Skip to comments.“Bare-bones” employer health insurance plans coming thanks to #ObamaCare
Posted on 05/22/2013 3:23:15 AM PDT by 2ndDivisionVet
The Wall Street Journal reports on what National Review Onlines Veronique de Rugy calls one more in the law of unintended consequences to the implementation of our Presidents signature law ObamaCare (via Memeorandum -bolded emphasis added by me):
"Employers are increasingly recognizing they may be able to avoid certain penalties under the federal health law by offering very limited plans that can lack key benefits such as hospital coverage.
Benefits advisers and insurance brokersbucking a commonly held expectation that the law would broadly enrich benefitsare pitching these low-benefit plans around the country. They cover minimal requirements such as preventive services, but often little more. Some of the plans wouldnt cover surgery, X-rays or prenatal care at all. Others will be paired with limited packages to cover additional services, for instance, $100 a day for a hospital visit.
Federal officials say this type of plan, in concept, would appear to qualify as acceptable minimum coverage under the law, and let most employers avoid an across-the-workforce $2,000-per-worker penalty for firms that offer nothing. Employers could still face other penalties they anticipate would be far less costly.
It is unclear how many employers will adopt the strategy, but a handful of companies have signed on and an industry is sprouting around the tactic. More than a dozen brokers and benefit-administrators in 10 states said they were discussing the strategy with their clients.
There had to be a way out of the penalty for employers with low-wage workers, said Todd Dorton, a consultant and broker for Gallagher Benefit Services Inc., a unit of Arthur J. Gallagher & Co., who has enrolled several employers in the limited plans.
Pan-American Life Insurance Group Inc. has promoted a package including bare-bones plans, according to brokers in California, Kansas and other states and company documents. Carlo Mulvenna, an executive at New Orleans-based Pan-American, confirmed the firm is developing these types of products, and said it would adjust them as regulators clarify the law.
The idea that such plans would be allowable under the law has emerged only recently. Some benefits advisers still feel they could face regulatory uncertainty. The law requires employers with 50 or more workers to offer coverage to their workers or pay a penalty. Many employers and benefits experts have understood the rules to require robust insurance, covering a list of essential benefits such as mental-health services and a high percentage of workers overall costs. Many employers, particularly in low-wage industries, worry about whether theyor their workerscan afford it.
But a close reading of the rules makes it clear that those mandates affect only plans sponsored by insurers that are sold to small businesses and individuals, federal officials confirm. That affects only about 30 million of the more than 160 million people with private insurance, including 19 million people covered by employers, according to a Citigroup Inc. report. Larger employers, generally with more than 50 workers, need cover only preventive services, without a lifetime or annual dollar-value limit, in order to avoid the across-the-workforce penalty."
What.a.surprise. Not. Hate to say Toldjah So but in this instance its well-worth reminding people. Heck, most of us Toldjah So with respect to this law long before it passed via lots of strong-arming and the backroom arm twisting and political promises that candidate Obama, when first running for the highest office in the land, told us he couldnt stand tactics he would seek to change. Riiiight.
All that glitters is not gold and, in fact, you didnt even have to read the fine print in the Affordable Care Act to figure out what a monstrous, disastrous, unhealthy law this was for our nation and its people. Hours are being cut, full time employee status types are changing to part time, jobs are being lost, employer plan coverages all across the country are changing to either being unaffordable or worthless to the average workaday Jane and Joe, and no in many instances people have NOT been able to KEEP THEIR PRIMARY CARE PHYSICIANS as a result of the passage of this law one of the biggest whoppers told about this bill early on by its proponents. Employer health plan offerings as we know them are changing and not for the better. This is, of course, in keeping with our President and his partys ultimate goal: single payer health care coverage.
You got what you asked for, 51%. Too bad the rest of us have to suffer long-term for your woefully ill-informed decision to not only vote our celebrity President in the first time, but also for being clueless enough to turn around and do it again.
Will they ever learn?
Yeah, it doesn’t cover any of that stuff, but we are forced to purchase contraception/abortifacient coverage that we don’t want, cannot use, and isn’t medical care.
This isn’t all bad. The sooner people start paying for their own health care the sooner prices and practice will become reasonable.
You must not yet be at the stage of life where a lengthy hospital stay becomes more of a possibility, and would bankrupt even individuals with decent assets and savings.
Yeah, it's called a free market. You want medical treatment, pay out of pocket, or buy insurance if you think you won't be able to afford a big ticket item. Or die. In a free market you get to buy or not. In fascism you are threatened with fines and jail if you fail to pay the government-industry complex.
Color me mucho skeptical
My guess is many Americans will end up paying for both Obamacare and out-of-pocket care. In order to get decent healthcare they will be forced to pay out of their own pockets. Meanwhile, they will be forced in to Obamacare where the money paid provides care to illegal immigrants, welfare Moms and shot up drug dealers.
I’m almost there, but we can’t go on with medical costs going up %10 a year. The reason we’re in this mess is having too many people purchasing medical care with other people’s money. It has too stop somewhere and I’m willing to suffer to do that.
Paying for Health care that does not include hospital stays or surgery is not paying for health care. It’s giving gravy money to Insurance Company’s.
It’s like buying car insurance that only covers a scratch and wont replace a fender.
“The sooner people start paying for their own health care the sooner prices and practice will become reasonable.”
You’re absolutely correct. medical infrastructure, much like higher education infrastructure, has been built around an endless supply of government money being available.
When the consumer must pay for it, they will go for best value to them and the system will necessarily collapse under the burden of it’s unsustainable weight.
It is, to be sure, a bit tough on the folks in need of the more advanced medical are in the interim, but over the long run, it’s the only way to get the best medical care for the most people for a reasonable cost.
The problem is the government promises that people have gotten used to hearing and believing.
Aligning services, facilities, and costs with peoples ability to pay for it themselves is the only way to assure a long-term medical capability. Somewhere in there some form of medical insurance factors in, but not the way people are used to it doing so now.
They want to promote death. That means fewer people they have to “insure.”
If my wife gets pregnant any time in the future, the chances are high that our child won’t get the same level of care we did when we were born over 30 years ago. To boot, the chance of my wife dying during delivery could be higher than the last 30 years, as evidenced by the increase of both infant mortality and perinatal complications in women over in the UK under their disgusting system.
Cut out all the coverage except catastrophic care, pay less for less coverage, and Obama and the Democrats will crow that they “brought down the cost of health care”.....very shrewd of them. Better start saving up for those tens of thousands of charges now if you have to go to the hospital for something extremely serious.
ObamaCare will put the nail in coffin of the fake economic recovery that Wall St. and ObamaBots have been touting since June 2009.
“You got what you asked for, 51%. Too bad the rest of us have to suffer long-term for your woefully ill-informed decision to not only vote our celebrity President in the first time, but also for being clueless enough to turn around and do it again.”
I actually think the election was stolen the second time...that I am convinced of with the IRS scandal. The celebrity presidork will impose his hate on us, even if it means our complete demise.
Had a patient show up in the ER yesterday DEMANDING an MRI of her neck. Has a chronic condition, recently got a little worse, but nothing emergent. NO insurance, followed by an orthopedic surgeon. Told her to go to her ortho and have it arranged. “ I don’t have the money so I came here”. People thing everything we do in the ER is free, and an entitlement. I am sick of seeing people who are demanding, want care, free medicine, a meal, and a damn cab ride home, treat the staff like their servants and don’t pay us a fricking penny. The sick part is the idiot hospital caters to it, terrified it’s “patient satisfaction” numbers will suffer if we don’t provide it all. Thank God I am at the tail end of my career, and knock on wood I have an escape hatch for the next two years....
That same model already exists in Europe, India and other places with “socialized” medicine. The public facilities are abysmal. The private ones where you pay for care out of pocket rival American private hospitals.
Let's look at this from a different perspective - one that I consider the right perspective, even though it is rarely articulated.
Accepting your number that medical costs are going up 10% per year, that is a VERY good thing if we are getting what we pay for. Look at the economy as a whole, and imagine it is growing at 2% per year real growth with medical costs 20% of the economy. What is the best place to spend that extra wealth?
Should we spend that extra money on more trinkets from China?
Should we spend that extra money on more restaurant meals with larger portions and double desserts?
Personally, I think the best possible place to spend that money, where I would choose to spend that money from my own wallet, is on improved medical care.
We are not spending a lot more for the same checkup on the sniffles. We are in most cases spending a lot more for medicines that treat conditions that used to require surgery. We are in most cases spending a lot more for surgeries that treat conditions that used to be crippling or fatal. We are in most cases spending a lot more for devices that allow my father to remain mobile despite his knee damage in Korea, and allow my mother to see despite a condition that would have blinded her just a decade ago. That is a VERY good use of our money. What ObamaCare will do is stifle that innovation, so that we will find few new treatments, just cheaper alternatives to existing treatments. I rather like the idea of curing conditions that are currently crippling or fatal, and I'm willing to pay more to get more.
There are areas where medical effort is being wasted and costs are non-productive, but they are mostly due to excessive government intrusion or perverse insurance incentives. If we can reform malpractice - get rid of the frivolous lawsuits - we can cut the wasteful medical spending. If we can reduce the frivolous record keeping requirements, we can cut wasteful spending. If we can return to insurance as coverage for major, unexpected expenses instead of comprehensive coverage of sniffles check ups, birth control for party girls, and any other service on demand, consumers will have an incentive to control costs. But the idea that more government involvement will improve quality and cut costs strikes me as optimistic to the point of absurdity.
> You must not yet be at the stage of life where a lengthy hospital stay becomes more of a possibility, and would bankrupt even individuals with decent assets and savings.
Definitely one of the scarier aspects of life when you start getting up in years and realize its not a matter of if but when. I have seen friends of mine have one heart attack eat up their savings up in one fell swoop even when they had healthcare coverage. To imagine that you spent all those years savings and then BAM gone. Your backup funds out the door. It’s very scary.
When my doctor gave me the news last October, it was a "holy $hit" moment. It was the kick in the rear that I needed.
My next followup is in 2-3 weeks. My goal is to get the cholesterol down to where I no longer need medication (Crestor). I was on diabetes medication for 3 months, but that was no longer needed after I made significant changes in diet and exercise.
For my birthday two weeks ago, my daughter included a few pictures of me from Father's Day 2012, as well as a few more recent photos. The comparison was striking: I looked like the Pillsbury Doughboy before I changed. I'm not there yet, my goal is to get down to 180, about my weight when I was in my 20s.
I do cross fit. Trust me it gets you into shape and wears you out. Plus I do about 15 - 20 miles a week walking and/or jogging. It knocked about 30 lbs off me and my wife irsnt want me to lose anymore though I’d like to take another 10 - 15 off...
I thought the only plans available were the ones that included coverage of things mandated by Obama?
I feel for you and the other physicians who are having their careers ruined by this law.
Some years ago my grand nephew was intent on becoming a doctor, but because his finely-tuned political antennae told him that there was a good chance that we would have socialized medicine in the near future, he changed his mind and became an engineer instead.
Yes, but they apparently only mandated the stuff that they were concerned about and didn’t mandate that insurance remain as it is. Letter of the law. Must have free mammograms and contraception. No law says they have to pay for hospitalization.
And yes, it is illegal to just have a high-deductible catastrophic insurance plan. It must cover all the free stuff.
That is not going to happen, it is not a free market with obamacare, Medicare, Medicaid etc... Prices will continue to climb.
Move to Cuba. You’ll get the socialized medicine you are asking for.
What sort of blooming idiot are you? Employers dropping hospitalization is under discussion, which is a direct result of Obamacare.
If employers reduce benefits they’ll lose their best employees to companies that don’t. Basic capitalism. Maybe you “feel” that people should just sit and take it, and be happy with whatever?
Sounds pretty socialist of you. So, you move to Cuba. You’ll find what you’re looking for through the haze of your confusion.
Accepting your number that medical costs are going up 10% per year, that is a VERY good thing if we are getting what we pay for.
Only for those who can pay, besides, most of the increase goes to lawyers and other parasites.
It’s not just the government money, even insurance takes away the emphasis on getting good value for medical payments.
Maybe you are unaware that the whole employer-supplied health insurance thing is an unintended consequence of tax law changes in the Fifties. I stand behind my comment: pay for your healthcare, or move to a country where the government will steal at gunpoint from your fellow citizens to pay for you.
You are bombastic, ignorant and proud of it. Compensation is compensation, whatever the form. Reduce it, lose good employees.
You’re working a temp job with no benefits and resent anyone else having them, I take it? How Soviet of you. Them’s Russians now, by the way.
Okay, I’ll humor you: you can work for me. I will pay you a basic salary and I will “pay for” your health insurance on top of it; or, I can allow you to buy it yourself, and I will pay you the money I would have spent on your insurance.
Which would you choose? It’s all the same to me.
You have identified one of the reasons the US healthcare system got to the crazy place it is.
Health benefits were not taxed as income.
So it became very common for employers to offer them.
Tying “healthcare” to employment broke the connection between cost and the actual consumer of the service.
I suggest you work your way up to paying for your own first.
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