The ACA and Small Businesses

[B-Man]

WASHINGTON (AP) — Millions of people who take advantage of government subsidies to help buy health insurance next year could get stung by surprise tax bills if they don’t accurately project their income.

 

President Barack Obama’s new health care law will offer subsidies to help people buy private health insurance on state-based exchanges, if they don’t already get coverage through their employers. The subsidies are based on income. The lower your income, the bigger the subsidy.

 

But the government doesn’t know how much money you’re going to make next year. And when you apply for the subsidy, this fall, it won’t even know how much you’re making this year. So, unless you tell the government otherwise, it will rely on the best information it has: your 2012 tax return, filed this spring.

 

What happens if you or your spouse gets a raise and your family income goes up in 2014? You could end up with a bigger subsidy than you are entitled to. If that happens, the law says you have to pay back at least part of the money when you file your tax return in the spring of 2015.

 

That could result in smaller tax refunds or surprise tax bills for millions of middle-income families.

 

Health care providers, advocates and tax experts say the vast majority of Americans know very little about the new health care law, let alone the kind of detailed information many will need to navigate its system of subsidies and penalties.

 

“They know it’s out there,” said H&R Block manager Mark Cummings. “But in general, they don’t know anything about it.”

 

A draft of the application for insurance asks people to project their 2014 income if their current income is not steady or if they expect it to change. The application runs 15 pages for a three-person family, but nowhere does it warn people that they may have to repay part of the subsidy if their income increases.

 

There’s another wrinkle: The vast majority of taxpayers won’t actually receive the subsidies. Instead, the money will be paid directly to insurance companies and consumers will get the benefit in reduced premiums.

 

 

 

 

.

[birdog1960]

You simply don't bother to read, do you? If you actually read the work of those who you presume to disagree with, instead of just dismissing them out of hand according to your confirmation biases, and the demagoguing you would know that your characterization of Dr. Carson's position is far from accurate.

i read his comments at the prayer breakfast that had nearly every nutjob con radio host wetting themselves with excitement. i didn't see where he published a position paper on the "plan". care to steer my towards one?

[TakeYouToTasker]

i read his comments at the prayer breakfast that had nearly every nutjob con radio host wetting themselves with excitement. i didn't see where he published a position paper on the "plan". care to steer my towards one?

Jesus... you don't even listen to opposing postions before dismissing them out of hand? He talked about government subsidies directly funding HSA's for the needy in his speech.

 

How do you propose that anyone relate ideas to you? Apparently it goes beyond an unwillingness to read... you won't even !@#$ing listen...

Edited April 2, 2013 by TakeYouToTasker

[B-Large]

The more I think about it, the more I come to believe that Dr. Carson has come up with the single most efficient, effective, and elegant solution to the US Healthcare situation that I've ever encountered.

 

HSA's and a nationalized catastrophic risk pool solves every problem that deserves solving.

 

but isn't that just Nationalized Healthcare with a personal deductible? I like the idea, but I would think the insurance industry would have a gripe or two about that.

[birdog1960]

Jesus... you don't even listen to opposing postions before dismissing them out of hand? He talked about government subsidies directly funding HSA's for the needy in his speech.

 

How do you propose that anyone relate ideas to you? Apparently it goes beyond an unwillingness to read... you won't even !@#$ing listen...

so what are the govt subsidies? for a pt on medicaid does that mean that medicaid funds an HSA and pays for "catastrophic' illnesses? how do you define catastrophic? if the patient needs a bypass and has $5000 in his hsa as funded by medicaid, does medicaid pick up the rest? it's easy to say "pay for everyhting with hsa's. it's much more difficulty to make that fit with the realities of healthcare. and since, in this model as i described, medicaid essentially pays for all care anyhow, how does that save money?

[B-Man]

Mangling the Facts on Obamacare’s Impact

April 2, 2013 12:00 P.M.

 

Since the arrival of Obamacare, before and after its rough passage into law, thousands of pundits and ordinary citizens have debated what impact its regulations and mandates will have on employers, and thus on employees. On Thursday, March 21, the Huffington Postpublished an article arguing that only a tiny minority of companies will need to cut employee hours in order to avoid certain costs of Obamacare. “All those companies threatening to cut workers’ hours as a result of Obamacare are actually an exception to the rule, according to a recent survey from the Minneapolis Federal Reserve,” HuffPo wrote, adding:

Nearly

90 percent

of employers don’t plan to shift full-time workers to part-time status as a result of President Obama’s health care reform law, the study found. . . . In the wake of the law,

some health care experts worried

that companies would shift some of their employees to part-time status — or 30 hours per week or less — in order to avoid covering them. Though the survey notes that businesses may change their mind once they realize the full effects of Obamacare, it seems companies cutting (or threatening to cut) workers’ hours

are more outliers than the norm

.

 

 

The article was prominently displayed throughout Friday and received more than 700 Facebook shares, more than 80 Tweets, and almost 1,900 comments — but it misses important context and key facts.

 

The piece claims that “nearly 90 percent of employers don’t plan to shift full-time workers to part-time status as a result of President Obama’s health care reform law.” However, the study the piece cites — conducted by the Federal Reserve Bank of Minneapolis — does not support HuffPo’s reassuring conclusion.

 

First, the survey was not based on a representative national sample. Instead, it used information from 205 “contacts” from around the Ninth District of the Federal Reserve. Overlooking this, as HuffPo did, is misleading.

 

Second, the survey was not conducted scientifically. From the study:

Methodology: On March 12, 2013, the Minneapolis Fed invited, via email, about 1,000 Beige Book contacts from around the Ninth District to answer the special question in a web-based survey. By March 13, 205 contacts had filled out the survey. The respondents come from a variety of industries (see table).

 

Further, the survey failed to ask businesses if they planned to modify their staffing in ways other than switching to part-time labor, perhaps by downsizing the number of employees instead of their hours worked, by outsourcing, by selling to a larger competitor that can afford Obamacare’s increased costs, or by hiring new staff to navigate Obamacare’s regulations and mandates, perhaps a lawyer or an accountant.

 

Third, the survey itself issues caveats that the Huffington Post totally ignores:

Based on the comments received with the poll, the relatively low change rate could be based on three factors. First, many responding organizations employ fewer than 50 people and are exempt from some provisions of the act. Second, some commented that it is too early to know the effects of the law’s detailed regulations. . . . Finally, some businesses do not function well with part-time workers

.

 

In addition, the survey’s use of the phrase “the relatively low change rate,” when it comes to how employers will react to Obamacare, is confounding. The survey (and HuffPo, in the way it reported the survey) is essentially asserting that the change rate owing to Obamacare would be “relatively low” if 10 percent of employers shifted to using more part-time workers.

 

That’s ridiculous. Let’s assume for the moment that this holds true for the entire nation. It would indeed be a big deal if 10 percent of America’s businesses suddenly cut back workers’ hours. And it is likely that smaller businesses, so crucial to our economy, will be the ones cutting back on full-time employees. These are the places that may have more than 50 employees but that don’t have enough resources to absorb the costs of Obamacare, and that are unlikely to have received any of the 1,231 insurance waivers given out under the law (the average number of employees in each company given a waiver is over 3,300). As a result, Obamacare may very well be responsible for the further corporatization of America.

 

So, in sum, the Huffington Post article neglects to mention that the survey represents only a small number of businesses in the upper Midwest, that it was not scientific, and that it came with at least three major caveats.

 

 

.

Edited April 2, 2013 by B-Man

[TakeYouToTasker]

so what are the govt subsidies? for a pt on medicaid does that mean that medicaid funds an HSA and pays for "catastrophic' illnesses? how do you define catastrophic? if the patient needs a bypass and has $5000 in his hsa as funded by medicaid, does medicaid pick up the rest? it's easy to say "pay for everyhting with hsa's. it's much more difficulty to make that fit with the realities of healthcare. and since, in this model as i described, medicaid essentially pays for all care anyhow, how does that save money?

Because, again, you're talking about it in a way that presumes to slap a bandaid on a severed artery.

 

Fist, you open up the entire country to real, competitive markets for healthcare by removing artificial state restrictions, and allowing individuals to purchase the care they want.

 

Secondly, the things that are covered by HSA's don't require health insurance to pay for. In fact, presuming to "insure" routine care only drives up costs to a level of pre-payment for all care, and puts a massive layer of insurance beuracracy between the patient and his doctor, and separating the funding for actual medical care from those who provide it and giving it instead to the legions of red-tape bureaucrats who restrict it.

 

As to the catastrophic care insurance? I don't think it's something that markets can nessecarily do; so I wouldn't object to a nationalized catasrophic care pool, because that's what shared risk truely is.

[IDBillzFan]

i read his comments at the prayer breakfast that had nearly every nutjob con radio host wetting themselves with excitement.

 

Man, you progressives sure get crazy when the coloreds don't fall in line with your orders.

 

Predictable, but crazy.

[B-Large]

 

 

Man, you progressives sure get crazy when the coloreds don't fall in line with your orders.

 

Predictable, but crazy.

 

 

Thats cuz he's an educated, uppity Uncle Tom

[birdog1960]

Because, again, you're talking about it in a way that presumes to slap a bandaid on a severed artery.

 

Fist, you open up the entire country to real, competitive markets for healthcare by removing artificial state restrictions, and allowing individuals to purchase the care they want.

 

Secondly, the things that are covered by HSA's don't require health insurance to pay for. In fact, presuming to "insure" routine care only drives up costs to a level of pre-payment for all care, and puts a massive layer of insurance beuracracy between the patient and his doctor, and separating the funding for actual medical care from those who provide it and giving it instead to the legions of red-tape bureaucrats who restrict it.

 

As to the catastrophic care insurance? I don't think it's something that markets can nessecarily do; so I wouldn't object to a nationalized catasrophic care pool, because that's what shared risk truely is.

carson said about 30 words on the subject at the prayer meeting. very few of yours above were included. i think you're confusing your plan with his.

 

Thats cuz he's an educated, uppity Uncle Tom

no, it's cuz he said very little. a broad outline that might be very good or very bad. but from what little he said we can't even hazard a guess which that might be.

[3rdnlng]

carson said about 30 words on the subject at the prayer meeting. very few of yours above were included. i think you're confusing your plan with his.

 

no, it's cuz he said very little. a broad outline that might be very good or very bad. but from what little he said we can't even hazard a guess which that might be.

 

Forgive me for being late to the party, but are youins talking the National Prayer Breakfast?

[birdog1960]

Forgive me for being late to the party, but are youins talking the National Prayer Breakfast?

sort of. apparently, a short, vague blurb uttered at an inappropriate time and place is the answer to all of our healthcare problems.

[B-Man]

sort of. apparently, a short, vague blurb uttered at an inappropriate time and place is the answer to all of our healthcare problems.

 

 

 

 

Backwards thinking (as usual)

 

Apparently, a nationally recognized and celebrated neurosurgeon giving a speech with his beliefs about our healthcare at the National Prayer Breakfast isn't good enough for some. He must, at the same time give in depth research papers ........................lol

 

 

No reference to the speeches and ideas he has made since,

 

No dicussion about his points at all really.....except they're "too vague".......lol

 

Just admit it, (like it was stated earlier) Prominent African-Americans are NOT ALLOWED to think differently than the democrat code,

 

if they do, they are attacked.

 

 

.

Edited April 3, 2013 by B-Man

[birdog1960]

Backwards thinking (as usual)

 

Apparently, a nationally recognized and celebrated neurosurgeon giving a speech with his beliefs about our healthcare at the National Prayer Breakfast isn't good enough for some. He must, at the same time give in depth research papers ........................lol

 

 

No reference to the speeches and ideas he has made since,

 

No dicussion about his points at all really.....except they're "too vague".......lol

 

i've asked once in this thread already but i'll ask again; where are the details? i'd be happy to read them. and what are the answers to the questions i posed earlier. how bout a new hypothetical: 30 yo medicaid pt with a skin lesion. $2k in his hsa (that apparently was funded from birth). lesion biopsied and is melanoma. numerous scans reveal generalized metastasis (and who pays for the scans?) he needs chemo and as a complication, multiple hospitalizations for opporunistic infections. runs up a six figure bill. who pays for that? if it's medicaid via an hsa and "catastrophic care" provision, how does that save money? or does he go untreated due to lack of funds in his hsa?i don't care if he's from another galaxy,is reptilian and has mastered time travel, these are the types of questions and answers that must be addressed...

 

 

.

Edited April 3, 2013 by birdog1960

[TakeYouToTasker]

A catastrophic care shared risk pool. Do you not understand the concept of shared risk? Do you not understand the difference between insurance and pre-payment?

[birdog1960]

A catastrophic care shared risk pool. Do you not understand the concept of shared risk? Do you not understand the difference between insurance and pre-payment?

ok, so where's the savings. $2000 is a drop in the bucket for this pt's care cost. in fact, "noncatastrophic" care as currently defined by most hsa's is a small percentage of total health care costs in the us. do you not understand that? end of life care is by far the most expensive care we provide. this doesn't address that at all. you'd still need someone or something defining extraordinary care. isn't that we you all call death panels?

[B-Large]

Because, again, you're talking about it in a way that presumes to slap a bandaid on a severed artery.

 

Fist, you open up the entire country to real, competitive markets for healthcare by removing artificial state restrictions, and allowing individuals to purchase the care they want.

 

Secondly, the things that are covered by HSA's don't require health insurance to pay for. In fact, presuming to "insure" routine care only drives up costs to a level of pre-payment for all care, and puts a massive layer of insurance beuracracy between the patient and his doctor, and separating the funding for actual medical care from those who provide it and giving it instead to the legions of red-tape bureaucrats who restrict it.

 

As to the catastrophic care insurance? I don't think it's something that markets can nessecarily do; so I wouldn't object to a nationalized catasrophic care pool, because that's what shared risk truely is.

 

Wouldn't Medicare for all US Citizens, with a deductible of $X amount of dollars fit what you describe? I'd go as far to suggest maybe we don't even give people HSA's to fund that intial amount, perhaps people should just be expected to put away after tax money on their own to pay for services that are not going to catagorically catastrophic. My reason being, is we are looking to get the Government out of Healthcare and balance budgets, another tax subsidy for an HSA account would be a pretty big line item. I might also suggest the risk pook be State Wide, not Federal- in an attempt to remove the Federal Government from as much program adminstration as possible.

 

So, a State Risk Pool, with a Self Pay Spread, and perhaps its Means Tested so if you have more money, you cover more expenses until the Insurance Money kicks in... I know that sounds like a penalty for higher earners, but if asked I am sure they would rather pay more for health services if needed rather than taxed upfront for healthcare....

[birdog1960]

Wouldn't Medicare for all US Citizens, with a deductible of $X amount of dollars fit what you describe? I'd go as far to suggest maybe we don't even give people HSA's to fund that intial amount, perhaps people should just be expected to put away after tax money on their own to pay for services that are not going to catagorically catastrophic. My reason being, is we are looking to get the Government out of Healthcare and balance budgets, another tax subsidy for an HSA account would be a pretty big line item. I might also suggest the risk pook be State Wide, not Federal- in an attempt to remove the Federal Government from as much program adminstration as possible.

 

So, a State Risk Pool, with a Self Pay Spread, and perhaps its Means Tested so if you have more money, you cover more expenses until the Insurance Money kicks in... I know that sounds like a penalty for higher earners, but if asked I am sure they would rather pay more for health services if needed rather than taxed upfront for healthcare....

and exactly none of this or what tasker described was verbalized by carson at the prayer breakfast....has it been subsequently as bman alludes to? i wouldn't know. no one has posted a link.

[B-Large]

and exactly none of this or what tasker described was verbalized by carson at the prayer breakfast....has it been subsequently as bman alludes to? i wouldn't know. no one has posted a link.

 

If this is the same guy I am thinking it is, I saw an interview with him on 60 minutes or world news, or something. He was a smart guy, but I seem to remeber the interview being kind of vague, but he obviously understood the issues facing the system, etc. I'd search for the interview, but the hospital blocks everyting upon everything here...

[TakeYouToTasker]

Wouldn't Medicare for all US Citizens, with a deductible of $X amount of dollars fit what you describe? I'd go as far to suggest maybe we don't even give people HSA's to fund that intial amount, perhaps people should just be expected to put away after tax money on their own to pay for services that are not going to catagorically catastrophic. My reason being, is we are looking to get the Government out of Healthcare and balance budgets, another tax subsidy for an HSA account would be a pretty big line item. I might also suggest the risk pook be State Wide, not Federal- in an attempt to remove the Federal Government from as much program adminstration as possible.

 

So, a State Risk Pool, with a Self Pay Spread, and perhaps its Means Tested so if you have more money, you cover more expenses until the Insurance Money kicks in... I know that sounds like a penalty for higher earners, but if asked I am sure they would rather pay more for health services if needed rather than taxed upfront for healthcare....

A) The larger the shared risk pool, the lower the individual costs.

B) If you want to get the government as far away from healthcare as posible, and want to incentivize people to actually save money and take charge of their own health savings and decision making, then you incentivize those things by making doing so a tax-free endeavor.

C) No means testing, because it incentivizes the wrong things. Worst case senario you have public contributions to HSA's which empowers people to make their own health care decisions, and encourages them to wisely allocate their dollars, which ultimately drives down the costs of hospitals.