Page 4 of 6 FirstFirst 123456 LastLast
Results 46 to 60 of 81

Thread: Professional Woodworkers and The Affordable Care Act

  1. #46
    Had a good friend of mine that has a decent job at a place that employs about 1000 people across the US tell me that they got the call from corporate last week. The company was paying for all their healthcare costs for them and their families. Not a bare bones plan, but a nice, good plan with low deductibles, etc. Company now says they have no choice but to stop paying for families because of the changes. If they continued to pay for the families under the new regulations, it would cause them to go out of business. The cost to cover a wife and 2 kids- $700 a month out of his pocket. So where his cost was zero before, it's now $8400 a year increase in his costs. If they don't do that and get it on the exchange, it's still a net increase, no matter what the cost will be. So it's not a matter of their plan was poor and it was being cancelled, it was a matter of the employer saying it was going to do grave financial harm to their company if they continued under the new requirements.

    There are a lot of people there with families. Lots of blue collar workers making $40,000 a year. How someone making $40,000 a year can take a $8400 increase in costs is beyond me. Those people are losing some really good healthcare insurance. I honestly don't know what most of them are going to do. They can't afford $8,400 a year more. Most of them can't afford $1000 a year more. $8,400 a year isn't "we can eat out less" money, that's "we can't pay the mortgage" money.
    Lasers : Trotec Speedy 300 75W, Trotec Speedy 300 80W, Galvo Fiber Laser 20W
    Printers : Mimaki UJF-6042 UV Flatbed Printer , HP Designjet L26500 61" Wide Format Latex Printer, Summa S140-T 48" Vinyl Plotter
    Router : ShopBot 48" x 96" CNC Router Rotary Engravers : (2) Xenetech XOT 16 x 25 Rotary Engravers

    Real name Steve but that name was taken on the forum. Used Middle name. Call me Steve or Scott, doesn't matter.

  2. #47
    Quote Originally Posted by John Sanford View Post

    From a practical standpoint, I question why they would use ZIP in HEALTH risk assessment. Age, sex, and tobacco use all make some sense. ZIP though? Not really, unless it's basically a form of reverse redlining, i.e., charge higher rates in the wealthier ZIP codes in order to mask subsidy collection.
    There is a true difference in claims costs by different geographies. I don't know why that is (if providers charge more, if utilization is higher, if general health is worse...), but I know that it exists because I've seen it for 15 years when costing future cash flows from different region. It's not like one region is twice as much as another, but it's plenty substantial enough to affect rates.

    If you think of the ratemaking items in insurance that are allowed, they are things you'd like to know so that if you were betting on your accuracy, you'd have a better chance. Geographic region is one of those things that is statistically significant.

  3. #48
    Join Date
    Jan 2008
    Location
    Western Nebraska
    Posts
    4,680
    Quote Originally Posted by Scott Shepherd View Post
    There are a lot of people there with families. Lots of blue collar workers making $40,000 a year. How someone making $40,000 a year can take a $8400 increase in costs is beyond me. Those people are losing some really good healthcare insurance. I honestly don't know what most of them are going to do. They can't afford $8,400 a year more. Most of them can't afford $1000 a year more. $8,400 a year isn't "we can eat out less" money, that's "we can't pay the mortgage" money.
    Scott, I think that the average Joe doesn't care one whit what the 80/20 rule is, they just know that the reality of the situation is that they now cannot afford insurance. This major flaw gets covered up so quickly in the discussion of details, that it gets ignored. Like it or not, the healthcare law doesn't look feasible with these kind of situations out there. I used my company earlier for an example. We have a one year window where we can get by without the rates going up, but the company cannot afford to pay double in 2015, and we will have to pull coverage at that point too. What else can we do?

  4. #49
    Quote Originally Posted by Scott Shepherd View Post
    There are a lot of people there with families. Lots of blue collar workers making $40,000 a year. How someone making $40,000 a year can take a $8400 increase in costs is beyond me.
    I think someone making 40k a year with two kids is going to get some subsidies, aren't they?

  5. #50
    Join Date
    Feb 2012
    Location
    Licking County, Ohio
    Posts
    135
    Quote Originally Posted by John Sanford View Post
    From a practical standpoint, I question why they would use ZIP in HEALTH risk assessment. Age, sex, and tobacco use all make some sense. ZIP though? Not really, unless it's basically a form of reverse redlining, i.e., charge higher rates in the wealthier ZIP codes in order to mask subsidy collection.
    I would argue that it's likely to result in LOWER costs in richer areas since they're lower risk to the insurer.

    Geographic location (ZIP code) is highly correlated with socioeconomic status. Socioeconomic status is highly correlated with several factors that affect what your total healthcare costs (to the insurer) are likely to be. To use a specific example local to me, if your ZIP code is 43016 (Dublin, Ohio) it's much more likely that you are a white collar worker and receive regular preventative medical care (both factors which lower total healthcare costs) than if your ZIP code is 43066 (rural Delaware County, Ohio) where you're probably either a farmer (PTO raises possibilities of injuries that result in your landing in more than one field at a time) or factory worker (which raises possibilities of you being crushed by a load of steel) and probably aren't as likely to seek preventative medical care. So those two locations would see very different healthcare profiles even though you can drive between them in 7-10 minutes.

    It's all based on actuarial tables, which do correlate to geographic location.

  6. #51
    Join Date
    Feb 2003
    Location
    Pleasant Grove, UT
    Posts
    1,503
    Quote Originally Posted by Ty Williams View Post
    I would argue that it's likely to result in LOWER costs in richer areas since they're lower risk to the insurer.

    Geographic location (ZIP code) is highly correlated with socioeconomic status. Socioeconomic status is highly correlated with several factors that affect what your total healthcare costs (to the insurer) are likely to be. To use a specific example local to me, if your ZIP code is 43016 (Dublin, Ohio) it's much more likely that you are a white collar worker and receive regular preventative medical care (both factors which lower total healthcare costs) than if your ZIP code is 43066 (rural Delaware County, Ohio) where you're probably either a farmer (PTO raises possibilities of injuries that result in your landing in more than one field at a time) or factory worker (which raises possibilities of you being crushed by a load of steel) and probably aren't as likely to seek preventative medical care. So those two locations would see very different healthcare profiles even though you can drive between them in 7-10 minutes.

    It's all based on actuarial tables, which do correlate to geographic location.
    Except your factory worker's injury is going to be covered under workman's comp, as quite possibly the farmer's injury will as well. Those are, for the moment, completely unaffected by PPACA, although there may very well be second order effects on those down the road.

    While I suspect that the ZIP info gathering is tied to socio-economic status, I'm just a bit too cynical anymore that think that it's only so that the insurer can properly rate the RISK. I think it's more a matter of rating the HOW MUCH THE MARKET CAN BEAR potential. Those higher risk, lower income areas aren't going to be paying for themselves, and since the plans themselves are already set up to have the young subsidize the old and men subsidize women, it wouldn't surprise me in the least to see some rich ZIP getting tapped for a lot more than their risk profile costs in order to subsidize poor ZIPs.
    It came to pass...
    "Curiosity is the ultimate power tool." - Roy Underhill
    The road IS the destination.

  7. #52
    Quote Originally Posted by Phil Thien View Post
    I think someone making 40k a year with two kids is going to get some subsidies, aren't they?
    They didn't need subsidies before, so someone that needed no subsidies by anyone else is now forced to enter a program that requires someone else pay for it?

    Forget it's $40,000 a year. Bump it to $80,000 a year. That's still a 10% cut in your pay. I'm don't know many people out there today than can take a 10% pay cut. Not blue collar workers, that's for sure.

    Not to mention that new plan they are forced into now has a $6000 deductible where they had a $1000 deductible before. Not to mention that their doctor who has been their family doctor since the kids were born is no longer an option to them. Really sad situation for a lot of people. Both my parents have lost their primary care doctors because of this. The doctors have opted to go in a different direction and if they want to remain patients, they have to have $1000's a year out of pocket. Telling a senior citizen with medical issues that they have now lost their primary care doctor isn't a desirable outcome in my opinion.
    Last edited by Scott Shepherd; 11-09-2013 at 8:27 AM.
    Lasers : Trotec Speedy 300 75W, Trotec Speedy 300 80W, Galvo Fiber Laser 20W
    Printers : Mimaki UJF-6042 UV Flatbed Printer , HP Designjet L26500 61" Wide Format Latex Printer, Summa S140-T 48" Vinyl Plotter
    Router : ShopBot 48" x 96" CNC Router Rotary Engravers : (2) Xenetech XOT 16 x 25 Rotary Engravers

    Real name Steve but that name was taken on the forum. Used Middle name. Call me Steve or Scott, doesn't matter.

  8. #53
    Quote Originally Posted by Ty Williams View Post
    I would argue that it's likely to result in LOWER costs in richer areas since they're lower risk to the insurer.

    Geographic location (ZIP code) is highly correlated with socioeconomic status. Socioeconomic status is highly correlated with several factors that affect what your total healthcare costs (to the insurer) are likely to be. To use a specific example local to me, if your ZIP code is 43016 (Dublin, Ohio) it's much more likely that you are a white collar worker and receive regular preventative medical care (both factors which lower total healthcare costs) than if your ZIP code is 43066 (rural Delaware County, Ohio) where you're probably either a farmer (PTO raises possibilities of injuries that result in your landing in more than one field at a time) or factory worker (which raises possibilities of you being crushed by a load of steel) and probably aren't as likely to seek preventative medical care. So those two locations would see very different healthcare profiles even though you can drive between them in 7-10 minutes.

    It's all based on actuarial tables, which do correlate to geographic location.
    Preventive medical care actually increases medical costs. I remember talking to some health actuaries when comments about cost were being made, and they said something along the lines of "that's absurd, the data shows higher costs with more preventive care. Don't you think the policies would cover more preventive care if it lowered claims?"

    As far as geographies go, the kaiser family foundation is a non-partisan foundation with excellent excellent data on all sorts of things. Here's a per capital expenditure list by state (keeping in mind that it is not normalized for age, or percentage employed, etc):
    http://kff.org/other/state-indicator...-capita/#table

    I would imagine there is some correlation between age and the chart, though it doesn't explain it all.

    http://www.statemaster.com/graph/peo...ple-median-age

    Aging top to bottom in this list is probably worth about a 15% difference.

    As far as occupations go, care costs are somewhat specific, especially after retirement. There's definitely a difference in expected lifetime, but there are some blue collar jobs where data doesn't seem to show that and some where it seems to show it very strongly. At least in some cases with those, the retiree and late-life employee health bears out that (think of construction trades, etc, that have been exposed to asbestos, etc, over their working lifetimes, working in confined spaces).

    I'm a big surprised how big the geographic component is above in kaiser's data vs. age is sort of surprising to me, but I'm used to seeing data mostly from the region where I live (I don't specifically work in health care and am no expert, just have contact with numbers at work).

    There may be coverage issues in some of those western states that have low average costs, and to some extent, the NY, Maine, PA area has very high levels of coverage - not just in numbers covered, but in the level of benefits such that it doesn't cost individuals as much to go get medical care.
    Last edited by David Weaver; 11-09-2013 at 9:29 AM.

  9. #54
    KFF.org's calculator says that the cost to the EE with a family of 4 and a 40k income would be limited to about $2k, and if they got the silver plan, would have an out of pocket limit of about $4500.

    IIRC, someone at 80,000 would also get a subsidy, but obviously not as much.

    Certainly there will be folks who are not as well off after all of the changes.

  10. #55
    Join Date
    Oct 2006
    Location
    Minneapolis, MN
    Posts
    5,427
    I'm wondering if employers aren't using ACA as an excuse to reduce healthcare costs. My employer is offering the same healthcare plans as they have since 2009 and the employee premiums are exactly the same for 2014 as they were for 2013.

    I don't quite understand what changes the ACA made that would cause an employer to go from covering 100% of a family plan to dropping coverage altogether. Why wouldn't they do something like cover 80% and have the employee cover the other 20%?

  11. #56
    If an employer didn't have qualifying coverage before, they could end up paying more, including more family coverage since the dependents stay on longer, etc.

    IF they have low income employees who go to the exchange because of subsidies, they end up paying a nondeductible excise tax for those individuals, and if their coverage isn't qualifying coverage, they pay the excise tax on all -30 if someone goes to the exchange.

    I think some just don't want to deal with providing coverage any longer if they can't control the costs. Since the excise tax is based on FT employees, it's easier to bring people below that line (30 hours), which we've seen.

    If you have an employer who provides generous coverage and always has, then it's more an issue that the employer believes that it's a priority in principle or an advantage to them for hiring and retention.

    Each employer probably has different reasons. Some received steep renewals, and there may be some correlation between renewals and desire to stop offering coverage.

  12. #57
    Join Date
    Dec 2008
    Location
    Northern Michigan
    Posts
    4,973
    I find it rather ironic that they call it the "Affordable Health Care Act", and then my premiums go up 42% for the same coverage. Affordable for who?

    I will no longer have full time employees, I lose money.

    Larry
    Last edited by Larry Edgerton; 11-09-2013 at 1:07 PM.

  13. #58
    Join Date
    Jul 2007
    Location
    CT
    Posts
    734
    Some companies are using the 2014 timing of the AFA and exchanges to just exit from the cost or hassle of providing employee medical insurance. Frankly, in many cases it is a no-win situation for a firm. I retired from IBM years ago and part of my retirement agreement was that IBM will always offer my spouse and I medical insurance at a company subsidized cost. IBM has over 100K retirees and each year they spent millions of dollars and management energy looking for multiple medical plans at various price points and features to offer to their retirees all over the country.

    This year, IBM threw in the towel and told all of its retirees to join a commercially sponsored "Medicare Exchange" (run by Towers Watson Co.). IBM sent all of the retired employee's subsidies to this firm and they offer all flavors of medicare policies (Supplemental, Advantage, Drug, Dental, Vision, etc). This firm maintains an "Exchange Website" (similar to the Government, but it works). I was able to find the same plan that IBM offered previously, so I am OK. My IBM subsidy is being applied against the policy cost. There will be winners and losers in this process.

    I spent much of my IBM career in Corporate Finance. For the most part, we self-insured our various insurance plans out of respect for the employees, but it cost us a fortune to administer, in addition to the actual insurance cost.

    I think that this Outsourcing will be the direction for providing insurance to active and retired employees in the future. The trend will be for companies to outsource the whole process to "Commercial Exchanges." Some employers will be honorable, such as IBM, and will continue to subsidize the cost. Other firms will use this opportunity to reduce their subsidies and perhaps blame it on the AFA.

    We'll see

  14. #59
    Reading this reminds me just how lucky I am to live where I do. I have to admit I don't understand the US system at all well but what I believed was you guys have to pay for medical care, over here we get "at source" deductions (that amount to very little) for employees and that's it...done...no matter how much it costs for anybody to be treated it's all paid in full. If a person is unemployed those payments are made for them by the government and they get the same level of healthcare.

    Here you can get private health care but all it really means is you see the same Doctors just have a shorter wait.

    When my late Mom broke her Femur she was given the exact same level of care as if she had been her Majesty Queen Elizabeth. (the British term, "treated like Royalty")

    Am I right to think over there the people who can least afford it will be hit the hardest?

    cheers

    Dave
    You did what !

  15. #60
    Not really. There's a limit on how much of your income will be spent for health care, and above that amount you are subsidized (under the new law). Under prior law, you had to spend your money until you were pretty much insolvent and then qualify for medicaid after that.

    The difference here is that generally health care has no wait. You'll get the same type of treatment your mother got even for basic routine services unless you live so rural that you have to travel for health care.

    But we sure do pay for it as a percentage of GDP, and for things like drugs, we subsidize the rest of the world.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •