How to Protect Yourself From Obamacare

[heironymouspasparagus]

So far what I have learned from this thread is that premiums went way up for republicans and not so much for democrats.

That is some trick.

??

Mine went up $30 a month.  That's almost 10%....  won't be a biggie to pay that, but it seems like "way up" compared to other cost increases I have in life.  When I keep it in context to the coverage, and the possibility that we might need it, well, I don't complain too much.  Our annual medical costs (if paid for directly without insurance) have almost always been less - usually much less - than the total premium cost.  Even with the grandkid recently, it is still less.  I feel blessed for that - the doc never ceases to be amazed that I am not about to die of something - and look at it as paying that money to not have medical issues. 

It IS a whole lot more than car insurance and house insurance...combined.  One car and the house is about 1/3 of that annual cost.  But I can replace those things relatively cheaply - tougher to replace this old carcass without major expense.

[Gaspar]

So far what I have learned from this thread is that premiums went way up for republicans and not so much for democrats.

That is some trick.

Not really Dem/Repub.  Most everyone I know has seen a rather significant increase and/or reduction of service.  The cost of low end plans has remained relatively stable because they already have high deductibles and limited options.  My company likes to provide employees with the best plan available from the provider and then pays 50% (typical for many companies).  Two years ago when Prudential pulled out, we were transitioned into United.  They increased our deductibles and co-pays for essentially the same coverage and doctor network.  The rep at that time cited the anticipated cost of compliance as a reason for the changes.  Last year when United stopped offering our plan we were left with BSBC.  I like their coverage and service, but they are significantly higher on deductible and co-pay if you want to get the monthly fee down.  To soften the blow my employer pays each employee an additional cash bonus each year of $500 to be dedicated to medical expenses.

Basically the difference you see is not Repup vs. Dem, because we have a few Dems that work for us.  I also have many friends and clients that are small business owners with both full and part time staff, some are even still Democrats. Each and every one has cited increases in their plans, and most (anyone who did not have BCBS to begin with) have had to switch companies as the competitive landscape shrinks in the face of increased regulation. 

If you actually read the articles that Swake proudly posted, the "slow growth" of insurance price increases back in March was due to continued high unemployment, a slow economy, and fewer employers participating in health plans.  Not really much of a victory.  Yey! No one has to pay more for insurance because they are unemployed!

I don't have many friends that work for the government, unions or similar sectors, so I can't comment on how the protected labor sectors have been affected so far, but they have secured many wavers and have the negotiating power to better protect their folks.  It's really just the small business person and their employees that suffer.

[Conan71]

RM- I do believe the three who are saying premiums didn't increase that much work for larger employers.  No one seems to mention if it's their personal share of the premium which has gone up or the premium that the company pays on their behalf.  Personally, I only pay for my dependent coverage, mine has been completely comped by the company since my fifth anniversary with the company. That was a long-standing policy of the company for years but is being phased out due to the costs. /edit: fortunately, those of us who already have this benefit are grandfathered in.

Assuming that larger corporations likely have had lower overall premium increases since they are a big catch and bring in a larger pool of premiums.

A small company like ours brings 12 insureds and their dependents to the table.  Increases are simply the reality for small businesses and has nothing to do with "people not knowing what they are doing" as Sheen claims.

[Cats Cats Cats]

RM- I do believe the three who are saying premiums didn't increase that much work for larger employers.  No one seems to mention if it's their personal share of the premium which has gone up or the premium that the company pays on their behalf.  Personally, I only pay for my dependent coverage, mine has been completely comped by the company since my fifth anniversary with the company. That was a long-standing policy of the company for years but is being phased out due to the costs.

Assuming that larger corporations Larger companies likely have had lower overall premium increases since they are a big catch and bring in a larger pool of premiums.

A small company like ours brings 12 insureds and their dependents to the table.  Increases are simply the reality for small businesses and has nothing to do with "people not knowing what they are doing" as Sheen claims.

Sounds like there needs to be a larger pool that you could buy into like the bigger businesses to keep your premiums lower.

[Conan71]

Health insurance premiums this year were expected to be about 5% up from last year. That growth rate was projected as a 15 year low.
http://www.forbes.com/sites/brucejapsen/2013/03/07/health-costs-slow-to-lowest-rate-in-15-years-as-employer-commitment-to-benefits-wanes/

This despite an increase in benefits by removing preexisting conditions, lifetime maximums and raising the age that children age out to 26.

Did you read this article? The only good news was in the headline.  Read on:

Employer health care costs slowed this year to a five percent increase, the slowest growth in 15 years, but just one in four companies say they are "very confident" they will offer medical benefits 10 years from now even as more costs are shifted to their workers, a new analysis shows.

A report linked here from benefits consulting firm Towers Watson and the National Business Group on Health, a coalition of large employers, said employers expect total costs for "active employees" to rise 5.1 percent in 2013 to $12,136. That compares to $11,457 in 2012.

The slowing of the rate of health care cost increases comes amid a sluggish economy and a period of high unemployment that has made it easier for companies to reduce benefits of their workers. And like other surveys, the Towers Watson report shows employers are continuing to shift the cost of the total premium onto their workers with the employee share of the costs rising to 37 percent this year from 34 percent in 2011.

The cost-shifting trend is expected to continue as employers wrestle with the uncertainty that lies ahead with the implementation of the Affordable Care Act, which will expand health benefits to millions of uninsured Americans via an expanded Medicaid program for the poor or through online exchanges where uninsured will buy government-subsidized private coverage.

"We expect employers to take more aggressive action, using emerging strategies to improve delivery, cost management and employee accountability," said Ron Fontanetta, senior health care consultant for Towers Watson.

As the health law is rolled out and uninsured individuals and small businesses turn to the online marketplaces known as "exchanges" to purchase their benefits, large employers are bracing to see how that may impact them.

Some employers are thinking about whether they will even offer benefits in the future. Just 26 percent, or about one in four employers in the survey, said they are "very confident that health care benefits will be offered by their organization 10 years from now," the report said.

The net result is those who end up paying a higher share of their premium costs or those who already have a catastrophic personal plan and now have to buy a more comprehensive plan is that money gets sucked out of the consumer economy.  That's yet one more reason I'm not an enthusiastic supporter of Obamacare.  I've been giving serious thought about shifting gears and doing something different in the next few years career-wise but losing employer-paid health benefits may well put a damper on that depending on what exchange costs are at that point.

I'm willing to admit, not near enough is known at this point as to what all the real costs will be to employers, employees, and the overall effects on the economy.  I'd hope I can look back two or three years from now and see that a lot of the predictions of even higher premium costs as more previously uninsurable risks enter the pool are wrong as well as deleterious effects on the economy.  I'm just not that optimistic that will happen given the realities of economics. 

[Conan71]

Sounds like there needs to be a larger pool that you could buy into like the bigger businesses to keep your premiums lower.

Unfortunately there isn't.  We work with a broker out of OKC who specializes in small business plans.  There are basically three insurers left serving Oklahoma so options are limited.  If Oklahoma were deemed a more lucrative market, I would assume we'd have 30+ companies clamoring for business.  That's what happens when competition shrinks: prices tend to go up.

Insurance companies won't treat smaller businesses as one large pool. It may also have to do with higher risk with smaller companies.  Being in the heat exchange fabrication and mechanical contracting business might not help us either as the risk for injury is greater and lets just say that the guys who work in the shop aren't exactly as health-conscious as I am these days.

I have a friend who is an actuary for BCBS, I'll quiz him about whether or not small businesses are deemed more of a risk than larger pools.

Other part I hadn't thought of is many large companies actually self-insure and have the plan managed and administrated by an insurance company.  At least a Fortune 500 company I used to work for did that.  I'm not sure how many are doing so these days and how much that has mitigated rising costs to the company since in reality, they pay your medical bill and pay a percentage for someone else to actually manage that, rather than the insurer taking on a lot of new risk.

[Cats Cats Cats]

Did you read this article? The only good news was in the headline.  Read on:

The net result is those who end up paying a higher share of their premium costs or those who already have a catastrophic personal plan and now have to buy a more comprehensive plan is that money gets sucked out of the consumer economy.  That's yet one more reason I'm not an enthusiastic supporter of Obamacare.  I've been giving serious thought about shifting gears and doing something different in the next few years career-wise but losing employer-paid health benefits may well put a damper on that depending on what exchange costs are at that point.

I'm willing to admit, not near enough is known at this point as to what all the real costs will be to employers, employees, and the overall effects on the economy.  I'd hope I can look back two or three years from now and see that a lot of the predictions of even higher premium costs as more previously uninsurable risks enter the pool are wrong as well as deleterious effects on the economy.  I'm just not that optimistic that will happen given the realities of economics.  

Some of the stuff you bolded.  25% of companies "are very confident they will offer medical benefits in 10 years?"  This doesn't have anything to do with ACA. It has been coming for quite a while. Is the ACA a great thing to point at and blame so they company doesn't take the heat?  Hell yes it is!  If there are any more healthcare laws passed closer to that time they will blame that one.  A great cost savings to the businesses.  They cut your insurance and then pay you 80% of what they were spending before in increased wages to compensate.  Then the next generation of workers will eventually not get the 80% increase in pay because they benefit wasn't there when they started.

[Cats Cats Cats]

Unfortunately there isn't.  We work with a broker out of OKC who specializes in small business plans.  There are basically three insurers left serving Oklahoma so options are limited.  If Oklahoma were deemed a more lucrative market, I would assume we'd have 30+ companies clamoring for business.  That's what happens when competition shrinks: prices tend to go up.

Insurance companies won't treat smaller businesses as one large pool. It may also have to do with higher risk with smaller companies.  Being in the heat exchange fabrication and mechanical contracting business might not help us either as the risk for injury is greater and lets just say that the guys who work in the shop aren't exactly as health-conscious as I am these days.

I have a friend who is an actuary for BCBS, I'll quiz him about whether or not small businesses are deemed more of a risk than larger pools.

Other part I hadn't thought of is many large companies actually self-insure and have the plan managed and administrated by an insurance company.  At least a Fortune 500 company I used to work for did that.  I'm not sure how many are doing so these days and how much that has mitigated rising costs to the company since in reality, they pay your medical bill and pay a percentage for someone else to actually manage that, rather than the insurer taking on a lot of new risk.

My company is self insured. To me since my company is self insured the full effects of the ACA should be very direct.  They did say the ACA cause rates to go up.  Those 22-26 year olds and pre-existing conditions will cost more.  Obviously it isn't much more than we have had in the past or  I would feel it.  But I think we need to see what 2015 brings.  They could be over or under estimating.

[Conan71]

Some of the stuff you bolded.  25% of companies "are very confident they will offer medical benefits in 10 years?"  This doesn't have anything to do with ACA.  It has been coming for quite a while.  A great cost savings to the businesses.  They cut your insurance and then pay you 80% of what they were spending before in increased wages to compensate.  Then the next generation of workers will eventually not get the 80% increase in pay because they benefit wasn't there when they started.

Care to cite something which shows ACA is not a factor in reduced benefits?

There's article upon article over the last three years which have shown that Obamacare is a factor in decreasing benefits to employees and their families.  The larger point is Obamacare was cited as a panacea for health insurance and it wasn't supposed to change a thing for those with coverage already.  That's simply not true.

Question: Are companies cutting employees' benefits because of Obamacare?
Answer: Yes

The simple answer is yes. But, this doesn't mean all companies are pulling back on employee benefits, and for those that are, Obamacare may not be the only reason for the cutbacks. So the explanation is two-fold.

This past spring, President Obama said that little will change for the 85% to 90% of Americans who already have health coverage. He said all that will change is that "their insurance is stronger, better, more secure than it was before."

But over the past few months, we've discovered that's actually not the case at a growing number of companies -- big and small.

Several employers, including UPS, Delta Air Lines, the University of Virginia, Trader Joe's, and Home Depot have announced changes to their employee benefits and cited Obamacare as the reason for the cutbacks on benefits.

The employer mandate only pertains to companies with at least 50 full-time workers. Those employers must offer coverage for full-time workers and dependents, and the plans must cost no more than 9.5% of a worker's income. By 2015, employers will have to contribute at least 50% of an employee's premium cost to receive tax credits in the new exchanges. If an employer with 50 or more workers does not offer its employees health coverage, or the coverage is not deemed sufficient under Obamacare, the company will be required to pay penalties. The company will be required to pay a fine per employee who's not covered, but the first 30 full-time workers are exempted, so smaller businesses that don't provide coverage will be burdened less than bigger businesses that don't provide coverage.

The law only pertains to full-time workers -- those who work an average of 30 or more hours a week -- which means some employers may cut worker hours below that 30-hour threshold to avoid the expense of providing health coverage. Workers who aren't provided coverage by their employers must purchase coverage through the new exchange in their state, or obtain an exemption.

As a result of these new requirements under Obamacare, some workers will not have coverage that's "better, more secure than it was before." UPS told employees that health reform is contributing a 4% increase to the cost of coverage for 2014, while health care inflation adds another 7.25% increase in costs. Delta said that Obamacare and inflation would increase costs by $100 million for the major airliner -- contributing $38 million to health reform. As a result, UPS said it's dropping coverage for employees' spouses who have access to coverage elsewhere. Delta said it will have to pass along some of its rising costs to employees. Plus, Home Depot and Trader Joe's announced they will drop part-time workers from their coverage.

The individual mandate will also impact employers. Since Americans are required to have coverage beginning January 1, 2014, many people who previously opted out of their employer-sponsored coverage will now enroll for coverage. Delta estimates this will add $14 million to its annual costs.

Part of the idea behind Obamacare was to maintain Americans' current health coverage as much as possible, increase consumer protections in the health insurance marketplace, reduce costs and to cover Americans who are currently uninsured. So although jobs will remain the most common source of coverage for Americans, people who work part-time, low-wage jobs or for smaller companies, are most likely to lose their employer-based coverage. They then must use the exchanges to purchase individual insurance.

But remember, only companies with 50 or more full-time workers are impacted by the employer mandate, so businesses smaller than that may not be impacted very much at all by the new reform (unless employees who previously opted out of the employer's coverage decide to opt in to meet their individual requirement). As of 2010, there were roughly 5.7 million small employers -- defined as those with fewer than 500 workers -- in the U.S. About 97% of them had fewer than 50 employees. That means Obamacare's employer mandate would apply only to 3% of America's small businesses. That's fewer than 200,000 companies.

So while it is true that Obamacare is raising costs on employers, health care reform isn't solely to blame. There are other factors increasing health care costs, such as the improving economy. When the economy is healthier, people typically use more medical care, and costs increase across the board.

Although many companies have announced cutbacks and shifting costs to employees, not all employers are planning to do the same. Starbucks' CEO Howard Schultz told CNN that Obamacare may raise the company's insurance costs, but Starbucks will not change its coverage.

http://www.hlntv.com/article/2013/10/01/obamacare-health-insurance-truth-company-benefits

Here's a list of employers both public and private who are cutting hours to 30 hours or less a week to avoid having to participate in Obamacare or at least limit their benefit costs.  The ACA is directly cited as the cause:

http://news.investors.com/politics-obamacare/100913-669013-obamacare-employer-mandate-a-list-of-cuts-to-work-hours-jobs.htm

[Cats Cats Cats]

The point you appeared to be trying to make from the bolded section was that because of Obamacare a lot of employers weren't going to offer insurance.

There are more articles like this and it is been going for a while.
http://usatoday30.usatoday.com/money/industries/insurance/2005-09-14-health-insurance_x.htm
http://accounting.smartpros.com/x49029.xml
"Shifting a greater share of spiraling healthcare costs to employees is a trend that is likely to continue"
Eventually that trend will be 100%.

I don't think we have enough information on how much more everything will cost next year. Based on the numbers now I don't think it will change the time table when my company decides to no longer provide subsidized health benefits. It still seems like even if we all paid 100% we would be better off than small businesses.

[Conan71]

The point you appeared to be trying to make from the bolded section was that because of Obamacare a lot of employers weren't going to offer insurance.

There are more articles like this and it is been going for a while.
http://usatoday30.usatoday.com/money/industries/insurance/2005-09-14-health-insurance_x.htm
http://accounting.smartpros.com/x49029.xml
"Shifting a greater share of spiraling healthcare costs to employees is a trend that is likely to continue"
Eventually that trend will be 100%.

I don't think we have enough information on how much more everything will cost next year. Based on the numbers now I don't think it will change the time table when my company decides to no longer provide subsidized health benefits. It still seems like even if we all paid 100% we would be better off than small businesses.

You quote two articles that pre-date enactment of ACA by five years to refute articles published three years after ACA was passed which spell out the reasons for employers making even more cuts to benefits?  Growing benefit costs have always been a detriment to employers.  Surprise! Eight years later, they still are! Specifically, employers are citing the ACA as a factor in cutting benefits.  What is so hard to accept about that?

If you recall, Obamacare was supposed to help get more employers on board.  It does not appear to be achieving this lofty goal.

[Cats Cats Cats]

You quote two articles that pre-date enactment of ACA by five years to refute articles published three years after ACA was passed which spell out the reasons for employers making even more cuts to benefits?  Growing benefit costs have always been a detriment to employers.  Surprise! Eight years later, they still are! Specifically, employers are citing the ACA as a factor in cutting benefits.  What is so hard to accept about that?

If you recall, Obamacare was supposed to help get more employers on board.  It does not appear to be achieving this lofty goal.

How else do you show that employers are trying to ween themselves out of the healthcare business prior to ACA? If it wasn't before Obama was elected they will just blame the ACA.  Employers like to act like the car salesman/manager bit. Your company is your friend and is looking out for you.  They want you to have sunshine and rainbows and be happy.  It's not them that you are negotiating with its the manager (ACA).  Its outside of their hands so you can't blame them.  So with that I agree that dropping your part time workers to less hours will save businesses money.  But I don't trust what businesses say about much else.  Because they want out and they have somebody to blame.

[heironymouspasparagus]

RM- I do believe the three who are saying premiums didn't increase that much work for larger employers.  No one seems to mention if it's their personal share of the premium which has gone up or the premium that the company pays on their behalf.  Personally, I only pay for my dependent coverage, mine has been completely comped by the company since my fifth anniversary with the company. That was a long-standing policy of the company for years but is being phased out due to the costs. /edit: fortunately, those of us who already have this benefit are grandfathered in.

I probably work for the biggest company of anyone here (unless someone is at Walmart - almost triple AMR).  It is my personal premium that went up just under 10%.  Could have been much worse, but they also have a health and wellness program that cuts one some slack if participate.  We self insure, so don't know how much the costs of that part have gone up.  Probably about the normal national rate.

[Hoss]

I probably work for the biggest company of anyone here (unless someone is at Walmart - almost triple AMR).  It is my personal premium that went up just under 10%.  Could have been much worse, but they also have a health and wellness program that cuts one some slack if participate.  We self insure, so don't know how much the costs of that part have gone up.  Probably about the normal national rate.

Hmm.  Sounds suspciously like where I work, but my company isn't extremely large.  Probably about 500 employees globally.  We self-insure and my premiums last year to this year increased about 3 percent.  Which is less of an increase than at my old place of employment.  We have a wellness program that does the same (actually cuts insurance nearly in half for participants).

[swake]

My company has about 3,000 employees and we have open enrollment going on now. There's no increase on employee contributions this year. None last year either. Aetna is the insurance company in Oklahoma but I think there are others in other states. I'm actually insured through my wife with BCBS. She works for one of the tribes with no increase that I know of. My company pays me enough to NOT be insured with them that it covers our cost of insurance on her plan. And her plan is better than mine. And it's not Aetna, which is always good.