Obama Health Care

 The health care law continues to move forward.  A few days ago, the administration began to move forward with Obama health care, toward making it illegal by the year 2014 for insurance companies to discriminate against individuals who have pre-existing medical conditions.

News reports claim that consumers will be able to more easily compare health plans with the ACA provisions, and that ultimately the act will allow for a health insurance market that benefits consumers.  Those who have pre-existing conditions will not be discriminated against once the Obama health care provisions are implemented, according to Kathleen Sebelius, Health and Human Services Secretary.

Proposed rules recently issued by the Obama administration include:

Starting in 2014, individuals who have chronic or pre-existing health conditions may not be discriminated against by health insurance companies.  Past health issues, occupation, industry and/or employer size and gender, according to the provision, will no longer be legitimate reasons for health insurance companies to deny coverage or charge increased premiums to select enrollees.  However, health insurance providers can vary premiums based on geographical location, age, family size and tobacco use, but only within limits under Obama health care.

Wellness programs will be implemented and expanded by employers; these programs are designed to control health care spending, and to promote better health of employees.  This proposed rule will purportedly help to ensure that unlike in the past, employees will not be susceptible to unfair underwriting practices which could potentially, based on health status, reduce benefits.

Other changes under Obama health care take place in the near future, such as the Medicare taxes which will apply to individuals who earn more than $200,000 annually, or married couples who earn more than $250,000.  This Medicare tax was implemented beginning in 2013, according to CNN, and was enacted to assist in paying for new federal subsidies consumers will get when they purchase health coverage.  Additionally, a 3.8% tax could be imposed on at least a portion of capital gains and dividends for those who have investment income.

Under Obama health care, employers who employ 50 or more employees who are considered full-time must provide health coverage by 2014; those that fail to do so will be fined $2,000 per employee, however the fines do not apply to the first thirty workers.

Now that it is clear that Obama health care will continue to move forward, hopefully all will work as it is intended to and we will see that millions more U.S. citizens have the coverage they previously could not afford, with little or no ill effects on employers.  This is a topic which has been hotly debated for several years now, many people “pro” Obama health care and many against.  Now that it looks like the Affordable Care Act will continue to stand, perhaps it will ultimately be a good choice for the people of our nation.  The coming two years will certainly be interesting, and hopefully positive in terms of affordable health insurance coverage for all.

While Obama health care certainly hasn’t been popular with a large percentage of the U.S. population over recent years, a study released by the Commonwealth Fund recently indicated that in 2012, health care reform rules essentially saved consumers almost $1.5 billion.  This is largely due to the rules targeting health insurance providers and pressuring them to become more efficient, thus more affordable.

Due to these rules under Obama health care, insurance companies delivered rebates, cut overhead, and even reduced profits in some cases in order to comply with the rules, which stated that health insurance companies would be required to refund the difference to customers if they failed to spend a minimum of 80% of the premiums collected on medical care.  Additionally, companies which sold group plans to employers with 50 or more workers were required to spend 85% of premiums on medical care.

Sara Collins, Commonwealth Fund’s vice president for affordable health insurance, said that the report regarding the study was encouraging, as it “demonstrates that these new rules are improving value for people buying health insurance.”  Collins also said that under Obama health care, the standards under medical loss ratio rule are meant to give insurance providers an incentive to use the majority of premiums collected for patient care, and to increase efficiency.

Because of the medical loss ratio rules under Obama health care, health insurance companies slashed profits and administrative costs by $350 million in 2012; they also issued rebates which amounted to $1.1 billion.  To calculate these numbers, researchers involved in the study used reports filed by health insurance providers to a group of state regulators, the NAIC (National Association of Insurance Commissioners).

The study also found that the individuals who experienced the biggest benefits of Obama health care were those who purchase coverage on their own, rather than obtain it through an employer.  Individuals received $394 million in rebates; in fact, when compared to 2010 health insurance companies’ profits for individual products disappeared.  In all, profits fell to -1.2% in 2012 from 0.15% in 2010, a total reduction of $351 million.

While this may seem like good news, it may eventually be a real cause for concern according to the report, which stated that individuals may find it harder to obtain coverage in the future if health insurance companies cannot profit from individual products, or make up the difference through selling insurance products to groups.

The news is good at the moment for individuals purchasing health insurance, however it remains to be seen how Obama health care (and the U.S. population) will fare in coming months and years.

Signed into law by President Obama on March 23, 2010, Obama health care, officially known as the Affordable Care Act or by its more informal name “Obamacare,” sought to establish sweeping health-care reforms. Set to unfold over several years’ time, these changes seek to give citizens access to health care regardless of income or pre-existing conditions, among other factors. The plan continues to slowly roll out mostly on schedule, with some delays.

What benefits has the Obama health care plan offered so far?

• Children cannot be denied coverage because they have pre-existing conditions.
• Insurance coverage cannot be withdrawn if you’ve made an error on your application, as was previously true.
• Services like colonoscopies, mammograms, and other preventative tests and services will be covered without co-pays.
• Specific people with pre-existing conditions can now have insurance access.
• Young adults can stay on parents’ insurance until 26 years old.
• Primary care physicians are receiving increased Medicaid payments.

Component of the plan delayed until 2015

Implementation of one aspect of the Affordable Care Act, the large employer requirement, has recently been delayed until 2015. When in effect, large employers with more than 50 employees will need to provide affordable insurance coverage for their employees, or face penalties.

What does Obama health care mean for you?

Although businesses (and some individuals) are worried about increased costs under Obama’s plan, proponents say that for most people, it will only be beneficial. Some benefits:

• Lower costs for most

The Health Insurance Marketplace will be available for families, individuals without employer-provided insurance, and small businesses to get coverage; open enrollment begins on October 1, 2013. What individuals will pay, for example, will depend on income, family size, and out of pocket cost for private insurance, as applicable. Some citizens may qualify for free or low-cost coverage through the Children’s Health Insurance Program (CHIP) or through Medicaid. (All citizens are eligible for coverage through the Marketplace regardless of where they live.)

• Essential health benefits covered without exception

All plans covered through the Marketplace must offer comprehensive coverage of so-called “essential health benefits.” These include preventative care, hospitalization, doctor’s visits, prescriptions, and more.

• Coverage for those with pre-existing conditions

You can no longer be denied coverage or be charged more for health insurance because you have a pre-existing condition. This includes pregnancy or disability.

What rights and protections exist for citizens in regard to the Obama health care law?

The Affordable Care Act (Obama health care) protects citizens in the following way:

• The aforementioned Healthcare Marketplace allows all citizens access to coverage.
• Pre-existing health conditions must now be covered by insurance companies.
• Insurance companies will be accountable for rate increases and won’t simply be able to set increases arbitrarily.
• Your health insurance can no longer be canceled simply because you get sick – it’s illegal for health insurance companies to do so under the new law.
• You have access to free preventive care.
• Essential health benefits no longer have lifetime or yearly dollar limits in regard to coverage.
• If you don’t agree with a health plan decision, you have the right to appeal it (your rights may vary depending on the state you live in).

Are there any drawbacks to Obama health care?

If it is deemed that you can afford specific coverage based upon your income level and you don’t purchase it, you may be assessed a fine of $95 or 1% of your income, whichever is greater. However, a tax credit called the Advance Premium Tax Credit is offered based upon income level (the 2013 cut off for the premium savings is $45,960 for individuals). This credit is meant to help offset the cost of premiums, and is applied directly to monthly premiums immediately, resulting in lower costs right away.

Many people are concerned how well Obama health care will actually work in reality, although conservatives for the most part believe it will be a costly disaster.  Next month, the most important elements of the health care law are slated to be phased in, and according to the Washington Post, real data returns are indicating that contrary to popular belief, those who do not have employer-sponsored coverage and who are forced to buy individual coverage will not face astronomical costs to obtain coverage.

A recent analysis of the costs Americans will face with Obama health care offers the clearest picture yet of how things will be in reality.  This analysis, presented by the Kaiser Family Foundation, examines how much Americans who will purchase coverage from exchanges will face in regards to cost for individual coverage.  Much like coverage obtained from health insurance providers in past years, the bottom line is that the cost to an individual will vary depending on a number of factors including income, age, health issues, geographical location, and other factors.  The report concludes that across the U.S. premiums will vary substantially, however overall the costs will be lower than many anticipated with Obama health care.

One part of the report stated that the Congressional Budget Office’s latest projections indicate that across the nation, the average premium for an individual who is 40 years old and who chooses the lowest cost silver plan would spend approximately $320 per month for coverage.  In fact, the report goes on to say that of the eighteen areas examined in the analysis, fifteen of those would offer premiums lower than $320 per month.  It seems that maybe, just maybe, the cost of Obama health care may not be as astronomical as many initially thought.

What about competition from private insurance companies, what will the impact be on premium costs?  According to the article, supporters of Obama health care have argued that the competition among private insurance companies and exchanges will keep the costs under control.  In fact, the Kaiser report indicated in most of the regions that were studied, four or more insurers will be competing for customers, which will result in private insurance companies offering coverage at competitive rates in order to prevent customers moving into the exchanges.

Ultimately, the Kaiser report strongly supports the notion that the health coverage options under Obama health care will not place unexpected burdens on the federal Treasury, nor will it be so costly that premiums would “break the bank” for many individuals, regardless of medical issues or pre-existing conditions.  Still, not all agree with the report, saying that the data was taken from the District and 17 states, which means the information is not fully complete.  When it comes to Obama health care and its success – or lack thereof – only time will tell.

It is expected that the Supreme Court will make a decision this month regarding Obama healthcare; while there are 4 potential outcomes, you can be sure that whichever outcome it is, you haven’t heard the last of this hotly debated health care law.  Regardless of what happens, it’s highly likely that we will see more lawsuits, more congressional battles next year, and more state actions taken.  How do you stand on Obama healthcare?  Are you for the law in its entirety, against it, for the individual mandate, or against it?  Here are a few interesting takes on what could happen depending on the decision of the Supreme Court later this month.

Obama healthcare law totally upheld.  Opponents will not go away, according to Cato Institute health policy director Michael Cannon.  If a decision is made by the court to uphold the law in its entirety, you can be sure the flood gates will open to lawsuits, as well as political and legislative action.  Legislative attacks will resume by Republicans in Congress.

The entire healthcare law struck down.  If the courts decide to completely kill the Obama healthcare law, confusion and chaos could ensue, partly because certain aspects of the bill have already been enacted.  One question many have if the healthcare law is struck down is whether the effect of the Supreme Court’s ruling would be retroactive or prospective.  According to non-partisan Kaiser Family Foundation’s V.P. of special projects Larry Levitt, a mess would ensue if the law is killed in the court.  Levitt states that anything that has already happened is kind of water under the bridge in a general sense.

Uphold Obama healthcare, strike down the individual mandate.  Most feel this is the scenario most likely to unfold, and huge complications would be presented.  Why would this create complications?  Because insurance companies would be required under the expansive provisions of this law to cover individuals who have pre-existing conditions, yet Americans would not be required to purchase health insurance coverage.  If the healthcare law is upheld but the mandate struck down, it is estimated that premiums would increase by about 15% to 20% in the individual health insurance market, becoming ‘unworkable’ for insurance companies according to former Florida attorney general Bill McCollum.

Further provisions of Obama healthcare invalidated.  In the event the mandate is struck down, lawmakers feel that if those with pre-existing conditions should no longer be protected.  In this way, the future insurance market would be much like today’s, with premiums being cheaper overall, but particularly for those who are healthy and young.  The huge disadvantage is that those who need coverage most, the elderly and those in bad health, would suffer in terms of quality of coverage.

Regardless of how the Supreme Court rules on Obama healthcare, there is one certainty:  it will not end the discussion and disagreements.  This is a topic that is likely to be heated for quite some time to come.

As Republican support for Obama health care continues to grow, southern states continue to oppose it; in fact, governors from some of the unhealthiest states have voiced their opinions about the unpopular health care plan, including Governor Nikki Haley of South Carolina who said “Not in South Carolina.  We will not expand Medicaid on President Obama’s watch.  We will not expand Medicaid ever.”

 According to a recent news article at Fox News, Obama health care, our president’s signature domestic accomplishment, remains highly unpopular for many reasons.  As opponents of health care reform had predicted, health care premiums are going nowhere but up.  Media reports all around the country are highlighting the fact that Obama health care had led to companies cutting back on hiring new employees, and forced many citizens into working part-time not because they want to, but because there are so few companies hiring full-time workers.

In just a few months, state-based health insurance exchanges are scheduled to be up and running; however, very few people believe that the exchanges will function properly.  In fact, news reports reveal that the federal bureaucrat in control of implementing the exchanges recently said that now he is desperately hoping that the implementation of health exchanges won’t provide “a Third World experience,” instead of the “world-class experience” industry officials had hoped to provide.

Expanding Medicaid insurance rolls is an anchor of Obama health care; however very few governors in the Confederacy and Civil War border states region which run from Virginia to Texas are endorsing the deal, according to the Huffington Post.  In fact, Bill Haslam, governor of Tennessee, was the last governor of the Deep South to add his name to the opposition’s side.

While governors in southern states have their own ideas about Obama health care and Medicaid, until something is done there will be many Americans left without coverage because their salaries go above what is required to qualify for Medicaid.  On the flip side, the same people do not make enough money to qualify for subsidies to purchase insurance through the state exchanges.  Unfortunately, numerous public health studies which have been conducted bear out the fact that it is this same group of people who suffer most from health issues related to diabetes, obesity, and smoking.

Under Obama health care, states were to make Medicaid available to all households with an income up to 138% of the federal poverty rate.  This equates to approximately $32,000 for families of four, and $15,420 per year for individuals.  While the federal government would pick up most of the tab between 2014 and 2016 for new Medicaid patients, states would pay up to 10% of the cost.  The Supreme Court declared that the decision whether to expand would be left up to the states – and southern states, at the moment, are not willing to do that.  Drew Altman, leader at the Kaiser Family Foundation, predicted that over time, the staunch opposition will wane.

It seems that Obama health care is already having an impact on some industries, as some are already shifting from full-time workers to part-time employees as 2014 quickly approaches.  Recently, it was announced that Darden Restaurants, Inc. will experiment with shifting full-time employees to part-time status; this change is because of Obama health care, and the impending health benefit requirements which will go into effect in 2014.  Darden Restaurants owns the Olive Garden and Red Lobster restaurant chains.

Beginning just over one year from now, companies with 50 or more employees who are full-time will be required to offer workers basic health benefits; if they do not comply, they will risk paying a fine.  Although studies which have been conducted demonstrate that Obama health care increases health care costs for larger companies only slightly, many large employers still fear the health care law and what it will mean for their companies.

So, what does this mean for Obama health care?  It’s still a bit early to tell, but the executive director of the Deloitte Center for Health Statistics, Paul Keckley, who notes that it may be necessary to implement follow-up legislation to make sure that companies cannot avoid providing coverage by shifting more employees to part-time, said that, “There’s not a company in those industries that aren’t looking at this.”

McDonald’s has already been considering the impact of Obama health care on its bottom line.  Just this summer, a conference call between investors and McDonald’s Corp. Chief Financial Officer Peter Bensen noted that the popular fast-food chain was essentially analyzing the numerous factors which will impact health care costs; this included the number of full-time workers employed by the company.

Even before Obama health care came into play, employers have looked for ways to cut employees’ benefits and increase contributions to health plans.  In many cases, companies only have to cut 8 hours from an employee’s total work hours for a one-week period for those employees to be considered part-time.

According to news reports, Darden has engaged in anti-labor practices in the past.  Recently, a labor activist group sued Darden for allegedly circumventing the federal minimum wage; supposedly, the company was paying as little as $2.13 per hour which was said to be a “tip credit wage.”

It’s very apparent that companies put profits over employees’ well-being and satisfaction, however Obama health care has many large companies and corporations very worried over the costs they will face to provide health coverage for employees – or the fines they will be forced to pay.  Between the new health care law and companies working vigorously to protect their own bottom lines, it looks as though the employees could be “hung out to dry” once again.

The Affordable Care Act (ACA) or Obama health care as it’s commonly become known as, is a law that will greatly effect small businesses come 2014, when small companies must choose to keep the coverage they currently have on employees, or use the health insurance exchanges.  For most small businesses, the subject of Obama health care is one that is confusing and complicated, to say the least.  Just over a year until many of these changes will take place, many small business owners still find the changes that will be implemented over time about as clear as mud.

Here are a few answers to questions about Obama health care and how exchanges will work.

Through exchanges, will health insurance rates go up?  Yes.  Over the first few years, premiums will actually increase because the ACA does nothing to reduce medical costs on which the premiums are based immediately.  Over time, rates should go down substantially.

If you are a business owner with fewer than 25 employees, should you cancel your current employee coverage prior to 2014?  It all depends on the average income of your employees and the market.  For instance, if you are a retail business owner with employees who are mostly low-income and will qualify for premium subsidies in the exchange, it may be more beneficial to cancel your employee healthcare plan before 2014.  However, if your employees earn a moderate income and are in a field where it is more difficult for you to replace or train staff, it may be beneficial to keep your present plan.  This will help entice your employees to stay.

Obama health care isn’t all bad for small business, and in fact some provisions are good.  For instance, businesses with fewer than 25 full-time employees who pay at least 50% of the total premiums in order to qualify for a tax credit will not see that go away.  As it currently stands, those employers currently get a tax credit of up to 35%, which will increase to 50% in 2014.

State-based exchanges will eventually mean that smaller companies can compete with the bigger companies, as they will have “pooled” purchasing power, meaning more affordable coverage.

Ultimately, there are advantages and disadvantages for small businesses when it comes to Obama health care.  Many business owners feel that it will result in a bigger unemployment rate, as the biggest expense of all for the small business owner is the labor force.

Even though the individual mandate was upheld by the Supreme Court in June of this year, many believe that the political debate over Obama health care is far from over.  The opinion of many is that throughout the process to reform health care, the small businesses have been completely overlooked.   It’s apparent that many people are still in the dark when it comes to the future of health care and affordable health insurance.  Unfortunately, it seems that small business owners may be the ones affected most by the changes in a negative way. No matter what happens, no doubt it will go down in history as one of the most debated political issues for generations.

Even though the Supreme Court upheld the individual mandate portion of Obama health care recently, millions of uninsured individuals around the nation are still not sure what it means for them.  It seems as though Obama
Why are so many still left in the dark regarding Obama health care, even though it has been upheld?  Governors of several states have not yet determined how to proceed in their own states regarding new insurance exchanges and the expansion of Medicaid, parts of the health care law that falls under their control.  Governors of Colorado, Oklahoma and Wyoming tell citizens they’re crunching numbers in an effort to determine the best course of action for residents.  Millions of people keep thinking they will finally have a firm answer on Obama health care, only to find there are more obstacles in the way.health care is still something many are muddling through, and that will continue to be unclear for months or perhaps even years to come.

While the Supreme Court did uphold the individual mandate requiring people to either buy insurance or pay a fine (or be taxed, however you want to view it), Obama’s plan was undercut by the justices making it possible for states to opt out of Medicaid expansion, which is government run.  In states that decide against the Medicaid expansion, those who do not have health care insurance will not be fined, according to a statement made by the Obama administration recently.  In short, this essentially means that.

Essentially, Republican governors are forgoing the expansion of Medicaid, claiming that because the program is already under-funded the cost is weighing heavy on their budgets.  However, in the first three years the law covers the entire cost, then drops to 90% with states responsible for covering only 10% of the cost.  Proponents argue that the Medicaid expansion component is a great deal, but many governors disagree.  As usual, Obama health care seems to be a topic of constant debate, leaving those who do not have health insurance uncertain of what the future holds.