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If you have a middle class family that has employer subsidized health insurance, you are likely to have the problem discussed in this diary.

As the Affordable Care Act (ACA) is complex, the ways for employers and employees to use the law to their best advantage can be very surprising. Many here are already aware of the perverse incentive to employers to shift their employees to part time working less than 30 hours/week, as much as practical.

Here is another perverse result from ACA that will get great attention over the next few months not only in the press but in the workplace.

For many employees with families who receive a subsidy from their employer for health insurance, these employees will be substantially better off if their employer stops offering a subsidy.  In addition, the employer enjoys a windfall, in that she no longer needs to help pay for employee health insurance. This is even true when the employer is subject to an ACA penalty for not providing affordable health insurance.

From CNBC Obamacare penalty: Your family could pay more for insurance

That quirk means that for some people, it will be more economical to have an employer not offer health insurance subsidies for them and their families—and for the entire family to then instead be able to buy insurance with government subsidies on the new Obamacare state health exchanges.
Under ACA, if the cost to the employee for employer subsidized health insurance is less than 9.5% of household income this is called "affordable coverage."  When an employer offers this, the employee is not allowed to reject this insurance and purchase insurance through an exchange and get government subsidies (subsidies only if household income is less than $94,200)

The problem is this affordability test only applies to insurance that covers only the employee and not the entire family.

In other words, even if the cost of obtaining coverage for a worker's entire family exceeds 9.5 percent of household income, that family then cannot potentially save money by buying subsidized insurance on the state health exchanges.
This problem is most sever when the employer subsidies only the employee and does not provide additional subsidy for family members.

The impact of this will be that both employers and middle-class employees with families will want their employers to stop subsidizing employee health insurance.

Let's compare how well an example employee actually does with and without an employer subsidy for health insurance.

Consider an employee with a family of four who lives and works in New York state with a family income of $50,000 a year.

Assume the employee has the choice of employer insurance of $13,646/yr for the family, or $4,788 for only himself.  In addition, the employer pays for 1/2 of the cost of insuring the employee but no subsidy for the rest of the family.  This subsidy therefore reduces the cost to the employee for both choices by $2,394/yr

With an employee only cost of insurance of $2,394/yr, this cost is far lower than 9.5% of the $50,000 household income - so the entire family cannot get federal subsidies to buy insurance on ACA exchanges.

For the employee to insure his entire family, he can either:

  • Insure the family through the employer for $13,646 - $2,394 = $11,252
  • Buy insurance for only the employee from the company for $2,394 and then insure the rest of the family with a Silver plan on the New York exchange for $7,120.  Total cost of $9,514 to insure the entire family - this is the lower cost of the two choices

    . No government subsidies are here because the family is not eligible because the employer had "affordable" insurance for the employee.

But the employee and his family could have saved thousands of dollars per year if the employer did not offer "affordable insurance."

If the employer did not offer a subsidy, the individual insurance to the employee would no longer be "affordable insurance", so the family would be eligible to receive government subsidies on the ACA exchange.  The total cost to the family after subsidies would be only  $3,365/yr, a saving of over $6,000/yr for the family.

A difference of over $6,000/yr is huge for a household with $50,000/yr income, this is not a minor factor.  

There is something very wrong when an employer providing $2,400/yr in a healthcare subsidy results in reducing her employee's after tax and after insurance income by over $6,000/yr.

This will become a major issue in politics and the workplace, starting in October as ten's of millions of employees see this perverse impact from ACA on their family after years of little or no pay increases for years.

In addition, this issue will result in a massive shift in health care cost from employers to the Federal government that is not included in current Federal budget estimates.

Democrats and the White House need to get in front of this issue now to fix this perverse impact that hits the middle class, rather than wait for massive employee and employer outrage when they see this problem hit them in the face.

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Comment Preferences

  •  Tip Jar (10+ / 1-)

    The most important way to protect the environment is not to have more than one child.

    by nextstep on Tue Aug 20, 2013 at 11:35:53 AM PDT

  •  What About Pension Health Care Plans? nt (4+ / 0-)

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Tue Aug 20, 2013 at 11:40:00 AM PDT

    •  I don't know if the same problem applies for (1+ / 0-)
      Recommended by:
      commonmass

      Pension Health Care Plans.  One could look it up in the ACA itself, but one must also reference the many regulations as well.  

      It would be best to ask HHS or contact your members of Congress.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 11:45:05 AM PDT

      [ Parent ]

  •  The ACA is going to be, in itself, the best (10+ / 0-)

    argument for extending Medicare to all that has ever been made. Watch.

    I resent that. I demand snark, and overly so -- Markos Moulitsas.

    by commonmass on Tue Aug 20, 2013 at 11:56:46 AM PDT

    •  Your comment is ambiguous (1+ / 0-)
      Recommended by:
      commonmass

      Are you saying that ACA will work so well that we get Medicare for all, or are you saying that ACA will work so poorly that we get Medicare for all? Or are you saying something else?

      I would think that if ACA is viewed as a failure, independent voters will have less trust in government and Democrats on health care issues.

      Democrats, who want Democrats to control Congress and the White House should be working to make ACA as successful as Medicare.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 12:03:09 PM PDT

      [ Parent ]

      •  I think its benefits will be clear, and its (8+ / 0-)

        complexity and unintended consequences will also be clear, and in that way it will be both a success and a failure. It will certainly be a success with private insurance. But where it fails, I think will not have the effect on voters that you think it will. I think when it is seen as over-complicated and full of unintended consequences, voters will say "look, let's just do the single-payer deal".

        I really think its failures will lead us there. I sure hope so. But I am grateful for those things which are already clearly successful.

        I resent that. I demand snark, and overly so -- Markos Moulitsas.

        by commonmass on Tue Aug 20, 2013 at 12:10:48 PM PDT

        [ Parent ]

        •  Addendum: like all compromise legislation (4+ / 0-)
          Recommended by:
          nextstep, ZZZzzz, tardis10, Sunspots

          (don't forget, this is basically the GOP's counterplan to Clinton's health insurance proposal, passed through Mitt Romney and Massachusetts, with a shiny Presidential seal on it) its intention is to address problems and avoid substantive change (especially where business is concerned) in the proportion of about 1 part fix and 3 parts pander. It's a terrible bill. Terrible. One of the greatest wastes of energy and political energy ever made, IMO. But, like many bills like the ACA, it also does a lot of good. But it is careful not to do too much good. That, well, that, would be Socialized medicine!. And not even the President truly believes that every American has a right to affordable health care. Because he made it clear that that option was NOT on the table.

          I resent that. I demand snark, and overly so -- Markos Moulitsas.

          by commonmass on Tue Aug 20, 2013 at 12:15:57 PM PDT

          [ Parent ]

          •  You can peddle this meme 'til hell freezes over, (0+ / 0-)

            but it's ameliorative effect will be zero.

            (don't forget, this is basically the GOP's counterplan to Clinton's health insurance proposal, passed through Mitt Romney and Massachusetts, with a shiny Presidential seal on it)
        •  It depends upon specific successes and failures (1+ / 0-)
          Recommended by:
          commonmass

          as perceived by the political middle as the swing of power in changing laws.

          The most important way to protect the environment is not to have more than one child.

          by nextstep on Tue Aug 20, 2013 at 12:18:45 PM PDT

          [ Parent ]

          •  Which is why single-payer should have at least (6+ / 0-)

            been on the table so that people like Teddy could have made the case for it. But Obama refused to go there. Because he doesn't believe in universal access to health care. He believes in tweaking the status quo, and so does most of the Democratic congressional leadership.

            In Germany, Obama would be a conservative.

            I resent that. I demand snark, and overly so -- Markos Moulitsas.

            by commonmass on Tue Aug 20, 2013 at 12:26:58 PM PDT

            [ Parent ]

            •  ACA barely was passed (2+ / 0-)
              Recommended by:
              commonmass, FG

              Some conservative Democrat Senators and Sen Liebermann would not have voted for anything beyond what ACA does and no Republicans would have supported single payer.

              The most important way to protect the environment is not to have more than one child.

              by nextstep on Tue Aug 20, 2013 at 12:39:53 PM PDT

              [ Parent ]

              •  I'm aware of that. That's true, as it was. (4+ / 0-)
                Recommended by:
                tardis10, nextstep, Sunspots, kareylou

                but what was pointedly not allowed was to hear how efficient traditional Medicare is, and strong arguments as to the money-saving for small businesses, taxpayers, and the government in general going single-payer would have been.

                I think if we had some real argument for single-payer, the ACA would have ended up with fewer flaws though I agree with you, single-payer would not have passed.

                So, instead, the flaws in the bill will be the greatest advocate for single-payer/Medicare for all. Once people get a taste for the benefits of the ACA, they will want more. And people deserve more. For now, I won't argue that it's not a great improvement over what we had.

                I resent that. I demand snark, and overly so -- Markos Moulitsas.

                by commonmass on Tue Aug 20, 2013 at 12:47:00 PM PDT

                [ Parent ]

    •  ACA was never meant to fix the problem (3+ / 0-)
      Recommended by:
      commonmass, nextstep, ZZZzzz

      It is nothing more than a tool to hasten the imminent demise of an insurance based healthcare system.  Obviously the system won't get fixed until its broke.

      •  I think it's more nuanced than that. It is tied up (6+ / 0-)

        in the agenda of the first year of the President's first term. It's tied up in this idea of "bipartisanship". It is, really, the result of saying to an armed robber "OK, I'll give you my money and credit cards but will you let me at least keep my drivers' license?"

        I'm not saying there were not the best intentions to this. But I feel that the entire thing, which I followed very closely, was more political than it was about helping people. If Democrats and the President wanted to help people, they would have raised the cap on FICA and given everyone the option to opt in to Medicare while allowing for private insurance along side and pass regulations which require all providers (doctors, etc) to accept Medicare patients. Plenty of people would still have private insurance. It's weak sauce.

        I resent that. I demand snark, and overly so -- Markos Moulitsas.

        by commonmass on Tue Aug 20, 2013 at 12:23:56 PM PDT

        [ Parent ]

        •  And what Congress was going to pass that (5+ / 0-)
          Recommended by:
          nextstep, commonmass, htowngenie, FG, Samer

          or anything like it? Of course it was political. You can't do anything in government without it being political.

          The Republicans and insurance companies both knew that if given a choice, people would move off private insurance rolls in droves. After all, who doesn't get on Medicare just as soon as they are eligible?

          "Nothing happens unless first a dream. " ~ Carl Sandburg

          by davewill on Tue Aug 20, 2013 at 01:19:45 PM PDT

          [ Parent ]

          •  Which is why I was an advocate of Germany's (3+ / 0-)
            Recommended by:
            Sunspots, nextstep, kareylou

            Bismarck Model. Germany has universal coverage, but it's not exactly "socialized medicine". It's a public-private cooperation, highly regulated, and much cheaper than what the insurance exchanges under the ADA can offer.

            I'd rather have Medicare for all, but I thought that model should have been considered. Germans are very happy with it. I think many Americans would be happy with it too.

            I resent that. I demand snark, and overly so -- Markos Moulitsas.

            by commonmass on Tue Aug 20, 2013 at 01:54:21 PM PDT

            [ Parent ]

  •  anyone know (2+ / 0-)
    Recommended by:
    nextstep, SoCaliana

    If a former employee would be required to take COBRA in lieu of signing up for an exchange? Also, if someone misses the October sign up can they enroll some other time? I know almost nothing about the actual workings of the ACA.

    It's easy to be a libertarian if your finances are secure, you have good healthcare and your future is bright.

    by Cecile on Tue Aug 20, 2013 at 12:08:36 PM PDT

  •  How would I find out I am in Va (0+ / 0-)

    no state exchanges

    •  VA navigators (0+ / 0-)

      Virginia (like Texas where I am) is one of those states that refused to co-operate and is basically handing the control of state exchanges to the Feds (weird right?  for all those harpies who hate the Feds telling them what to do).  

      Anyway, the two organizations awarded the contracts for training navigators in VA (those are the people who will help you find the website or guide you to specific help) are The Virginia Poverty Law Center Inc and Advanced Patient Advocacy LLC.  They may be able to point you in the right direction but rest assured the website for signing up will be available on Oct 1st.  From the looks of websites already up and running in more compliant states, it will be very simple, no small print,  and no marketing of plans to confuse the consumer, just a comparison chart between plans being offered with the cost of each.  

      As for your Cobra issue, I just did a cursory search on the actual PPACA bill and came up with zero hits.  Cobra is completely voluntary on your part and typically very expensive as it is NOT subsidized by the former employer.  You are more likely to find cheaper insurance on the exchange, and if you are unemployed, you may qualify for the tax credit.  

      The diarist is not pro ACA and wants it to fail, so is unlikely to offer you assistance.  

      Good luck!  

      We are all in this together.

      by htowngenie on Tue Aug 20, 2013 at 02:19:04 PM PDT

      [ Parent ]

      •  You are wrong in writing, diarist does not support (1+ / 0-)
        Recommended by:
        kareylou

        ACA.  I do support it, and when I see errors in it, I want them fixed before they damage ACA or the people's trust in Democrats.

        The most important way to protect the environment is not to have more than one child.

        by nextstep on Tue Aug 20, 2013 at 02:47:16 PM PDT

        [ Parent ]

        •  Don't know why you posted this myth then. (0+ / 0-)

          You should retract right away now that you know it doesn't stand up to a smell test.  

          We are all in this together.

          by htowngenie on Tue Aug 20, 2013 at 03:11:43 PM PDT

          [ Parent ]

          •  You are wrong that this is myth. (1+ / 0-)
            Recommended by:
            peregrine kate

            If you believe employers will routinely subsidize employee health insurance at the rate of $2400/yr (and lowering their profits) knowing that their employee's family will be worse off by $6,000/yr then you will believe this is a myth.  But people with experience in the real world immediately understand this is not what will happen, except for the few less bright business people taking time to understand this.

            I have experience in having health insurance programs setup at several companies and how company subsidies work.

            The mathematics of ACA combined with how employee subsidized healthcare frequently works brings this problem.

            Democrats are going to take a political beating on this issue, and getting hurt in the 2014 elections unless they are seen as being proactive in fixing this problem.

            The most important way to protect the environment is not to have more than one child.

            by nextstep on Tue Aug 20, 2013 at 03:32:22 PM PDT

            [ Parent ]

            •  HR'd for plagerism. (0+ / 1-)
              Recommended by:
              Hidden by:
              nextstep

              Like I said, this hypothetical family is $1500 the better for having ACA.  But considering you plagerized the original article almost entirely and can't explain your support of this story adequately even with a background in insurance is very telling.  I have a summa cum laude degree in finance and 30 years in corporate banking.  I'm not not your average low information reader.  Your explanation and excuses don't fly with me.

              We are all in this together.

              by htowngenie on Tue Aug 20, 2013 at 03:54:14 PM PDT

              [ Parent ]

              •  You both need to pull the HRs. (2+ / 0-)
                Recommended by:
                nextstep, kareylou

                As both of you are abusing their intent. First, htowngenie, your charge of plagiarism is unfounded. I reviewed his source article myself and he does a good job of paraphrasing what's being said, but certainly does not plagiarize (and after all my years of teaching, I can assure you I know what plagiarism is.) Your HR for this is incorrect and should be removed. If you want to argue that he doesn't actually understand what he's saying, fine, but that's a difference of opinion and not HR worthy under any circumstances.

                On the other side of this, nextstep, you also need to remove your HR for two reasons. First, it's very poor form to HR someone in your own diary, a mistake I made in the past when less familiar with the community standards on this kind of thing. Second, this is a retaliatory HR, which is also frowned upon to put it mildly.

                Since we just had the comment system updated, this is not a good time to be throwing around HRs just because you have a serious disagreement. Let's clean this up and just argue your points as forcefully as you think necessary, okay?

                Strategy without tactics is the slowest route to victory, tactics without strategy is the noise before defeat. Sun Tzu The Art of War

                by Stwriley on Tue Aug 20, 2013 at 07:53:08 PM PDT

                [ Parent ]

          •  You don't make a case to argue this a myth (0+ / 0-)

            other than repeating the word myth.

            The most important way to protect the environment is not to have more than one child.

            by nextstep on Tue Aug 20, 2013 at 04:08:11 PM PDT

            [ Parent ]

            •  Do you have an actual case of this happening? n/t (0+ / 0-)

              We are all in this together.

              by htowngenie on Tue Aug 20, 2013 at 06:14:16 PM PDT

              [ Parent ]

              •  Several people have already commented to the diary (0+ / 0-)

                saying that is the case for them.

                In three of the Silicon Valley tech firms I where I am on an advisory board, this would occur in all these companies. Other companies in the area have similar policies as the three companies were following local norms.

                If you think through the math of this, this issue occurs whenever both of the following occur:

                • an employer provides an employee, with a family, a subsidy that puts the employee under the "affordable" ACA designation so the family is no longer eligible for government subsidy - this will be common for middle class families with employer subsidies as subsidies are provided to households with annual income up to $94,000.
                • cost of employee plus family  insurance less employer subsidy is greater than the cost of company employee insurance plus family insurance through the exchange less otherwise government subsidies.  Unless only very expensive insurance is available through the exchange, this will be common as well.

                The most important way to protect the environment is not to have more than one child.

                by nextstep on Tue Aug 20, 2013 at 07:19:48 PM PDT

                [ Parent ]

                •  Every case explained here in the comments has (0+ / 0-)

                  NOT been to an exchange to see the ramifications on them personally.  They are worried about what it MIGHT do.  Your diary did them harm by adding to their worries.

                  What I want to see evidence of is an actual middle class family who tried to get insurance on the exchange and was presented with a situation where they were harmed by ACA - rather they were compelled to spend more than what was available to them before passage.  Until you can come up with one, this diary is a scare tactic that is harmful to people and the ACA.  Like I said before, I think you should delete it.  

                  We are all in this together.

                  by htowngenie on Tue Aug 20, 2013 at 07:33:55 PM PDT

                  [ Parent ]

                  •  You should read up on how "Affordable" (0+ / 0-)

                    insurance from employers impacts employee family access to government subsidies.  You may understand the issue then.  Right now you simply refuse to understand and mistakenly believe you are defending ACA.

                    The management of companies already see this issue.

                    As I wrote in the diary.  The issue will be big once the exchanges are up and running and people can go to them in volume.

                    I am an associate at an economic policy institute at a top 5 university.  To me, the impact of what will happen is obvious, others will need to see Democrats take major political damage before they recognize this. Based upon your comments, you need to see the damage first.

                    The most important way to protect the environment is not to have more than one child.

                    by nextstep on Tue Aug 20, 2013 at 08:40:47 PM PDT

                    [ Parent ]

                    •  Well if you are all that, (0+ / 0-)

                      how come you didn't write your own diary?  And back it up with a scenario that actually made sense, ie, a middle class family hurt by Obamacare.  Because that is what the thesis of the other article was...that the middle class would suffer unintended consequences.  But, the case was weak.  All I'm asking for is a scenario that explains the collateral damage you claim or and actual instance of it happening.  

                      It seems to be me you are coming at this from a business standpoint with a veiled threat that businesses will quit offering subsidies to their employees because of ACA or will do away with health insurance as a benefit.  As I said before, fine by me, healthcare should not be tied to employment, the sooner we get rid of it the better.  

                      In the meantime, where is that middle class family that is going to be hurt by Obamacare?

                      We are all in this together.

                      by htowngenie on Tue Aug 20, 2013 at 09:17:25 PM PDT

                      [ Parent ]

                  •  Absolute nonsense (0+ / 0-)

                    Is the diarist misinterpreting the law? If so, please tell us in what way.

                    We decided to move the center farther to the right by starting the whole debate from a far-right position to begin with. - Former House Majority Leader Tom DeLay

                    by denise b on Wed Aug 21, 2013 at 12:21:52 AM PDT

                    [ Parent ]

              •  Based on what I have read (0+ / 0-)

                I think this situation can definitely arise. Whether it has happened yet or not is irrelevant.  What exactly is incorrect in the analysis?

                We decided to move the center farther to the right by starting the whole debate from a far-right position to begin with. - Former House Majority Leader Tom DeLay

                by denise b on Wed Aug 21, 2013 at 12:17:55 AM PDT

                [ Parent ]

    •  Also Kaiser Family Foundation (1+ / 0-)
      Recommended by:
      ItsSimpleSimon

      offers a basic calculator that you may find helpful in the meantime.  

      Don't be scared off of ACA by all these "but what if" and "maybe" arguments against Obamacare.  The ACA is going to help a lot of people and I hope you are one of them.

      We are all in this together.

      by htowngenie on Tue Aug 20, 2013 at 02:30:03 PM PDT

      [ Parent ]

      •  Part of the diary is definitely not (4+ / 0-)

        a myth and it can hit people with family coverage hard.  For example, right now I get insurance coverage through my husband's job, but he can afford it only because I work.  If I lost my job he would not be able to afford coverage for the insurance (it would be more than 50% of his salary for "family" coverage), but he would not be able to get a subsidy on the exchange because only the individual premium counts when figuring the eligibility for a subsidy.  I would not be eligible for the exchange because I could get coverage through my spouse, even though we couldn't afford it.

        Mind you I am very pro ACA but this catch 22 is a big wrinkle.

        Democrats give you the Bill of Rights; Republicans sell you a bill of goods!

        by barbwires on Tue Aug 20, 2013 at 03:56:28 PM PDT

        [ Parent ]

        •  You would still be able to (0+ / 0-)

          buy insurance through the exchange.  It might not be subsidized or gain a tax credit, but you would still be able to get it.  I'm not sure how much your husband's salary is or how expensive your family policy is now (but it sounds expensive if it's 50% of his salary).

          If you lose your job, I assume your family income will be cut at least in half based on the 50% family premiums of his salary you quoted above.  And you don't indicate the percentage of his insurance premium alone that is above the 9.5% cap that requires him to keep it.  So I can't really comment to that without specific numbers and this is a public forum, but my guess is, you would qualify for a subsidy.

          Initial indications from the states that already have exchanges open, California, Florida, Idaho, to name a few, are that people in your situation are able to get cheaper insurance premiums on the exchanges.  

          I have yet to hear from anyone who has been economically harmed by this law.  Is there someone out there who has actually experienced a rise in premiums?  Anybody?

          We are all in this together.

          by htowngenie on Tue Aug 20, 2013 at 06:32:08 PM PDT

          [ Parent ]

  •  This problem is starting to percolate (4+ / 0-)
    Recommended by:
    nextstep, Sunspots, SoCaliana, barbwires

    into people's concerns,I'd say. At least I've heard about it from a couple business owners and a neighbour here in NY.

    "George RR Martin is not your bitch" ~~ Neil Gaiman

    by tardis10 on Tue Aug 20, 2013 at 01:07:00 PM PDT

    •  I'm expecting a geyser of people raising this (2+ / 0-)
      Recommended by:
      tardis10, Sunspots

      issue between October and December, unless the White House and HHS takes the lead in fixing this.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 01:20:10 PM PDT

      [ Parent ]

      •  From percolation to a geyser (1+ / 0-)
        Recommended by:
        ItsSimpleSimon

        thats what the anti-ACA crowd wants for their scare stories.  All based on "what ifs" and "maybes".  The fact is, many states have opened exchanges and we've heard not one instance of this happening.  

        I've asked it a bunch, forgive me for repeating, but when did the smart people who read and post at DKos become so gullible to the lies from the right?

        We are all in this together.

        by htowngenie on Tue Aug 20, 2013 at 02:33:12 PM PDT

        [ Parent ]

        •  Does not have anything to do (1+ / 0-)
          Recommended by:
          nextstep

          with right/left. What is going on is that  actual people have begun to run their numbers & the results are not as good as some thought they would be AND in some cases, there are some definite issues.(like my neighbor)
          Enough to force changes and improvements in the law? Maybe,that will depend on how many & how vocal the folks impacted are. A further complication is that what is available on the ACA varies from state to state. Pretending the ACA is perfect isn't smart politics,ime. YMMV.  

          "George RR Martin is not your bitch" ~~ Neil Gaiman

          by tardis10 on Tue Aug 20, 2013 at 02:50:41 PM PDT

          [ Parent ]

          •  Never said it was perfect, (0+ / 0-)

            too many hands in the pie for my taste and besides, from the beginning I wanted Medicare for All.  

            If there is some specific part of it that is not fair and creates a REAL burden for a great many people, it is the function of their elected representatives to bring amendments forward.  Believe me, if what was said in this scenario was evenly remotely true, every representative out there would be hearing from his/her constituents.  

            This story is a myth.  Send me one that is factual and I will consider it, thoughtfully I might add.

            We are all in this together.

            by htowngenie on Tue Aug 20, 2013 at 03:10:05 PM PDT

            [ Parent ]

  •  It amazes me that such a major flaw (2+ / 0-)
    Recommended by:
    nextstep, Sunspots

    in the law could have been overlooked.  Congress worked on this bill for a long time.

    I work in pharmaceutical research and we actually have to think through a process before implementing it.

    It goes without saying that the Republicans will not allow anything that is wrong with the ACA to be fixed.  That way, they can lobby against the law each time a problem emerges.

    •  Actually, as it turns out, (2+ / 0-)
      Recommended by:
      never forget, ItsSimpleSimon

      many of the things that are slyly, and coyly I might add, being pointed out have their roots in the Republican party amendments to the bill.  That big hullabaloo from the Republicans about Congress being "exempt" from the law?  A republican sponsored that amendment.  

      And this instance of a made-up family of four is bogus, too.  In the example, the family is going to save $1500 a year because of Obamacare.  They are not losing anything!  Worst case scenario?  They decide to keep their insurance with the employer and continue to pay what they've always paid.  Their choice.  This is a red-herring meant to scare the middle class.  My advice, don't listen.  

      We are all in this together.

      by htowngenie on Tue Aug 20, 2013 at 02:25:21 PM PDT

      [ Parent ]

  •  Let me get this straight (1+ / 0-)
    Recommended by:
    ItsSimpleSimon

    4 person family - 1 person employed with employer subsidized insurance for the breadwinner only.  Breadwinner can choose to continue having his family on his plan but it's cheaper for the family to go to the exchange for their insurance.  The family saves $1500 a year because ACA was enacted.  I dunno, but that sounds like something GOOD coming out of ACA for that family.  Maybe not as good as their neighbor down the street who has different circumstances, but $1500 is nothing to sneeze at.  

    What the employer decides to do will be determined by the makeup of his workforce.  Will this apply to the majority of his workers?  A few?  Who knows in a hypothetical story?

    My question for Wu would be, how many people will this affect?  Will it negatively impact the people?  Because in the hypothetical case he cites, I think the family will gladly accept $1500 a year and thank the ACA for it.  

    We are all in this together.

    by htowngenie on Tue Aug 20, 2013 at 01:17:10 PM PDT

    •  Not clear ACA resulted in $1500 in savings (0+ / 0-)

      due to all the other changes in insurance ACA causes, as ACA policies change the cost of insurance for the employer.

      There is no "with ACA" Vs "without ACA" in this analysis.  The analysis assumes ACA in effect under all scenarios.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 01:27:34 PM PDT

      [ Parent ]

    •  Considering how ACA subsidies are provided for (0+ / 0-)

      households with incomes less than $94,000/yr,  this problem should be extremely common for families where employers do not provide a subsidy for family members except in states where health insurance is inexpensive - as the out of pocket cost difference would be less in absolute dollars.

      Fundamentally, the problem occurs because the employer only subsidized the employee with no subsidy for the family members.  The government subsidies however apply to the employee and all family members.  So if the employer provides an employee subsidy, the employee's insurance qualifies for being "affordable" and the family members becomes ineligible for government subsidies.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 01:42:57 PM PDT

      [ Parent ]

      •  That's the problem with opposing a bill (0+ / 0-)

        because of hypothetical cases.  Who knows if such impacts will be felt.  In the meantime, where the exchanges have already opened, no such REAL cases have come to the forefront. Hypothetical cases don't sway me against ACA.  And so far, the scare tactics from the right have been nothing but hypothetical.  Give me something real to oppose it on, and I may change my mind.  But a case where a family might get $1500 a year extra in their pocket doesn't do it.

        If employers stop offering subsidized insurance to their employees because it behooves them to do so, I'm all for it.   Healthcare should have never been tied to employment to begin with.  

        If 30 million gain access to healthcare, it's a good bill to me. The goal for me is Universal healthcare for all, ACA is just a stepping stone we need to get there.  

        We are all in this together.

        by htowngenie on Tue Aug 20, 2013 at 02:00:54 PM PDT

        [ Parent ]

        •  It's likely real for my family. (6+ / 0-)

          The affordability ceiling of 9.5% applying only to the employee's policy premium is really a bad move.

          Support Small Business: Shop Kos Katalogue If you'd like to join the Motor City Kossacks, send me a Kosmail.

          by peregrine kate on Tue Aug 20, 2013 at 02:07:13 PM PDT

          [ Parent ]

          •  Wasn't this something that (0+ / 0-)

            was decided in court but wasn't the original intent of the ACA?(or maybe I'm confusing some other provision)

            "George RR Martin is not your bitch" ~~ Neil Gaiman

            by tardis10 on Tue Aug 20, 2013 at 02:22:43 PM PDT

            [ Parent ]

          •  I agree, it's not good, and you need to contact (0+ / 0-)

            your Congressperson about it if you are negatively impacted.  I have no doubt this may affect some people, but not NEGATIVELY.  They will still have employer based insurance.  Nothing changes for them.  So how will you be harmed?

            If you haven't visited your state exchange website yet, or you are not able to do the math yourself, try the Kaiser Family Foundation's calculator.  

            You might be surprised and end up saving $1500 a year like the family Mr. Wu imagines.  

            We are all in this together.

            by htowngenie on Tue Aug 20, 2013 at 02:52:19 PM PDT

            [ Parent ]

            •  When we are paying $1100 per month (2+ / 0-)
              Recommended by:
              tardis10, nextstep

              out of pocket for health insurance premiums (1 working person, 1 minor child, and 1 person on disability now receiving Medicare) then not being eligible for potentially cheaper and perhaps better coverage via an exchange is a negative consequence. $1500/year is not a negligible amount of money, especially given the medical bills we have.
              Yes, I've looked at the Kaiser site FWIW. The exchange info is not yet available for my state. How dare you be so condescending as to imply I have no idea what I'm talking about.

              Support Small Business: Shop Kos Katalogue If you'd like to join the Motor City Kossacks, send me a Kosmail.

              by peregrine kate on Tue Aug 20, 2013 at 03:35:35 PM PDT

              [ Parent ]

              •  I'm not condescending. (0+ / 0-)

                Don't want to pry, but how will you be harmed by ACA?  Maybe I can alleviate some of your fears since the anti-ACA crowd has been spreading scare stories that are false like the one in this diary.  I'm looking for a REAL case to convince me and welcome your input into the discussion.

                We are all in this together.

                by htowngenie on Tue Aug 20, 2013 at 04:07:57 PM PDT

                [ Parent ]

                •  I'm not harmed in that it won't be worse. (3+ / 0-)
                  Recommended by:
                  nextstep, tardis10, kareylou

                  But I'm not going to be helped.
                  Is it necessary for one's position to be worse to be disappointed by the shortcomings in the ACA? Surely you would not say that to someone who will not be covered by the ACA due to the Medicaid fiasco. They're no worse off than they were, having had no insurance before. But you're wrong if you think this is not a harm.
                  Am I an opponent of the ACA? No. It has been helpful already to many and may eventually help more. But as has been so often lamented, it is not as good as what we need, and it is not as good as we had been led to believe.
                  And by the way, simply asserting you're not being condescending doesn't make it so.

                  Support Small Business: Shop Kos Katalogue If you'd like to join the Motor City Kossacks, send me a Kosmail.

                  by peregrine kate on Tue Aug 20, 2013 at 04:17:41 PM PDT

                  [ Parent ]

                  •  Sorry if I offended you. (0+ / 0-)

                    I've re-read my comment.  Was it the math part that upset you?  I can see how that would offend someone. And I apologize, it wasn't necessary.  

                    I, too, am disappointed in the ACA but believe it will be the only means to move us forward to single payer.  

                    I am not sure I understand your comment about the medicaid fiasco, but I assume you are referring to states that did not accept expanded Medicaid.  I live in such a state - Texas.  And I am volunteering for Enroll America and have volunteered to work with the navigators at the non-profit in Houston.  My support of ACA doesn't mean that I do not lament the suffering, quite the contrary, it means I feel the suffering and see the suffering, and want to do everything in my power to get everyone access to affordable healthcare, regardless of how I feel about ACA.  

                    This diary did harm to ACA without merit, it was copied nearly word by word from the original.    

                    I hope your own personal story works out better for you, and I am confident it will.  

                    Peace

                    We are all in this together.

                    by htowngenie on Tue Aug 20, 2013 at 05:42:18 PM PDT

                    [ Parent ]

                    •  I appreciate your apology. (1+ / 0-)
                      Recommended by:
                      kareylou

                      It was in part the suggestion that I wasn't able to make the calculations which I found condescending. But also, within the bounds of the dialogue we were having, I found it patronizing that you would insist that I was wrong about the judgment I was placing on my own anticipated experience with the ACA.

                      I lost my job due to my serious illness just over 2.5 years ago, and with it my family's paid health insurance. We have been struggling for months as a result of a precipitous drop in household income, a similarly dramatic increase in medical expenses, and the need to pay $18,000/year for insurance for a family of three (until I qualified for Medicare). When all this started, we were yearning for January 2014 in the hope that at least some of this burden would be lifted. Unfortunately for us, it does not appear that it will be. This is not a miscalculation or a misreading on my part; I've been following carefully and I haven't seen anything to indicate I'm wrong.

                      Now, the hypothetical family that is used here to illustrate the ACA design flaws may well wind up $1500/year ahead of the game if the dependents get coverage on the exchange while the employee retains employer-sponsored health care. But I'm pretty confident that anyone in this situation would be frustrated that more relief is still so far away, when by rights it shouldn't be.

                      Yes, of course it will be helpful to all of us if the ACA also helps slow the insurance cost increases. I don't think I'm unusual, however, in looking at today's bills before I look at those a few years down the road. As you note, so many of us are already suffering; promising help at some later point doesn't often provide much comfort.

                      Will problems like these under discussion here be enough to advance the cause for Medicare for All? Maybe. Time will tell.

                      It is good to see that you are active with the effort to enroll people in programs available for the poor and uninsured in Texas. I salute your service. The final decision has not been made in my state, and there is some chance it will go in the right direction here. In any case, I hope that the backlash against the politicians who are willing to sacrifice people's lives for ideology will be fast and severe. But time will tell that too.

                      Peace

                      Support Small Business: Shop Kos Katalogue If you'd like to join the Motor City Kossacks, send me a Kosmail.

                      by peregrine kate on Tue Aug 20, 2013 at 06:54:46 PM PDT

                      [ Parent ]

                      •  I am sorry to hear that (1+ / 0-)
                        Recommended by:
                        peregrine kate

                        and I feel your pain.  Really I do.  I've been laid off before and I was sole insurance in my family (my husband was a self-employed musician).  Although, unlike you, I didn't have any medical needs, which was divine luck.  I worried about it constantly.  This was many years ago now.  

                        However, my own parents, 86 and 84, spend $6,000 of their own money each month on his nursing home expenses.  At this rate, their savings will run out when they are 99 and 97.  They may die before that happens but my mother frets about it each and everyday and lives like a hermit.  For people born during the depression who spent their lives working and saving just to see it all go this way is tragic.  

                        Our healthcare system is broken and I think about it constantly.  ACA is the only thing we have to latch onto at the moment and I have to go for it to alleviate the suffering and injustice I see until something better comes along.  

                        We are all in this together.

                        by htowngenie on Tue Aug 20, 2013 at 07:09:13 PM PDT

                        [ Parent ]

      •  I think it's a problem if the employee (2+ / 0-)
        Recommended by:
        nextstep, peregrine kate

        can't choose for him/herself to either elect the employer's plan or go with an ACA plan. And without a penalty.

        Have we discovered whether that much is allowable yet? Because depending on the employer, it may be better to choose the ACA exchange over your employer's group health plan.

  •  Seems to me that Wu's example is suspect (1+ / 0-)
    Recommended by:
    htowngenie
    Wu demonstrated the phenomenon with data from New York state's health insurance exchange and the hypothetical example of a family of four earning $50,000 per year. He assumed they were being offered, in the employer plan, insurance costing $13,646 annually for the entire family, and $4,788 annually for coverage for just the employee.
    So we have an apples - oranges issue right there.
    The employee has a family of four, but is only presently getting insurance for himself? That is somewhat unrealistic.
    In his scenario, the company paid 50 percent of the employee's premium for coverage, but nothing for the premiums for the rest of the family.
    As, frankly, is this proportionation of employer - employee contributions. It is typically the case that group health plans provide marginally more generous subsidies to single vs. family plans - but it rarely goes down to a flat subsidy by the employer, with no kicker to help defray the cost of the employee's total coverage.

    As for this suggestion:

    Our analysis suggests that employees and employers across the country should sit down and discuss the potential merits of discontinuing employer-sponsored plans
    that is completely hysterical.

    A well designed plan for a typical heterogenous population, within an existing larger employer actually offering subsidized health coverage using a cafeteria plan, would not be designed as Wu suggests. Moreover, it would be financially injurious to all, except the outlying example insured, to engage in the type of behavior Wu suggests - and that Mangan trumpets by headline as evidence of a failure in the law. I'd love to hear McCarter's FP views on this CNBC article, it sounds very much like a developing Obamacare myth.

    •  What would be the advantage to the employer (0+ / 0-)

      or employee to have health insurance for an employee and her  family give up the opportunity for government subsidies for family members?  This is especially the case when the employer subsidy is otherwise greater than the $2,000/employee penalty from ACA.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 03:42:57 PM PDT

      [ Parent ]

    •  You mis-read the CNBC article (0+ / 0-)

      In all cases, the employee and family have health insurance, not only for the employee as you wrote in your first PP.

       The article compares the different ways this can be done.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 03:55:48 PM PDT

      [ Parent ]

      •  I am certain it does not cover this (0+ / 0-)
        the different ways this can be done
        I am certain it is cherry picking a specific example - and having looked at the "study" on which this was based so did ValuePenguin, in all 3 examples they employed.

        I will grant that I did not scan the first paragraph I quote as intended - but I did not misread the entire article.

        •  The Article's example was to explain (0+ / 0-)

          some perverse effects when employer subsidies to an employee for health insurance results in the family becoming ineligible for government subsidies at great economic cost to the family.

          It could have been explained with equations, but that generally does not work well for most people.

          ACA provides significant government subsidies to families with household incomes below $94,000/yr (a large share of families), losing that entire benefit from ACA because of an employer subsidy (smaller than what ACA provides plus an adjustment for what ACA insurance Vs employer insurance costs) has an outcome most all advocates of ACA would not be happy with.

          The most important way to protect the environment is not to have more than one child.

          by nextstep on Tue Aug 20, 2013 at 04:46:10 PM PDT

          [ Parent ]

  •  There is also the whole issue of grandfathering (1+ / 0-)
    Recommended by:
    htowngenie

    of existing plans - the implications of which rather run counter to ValuePenguin's thesis - via KFF

    Employer plans that were in place on March 23, 2010, the date the new health reform law was enacted, are referred to as "grandfathered plans" and are subject to some of the new rules but exempt from others. Beginning on September 23, 2010, grandfathered employer plans are required to eliminate any lifetime limits on coverage and restrict any annual limits on coverage, eliminate pre-existing condition exclusions for children, and if the plan provides dependent coverage, extend that coverage to adult children up to age 26. Beginning in 2014, grandfathered employer plans will be required to eliminate any annual limits on coverage, eliminate pre-existing condition exclusions for adults, and limit waiting periods for coverage to no more than 90 days. Grandfathered employer plans will not, however, be required to alter their benefits to meet the new minimum benefit standards nor will they have to limit enrollee cost sharing or provide coverage for preventive services with no cost-sharing. In order to maintain its grandfathered status, a plan cannot reduce or eliminate benefits to treat particular conditions, increase employee cost-sharing (including deductibles, co-insurance, and co-payments) above certain thresholds, reduce the employer share of the premium cost, or change insurers. Once a plan loses its grandfathered status, it will have to comply with all the new rules.
    •  Very few grandfathered plans are being retained (0+ / 0-)

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Aug 20, 2013 at 03:35:12 PM PDT

      [ Parent ]

      •  If by very few you mean, at recent count (0+ / 0-)

        under a fifth.

        Which is still a large number of plans, considering we are speaking of prior existing employer-subsidized health coverage.

        It may affect nearly as many insured as those HHS is hoping to attract to the exchanges.

        Hardly chicken-feed.

        •  Or - per KFF - 36% of employees (1+ / 0-)
          Recommended by:
          nextstep

          via

          The percentage of covered workers enrolled in grandfathered health plans – those plans exempt from many provisions of the Affordable Care Act – declined to 36 percent of covered workers, from 48 percent in 2012 and 56 percent in 2011. This suggests employers made changes to their policies. The array of health benefits required under Obamacare is generally greater than under grandfathered plans.
          but, you know, still not chicken-feed.

          KFF link on this.

  •  Plagiarism alert? (1+ / 0-)
    Recommended by:
    htowngenie

    All of the data in this diary appears to come from the CNBC story that is cited for the first couple of block quotes, and quite a bit of the specific language does too.

    If one of my college freshmen writing students turned this in, I would (for a first offense) mark it "0" and make them do it over. That's my policy for what I assume is unintentional tracking and borrowing from another source without adequate attribution.

  •  Some Will Get Subsidies, Some Won't, That Is The (2+ / 0-)
    Recommended by:
    nextstep, htowngenie

    nature of how it works.

    A single person making more than around $45960 annually will not get a subsidy at all.  Those making less than around $45960 will get a subsidy of around $3000.

    Is that fair?  They could have done some proration around the cutoff so it isn't such a cliff, but that's how the chips fall at this point.

    I'm just glad that Obamacare will help slow down the cost of premiums for health insurance.  Seeing premiums rise by 12 to 20% or more per year prior to Obamacare was unsustainable for most people.

    "I think that gay marriage is something that should be between a man and a woman.” - Arnold Schwarzenegger 2003

    by kerplunk on Tue Aug 20, 2013 at 05:10:45 PM PDT

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