How to Protect Yourself From Obamacare

[TulsaRufnex]

That's a rather gross generalization that anyone who employs more than 50 employees is making six figures plus or isn't struggling already.  If they do make six figures plus, that's doesn't change that the business may already be marginally profitable and will become either a) less profitable or b) less competitive with their global counterparts or domestic counterparts with fewer than 50 employees when they raise prices to cover the cost of Obamacare.

Do you see a likelihood that someone with a workforce of 51 to 60 might find it necessary to cut payroll to remain under 50 employees?

Actually, you've been making gross generalizations about President Obama and Obamacare for years now...  

Let's first admit that there'd been a problem with rising healthcare costs and premiums that pre-dates the ACA by at least a decade.

And I believe it had already affected small businesses significantly more than larger ones.  When I worked full-time in management at a record store in the 90s, the Rose family was able to "self-insure" full-time employees outright (or close to outright).  I don't know the full details, and I know I'm generalizing and oversimplifying, but I believe the options available to small businesses (let's say 0 -100 employees) in the 90s were of less and less value during the 2000s due to rising health costs in general, while businesses with hundreds of employees got a bigger and bigger advantage over smaller businesses due their larger pool of insured full-time employees = bargaining power.  In the year 2001, I had a full time job with a medium-sized Chicago company that booked conventions that allowed me to take time off for my singing gigs, and they chose to deal with increasing costs by laying off half the Chicago office and started outsourcing alot of the work to Orlando... many of the remaining Chicago employees smelled a rat and took jobs with the competing small Chicago company that chose to treat their employees more fairly.  Guess which company is still in business?  I believe many of the loudest voices threatening to cut back on their employees and raise their prices (but can still afford a hefty advertising budget to market 2-million free pizzas?) will pay a steep price for not embracing the change from the unsustainable status quo...

Opinion: Health-care reform puts power of coverage back in small business owners' hands
By Kenneth Wisnefski
http://www.washingtonpost.com/blogs/on-small-business/post/opinion-health-care-reform-puts-power-of-coverage-back-in-small-business-owners-hands/2012/07/20/gJQAKVzSyW_blog.html

The bill is loaded with tax credits and incentives for small businesses to provide affordable health-care options to workers. These tax credits can benefit companies like ours by reducing our costs and therefore allowing us to reallocate funds to other key areas of the business.

The bill requires companies with more than 50 employees to provide health coverage to their workers by 2014. The leading reason small businesses have stopped offering coverage is that the average family premium for small business workers increased more than 120 percent in the last decade.

96 percent of businesses have fewer than 50 employees.  Of those firms with more than 50 employees, more than 96 percent already offer health insurance to their workers.  HHS says that less than 0.2 percent of employers will be hit with the requirement.  And, starting in 2014, firms with up to 100 employees will have access to state-based Small Business Health Options Program (SHOP) Exchanges, which are intended to increase competitive pressure on insurers and bring down costs.

Democrats may not be as strong an advocate for small business as Republicans claim to be, but I can guarantee you the dems don't want to piss off their small business contributors....  
https://docs.google.com/viewer?a=v&q=cache:kF4HAZRDXrMJ:housedocs.house.gov/energycommerce/SMALLBUSINESSES.pdf+&hl=en&gl=us&pid=bl&srcid=ADGEESh7ux-2jOvg7YMl0bywzNe9e8mQwzC1J2-I-bzh48hMC4upWUJJ4ebBuqqHr_KmBeBoCSJpJm220cJJHEu4rtPgxsVrr29Bydb7mHS5w_j0pj2NYd7I_0IaHRvW7luGHkXlZLJH&sig=AHIEtbQBJmYudfPetlbi3rZJRxNs6CcgRg

So, we're left with the 0.2 percent of employers who may find themselves in a situation in which it makes more financial sense for them to pay a $2,000 per year penalty?/tax? for each full-time employee in excess of 30 full-time employees than use insurance exchanges and offer their full time employees medical benefits.  Just as it may make more sense for me to pay the tax?/penalty? for not having mandatory medical insurance starting in 2014 simply because I had to make the excruciating, gut-wrenching decision that I cannot afford it.  Or maybe I should just sell my house?

And what of the discount retail/grocery and fast-food/restaurant industries that could be adversely affected?  Well, alot of them already benefit by having a majority of their employees who work part-time hours.  I mean, how many more employees can they move down to part-time?  These same businesses already benefit from a new system in which their younger employees under age 26 will not need coverage or the unchanged fact that oftentimes the full-time worker's spouse will have an employer who offers better benefits...

But please, embrace the old libertarian pseudo-capitalist status quo, and tell me more stories about "class warfare" when, prior to ACA, 50 million Americans had to "self-ration" their healthcare.  

[Townsend]

Fallin delays decision on Okla. health insurance exchange

http://okpolicy.org/in-the-know-fallin-delays-decision-on-health-exchange

Gov. Mary Fallin decided Friday to announce later whether Oklahoma will set up its own online health insurance exchange under the nation's federal health care law, leave the task to the federal government or share responsibility for the plan. Fallin spokesman Alex Weintz said the governor opted to delay her decision after the federal government pushed back until Dec. 14 what had been a Friday deadline for states to decide how people can shop for coverage. States can set up their own exchanges, have federal workers set one up or operate an exchange in partnership with the federal government.

To pass on Medicaid expansion would be cruel

According to the Oklahoma Policy Institute, Medicaid expansion would provide health insurance coverage to more than 100,000 low-income Oklahomans who would otherwise remain uninsured. Gov. Mary Fallin hasn't yet announced whether she'll support or oppose this expansion of Medicaid. As a medical social worker, I encounter the effects of Oklahomans having no access to health insurance. For uninsured individuals, having medical needs but no resources takes a toll on emotional and physical well-being. The uninsured have a tendency to delay seeking medical attention until symptoms are severe. This often results in costly emergency room visits, generating bills that go unpaid.

CDC report highlights Oklahoma's growing diabetes problem

Over a 15-year time period, Oklahoma saw the largest increase in its diabetes rate when compared to any other state in the nation, according to a Centers for Disease Control and Prevention report released Thursday. In 2010, 10 percent of adult Oklahoma residents were diabetic, compared with 3 percent in 1995, the report said. An Oklahoma diabetes expert said Thursday that while the state has a big problem with this disease, the 15-year-old estimates may have been too low, making the increase look too big. However, Oklahoma does have a growing diabetes problem.

Smoking laws in Oklahoma City, Tulsa are weak compared to many major cities

Oklahoma City and Tulsa are among six of the largest cities in the United States that have weak laws regarding secondhand smoke in public places, according to a federal government report released this week. Meanwhile, 30 of the 50 largest cities in the U.S. have provisions that prohibit smoking in any indoor area, including private workplaces, restaurants and bars, according to a Centers for Disease Control and Prevention study released this week. State and city leaders say the main reason Oklahoma City and Tulsa do not have their own secondhand smoke ordinances is because they're not allowed to. Oklahoma state law prohibits municipalities from making their smoking laws stricter than state law.

It looks like Oklahoma is going to be expensive to insure.

[Townsend]

Governor Mary Fallin Rejects State-Run Insurance Exchange



http://www.newson6.com/story/20138032/fallin-rejects-state-run-insurance-exchange

OKLAHOMA CITY - Governor Mary Fallin says Oklahoma will not establish a state-run health insurance exchange under the federal health care law or expand its Medicaid eligibility to provide coverage to thousands of low-income, uninsured citizens.
Fallin made the announcement Monday. The Republican governor says the exchange was "forced on the people of Oklahoma by the Obama administration."

It's now up to the federal government to set up the insurance exchange in Oklahoma.

The issue of complying with provisions of the federal health care law has been a politically difficult one for Fallin. Last year, the governor rejected $54 million in federal funding to set up a state-run exchange after bitter opposition from grass-roots activists and conservative members of the Republican-controlled Legislature.

So who's celebrating this decision?

[nathanm]

Someone didn't get the memo about not cutting off their nose to spite their face.

To be fair, now the part about Obamacare costing the state a bunch of money might actually come true. If she had accepted the federal money, the anti position would have been proven to be nonsense, at least regarding that claim.

[Townsend]

Someone didn't get the memo about not cutting off their nose to spite their face.

To be fair, now the part about Obamacare costing the state a bunch of money might actually come true. If she had accepted the federal money, the anti position would have been proven to be nonsense, at least regarding that claim.

So will this make sure multi-national companies will be rushing to set up businesses in Oklahoma?  We're all set?

[nathanm]

So will this make sure multi-national companies will be rushing to set up businesses in Oklahoma?  We're all set?

Who wouldn't want one of the least healthy workforces in the nation? (says the fat guy in between swigs of HFCS-water)

[Townsend]

More of the story:

Oklahoma Rejects State-Run Insurance Exchange

http://www.publicradiotulsa.org/post/oklahoma-rejects-state-run-insurance-exchange#.UKp1jTOoe5Z.facebook

OKLAHOMA CITY (AP) — Gov. Mary Fallin says Oklahoma will not establish a state-run health insurance exchange under the federal health care law or expand its Medicaid eligibility to provide coverage to thousands of low-income, uninsured citizens.

Fallin made the announcement Monday. The Republican governor says the exchange was "forced on the people of Oklahoma by the Obama administration."

It's now up to the federal government to set up the insurance exchange in Oklahoma.

The issue of complying with provisions of the federal health care law has been a politically difficult one for Fallin. Last year, the governor rejected $54 million in federal funding to set up a state-run exchange after bitter opposition from grass-roots activists and conservative members of the Republican-controlled Legislature.

Below is the statement released from the Governor's office:

Governor Mary Fallin today released the following statement announcing that Oklahoma will not pursue the creation of a state-based exchange or participate in the Medicaid expansion in the Patient Protection and Affordable Care Act (PPACA):

"For the past few months, my staff and I have worked with other lawmakers, Oklahoma stakeholders and health care experts across the country to determine the best course of action for Oklahoma in regards to both the creation of a health insurance exchange and the expansion of Medicaid under the Affordable Care Act. Our priority has been to ascertain what can be done to increase quality and access to health care, contain costs, and do so without placing an undue burden on taxpayers or the state. As I have stated many times before, it is my firm belief that PPACA fails to further these goals, and will in fact decrease the quality of health care across the United States while contributing to the nation's growing deficit crisis.

"Despite my ongoing opposition to the federal health care law, the state of Oklahoma is legally obligated to either build an exchange that is PPACA compliant and approved by the Obama Administration, or to default to an exchange run by the federal government. This choice has been forced on the people of Oklahoma by the Obama Administration in spite of the fact that voters have overwhelmingly expressed their opposition to the federal health care law through their support of State Question 756, a constitutional amendment prohibiting the implementation of key components of PPACA.

"After careful consideration, I have today informed U.S. Secretary of Health Kathleen Sebelius that Oklahoma will not pursue the creation of its own health insurance exchange. Any exchange that is PPACA compliant will necessarily be 'state-run' in name only and would require Oklahoma resources, staff and tax dollars to implement. It does not benefit Oklahoma taxpayers to actively support and fund a new government program that will ultimately be under the control of the federal government, that is opposed by a clear majority of Oklahomans, and that will further the implementation of a law that threatens to erode both the quality of American health care and the fiscal stability of the nation.

"Furthermore, I have also decided that Oklahoma will not be participating in the Obama Administration's proposed expansion of Medicaid. Such an expansion would be unaffordable, costing the state of Oklahoma up to $475 million between now and 2020, with escalating annual expenses in subsequent years. It would also further Oklahoma's reliance on federal money that may or may not be available in the future given the dire fiscal problems facing the federal government. On a state level, massive new costs associated with Medicaid expansion would require cuts to important government priorities such as education and public safety. Furthermore, the proposed Medicaid expansion offers no meaningful reform to a massive entitlement program already contributing to the out-of-control spending of the federal government.

"Moving forward, the state of Oklahoma will pursue two actions simultaneously. The first will be to continue our support for Oklahoma Attorney General Scott Pruitt's ongoing legal challenge of PPACA. General Pruitt's lawsuit raises different Constitutional questions than previous legal challenges, and both he and I remain optimistic that Oklahoma's challenge can succeed.

"Our second and equally important task will be to pursue state-based solutions that improve health outcomes and contain costs for Oklahoma families. Serious reform, for instance, should be pursued in the area of Medicaid and public health, where effective chronic disease prevention and management programs could address the trend of skyrocketing medical bills linked to avoidable hospital and emergency room visits. I look forward to working with legislative leaders and lawmakers in both parties to pursue Oklahoma health care solutions for Oklahoma families."

[RecycleMichael]

"Such an expansion would be unaffordable, costing the state of Oklahoma up to $475 million between now and 2020"

$475 million divided by 7 years divided by 3,791,508 Oklahomans equals $17.90 per year per Oklahoman.

$1.50 a month per Oklahoman.

[Townsend]

STATEMENT: Governor's decision not to join Medicaid expansion is deeply troubling

http://okpolicy.org/statement-governors-decision-not-to-join-medicaid-expansion-is-deeply-troubling

Oklahoma Policy Institute Director David Blatt released the following statement in response to Governor Fallin's decision not to join the Medicaid expansion under the Affordable Care Act:

Governor Fallin's decision not to expand the Medicaid program to cover uninsured low-income adults is deeply troubling and unfortunate, putting politics over the interests of Oklahomans. We are missing a vital opportunity to improve the health of our citizens, bolster the financial situation of our health care providers, and strengthen our state economy.

If we do not expand Medicaid, some 150,000 low-income uninsured Oklahomans will be stuck in a 'coverage crater', earning too little to qualify for subsidized coverage through the health insurance exchanges that the Affordable Care Act reserves for individuals earning between 100 and 400 percent of poverty. These Oklahomans will be denied coverage that we know ensures better access to health care services, less financial hardship, and better health outcomes.

Not expanding Medicaid also means that federal taxes paid by Oklahomans will be spent on health care in other states, not here in Oklahoma. Hospitals, community health centers, physicians, and other medical providers across Oklahoma will continue to absorb unnecessarily high levels of uncompensated care, while shifting costs to Oklahomans with insurance through higher charges and insurance premiums.

The Governor's statement suggests that Medicaid expansion would impose unmanageable costs on the state.  In reality, the expansion is a very favorable deal for Oklahoma. The federal government will pay 100 per cent of the cost for the first three years and ultimately 90 percent of the cost in 2020 and thereafter. The Oklahoma Health Care Authority estimates the state's share of Medicaid costs in 2020 at $28 – $37 million – an amount that is less than 0.5 percent of current state appropriations. In fact, Medicaid expansion could well save the state money, since Medicaid would pick up expenditures currently paid for with state-only dollars by the Department of Mental Health and Substance Abuse Services and Department of Corrections.

We fervently hope that in the coming months, the Governor will reconsider this decision, and along with legislative leaders, choose to do what is best for Oklahoma's citizens by expanding Medicaid for low-income adults.

[Red Arrow]

"Such an expansion would be unaffordable, costing the state of Oklahoma up to $475 million between now and 2020"
$475 million divided by 7 years divided by 3,791,508 Oklahomans equals $17.90 per year per Oklahoman.
$1.50 a month per Oklahoman.

How much per Oklahoman that would actually be paying?

[Hoss]

How much per Oklahoman that would actually be paying?

Probably just a dollar, since Oklahomans get 1.50 in federal money for each 1.00 of taxes submitted to the feds.

Wait..you know that makes Oklahoma?....

[nathanm]

The cigarette tax alone could pay for our share five times over, RA. You wouldn't have to pay a dime.

[Red Arrow]

Probably just a dollar, since Oklahomans get 1.50 in federal money for each 1.00 of taxes submitted to the feds.

I was just going by what RM posted.

"Such an expansion would be unaffordable, costing the state of Oklahoma up to $475 million between now and 2020"

Feel free to change RM's data as you see fit.

[Red Arrow]

The cigarette tax alone could pay for our share five times over, RA. You wouldn't have to pay a dime.

Where is that cigarette tax money going now that you would divert?

[nathanm]

Where is that cigarette tax money going now that you would divert?

Only about a third presently goes to health care or smoking cessation, despite the cigarette tax collections tripling in the last decade. I would expect that to be the other way around given the justifications for the increases. Instead, the original amount continues to be sent to the Building Bonds Sinking Fund as before, while half of the new collections go to the general fund and city/county governments, while a little under half of the increase goes to pay for the things that were claimed to be the reason for the increased taxes.

You can see the amounts of all the taxes OTC collected in FY2011-12 and how those receipts were apportioned in their annual report.