Official Brief Comparison of House/Senate HC plans

Not quite sure if I follow you. It seems to me that an insurance company will payout more medical losses (in $) for a low-deductible policy than a high one? So even if the 10% number is the same for both, it will lead to more $ in revenues (and hence earnings) for the low-deductible policy, since the 10% is applied to a larger $-volume of medical losses.

For example, if I find a riskless arbitrage opportunity in the market, I am better off to leverage my investment as much as I can since it will increase my $-return, even though the percentage return on the underlying notional amount is still the same.

They might make more money, but then again they might not. That is the point 10% would be the max they could earn. I could also be less. If the maximum return is the same no matter how they structure their policies, there is little benefit for offering a better policy where they would take more risk for no better return, and possibly lower returns. You are correct in that there would be higher medical loss, but that 10% is the maximum they can earn. I think what would happen, if they did offer the current type policies, is they would be very expensive, triggering the cadillac plan tax.

Your point also brings up another issue. Insurance companies would have no incentive to keep medical expenses down, and in fact would receive an incentive to maximize their medical expenses.
 
To me the funding mechanisms are the worst problem because of its disproportionate impact on "effective" middle class tax brackets. The phaseout of the subsidy occurs entirely within the solidly middle class brackets and then goes away. So people needing to buy their own health insurance on a middle class income take the brunt of reform.

As a result, every extra dollar a $60K household earns can effectively have its take-home equivalent pay reduced a lot more than someone earning $200K because the former is losing somewhere in the neighborhood of 15-18 cents on the dollar in the form of reduced subsidy to buy health insurance.

This analysis provides examples of this craziness (emphasis added):
Those mandates and subsidies would impose effective marginal tax rates on low-wage workers that would average between 53 and 74 percent— and even reach as high as 82 percent—over broad ranges of earned income. By comparison, the wealthiest Americans would face tax rates no higher than 47.9 percent.
Over smaller ranges of earned income, the legislation would impose effective marginal tax rates that exceed 100 percent. Families of four would see effective marginal tax rates as high as 174 percent under the Senate bill and 159 percent under the House bill. Under the Senate bill, adults starting at $14,560 who earn an additional $560 would see their total income fall by $200 due to higher taxes and reduced subsidies. Under the House bill, families of four starting at $43,670 who earn an additional $1,100 would see their total income fall by $870.
Does anyone think this legislation is rational and well designed? Here's an idea--let's use the normal process for producing legislation instead of the secret "let's cut a deal" method. Maybe some transparency, and allowing lots of people to read it while it is being built. Novel. At least the some of the biggest mistakes might get fixed before the vote.
 
You don't know that

How can anyone comment on exactly what the legislation/taxation is until it emerges form the conference ?

All this speculation and assuming the worst possible outcome will drive you crazy.


- death and taxes
 
How can anyone comment on exactly what the legislation/taxation is until it emerges form the conference ?

All this speculation and assuming the worst possible outcome will drive you crazy.
Because these proposals are out there, and it seems to me that the best time to comment on, and draw attention to, the worst aspects of potential legislation is *before* it becomes law, yes?
 
Well if you really want to be involved, this is the wrong forum.

- As I posted you are just going to work yourself into a tizzy and make yourself crazy if you are going to get excited about every possible proposal.

There are so many voices in this game. Some of those voices just might get you really worked up when in reality their view of the world never comes to be.
 
Well if you really want to be involved, this is the wrong forum.

- As I posted you are just going to work yourself into a tizzy and make yourself crazy if you are going to get excited about every possible proposal.
So if we don't think something about it is a good idea, we either need to either "get involved" (per your definition) or shut up about it?

That is the implication you seem to be making, and I reject it utterly. And I'm not sure how merely mentioning it equates to "working myself into a tizzy."

And by the way, there IS something to be said for making sure more people understand the ramifications of some of the proposals. After all, some of them might make it to the president's desk, and he's not going to veto it because of a few questionable provisions.

And in closing, if it isn't worth discussing here because it's not "getting involved," why would you even read this forum?
 
Ziggy:

calm down. I wasn't trying to insult you or silence you. I just thought that your posts were premature.

If you want to comment on the heath proposals - post away.
 
How can anyone comment on exactly what the legislation/taxation is until it emerges form the conference ?

All this speculation and assuming the worst possible outcome will drive you crazy.

The portions I've commented on are essentially the same in each of the bills. There hasn't been much discussion about those areas either, so odds are they are not going to be taken out of the bills and will most likely come through in about the same condition.
 
I figure the basics of the premium/tax credit structure will probably be somewhere in between the house and the senate version. I doubt that section will be ripped up and written anew.
 
Cadillac health insurance tax--Bill to contain special exemption for union members?

This development may be of interest to any board members who are in a union: In the latest twist, the White House and the select group of legislators negotiating the merged version of the health care legislation have reportedly reached a compromise regarding the proposed tax on "Cadillac" health plans. As before, the value of these plans exceeding certain limits will be taxed at 40% starting in 2013. The compromise is that if the insurance is part of a collective bargaining agreement (i.e. part of a union-brokered contract), a Taft-Hartley multiemployer plan, or part of a state-employer plan, then the tax will not go into effect until 2018. I assume the unions will use the time to renegotiate these contracts and have the compensation moved into other areas rather than health care.

Additonal info is here.

For anyone else who has a generous health care plan through your employer (i.e. you negotiated it independently one-on-one, or you selected it as part of a benefit package, or you are a non-union employee and the employer has always offered these plans to you)--no special deals. Sorry, you are not part of a favored, protected group and so you are a "bill payer."

Of course, as time goes by, there will be virtually no government revenues due directly to this tax. Employers and employers will shift compensation to avoid it. The government revenues will come from other taxes that people pay as they try to avoid this tax. From Bob Herbert's NYT column of a few weeks ago:
If even the plan’s proponents do not expect policyholders to pay the tax, how will it raise $150 billion in a decade? Great question. . .
According to the Joint Committee on Taxation, less than 18 percent of the revenue will come from the tax itself. The rest of the $150 billion, more than 82 percent of it, will come from the income taxes paid by workers who have been given pay raises by employers who will have voluntarily handed over the money they saved by offering their employees less valuable health insurance plans.
With the revised carve-outs for union plans, the government now expects to bring in "only" $90 billion , not $150 billion, over the arbitrary 10 year window. So someone else (. . . "that man behind the tree!") will be making up the difference.

The hits just keep on coming!
 
samclem, thanks for these updates. I don't think these special deals help to convince the public that this bill is "for the common good".

Gallup poll is showing only 37% of the public would tell their reps to vote for the bill, add in the "leaning to" vote for the bill, and it is still a minority (49%).

Healthcare Bill Support Ticks Up; Public Still Divided

On an earlier post...

We've discussed the sly bits of budgetary subterfuge that help the Senate bill look more budget neutral, and there's been some question about the real cost after everything is in place. I looks like about $100 billion in additional federal red ink every year. Here's the source of that helpful factoid, a column in the Arizona Republic. The assumptions look fair to me. ...

These are big numbers, so if I break it down correctly - $100B in red ink every year, divided by ~ 300M people in the US, that is an added $333 of added debt each year for each person. At first, I was thinking "cost", but if I have that right it isn't "cost", it's the amount of spending we are not paying for, just adding to the debt.

I'll go back to statements I made months ago - it seems hypocritical to me for people to say "we want health care reform now" if they are not willing to pay for it now (let our kids/grandkids pay tomorrow for the health care we want today).

images


"I'll gladly pay you Tuesday, for a hamburger today...." Hey, at least Wimpy was willing to pay for it himself....

Maybe that should be: I'll gladly let your kid pay you Tuesday, for my hamburger today....

-ERD50
 
A bill with so many pay offs, can't be good.

Unless you are a payee like us ER's and ER wannabes. :D Just become a grasshopper and let the ants feed you. It's easier this way.
 
I'm definitely working on it. It feels a little slimy, but it's better than being a sucker.

When life gives you lemons, you make lemonade.
 
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