May I offer the following five brief caveats: 1) Higher oil prices are an external Sword of Damocles hovering over the US economy. Oil prices in excess of $100 per barrel during the summer of 2008 played a significant part in the start of the Great Recession; and the US auto companies later financial distress. 2) The sharp decline in effective federal versus statutory corporate income tax rates has significantly increased the after-tax cost of providing health insurance as an employee benefit. 3) Small businesses with 500 or fewer employees each are so vital to this issue because this business sector currently creates the most jobs. According to March's (2016) ADP payroll survey, of the 200,000 private sector jobs created in March, about 161,000 or 80.5% were created by firms with fewer than 500 employees.
4) The phenomenon of adverse selection is a continual problem of selectively, instead of universally insuring people. Should health care costs spike for some reason, then insurance coverage costs will increase too. As they do, more healthy people will not re-enroll due to these higher premiums. Then, the less healthy, and more costly people, will re-enroll, driving insurance costs upward; in a spiraling "vicious cycle," theoretically.
5) Recent work by the Times and the 2015 Nobel Economist shows that the life expectancy curves for people under 64 in the US have reversed, and are declining for these age groups; a very worrisome development.
4/5/16 5:32 p Greenville NC
4) The phenomenon of adverse selection is a continual problem of selectively, instead of universally insuring people. Should health care costs spike for some reason, then insurance coverage costs will increase too. As they do, more healthy people will not re-enroll due to these higher premiums. Then, the less healthy, and more costly people, will re-enroll, driving insurance costs upward; in a spiraling "vicious cycle," theoretically.
5) Recent work by the Times and the 2015 Nobel Economist shows that the life expectancy curves for people under 64 in the US have reversed, and are declining for these age groups; a very worrisome development.
4/5/16 5:32 p Greenville NC
1
Premiums for our small business of five people went up by about 40%. Is this a success? Not in my opinion. ObamaCare is a windfall for the insurance companies and providers. Health care costs just keep going up.
4
I'm sorry to hear that, if your numbers are accurate. But isn't that just about the amount it would have gone up without ObabmaCare, given the rate of increases before the ACA? So you're no worse off, and millions of people now have coverage (including my daughter, who wouldn't have it without ObamaCare).
4
I wish employer-provided health had been uprooted. I don't want my employer's nose in my health care!
2
Don't forget a lot of employers (including mine) have reduced the number of hours their part-time staff (already working for barely above minimum wage and ineligible for the employer-paid health plan) are allowed to work, thanks to the ACA. (They actually come out and say this.) In the case of my company, that's 24 hours per week.
2
What are Americans thinking they deserve? To be kept alive for as long as possible by any means necessary using all the doctors and nurses available with the most state of the art equipment all of it insured to the teeth from malpractice as well?
And they want to drive down the biggest roads, fly in the world any time they want.
And they want to eat as much food as they can possibly shove down their throats whenever they want.
All this while we are at war for the past century.
Your grandparents would shake their heads. You are asking for a lot.
And they want to drive down the biggest roads, fly in the world any time they want.
And they want to eat as much food as they can possibly shove down their throats whenever they want.
All this while we are at war for the past century.
Your grandparents would shake their heads. You are asking for a lot.
3
It is Obamacare's FAILURE TO EXTEND pre-tax-dollar health insurance purchasing power to ALL those Americans who do not get their health insurance thru an employer which keeps America's health insurance and care system as balkanized, overpriced, complicated, and non-universal as it is. All it takes is a severe illness or job change or loss to mess up one's health care in the US, and yet the NYTimes and Wall street are HAPPY with this setup! Americans should demand that the ACA/Obamacare be amended to grant equal income tax treatment for health insurance purchases for All Americans. This is the easiest "free market" step towards a greater standardization of the private health insurance/care system.
4
There should be a Federal Income Tax on the employer-paid health insurance premiums. All employees receiving health insurance as a job benefit should be taxed on the cost of the premiums as earned income. Then, the Federal government will raise several hundred billion dollars each year, and that money can be applied to paying for health insurance for the millions of people who are being forced to buy insurance on their own. The so-called Affordable Care Act is not Affordable.
1
We the People allow insurance companies to use the excuse that certain group plans are losing too much money and raise premiums for the groups. IF you are a shareholder of these insurance companies, do you get dividends based on which group plans or just based on one single business entity, the insurance company? No, you get paid dividends by the insurance company, which has only one tax payer ID. Why do we let insurance companies divide us into groups then? I think each insurance company should treat all subscribers in all different plans as ONE insured pool. Statistically, the Law of Large Numbers dictates that the larger the insured pool gets, the insurance loss and thus premiums become more predictable. There should be no year by year drastic increase on premiums. We should stop being pushed around by insurance companies and their lobbyists in DC and states.
1
Let's debunk another myth around ACA, the number of hours you can work a week before your employer is required to offer health benefits. I keep seeing comments by folks claiming to work 40+ hours a week before ACA and now their employer won't let them because they'll have to offer health benefits. That's not true, just another bit of GOP mis-information. For decades, it was 32 hours a week at which point benefits would have to be offered, and this requirement only applies to employers who have more 50 full-time employees. What did ACA do? It reduced it from 32 to 30 hours a week. As a side note, Ronald Reagan, for a brief period in the mid-80s, reduced it to 17/18 hours a week before reversing course due to a public outcry. Please research and get your facts straight. If you wish to comment, then learn about it. There are plenty of great resources for doing so, but be warned. It takes time and once encumbered, you'll no longer be ignorant.
2
There is nothing affordable about this, I live in NY, but work in NJ. I cannot use the plan my company offers because it is only good for doctors in NJ. Again, I live in NY. I am forced to use after tax dollars, to purchase from NY Marketplace. Its known as Obamacare, and I just found out that the $1200 I dish out for a family plan, I receive no tax benefits in filing my taxes. My company does not offer a HSA.
7
There is a lot of valid criticism in the comments here, but you have to compare what we have now under the ACA with what we would have with no ACA. Would premiums be rising as fast or faster w/o the ACA? Do critics consider the value in not being canceled and left without insurance due to pre-existing conditions? Or no caps on coverage? Or maximum annual out of pocket costs? Or being able to keep children up to 25 on your insurance? Or free preventative care? Or hospitals not having to eat tens of millions in uncompensated costs?
There could undoubtedly be improvements enacted to the ACA is Republicans were willing to do so. Instead, they symbolically repeal it over and over. They have no viable option. Notice how Republican campaigns never tout a better
alternative? More generous subsidies, negotiating lower drug prices, etc. would be sensible modifications that the GOP will never adopt.
The fact that one of the GOP talking points, i.e. employers will drop insurance coverage in droves, has proved to be wrong is worth mention, to say the least. As is the reduction in the number of uninsured. And the millions who now have coverage for chronic illnesses who we shut out before.
There could undoubtedly be improvements enacted to the ACA is Republicans were willing to do so. Instead, they symbolically repeal it over and over. They have no viable option. Notice how Republican campaigns never tout a better
alternative? More generous subsidies, negotiating lower drug prices, etc. would be sensible modifications that the GOP will never adopt.
The fact that one of the GOP talking points, i.e. employers will drop insurance coverage in droves, has proved to be wrong is worth mention, to say the least. As is the reduction in the number of uninsured. And the millions who now have coverage for chronic illnesses who we shut out before.
8
The cost of private plans has skyrocketed since Obumblercare, particularly for small business. Our portion of our employer-provided plan increased a total of 400% over the last three years. Deductibles and maximum out-of-pocket costs have doubled. And this in Anthem Blue Cross.
This thing was a boondoggle from the beginning, and defenders are simply liars who are profiting from it. Employers are trying to do the right thing, but the only way they can is to drastically reduce their share.
This thing was a boondoggle from the beginning, and defenders are simply liars who are profiting from it. Employers are trying to do the right thing, but the only way they can is to drastically reduce their share.
6
The section of the law designed to do away with employer health care is the punitive tax on so called Cadillac health plans that is NOT indexed to health care inflation. By design, more and more plans will be hit with a 40% surtax that employers can't afford to pay. The point of the whole thing is to level the playing field for multi-nationals who must compete against foreign companies who don't have to pay for their employee's health insurance. As for the poor, the expansion of medicaid would have accomplished more, and not forced virtually every citizen who actually pays part of their health insurance to pay more for the "privilege".
5
For all those complaining that your health care costs are rising, you are correct.
But what conservative news sources don't say is that health care costs have been rising faster than inflation for 50 years.
Even Richard Nixon recognized the problem back then.
In the meantime, health care inflation has gone down:
Health Care Inflation – from Factcheck.org:
http://www.factcheck.org/2014/02/aca-impact-on-per-capita-cost-of-health...
But what conservative news sources don't say is that health care costs have been rising faster than inflation for 50 years.
Even Richard Nixon recognized the problem back then.
In the meantime, health care inflation has gone down:
Health Care Inflation – from Factcheck.org:
http://www.factcheck.org/2014/02/aca-impact-on-per-capita-cost-of-health...
5
That's great. So people whose insurance only went from $400/month to $1200 should be grateful it's not $1600? I'm sure that makes them feel a whole lot better.
2
No surprise here. What is surprising is that we were lied to about it, Nancy Pelosi still hasn't read it (why should she? Congress makes itself exempt from most laws, including this one), the unions that liked it now don't like the Cadillac tax so I assume that'll drop by the wayside, my coverage has tripled in cost and my deductibles have gone up. Oh, and the money I spend on health insurance is taxable income, while the money corporations spend on their employees coverage is not. If this was a republican idea, the democrats writing in here would be bleating about how the republicans lied. Lied! The "system" is grossly broken, but nothing has been done, or said, about that.
7
My first thought after reading through many of the comments here is that the ACA has been valuable as education, making more people aware of health care economics. There are many complaints below, but I did not find one of them that did not exist prior to implementation of the ACA. I also did not read a single comment (though I didn't read them all) that questions a major cause of the cost increases: the constant development and implementation of new medical treatments, technologies, and drugs. This is very expensive and someone has to pay. Yet, if you asked the body of commenters here about cutting off medical R & D, and in other ways freezing the current system as a cost-saving measure, there would be howls of protest. The problems described in the comments are not the fault of the ACA, they are inherent problems in the way we provide health care. A single-payer program might mitigate them (once the profit motive in insuring people is eliminated), but the underlying paradox remains: you can improve the effectiveness of health care, you can increase people's access to health care, and you can reduce or control the cost of health care, but you can't do all three simultaneously.
3
Actually you can, only I the US is that a problem amongst advanced nations.
Healthcare is just a word in this country, used to manipulate an extremely insecure, financially and politically naive public, nothing more. The greater the number of "elephants", that keep coming into already overcrowded rooms, the more desperate the refusals become to acknowledge their existence.
5
Irrational and unfounded fear is what the Republicans use to push their agenda of opposing anything supported by the Democrats and the Democratic President.
Be very AFRAID!
"Making healthcare more accessible and fair will force employers to drop health insurance benefits which prevent YOU from having access to healthcare."
"Increasing revenues at businesses by putting more money in the pockets of the consumers who buy things by raising their pay to a livable wage will cause employers to layoff workers."
"Failure to cut public sector and government jobs will lead to higher unemployment." (Paraphrasing something John Boehner once claimed)
"The additional revenues realized by healthcare providers and drug companies, leading to the need to hire more people due to the fact that more people can afford these essential live saving services and products, is proof that the ACA was only created to help hospitals, big drug companies and overpaid doctors."
"Making healthcare more affordable will cause healthcare costs to go up."
By buying into these fears, the GOP can convince Americans, especially Fox News viewers and others with limited critical thinking skills, that the Affordable Care Act is taking away their jobs, their access to healthcare and only lead to death panels designed to put money into the pockets of the healthcare industry.
Be very afraid, yes . . be very afraid of letting the GOP scaring Americans into going against their own best interests!
Be very AFRAID!
"Making healthcare more accessible and fair will force employers to drop health insurance benefits which prevent YOU from having access to healthcare."
"Increasing revenues at businesses by putting more money in the pockets of the consumers who buy things by raising their pay to a livable wage will cause employers to layoff workers."
"Failure to cut public sector and government jobs will lead to higher unemployment." (Paraphrasing something John Boehner once claimed)
"The additional revenues realized by healthcare providers and drug companies, leading to the need to hire more people due to the fact that more people can afford these essential live saving services and products, is proof that the ACA was only created to help hospitals, big drug companies and overpaid doctors."
"Making healthcare more affordable will cause healthcare costs to go up."
By buying into these fears, the GOP can convince Americans, especially Fox News viewers and others with limited critical thinking skills, that the Affordable Care Act is taking away their jobs, their access to healthcare and only lead to death panels designed to put money into the pockets of the healthcare industry.
Be very afraid, yes . . be very afraid of letting the GOP scaring Americans into going against their own best interests!
1
Going against the ACA is the opposite of going against one's own best interests. And no, I didn't get that from Fox news; I got that from my own thankfully limited experience with the thing as well as extensive experience with friends and family who live overseas in places with high standards of living and where single-payer health care has no association whatsoever with rainbows and unicorns.
1
I have to wonder how the unilateral delay of imposing the employer mandate affected these results. The law has never been implemented as intended, so any results are skewed by these political actions.
My wife and I retired (we are part of that burgeoning bubble) which forced us into the marketplace. A $10k deductible and $1550/mo premiums forced us out of all coverage. It is cheaper to pay the penalty. So few are covered now that did not have coverage options before suggests to me that the devastating affect on deductibles, costs and, thus, access to healthcare makes this law every bit as bad as many contend.
My wife and I retired (we are part of that burgeoning bubble) which forced us into the marketplace. A $10k deductible and $1550/mo premiums forced us out of all coverage. It is cheaper to pay the penalty. So few are covered now that did not have coverage options before suggests to me that the devastating affect on deductibles, costs and, thus, access to healthcare makes this law every bit as bad as many contend.
3
Did Abelson actually read the CBO report?
It predicts that about 9 million fewer people will have employer based group insurance by 2026.
it also projects the Federal subsidies of $660 billion, will rise to $1.1 Trillion by 2026, or 4.1% of GDP.
Leave it to the NYT to find sunshine in the rain
It predicts that about 9 million fewer people will have employer based group insurance by 2026.
it also projects the Federal subsidies of $660 billion, will rise to $1.1 Trillion by 2026, or 4.1% of GDP.
Leave it to the NYT to find sunshine in the rain
6
For years the Family Glitch has prevent me from having insurance. My husband's employer offered insurance but because two separate definitions of "affordable" apply I have been exempt. Now, low and behold, the employer ( with a total of three employees who were covered) has dropped insurance, and as of the first of this month I actually have insurance. From my perspective the ACA is designed to force small companies to drop insurance because insurance cost for companies with only a handful of employees have not come down. The difference of course is that the employees in question qualify for subsidies. In turn, as more and more companies turn away from providing insurance and those employees go through the ACA, it eventually becomes clear that Single Payer is the only reasonable outcome.
But the Family Glitch still exists, and it is still being ignored by all presidential candidates except for Bernie Sanders.
But the Family Glitch still exists, and it is still being ignored by all presidential candidates except for Bernie Sanders.
5
Another I told you so moment for the pessimists. I agree that some small businesses changed their coverage and know a number of them that did it successfully. Their employees were provided with a prefunded portable HSA that carried over from year to year, and the employee purchases a high deductible policy on the exchange. On the whole, it is working at those businesses, particularly for younger people and families. For those of us with employer provided insurance, nothing changed. A good employer recognizes that employer provided insurance is part of the total compensation package that both retains employees and engenders loyalty. Perhaps we are lucky, but both my wife and I have always had a job with employer provided insurance and it was the deciding factor on which job to take, twice.
1
Therein, however, lies the continuing problem with employer provided coverage. In the case of those with families and obligations, where a job opportunity might arise that would improve ones career path, there is still the important issue of determining how does that new companies health plan compare to the existing employers? As you stated, on a couple of occasions, that determined which job you may or may not have accepted, not necessarily the one you might have really wanted.
In all the other industrialized countries where universal health care, i.e single payer is a natural part of the landscape, the employer/healthcare choices is never an issue.
In all the other industrialized countries where universal health care, i.e single payer is a natural part of the landscape, the employer/healthcare choices is never an issue.
1
Employer insurance may be alive and well, but have you looked into how much it really offers? In ten years, my Fortune 50 company has progressively gutted its offerings, while beefing up its public relations. The result projects a caring attitude, but what they really want is for you to finance your own health care through your contributions to Health Savings Accounts. I may jump ship to the ACA. It couldn't possibly be much worse.
2
Here we go again kiddies... there was a time -- in my lifetime --when
health insurances were paid completely by employers -- completely!!!
it was full coverage for most and there were no specifications of which
physician or procedure was covered ... hell ..folks actually stayed in hospital
until fairly well healed... no co pays!!! no generic drugs ... it goes on citizen
Can we see here another example of social decay in America .. And now Uncle Sam has his mitts in the action.. the new government banner dictium should well be ( in this matter for sure ) EXPECT LESS ..
health insurances were paid completely by employers -- completely!!!
it was full coverage for most and there were no specifications of which
physician or procedure was covered ... hell ..folks actually stayed in hospital
until fairly well healed... no co pays!!! no generic drugs ... it goes on citizen
Can we see here another example of social decay in America .. And now Uncle Sam has his mitts in the action.. the new government banner dictium should well be ( in this matter for sure ) EXPECT LESS ..
3
What world do you live in? Do you understand how much more complex medicine is than it used to be?. Do you understand that back in the glory times you extol over, the poor and elderly were largely excluded? I have been a practicing physician for about 30 years. Without the government intervention that you despise, many of my patients would be dead due to inability to afford medications for diabetes and hypertension, as well as hospital care.
2
I has not so far, but it's a matter of time before it will. For now, those of us who are basically healthy are stuck with high payments without coverage.
A Democrat.
A Democrat.
2
ACA was supposed to extend coverage to those without. So far, about 1/3 of those without coverage have received it. What about the others who remain without coverage? You know, the ones who do not get subsidies. What about them?
Example: In my state, those in their sixties find that coverage starts at over $12,500 with an equal amount in deductibles. Most can't afford it.
So, what did ACA do? Screw the top 2/3rds of those without coverage to help the bottom 1/3?
Don't get me wrong, I am very happy that some got coverage. At the same time, that doesn't make me confused about ACA. It is a disaster for far more people than it has helped. It is time that the NYT, Professor Krugman, and many of the commenters here to stop being be ACA cheerleaders. Progressives created ACA and we should change it.
Example: In my state, those in their sixties find that coverage starts at over $12,500 with an equal amount in deductibles. Most can't afford it.
So, what did ACA do? Screw the top 2/3rds of those without coverage to help the bottom 1/3?
Don't get me wrong, I am very happy that some got coverage. At the same time, that doesn't make me confused about ACA. It is a disaster for far more people than it has helped. It is time that the NYT, Professor Krugman, and many of the commenters here to stop being be ACA cheerleaders. Progressives created ACA and we should change it.
3
Corporations complain that environmental and employment regulations add to cost and make American companies less competitive. It seems that providing health insurance is another burden that corporations in foreign countries don't face. So then why aren't corporations demanding single-payer government provided insurance? For that matter, why aren't state and local governments arguing for single-payer to alleviate their retiree health insurance obligations? Single-payer would seem to save money for both private and public employers and enhance our competitiveness.
4
Because if the government imposes single payer, THEY will bear the brunt of the taxes to fund it, while simultaneously losing one of the biggest tax breaks they currently have (pre-tax funding of health insurance).
Economically, they are not convinced they would be better off.
Let's be clear, they do better in other countries because HEALTHCARE IS CHEAPER, not health insurance. Other countries can afford Single Payer because HEALTHCARE IS CHEAPER, not health insurance.
When your insurance company is ordered, by law, to spend at least 85% of your premiums on HEALTHCARE, then it doesn't matter how much the CEO makes, your cost increases are coming from HEALTHCARE, not health insurance.
HEALTHCARE COSTS ARE OUT OF CONTROL, that's the only reason insurance actually exists.
WR
Economically, they are not convinced they would be better off.
Let's be clear, they do better in other countries because HEALTHCARE IS CHEAPER, not health insurance. Other countries can afford Single Payer because HEALTHCARE IS CHEAPER, not health insurance.
When your insurance company is ordered, by law, to spend at least 85% of your premiums on HEALTHCARE, then it doesn't matter how much the CEO makes, your cost increases are coming from HEALTHCARE, not health insurance.
HEALTHCARE COSTS ARE OUT OF CONTROL, that's the only reason insurance actually exists.
WR
1
Question: How many other "advanced" countries rely on employer-based health insurance coverage?
As our job market becomes shakier and more unstable (just wait until the TPP is locked into place), an employer-based health insurance system won't/doesn't really do the job.
As our job market becomes shakier and more unstable (just wait until the TPP is locked into place), an employer-based health insurance system won't/doesn't really do the job.
4
Here is the bottom line, the NYT got behind the Obamacare mess and if we would have had newpapers with courage the ACA would not have passed. The NYT, the Dems, and those that voted for them are to blame for this mess, and a real mess it is. The reason the employer based is ok is because when an employer say he will pay half or three fourths of the monthly premium he does. In the ACA, you have to jump through hoops to get a subsidy that is not enough.
The NYT is a democractic hack and never has reported farily on the horrible mess the ACA is.
The NYT is a democractic hack and never has reported farily on the horrible mess the ACA is.
1
According to the republicans, "Obamacare" (a term originally coined as a pejorative by conservatives) was not only a job killer, but many people who had jobs would be reduced to part-time employees. In addition there were death panels waiting to put down grandma, and of course premiums would sky rocket.
The fact that the opposite of a healthcare apocalypse has occurred will not deter republican efforts to destroy the ACA. After all, they are still doing their best to dismantle the New Deal and Medicare. Republicans never offer solutions; they are only purveyors of public panic.
The fact that the opposite of a healthcare apocalypse has occurred will not deter republican efforts to destroy the ACA. After all, they are still doing their best to dismantle the New Deal and Medicare. Republicans never offer solutions; they are only purveyors of public panic.
3
for arty, John, and jeff
on medical debt and personal bankruptcies:
http://www.theatlantic.com/health/archive/2014/10/why-americans-are-drow...
http://www.nytimes.com/2016/01/06/upshot/lost-jobs-houses-savings-even-i...®ion=stream&module=stream_unit&version=latest&contentPlacement=4&pgtype=collection
on medical debt and personal bankruptcies:
http://www.theatlantic.com/health/archive/2014/10/why-americans-are-drow...
http://www.nytimes.com/2016/01/06/upshot/lost-jobs-houses-savings-even-i...®ion=stream&module=stream_unit&version=latest&contentPlacement=4&pgtype=collection
2
I just canceled a plan from the NYS exchange- what a hassle getting it, maintaining it. Calling with any issues needed 2 hours and the person answering have an IQ of <50! no one knows anything, customer service - a joke !!
Combining insurances companies and the government is like mixing two deadly chemicals- the odor is enough to kill you !! The employer paid plan is way better. Obamacare will be the downfall of the Obama legacy !!
Combining insurances companies and the government is like mixing two deadly chemicals- the odor is enough to kill you !! The employer paid plan is way better. Obamacare will be the downfall of the Obama legacy !!
3
Last year we paid over 12,500 for ACA coverage. We couldn't use it because our deductible was about the same. This year we are doing without and for that privilege, we will get to pay a penalty.
And get this...when you don't have insurance you get charged at higher rates! If you don't qualify for Medicaid, the emergency room or hospital will treat you, sure. But not exactly for free. They will put you on a payment plan and charge you the full rate for everything. The full rate is many times higher (sometimes as much as 7 times higher - and that number is not a typo) than they charge the insurance companies. They leave it up to a finance firm to collect later, and that can leave you bankrupt.
So what are we going to do? Just don't get sick. Simple thing to do when you are in your sixties, right?
And get this...when you don't have insurance you get charged at higher rates! If you don't qualify for Medicaid, the emergency room or hospital will treat you, sure. But not exactly for free. They will put you on a payment plan and charge you the full rate for everything. The full rate is many times higher (sometimes as much as 7 times higher - and that number is not a typo) than they charge the insurance companies. They leave it up to a finance firm to collect later, and that can leave you bankrupt.
So what are we going to do? Just don't get sick. Simple thing to do when you are in your sixties, right?
4
No kidding. Not a single one of the doom and gloom predictions of the Republican party has come to pass. Now we need a Democratic president and a Democratic congress to address the needs of those still falling through the cracks, because no way are Republicans ever going to fix anything.
7
I saw my former company fold and now I am contracting for a much less wage. There is health care available but I cannot afford it. If I pay the monthly costs and co-pays based on Obamacare I would pay $24K before the health care actual paid anything. This includes meds and doctor visits. I cannot afford it and dropped my health care and will pay the tax fine. I really think this is the real plan of the government in Obamacare - get more taxes. Obamacare should be scrapped and no government health care should exist as anything the government does it does poorly and expensively.
2
The only reason is not enough time has passed. Obama and the Democrats put in place taxes, restrictions on the average worker or employer in steps. We will not know the full effect of the ACA until Obama leaves office. Already it is underwater and estimated ten million more workers will lose there employer coverage in the next two years because of it. ObamaCare has caused more trouble and cost than it is worth.
1
"... estimated ten million more workers will lose their employer coverage in the next two years because of it." Whose estimate is this? Did you actually read the article?
1
As someone who has been unemployed for the last 4 years, and with pre-existing conditions (minor, but enough to keep me out of the old market), I LOVE the ACA. It's not perfect, but without it I'd have no health coverage at all.
However, among the reasons I'm urgently hunting for a job is that I want much better health insurance. I want insurance that will let me get in-network coverage anywhere in the country, not just my home state. I want lower deductibles. I want to NOT feel like a second-class citizen when I go to purchase coverage. I want access to a reasonably-priced PPO and not to have an HMO be my only choice.
There are a lot of options with employer-based coverage, but the ACA hasn't encouraged insurance companies to offer much in the individual market that's above and beyond the basic ACA requirements.
Waiting now for nationwide single-payer ...
However, among the reasons I'm urgently hunting for a job is that I want much better health insurance. I want insurance that will let me get in-network coverage anywhere in the country, not just my home state. I want lower deductibles. I want to NOT feel like a second-class citizen when I go to purchase coverage. I want access to a reasonably-priced PPO and not to have an HMO be my only choice.
There are a lot of options with employer-based coverage, but the ACA hasn't encouraged insurance companies to offer much in the individual market that's above and beyond the basic ACA requirements.
Waiting now for nationwide single-payer ...
7
Good luck with your job search, seriously.
But if you're looking for better health insurance through your employer, I'm afraid you will be very disappointed. Health insurance plans have been gutted over the past four years. We all suffer with high deductibles and limited networks. We were just switched over to Cigna and that company simply refuses to pay for long term prescriptions if those medicines are not prescribed exactly according to standard of care - even if your doctor recommends otherwise after examining you and knowing your case.
But if you're looking for better health insurance through your employer, I'm afraid you will be very disappointed. Health insurance plans have been gutted over the past four years. We all suffer with high deductibles and limited networks. We were just switched over to Cigna and that company simply refuses to pay for long term prescriptions if those medicines are not prescribed exactly according to standard of care - even if your doctor recommends otherwise after examining you and knowing your case.
2
One thing is clear. The passage of the ACA has turned health care into a giant, nationwide liberal vs. conservative fight. Everyone who spends $1000 a month and gets nothing is ready to punch someone, although they're not exactly sure who. A policy wonk? An insurance company CEO? A presidential candidate?
If medical care wasn't so expensive in the US, none of this would be necessary. Arguing over how to pay gigantic bills won't make the gigantic bills go away.
If medical care wasn't so expensive in the US, none of this would be necessary. Arguing over how to pay gigantic bills won't make the gigantic bills go away.
3
Not all the provisions of the ACA has kicked in yet. including the "Cadillac Tax". The provision in which employers have to pay a tax for providing too good health coverage. When that kicks in, employers will start cutting health care plan levels or cut them entirely.
So, it makes sense there have not be an affect on employer group plans, but the Congressional, ""put more skin in the Game", provisions will hit in less than two years.
If what we are seeing with individual plans is any indication, for those who are too rich for subsidies and too poor to absorb the cost, what is left of this upper middle class will be hit very hard. By them Mr. Obama will be building his presidential library in Chicago.
Of course, once the pain is really felt, then maybe we will get that public option or Medicare for All, that should have been passed in the first place. Unfortunately, what we will get, is keeping our nasty system, but with no more subsidies (the GOP plan, let the markets decide).
So, it makes sense there have not be an affect on employer group plans, but the Congressional, ""put more skin in the Game", provisions will hit in less than two years.
If what we are seeing with individual plans is any indication, for those who are too rich for subsidies and too poor to absorb the cost, what is left of this upper middle class will be hit very hard. By them Mr. Obama will be building his presidential library in Chicago.
Of course, once the pain is really felt, then maybe we will get that public option or Medicare for All, that should have been passed in the first place. Unfortunately, what we will get, is keeping our nasty system, but with no more subsidies (the GOP plan, let the markets decide).
6
The mandate became effective January 1st, and now we're FOUR whole months into the real ACA. Do you really think four months is long enough to measure anything? It is disturbing how liberal-minded folks with secure income and well-funded insurance plans are so willing to write off our healthcare problem as if the ACA has solved anything.
For the small company I work for, the ACA is turning out to be a bureaucratic and logistical nightmare. We even got started early; consulting with our payroll provider and with consultants. Nevertheless, there are still a million questions about how the ACA will play out.
For instance, a part-timer who hits 30 hours consistently must be offered insurance through our plan. Not so great for the employee who might have been getting assistance through the exchanges and now has to give it up because he works too much. Not so easy for employers who have to micromanage part-timer's hours and weigh the costs of pushing everyone into the company's "affordable" plan vs paying large penalties for missing an employee whose hours exceeded the threshold.
The ACA is broken and still has a long way to go before it resembles national healthcare. The NYTimes isn't helping by publishing one-sided articles like this before the data is complete.
For the small company I work for, the ACA is turning out to be a bureaucratic and logistical nightmare. We even got started early; consulting with our payroll provider and with consultants. Nevertheless, there are still a million questions about how the ACA will play out.
For instance, a part-timer who hits 30 hours consistently must be offered insurance through our plan. Not so great for the employee who might have been getting assistance through the exchanges and now has to give it up because he works too much. Not so easy for employers who have to micromanage part-timer's hours and weigh the costs of pushing everyone into the company's "affordable" plan vs paying large penalties for missing an employee whose hours exceeded the threshold.
The ACA is broken and still has a long way to go before it resembles national healthcare. The NYTimes isn't helping by publishing one-sided articles like this before the data is complete.
9
It's as though the buying power of a large group is more effective than individuals attempting to bargain for individual plans. If only we could entice a "single payer" to bargain for health insurance for all Americans in order to get the most cost-effective, high-quality coverage... what could we call that? Hmmm.
2
Family doc here, 26 years in the ballgame. Obamacare Medicaid pays us $39 for a regular 15 minute visit, almost exactly what our overhead is. I could see 30 patients per day, 5 11-hour days per week, 48 weeks per year and earn about $0.
Needless to say, not many of these folks make it through the front door. We don't have a poverty clinic around here, so they have to go to the ER.
All is not perfect in Obamacareworld.
Needless to say, not many of these folks make it through the front door. We don't have a poverty clinic around here, so they have to go to the ER.
All is not perfect in Obamacareworld.
10
I'm sure you seem more than four patients an hour, and most of your patients probably have healthcare from their work that pays more than that. If you're turning patients away, I wouldn't want you for my doctor anyway.
2
I don't blame you. These folks are paying more out of pocket for many other things they find more worthy than seeing the doctor. Keep the door closed.
Perhaps most of his patients healthcare is paid by their employers (for now, anyway, until the Cadillac tax kicks in). But his point is that those who were supposed to have been helped by Obamacare are having to go the emergency room, just as before.
Are the editors aware that this piece contains a key factual error that is misleading large numbers of readers and needs to be corrected immediately? At the end of the article, discussing circumstances under which employers might drop coverage, the text reads (5th line from bottom): "Congress could also take steps to diminish the tax preference for employer-provided insurance." Congress has already taken these steps, with the Cadillac tax. The tax was delayed, first to 2018 and then to 2020, to postpone the pain, allowing the bill to be passed and promoting favorable reviews like this one in the first few years. But it is the law of the land, and Congress will not be taking any additional steps to impose it, because they don't need to.
Mr. Abelson acknowledges the importance of the health care tax break in promoting employer-sponsored health care near the beginning of the piece, but he is apparently unaware that the plans will begin to be taxed in 2020 UNLESS Congress takes action, so that as of now the favorable environment for employer-sponsored health care is just temporary, and any conclusions on the state of the system are premature.
It's shocking enough that the reporter for a front page NYT story on the ACA's impact is so poorly informed as to be apparently unaware of this excise tax, but if the Times refuses to correct this error, it will be moving into National Enquirer territory. I'll be informing the paper's competitors about this mistake.
Mr. Abelson acknowledges the importance of the health care tax break in promoting employer-sponsored health care near the beginning of the piece, but he is apparently unaware that the plans will begin to be taxed in 2020 UNLESS Congress takes action, so that as of now the favorable environment for employer-sponsored health care is just temporary, and any conclusions on the state of the system are premature.
It's shocking enough that the reporter for a front page NYT story on the ACA's impact is so poorly informed as to be apparently unaware of this excise tax, but if the Times refuses to correct this error, it will be moving into National Enquirer territory. I'll be informing the paper's competitors about this mistake.
5
Keep in mind that the game was rigged until Obama leaves office. When the so called Cadillac tax kicks in, the numbers will change
5
The opening paragraph is just so slanted to protect the ACA. This law, which if you recall one prominent Liberal said we must vote for it to see what is in it, has not been in existence long enough to ascertain the true damages and the companies who will drop some coverage. We do know it is costing the vast majority of CITIZENS more each year for coverage and we also know that we do not get to keep the physician of our choice. A blatant lie from the lips of Obama, but, that is all he has done in over 7.5 years! Disgraceful.
5
Sadly, that's about to change. it takes a little while for corporations to figure out how best to increase profits, especially with the ACA being such a new, unknown player. United Airlines has just created a ground handling company to pick up all the contract work American Airlines (as Envoy Air) is currently dumping (they want to concentrate on the American brand). United Ground Handling has made insurance so expensive for part time employees it will cost more than they will make. UGE is expecting the ACA to cover these people. So wait, low pay, (and I mean 10 something an hour or less) and high insurance costs......all these employees nationwide dumped into the ACA,where frankly many will have to go on state assisted healthcare, who wins? Looks like United will show a profit here. Disgusting. Don't be thinking this isn't going to happen all over the country. The ACA is going to be used by large profitable corporations to squeeze the low paid employee. We need to make this as transparent as possible. Investors, passengers, and voters need to know how corporations are providing for their employees.
1
As somebody generally supportive of healthcare reform, I will note that my own employer-provided insurance has become much more expensive since Obamacare became law. Monthly premiums are up, and several of the best plans are no longer available. I work for the third largest employer in the largest city in the country, so it's not like a small number of people were similarly impacted.
It's for this reason, along with experience visiting Europe, that I support Bernie Sanders and his plan for a single payer system. My employer won't constantly shift to save money by passing worse coverage and higher premiums on to me if I get my health insurance from the government. I'd happily pay more in taxes to get away from the current system.
Go Bernie!
It's for this reason, along with experience visiting Europe, that I support Bernie Sanders and his plan for a single payer system. My employer won't constantly shift to save money by passing worse coverage and higher premiums on to me if I get my health insurance from the government. I'd happily pay more in taxes to get away from the current system.
Go Bernie!
5
I'm terribly confused...the same people carping about high deductibles are the same people who complained that the government was "forcing" you to buy insurance...something you supposedly didn't want.
So if you had NO insurance, would that be a better situation than having a $5,000 deductible against future expenses?
You people simply don't make sense.
So if you had NO insurance, would that be a better situation than having a $5,000 deductible against future expenses?
You people simply don't make sense.
2
Yes,it would be preferable,if you don't expect to meet the deductible.
Sure it would be. All you really need is a low-cost catastrophic policy with a $100K deductible. Doctors working on a cash only basis would gladly provide routine care for far less than you are paying now.
Well that just about covers it - everything the republicans said would happen was wrong. Typical.
5
Mike
So you believe everything you read???? Maybe you ought to come out of your shell and look at what is happening in the real world!
So you believe everything you read???? Maybe you ought to come out of your shell and look at what is happening in the real world!
5
Of course everything the Republicans said was wrong. So was everything the President and Nancy Pelosi said about the ACA.
The Republicans have nothing and they did nothing. The Democrats actually passed this all by themselves. For some people it's an improvement for most people it hasn't kicked in yet and for a large group of people who were already insured it guaranteed them coverage if they got sick and vastly reduced their access to good providers if they did get sick.
The Republicans have nothing and they did nothing. The Democrats actually passed this all by themselves. For some people it's an improvement for most people it hasn't kicked in yet and for a large group of people who were already insured it guaranteed them coverage if they got sick and vastly reduced their access to good providers if they did get sick.
1
Like all social engineering attempts, the ACA hurts everyone but it hurts small businesses and small insurance companies more than big ones, ultimately favoring the big guys. It is the same phenomenon when you try to increase taxes or burdens of regulatory compliance on corporations - the biggest love this because the primary effect is putting smaller companies out of business.
When you already have a full-time team of accountants and lawyers to avoid or combat the regulatory regime - what's one more rule? But when you are the small business owner/manager/salesman/cleaning crew/merchandiser/accountant/etc, it is a huge burden.
When you already have a full-time team of accountants and lawyers to avoid or combat the regulatory regime - what's one more rule? But when you are the small business owner/manager/salesman/cleaning crew/merchandiser/accountant/etc, it is a huge burden.
2
for the umpteenth time, i am so relieved living in toronto. i dont understand the u.s. health system. a single payer system is so efficient. can it not be managed by a consortium of insurance companies?
1
As always, a lot of the comments show remarkable ignorance.
The highlights:
1. No, you cannot be denied coverage because you have a sick family member.
2. No, you cannot be charged a penny for checkups, routine labs--and cancer screening.
3. No, you cannot be charged more than about 9% of your annual income.
4. No, the subsidies are not about to "run out."
5. No, you are not without support if you make more than $48K a year.
6. No, you are not without support if you are a small business.
7. No, the Act did not send deductibles soaring.
Just not true, guys. There's plenty to criticize, but this stuff is not it. Kff.org provides excellent intros, and surveys of pros and cons. As has the Times.
The highlights:
1. No, you cannot be denied coverage because you have a sick family member.
2. No, you cannot be charged a penny for checkups, routine labs--and cancer screening.
3. No, you cannot be charged more than about 9% of your annual income.
4. No, the subsidies are not about to "run out."
5. No, you are not without support if you make more than $48K a year.
6. No, you are not without support if you are a small business.
7. No, the Act did not send deductibles soaring.
Just not true, guys. There's plenty to criticize, but this stuff is not it. Kff.org provides excellent intros, and surveys of pros and cons. As has the Times.
6
Excellent site to get a look at healthcare in America. But it's a place that too many Repubs don't want to go to-literally and figuratively.
Family doc here:
8. No, you can't come to my nice clean office and see me if you have Obamacare Medicaid because it doesn't pay enough to let me do anything other than make overhead.
9. No, you can't see any other family docs around here because they won't take it either.
10. Yes, you can go to the emergency department.
11. Yes, you can drive 75 miles to Spokane and see a doctor in a community health center there or see a nurse practitioner in Palouse (unless they close that clinic).
12. Yes, we would be happy to see you if the government doubled our fee for doing so.
13. No, that is not likely to happen.
14. You're right. This society is not doing right by you. Or by us either.
8. No, you can't come to my nice clean office and see me if you have Obamacare Medicaid because it doesn't pay enough to let me do anything other than make overhead.
9. No, you can't see any other family docs around here because they won't take it either.
10. Yes, you can go to the emergency department.
11. Yes, you can drive 75 miles to Spokane and see a doctor in a community health center there or see a nurse practitioner in Palouse (unless they close that clinic).
12. Yes, we would be happy to see you if the government doubled our fee for doing so.
13. No, that is not likely to happen.
14. You're right. This society is not doing right by you. Or by us either.
1
You are without support because the state exchanges don't work, in a state like Maryland millions were wasted on the first lemon exchange and the bureaucracy is terrible and each family has to undergo hell to navigate the bureaucracy and papers have to filled out each year under these adverse conditions to get the subsidies. It is hell and it is true the act did send deductibles soaring--health insurances are shrill about how many more sicker people they have to cover now, how their profits have dwindled in the case of the for profits and how their their reserves have dwindled in the case of the non profits and how therefore they have to charge more.
1
Good news. So where's the money we were all supposed to save when people without coverage stopped going to hospital emergency rooms?
3
Health care costs have been rising faster than the rate of inflation for 50 years.
Even Richard Nixon recognized health care cost inflation was a problem back then.
2014 had the lowest health care inflation in 50 years.
If you really want to save money, go to a single payer system.
Even Richard Nixon recognized health care cost inflation was a problem back then.
2014 had the lowest health care inflation in 50 years.
If you really want to save money, go to a single payer system.
I work at the other big box store and in the year of Obama care my deductible went from $450 to $750, my out of pocket maximum for the year went from $2000 to $5000. I am so glad I can help pay for all those on Obama care when I am still not paid enough to buy a house by myself. Everyone could see the writing on the wall from the beginning. We knew what was going to happen and now it has happened, more taxes for everyone whether you can afford or not. I am sick of all of you holier than thou well off liberals touting to the masses how stupid we all are and how if we just drank your Koolaid things would be all better.
5
Obamacare kicked in several years ago now, a $750 deductible is nothing, and neither your deductible nor your OOP max are taxes.
It's legit to complain about the OOP max--but that's not the PPACA. That's your boss, cutting costs and getting you to believe it's Obama's fault.
It's legit to complain about the OOP max--but that's not the PPACA. That's your boss, cutting costs and getting you to believe it's Obama's fault.
7
The Repubs need some cheese with their "whine."
2
Simple. A group plan is about 1/2 as expensive as getting coverage on your own. In the past, an employee might drop coverage and go out and get a super high deductible policy (with a lot of other loopholes) that was essentially worthless, but they can't any longer. Those plans no longer exist. The big losers in the ACA plan have been the self-employed.
2
Uh...how again does coverage that's worth having make the self-employed losers? And why not just get a catastrophic plan, which is cheap?
1
Robert you can't buy good insurance if you're self employed. There is no good insurance available for individuals. Provider benefits without a qualified provider is not a benefit.
@HL,
I have Obama-care. It is just a Blue Cross policy that I get on the exchange.
It is the same policy any one could get if they went to Blue Cross.
And it is a good policy.
I have Obama-care. It is just a Blue Cross policy that I get on the exchange.
It is the same policy any one could get if they went to Blue Cross.
And it is a good policy.
People are arguing, for and against the ACA. But the ACA is not really the issue. The issue is the for-profit healthcare system of the United States, where healthcare is considered a privilege instead of a right for all citizens. The ACA was a partial answer to a very difficult situation. It's like sticking your finger into the hole in the dam. But the dam continues to crack, groan, and soon will burst. The true answer, the moral answer, is single payer. But no one wants to face that answer, because it's too socialist, un-American (because Americans only care about the needs of the one and it's the emergency room for the needs of the many) and not designed for profit. So we squabble amongst ourselves about the ACA when the answer is all too clear. Single payer for all.
9
Supposedly when a supporter told Adlai Stevenson that Stevenson had the support of all thinking voters, Stevenson replied, “I need more than that, I need a majority.”
Similar to what you are saying, that is our country's problem.
Similar to what you are saying, that is our country's problem.
If and until we have National Healthcare (SOCIALISM!), many of us have rather lousy, high deductible insurance. Two years ago, my half was $98/month with a 2.5k deductible. Now my employer and me pay $240/month with a 3.5k deductible.
Don't get sick. On my income, it's better to risk than to acquire debt.
I suspect that monthly taxes for national healthcare would be considerably less and, if we're smart, at least as good as the capitalist morass now.
Whatever the market will bear. The invisible hand. Yep.
Don't get sick. On my income, it's better to risk than to acquire debt.
I suspect that monthly taxes for national healthcare would be considerably less and, if we're smart, at least as good as the capitalist morass now.
Whatever the market will bear. The invisible hand. Yep.
4
Before the ACA my wife's employer plan had a co-pay of $5-$20 per doctor's visit and $5 for generic drugs. Now we have a $2500 deductible plus monthly premiums. The only way we can get reimbursed for a doctor's visit is for welfare (annual check ups). ACA has many positives but it has gutted health insurance for many people.
3
if you make a law to make insurance mandatory, that is what will happen - insurance will be mandatory. If you make a law that employers have to provide insurance - that is what will happen.
This article glides over the fact that health care costs are slowly stifling this country. even if the employer pays for it, this article makes it clear that, on an average a family is paying 12,600 USD every year for 'health coverage' - money they could have on their paycheck if the health care system did not have the governments finger in it.
it is time to de-link health insurance from employers. Stop the employer tax break for buying health insurance and give the money to employees instead - they will figure out how to spend it - duh!
consider visiting healthpolicy101.org
This article glides over the fact that health care costs are slowly stifling this country. even if the employer pays for it, this article makes it clear that, on an average a family is paying 12,600 USD every year for 'health coverage' - money they could have on their paycheck if the health care system did not have the governments finger in it.
it is time to de-link health insurance from employers. Stop the employer tax break for buying health insurance and give the money to employees instead - they will figure out how to spend it - duh!
consider visiting healthpolicy101.org
2
Except that if we end the employer tax break (scheduled for 2020), companies will do what they've done over the last several decades with retirement plans - take the opportunity to replace the benefits with something of lesser value.
Single payer is the only sensible option.
Single payer is the only sensible option.
Providing health insurance is a no brainer. A company that says it will go bankrupt if it has to provide insurance for its employees probably should not be in business. The Republican strategy has been to create fear in the general population, but what they are really after is helping the 1% keep their absurd salaries as this will mean campaign contributions. A win win for the Republican elite and a lose lose for America.
3
While employer still provide coverage to the vast majority of Americans, the design of these plans has radically changed increasing costs to insureds via higher deductibles, higher co-pays and lower co-insurance. In addition, employees are paying a higher percentage of the insurance cost through higher shares of premiums.
The ACA is funded through the wallets of middle class Americans who see higher costs and lower coverage. I can't help but think there was a better way to provide health care to uninsureds without the negative impact on the
working middle class.
The ACA is funded through the wallets of middle class Americans who see higher costs and lower coverage. I can't help but think there was a better way to provide health care to uninsureds without the negative impact on the
working middle class.
1
The ACA, as Progressives expected, is near useless for many without the Public Option. For profit insurance companies do not turn into friendly kittens because they are tasked with a Public need. The disappearance of ppo's in favor of high deductible HMO's. So low income but barely over medicaid limit ( or a childless adult) citizens still must choose between ignoring health problems until they become un-ignorable or keeping the lights on. Same as it ever was. The high deductible makes this useless for low income people. ACA is only good as astop gap on the way to Single Payer. We the People must hold former Senators Baucus and Nelson accountable for their intransigent opposition to a decent ACA. Health care payment is only hurt by involvement with markets because markets do not work to provide better services. Funny how Prof Krugman, the most strident of ACA supporters, explained why for profit Insco's compete as to who can have the healthiest premium payers and fewest people who actually need money. ACA is not good enough and until employment is uncoupled from Health Care payment we are going to have a 'nice place for the young and healthy, everybody else who cares?' country.
3
When I was younger, progressives prided themselves on offering more than a jumble of complaints stuffed into incoherent phrases.
I wonder what happened?
I wonder what happened?
2
As a small business owner who covers about 90% of the cost of our employer sponsored health plan it still astounds me that I am responsible for picking the selection of insurance plans for my 22 employees. I do not know, nor do I want to know, their individual health care needs. Why should I have to guess what might be the best plan for any individual employee? That being said, we will continue to provide employer sponsored coverage until there is a single payer system.
Yes, the cost of health insurance has increased, both for employer groups and for individuals through the ACA exchanges and direct purchase from carriers.
The ACA added insurance benefits - these were mandated benefits by LAW so the costs were added automatically to group or individual insurance premiums.
The hospitals/doctors set the PRICE of insurance. The insurance carriers negotiate with the hospitals/doctors, etc to lower costs and decrease premiums.
**What i don't know is the negotiation process with the hospitals/doctors done on the state run exchanges level? With no network of providers to work with the costs will keep increasing. The true cost of health insurance is now transparent and that cost is not set by the insurance companies.
I spent 1 1/2 weeks in ICU and specialty care. The hospital staff were warm and caring people and the level of care was amazing - like a well run machine and these people need to be paid. I partner with my employer to cover the cost of my health insurance - the same level of coverage would not be affordable to me if i had to purchase it on the state exchange, even if my employer did the 'defined contribution'.
Unless we follow the European model of social we will not be able to have the level and quality of coverage we were lead to believe would happen.
The ACA added insurance benefits - these were mandated benefits by LAW so the costs were added automatically to group or individual insurance premiums.
The hospitals/doctors set the PRICE of insurance. The insurance carriers negotiate with the hospitals/doctors, etc to lower costs and decrease premiums.
**What i don't know is the negotiation process with the hospitals/doctors done on the state run exchanges level? With no network of providers to work with the costs will keep increasing. The true cost of health insurance is now transparent and that cost is not set by the insurance companies.
I spent 1 1/2 weeks in ICU and specialty care. The hospital staff were warm and caring people and the level of care was amazing - like a well run machine and these people need to be paid. I partner with my employer to cover the cost of my health insurance - the same level of coverage would not be affordable to me if i had to purchase it on the state exchange, even if my employer did the 'defined contribution'.
Unless we follow the European model of social we will not be able to have the level and quality of coverage we were lead to believe would happen.
4
Here's what is not mentioned in this poorly researched article--coverage changes every year and with it the medication formularies, the deductibles and the out of pocket expenses leading to changing caregivers, erratic care and erratic changes in medications, resulting in side effects galore and exacerbation of chronic conditions. Only full time employees are covered. Part time ones are left to the exchanges and are not even counted. I am a doctor and I dread employer given health care plans. From year to year I never know what insurance plan my patients will have, what meds they can get and whether or not they will require prior authorization for their meds. The employers go for the cheapest plans available each year and even though it is true the same insurers continue to be players in the employer driven health care market, those insurers are not static. They now have more stringent plans with higher premiums and higher out of pocket payments. The ACA is often vindicated by the NYT, with shallow articles like this one. Did you talk to the patients and the doctors? The employer based system is alive and well, may be, but it is a creature from hell, with a big maw for premiums and while you jaw to vindicate the ACA, it is the bane of the patients and the doctors--less benefits to the patients and the doctors while asking for more from both in the form of time and dollars, that be the gift of employer based health care, in the wake of the ACA.
4
Based on my personal experience, analysts who made this observation are wrong, " The early tumult in the insurance marketplaces, including the troubled introduction of HealthCare.gov, the federally run insurance marketplace for the Affordable Care Act, also made dropping coverage less tenable, analysts said."
People who are within the subsidy "powered" segment of the ACA have no reason to give up coverage. I don't know the numbers but they are probably not paying a lot.
People who are self employed/entrepreneurs/professionals who get ACA coverage and make more than a comfortable living in the Bay area, lets say over $150,000 for a family of three or four are probably OK but the premiums and deductibles are probably biting.
Those of us who chose to go alone, startup folk, entrepreneurs, small businesses with few employees and who make more than what can be covered by the subsidy but not enough to be "comfortable" are to put it mildly, very unhappy. Yes, its great that I cannot be dropped for pre-existing condition but what use is the ACA if I have to pay over $600 in premiums a month and have a large deductible of $6000 plus a year? And I have not yet navigated buy pharmaceuticals under the program but I have heard horror stories.
I would drop it instantly if a for profit insurance company or those that call themselves "non-profit" gave me a decent catastrophic plan with a reasonable premium/deductible. After all that is what ACA is to me today, a Catastrophic plan.
People who are within the subsidy "powered" segment of the ACA have no reason to give up coverage. I don't know the numbers but they are probably not paying a lot.
People who are self employed/entrepreneurs/professionals who get ACA coverage and make more than a comfortable living in the Bay area, lets say over $150,000 for a family of three or four are probably OK but the premiums and deductibles are probably biting.
Those of us who chose to go alone, startup folk, entrepreneurs, small businesses with few employees and who make more than what can be covered by the subsidy but not enough to be "comfortable" are to put it mildly, very unhappy. Yes, its great that I cannot be dropped for pre-existing condition but what use is the ACA if I have to pay over $600 in premiums a month and have a large deductible of $6000 plus a year? And I have not yet navigated buy pharmaceuticals under the program but I have heard horror stories.
I would drop it instantly if a for profit insurance company or those that call themselves "non-profit" gave me a decent catastrophic plan with a reasonable premium/deductible. After all that is what ACA is to me today, a Catastrophic plan.
2
Oh, for crying out loud. I know for a FACT that Covered California--the state's Exchange--offers a number of catastrophic and /or bronze plans to you. Well, it does if youngo look.
1
As I read through the comments on this article, I can't help but be struck by the fact that we, just like President Obama, just like the Dems in the House in Senate 2008-2010, are all focused on the wrong thing.
Insurance is not the problem. HEALTHCARE is the problem. If healthcare wasn't so outrageously expensive, if new life-saving drugs weren't costing tens of thousands of dollars a month, if a simple ER visit didn't run $5,000 or more, health insurance would be affordable to everyone.
IT's healthCARE that's the problem. Not health insurance. If healthcare was reasonably priced, we wouldn't need insurance AT ALL.
Why aren't we focusing on that? Why are we looking for our wallet under the lamp post, when we lost it back in that dark alley?
It is because the light is better out here?
WR
Insurance is not the problem. HEALTHCARE is the problem. If healthcare wasn't so outrageously expensive, if new life-saving drugs weren't costing tens of thousands of dollars a month, if a simple ER visit didn't run $5,000 or more, health insurance would be affordable to everyone.
IT's healthCARE that's the problem. Not health insurance. If healthcare was reasonably priced, we wouldn't need insurance AT ALL.
Why aren't we focusing on that? Why are we looking for our wallet under the lamp post, when we lost it back in that dark alley?
It is because the light is better out here?
WR
7
One man's expense is another man's income, that's why. Hospitals and doctors are prepared to vigorously defend their revenue streams, and nobody wants to take them on. People look at doctors as noble professionals dedicated to healing the sick, and overlook the fact that 25% of them are in the top 1% in household income. That's a household income greater than $410K!
There aren't many advantages to aging, but I found one. I was able to voluntarily leave my employer's high deductible health insurance plan. For the same money I was paying for deductibles, copays, exclusions and the percentage the insurance company wouldn't pay on almost everything else, I was able to purchase Medicare and a high quality supplemental policy.
Medicare doesn't cover everything, but it covers almost everything that is essential. Thankfully, I didn't have to make any claims the year I had the policy. The second year has been different, and I needed to use the insurance. The coverage provided the care I needed to stay healthy and it did so without adding an unexpected financial burden.
America's combined experiment with the-sky-is-the- limit fee for prescriptions and medical services and for-profit health insurance has been a dismal failure for everyone except the CEO's of insurance companies who rake in as much as $120 million a year and the CEO's of pharmaceutical companies who make as much if not more. Whether insurance is provided as an employee benefit or purchased by an individual, it ought to provide coverage for healthcare without subjecting the insured to unexpected financial burdens while enriching the few.
Healthcare in the US needs major reform if it is truly going to serve us. The AHA has been a small step in that direction. We have a systemic place that works: medicare. Isn't it time to expand that system?
Medicare doesn't cover everything, but it covers almost everything that is essential. Thankfully, I didn't have to make any claims the year I had the policy. The second year has been different, and I needed to use the insurance. The coverage provided the care I needed to stay healthy and it did so without adding an unexpected financial burden.
America's combined experiment with the-sky-is-the- limit fee for prescriptions and medical services and for-profit health insurance has been a dismal failure for everyone except the CEO's of insurance companies who rake in as much as $120 million a year and the CEO's of pharmaceutical companies who make as much if not more. Whether insurance is provided as an employee benefit or purchased by an individual, it ought to provide coverage for healthcare without subjecting the insured to unexpected financial burdens while enriching the few.
Healthcare in the US needs major reform if it is truly going to serve us. The AHA has been a small step in that direction. We have a systemic place that works: medicare. Isn't it time to expand that system?
5
But with Medicare, everyone between 16 and 64 who is working is paying 2.9% of income to subsidize your medical care, or 3.8% for high earners or wealthy investors.
So where would we find the 'someone else' to pay for the whole population? Maybe we can tax Europeans and Canadians?
So where would we find the 'someone else' to pay for the whole population? Maybe we can tax Europeans and Canadians?
I am still waiting to see those "Death Panels" and the taking away of Medicare for the seniors that we were told would happen due to the ACA. I wish more of the media would report the lies told by the GOP to protect their masters. You would think after hearing lie after lie for years some would start to catch on, I guess not.
9
Who needs death panels, when you've got the $10,000 deductible?
1
I have supported the ACA since day one even though I felt that it did not go far enough in containing costs. But at the end of the day it was the best bargain in a hostile political environment.
The fact that the Republican presidential candidates can get away with proclaiming their intention to scrap the ACA and actually get support amazes me. Probably some of the supporters hitherto had a low premium policy that really did not provide much coverage.
Working for a midsize company and as a part of the team that implemented ACA in our organization, I know that our reason for not dropping coverage was not altruistic but the fact that the penalties would have been too hard to stomach.
Make no mistake. It is just a numbers game. Once the cost of offering insurance to a company is greater than the penalty, they will drop coverage like a hot potato.
The next challenge will be to contain costs and to ensure money is actually spent on patients rather than pocketed as profits by the execs or companies through billing practices ... that is, if the ACA survives the next election if a Republican wins. How Kentuckians voted against their better interests in a recent gubernatorial race sometimes makes me questio...oh well that's another comment for another time.
ps.
From my experience implementing ACA, most companies are already gaming the system by risking the smaller - affordability - penalty while avoiding the punitive one if less than 95% of full time employees are covered.
The fact that the Republican presidential candidates can get away with proclaiming their intention to scrap the ACA and actually get support amazes me. Probably some of the supporters hitherto had a low premium policy that really did not provide much coverage.
Working for a midsize company and as a part of the team that implemented ACA in our organization, I know that our reason for not dropping coverage was not altruistic but the fact that the penalties would have been too hard to stomach.
Make no mistake. It is just a numbers game. Once the cost of offering insurance to a company is greater than the penalty, they will drop coverage like a hot potato.
The next challenge will be to contain costs and to ensure money is actually spent on patients rather than pocketed as profits by the execs or companies through billing practices ... that is, if the ACA survives the next election if a Republican wins. How Kentuckians voted against their better interests in a recent gubernatorial race sometimes makes me questio...oh well that's another comment for another time.
ps.
From my experience implementing ACA, most companies are already gaming the system by risking the smaller - affordability - penalty while avoiding the punitive one if less than 95% of full time employees are covered.
3
We are dealing with "Affordable Care". It is a nightmare. It is not the insurance companies that are the problem we have, it is the "Marketplace.gov". The nightmare we have entered is so Kafka-esque as to be unbelievable. I don't think you can understand this without experiencing it. We owned a small business so we were used to having our own insurance, and having to negotiate that insurance, but this is beyond that. And we are democrats, we were supporters of universal healthcare, I am not sure what we've gotten, at least in the execution, it is horrible.
16
Sometimes the State that you hail from will actually be the problem.
I know that does not make sense but I have friends and relatives in many States that for a plethora reasons had to apply for ACA.
The folks that had the most problems seem to be from Red States and/or States that did not have their own exchange.
I thought the gov. exchange was repaired but I am getting different empirical reports.
I know that does not make sense but I have friends and relatives in many States that for a plethora reasons had to apply for ACA.
The folks that had the most problems seem to be from Red States and/or States that did not have their own exchange.
I thought the gov. exchange was repaired but I am getting different empirical reports.
1
Pure made up garbage. Typical GOPer lies. Problems with the website? Right. Healthcare is complicated. To understand healthcare ones needs to understand a sentence that has 3 syllable words. Death panels anyone?
2
I've been on it. It is a piece of cake.
2
except the cadillac tax has been delayed again.... Obamacare is a failure by any measurement.
5
We'll see how Obamacare fares as more insurance companies leave the program. With the blocking of Government "bailouts" to insurance companies who underestimated the costs associated with Obamacare enrollees who are sicker than average the insurance Death Spiral has begun.
6
Another article about ACA that says it is not what was predicted. So all the GOPers jump on this. And those GOPers still have nothing to offer to Americans. Other than whining like small children.
We will approach a time when we'll question the entire premise of an insurance middle man. Just why in the world do we need the insurance companies? Just to pass around paperwork and money? While they siphon off a good portion for executive salaries? To do what?
The average cost of a colonoscopy in the US is over $6,000. It is reported that colonoscopies in Europe can be done for $400 to $800. Why the huge difference? Greed and fraud. To sustain the insurance middle men.
It is time once and for all that we brake the back of the insurance/medical
industry cabal. An arbitrary system that has lived past it's time and very ready for big changes. ACA was only a first step. There is a long way to go.
We will approach a time when we'll question the entire premise of an insurance middle man. Just why in the world do we need the insurance companies? Just to pass around paperwork and money? While they siphon off a good portion for executive salaries? To do what?
The average cost of a colonoscopy in the US is over $6,000. It is reported that colonoscopies in Europe can be done for $400 to $800. Why the huge difference? Greed and fraud. To sustain the insurance middle men.
It is time once and for all that we brake the back of the insurance/medical
industry cabal. An arbitrary system that has lived past it's time and very ready for big changes. ACA was only a first step. There is a long way to go.
12
Well said and great "macro" thinking.
It's time we stop with the scare tactics that the republicans push forward . It's the law and it works ... I wonder what else the next new scare is going to be.
The only way to stop this nonsense is to vote the republicans out of office that promote this nonsense
The only way to stop this nonsense is to vote the republicans out of office that promote this nonsense
1
You should look on your 'explanation of benefits' and see what the insurance company is actually paying the hospital and gastroenterologist. It is, in fact, the $6000 you're complaining about, so how can you say the price is due to 'insurance company overhead'?
The average income of a gastroenterologist in the US? $344K! How does that compare to France and Germany? Don't ask.
The average income of a gastroenterologist in the US? $344K! How does that compare to France and Germany? Don't ask.
We pay $25,000/yr for a healthy family of 4. Enough said.
17
Yes, that is about what we pay as well but it would be the same deductible and out of pocket costs even if all four members of my family were terminally ill. The Affordable Care Act has ensured that families fare better financially since it eliminated insurance companies ability to deny coverage for preexisting conditions.
2
One GLARING problem with ACA is the fact that for the people who have to buy insurance on the marketplace and make more than $48K per year (ie. no subsidies) the plans are super expensive and rising by double digits each year. The costs are not sustainable. As mentioned previously, the deductibles and out-of-pocket have risen exponentially since 2014. Once again, the guy in the middle gets crushed.
9
The small businessmen I consult with (under 100 employees, roughly 85% of all employers in my market) originally thought the same thing, that www.healthcare.gov would present a viable alternative and get them out of the health insurance business.
And then, reality set in.
The fines for employers, at $2000 PLUS per full time employee are not tax deductible, and those fines apply to companies with 50 full timers or more. That's money an employer would send to DC for the privilege of not offering coverage. Money for nothing.
Then, individual coverage on the exchange got expensive. VERY expensive and it continues to climb in price very quickly. Carriers who are losing $Billions and not receiving promised aid from CMS are struggling to create viable risk pools out of the regulatory miasma that is PPACA. Employers don't want to subject their employees to that.
Finally, key employees of every stripe typically earn far more than 400% of the federal poverty level, meaning they derive no benefit from buying on www.healthcare.gov, nor can they pay their premiums with pre-tax dollars, like they can in an employer group plan.
I'd say the employer market has been made even MORE secure by the dysfunction of the PPACA marketplaces.
WR
And then, reality set in.
The fines for employers, at $2000 PLUS per full time employee are not tax deductible, and those fines apply to companies with 50 full timers or more. That's money an employer would send to DC for the privilege of not offering coverage. Money for nothing.
Then, individual coverage on the exchange got expensive. VERY expensive and it continues to climb in price very quickly. Carriers who are losing $Billions and not receiving promised aid from CMS are struggling to create viable risk pools out of the regulatory miasma that is PPACA. Employers don't want to subject their employees to that.
Finally, key employees of every stripe typically earn far more than 400% of the federal poverty level, meaning they derive no benefit from buying on www.healthcare.gov, nor can they pay their premiums with pre-tax dollars, like they can in an employer group plan.
I'd say the employer market has been made even MORE secure by the dysfunction of the PPACA marketplaces.
WR
6
Bunk! Large employers have kept their insurance coverage as a significant perk, while small employers and individuals wrestle with the damage done by the ACA. I had great coverage at my small employer but we had to give it up for something more expensive with less coverage. To keep seeing my great doc of more than 30 years I have to pay completely on my own dime….without it even counting toward my sky-high deductible. To add insult to injury, large employers, including the State wizards who came up with our “plans” were exempted from its mandates and get to keep their cushy benefits. I am counting the years to Medicare and just praying they keep their hands off that.
12
And let us not forget how Mr. Obama lied to us. He deliberately and fully knowingly lied to us many time. "If you like your insurance, you can keep your insurance. If you like your doctor, you can keep your doctor." The man is an enemy within.
3
And yet I'd thought that the "keep government away from my Medicare!" people were just a myth.
1
Yes, Robert, I though so too. With their eyes wide open and completely blind to the hypocrisy. Amazing!
ACA health insurance does not compare to the insurance that most professionals can receive through their employers. Most ACA plans I've seen have deductibles ranging from $2,000-$6,000 for normal plans, or $12,000 for the catastrophic. That is for individual plans too, family levels are higher. These numbers are absurd.
Buying the $2,000 plan would easily set you back $800 a month, and the coverage is not the same as provided by a decent professional employer plan. My company pays 70% of my healthcare, and I pay $100 a month for my single-insurance, which is one of the better plans. There is NO deductible, and its not a limited HMO.
There is a huge difference between employer plans and ACA plans. The ACA benefits lower-income the most only because it subsidizes the costs significantly. It gets people covered, where otherwise they probably couldn't be. Professionals with income over the median wouldn't be happy shopping on ACA for quality insurance.
Buying the $2,000 plan would easily set you back $800 a month, and the coverage is not the same as provided by a decent professional employer plan. My company pays 70% of my healthcare, and I pay $100 a month for my single-insurance, which is one of the better plans. There is NO deductible, and its not a limited HMO.
There is a huge difference between employer plans and ACA plans. The ACA benefits lower-income the most only because it subsidizes the costs significantly. It gets people covered, where otherwise they probably couldn't be. Professionals with income over the median wouldn't be happy shopping on ACA for quality insurance.
5
The article implies that workers have the option of buying insurance on the exchange or participating in their employers' plans. This is incorrect. If you work full time for one employer and that employer offers health insurance that meets standards set by the ACA, then you have no choice but to go with your employer's plan. If, on the other hand, you work one or more part time jobs and you're ineligible for employer benefits because you're part time, you can shop the marketplace and choose a plan that's right for you, AND potentially get a subsidy to offset the cost of paying out of pocket for your insurance. I work one part time job and do freelance/contract work on the side. I'm empowered to choose my own plan -- and despite what the article says, there are plenty of plans to choose from, including higher deductible plans with low monthly premiums that offset the higher deductible with a health savings account. I hesitate to work full time for one employer again because I am very happy with the plan I chose. I don't like the idea of having my health insurance choice made for me by an employer. It's a personal decision and I would prefer that my employer have nothing to do with it.
I say open the marketplace to everyone.
I say open the marketplace to everyone.
8
I work for a good company that cares about its workforce. When the "Cadillac taxes" portion of the ACA became clear, my company had to go with much higher deductibles and less coverage to support a plan for 700+ employees. I pay more than I used to for far less coverage, as well as a $5,000 deductible per family member. While I have no problem paying to make it possible for others to have insurance, I get less of my own. Not sure how that makes it better.
10
The Cadillac tax got delayed until 2019, and you got lied to. Oh, under HHS rules that kicked in Jan 1., no individual family mamber may legally incur a deductible higher than the total deductible for the family, and any deductible they do get charged counts towards the total family deductible.
So unless your deductible for the family is twenty grand a year...which by the way would run afoul of the law and your OOP max...
So unless your deductible for the family is twenty grand a year...which by the way would run afoul of the law and your OOP max...
2
The drumbeat of "job killing Obamacare" that had been a trademark of a Ted Cruz speech has been recently absent from his perorations. Wasn't it at one time one of the endless list of Obama accomplishments he would reverse on Day One with the swipe of his pen?
Health insurance for all is still not reality, and never will be until profit is no longer the primary focus of the health delivery industry. Drugs remain outrageously overpriced, as do medical devices, especially the implanted ones. Medicare and Medicaid fraud should be a capital offense; never mind the taxpayers' dollars that are stolen, more people are hurt, financially and physically, or die prematurely from these crimes than are injured or dead from firearms each year.
I do hope that when the debates between the nominees of the two parties happen this fall (assuming, that is, the Republican candidate has the guts to participate in debates) that national healthcare be a significant part of those confrontations. Trump is and will remain ignorant on the subject. Cruz would be forced to walk back from or produce an itemized list of the "lost" jobs of his declarations for the past two years.
The goal should remain the development of the world's premier health delivery of health care for all, with financial devastation for none.
Health insurance for all is still not reality, and never will be until profit is no longer the primary focus of the health delivery industry. Drugs remain outrageously overpriced, as do medical devices, especially the implanted ones. Medicare and Medicaid fraud should be a capital offense; never mind the taxpayers' dollars that are stolen, more people are hurt, financially and physically, or die prematurely from these crimes than are injured or dead from firearms each year.
I do hope that when the debates between the nominees of the two parties happen this fall (assuming, that is, the Republican candidate has the guts to participate in debates) that national healthcare be a significant part of those confrontations. Trump is and will remain ignorant on the subject. Cruz would be forced to walk back from or produce an itemized list of the "lost" jobs of his declarations for the past two years.
The goal should remain the development of the world's premier health delivery of health care for all, with financial devastation for none.
4
We should ditch employer health insurance that was designed to skirt wage and price controls during WW II and provide traditional Medicare like Canada or a highly regulated Medicare Advantage like France. The move will unleash billions of additional revenue for our people, especially when business owners understand Medicare will cover the medical portion of worker’s compensation. Business could improve benefits like retirement, wages, and working conditions that will be much more beneficial for our nation. Imagine being able to see any doctor taking new patients or being admitted to any medical facility our doctors recommend knowing our bills will be fully covered! We still have time to get it right.
3
OK....sure lets follow the European model for socialist healthcare.
Are you ready for your taxes to increase 30% or more?
What you propose costs money and everyone will have to pay.
Are you ready for your taxes to increase 30% or more?
What you propose costs money and everyone will have to pay.
The best of both worlds would be creating a Medicare-lite for everyone under 65 and allowing employers to offer more robust benefits to attract employees. For the sake of argument, Medicare-lite could fully cover very basic preventive care such as one annual physical, two dental cleanings a year, birth control, coverage for emergency visits, and up to maybe $500 a year in prescriptions, at a cost of $25-50 monthly. Let employers and individuals have the option of paying for additional benefits.
1
Not PPACA-compliant, sorry! Such a plan is illegal in our new, Federalized individual and small group markets. Thanks PPACA!
WR
WR
2
I can't begin to tell you how weary I am of people telling me how wonderful the ACA is. Whenever people from median-income households with employer-sponsored insurance dare to point out the problems we face, NYT commenters slap us down. (The median income of Times subscribers is about $150,000; nationally for all, it's about $52,000. Grow some empathy.)
Insurance for my husband is generously subsidized by his employer. Start adding myself and our daughter, and our premiums easily exceed the 8% that allows you to get an exemption. Meaning, you don't have to buy insurance if you can't afford it. Meaning, you don't have insurance.
This situation exists in many families where one spouse has employer insurance and the other doesn't. If the spouse and child(ren) seek coverage on the exchange, what about family deductibles? For a family covered by the same policy, the deductible may be $5,000 for an individual, but $10,000 for the family as a whole. However, if Spouse A meets his employer's deductible, but Spouse B and children have a separate policy, doesn't their deductible start from zero? These absurd layers of complexity, along with opacity of care pricing, make shopping for insurance impossible.
Bottom line: spending $10,000 a year for health care on top of premiums is impossible for families earning $36,000 to $52,000 a year. We're lining the pockets of insurance companies, but can't afford actual health care.
Really tired of my fellow Dems telling me this is OK.
Insurance for my husband is generously subsidized by his employer. Start adding myself and our daughter, and our premiums easily exceed the 8% that allows you to get an exemption. Meaning, you don't have to buy insurance if you can't afford it. Meaning, you don't have insurance.
This situation exists in many families where one spouse has employer insurance and the other doesn't. If the spouse and child(ren) seek coverage on the exchange, what about family deductibles? For a family covered by the same policy, the deductible may be $5,000 for an individual, but $10,000 for the family as a whole. However, if Spouse A meets his employer's deductible, but Spouse B and children have a separate policy, doesn't their deductible start from zero? These absurd layers of complexity, along with opacity of care pricing, make shopping for insurance impossible.
Bottom line: spending $10,000 a year for health care on top of premiums is impossible for families earning $36,000 to $52,000 a year. We're lining the pockets of insurance companies, but can't afford actual health care.
Really tired of my fellow Dems telling me this is OK.
13
The real question is how much did you pay prior to ACA for premiums and deductibles? If you paid less than the ACA, then yes, it's not working.
I have dealt with the system for my wife's coverage and it is bureaucratic, cumbersome, counter-intuitive, repetitive and choices are minimal. But it still better than the alternative.
Clearly, it would have been better if Obama and the Democrats had followed through and went to a single payer system (Medicare for all) but they stupidly tried to get the bullies (Republicans) to support them so they nixed the smart thing to do for the politics. Unfortunately, the bullies did not come on board and have done anything, said anything, lied about anything, they could to cause the ACA to fail. If the Democrats had listened and just gone for it, the complaints and lies of the Republicans would not have been greater and the problems of merging a public health requirement into the private market would not have occurred and the terrible administration and costs of the ACA would not have occurred.
I have dealt with the system for my wife's coverage and it is bureaucratic, cumbersome, counter-intuitive, repetitive and choices are minimal. But it still better than the alternative.
Clearly, it would have been better if Obama and the Democrats had followed through and went to a single payer system (Medicare for all) but they stupidly tried to get the bullies (Republicans) to support them so they nixed the smart thing to do for the politics. Unfortunately, the bullies did not come on board and have done anything, said anything, lied about anything, they could to cause the ACA to fail. If the Democrats had listened and just gone for it, the complaints and lies of the Republicans would not have been greater and the problems of merging a public health requirement into the private market would not have occurred and the terrible administration and costs of the ACA would not have occurred.
That's funny. I'm really tired of my fellow Dems making stuff up.
For openers, families are eligible for subsidies or tax credits up to 400% of FPL, which is a bit over $90 grand a year. For another, the "easily exceed the 8% that allows you to get an exemption," is gibberish.
For openers, families are eligible for subsidies or tax credits up to 400% of FPL, which is a bit over $90 grand a year. For another, the "easily exceed the 8% that allows you to get an exemption," is gibberish.
1
With that income you would qualify for a subsidy for a plan purchased through the exchange. But you are right, Obamacare is a great thing for the insurance companies.
1
If the right wingers say it will happen then you are guaranteed that it won't.
1
Everyone is angry about rising medical costs. ACA at least starts to address this in several ways. It's a start.
But real price controls are needed in all healthcare markets. That includes prices for medical supplies, including drugs, also medical services performed by doctors and hospitals, as well as insurance premiums and deductibles.
Fragmentation of the US political system makes any change difficult. Insurance is mostly regulated by states, except for ERISA-exempted self-insurance. Medicare might be able to control medical service prices better, but only if doctors accept this, which really means that doctors need to undertake it themselves.
Prices for drugs and medical supplies, however, are a target that is protected mainly by lobbyists and politicians who represent states in which these industries are based, who include some of the most prominent liberals (with whom I might otherwise agree).
But real price controls are needed in all healthcare markets. That includes prices for medical supplies, including drugs, also medical services performed by doctors and hospitals, as well as insurance premiums and deductibles.
Fragmentation of the US political system makes any change difficult. Insurance is mostly regulated by states, except for ERISA-exempted self-insurance. Medicare might be able to control medical service prices better, but only if doctors accept this, which really means that doctors need to undertake it themselves.
Prices for drugs and medical supplies, however, are a target that is protected mainly by lobbyists and politicians who represent states in which these industries are based, who include some of the most prominent liberals (with whom I might otherwise agree).
5
Not surprisingly, the government has missed the unintended consequences of their actions. Employers are not as cold-blooded as they are made out to be. The benefits package is a large part of what forms a company's esprit de corps. To simply cut off medical and throw employees to the wolves, particularly when it was obvious that it was going to cost them more on the exchanges was never really going to happen. It would be a huge blow to company moral.
5
The old paycheck's take-home portion has been decimated in the last couple years. Thank goodness everything I read in the NYT reassures me that's a good thing!
6
A low deductible is $1000? You've got to be kidding. Many people can't afford to buy health care at this level.
9
Yes, that's a low deductible. I'd love to have that deductible. At my husband's workplace, which offers three-tier coverage options for the employee to choose among, that's the gold plan deductible. Ordinary folk who can only afford the bronze have a $5,000 deductible.
However, if you scrutinize the numbers, you find that there's really no difference in what you the health-care "consumer" will end up paying. If you add the premiums and the deductible for the gold and bronze plans, the total is about the same. So if you know you'll need to spend more than $5,000 a year on health care (that is, if you have an ongoing condition you're managing that you know will cost more than that), you're better off buying the gold policy. If odds are that you won't be spending that much, you're better off gambling on a bronze policy. And if you're healthy as my family is, it's always a bad deal. We never need to spend $5,000 a year on health care. So we ration ourselves and don't go to a doctor unless we feel desperate, because on top of premiums that eat up 12% of my husband's gross pay, we have to pay for any care we receive.
However, if you scrutinize the numbers, you find that there's really no difference in what you the health-care "consumer" will end up paying. If you add the premiums and the deductible for the gold and bronze plans, the total is about the same. So if you know you'll need to spend more than $5,000 a year on health care (that is, if you have an ongoing condition you're managing that you know will cost more than that), you're better off buying the gold policy. If odds are that you won't be spending that much, you're better off gambling on a bronze policy. And if you're healthy as my family is, it's always a bad deal. We never need to spend $5,000 a year on health care. So we ration ourselves and don't go to a doctor unless we feel desperate, because on top of premiums that eat up 12% of my husband's gross pay, we have to pay for any care we receive.
7
A thousand a year is an unaffordable deductible? On what planet?
3
Your right, $1000 deductible for the calendar year is not outrageous.
But depending on your income level $1000 is a lot of money to pay upfront until your costs are covered @ 80% for example and then your OOP (out of pocket) is $5000 or more until your covered benefits are paid at 100%.
But depending on your income level $1000 is a lot of money to pay upfront until your costs are covered @ 80% for example and then your OOP (out of pocket) is $5000 or more until your covered benefits are paid at 100%.
Healthcare Reform, of which ACA is only a component, is broad, hard for most to grasp and long-term in its effect. ACAs removal of lifetime caps and pre-existing conditions was critical, and you can't be denied access. The initial purpose was to insure the uninsured, it also made health insurance more accessible to the self-employed. For various reasons, ACA will not change the use of employer-sponsored plans, but it will change how those plans are offered to their employees. The use of private exchanges with an annual allowance is slowly growing. For the self-employed, you pay the whole premium, it's not subsidized by the employer, you're the employer, you should plan accordingly, don't you already pay the other half of social security and medicare taxes? This is no different. Employees pay 6.2% to social security and 1.45% to medicare. Employers pay the same, most employees don't know that. Self-employed are both employer and employee, so they pay 12.4% and 2.9%. So not only do you pay the typical insurance premium, you must pay what the employer typically does. So, account for that in your fees.
The next challenge for Healthcare Reform is to redistribute the spend/profit. Large health systems are experiencing windfalls due to the uninsured now paying a % on the dollar, versus nothing in the past. Overall provider prices need to be adjusted down to reflect this new, additional revenue. The insured always paid for the uninsured, the providers didn't lose money.
The next challenge for Healthcare Reform is to redistribute the spend/profit. Large health systems are experiencing windfalls due to the uninsured now paying a % on the dollar, versus nothing in the past. Overall provider prices need to be adjusted down to reflect this new, additional revenue. The insured always paid for the uninsured, the providers didn't lose money.
2
This is a totally skewered article. How many small businesses have gone under completely because they can't afford those options for their employees? How many more hundreds of dollars are the average American families now having to spend on this fiasco?
8
It's time this country takes a hard look at single payer. Employer-based insurance is great, if you have great insurance offered by your employer. I do. Many people don't. I've used the Marketplace at one point when I was freelancing, which was serviceable but expensive and not ideal. Time to stop the for-profit insurance and healthcare cartels and move to single payer.
2
Most Americans who get insurance through work are insured by their company, there is no insurance company carrying the risk. So very little profit there, the company pays their own claims.
Over 40 million Americans are covered by not-for-profit insurance plans, like Co-Ops and mutual Blue Plans. No shareholders or obscene profits there.
Don't miss the boat. The profits in insurance PALE before the profits in medicine itself. 16 of the top 25 paying professions are medical professions.
We need to focus on why MEDICINE is so expensive. Fix that, and nobody needs insurance at all. IT can just go away.
WR
Over 40 million Americans are covered by not-for-profit insurance plans, like Co-Ops and mutual Blue Plans. No shareholders or obscene profits there.
Don't miss the boat. The profits in insurance PALE before the profits in medicine itself. 16 of the top 25 paying professions are medical professions.
We need to focus on why MEDICINE is so expensive. Fix that, and nobody needs insurance at all. IT can just go away.
WR
3
Here is another instance where the facts on the ground make a mockery of right-wing, chicken little fear-mongering. It happens all the time but fear sells, so the GOP keeps pushing the scare button.
Republican obsession with "Obamacare" has reached the point where the symbolism of association with President Obama is all that counts. There's no longer any serious argument about the substance of the ACA, beyond vague prattle about job-killing and other fancied depredations.
The GOP will keep tearing at the fabric of Obamacare no matter what its benefits to America's most vulnerable citizens, for such is the nature of today's Republicanism. The GOP has stopped ignoring poor people; it now hates them outright with the loudest and meanest of demagogic spin.
www.endthemadnessnow.org
Republican obsession with "Obamacare" has reached the point where the symbolism of association with President Obama is all that counts. There's no longer any serious argument about the substance of the ACA, beyond vague prattle about job-killing and other fancied depredations.
The GOP will keep tearing at the fabric of Obamacare no matter what its benefits to America's most vulnerable citizens, for such is the nature of today's Republicanism. The GOP has stopped ignoring poor people; it now hates them outright with the loudest and meanest of demagogic spin.
www.endthemadnessnow.org
2
How do these large employers feel about the looming Cadillac Tax? Will they still sing the same tune?
5
The ACA was a godsend in TX until all the insurance companies dropped their PPO ACA plans. Back to being a slave to an employer for a decent healthcare plan.
6
My conservative friends here never let facts get in the way of what they want to believe.
And remember the summer of "Death Panels" and all the Tea Party people disrupting the town hall meetings.
My conservative friends also don't ask themselves if they should stop listening to these people telling these things.
And remember the summer of "Death Panels" and all the Tea Party people disrupting the town hall meetings.
My conservative friends also don't ask themselves if they should stop listening to these people telling these things.
1
Public Television should have a series of ongoing debates on this subject.
Because: this article may suffice for NYTimes on line viewers but that is
that is not bringing this necessary debate out to the general public.
The POTUS candidates should be tackling this subject in Town Hall meetings
which are covered by the Media....and this is not happening...at a crucial
time...the 2016 Presidential Election Coverage....
Because: this article may suffice for NYTimes on line viewers but that is
that is not bringing this necessary debate out to the general public.
The POTUS candidates should be tackling this subject in Town Hall meetings
which are covered by the Media....and this is not happening...at a crucial
time...the 2016 Presidential Election Coverage....
2
The ACA is the most inefficient health care system re our peer countries but it has curtailed some of the most de facto criminal aspects of the previous republican plan of be rich, or don't get sick, or don't have a bad life event.
Now it is time to join the rest of the advanced industrialized democracies and come up with systems like they have.
Now it is time to join the rest of the advanced industrialized democracies and come up with systems like they have.
3
In summary, the article and reader comments show the ACA as it is- a flawed plan but a step in the right direction
1
Family coverage for $1,000/month? Not in this metro area, not even close!
4
This should come as no surprise. Since the ACA was passed enrollment in health insurance plans has consistently risen each year. Maybe the Republicans will decide that they do need to try and block the ACA for the 40th time or whatever the number is. I see that in this election year the Republicans have backed off trying to eliminate the ACA sine it is working but what happens after the election if the Republicans maintain control of Congress? Will the Republicans take up their efforts to block the ACA? Let's hope not. My hope is the Republicans lose big in November and we can then resume reasonable governing in Washington.
ACA is working? for whom? for the very poor?
Do you have any idea what the premiums and deductibles are? Do you know what a "deductible" even is?
Do you have any idea what the premiums and deductibles are? Do you know what a "deductible" even is?
10
The ACA is working for those with pre-existing conditions who were unable to buy insurance at any price. Try that sometime.
2
I did not lose my coverage, but I lost my plan, and I work for a Fortune 1000 company. Our previous insurance was too expensive because of the ACA. My new plan is comparable in coverage, but my premiums and deductibles have tripled since the ACA passed.
So thanks, Obama and Democrats. It's 100% on you. I liked my plan, but I could not keep it. I can keep my doctors for now, but I cannot wait to vote in November, and there are MILLIONS like me!
So thanks, Obama and Democrats. It's 100% on you. I liked my plan, but I could not keep it. I can keep my doctors for now, but I cannot wait to vote in November, and there are MILLIONS like me!
16
The irony here is that "the free marketplace" that the GOP is always praising has driven the success of the ACA (note that now that it is having success it is loosing the label "OBAMACARE").
I am certain that the GOP, which has proven immune from any fact based analysis, will continue to slander the ACA and the President rather than see this as a first step toward fulfilling the US obligation to its citizens thus keeping America "Great".
I am certain that the GOP, which has proven immune from any fact based analysis, will continue to slander the ACA and the President rather than see this as a first step toward fulfilling the US obligation to its citizens thus keeping America "Great".
It may not of caused employers to drop Obama Care, but it did encourage them to put full time workers on a part time biases,so as not to pay for their insurance.There are too many loop holes, & the tax payer will again be left holding the bag, for another unworkable Government program.
7
Bye, bye, Boogeyman. Some of what Obamacare has actually done is to enable entrepreneurship, allowing people to start small businesses with reliable (if not cheap) health insurance. It has also allowed a lot of Boomers to retire early. You're welcome, Millennials!
1
Hilda, you have NO IDEA. Do you have any idea what a small little entrepreneur has to go through on healthcare.gov only to find policies with very high premiums combined with out-of-sight deductibles?
You have NO IDEA or you would never say such a thing.
You have NO IDEA or you would never say such a thing.
7
So true! My very small business has three employees - all of whom have their own insurance through their spouses; since they have opted out of MY insurance plan I've been able to have small group coverage for just my wife and myself. No more...I received a letter from BC/BS stating that due to the new rules of the ACA, my plan no longer qualifies as a group and I have to now find individual coverage - which will cost more and have fewer provisions.
5
I have to work for a large company to get good and inexpensive health insurance or I have to be under the poverty rate. But if I am a middle class freelancer I have to pay $800+ per month individual to get the same health insurance. The ACA has done nothing to help individuals who are self employed or own small business. ACA has failed miserably in this regard. I prefer the medicare for all plan better. Everyone should pay into it just like social security. Then if you want more insurance, since medicare only covers 80%, you can go buy your own additional in the open market. Just like it is done now when you retire.
4
While I would prefer universal coverage, this article disputes GOP talking points about ACA. When will Cruz and Trump be called out for their gross dissembling on this topic? Fact Checkers, where are thou?
It is for certain that the creators of ACA have never had to enroll in insurance on the Marketplace. A typical health insurance policy costs $400 a month for a single person with a whopping $13,000 deductible - all this with a no-name risky insurance brand. This law is killing small businesses.
7
Yeah right, you write that but just wait another year or two. I'm a small business owner and our healthcare costs shot up 25% per employee, only one year into offering medical benefits for the first time in our six year history. We're just about at our limit, didn't want to pull away our gold plan after only one year but we can't sustain double-digit annual increases.
24
Lies, Lies, and more lies! The ACA has caused SMALL businesses to drop healthcare coverage. In addition, these same businesses have eliminated full-time jobs in order to do so. As a result, many of those who lost their jobs during the recession have never resumed full time employment and have been forced into the 30 hour work week so their employers needn't offer healthcare anymore.
Not all people work for big corporate America. And even those who do have complained that they now must contribute more from their paychecks to their healthcare plans. And ask any NJ teacher and they will tell you the same as far their government paychecks. This is just another misleading NYT article. It is also the reason people why people like Bernie Sanders and Donald Trump have risen to such popularity. The American public is fed up!
Not all people work for big corporate America. And even those who do have complained that they now must contribute more from their paychecks to their healthcare plans. And ask any NJ teacher and they will tell you the same as far their government paychecks. This is just another misleading NYT article. It is also the reason people why people like Bernie Sanders and Donald Trump have risen to such popularity. The American public is fed up!
5
Another canard widely trumpeted by the GOP obstructionists bites the dust. What next? Do we discover there are no "death panels!" Mercy me.
What the unaffordable care act actually did was increase the costs of policies, increase co-pays, increase tax and will eventually have the effect of destroying the middle class. We can NOT continue to carry healthy people who have chose not to work. We have a moral responsibility to take care of children, handicapped and the elderly. Let the rest work for their health care. When I read they dropped out of the job market I wonder where did you drop too. Who pays for your home etc. Educate and make jobs.
7
"As it turns out, health care remains an important recruitment and retention tool as the labor market has tightened in recent years."
In other words, employers can STILL use the fear of losing health insurance to instill terror in the hearts of employees.
The GOP knew perfectly well what it wanted when it opposed Obamacare.
Although much better than the previous unaffordable COBRA alternative, Obamacare remains a baby step towards real health insurance reform.
Employers must eventually be removed from playing with people's medical lives.
In other words, employers can STILL use the fear of losing health insurance to instill terror in the hearts of employees.
The GOP knew perfectly well what it wanted when it opposed Obamacare.
Although much better than the previous unaffordable COBRA alternative, Obamacare remains a baby step towards real health insurance reform.
Employers must eventually be removed from playing with people's medical lives.
2
"But those predictions were largely wrong."
Can anyone tell me even one "prediction" the Republicans have been right about in recent years? The so-called Grand Old Party (GOP) has become the Wrong-About-Everything Party (WAEP), and it sad and maddening to witness.
Thanks NYT for following up on what is really happening with the ACA and disputing yet-another GOP/right-wing falsehood and damaging bit of propaganda.
Can anyone tell me even one "prediction" the Republicans have been right about in recent years? The so-called Grand Old Party (GOP) has become the Wrong-About-Everything Party (WAEP), and it sad and maddening to witness.
Thanks NYT for following up on what is really happening with the ACA and disputing yet-another GOP/right-wing falsehood and damaging bit of propaganda.
Rising deductibles in both ACA and company health insurance are not mentioned in the article at all. Sorry, but this article reads like glossy PR spin.
6
As usual this paper likes to flaunt any scrap of anything which helps to portray Mr. Obama as actually solving our very serious problems. The inconvenient fact, however, is that millions of people, the middle class, are now paying premiums in excess of $20,000 per year. It's like another mortgage, except you own nothing at the end. Mr. Obama's solution is not sustainable. He knows this, and so do those who are now redistributing their money to so many others. It's not sustainable. The loving affinity this president has with extreme leftists is apparent. Even when Americans had been killed in Belgium, he remained with his soulmate Castro.
6
It's simple. Any company looking to recruit and retain the best employees would need to continue to provide employer paid health insurance.
14
J, but it is not that simple. Many USA jobs today that have included company health care are filled by relatively easy-to-replace employees. That's the facts.
Yes, hiring companies or middle or large size are happy to attract staff that want healthcare BUT those some companies dont have any meaningful plan to _retain_ those staff for more than a few years because those staff are easily replaceable in the current hiring economy.
Yes, hiring companies or middle or large size are happy to attract staff that want healthcare BUT those some companies dont have any meaningful plan to _retain_ those staff for more than a few years because those staff are easily replaceable in the current hiring economy.
Any company looking to recruit and retain the best possible employees will need to continue to offer company paid insurance. It's a business decision.
1
Yes, my employer still offers health insurance and I am grateful. However, since the ACA became law, my health insurance has gotten more expensive and the deductibles are much higher. It has become a common complaint among my friends this year how expensive it has become to go to the doctor.
There are many positive things that came out of the ACA, but thanks to the Democrats and Republicans in Congress, and their puppet masters, we have been left with a still broken system that costs the average American too much money.
There are many positive things that came out of the ACA, but thanks to the Democrats and Republicans in Congress, and their puppet masters, we have been left with a still broken system that costs the average American too much money.
60
Premiums were going up at the rate of about 10% a year even before the ACA went into effect. The ACA is better than nothing, but the real solution to keeping costs down is a single payer system tailored to the U.S.
5
Yes, the yearly increase for my employer provided health coverage has slowed, but that doesn't tell the whole story. Where once I had a copay of $20 for my GP and $40 for any specialist, in plan, it is now no copay and I pay 10% of the bill until I meet a deductible of $1,500 per person.
While I would love a single payer system, I'm not holding my breath that will come for decades. What would help now is price transparency. If I need an MRI, for example, I should easily be able to shop around for the best price. The ACA should have a modification made that requires the full cost of care to be given to the patient before any treatment or procedure is done.
While I would love a single payer system, I'm not holding my breath that will come for decades. What would help now is price transparency. If I need an MRI, for example, I should easily be able to shop around for the best price. The ACA should have a modification made that requires the full cost of care to be given to the patient before any treatment or procedure is done.
3
Yes, let's blame the Republicans since not one of them voted for the bill.
1
In another view it has. Companies as well as Universities such as the University of Virginia increase part time employees, and strictly limit how many hours they can work, to avoid providing health benefits.
4
Employer-sponsored health insurance is just another bargaining chip corporations use to maintain power over their workers. After all, it's harder to quit a job--regardless of how horrible the conditions may be--when you and your family depend on it for coverage. A part of me wishes that doomsday scenario of employers dropping coverage actually did occur. Then more Americans would flock to Obamacare, and the importance of a single-payer system would become more apparent.
5
If American businesses were relieved of the exorbitant costs of what is now substandard health insurance they would be more competitive on the global field of play.
If we want to see a real economic revival with good paying jobs we need a game changer. The kluge we have now is holding us back as a nation and is not sustainable.
If we want to see a real economic revival with good paying jobs we need a game changer. The kluge we have now is holding us back as a nation and is not sustainable.
4
I don't think this is particularly surprising, and I really wonder who thought large employers would drop coverage for their employees. The burden is on small employers and as the article notes, they aren't providing health insurance to their employees.
But the bigger issue that is unmentioned is the increased cost to employees. The article notes that the MINIMUM deductible for Lowe's health insurance plans is $1,000 - and I'm sure that comes with higher premiums. Deductibles and copays have been increasing, which reflects the ACA's biggest failure - its inability to rein in health care costs.
But the bigger issue that is unmentioned is the increased cost to employees. The article notes that the MINIMUM deductible for Lowe's health insurance plans is $1,000 - and I'm sure that comes with higher premiums. Deductibles and copays have been increasing, which reflects the ACA's biggest failure - its inability to rein in health care costs.
5
I'm a small business owner who added a group plan and covered my two employees. The reason, it's impossible for me to get good insurance in the individual market. The access to good providers doesn't exist.
I went on the Government web site and was inundated by robocalls from brokers all over the country. They had one goal in mind, sell me the cheapest policy available. When ever I asked about access to quality providers in my area they had no clue what I was talking about.
Any employer who has a sick family member covered by their group plan can't get rid of their employee coverage. If they did they and/or their family member would not be able to get access to good providers.
If employers actually forced employees out into the individual market and subsidized their insurance the ACA would be DOA.
I went on the Government web site and was inundated by robocalls from brokers all over the country. They had one goal in mind, sell me the cheapest policy available. When ever I asked about access to quality providers in my area they had no clue what I was talking about.
Any employer who has a sick family member covered by their group plan can't get rid of their employee coverage. If they did they and/or their family member would not be able to get access to good providers.
If employers actually forced employees out into the individual market and subsidized their insurance the ACA would be DOA.
19
Sigh. About the FIRST thing the PPACA did was to make it ILLEGAL for an insurer to deny civerage to somebody because they are sick.
Robert they are not denying you insurance, they are denying you access to good providers. Take a loo at the provider networks available in the individual market. Compare that to any large employer network. It's shameful what is being sold to people as insurance in the individual market.
You can sigh but it's clear you don't have a sick family member in who has an ACA policy for an individual or family. If you do, you, like most people who have this policies don't have a clue to how poorly insured and vulnerable they actually are.
You can sigh but it's clear you don't have a sick family member in who has an ACA policy for an individual or family. If you do, you, like most people who have this policies don't have a clue to how poorly insured and vulnerable they actually are.
2
I'm not sure if the NYT doesn't get it or doesn't care. While employers are not abandoning health care coverage on a full-scale basis, what they are doing is moving their employees to far inferior policies that were not available before the debacle known as the ACA went into effect. After years of good health coverage, my employer used this opportunity to switch us to a plan that is so useless, I am categorically worse off: inflated deductibles and limited choice to meet the deductible. AND I still contribute a premium every month. So the rosy article that quotes insurance executives and CEOs doesn't give you the real story, or the story from common man who has been uprooted. But maybe the objective of the story is to present how good the law works for the insurance companies and corporations looking to save money and cut costs.
10
So another Republican (and Fox News) prediction about the ACA has turned out to be false. No matter, they will keep repeating it along with their favorite others:
- the ACA will balloon the deficit (false)
- the economy has been a disaster under Obama (false)
- we are no longer respected around the world (false)
- if only we cut taxes for the rich, the economy will boom (false)
- we need voter identification laws to stop election fraud (false)
One could go on and on. Sad thing is their base continues and will continue to believe these lies and so long as they do, Republican leadership will keep repeating them and harvesting anti-Democratic votes as a result.
- the ACA will balloon the deficit (false)
- the economy has been a disaster under Obama (false)
- we are no longer respected around the world (false)
- if only we cut taxes for the rich, the economy will boom (false)
- we need voter identification laws to stop election fraud (false)
One could go on and on. Sad thing is their base continues and will continue to believe these lies and so long as they do, Republican leadership will keep repeating them and harvesting anti-Democratic votes as a result.
In the past I have known a number of people chained to jobs for the health insurance. If they or a family member had a "pre-existing" condition, purchasing coverage independently was virtualy impossible. Maybe employers are motivated to keep their health benefits for employees now that there are other possibilities.
1
"But those calculations do not figure in the sizable tax break that comes with providing coverage. "
That is the key sentence in this entire article and the only reason employer coverage continues. The rest is fill.
That is the key sentence in this entire article and the only reason employer coverage continues. The rest is fill.
1
"Despite Fears ..." No, it was not fear, it was simply another attack intended to undermine Obamacare - no different than "death panels", "death spirals" and all of the other politically based attacks that have proven to be untrue.
Saying these were "widespread predictions" gives them an undeserved air of legitimacy, as if it was really expected to happen but did not. The unfounded attacks on Obamacare were propaganda attempting to make untrue charges appear to be true - no more than that.
Even though each of the charges, like this one about jobs, has been disproved, they created a source of "documentation" that Republican presidential candidates continue to use to misrepresent the impact of the law. Just this January, Ted Cruz said Obamacare "is the biggest job-killer in this country -- millions of Americans have lost their jobs, have been forced into part-time work."
That is why news articles need to quit giving credence to such lies by calling them what they are "lies", not "fears", not "predictions". Come on press, do your job.
Saying these were "widespread predictions" gives them an undeserved air of legitimacy, as if it was really expected to happen but did not. The unfounded attacks on Obamacare were propaganda attempting to make untrue charges appear to be true - no more than that.
Even though each of the charges, like this one about jobs, has been disproved, they created a source of "documentation" that Republican presidential candidates continue to use to misrepresent the impact of the law. Just this January, Ted Cruz said Obamacare "is the biggest job-killer in this country -- millions of Americans have lost their jobs, have been forced into part-time work."
That is why news articles need to quit giving credence to such lies by calling them what they are "lies", not "fears", not "predictions". Come on press, do your job.
Obama repeatedly told us we could keep our plan,doctor,and a family of four would save $2500 a year in premiums.That promise was a lie.My premiums have risen 45% since Obamacare was signed.In addition,my copays have doubled/tripled depending on whether you see specialists,etc.Tests that had no copay now have $100-150 copays.The family plan had a $5000 deductible;now it's $5000 per family member.So spare me the flawed rhetoric about the success of Obamacare.The bottom line is I'm paying more for health insurance to cover people who receive government payouts from my taxes to pay for their insurance.
3
I work for the largest employer in the state of Alabama (other than the state itself). We still have health insurance offered in three level (depending on who you wish for your carrier). They have ALL gone up - some in more hidden ways than others. My coverage is isn't what it was. My premium not covered by my employer is more. Diagnostic tests (such as colon cancer screening) that were once covered now have $250 deductible. Half my medications have been moved to a different "tier" of coverage meaning my co-pays have increased.
So, many employers have not dropped coverage all together, but they have made changes that are costly to the employees.
So, many employers have not dropped coverage all together, but they have made changes that are costly to the employees.
37
Sigh. Under the PPACA, it is illegal to charge you for routine screening tests.
1
Are you aware that many employers are making those "changes" and using the ACA as an excuse? How are you going to prove them wrong?
BUT THEN if any polyps are removed during the procedure, it goes from screening to diagnostic and that's how they get you. So one polyp? Fork over $250.
1
Perhaps not, but it hasn't stopped it from getting progressively worse either. Twice in the past couple of years I've been forced onto more "consumerist" policies designed to teach me how to spend healthcare dollars on my family with the marvelous tools of high deductibles, co-pays and premiums. I really can't imagine how a single payer system would not be more efficient, and whatever the raise in taxes, it could not be worse than the soaking I'm taking now.
43
Really? Out of the $3 trillion we spend on medical care, $1 trillion is currently paid for by medicare and medicaid. So $2 trillion would have to be covered. Since the total payroll in the US is $7 trillion, the additional tax would be 2/7 of your pay, or about 28%. Are you willing to pay that?
1
Think healthcare provided by the VA. Or the IRS. Any government entity. It's almost as if they want us to beg for the worst.
1
Uprooted? No. Made the employees share of the cost higher? Yes. The recent studies of what that increased cost is varies, but there is no doubt it is higher, some indicate about $4,500 a year since ACA came into being, and e the excludes the increase in coverage's. The idea that the ACA would lover cost by $2500 a year may have happened on the employers side, but not the employee's side. Higher premiums, higher co-pays and higher deductibles have been the rule. The poor have benefited with Medicaid being totally free, the middle class have not. Income has be re-distributed, big time.
3
One of the reasons employers may be continuing to provide coverage as a recruitment and retention tool is that Obamacare has a such bad reputation. I know someone who was forced to be "on Obamacare" between jobs, and all of sudden she couldn't find a pediatrician for her kids, and it was a total disaster. The prospect of being on Obamacare is quite frightening, although perhaps better than nothing, and not something an employer can force on its employees across the board. If my company tried it their would be a revolt.
5
Before the ACA, companies were already increasing premiums and co-pays and cutting back on benefits on health insurance. They had to - medical costs were prohibitive.
The ACA made the real cost of insurance benefits - full benefits, that is, ones which did not cap out or drop sick patients - an eye opener, no longer invisible to the insured. Company plans which had employees irate started looking better.
Moreover, companies that were not committed to providing benefits had already figured out how to avoid it - outsourced service, contractors, part-timers, dropping spouses who had insurance through their own jobs, even if it was vastly inferior.
The reality is that the ACA did not change employers plans too much, because employers had already changed everything before the ACA went into effect.
The ACA made the real cost of insurance benefits - full benefits, that is, ones which did not cap out or drop sick patients - an eye opener, no longer invisible to the insured. Company plans which had employees irate started looking better.
Moreover, companies that were not committed to providing benefits had already figured out how to avoid it - outsourced service, contractors, part-timers, dropping spouses who had insurance through their own jobs, even if it was vastly inferior.
The reality is that the ACA did not change employers plans too much, because employers had already changed everything before the ACA went into effect.
1
Things might be different if the ACA facilitated any reasonable options on the individual market. It of course did not, and most of the options are horrendous, requiring enormous deductibles and co-pays, such that you are essentially paying for insurance you cannot use. We are also in a very tight labor market for skilled employees, and employers know dumping people on to the exchanges is just the same as reducing cash wages so they won't do it. Pay closer attention during the next recession, when skilled employees have less negotiating leverage. I expect you'll see more employers drop coverage.
None of this changes the fact that the ACA is an unmitigated disaster. If it was a decent alternative that wouldn't cost employees money or employers talented employees, you would see more employers drop coverage. The fact is if you are very poor perhaps you benefited, if you are a middle-class skilled employee, the individual market is not a viable alternative.
None of this changes the fact that the ACA is an unmitigated disaster. If it was a decent alternative that wouldn't cost employees money or employers talented employees, you would see more employers drop coverage. The fact is if you are very poor perhaps you benefited, if you are a middle-class skilled employee, the individual market is not a viable alternative.
31
What about individuals who were shut out of the "individual market" because of pre-existing conditions? Those were people who had no choice. Now, at least an "individual market" exists. Insurance companies cannot deny them coverage, but the ACA doesn't prevent them from trying to squeeze every dollar they can. It would be nice if the GOP-controlled Congress would make some moves to improve the ACA...but you know, that's "highly improbable". Wait until President Trump or Cruz repeals Obamacare, and all those individuals lose ALL their coverage. The good old days, right?
1
It doesn't sound like you had the experience of shopping for individual health insurance pre-ACA, where actual choices were few and confusing in the best case, and completely nonexistent if you ever had any kind of health problem, including common ones like asthma or allergies.
1
Not true. My wife and I have a small business and because I have high blood pressure my premiums were tripled before ACA, if I could get coverage at all! Now instead of almost $2K a month for us and our 20 year old daughter in college, we pay about $600 a month with more coverage and no costs for such things as mammograms for my wife at no extra charge. Many of our friends and family report changes for the better and most to barely any significant differences at all. Health insurance has been skyrocketing since the 80s and needed reform. Is it a perfect system? No. Is it better than before? Absolutely. The U.S. healthcare system is huge and anytime huge systems undergo changes their will be ups and downs and a time requirement to see what works and what doesn't. Now if we had a Congress that was an ally to the people instead of ideology and obstruction, we may have had an even better system. To date the Republicans have not put forth a better plan, only a return to the way things were before, which didn't work.
1
There are over 20 countries around the world---high income countries like Canada, Germany, Japan, Norway, Sweden, UK---that provide single payer national health insurance programs.
And they do it for less than 10% of GDP vs. 18% in the US. So what does it take? It takes a willingness to learn from others and implement rational policies without fear of labels like 'not invented here' or 'ain't that socialist?'
The most prevalent trigger of personal bankruptcy in the US is catastrophic illness. Imagine what a well planned national healthcare system would do for US consumption expenditures and corporate earnings.
It is time for corporate America and the GOP to endorse ACA and a move towards a more comprehensive ACA. If not, corporate America--including Koch Industries--is headed towards reduced global competitiveness.
And they do it for less than 10% of GDP vs. 18% in the US. So what does it take? It takes a willingness to learn from others and implement rational policies without fear of labels like 'not invented here' or 'ain't that socialist?'
The most prevalent trigger of personal bankruptcy in the US is catastrophic illness. Imagine what a well planned national healthcare system would do for US consumption expenditures and corporate earnings.
It is time for corporate America and the GOP to endorse ACA and a move towards a more comprehensive ACA. If not, corporate America--including Koch Industries--is headed towards reduced global competitiveness.
2
Time to do some more digging. 96% of all French citizens have a private insurance policy to subsidize their "government" coverage because it is so poor. Germany's system is run by private insurance companies, although tightly regulated with price controls on docs and hospitals.
The main thing they all have in common is membership is REQUIRED all the time, whether you like it or not, and you are taxed appropriately.
In the US, despite PPACA, we still have millions of free riders, mostly young folks, who are not contributing to the system or joining an insurance pool. Makes the costs for everyone higher.
WR
The main thing they all have in common is membership is REQUIRED all the time, whether you like it or not, and you are taxed appropriately.
In the US, despite PPACA, we still have millions of free riders, mostly young folks, who are not contributing to the system or joining an insurance pool. Makes the costs for everyone higher.
WR
2
The other important thing to note about Germany is that their doctors make about 40% of the income that doctors in the US make. They don't have any orthopedic surgeons who make $405K, which is the average income of an orthopedic surgeon in the US.
1
It's really hard to listen to Ted Cruz et. al. continue to claim that workers are losing coverage, and employers are cutting back hours, etc. --"job -killing Obamacare"--and on and on.
They continue to make an argument utterly refuted by the facts.
A smart Republican Party would have accepted Obamacare as a reality--and developed a critique of healthcare (not insurance premium )costs, waste, bureaucracy and cronyism that run through the entire system.
Those are real problems that won't go away--along with the VA scandal that falls entirely on the Obama administration and has yet to be solved.
If the Republicans can re-invent themselves by purging their ranks of the racists, crackpot economic theorists, science-deniers and the phony freedom-of-religion persecuted (for starters ) --they might be eventually viable again. For now that seems a very long time away.
They continue to make an argument utterly refuted by the facts.
A smart Republican Party would have accepted Obamacare as a reality--and developed a critique of healthcare (not insurance premium )costs, waste, bureaucracy and cronyism that run through the entire system.
Those are real problems that won't go away--along with the VA scandal that falls entirely on the Obama administration and has yet to be solved.
If the Republicans can re-invent themselves by purging their ranks of the racists, crackpot economic theorists, science-deniers and the phony freedom-of-religion persecuted (for starters ) --they might be eventually viable again. For now that seems a very long time away.
Here in Las Vegas, we have seen the widespread shifting of lower-income casino workers from employer-provided private insurance plans to Medicaid. In some cases, hours are cut so that the employee is no longer eligible for the company plan and is gently guided over to Medicaid with the added bonus of no deductible or co-payments. It's a win-win unless you are a taxpayer. Meanwhile, those with private insurance face ever-increasing premiums and deductibles. Those with large subsidies may find their share is now equal to the cost of insurance before ACA--a windfall for big business at taxpayer expense.
1
How is Medicaid a "win-win". Every try to see a specialist on Medicaid? Get your kid to an asthma doctor? Get a relative on chemo or dialysis? Good luck with the waiting lists and lack of providers who will take the sorry amounts Medicaid pays.
Medicaid is rapidly becoming the lower tier of our three tier healthcare system. Sure you've got a card in your pocket, good luck trying to use it.
WR
Medicaid is rapidly becoming the lower tier of our three tier healthcare system. Sure you've got a card in your pocket, good luck trying to use it.
WR
@WellRead29 - But, at the same time, Medicaid is devastating state budgets, and eating up nearly all the local tax revenue.
1
Larry Summers found the idea of restricting profits in the health care system "nonsense".
Rhambo had convinced the president to drop any support for a single payer in the first month of his tenure.
Our president, who divulged his admiration for Reagan soon after neutralizing HRC, is deacon in the church of the free market..
He stated in '09 that: "a rising tide lifts all vessels".
I'm confident that the portion of of our GDP covering health care has risen.
The only people being asked to sacrifice are everyone in the system below the MD's. I should also add all those whose employers are shifting the rising costs to their employees.
There are still too many health related bankruptcies and people having to choose between paying their groceries or paying for their medications.
When I compare our situation here with my friends in France, I wince.
Rhambo had convinced the president to drop any support for a single payer in the first month of his tenure.
Our president, who divulged his admiration for Reagan soon after neutralizing HRC, is deacon in the church of the free market..
He stated in '09 that: "a rising tide lifts all vessels".
I'm confident that the portion of of our GDP covering health care has risen.
The only people being asked to sacrifice are everyone in the system below the MD's. I should also add all those whose employers are shifting the rising costs to their employees.
There are still too many health related bankruptcies and people having to choose between paying their groceries or paying for their medications.
When I compare our situation here with my friends in France, I wince.
1
I strongly favor eliminating employer provided health insurance.
Doing so would remove my employer from health care decisions and eliminate the particularly odious debate on faith-based tinkering with health care coverage and choices.
Furthermore, this would correct the tax unfairness of some of us getting an untaxed benefit, while others have to pay with after tax dollars.
Personally, I waste far too much time researching and picking insurance providers, trying to understand their bizarre coverage details, and fighting with them to be paid for claims and to approve doctors and procedures.
Finally, and hopefully, this would remove much of the power of health insurance industries to set prices and negotiate with doctors and hospitals and pill pusher big pharma.
I look forward to the elimination of health insurance companies and the full implementation of Medicare for all.
Doing so would remove my employer from health care decisions and eliminate the particularly odious debate on faith-based tinkering with health care coverage and choices.
Furthermore, this would correct the tax unfairness of some of us getting an untaxed benefit, while others have to pay with after tax dollars.
Personally, I waste far too much time researching and picking insurance providers, trying to understand their bizarre coverage details, and fighting with them to be paid for claims and to approve doctors and procedures.
Finally, and hopefully, this would remove much of the power of health insurance industries to set prices and negotiate with doctors and hospitals and pill pusher big pharma.
I look forward to the elimination of health insurance companies and the full implementation of Medicare for all.
106
It's rare I find someone so anxious to pay another 10-15% of their income in taxes while losing choices and enduring queuing and rationing at the same time. That's what the Medicare system must become, if you are going to start drawing benefits from it at birth, instead of AFTER you've contributed 1.5% of your salary for your working years. Even with those contributions, Medicare already burns another $600B a year in federal dollars.
Do you honestly think you will save money applying that plan to every American from birth? Very optimistic.
WR
Do you honestly think you will save money applying that plan to every American from birth? Very optimistic.
WR
1
Then get ready for your taxes to skyrocket.
If we want to have the European style of socialist medical coverage then we will have to raise taxes to an unheard of level.
The costs are not set by the insurance companies but by the doctors / hospitals. Your benefits are decided by the health insurance plan YOUR EMPLOYER purchases. If you have issue with that plan then have a conversation with your employer.
If we want to have the European style of socialist medical coverage then we will have to raise taxes to an unheard of level.
The costs are not set by the insurance companies but by the doctors / hospitals. Your benefits are decided by the health insurance plan YOUR EMPLOYER purchases. If you have issue with that plan then have a conversation with your employer.
1
All too true, and with a health care industry that siphons more than $2 trillion from us every year it is also never going to happen. Way too many way too rich people would lose their cash cow if we had a sensible health delivery infrastructure.
The conclusion of this article is premature. As the piece acknowledges, employers get a sizable federal tax break for providing health coverage. But beginning in 2018, the ACA calls for a 40% excise tax on employer sponsored plans - the "Cadillac tax". Any evaluation of the effect of the ACA on employer-sponsored plans made before this tax has been in effect for several years has little meaning.
Ezekiel Emmanuel has publicly, almost gleefully acknowledged that his intent in including this provision in the ACA was to disrupt employer-sponsored health care. His hope and expectation was that companies would replace health plans with a salary boost, the taxes on which would then fund the ACA. Many have pointed out that this is unrealistic, that when this tax begins employers will reduce coverage but not compensate fully with increased wages. This would be consistent with the behavior of companies as they reduced retirement benefits over the last several decades, and it would mean that not only would employees lose coverage, but the ACA would be insufficiently funded - the only winners would be the corporations who would end up paying less.
This all might not happen, however, because there is a bill in Congress, HR2050, which would repeal the excise tax. Companies have not made dramatic changes yet because they are waiting to see if the tax will be reversed. But contrary to what is stated in this article, the tax is current law. This piece needs to be corrected.
Ezekiel Emmanuel has publicly, almost gleefully acknowledged that his intent in including this provision in the ACA was to disrupt employer-sponsored health care. His hope and expectation was that companies would replace health plans with a salary boost, the taxes on which would then fund the ACA. Many have pointed out that this is unrealistic, that when this tax begins employers will reduce coverage but not compensate fully with increased wages. This would be consistent with the behavior of companies as they reduced retirement benefits over the last several decades, and it would mean that not only would employees lose coverage, but the ACA would be insufficiently funded - the only winners would be the corporations who would end up paying less.
This all might not happen, however, because there is a bill in Congress, HR2050, which would repeal the excise tax. Companies have not made dramatic changes yet because they are waiting to see if the tax will be reversed. But contrary to what is stated in this article, the tax is current law. This piece needs to be corrected.
5
The author has pointed out Obamacare has provided free healthcare to millions of Americans, yet there are millions who are paying more for their coverage. There are 30 million people in this country who have or had private health insurance; many have already had their coverage cancelled because their plans didn’t meet the ‘ten essential health benefits’ of Obamacare (like maternity, which they didn’t need). Millions more will lose their coverage as a result of that restriction, and yet the President ‘promised’ no one would lose coverage. There will be millions more that will lose their company sponsored plans in the near future as costs continue to spiral upwards making it prohibitive for some employers to provide coverage. In many states, more than half the plans on the federal exchanges have a deductible of $3,000 or more – many with coverage are finding it difficult to maintain due to the deductible. The largest healthcare providers in the U.S., Aetna and Humana may leave the exchanges since losses are mounting as Obamacare continues cutbacks through 2017. The verdict is still out on Obamacare as the subsidies it initially allowed will be running out shortly and we may find it was a ‘one trick pony’ – not truly beneficial to the country in the long run. It was quickly conceived and written without much thought and will have to be changed as it’s not sustainable. Health care costs will continue rising and the government will not be able to keep pace with those costs.
23
The bit about the subsidies running out? That's untrue. Extremely untrue.
1
No one is getting "free" health care. Either one pays premiums or their employer does and lowers their pay commensurately. And I know of no insurance without some sort of copay unless it is very high premium insurance. Those of us on Social Security have a payment for Medicare taken out of our Social Security every month. Some years mine has been as high as $350 per month. And my husband pays the same.
The ACA is a start. By the time this law was finished running the political gauntlet, many of consumers' key concerns were flogged from, or never inserted into the original legislation. The public is left with a very imperfect law. Single payer was eliminated; the fee for service model with its insidious duplicative treatment costs; the failure to address a standard for electronic medical records; the failure to shackle big pharma.
The reasons for the apparent robustness of the employer-based system is that the ACA actually strengthened it! Gone is the threat of Medicare for all. The insurers actually wrote the bill!
But the biggest problem with the ACA is the unintended consequence of institutionalizing the high deductible health insurance that poor, low and middle consumers have to deal with. Not only are most of us confronted with giving a relatively high percentage of income to a health insurer, but also we are force to fork over high out of pocket co-pays or co-insurance for medical services.
Steps towards single-payer need to be made. The first one is to change the Centers for Medicare and Medicaid Service's stranglehold on pricing of health insurance policies. Eliminate the Actuarial Value Calculator which is how both public and private insurance values services. It's perverted and archaic. No incentives for cost control. Simply asking for single payer without going under the pricing hood won't do it. There is much work to do on this issue.
The reasons for the apparent robustness of the employer-based system is that the ACA actually strengthened it! Gone is the threat of Medicare for all. The insurers actually wrote the bill!
But the biggest problem with the ACA is the unintended consequence of institutionalizing the high deductible health insurance that poor, low and middle consumers have to deal with. Not only are most of us confronted with giving a relatively high percentage of income to a health insurer, but also we are force to fork over high out of pocket co-pays or co-insurance for medical services.
Steps towards single-payer need to be made. The first one is to change the Centers for Medicare and Medicaid Service's stranglehold on pricing of health insurance policies. Eliminate the Actuarial Value Calculator which is how both public and private insurance values services. It's perverted and archaic. No incentives for cost control. Simply asking for single payer without going under the pricing hood won't do it. There is much work to do on this issue.
2
with over 40 years in the fields of medical care and insurance and representing both users of medical care services and products and providers here are a few ideas which many Americans need to consider:
medical care is not = to health care
medical care insurance is not = to quality medical care
medical insurance is not = to adequate access to medical care
medical insurance does not = adequate insurance
coverage of the uninsured is not = adequate coverage
forcing people to have medical insurance under the above is a sad joke.
it is nothing more than forcing people to purchase insurance products that do not guarantee anything more than continued excessive profits and compensation for the top 1% of the administrative employee force.
waste including unnecessary profits, top 1% compensation, advertising/marketing and general administrative expenses range from an extreme low of 15% to almost and even more extreme 40%.
major killers of Americans often not reported or glossed over include the medical care received by Americans. all major studies claim of the 2.3 million deaths in America that as high as 1,000,000 are caused by the medical care received.
only 20,000 deaths were reported by studies as due to a lack of medical insurance.
the medical-insurance complex is a major reason why America has lost competitive edges in production and services.
America spends more than any other country per person and in total than any other country on medical as quality falls.
Thimk!
medical care is not = to health care
medical care insurance is not = to quality medical care
medical insurance is not = to adequate access to medical care
medical insurance does not = adequate insurance
coverage of the uninsured is not = adequate coverage
forcing people to have medical insurance under the above is a sad joke.
it is nothing more than forcing people to purchase insurance products that do not guarantee anything more than continued excessive profits and compensation for the top 1% of the administrative employee force.
waste including unnecessary profits, top 1% compensation, advertising/marketing and general administrative expenses range from an extreme low of 15% to almost and even more extreme 40%.
major killers of Americans often not reported or glossed over include the medical care received by Americans. all major studies claim of the 2.3 million deaths in America that as high as 1,000,000 are caused by the medical care received.
only 20,000 deaths were reported by studies as due to a lack of medical insurance.
the medical-insurance complex is a major reason why America has lost competitive edges in production and services.
America spends more than any other country per person and in total than any other country on medical as quality falls.
Thimk!
4
First, the point of the ACA was not to give Americans more options for their healthcare. The point was to force Americans to pay into a fraudulent system before it went bankrupt, thus propping up the corrupt players in a shameful health care system - insurance companies being only the most obvious culprits. The result? Millions of Americans pay hundreds of dollars every month for insurance that is utterly useless to most.
Second, part of the deal that Obama struck with the insurance companies was the promise that companies which provided employee health insurance would eventually start to receive fines for doing so in order to push everyone into Obama's unconscionable giveaway to the insurance industry. This is what's coming down the pike if no one changes anything.
It would be nice if the Times actually did their homework every now and again rather than shilling for corrupted liberals like Obama (and Clinton).
Second, part of the deal that Obama struck with the insurance companies was the promise that companies which provided employee health insurance would eventually start to receive fines for doing so in order to push everyone into Obama's unconscionable giveaway to the insurance industry. This is what's coming down the pike if no one changes anything.
It would be nice if the Times actually did their homework every now and again rather than shilling for corrupted liberals like Obama (and Clinton).
8
The only fraudulent system soon to go bankrupt is the GOP. Have you checked their tea leaves lately? We're still waiting for the GOP alternative, other than "free market." Crickets.......
2
Wow, you sure have the wrong end of the stick.
By definition insurance is only helpful for the few who need to collect.....therefore "utterly useless to most".
By definition insurance is only helpful for the few who need to collect.....therefore "utterly useless to most".
3
As I understand the ACA, the belief is that many large employers would drop health coverage when they are penalized for providing "cadillac" plans. The implementation of the penalty has been delayed for this reason. This article makes no mention of that... incredibly misleading!
12
Another magical thinking alternative universe prediction about the disastrous effects of passage of the ACA touted by the McConnell and the GOP courtesans of big bid'ness that has not come true.
You don't hear about repeal of the ACA as the number one talking point of GOP
politicians these days. Why? Because it's largely working warts and all, and the GOP can get more political mileage spewing bigoted screed about immigrants.
You don't hear about repeal of the ACA as the number one talking point of GOP
politicians these days. Why? Because it's largely working warts and all, and the GOP can get more political mileage spewing bigoted screed about immigrants.
6
Lets revisit this after all the employer mandates become effective AFTER the coming election cycle. As it stands now, on my new AFFORDABLE care plan I just had to pay $4000 out of pocket for a screening colonoscopy which was recommended by my IN PLAN doctor. How is that going to encourage people to get preventative health care?
4
A colonoscopy in Europe can cost between $400 to $800. Why in the world does it have to cost so much here? Answer this and we know why we have only begun to scrape the surface of fraud and waste in American healthcare.
There are literally trillions in savings for the American people within this bloated and distorted healthcare market in America.
There are literally trillions in savings for the American people within this bloated and distorted healthcare market in America.
4
It has for themost part made insurance useless. My premiums for a family of four have gone up over 300 dollars since 2013 and my deductible has doubled. Why doesnt the times for once be honest and write a story based in reality. Sure, few employers have dropped care. What is not mentioned is the increased use of contract labor and increasingly unafordable and unuseable health insurance as a result of Obama care. In short it fixed a problem for 20% of the population by vastly increasing costs for the other 80%. Rather than being a propaganda arm for the Obama administration, just for once this paper paper should try accurately reporting the news
9
A "propaganda" arm of the Obama administration, hardly. Costs for insurance only go up and if you remember the good old days prior to Health Care Reform, cost sky rocketed year, after year, after year with increase 3, 4 or 5 time inflation all so the Insurance Co. executives could make their profit targets. Price increases are the norm and if you didn't complain in the past, don't complain now and blame health care reform for an industry-wide problem. Real reform was blocked by the GOP and their army of lobbyists from the Pharmaceutical industry, hospital conglomerates like HCA, medical device manufactures and of course big Insurance companies.
4
My employer has not dropped coverage. On the other hand, the cost of coverage has increased dramatically over the past three years, resulting in a significant decrease in take-home pay.
Can someone explain why, when an industry gains tens of millions of customers, the cost for each should increase?
Can someone explain why, when an industry gains tens of millions of customers, the cost for each should increase?
9
The previously uninsured were quite ill. As reported several weeks ago.
2
Really? Nothing like a health care program, passed by congress, led by Nancy Pelosi's infamous “we have to pass the bill so that you can find out what is in it,...."
A health care program promising reforms which simply moved great numbers of people from working 40 hrs or more per week to a new workforce of 32hrs or less per week, along with establishing a tax.
Health care reform would address things such as lowering the cost of medicines, as found in other countries, or lowering the cost of a medical education, or tort reform, or reducing the cost of liability insurance for practicing physicians, as well as, better enforcement policing licensure for incompetent physicians with repetitive litigation for mal practice against them, or reducing the tax breaks hospital facilities receive for over expanding....
A quick read thru, a number of questions develop regarding this study and if you believe its conclusion, talk to a good number of new workers in the part time workforce who had their hours reduced to avoid the health care mandate.
A tax is a tax is a tax.
A health care program promising reforms which simply moved great numbers of people from working 40 hrs or more per week to a new workforce of 32hrs or less per week, along with establishing a tax.
Health care reform would address things such as lowering the cost of medicines, as found in other countries, or lowering the cost of a medical education, or tort reform, or reducing the cost of liability insurance for practicing physicians, as well as, better enforcement policing licensure for incompetent physicians with repetitive litigation for mal practice against them, or reducing the tax breaks hospital facilities receive for over expanding....
A quick read thru, a number of questions develop regarding this study and if you believe its conclusion, talk to a good number of new workers in the part time workforce who had their hours reduced to avoid the health care mandate.
A tax is a tax is a tax.
25
Read the next comment from John.
2
ACA provides tax subsidies which are tax cuts. A tax cut is a tax cut.
2
"Truthiness" is defined as the quality of stating concepts one wishes or believes to be true rather than the facts. While truthiness has been rampant among conservatives, nowhere do we see it more on display than in discussions of the Affordable Care Act.
Those predictions of course came from Republicans. Now they've switched the attack. Because fewer employers dropped coverage there has been lower than forecast take up of coverage via the exchanges. This means the exchanges are failing according to Republican spin. Republican creativity when it comes to inventing lies about Obamacare has no limit.
18
Imagine that! Another GOP doomsday scenario about Obamacare bites the dust. How surprising! ;-)
20
My nephews lost their coverage not because It wasn't available, but because the premium got so high that they couldn't afford it. When contacted by the IRS the IRS agreed with them and exempted them from the fine.
2
Where's the 'upheaval' and 'dire consequences' that the GOP just *knew* was going to happen?
Oh, that's right...the party of Fear was wrong, yet again.
Oh, that's right...the party of Fear was wrong, yet again.
101
As I replied to another comment, my 2 nephews lost their employee insurance not because it wasn't offered, but because the premium got so high that they couldn't afford it. The IRS agreed with them and exempted them from the fine. They insurured, now they aren't.
1
No, they really weren't. For most people, it is a lot more expensive to get care, you get fewer options, and higher copays.
1
I wish there was upheaval but as long as regular people get check ups for their kids paid for the for profit insco's people accept their lot. The people who cannot afford high deductible's will go without health care because of price.
2
Last year my company's health insurance rose 9%. This coming year, 12%. And our company buys its insurance within a large consortium of related non-profits.
To mitigate the costs (employees pay 20% for single coverage and family plans pay 50% out of pocket) we are now buying policies with $1500 deductibles per individual and $3000 per family plan.
It's good that companies are offering health insurance but to get a true picture of the effects of the ACA, you really have to get into the weeds of deductibles and the specifics of what kind of coverage employer-based health insurance is providing.
The vacuum cleaner effect health insurance is having on workers' paychecks is not good for individual workers nor does it do anything for the overall economy.
Insurance companies are making money and hospitals are much less likely to be stiffed for the entire cost of a hospitalization. Hooray for them.
However, the ACA is hardly a success, especially when the enormous deductibles are factored in. As Bernie says, the outrageously deductibles sometimes $3000 to $5000 are, in effect a form of rationing because individuals and families postpone diagnostic tests (seldom if ever covered) are too costly.
It's too premature to laud the ACA without reservations.
To mitigate the costs (employees pay 20% for single coverage and family plans pay 50% out of pocket) we are now buying policies with $1500 deductibles per individual and $3000 per family plan.
It's good that companies are offering health insurance but to get a true picture of the effects of the ACA, you really have to get into the weeds of deductibles and the specifics of what kind of coverage employer-based health insurance is providing.
The vacuum cleaner effect health insurance is having on workers' paychecks is not good for individual workers nor does it do anything for the overall economy.
Insurance companies are making money and hospitals are much less likely to be stiffed for the entire cost of a hospitalization. Hooray for them.
However, the ACA is hardly a success, especially when the enormous deductibles are factored in. As Bernie says, the outrageously deductibles sometimes $3000 to $5000 are, in effect a form of rationing because individuals and families postpone diagnostic tests (seldom if ever covered) are too costly.
It's too premature to laud the ACA without reservations.
13
The current solution to deductibles are HSAs. The issue is that people don't appear to understand, or care to read up on, the benefits of having an HSA and therefore just waive their rights to one. Saving a few tax-free dollars every month easily covers just about any deductible gap.
3
All the more reason for a single payer system.
1
I suppose your insurance costs decreased year by year before the ACA.
3
"The surprise turnaround adds to an emerging consensus about the contentious health law: It has not upturned the core of the country’s health insurance system, even while insuring millions of low-income people."
The GOP mantra against "Obamacare" is so firmly rooted within their electorate that I doubt even these new statistics will do much to convince those convinced the law is the worst thing to happen to our Republic since the nation was founded.
That said, I am not surprised because as the economy continues to uptick. offering better benefits than the ACA is a sound recruitment tool, as this article points out.
But I want to see what happens when the medical arms race resumes its merry march. Until US citizens have the guts to vote in officials who will take a look at the screwed up incentives in the US healthcare system, we will all be subject to the vagaries of the "market". Device manufacturers, drug companies, large hospital conglomerates, and many physician practice are so used to raising prices to keep profits high for shareholders that at some point, we'll return to the point of no return.
There is so much inefficiency and duplication in the delivery of health services that when added to the nature of for-profit healthcare, will sorely tax our healthcare "system" to the breaking point. Only then will the idea of morphing the ACA into Medicare for All really start to take root.
The GOP mantra against "Obamacare" is so firmly rooted within their electorate that I doubt even these new statistics will do much to convince those convinced the law is the worst thing to happen to our Republic since the nation was founded.
That said, I am not surprised because as the economy continues to uptick. offering better benefits than the ACA is a sound recruitment tool, as this article points out.
But I want to see what happens when the medical arms race resumes its merry march. Until US citizens have the guts to vote in officials who will take a look at the screwed up incentives in the US healthcare system, we will all be subject to the vagaries of the "market". Device manufacturers, drug companies, large hospital conglomerates, and many physician practice are so used to raising prices to keep profits high for shareholders that at some point, we'll return to the point of no return.
There is so much inefficiency and duplication in the delivery of health services that when added to the nature of for-profit healthcare, will sorely tax our healthcare "system" to the breaking point. Only then will the idea of morphing the ACA into Medicare for All really start to take root.
73
Christine,
With the exception of getting many more covered;
leaving Big Pharma, the insurance companies, and the corporate health providers in charge amounted to nothing more than "polishing a turd".
With the exception of getting many more covered;
leaving Big Pharma, the insurance companies, and the corporate health providers in charge amounted to nothing more than "polishing a turd".
4
Another Republican bogeyman fails to show up in reality once again, but not until after inflicting fear, end-times paranoia and right-wing vitriol upon the masses that the ACA would bring down America.
If you love being scared to death over imaginary threats and if you hate healthcare, the Republican Party could be just the right mental asylum for you.
Single-payer, of course, would be much better than America's current 18% of GDP corporate-healthcare extortion racket, but GOP fear of reality and reason keeps that logical, efficient and economical solution from gaining American citizenship.
Reality has a liberal bias...and it's very upsetting to the fearful, conservative mind.
If you love being scared to death over imaginary threats and if you hate healthcare, the Republican Party could be just the right mental asylum for you.
Single-payer, of course, would be much better than America's current 18% of GDP corporate-healthcare extortion racket, but GOP fear of reality and reason keeps that logical, efficient and economical solution from gaining American citizenship.
Reality has a liberal bias...and it's very upsetting to the fearful, conservative mind.
155
Everything's coming up roses except employers are getting the money for healthcare from employees. Stagnate wages, retirement benefits, you name it employees are suffering. Go Bernie!
1
I much prefer the conservative mindset: Fend for yourself and, if you can't, die sooner rather than later (and if you take your children along with you, all the better.)
6
This information makes Ted Cruz's goals vis a vis health insurance even more questionable. He would "delink health insurance from employment", so you can take it with you, assuming you could afford to, and of course, don't have pre-existing conditions.
43
Mr. Abelson's research is palpably, inexcusably weak, blowing up his entire thesis. Sadly, his article doesn't penetrate beyond the surface layer of what is really going on with healthcare in the workplace, especially for small to midsized employers - not the Lowe's of the world who have many times the disposable dollars to spend and in turn the ability to generate far better plan options and more favorable rates. In the trenches, where I toil with and for our clients on these issues, what is really happening is that prices rise annually anywhere between 8 and 35 to 40% a year, and so employers must try to control their out-of-control costs by reducing their full-time benefits-eligible employee complements, instead adding more part-time or contingent workers - not really good for anyone, or for efficiency - and continually forced to reduce benefits, increase deductibles and co-pays, and require employee cost-sharing. In negotiating labor contracts for unionized companies, healthcare is THE #1 issue... and though bargaining often get heated on this subject, employers and unions commonly agree on one thing: their common enemy is a federal government that force-fed an ill-conceived, tragically flawed healthcare system on our nation, causing at least as much immediate harm for so many as the good it may have produced for others, especially those companies, and their employees and families, who can least afford it.
Bob Ufberg
Ufberg & Associates, LLP
Scranton, PA
Bob Ufberg
Ufberg & Associates, LLP
Scranton, PA
31
Thanks for your very informative response. It leaves me wondering though, with the parties at the negotiating table as you described, where do the pharmaceutical firms, hospital administrators (those who make the costs what they are) come in? Are they, or could they be brought to the table - and who best to do so?
4
That's curious. Because what I find curious is this: a rep for a firm that supports MANAGEMENT, not labor, doesn't seem to know that a) a lot of those costs stem from Republcans in his state blocking any and all efforts to expand Medicaid and create a state Exchange, and b) the PPACA offers subsidies of up to 50% for businesses with fewer than 50 employees.
For that matter, he doesn't seem to know that "Obamacare," isn't a "healthcare system," but an INSURANCE system.
Golly, I wonder why this might be?
For that matter, he doesn't seem to know that "Obamacare," isn't a "healthcare system," but an INSURANCE system.
Golly, I wonder why this might be?
4
Wonderful for them. This shows how the ACA was designed to help the big players by catering to their needs while it threw the little people under the bus.
The individual market is where the little people reside. If you are young and/or low income, the ACA has been a godsend. If you are middle class and middle age or older, you got thrown under the bus. We are the statistical leftovers.
The ACA was designed by ivory tower economists. Their minds work by considering how to most easily take care of the biggest chunk of the people. The constraints were to not upset employer based coverage, increase business for the insurance companies and get the uninsured covered. That is exactly what they did.
Except there is a politically powerless minority of people that were intentionally left out of the reforms, the self-insured. I specifically remember Sebelius making statements that this was the smallest section of the market. They were not concerned about us because of our numbers, just millions of people.
My premiums will exceed $6700 this year. I spoke to a restaurant owner with a small family owned business and he pays $26,400 to cover four people. I almost fell over when he told me. He said don't get sick. Don't go to the doctor. He can't afford the deductibles. Neither can I.
They left out the public option for people like us. We are statistically insignificant and politically unimportant. You can find us under the bus.
The individual market is where the little people reside. If you are young and/or low income, the ACA has been a godsend. If you are middle class and middle age or older, you got thrown under the bus. We are the statistical leftovers.
The ACA was designed by ivory tower economists. Their minds work by considering how to most easily take care of the biggest chunk of the people. The constraints were to not upset employer based coverage, increase business for the insurance companies and get the uninsured covered. That is exactly what they did.
Except there is a politically powerless minority of people that were intentionally left out of the reforms, the self-insured. I specifically remember Sebelius making statements that this was the smallest section of the market. They were not concerned about us because of our numbers, just millions of people.
My premiums will exceed $6700 this year. I spoke to a restaurant owner with a small family owned business and he pays $26,400 to cover four people. I almost fell over when he told me. He said don't get sick. Don't go to the doctor. He can't afford the deductibles. Neither can I.
They left out the public option for people like us. We are statistically insignificant and politically unimportant. You can find us under the bus.
165
Bruce,
ACA includes an individual tax credit that didn't exist previously. What am I missing here? It has nothing to do with the Public Option, although we all wish that had been implemented. It's a big step forward for the self-employed.
Can you explain exactly what you "should" be paying? People in employer health plans may be paying even more than you in terms of net compensation.
ACA includes an individual tax credit that didn't exist previously. What am I missing here? It has nothing to do with the Public Option, although we all wish that had been implemented. It's a big step forward for the self-employed.
Can you explain exactly what you "should" be paying? People in employer health plans may be paying even more than you in terms of net compensation.
32
@Bruce Rozenblit
Kansas City
"and get the uninsured covered. That is exactly what they did."
Exactly. Mission Accomplished. You have been posting nonsense about the ACA at the NYT for years. No one has been thrown under a bus. About 20 million people (many of them middle class) have gained coverage and the uninsured rate is down to 9% which is the lowest in US history. You don't seem to be any worse off than you would have been without the act (these anecdotal incidents of personal injury have always turned out to exaggerated). You also seem to believe deductibles didn't exist before the ACA. They were always high if you had bare bones insurance.
Kansas City
"and get the uninsured covered. That is exactly what they did."
Exactly. Mission Accomplished. You have been posting nonsense about the ACA at the NYT for years. No one has been thrown under a bus. About 20 million people (many of them middle class) have gained coverage and the uninsured rate is down to 9% which is the lowest in US history. You don't seem to be any worse off than you would have been without the act (these anecdotal incidents of personal injury have always turned out to exaggerated). You also seem to believe deductibles didn't exist before the ACA. They were always high if you had bare bones insurance.
12
For a single person, the tax credits go away if you over $50,000. After all taxes, if I make $50K, I will have about $36,000 left to live on. $6700 (which includes dental) is then nearly 19% of my after tax income. I have a deductible of $6450. The insurance pays for nothing until the deductible is met. That means if I get sick, I will have to come up with $13,150. That would then be 36.5% of my after tax income.
So how much do YOU think I should be paying?
So how much do YOU think I should be paying?
26
In the final analysis, it was an important step toward universal coverage. That is the ultimate and essential goal.