Major employers to shift more health-care costs to workers, survey shows

[Newsjock]

Source: Washington Post

Most major employers plan to shift more health-care costs to their workers next year, according to a survey released Thursday.

Many say they may charge more to cover spouses, tighten eligibility standards for their health plans and dispense financial rewards or penalties based on the results of certain lab tests. At some companies, overweight employees could be excluded from the best plans.

Meanwhile, employees at many companies can expect significantly higher premiums, deductibles and co-payments, according to the annual survey by the National Business Group on Health, a coalition of major employers, and Towers Watson, a consulting firm that advises companies on employee benefits.

"This shows that the constant, unrelenting increases in health-care costs are going to cost employees and their families more and more," said Helen Darling, president of the business group.

... In addition, employers increasingly are moving toward high-deductible plans, which carry lower premiums while leaving workers responsible for higher out-of-pocket expenses. Next year, 12 percent of employers plan to offer only high-deductible coverage, the survey found.

Read more: http://seattletimes.nwsource.com/html/nationworld/2011324143_insure12.html

[napi21]

1. There are max out of pocket expenses in the HC bill. I believe it's $2,000 for individuals

and $4,000 fir a family. If the bill passes, that will prevent the threat of high deductibles and co/pays.

[Dr.Phool]

2. Those are already high deductibles and co-pays.

[girl gone mad]

4. I don't think those numbers are accurate..

"The proposal would limit out-of-pocket costs at $5,950 year for an individual and $11,900 for a family."

[inna]

9. These are correct numbers (for the year 2010), but... that is in ADDITION to

health insurance premiums (which can be more than DOUBLE that amount).

[napi21]

12. Here is a clip from the bill.

Sec. 1302. Essential health benefits requirements. Defines an essential health benefits package that covers essential health benefits, limits cost-sharing, and has a specified actuarial value (pays for a specified percentage of costs), as follows:
5
1. For the individual and small group markets, requires the Secretary to define essential health benefits, which must be equal in scope to the benefits of a typical employer plan.
2. For all plans in all markets, prohibits out-of-pocket limits that are greater than the limits for Health Savings Accounts. For the small group market, prohibits deductibles that are greater than $2,000 for individuals and $4,000 for families. Indexes the limits and deductible amounts by the percentage increase in average per capita premiums.
3. For the individual and small group markets, requires one of the following levels of coverage, under which the plan pays for the specified percentage of costs:
Bronze: 60 percent
Silver: 70 percent
Gold: 80 percent
Platinum: 90 percent
In the individual market, a catastrophic plan may be offered to individuals who are under the age of 30 or who are exempt from the individual responsibility requirement because coverage is unaffordable to them or they have a hardship. A catastrophic plan must cover essential health benefits and at least 3 primary care visits, but must require cost-sharing up to the HSA out-of-pocket limits. Also, if an insurer offers a qualified health plan, it must offer a child-only plan at the same level of coverage.

http://dpc.senate.gov/healthreformbill/healthbill49.pdf

The section I referenced is on page 4 of the PDF file.

The other poster is correct that this does not include your premiums.

[Iowa]

15. I think your figures up-thread are wrong...

"There are max out of pocket expenses in the HC bill. I believe it's $2,000 for individuals and $4,000 for a family. If the bill passes, that will prevent the threat of high deductibles and co/pays." and then you go on to quote this: "...prohibits deductibles that are greater than $2,000 for individuals and $4,000 for families."

Someone please correct me if I'm wrong, but this doesn't appear to be correct. "Deductible" is not the same thing as "out-of-pocket maximum". Deductibles are what you pay before the insurance company pays anything. Then co-insurance kicks in - for example, you might continue to pay 20% of costs after the deductible is met. And there are also "co-pays" which are another thing entirely.

From your post, it appears that this is the line that addresses out-of-pocket maximums:

"For all plans in all markets, prohibits out-of-pocket limits that are greater than the limits for Health Savings Accounts."

I did a brief search for 2010 out-of-pocket maximums for HSAs. I don't have a Health Savings Account, so there may be wrinkles I don't understand. Nevertheless, I checked several sources and they were all the same. I'll include this URL simply because it isn't a mile long:

http://www.hsacenter.com/2010-HSA-Contribution-Limits.php

Here's the bottom line:

Individual Out-of-Pocket Maximum: $5950
Family Out-of-Pocket Maximum: $11,900

And they go up every year. And on top of that you must pay the premium. Furthermore, in many plans today co-pays do NOT count toward out-of-pocket maximums. So it's possible the actual out-of-pocket is even higher (depending on what actually "counts" toward the out-of-pocket maximum. This is a huge risk exposure for most families. Those with a family member who has a chronic illness, and who pay such a large out-of-pocket max every year, would likely be wiped out in short order.

[No Elephants]

5. For some groups, not all.

[Roland99]

21. How does that help with the high premiums? This is what happens with no Public Option!

Insurance companies are raising the floor, and quickly, so that when they are forced to cover those with pre-existing conditions and are allowed to charge double/triple the floor, that ceiling will be all that much higher.

And who's going to continue to be able to afford to pay those premiums?

[GreenTea]

3. The Public Option's Last Stand: A Matter Of Will, Not Votes - We've got to be heaard!

http://www.huffingtonpost.com/2010/03/11/the-public-options-last-s_n_495383.html

The public option faces its last stand. With more than 40 senators publicly willing to vote for a health care reform reconciliation package that includes the option, the opportunity to reinsert it into the final bill has never been greater, though the battle is nearly over without having been fought.

Sen. Dick Durbin, the Democrat in charge of rounding up votes for the health care reconciliation bill, said on Thursday that he will whip support for whatever package comes through the House. With 50 Democratic votes, Vice President Joe Biden could then break the tie and send the bill directly to the White House. If any amendments are adopted, it slows the process down by requiring the House to vote once again.

[No Elephants]

6. An article that is the OP in another thread said Durbin is whipping against the public option.

This sounds very different. Which is Durbin and which is Memorex?

[Donnachaidh]

7. if it's to be believed, Durbin did a massive flip flop yesterday

LO announced on Countdown that due to lots and lots of screaming on the intertubes AND the PO letter getting more names, Durbin was *now* going to whip the bill with a PO.

It's like trying to dance with snakes - just keeping up on the flopping around these chuckleheads do in the course of a day. :grr:

[No Elephants]

10. Thanks. I am beginning to think it's all kabuki anyway. They don't want to pass a PO, but they

don't want to take the heat from voters for killing the PO, either.

The biggest joke: the PO in the House bill was so damned lame, anyway.

Is "sell out" one word or two?

[DebbieCDC]

16. Read Glenn Greenwald on Salon today

He nails the Senate Dems to the wall on this. This WAS kabuki all along.

[inna]

18. You might find this thread interesting:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7902764

[inna]

8. And it's going to get a LOT worse, with or without the HCR.

It's all about shifting financial burden to individuals and families.

Current employer-based health coverage - in a market monopolized by completely out-of-control, rapacious for-profit insurance industry - is completely unsustainable.

The Insurance Industry Profits Protection Act of 2010 will weaken and erode employer-based insurance even further and place great financial burden on the middle class, while enshrining for-profit insurance cartel and weakening and defunding publicly-funded health care.

[No Elephants]

11. Yet, Obama cites employer plans as the reason he opposes single payer.

Pay no attention to the suffering employee behind the "employer-provided" plan curtain. No reason for single payer. None at all.


"I think that the Democrats ought not to be fronting for insurance company interests, and frankly every time they lay a bill out insurance stocks go up. I mean, how -- how would that happen?” he added. “I mean, we have to have a bill for the American people and if the administration wants to change its position, I’m all ears.”

<snip>


"I’ve been in Congress for almost 14 years, and I have never experienced any kind of strong-arm tactics,” Kucinich said. “So you know, what happens is if somebody’s a newer member they may have a perception that there’s pressure being put on them, and how they interpret it is as vast as individuals’ personalities. But you know what? I’ve never experienced anything, like that and I’ve taken some pretty tough stands.”


Full interview at link:
http://blogs.abcnews.com/thenote/2010/03/dennis-kucinich-white-house-knows-how-to-get-my-vote.html

[mbperrin]

13. Our school district coverage premiums will stay the same this year (about

$8,000 per year for the two of us), but the out of pocket on our medications will change from about $3,000 per year to $8,000.

Kinda makes that $500 a year step raise look a little puny, don't it?

[Earth_First]

14. Essentially, what raise?

:shrug:

Sorry to hear that...

[DebbieCDC]

17. My company insurance plan deductible more than doubled this year

From $200/year to $500/year (for single coverage)

Of course co-pays are NOT included in the deductible

Just the way the insurance companies and Big Pharma want it

Thanks for nothing Dems

[GeorgeGist]

19. Heckuva job ...

Barry.

[Supersedeas]

20. nothing to see here, at least, nothing the Corporate Media shills want to disseminate