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United Healthcare May Leave Obamacare by 2017

This prediction isn't about being "anti-Obamacare," if anything just the opposite, as it would actively take advantage of the law's provisions and reduce insurance burdens on employers and employees in particularly high cost areas. In Alaska the law has been a failure, but it doesn't have to be a failure if employers would take advantage of what the law provides.

No Neo, they were as much "anti Obamacare" as the "the CBO is lying" or "Obama will increase the deficit". What proves its was yet another lying conservative narrative was the lacked “a lot of balance or objectivity”. so much so that you are still amazed no company "took advantage" of it when I thought it was BS in 2011. Obamacare only made it harder for employers to drop coverage not easier. See that's why I'm not shocked that few if any companies have dropped coverage. You're still surprised.

Oh, here’s a thread predicting people would lose coverage when the mandate took effect. Yea, another lying conservative narrative.

http://www.debatepolitics.com/obamacare-aca-/178824-50-100-million-policies-cancelled-aca-rules.html

It's clear you don't understand how the subsidies work, hence here I am having to explain this to you as well. Up to 400% FPL the Federal Government subsidizes insurance premiums above roughly 9.5% of income. Where premiums are less than 9.5% of 400% FPL income as it is, this allows for it to taper to zero, i.e. even without a subsidy people in these lower-cost places still aren't spending over 9.5% on the second cheapest silver plan. Where premiums are significantly higher than 9.5% of income even at 400% FPL, people earning just over it suffer from a subsidy cliff.

I understand your point now. You’re concerned about people’s ability to get over the health care “cost wall” after subsidies taper off. Wait, I don’t understand. Conservatives have obediently supported not expanding Medicaid which left about 3 million people with no help to get over the “cost wall”. Conservatives have obediently supported repealing Obamcare which helped 5-10 million people get over the “cost wall”. But now you complain about people who make over 400% of FPL who get no help. I’m sorry neo, I think you need to reconcile your health care cost concerns for people who make over 400% of FPL but have zero concern for those under the 400% level.
And not for nothing, why doesn’t the republican congress propose extending the 9.5% rule to everyone? Oh,I guess they’re too busy pretending to be trying to repeal Obamacare.
 
The subsidies are paid for by taxes on insurance companies, makers of medical equipment and people who make more than $250K/yr in capital gains.

IOW, increases in premiums have nothing to do with subsidies.

Yeah no on that.

I guess you and Buck can think that insurance companies won't increase rates when they realize that the government is on the hook for providing subsidy for health insurance (especially since its MANDATED that you have it).

The rest of the (objective) world isn't going to believe it.
 
Please explain buck how united healthcare was in 4 states and was in the exchanges for a while, and decided then in 2015 to expand from 4 states to 23 and now they do a sudden about face?

Are they simply stupid?

It probably has a lot to do with the subsidies that OCare paid to insurers to cover losses in the first few years. Not expanding into more states was simply leaving money on the table. I think those subsidies are set to end in 2017.
 
No Neo, they were as much "anti Obamacare" as the "the CBO is lying" or "Obama will increase the deficit".

Don't be such a partisan pants-wetter. Do you want to understand this or not?

Even Democrats have called for divorcing health insurance from employment and I actually agree with them on that. And some Democrats (e.g. H. Reid) have suggested PPACA is a "step toward" divorcing insurance from employment. What sense would that make, considering there's an employer mandate? Well, if employers would think of it not as a "mandate" with a "penalty," but rather as an "option" to pay a "shared responsibility payment" instead of buying insurance for the employees, and actually understood how the subsidies were designed into the law, fewer of them would have dismissed this strategy and more would be considering it. I expect it to take time to sink in. They can fairly easily determine which is the better option for them financially. Obviously in the lowest-premium-cost states like Utah, Arkansas, Virginia, it will probably remain financially advantageous to just continue buying the insurance benefit for employees. In Alaska, Wyoming, New Hampshire, Maine, states on the other end of the premium cost spectrum, it pencils out differently. But no one (myself included) ever insisted all employers in high cost areas would have instantly dumped insurance and gone this route as of 2015. I expect it to happen gradually, unless the Feds go back and drastically hike the "shared responsibility payments."

Any projection of the impact of the law over a period of numerous years has to involve numerous assumptions that may or may not play out over that period of time. That doesn't mean anyone stating the projection "is lying." It just means there are a lot of variables and assumptions involved in any such projection.

Obamacare only made it harder for employers to drop coverage not easier. See that's why I'm not shocked that few if any companies have dropped coverage. You're still surprised.

The existence of subsidies if employers dump insurance very much changes the financial analysis of this option, especially in high cost areas. This is just objective mathematical fact, but I'm not surprised at all that more haven't done this just yet. I've explained why I'm not surprised in previous posts. But the fact that not many have done this yet doesn't change the math.

I understand your point now. You’re concerned about people’s ability to get over the health care “cost wall” after subsidies taper off. Wait, I don’t understand. Conservatives have obediently supported not expanding Medicaid which left about 3 million people with no help to get over the “cost wall”. Conservatives have

Just stop. I'm not speaking for random other conservatives. The subsidy cliff exists. You comprehend this now. Good job. Maybe you can help your friend sangha.

And not for nothing, why doesn’t the republican congress propose extending the 9.5% rule to everyone? Oh,I guess they’re too busy pretending to be trying to repeal Obamacare.

Why don't Democrats, for that matter? I'm not here to defend any federal politicians. You, on the other hand...
 
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Don't be such a partisan pants-wetter. Do you want to understand this or not?

yea, cons always get mad at me when I point out their hypocrisy. I'm going to ignore your "quick, post a bunch of words" deflection and again inform that if dropping coverage made sense companies would have done it. They didn't because it didn't make sense. and you still don't understand. and you're still trying convince yourself it does. Now please address the fact that you've obediently complained about the "cost wall" for people over 400% of FPL but don't care about republican efforts to hurt those under 400%. Lets face it, you parroted yourself into a corner and want to discuss anything but that.

and fyi, repealing Obamacare is not some ramblings from "random conservatives". It's the official goal of every republican.
 
yea, cons always get mad at me when I point out their hypocrisy. I'm going to ignore your "quick, post a bunch of words" deflection

You mean all the actual content that explains how this works? You don't care about the issues, you just want to prattle on in a partisan manner? Okay, go ahead and ignore all the content then.

and again inform that if dropping coverage made sense companies would have done it. They didn't because it didn't make sense. and you still don't understand. and you're still trying convince yourself it does.

There's nothing to suggest employers (public and private) can or will immediately synthesize the complexity of a regulatory monstrosity like the ACA (which has been and still is a moving target in terms of what comes into effect for whom and when) and analyze the viability to this option. The reasons more haven't done it yet could include any number of things, but your lazy assumption that it's all or nothing, either they all would have done it already or none of them ever will, is intentionally ignorant.

I was in a conference a couple of years ago in which the Director of the Alaska Health Care Commission at the time predicted publicly that within about 10 or so years, insurance would be permanently separated from employment in Alaska. She admittedly was lofting up a long range prediction, but if you look at the prices of insurance in Alaska, and consider the fact that the law provides for ways (albiet roundabout) to externalize some of this cost by disentangling it from employment, you can see why that might be a reasonable prediction. Our premium prices are crisis-level up here.

I have consulted some businesses who expressed being at a loss and distressed over the fact that they believed the law was forcing them to insure people averaging over 30 hours that their entire business model depended on not having to insure. They were furious with Obamacare because they felt it was putting a major strain on their business. I told them to just intentionally not insure those people. They were perplexed and literally asked, "but don't I have to?" I said no, pay the $2,000 federal "penalty" and reassure them that the fact they're not offered insurance renders them eligible for subsidies that will cap their premium costs at some paltry percentage of their income.

Businesses specialize in a lot of different specific things, and navigating a 1,200 (or whatever) page piece of federal legislation on health insurance is almost never one of those things. Especially small businesses between 50 and 150 employees are not experts in navigating federal legislation. It hasn't dawned on them yet that they can actually work within the law to their own advantage. If the glitches in the law were fixed and employers had help navigating the complexity of this law, there would probably be quite a bit less resistance to it.

But what do you care, right? You're too busy trying to get me to defend Republicans and telling me employers haven't done (x) yet and therefore they never will. Why do I bother explaining things like this to partisan clowns?

Now please address the fact that you've obediently complained about the "cost wall" for people over 400% of FPL but don't care about republican efforts to hurt those under 400%.

Lets face it, you parroted yourself into a corner and want to discuss anything but that.

Why the hell would I have to address that? You're trying to assign an argument to me that I'm not here to make, as an attempt to ignore what I'm actually saying.

and fyi, repealing Obamacare is not some ramblings from "random conservatives". It's the official goal of every republican.

Really? Cool.
 
The government already insures the most expensive patients- the elderly, nursing homes, hospice, veterans, children with genetic disorders, etc. Why not give them the "good" patients that the for profit health insurance companies want, and go single payer?
 
There's nothing to suggest employers (public and private) can or will immediately synthesize the complexity of a regulatory monstrosity like the ACA (which has been and still is a moving target in terms of what comes into effect for whom and when) and analyze the viability to this option.

ACA passed 5 years ago. How much time do they need?

When do you predict these idiot CEO's will finally figure out they can save billions by eliminating their health care coverage?
 
ACA passed 5 years ago. How much time do they need?

It's still coming into effect, many provisions just this year, others still haven't. So, probably a bit more time than immediately.

When do you predict these idiot CEO's will finally figure out they can save billions by eliminating their health care coverage?

Several years probably, but who said anything about saving billions? Because I recommended hiking wages commensurately with the savings, the savings to organization would usually be modest, but the greatest benefit would be predictability and protection from future premium cost increases, as well as reduced administrative and HR burden dealing with insurance companies on behalf of employees, oh and of course more money left in the pockets of healthy families. And larger contributions to benefits that are a function of wages (e.g. retirement). And employees getting to buy insurance that better suits them instead of accepting whatever the employer selects for the whole organization.

Don't liberals love the thought of higher wages, more spending money in workers' pockets, and using government provisions to ease the burden of health care prices? If so, WTF is causing you guys to go all zombie rabid about this? This is right in your wheelhouse and yet you're staging a protest and you don't even know why. This stuff must be really difficult for you guys. That's okay though, as I said before, I'm happy to help.
 
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You mean all the actual content that explains how this works? You don't care about the issues, you just want to prattle on in a partisan manner? Okay, go ahead and ignore all the content then.

There's nothing to suggest employers (public and private) can or will immediately synthesize the complexity of a regulatory monstrosity like the ACA (which has been and still is a moving target in terms of what comes into effect for whom and when) and analyze the viability to this option. The reasons more haven't done it yet could include any number of things, but your lazy assumption that it's all or nothing, either they all would have done it already or none of them ever will, is intentionally ignorant.

I was in a conference a couple of years ago in which the Director of the Alaska Health Care Commission at the time predicted publicly that within about 10 or so years, insurance would be permanently separated from employment in Alaska. She admittedly was lofting up a long range prediction, but if you look at the prices of insurance in Alaska, and consider the fact that the law provides for ways (albiet roundabout) to externalize some of this cost by disentangling it from employment, you can see why that might be a reasonable prediction. Our premium prices are crisis-level up here.

I have consulted some businesses who expressed being at a loss and distressed over the fact that they believed the law was forcing them to insure people averaging over 30 hours that their entire business model depended on not having to insure. They were furious with Obamacare because they felt it was putting a major strain on their business. I told them to just intentionally not insure those people. They were perplexed and literally asked, "but don't I have to?" I said no, pay the $2,000 federal "penalty" and reassure them that the fact they're not offered insurance renders them eligible for subsidies that will cap their premium costs at some paltry percentage of their income.

Businesses specialize in a lot of different specific things, and navigating a 1,200 (or whatever) page piece of federal legislation on health insurance is almost never one of those things. Especially small businesses between 50 and 150 employees are not experts in navigating federal legislation. It hasn't dawned on them yet that they can actually work within the law to their own advantage. If the glitches in the law were fixed and employers had help navigating the complexity of this law, there would probably be quite a bit less resistance to it.

thanks for your life story but it really has nothing to do with my post. try to focus. Businesses did not drop millions of people to save money as predicted and you still don't get that. And I see you're back to making pathetic excuses for businesses not dropping millions from coverage. No need to "synthesize the complexity of my posts". Businesses didn't do it because it didn't make sense. No "synthesizing" necessary.

But what do you care, right? You're too busy trying to get me to defend Republicans and telling me employers haven't done (x) yet and therefore they never will. Why do I bother explaining things like this to partisan clowns?

Partisan clown? what facts am I ignoring. That's what partisan clowns do. they ignore the facts and cling to narratives. Oh and they also ramble on and on about unrelated points. And they don't understand simple points. For example, I'm not trying to get you to "defend republicans". I pointing out the hypocritical concern you have for people who get no help to get over the "cost wall" of health insurance but don't seem to have any concern for the millions of people who are being denied that help and the millions more that republicans would take that help from. these are really simple points. Hey I know, tell us about that time somebody told you something that you thought was interesting.

fyi, if you feel the need to explain something, explain something related to our discussion.

Why the hell would I have to address that? You're trying to assign an argument to me that I'm not here to make, as an attempt to ignore what I'm actually saying.
see Neo, that's funny, I explained that to you. sometimes "partisan clowns" parrot themselves into a corner and start throwing out insults to deflect from the point. Since I'm sure its an innocent misunderstanding on your part I'll explain it again. You whined and whined about people over 400% FPL who get no help to get over the health care "cost wall". 3 million people are being denied that help in states that didn't expand Medicaid. And republicans want to take it away from 5-10 million more by repealing Obamacare. Where's your concern for that?
 
You again say nothing except repeat the same inane response: "1) no way would this happen gradually in the years during and following the bit-by-bit implementation of this law, no, employers would've immediately and universally done this or it must be non-viable (math and facts be damned), and 2) now defend this Republican position that I'm assigning to you.

Are you going ignore the content of my post to say the same thing a fifth time now too?
 
It's still coming into effect, many provisions just this year, others still haven't. So, probably a bit more time than immediately.

The law passed 5 years ago. They've had 5 years to figure it out.

How long will it take? Try answering the question. Your dodging is not going unnoticed


Several years probably, but who said anything about saving billions?

You did. I guess you "forgot" which I noticed you do whenever you get pwned on a point

Because I recommended hiking wages commensurately with the savings, the savings to organization would usually be modest, but the greatest benefit would be predictability and protection from future premium cost increases, as well as reduced administrative and HR burden dealing with insurance companies on behalf of employees,

so which is it? Will companies save a lot of money by eliminating their coverage or will they not save a lot?

And if they're not going to save a lot, why do it? "Protection from future premium cost increases" is nonsense because if premiums go too high, they can always do that. They're not going to eliminate coverage because it MIGHT save them money someday. They will only do so if it does save them money, which you're now saying it won't do.
 
The law passed 5 years ago. They've had 5 years to figure it out.

How long will it take? Try answering the question. Your dodging is not going unnoticed

Answered in previous post.

You did. I guess you "forgot" which I noticed you do whenever you get pwned on a point

so which is it? Will companies save a lot of money by eliminating their coverage or will they not save a lot?

Depends on how much of the money they're not sending to insurance companies they then pass along to their employees in wages instead. If they're stingy on the pass-along wages, they'll save immensely but suffer retention and discontentment issues. If they pass 100% to employees, their savings will be limited the future difference between wage growth and insurance price growth. Where premiums are already very expensive, there's also a middle ground that provides for both higher incomes and employer savings. Overall, assuming most companies don't want to drive away their trained, benefitted employees, the pass-along wages would have to be enough to exceed the share of employees' income they'll have to spend on their own premiums, i.e. at least a 13% wage hike across the board. Sounds expensive but some organizations up here already spend over 30% of average gross wages on average employee insurance, so there is plenty of room for that kind of raise, plus savings on the employer side, even when factoring in the SRPs and payroll taxes/expenses.

And if they're not going to save a lot, why do it?

I answered this. Cost predictability and protection from future premium increases.

"Protection from future premium cost increases" is nonsense because if premiums go too high, they can always do that. They're not going to eliminate coverage because it MIGHT save them money someday.

All evidence points to continued rising premiums for Alaskans. It's a very safe prediction up here. If it turns out wrong and premiums in Alaska start to drop, that'd be a first and nothing short of a miracle and I'd be the first one celebrating in the streets. If that happens they can always go back to buying a group plan.

They will only do so if it does save them money, which you're now saying it won't do.

Read what I'm writing and try to think. I know this is hard for you but I believe in you sangha.
 
Answered in previous post.

You're lying


Depends on how much of the money they're not sending to insurance companies they then pass along to their employees in wages instead. If they're stingy on the pass-along wages, they'll save immensely but suffer retention and discontentment issues. If they pass 100% to employees, their savings will be limited the future difference between wage growth and insurance price growth. Where premiums are already very expensive, there's also a middle ground that provides for both higher incomes and employer savings. Overall, assuming most companies don't want to drive away their trained, benefitted employees, the pass-along wages would have to be enough to exceed the share of employees' income they'll have to spend on their own premiums, i.e. at least a 13% wage hike across the board. Sounds expensive but some organizations up here already spend over 30% of average gross wages on average employee insurance, so there is plenty of room for that kind of raise, plus savings on the employer side, even when factoring in the SRPs and payroll taxes/expenses.

IOW, they will save a lot of money, but they won't save a lot of money



I answered this. Cost predictability and protection from future premium increases.

That's nonsense because no business is going to risk losing their employees over something that might not happen
 
You're lying

IOW, they will save a lot of money, but they won't save a lot of money

This was thoroughly explained in simple terms for your benefit. As usual you are trying and/or pretending to be unable to understand.

That's nonsense because no business is going to risk losing their employees over something that might not happen

If they leave it up to their employees to decide if they want more money in their pockets or not, and they vote yes for more money, there will be no real risk of turnover.

It appears despite exhaustive explanation it still isn't computing for you. At this point you'll just have to go back and re-read until the light bulb flickers on.
 
Because I recommended hiking wages commensurately with the savings, the savings to organization would usually be modest, but the greatest benefit would be predictability and protection from future premium cost increases, as well as reduced administrative and HR burden dealing with insurance companies on behalf of employees, oh and of course more money left in the pockets of healthy families. And larger contributions to benefits that are a function of wages (e.g. retirement). And employees getting to buy insurance that better suits them instead of accepting whatever the employer selects for the whole organization.

That exists. It's called the employee choice feature of SHOP exchanges.

Small employers are extremely sensitive to the price of health insurance coverage. The premiums of SHOP Marketplace plans will depend on a number of factors, but the SHOP Marketplace does offer employers something that large businesses and public employers have offered for years: the ability to provide their workers a choice of plans while making a predictable contribution to coverage, regardless of the plan an employee chooses.

This is also known as "defined contribution," which is relatively simple to administer when employers contribute a set percentage toward a single plan for all employees. To make employee choice possible, SHOP Marketplaces must develop a mechanism to allow employers to contribute to each employee's individual premium.

In 2014 most state-based SHOP Marketplaces chose to establish a mechanism allowing employers to designate a percentage contribution toward one particular plan--known as a "reference plan"--from among the menu of plans available to employees. This percentage contribution can then be translated into a defined dollar amount, based on the premium for the reference plan. If employees choose plans that are more expensive than the reference plan, they pay the difference.

The defined contribution option offers greater predictability to the employer, while the employee gets to shop for a plan of his choosing in the market (injecting market dynamics into an area where, as you note, the employer historically has chosen on behalf of the employees).
 
That exists. It's called the employee choice feature of SHOP exchanges.

Kind of interesting, although not sure it really makes much difference in the case of my state as the choices are Premera of AK or Moda, and the prices are insane regardless. Transparency and one-stop-shopping are great in theory, but when your prices are off the charts, an "affordable" plan comes with a lot of catches. Narrow or counterintuitive networks, lasered out benefits, or whathaveyou. No insurer can offer great comprehensive coverage at cheap prices in Alaska, thus anyone choosing a cheap plan here is a sucker buying a false sense of security and anyone buying real security is paying out the nose.

I realize this state is anomalous but nonetheless I live and shop for insurance within this state, so an intelligent person should be able to understand why my perspective is as it is.

The defined contribution option offers greater predictability to the employer, while the employee gets to shop for a plan of his choosing in the market (injecting market dynamics into an area where, as you note, the employer historically has chosen on behalf of the employees).

Irrespective of the SHOP thing, I agree with defined contribution model for the sake of employers but, again, because the firms I interact with are in Alaska, what doesn't crush the employer in insurance costs crushes the employee in insurance costs. Unless of course part of the cost were shared with some third entity, say for example, the Federal Government.
 
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And one other thing on the notion of "transparency," I think transparency sounds great but I think it's disingenuous to suggest there's any real transparency in health insurance currently, even in light of these one-stop-shop concepts. Let me explain why I think so.

An employer begs and begs for next year's plan offerings from the current insurer and they often come JUST before fiscal year end. There are a million excuses insurers give, especially with new regulatory burdens they face, as to why they can't provide plan offerings sooner. What incentive do they have to offer plan info sooner? So that their customers can shop? Haha, yeah, right. Then employers who have all their normal administrative job duties have a rapidly ticking clock with which to digest what information is provided, try to share that information with employees to get their opinions if at all possible, factor the information into next year's proposed budget, and make a decision to buy or else madly scramble to find an alternative.

And often what information they do get (late in the game) is limited. For example, say specialty drugs are a 30% copay. Subject to deductible? You won't know in the summary descriptions. What are specialty drugs and what aren't? You won't know that either. Do any of your employees actually take specialty drugs? You absolutely won't know that. Alright, well, what providers and facilities "in-network?" They won't tell you that, they just give you a link to their website and tell you to poke around. So you say, "screw this, we'll shop around." New proposals require claims histories for firm proposals, which the current insurer won't release, citing HIPAA. Even if you beg them to exclude patient identifying info, they won't release it, citing HIPAA. On and on it goes. There is a seemingly endless amount of detail and what-ifs that employers don't, can't and won't ever have. They don't just have imperfect information, they have critically bad information on top of limited time with which to make the optimal insurance purchasing decision.

And because most employers, especially small to medium size ones, don't have the time, expertise, intelligence, or other resources to delve into the type of detail that they can reasonably be said to encounter "transparency" and have good information in their insurance purchasing decisions, why shouldn't they consider paying a SRP to the Federal Government, hiking wages more or less commensurately with what the insurance would cost, and set their employees loose to buy their insurance individualized to their and/or their family's needs, and get federal subsidies to boot? For what reason should they not do that?
 
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