Employers get a delay in providing insurance

[ERhoosier]

So I'm covered by a large employer in CA.

If I retired within the next 12 months, I would just go apply for the CA exchange?

IOW, ACA as the trigger point for ER? Or maybe COBRA is a better option while we see how things shake out for the first year or two?

As I understand it, and I could well be mistaken or the rules could change, you could go from COBRA to an Exchange but not back again (even if within your COBRA time allowance). So best to be sure Exchange would serve you better, which is difficult to do at this point in most states.

 

[ERhoosier]

Huge impact. I go in and claim 140% FPL so I get virtually no co-pays and low deductible. At year end I find I am eligible for 390% plan. I have to pay increased premiums but I have still had low deductible and low co-pay. No crawl back provision that I am aware of.

Don't know how that really work out in practice. If Feds decide to charge you significant interest on setting up, it could be costly. Or more costly if they decided you deliberately falsified income & decided to charge fraud.

 

[Which Roger]

As I understand it, and I could well be mistaken or the rules could change, you could go from COBRA to an Exchange but not back again (even if within your COBRA time allowance). So best to be sure Exchange would serve you better, which is difficult to do at this point in most states.

I plan on starting with COBRA later this year and sticking with it a while to see how things play out with the exchanges. Might cost me more in the short run, but leaves more options open.

 

[harley]

I agree. No foot-dragging or excuses. No "Oops, this is hard." Implement exactly what Congress passed on the timeline they specified so we can all see how this works.

They can't. They still haven't read it.

 

[samclem]

An interesting take (link) on some of the (predictable) IT issues that may be part of the reasons for the delay in the employer mandate. And the relative importance of various functions of the law as viewed by various constituencies.

As the law (and all the wonks) had described them, the exchanges needed real-time data from the IRS, in order to calculate whether purchasers were eligible for subsidies, and how big those subsidies should be. In order to determine subsidy eligibility, they also needed to know whether your employer had offered you health coverage costing no more than about 10% of your family income, as they were required to by law (and subject to a fine if they didn’t). Only those who couldn’t get affordable employer coverage were eligible to purchase subsidized insurance on the exchange.
That’s two sets of big, secure databases that needed to be hooked into just for the subsidy part. One of them had to be created from scratch, and it wasn’t clear to me that the IRS was ready to deliver real-time payroll data, either.
Then there was supposed to be some sort of hook into the state Medicaid systems, for those below 133% of the poverty line. There was also, of course, the part where insurers sell you insurance. That seems like an enormous project all by itself.

and

It turns out we were all missing something. I was right that the administration could not possibly implement the exchanges that had been described when selling the law, described in the law itself, and described by all the wonks who supported the law after we passed it and found out what was in it. But I was wrong that the administration viewed this as an essential part of “getting the exchanges up and running on time”. Instead, they were going to start jettisoning large chunks of what they’d promised.

. . .
In one view, Obamacare really has only one feature: putting as many people as possible onto the insurance rolls. As long as you’re doing that, nothing else matters–not cost control, not fraud prevention, not the words in the Patient Protection and Affordable Care Act. Take them away and Obamacare still exists, as long as there are exchanges with subsidies.

Things will get a lot clearer, for ER types and those still working, once there's more info on how this implementation is supposed to proceed with big hunks ripped out of it.

 

[bUU]

In one view, Obamacare really has only one feature

This conclusion is rabidly partisan. The core of ACA isn't just the subsidies. Rather, the core of ACA includes Guaranteed Issue and renewal (folks with preexisting conditions aren't kicked to the curb, nor are folks who exceed a lifetime cap); Community Rating (insurers cannot evade Guaranteed Issue by charging excessively unaffordable rates); Rate Review and Medical Loss Ratio (insurers cannot garner windfall profits, but rather have to return profits in excess of a community standard to subscribers); Essential Benefits and Exchanges (insurance products standardized so consumers can do price comparisons, and insurers offering insurance through a marketplace where consumer can pick and choose between available alternatives). The subsidy is just one portion of ACA.

 

[samclem]

In one view, Obamacare really has only one feature: putting as many people as possible onto the insurance rolls

This conclusion is rabidly partisan.

Well, maybe that's why the author specified that it was "one view." And, the law itself was "radically partisan"--that's not a political opinion on my part, it's a straight objective reporting of the vote count in Congress.

Portions of the law are being stripped away during implementation--maybe temporarily. Some of the changes (like elimination of the employer mandate) are expected to increase the number of people being added to the insurance exchanges/government insurance. None of the changes are expected to decrease the loading of people into the exchanges. I suppose people are drawing their conclusions based on what they are seeing.

 

[bUU]

ACA stopped being partisan the day it was passed, and that was affirmed the day that the SCOTUS ruled. As MichaelB has said in the past, it is now the law of the land and our focus is to be on what it is and how best to operate within it. Claiming that ACA has one feature is counter-productive to promulgating the message about all the features that it actually does provide.

 

[Texas Proud]

ACA stopped being partisan the day it was passed, and that was affirmed the day that the SCOTUS ruled. As MichaelB has said in the past, it is now the law of the land and our focus is to be on what it is and how best to operate within it. Claiming that ACA has one feature is counter-productive to promulgating the message about all the features that it actually does provide.

I am not trying to get a back and forth going that might bring on the pig... but just because a law is passed and is the law of the land does not change if it is partisan or not...

There are a lot of partisan laws on the books that have been upheld by SCOTUS...

Yes, it is the law of the land.... and it should be followed as written... I think the point that people are making is that it is not... and the people that are making those decisions were the people who pushed it through...

 

[Bestwifeever]

Thanks for yet another lively discussion, everyone!

Porky Pig Cartoon Ending "That's All Folks!" - YouTube