My first reaction to this story about McDonald’s potentially dropping its health insurance coverage for employees was to ask myself, “McDonald’s offers health coverage to employees?” The answer is yes. They offer really bad health coverage.
Trade groups representing restaurants and retailers say low-wage employers might halt their coverage if the government doesn’t loosen a requirement for “mini-med” plans, which offer limited benefits to some 1.4 million Americans.
The requirement concerns the percentage of premiums that must be spent on benefits.
While many restaurants don’t offer health coverage, McDonald’s provides mini-med plans for workers at 10,500 U.S. locations, most of them franchised. A single worker can pay $14 a week for a plan that caps annual benefits at $2,000, or about $32 a week to get coverage up to $10,000 a year.
That’s about $1,600 a year for coverage you can’t really use if you actually get sick. As most people would try to avoid that annual limit by deferring care, this sounds more like a profit center for McDonald’s than a health insurance plan. Given that McDonald’s line workers aren’t making much more than the minimum wage, once the exchanges are up, the basic plan would almost certainly provide better value than the mini-med nothingburger, and would cost less. So who’s exactly threatening who, here? These mini-med plans are gone after 2014, anyway.
McDonald’s does want to cut people off between 2011 and 2014, leaving them in pretty dire straits (although the majority of McDonald’s line workers under 26 could go on their parents’ plans). The company doesn’t want to comply with the medical loss ratio, which forces that 80-85% of premiums be spent on actual medical care (because that would mean less profit for their insurer). They’ve determined that such an MLR is unrealistic for mini-med plans. Yeah, that’s because mini-med plans are unrealistic about the cost of medical care.
Some are calling this an unintended consequence of the health care law. Actually, it looks quite intended to me. If your company doesn’t want to pay for decent health care for your employees, the company can pay a fee and the workers can go on the exchanges. There are problems with the exchanges, of course, but compared to these mini-med non-plans, they look pretty OK to me.
What this shows is that the employer-based insurance system will die out within a couple decades. The employers are looking for any excuse to drop coverage, and will pay the associated fees as part of the cost of doing business – a much cheaper cost than skyrocketing health premiums. This means that the initial estimates for the exchanges and the subsidies necessary to provide affordable coverage are all out of whack. The subsidies will cost much more than expected and more people will need to use the exchanges, or expanded Medicaid. Which is why Republicans are attacking the funding streams as a way to strangle the law.
A push by Republicans to scuttle the U.S. health overhaul by denying funding through the House’s constitutional control over appropriations is gaining momentum.
Representative Todd Tiahrt of Kansas, the senior Republican on the House Appropriations subcommittee, said the “defunding” strategy “is a very serious idea” that’s gaining support among party members emboldened by the response of constituents in their home areas, Bloomberg Businessweek reports in its Oct. 4 issue. “There is definitely going to be a run at it,” he said in a telephone interview [...]
John Murray, a spokesman for Representative Eric Cantor of Virginia, the second-ranking Republican in the House, said that if control of the House flips, possible targets for defunding may be the insurance exchanges, the new agency set up under the law to compare different drugs’ effectiveness and any added staffing that may be sought to manage coverage expansions.
By vetoing spending measures that don’t include money for the law, Obama may set up a situation similar to the 1995 government shutdown triggered by a spending dispute between the then Republican-controlled Congress and Democratic President Bill Clinton.
The simplicity of a single-payer system like Medicare is that everyone gets affected by de-funding, regardless of income or class or political power. Poor people, in general, will be using these exchanges. And they will face an adversary in Congress determined to cut the funding for them. They don’t have a lot of political power, and as a result they’ll have a hard time keeping the subsidy levels. So those percentages of income in the law? You can see those as tentative as well. In fact, you can see this whole thing toppling before it even begins.
UPDATE: McDonald’s probably won’t drop their coverage in the near-term. In the long-term, I certainly hope they do!




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…if the parents are employed and have plans, if they have insurance despite being unemployed, if they can afford to add another person to whatever plan they have.
It’s bad all right. Look what’s happening to Medicaid, which already excludes millions who are very poor but do not qualify for welfare (usually single adults) and, as the article notes, the states are restricting the program even further: “A record 20 states placed restrictions on benefits, and 14 plan new restrictions next year.”
Medicaid enrollment spikes to 48M in weak economy
LINK.
How are the mini-med plans even legal right this minute since I thought annual caps and lifetime caps were verboten as of now?
Not to mention they barely qualify as insurance. They are outrageously expensive for little to no coverage if one actually had a major illness or accident.
There are countless employers who offer completely bogus “insurance” just like this. I think they are scams. I also know of companies who have a double tiered insurance system – real insurance for salaried employees and mini-med scam insurance for hourly employees. I think the practice of having tiered benefits like that should also be illegal.
One of the insidious aspects of this health care reform is that the extended time allotted to implement it provides an excuse for inaction by Congress. Each flaw revealed in this 2000 page Rube Goldberg monstrosity will get the same response: “Just wait a few years.” If the end result, after maybe ten years, is merely mediocre, but with only the worst coverage horrors gone, there will never be enough anger and dissatisfaction to cause Congress to reexamine it. If the Republicans kill it next year, then we will be back to square one immediately and will have an opportunity to get single payer/Medicare for all.
If the GOP gets control, Obama can just keep vetoing things. Also, shut down the government. Let’s see how popular the Tea Party is when they can’t their Medicare prescriptions filled.
“Grandfathered” plans.
As much as I’d like to see the Republicans kill the legislation so we can start from scratch, it ain’t gonna happen. The law contains too much stuff that benefits the pharma and insurance corporations. Of course, that’s because they wrote the bill.
Watch for kabuki in which the Repubs try to repeal it, but darn it they just don’t have the votes. Watch for them to whine and make excuses in the manner of Obama.
These are not insurance plans. They are a toy. If you do the math you will see that an average of 3 hourly workers at each restaurant avails themselves of this plan. What McD’s is really trying to do is avoid the employer mandate, since most of their franchisees have more than 50 employees. BARF.
Exactly. The statistics show that parents of most 26 years CANNOT afford to add a child to their plan. Let them eat cake.
I guess this is intended to scare us…
The words Public Option come to mind.
It does.
agree,i lickened it to STEERAGE class on the TITANIC
in the mean time 100,000 plus humans die without care
I understand that there are a lot of folks here who have said that don’t like Ed Schultz, but he just called out the president big time. And, he’s now interviewing Sheldon Whitehouse.
I’ve got to get my news from somewhere. You don’t have to agree with everything Ed says, but he’s consistancy brought important news to the tv.
The average sales volume per McDonalds Franchise in 2008 was $2.3 million per year, per the 2009 McDonalds FDD Franchise Disclosure Document. The highest performer in 2008 was 9.5 million. The lowest had sales of $491,000. Average profit margin per Franchise runs about 10% of sales per Mr. Franchise of Franchise Foundations, a Professional Corp.
see http://www.franchisefoundations.com/mcdonaldsfranchise.html
i like ED
he seems moved by the plight of the average worker,and the less fortunate…he gets it
Thanks. I’m glad I’m not the only one. We’re never going to find a nother person who says and feels like we do. Fact! I better stop there. :)
What pathetic coverage. If I were working there, I’d save the $14 every week in the bank until I hit the $2000 mark, and pay out of pocket for my med care.
Who could have predicted?
Well actually anyone paying attention was predicting this because of the low penalty.
It is a real stretch calling it unintended.
But will he? Remember, we’ve been surprised before…
I am watching now. He sometimes goes to far but hell We need some cheerleaders!
Why would veto a bill passed by a GOP congress? My god, that would not be very bipartisan now, would it?
Plus, the man has an hour spot on prime time cable. Nuff said?
Hugs to you, baby. Stuff be getting hot on all fronts these days.
Almost too much.. Need to take sanity breaks.. (SciFi channel or a good cooking show or NATGO or or or… Shit I just havet’a take a break frfrom all this crap…)
Huggies to you demi ☺ ☺ ☺
Here is a helpfull link http://madashelldoctors.com/caltrip/sacramento-october-12/ Single payer is coming to California The Mad as Hell Doctors are on tour and may be in your area soon to support single payer healthcare.
It’s a good thing poor people are smart enough to be liberals and not vote against their own interests. /S
Something else to ponder. For all the screeching commentary about the minimum wage, how many workers does it actually affect?
Just 980,000 people get paid the minimum wage AND 2.6 MILLION PEOPLE IN AMERICA EARN EVEN LESS THAN THAT and are not affected by upward changes in the minimum wage, apparently. Great enforcement, guys! This insane, decades-long battle is about what is now only 980,000 people that haven’t yet been impoverished more than the nearly ignored law limits. Nearly 3 times as many people earn LESS than minimum wage than earn minimum wage? And there are what, 100+ million workers in America? OMG! How callous can our self-serving political class be?
We now return you to our regularly scheduled collective discussion of the merits of crappy health insurance policies which wouldn’t exist if our government cared for its people, instead of fawning all over its benefactors in high places.
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At least those employees will now have a decent option. The exchanges insurance options seems much more superior to the McDonalds plan.
Balloon Juice had a pretty good piece on this also today.
“I went over to the Kaiser Family Foundation to take a look at what I might qualify for under the healthcare law if I were a single McDonald’s worker (using 2014 dollars). Generously assuming I’d make $10/hour (I believe shift managers make about $9.81/hour) I calculate my yearly salary at $20,800 – or about 181% of poverty.
Turns out I’ll be on the hook for a premium of about $1127 a year, or about $21 per week. That’s $11 less a week than I’d pay for McDonald’s mini-med benefits. But instead of yearly maximum benefit of $10,000 I’d have no maximum benefit at all since maximum benefits are no longer legal. And I’d only have a maximum out-of-pocket expense of $2,083. This plan – a ‘silver’ plan under the new law – is going to be quite a lot better than McDonald’s, actually…
As a cashier making $7.51 an hour I would be on the hook for a yearly premium of $494 or about $9.5 a week.”
http://www.balloon-juice.com/2010/09/30/id-rather-have-a-plan-on-the-new-health-exchanges-than-mcdonalds-health-insurance-any-day-of-the-week/
A comment on the thread attached to that site I thought was worth reposting:
patrickhenrypress,
That’s a great story. Believe me, if that were the choice, that should be the choice. Unfortunately we have a bunch of clowns in this country.
But, I consider the option the McDonalds worker has now to be superior to his previous option which didn’t cover much.
cheers.
I’m having a tough time wrapping my head around the fact that our elected officials, both Democrat and Republican, appear to dispise the American people. Unlike Europe, where their citizens are (for the most part) considered a valuable resource, our government treats us like a bunch of deadbeats undeserving of a living wage, clean air and water, family support services, basic healthcare, safe food, a decent vacation, affordable education, affordable housing, maternal support–need I go on.
When the richest nation in the world can bail out billionares here and the Bank of Kabul over there, yet feels it’s own citizens should work their entire lives at minimum wage or less and be happy about it,something is horribly wrong.
Sorry, but I’m just not feeling the love or seeing the ‘Christ’ in this so-called Christian nation that has nerve enough to criticize Iran for ‘barbaric’ executions, then procedes to execute a mentally challenged woman and a suicidal young man. Frankly, I wish I could move.
“The company doesn’t want to comply with the medical loss ratio, which forces that 80-85% of premiums be spent on actual medical care (because that would mean less profit for their insurer”
david,
normally you’re pretty bright or at least you seem to have a clue to what’s going on. What happened to you in the above statement.
Think about that statement you made for a second. Look at the premium the McDonald’s employee is paying. $14 a week. If insurers profits are 10% (and almost none are) then that’s $1.40 per week that they’d make in profit per person. Then again if this insurers profit is the standard 3% then you’re talking about their profit being not quite enough to mail a first class letter. Oh and don’t forget we don’t know if the insurer is self-insured (probably the case with 29000+ employees) and if so then the insurer really has no profit and just collects a small fee per employee. Oh and McDonald’s has plenty of other things they can make much more profit on than providing healthcare to their employees before its required by law or before they’re required to pay a small fine (raise the price of my kids happy meal) and dump their employees on the exchanges.
Rational thought please.
This has everything to do with the cost to administer a plan for 29000 employees where most don’t have a clue how to read their employee manual much less an insurance contract. Good luck with them on the exchanges. I can smell the stink already.
I’m not David – I’m just an actuary reading your post and noting a few omissions.
“Think about that statement you made for a second.”
As noted by others this is not about the ins.co – - it is about McDonalds avoiding the “mandate that is not a mandate” (employers are not forced to offer health ins) in all the operations with more than 50 employees. There is a fairly steep penalty for businesses that don’t offer health care coverage which business groups say resembles what many might call a federal mandate that goes into effect Jan. 1, 2014 with a penalty of $2,000 per employee Employers with 50 or more workers that do provide health insurance benefits could be subject to the penalty if just one employee applies for a federal subsidy to help pay for their health care insurance because he feels the employer plan sucks – a workerer who earns up to four times the national poverty level ($10,800 for individuals and $22,000 for families) can choose to opt out of their employer’s health care plan—if out-of-pocket expenses for the plan cost more than 8 percent of the employee’s annual income. Employers would have to give any employee opting out of the company health plan a voucher equivalent to the amount that the business pays to provide coverage for its health plan participants. The McDonalds plan is ripe for such opt outs. Heck, even after the voucher is offered, workers would still have the option to refuse the company support and apply for a federal subsidy to help defray the cost of purchasing health care insurance, McDonalds, once an employee applies for the federal subsidy, being notified that it faces the $2,000-per-employee penalty.
As to your calculations they are not on point – having worked in this field the 3% profit is obtained by fake expenses that are in effect payments to management (reinsurance companies owned by management, etc.). Buried in the “expenses” is one hell of a good life for management -and dividends to shareholders – even when paid for with 40% of $728 per person in a 29,000 person group case (about 8.5 million for “expenses” that do not really exist in terms of administrative cost).
At $14 per week we have only $728 dollars a year – no serious coverage can be provided by that so we are talking about Medicaid persons working at McDonalds not causing States to look at low wage companies (like Wallmart in Md) that in MD got folks talking about taxes to reimburse the state for the Medicaid cost.
“raise the price of my kids happy meal” does seem to be your concern – sorry, but that is not my concern.
I believe the above is “Rational thought” – fact based.
Everybodys personal situation is different. There is a reason why some do not take insurance coverage which is huge risk because of personal obligations. BTW these mandates for corporations is against the free choice spirit of our constitution. Imagine what Pres. Thomas Jefferson would have done if present now. Would have asked every American to primary his own party incumbents for agreeing to do such a thing.
If President vetoes a simple bill containing Individual Mandates for HCR companies Repeal from any party his ratings will beat lowest set by GWB and Pres. Nixon. So I really doubt it he will do that.
This is the kind of thing ACORN was built to take on. Fucking Congress used the O’Keefe sting as a straw man to take them down.
MLR compliance? It’s well documented that the health insurance companies reclassify administrative expenses as medical expenses.
http://commerce.senate.gov/public/index.cfm?p=PressReleases&ContentRecord_id=c9a3b9b4-175f-4b71-9086-a080e2b08480
appreciate your response and knowledge on the subject. My basis for comparison is that I work in HR for a fairly large company (almost 2000 employee) and I’m close enough to our costs to see all the figures. I see 4% admin for the insurance company $700k of $15 million that includes the level of service we get (fairly high by today’s standards) so I’m sorry but I’m not seeing this misuse of funds towards management that I’ll also state happens in every large employer. If we pulled all that out I doubt it’d make it anywhere close to the 40% I’m guessing you’re inferring in your comment:
“even when paid for with 40% of $728 per person in a 29,000 person group case (about 8.5 million for “expenses” that do not really exist in terms of administrative cost).”
Sure my company is large enough that it can negotiate better deals which is the reasons behind the exchanges so “Joe’s store” can get the same deal our employees get but I still don’t see it as bad as you seem to think it is and its just a little disingenious for some on here to assume that’s the case nationwide. How do you account for (in your dividend argument) that 50% or so of insurance companies are non-profit although I hear those numbers are going down.