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Thread: Omamacare is Romneycare.

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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Greenbeard View Post
    Used to be that if your employer coverage was going to cost you more than 8% of your income, you could take the value of your employer's financial contribution to the company plan and put it toward any plan sold in the open marketplace. In essence you would be uncoupled from your group--probably self-insured--plan and got to shop in the marketplaces without giving up your employer's financial support. That was one of the first pieces of the ACA the GOP repealed in 2011 when they took the House, so it was never implemented. I'm all for supporting ways toward organically moving the employer market to either transition into the individual market or effectively mimic it (which is what I had hoped the employee choice aspect of the SHOP exchanges would facilitate).

    Anyway, I agree it's long past time to make the premium tax credits more generous and remove the 400% FPL cap. That's quite high on Congressional Dems' agenda!
    I wonder if the employee choice would have created adverse selection in employer groups. For example the employers I've had pay the same amount per employee, unadjusted for age, so as a relatively young person, it would have always made sense to take the employer's contribution and shop with it (and I'd have bought an HDHP starting over 10 years ago and have tens of thousands in health savings by now). If employer pools were full of old and unhealthy people, then wouldn't the "employer's share" be inflated for younger employees based on that?

    Eliminating the 400% cap alone could do a lot, I feel. People's cost would increase with income, not age (though perhaps it should tick up a bit with age, too, which it doesn't currently for the employer-insured and subsidy-eligible).

  2. #12
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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Neomalthusian View Post
    I wonder if the employee choice would have created adverse selection in employer groups. For example the employers I've had pay the same amount per employee, unadjusted for age, so as a relatively young person, it would have always made sense to take the employer's contribution and shop with it (and I'd have bought an HDHP starting over 10 years ago and have tens of thousands in health savings by now). If employer pools were full of old and unhealthy people, then wouldn't the "employer's share" be inflated for younger employees based on that?
    All the more reason to get out of the insurance business and let all of your employees take a contribution to put toward their coverage in a SHOP exchange!

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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Greenbeard View Post
    Used to be that if your employer coverage was going to cost you more than 8% of your income, you could take the value of your employer's financial contribution to the company plan and put it toward any plan sold in the open marketplace. In essence you would be uncoupled from your group--probably self-insured--plan and got to shop in the marketplaces without giving up your employer's financial support.
    That was one of the first pieces of the ACA the GOP repealed in 2011 when they took the House, so it was never implemented. I'm all for supporting ways toward organically moving the employer market to either transition into the individual market or effectively mimic it (which is what I had hoped the employee choice aspect of the SHOP exchanges would facilitate).

    Anyway, I agree it's long past time to make the premium tax credits more generous and remove the 400% FPL cap. That's quite high on Congressional Dems' agenda!
    Green beard, my interpretation of larger employers medical insurance responsibilities as described within
    Employer Responsibility Under the Affordable Care Act | The Henry J. Kaiser Family Foundation , is:
    If an employer of 50 or more full time employees
    and
    offers affordable medical insurance to 95% of those employees,
    and
    the insurance pays for no less than 60% of the covered health care for “a standard population (called minimum value)”,
    then that employer is in compliance with the federal Patient Protection Affordable-Care-Act.

    I'm confused upon that mouthful of “a standard population (called minimum value)”. Is this a concept that replaced the concept of the 8% of an employees income that you referred to? If you have some insight to this, please help me understand it.

    Respectfully, Supposn

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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Greenbeard View Post
    Used to be that if your employer coverage was going to cost you more than 8% of your income, you could take the value of your employer's financial contribution to the company plan and put it toward any plan sold in the open marketplace. In essence you would be uncoupled from your group--probably self-insured--plan and got to shop in the marketplaces without giving up your employer's financial support. That was one of the first pieces of the ACA the GOP repealed in 2011 when they took the House, so it was never implemented. I'm all for supporting ways toward organically moving the employer market to either transition into the individual market or effectively mimic it (which is what I had hoped the employee choice aspect of the SHOP exchanges would facilitate).

    Anyway, I agree it's long past time to make the premium tax credits more generous and remove the 400% FPL cap. That's quite high on Congressional Dems' agenda!
    Green beard, the Republicans voted to repeal permitting employees' some determination of their own individual medical insurance at little or no additional cost to their employer?

    Even if something is better promotes individual employees' self determinations and is of little or no additional cost to employers or our government, Republic Party's policy is not to support anything that may not be politically detrimental to Democrats? Given a choice between serving their nation or their party, they generally choose in favor of of their party?

    Respectfully, Supposn

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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Greenbeard View Post
    All the more reason to get out of the insurance business and let all of your employees take a contribution to put toward their coverage in a SHOP exchange!
    Need that 400% FPL thing to go away, and that could start happening.

    Where I used to live and work, the employer is paying 40% of a 55-year old employee's gross wages toward health insurance for that employee and her spouse. The employee/spouse's share of the premiums were $3,000 a year. Thanks to the subsidy cliff, if we had gotten out of the insurance business, that $3,000 would have jumped to over $40,000 per year in premiums, on a household income of about $80,000. Net of the employer share distributed to the employee, that's still ~$20,000 per year net increase in premium cost to the employee.

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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Greenbeard View Post
    ... Anyway, I agree it's long past time to make the [medical insurance] premium tax credits more generous and remove the 400% FPL cap. That's quite high on Congressional Dems' agenda!
    Greenbeard, isn't the tax credits for medical insurance premiums and a federal subsidy of insurance for individuals with incomes that do not exceed 400% of the federal poverty line both sufficiently generous?

    Wouldn't increasing those individuals' tax credits or caps upon those subsidies be net detrimental to our annual federal budgets?
    Why do you believe increasing the annual federal budget deficits in those particular cases would be justified?

    Respectfully, Supposn

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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Neomalthusian View Post
    Need that 400% FPL thing to go away, and that could start happening.

    Where I used to live and work, the employer is paying 40% of a 55-year old employee's gross wages toward health insurance for that employee and her spouse. The employee/spouse's share of the premiums were $3,000 a year. Thanks to the subsidy cliff, if we had gotten out of the insurance business, that $3,000 would have jumped to over $40,000 per year in premiums, on a household income of about $80,000. Net of the employer share distributed to the employee, that's still ~$20,000 per year net increase in premium cost to the employee.
    Neomalthusian, in what state does medical insurance cost $40,000 annually for a married couple? Respectfully, Supposn

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    Re: Omamacare is Romneycare.

    Quote Originally Posted by I'm Supposn View Post
    Neomalthusian, in what state does medical insurance cost $40,000 annually for a married couple? Respectfully, Supposn
    Alaska.

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    Re: Omamacare is Romneycare.

    While the ACA was being debated, I brought up the point on some of these politics discussion boards that the ACA was nothing more than Romneycare, and was originally proposed by the Heritage Foundation. The response I usually got was that it's OK for states to implement it at the state level, but it's unconstitutional to implement it at the national level.

    I don't know. I think that's all just an excuse, and they just wanted to make sure Obama didn't pass anything to make him look bad.

  10. #20
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    Re: Omamacare is Romneycare.

    Quote Originally Posted by Neomalthusian View Post
    These observations could have been made a full ten years ago now. It's well understood that the support for the ACA has had broad bipartisan support, conceptually, albeit at different points in time because of partisan politics.
    They were, ad nauseum.
    Didn't matter...Republicans seized on the fact that a Democratic administration was pushing the idea, so man the battle stations. And they did. And several turncoat "Democrats" (who have proven all along that they're really just Republicans) helped them.

    Joe Lieberman is the single reason the Public Option never even made it to the floor of the Senate.

    “A public option plan is unnecessary,” he told Fox News. “It has been put forward, I’m convinced, by people who really want the government to take over all of health insurance.”
    True, President Obama could have fought tooth and nail, but he didn't. I don't know if he was simply trying to placate the Republicans, or if he simply threw in the towel due to weakness.
    But former CIGNA executive Wendell Potter tells the story.

    ELIMINATION OF ‘PUBLIC OPTION’ THREW CONSUMERS TO THE INSURANCE WOLVES
    Wendell Potter, February 2015

    Knowing the industry as I did, I told the committee that if Congress failed to create a public option to compete with private insurers, “the bill it sends to the President might as well be called “The Insurance Industry Profit Protection and Enhancement Act.”
    Quote Originally Posted by aociswundumho View Post
    I wouldn't know, I'm not a big Trump fan. I did vote for him, and I'll vote for him again in 2020.

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