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The PPACA - Implementation Phase I

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Re: The PPACA - Implementation Phase I

I'm sure some of you righties were going to get around to mentioning that Medicare spending is slowing down, right? You just haven't had a chance to get to your computers yet?

http://thehill.com/blogs/healthwatc...edicare-spending-slowing-faster-than-expected

Hmmm...check out the rate of growth from 2002-2009 and then 2009 to now. Wasn't there some sort of law passed recently that might help explain the reductions?!?! :D
 
Rover said:
I'm sure some of you righties were going to get around to mentioning that Medicare spending is slowing down, right? You just haven't had a chance to get to your computers yet?

http://thehill.com/blogs/healthwatc...edicare-spending-slowing-faster-than-expected

Hmmm...check out the rate of growth from 2002-2009 and then 2009 to now. Wasn't there some sort of law passed recently that might help explain the reductions?!?! :D
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This means nothing. If I add 2000 to my total spending every year, guess what?? The growth rate goes down :)
 
Rover said:
That makes no sense, but its cool. ;)
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Well not as cool as your blubber.... I'm excited cause spending is going down? Or the rate is going down? Or the rate of growth is going down?

Only one of those takes less money from me :)
 
Re: The PPACA - Implementation Phase I

One of the single most important metrics for any business owner is the answer to the question (or variants thereof): "what happens if we add one more?" Is it worth it to hire one more person? is it worth it to sell one more item? etc.

It is quite clear that the people who drafted PPACA understood this concept not at all. The law is perverse in the old-fashioned sense in that there are outright contradictions between what it purports to do and the incentives it offers.

There is an excellent article here that explores many of these perversities for those who have the patience and interest to read it.

Here's a trend you'll be reading more about: part-time "job sharing," not only within firms but across different businesses.

It's already happening across the country at fast-food restaurants, as employers try to avoid being punished by the Affordable Care Act. In some cases we've heard about, a local McDonalds has hired employees to operate the cash register or flip burgers for 20 hours a week and then the workers head to the nearby Burger King or Wendy's to log another 20 hours. Other employees take the opposite shifts.

Welcome to the strange new world of small-business hiring under ObamaCare.

....

The savings from restricting hours worked can be enormous. If a company with 50 employees hires a new worker for $12 an hour for 29 hours a week, there is no health insurance requirement. But suppose that worker moves to 30 hours a week. This triggers the $2,000 federal penalty. So to get 50 more hours of work a year from that employee, the extra cost to the employer rises to about $52 an hour—the $12 salary and the ObamaCare tax of what works out to be $40 an hour.

....

But the damage won't be limited to franchisees or restaurants. A 2012 survey of employers by the Mercer consulting firm found that 67% of retail and wholesale firms that don't offer insurance coverage today "are more inclined to change their workforce strategy so that fewer employees meet that [30 hour a week] threshold.
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It is kind of strange to me that when Congress passes a really bad law and people then try to comply with it the best they can, it's the people trying to comply with the law who get criticized because they are not doing what they are "supposed" to be doing, which is react to the law's "intentions." Instead, they are excoriated for responding to the law as it is actually written.

So Congress writes a bad law, the President signs a bad law, and yet it is "greedy businesses" who are at fault because they comply with the law??
 
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Re: The PPACA - Implementation Phase I

Lots of apocalyptic BS about nothing Fishy. Problem for you is universal health care has already happened in one state. We call it "Romneycare" and its been in place for years. No signs of a massive effort of employers dumping people onto state exchanges or screwing them over hours, and MA is a pretty expensive state so if were to happen anywhere it would happen here.

A for effort though, and I'm curious what you think about conservative hero Rick Scott now also agreeing to implement Obamacare. :D
 
Re: The PPACA - Implementation Phase I

Rover said:
Lots of apocalyptic BS about nothing Fishy. Problem for you is universal health care has already happened in one state. We call it "Romneycare" and its been in place for years. No signs of a massive effort of employers dumping people onto state exchanges or screwing them over hours, and MA is a pretty expensive state so if were to happen anywhere it would happen here.

A for effort though, and I'm curious what you think about conservative hero Rick Scott now also agreeing to implement Obamacare. :D
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Rover

If a state wants to implement a health care plan for it citizens fine. I don't like the feds involved. And they've been getting involved more and more into what used to be state issues, such as education and now health care. We've seen the disaster in NCLB and RTTT with how the children are taught, how teachers are evaluated, how $$ is doled out. All based on some nameless group of bureaucrats who publish something in the Federal Register. What works in Massachusetts may not work in Montana.

One size does not fit all.
 
mookie1995 said:
didn't he already switch parties?
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No, but he did hit the Old Country all you can eat buffet on Wednesday two weeks ago and stayed there until the following Tuesday.

Seriously though, I do have to wonder if someone who accepts Obamacare dollars can then turn around and survive a GOP primary if he choses to run for Prez. He'd be a lot of fun in the debates though. Hell, even I'd tune into that.
 
Re: The PPACA - Implementation Phase I

There was case making headlines in Germany recently that seems also to have been affirmed here.

A woman was raped and went to a Catholic hospital for treatment. The German council of bishops put out a statement that said Rape is not a procreative act (it is an act of violence) and so the woman has the right to defend herself against the rapist's sperm, which makes it okay for the hospital to administer a spermicide to her in order to kill the rapist's sperm before it can fertilize an egg. I think I read that the US council of bishops affirmed that decision as well.
 
Re: The PPACA - Implementation Phase I

In response to Obamacare becoming law, my employer switched up insurance plans. Where I once had an HMO, paid the copay, and a % of the bill after a certain dollar amount was hit, I now have an HRA setup where I've had $1300 in claims trying to have a shoulder injury fixed, and not a single bit of it has been paid for by my insurance yet. Excuse me, that's not entirely true, they have been paying the 2% proivder tax. Wow, thanks for lowering my out-of-pocket expenses, government! I still have another $1700 to go before my insurance actually starts to pay benefits. Oh, and my premiums went up for this greatly "improved" service.
 
Re: The PPACA - Implementation Phase I

Rover said:
No, but he did hit the Old Country all you can eat buffet on Wednesday two weeks ago and stayed there until the following Tuesday.

Seriously though, I do have to wonder if someone who accepts Obamacare dollars can then turn around and survive a GOP primary if he choses to run for Prez. He'd be a lot of fun in the debates though. Hell, even I'd tune into that.
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Crazy, not stupid.
 
Re: The PPACA - Implementation Phase I

One of PPACA's most egregious mistakes might be on the way out.

WASHINGTON—The Senate voted overwhelmingly Thursday night to repeal a tax on medical-device sales, despite the fact that the levy helps finance the health-care overhaul.

The vote was largely symbolic, but the 79-20 tally signals strong opposition to the 2.3% tax on device sales that went into effect Jan. 1. Even though the levy is meant to help foot the bill for the signature legislative achievement of President Barack Obama's first term, 33 Democrats as well as independent Sen. Angus King of Maine joined Republican senators in voting to repeal the tax.

... the solid bipartisan support shows growing momentum for repealing the tax, which lawmakers have argued hurts U.S. competitiveness and costs highly paid jobs.

Sen. Orrin Hatch (R., Utah) introduced the measure earlier Thursday with the support of nine Democrats, including Sen. Elizabeth Warren of Massachusetts and Sen. Sheldon Whitehouse of Rhode Island. Sen. Amy Klobuchar (D., Minn.) said on the Senate floor Thursday that she had long opposed the tax, despite its connection to the health-care law.

"It still isn't right because it creates too much of a burden," Ms. Klobuchar said, arguing that the health-care overhaul won't generate enough new customers to offset the costs for medical-device companies.
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One can only hope that more of the many mind-boggling mistakes in the law also get corrected...

Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law, with the nation's biggest firm projecting that rates could more than double for some consumers buying their own plans.

The projections, made in sessions with brokers and agents, provide some of the most concrete evidence yet of how much insurance companies might increase prices when major provisions of the law kick in next year
....
The gulf between the pricing talk from some insurers and the government projections suggests how complicated the law's effects will be. Carriers will be filing proposed prices with regulators over the next few months.

Part of the murkiness stems from the role of government subsidies. Federal subsidies under the health law will help lower-income consumers defray costs, but they are generally not included in insurers' premium projections.
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That last sentence is key. The law forces insurance premiums higher and then gives people subsidies to pay for those premium increases. Yet somehow this is supposed to be viewed as "reducing" costs. This is what happens when you have people who don't understand how math works trying to force outcomes while ignoring process.
 
Re: The PPACA - Implementation Phase I

Health insurers, including UnitedHealth Group Inc. and Aetna Inc., held private sessions with insurance brokers and agents, warning them that individuals and small businesses could see a spike in their premiums in 2014, when most of the provisions of the Affordable Care Act are due to kick in, The Wall Street Journal reported. UnitedHealth told brokers in a private presentation in February that premiums for some consumers who buy their own plans could increase up to 116%, while small-business owners could see rates go up as much as 25% to 50%. Aetna told its national broker advisory council that individual plan rates could increase 55% on average, and gave a figure of 29% for small business rates. Blue Cross and Blue Shield of North Carolina also talked to brokers on expected premium increases.


A Florida Senate committee recommended that the state strip the Florida Office of Insurance Regulation of its power to set rates for insurers under the Affordable Care Act and instead give that authority to the federal government, The Associated Press reported. Those in favor contend that given the uncertainty surrounding the federal act, the FLOIR may have a hard time determining reasonable rates.
 
Re: The PPACA - Implementation Phase I

mookie1995 said:
Health insurers, including UnitedHealth Group Inc. and Aetna Inc., held private sessions with insurance brokers and agents, warning them that individuals and small businesses could see a spike in their premiums in 2014, when most of the provisions of the Affordable Care Act are due to kick in, The Wall Street Journal reported. UnitedHealth told brokers in a private presentation in February that premiums for some consumers who buy their own plans could increase up to 116%, while small-business owners could see rates go up as much as 25% to 50%. Aetna told its national broker advisory council that individual plan rates could increase 55% on average, and gave a figure of 29% for small business rates. Blue Cross and Blue Shield of North Carolina also talked to brokers on expected premium increases.


A Florida Senate committee recommended that the state strip the Florida Office of Insurance Regulation of its power to set rates for insurers under the Affordable Care Act and instead give that authority to the federal government, The Associated Press reported. Those in favor contend that given the uncertainty surrounding the federal act, the FLOIR may have a hard time determining reasonable rates.
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I actually saw a Facebook picture on this, and it said that only two states will not see a significant increase because the insurance prices are already insanely high. I'm in one of them, while Vermont is the other. Once again, the perils of the Vampire State, although it's interesting that others are rising to the occasion.

Giving the power to price to the feds is an inherently bad idea, because of a Constitutional regulation that the price must be the same across the board. This will create the scenario described in the economics thread; I'm not going to bother echoing it here.
 
mookie1995 said:
Health insurers, including UnitedHealth Group Inc. and Aetna Inc., held private sessions with insurance brokers and agents, warning them that individuals and small businesses could see a spike in their premiums in 2014, when most of the provisions of the Affordable Care Act are due to kick in, The Wall Street Journal reported. UnitedHealth told brokers in a private presentation in February that premiums for some consumers who buy their own plans could increase up to 116%, while small-business owners could see rates go up as much as 25% to 50%. Aetna told its national broker advisory council that individual plan rates could increase 55% on average, and gave a figure of 29% for small business rates. Blue Cross and Blue Shield of North Carolina also talked to brokers on expected premium increases.


A Florida Senate committee recommended that the state strip the Florida Office of Insurance Regulation of its power to set rates for insurers under the Affordable Care Act and instead give that authority to the federal government, The Associated Press reported. Those in favor contend that given the uncertainty surrounding the federal act, the FLOIR may have a hard time determining reasonable rates.
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I call bull*****, and here's why. Insurers have two issues under ACA. Everybody needs to have insurance (good thing for insurers) and you can't deny people insurance for prior disabilities (bad thing for insurers).

So, insurers get a flood of healthy people paying premiums who aren't using the system all that much, and a bunch of older sickly people as an offset. The benefit for the insurers is, the older sickly people are most likely being subsidized by the feds while the younger healthy people aren't. So, why the rate increases unless its to line the insurers' pockets?
 
Re: The PPACA - Implementation Phase I

Rover said:
I call bull*****, and here's why. Insurers have two issues under ACA. Everybody needs to have insurance (good thing for insurers) and you can't deny people insurance for prior disabilities (bad thing for insurers).

So, insurers get a flood of healthy people paying premiums who aren't using the system all that much, and a bunch of older sickly people as an offset. The benefit for the insurers is, the older sickly people are most likely being subsidized by the feds while the younger healthy people aren't. So, why the rate increases unless its to line the insurers' pockets?
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The rate increases would be to cover the risk they must assume because "you can't deny people insurance for prior disabilities". Sure, the lack of elasticity of the product will allow for some different pricing, but that is also offset by the fact that states still have multiple insurers (at least I assume they do). In addition, who says that you can't change the pricing paradigm to just gouge the freeloaders that try to get insurance once they get sick? Sure, you can accept them, just charge them more. If that's not allowed, then the insurance price will end up going above the tax amount, thereby causing what you colloquially referred to as "doomsday".
 
Re: The PPACA - Implementation Phase I

Rover said:
So, insurers get a flood of healthy people paying premiums who aren't using the system all that much, and a bunch of older sickly people as an offset. The benefit for the insurers is, the older sickly people are most likely being subsidized by the feds while the younger healthy people aren't. So, why the rate increases...?
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A "flood" seems overly optimistic....a "trickle" more likely.

Your question was already answered in the articles, you know. The subsidies are not included in the premium, they are used to pay the premium.

Great plan so far, eh? : "PPACA imposes costs that cause premiums to go up 85% and subsidies will cover 75% of that increase."

Oops, Congress has never been known for its actuarial acumen, what makes you think they'd suddenly discover how to do calculus when they can't even do basic arithmetic? :rolleyes:
 
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