk policies?
If it saves them money overall, employers will be delighted to do just that.
Where can a bonafide employee go in a shit economy like this – where jobs are trending toward independent contract work with no benefits?
Employers can pretty much do whatever they want. And many if not most will do anything to save a buck.
There are very few new job opportunities – upward or laterally for employees.
A friend of mine sent me a link to a NY Post article about ObamaCare. It seems there was disagreement between WH advisors and HHS, but in the end it will mostly be HHS that promulgates the rules and regulations for the legislation. Once again it is nothing like what we were promised.
http://www.nypost.com/p/news/opinion/opedcolumnists/you_re_losing_your_plan_O2H1EFmYlHSoQmqp48uDHI
Oh bullshit. To think that O gives a ff about medical care for anyone is to be so far into the veal pen as to be not funny. O wants privatization with ripping off real peeps as quickly as possible.
The entire employer-based HC system sux.
I thought that the whole point of HCR was to get us out of that system. But what do I know, I’m just a “fuckin’ retard”.
Actually the Obama Administration is becoming basically irrelevant. All decisions have been outsourced to corporations. It is all kept secret who and how decisions are made, whether financial fraud, Corexit dumped into the ocean, Lithium in Afghanistan and ISI supporting the Taliban. Or is it the other way around?
But Obama? He certainly did whip the left’s ass everywhich way, especially on health care. But he is slipping into the eleventh dimension and nobody will miss him. So tweaking Health Care Insurance in 2014 is also pointless. Medicare for all.
Is that a “flying” f?
Here’s a way to stop it: Single payer.
Obama Care passes.
Obama’s eyes open wide!
Obama starts putting thumbs in dikes.
[no offense]
You get what you pay for.
Correction: corexit wasn’t “spilled” it was put there deliberately. Otherwise, I’m with ya.
That article from the New York Post and written by the American Enterprise Institute was more of the same…be afraid, be very afraid of government takeover B.S. We didn’t remotely get “federal takeover of health care” as stated in the article and it is completely disingenuous of the author to even imply it.
Damn, I’m so tired of voting for the lesser of evils.
Dude, I paid and paid, and paid. But apparently I’m a “Fuckin’ retard”
Ok, I thought I’d get over it, but apparently it keeps getting worse.
My, my, M’dear…! A tad cynical are we…? ;-)
Not cynical in the slightest. *g*
Edit is our friend and Corexit is our enemy. This use of Corexit I predict is one of the worst decisions made by the corporate terrorists of British Petroleum. Goldman Sachs, Blackstone and other banksters with ownership of Corexit used this man-made disaster for disaster profiteering. But this is a wicked toxin and BP is a wicked gang of criminals.
Obama doesn’t understand unintended consequences?
Possible causes of unintended consequences include the world’s inherent complexity, perverse incentives, human stupidity, self-deception, failure to account for human nature or other cognitive or emotional biases.
I thought he was smarter than Bush, not that I think Bush knew these things.
I call ‘em Tweedle Dumb and Tweedle Smart. Need one type more?
When I saw the title to this I was hoping this would be one thing that could get Progressive support and show Obama our support is valuable.
It is sad to be, and I am, so cynical as a result of his so many betrayals of our values.
Wait just one damn minute here. This “degradation” is exactly what the Administration paid Jonathan Gruber to PREDICT!
Nothing is what it seems, so just what exactly is going on?
Well said. My sentiments exactly.
Ugh. I’ve barely started to read the post, but ~ UGH ~ why is Congress
instead of strongly discouraging the insurance companies from taking their bacon before the pig has even had a chance to lay down for the slaughter in 2014? I may be back for apologies later ~ but really! (:>
score
This whole insurance reform is such a toady POS. I spose the businesses are just shaking in their boots at the threat from Sibelius.
What a POS Administration we bought into! Nie wieder!
Probably trying to distract the “masses” once again with rhetoric…. ignore Afghanistan, ignore the gulf, we will “improve” health insurance!!
I’m sure you’ve heard:
Tweedle Dumb and Tweedle Dumber.
Because O didn’t wage two wars, oops, well he didn’t mess up a Gulf disaster, oops.
Because if you already “sold out” to the health insurance companies, they aren’t afraid of you.
NY Post should be read with a grain of rock salt.
It’s almost satirical at times.
It’s also part of the Murdoch empire.
Works for me too.
So the point of this then is to keep prices propped up on the provider end, and shield the bulk of the citizenry from the increases by saddling employers with the full scope of the cost-increases.
It’s not wonder the U.S. has such a hostile corporate environment, and such a combative relationship with the public. The government won’t do its damn job in taking over markets that are de facto welfare, thus meaning the private sector should not be operating them, and then favoring some enterprises over others in the process.
If I’m a small to mid-sized business (and I am), where am I supposed to get the money to keep subsidizing the insurance industry, especially in a deflating economy?
D’oh!
Er, I mean “oink”. And they’ll use each and all of us ~ including the squeel. (:>
Lessee making rules so the fucked up employer-based health insurance system doesn’t fuck up before the universal employer-based health insurance fucks up.
My. What a uniquely American solution.
Did you actually read the piece?
Hang on there PW. I won’t jump as deep in the cynic pool, but this is pretty much what the Admin paid Gruber to predict; reduce “services”, reduce cost, and then the excise tax for luxury plans was carved out for unions by Union bargaining.
So why the Admin shift now? Things are not what they seem. Just saying.
No. Is there a reason why I should regard the title as unrepresentative?
Shout it from the roof tops.
HE’S A CORPORATIST, WALL ST. SHILL!
. . .
Also. (:>
Jon Walker is upstairs!
AL-02: Cong. Hopeful Wants to Impeach Obama And Americans To “Gather Your Armies”
We can blame Obama, but Congress voted for it.
100% Democrats, no Republicans.
Do Democrats not understand unintended consequences?
Or are they crazy smart. Make everyone lose their insurance (even though Obama said you could keep yours) then force a wonderful new plan on all of us?
With no unintended consequences.
What am I missing here…if an employer wants an exemption which allows them to keep “their existing health plans intact”, then they wouldn’t be making changes, right? So, if someone is trying to make changes now, then obviously they aren’t trying to keep their “existing health plan intact” and therefore the exemption wouldn’t matter…what did I miss?
Siun is upstairs…
John Bolton Pal Appointed to Israeli Whitewash Panel
I hope you aren’t trying to make excuses for Republicans…the health care bill was written by AHIP and the Heritage Foundation. The Republicans only voted against it as a political move, but in the end, the outcome will be exactly what they wanted for Big Pharma and the health insurance companies.
Both Democrats and Republicans have been telling us repeatedly that Americans use “too much” health care. It’s hard to believe they are suddenly concerned with employers cutting benefits from their health plans.
Fair enough, but if the “health care bill was written by AHIP and the Heritage Foundation.” the only votes for were Dems. The Republicans may have voted against as a political move, but is the bill good or crap?
Who voted yes and who voted no?
My interpretation of the law was that grandfathered plans couldn’t be changed at all, so color me unimpressed by the new regulations.
Am I missing something?
Wasn’t this the plan?
Companies would spend less on health care and (according to Obama) give the difference back in higher wages, thus increasing taxes and paying for HCR.
“… if it increases deductibles or co-payments by more than the rate of medical inflation plus 15 percentage points …”
If I read this right,a plan with a $1000 deductable could raise the deductable by 9% (expected increase in med costs for next year) or $90 plus 15% or $150 for a total of $240. At that rate the deductable would double in 3 years, just about the time most of HCR kicks in. And that is just deductable not including increases in premium contribution or co-pays.
Anybody think their salary is going to keep up with that?
“Do Democrats not understand unintended consequences?”
The only consequence of interest to congress is anticipated corporate campaign donations from health insurers and providers.
Gee, “who could have anticipated . . . ”
Oh, right, a bunch of “fucking retards” anticipated just this, but they were told they were stupid, and that the “health care reform” bill HAD to pass.
It seems the WH is learning the hard way. Rules AKA regulations are derived from the actual wording of laws. If Congress with a little help from their friends in the WH and K Street pass crap legislation, the oversight agencies will have many problems writing regs that try to do something other than what the legislation stipulates. If the WH and Congress try to correct this POS with regs the courts will tell them to read the fucking bill before they pass and sign it and pass some new laws if they want something else. The health corporations know this, so does Congress, and unless the WH is terminally stupid I fear they do also. Do not believe the spin and horseshit coming from the WH. “We didn’t know this would happen” is not an excuse anyone over the age of twelve is allowed to make.