What Obama doesn't realize - It's about Health Care, Stupid

[Laura PourMeADrink]

IMHO, Obama has done a shitty job allaying fears about the health care
plan going in 2014. It is no wonder no one will hire.

What he doesn't get is the real world fear that's out there among
businesses about what is going to happen.

In my perfect world, every company would care first about their
workers well being. But real world, after 8 years of focus on
the balance sheet and profits only...it is now a way of life.

A few Examples:
I talked to a small business with 48 employees. They want
to expand...but can not afford to insure everyone. So they
are holding off on hiring.

I talked to a bank CFO, who calculated that it would be
cheaper to pay the $2000pp,per year penalty than to pay
for insurance for everyone. This bank already pays for insurance, but
is considering the option not to.

I talked to someone in healthcare who sells cardiac
equipment to hospitals. She said that hospitals are scared
to death of what their staffing needs will be like when
all the addtional patrons want care....and therefore
are not spending on new equipment until all this is figured
out.

You will not see much altruism out there....but it strikes
me as crystal clear that fear of this law's implications
is a real issue.

I just don't understand why Obama isn't out there
explaining it, educating people, and listening.

No wonder no one is hiring.

[lib2DaBone]

1. Just got notice today..my crappy health insurance is going up 7%...

No wage increase.. but more and higher deductables.. WHAT HAS CHANGED?

[Laura PourMeADrink]

16. oh man, that's another thing...premiums going up - because

on the health care bill. I am starting to think it should have
gone in immediately instead of these years of uncertainty

[frazzled]

2. Such a false argument

It's the one Republicans would make.

[Laura PourMeADrink]

17. Whaa??? What's false? Just reciting real world. And, don't

you think it's odd that our administration doesn't
know there's a real world out there and these
are the things businesses are concerned about?

I want more than anything for Obama to win again - I just
don't understand why he's not addressing this somehow. Obamacare
has turned into a dirty word with the opposition and there is
not a single, solitary PR word to combat it.

[frazzled]

29. Small businesses like that of the "CFO" you cite are being HELPED by the ACA

From an article in the Richmond Times Dispatch this January:

After years of dropping coverage, the number of small businesses offering health insurance to their workers is actually going up. According to the Kaiser Family Foundation, 9 percent more small businesses with fewer than 200 employees provided coverage in 2010 compared with 2009. For those with fewer than 10 employees, the expansion in coverage was even greater: 13 percent.

Right now, these small-business owners are preparing their 2010 tax forms. Many of those who have been hardest hit in recent years — the smallest employers — are discovering that they are eligible for tax credits up to 35 percent if they paid at least half their employees' premiums. And in 2014, they will get even bigger tax credits of up to 50 percent.

Already, the incentives in the Affordable Care Act are helping drive increased signup rates from California to Kansas City to Maryland.

We're hearing stories from people like Tammy Rostov of Rostov's Coffee and Tea in Richmond. She has worked to provide the best possible coverage to her employees in recent years, despite increasing premiums. With the new tax breaks, she estimates that her business will save thousands of dollars.

In addition, I've heard from many small-business owners who are excited about the health insurance "exchanges" that the states are rolling out by 2014. These exchanges will allow even more small businesses to pool together, reduce their administrative costs and have more power when negotiating rates with big insurance companies.

Just as important, the Affordable Care Act supports our nation's entrepreneurial spirit as our economy is showing signs of growth. For example, entrepreneurs who want to set out on their own and start a business will no longer face "job lock" because they fear not having health coverage. Now more than ever, we need to give the next generation of job creators our full support to pursue their dreams.
http://www2.timesdispatch.com/news/2011/jan/11/TDOPIN02-affordable-care-act-helps-small-businesse-ar-765549/

The false argument you make is the very thing that Republicans like to spew, and very much like the "raising taxes on the wealthy will hurt the job creators." You're either confused or intentionally trying to mislead on this issue.

[Laura PourMeADrink]

32. how rude..Isn't it against DU rules to call someone a republican? And

NO, I am not confused nor am I intentionally confusing anyone.

[frazzled]

35. I in no way called you that

I said the argument is like the ones ... etc.

[Laura PourMeADrink]

36. ok, I'll forgive you :>) I was just looking at the law and unfortunately

the tax credits look like they are only if you have 25 or fewer employees. One of the
companies I talked to has 48. Course, guess there would still be the effect of reducing
their tax liability since providing health care is a legitimate business expense



http://www.irs.gov/newsroom/article/0,,id=223666,00.html


Eligibility Rules

Providing health care coverage. A qualifying employer must cover at least 50 percent of the cost of health care coverage for some of its workers based on the single rate.
Firm size. A qualifying employer must have less than the equivalent of 25 full-time workers (for example, an employer with fewer than 50 half-time workers may be eligible).
Average annual wage. A qualifying employer must pay average annual wages below $50,000.
Both taxable (for profit) and tax-exempt firms qualify.

[ProSense]

3. I don't know

"IMHO, Obama has done a shitty job allaying fears about the health care
plan going in 2014. It is no wonder no one will hire.

What he doesn't get is the real world fear that's out there among
businesses about what is going to happen."

...business owners are still complaining about regulations. Health care policy shouldn't be based solely on what selected business owners complain about.

The health care law doesn't go into full effect until 2014, why that should be causing them uncertainty and preventing hiring is curious.

The law was designed to address the needs of those having trouble getting insurance.

[Mimosa]

9. I had to drop my insurance. I'm among MILLIONS, ProSense.

Help ME!

'Yes, I know the GA link. I can't afford 500 dollars a month.

[Autumn]

11. I canceled mine in March of this year

I couldn't afford it any more. It was like flushing money down the toilet. I couldn't afford the co pay anyway after my insurance premium was paid. Since I dropped it I have been able to go to the Dr. twice. I had the money to pay cash for the visits. Now if I get a serious sickness I'm fucked but what the hell, I'll just use the republican plan of hurry up and die.

[Mimosa]

12. Autumn, you're my latest 'adding buddy error'

We're in the same boat. OMG, I fear it's the TITANIC!

Our opinions are often similar.

Shouldn't we be dating? ;) how close are you to ATL? *kidding*

[Autumn]

14. We can just date right here at DU

I'm pretty far from ATL, I'm way the hell over here by fundy ville in CO. :toast: And the ship is sinking fast. :rofl:

[Laura PourMeADrink]

22. that's what I think....go back to just paying freaking cash to see

a doctor and insurance for hospitalization.

It worked just fine many years ago.

WTF, someone, somewhere, in a country club bar, said, "How can we make money
out of all the money spent when people see a doctor for a sore throat."

[Skittles]

4. what he doesn't realize is - well, too much

[elocs]

5. No, it's about the economy & getting people to work. It's stupid not to realize that.

When Obama took office he would have done better to be the warrior of the middle class, the working people that he now claims to be. He would have done better in actually getting them back to work or at least as much time as was spent in socializing the losses of said banks and big business while making sure their profits are private.

Billion$ went to banks and big business while people have gone begging for jobs. That was stupid.

Lose the election to any Republican next year and the vaunted healthcare will be quickly dismantled. How could a Republican win the presidency in 2012? It's the economy, stupid, not healthcare.

[Laura PourMeADrink]

19. BUT, it's fear of healthcare that is stifling job growth in small businesses - so

I agree - but I think it's important to look at the things that
are causing companies to not hire, don't you? I mean, Obama
can't just snap his fingers and make it happen. I would hope
he has some analysts around him?

1. Just before Obama got in they told the world get ready for the Great Depression II. Businesses
cut staff. They learned how to get by with fewers. Workers got screwed - had to do more for the same pay. So, why hire, if they can get along ok now.

2. The smaller businesses are scared about healthcare....they don't know what's going to happen. So they don't expand and don't hire.

The second one is the only one he can control..

[bhikkhu]

6. Why would our employers be the ideal providers of health insurance?

I know it has worked reasonably well in the past, I think, but then again perhaps the entanglement has had a part in the ridiculous costs we have. In any case, I think businesses of every sort do a whole lot better if they don't have to deal with the costs and complications and responsibilities of health insurance.

[Mimosa]

10. Canada and the UK don't do it like that! n/t

[Laura PourMeADrink]

15. Curious that you say that...a businessman asked me.."When

did it become the responsibility of the employer to cover insurance costs?"

After me ranting a bit about excessive profits, greed, etc. I did stop
and think..about that simple question - why are employers responsible.

[Historic NY]

7. #3 is pure crap..they just built a new level 1 Trauma Center where I live...

and they only took one new item from their old building all the rest stayed behind. Since the health care bill went in we have had several health care centers open. Their purpose is to treat people outside the ER. My Dr. just joined her practice to this group...she gets all the benefit of having scheduling, reception and billing done by the center. They also offer urgent care, adult, women, center for recovery (drug, addiction & alcohol), dental, pediatric & infant care. They open from 7am - 10pm for urgent care. In the long run this center will take the demand care away from the Hospital ER & put it in a setting that is cost effective. All this is new and was privately endowed. The idea was to intergrate all the most used facets of treatment in the community into one format. They treat all in the community. They seem to be pretty busy too.

There afraid that they will have more patients........WTF.

[Laura PourMeADrink]

21. You are in New York, duh. You are surrounded

by itelligent, forward thinking people! They are smart enough to
anticipate results and pro-actively manage around it.

To the worries about health care (staffing)that I mention in my post...I said
that it all didn't make sense. Supposedly, ERs are jammed with people without
insurance who really just need a doctor's visit. So, it struck me that
their hospital staffing would be alleviated.

[Mimosa]

8. I can't believe JERKS are un-reccing this heartfelt topic.

Damn you to hell who don't understand or care about the anxiety, fear and pain REAL PEOPLE are suffering each and every DAY!

[Laura PourMeADrink]

18. I miss the days here where we actually debated issues - openly

without blanket, automatic knee-jerk flaming.

[chervilant]

20. Interesting, isn't it,

how many of Teh Sycophants now just unrec and flee.

Just FYI, I have no doubt that--like Autumn--I'll be resorting to the Republican plan, especially if one of my damaged molars goes septic. If a 24 yo man cannot survive such an event, I'm sure that I won't.

[izquierdista]

13. Care? who needs care?

But insurance? He's gonna make sure everyone pays into insurance.

[Carolina]

50. TOUCHE!

Along with many others here, I have said repaetedly that health insurance is NOT healthcare! :hi:

Course the apologists on this board can't seem to grasp that; in their eyes, BHO can do now worng... sheesh.

[mbee]

23. In a recent article which I believe was posed on DU it was

stated that under the Obama health plan begining in 2011 that insurers would need to use I believe it was 80 to 85% of premiums for patient care and, if not, would have to issued refunds to the insureds or their employers and I've heard recently of a couple examples of that where employers were either not getting increased premiums next year or were getting reduced premiums. Has anyone else heard anything about this?

[Laura PourMeADrink]

24. Haven't heard that -- But, I wonder if fees and co-pays are included

in the term "premium" because my provider has instituted more fees lately based on where you
seek care (i.e. the main hospital vs. satellite health care centers)

Another way they get you is when the co-pay is more than the actual cost of
the medicine. Ran into that with a prescription. Insurance would only
allow you to get the meds filled for one month -- at $20 copay. We asked
what a 3 month supply was paying outright and it was $16. They are pocketing
$40!

[kjackson227]

44. this is true... it's called the Medical Loss Ratio provision.

[treestar]

25. Don't know. Guess there is a reason why Obama hired others

to be his advisors. Obama needs advice from a broad range of people, not just your employer (if what they say is true and not just excuses from a Republican boss).

[Laura PourMeADrink]

28. how demeaning! First of all, never said "my boss." Second of all,

give me credit for knowing whether or not something is repuke bullshit.

Reread what you wrote and think about how shitty you sound !

[treestar]

38. Playing the hypersensitive victim doesn't help

But you offer no real argument for why your advice should trump those who got the jobs advising the chief executive. Just some personal observations about people you talked to.

How can you prove there is no hiring due just to or mainly to health care? You can't, there are no statistics and common sense says there are many other reasons.

Then you're claiming the POTUS doesn't get it. IMO it is much more likely you don't.

[Laura PourMeADrink]

41. Playing the KIA bully doesn't help either. According to Business Journals survery

http://www.portfolio.com/business-news/2011/04/26/health-care-insurance-costs-key-concern-to-small-business-owners/

snip

Last year’s health reform law revamping the U.S. health insurance system has small-business owners worried, according to a new survey.

Sixty percent of the 2,223 small-business owners and top executives who took the survey identified the cost impact from President Barack Obama’s reform initiative on their business as a top concern.

[quaker bill]

26. I must argue

Healthcare gets paid for. The only real question is where the money comes from. Currently it comes from higher premiums on those who can afford insurance and tax funded subsidies for indigent care.

Smart business people read the law and plan around it. If they can figure out how to expand and make more profits (the only reason a business is ever expanded) then these costs are factored in to the profitability determination, compensation structures are always part of this decision.

If the penalty is only $2000, it will always be cheaper to pay it than purchase insurance, the cost is predictable and therefore not a factor in business risk assessment.

Yes, there is a threshold issue. Starting a business with one or two employees, there is the workman's comp threshold. Once you expand to three employees, you are required to purchase workman's comp coverage. This does keep some businesses small, but most press on, because if you have the demand to keep 3 or more busy, the additional profits more than make up for this cost. Health insurance is probably a somewhat bigger hurdle for those inching up to the threshold, but the penalty is really not different than the added cost of workman's comp coverage. You pick your business model and run with it.

People using this excuse for not hiring, would not seem to be talented at running a business.

Socialized medicine is not the answer to this question, as healthcare still gets paid for, just through higher taxes instead of premiums. Taxes are a cost of doing business, the same as premiums, the only difference is where you are sending the check.

Not providing healthcare is not the answer either. People get healthcare, they show of at the emergency room and get treated, the only question is how it gets paid for.

[Laura PourMeADrink]

30. The small business I was referring to does not offer any insurance

to it's employees now. If he did, it will cost him about $180,000 EXTRA PER YR...hardly a small blip for a small business.

You are right, he could hire the two more people, reach 50 and pay the government $100k..still a lot of money. I am not sure if the $100k goes specifically toward paying for govt insurance for his staff? Or if it's just a penalty and the employee still has to come up with the money to get the govt insurance.

[quaker bill]

39. What portion of the premium

is the employer required to pay? Sounds like the employer is only covering $3500 a year with these figures. Where I live, this would not even be half of the premium. Put another way, its $1.75 an hour. This would be alot of money to a business paying minimum wages.

In a business with 50 employees, if everyone working there is making minimum wage, payroll with employer share taxes and workman's comp would likely exceed $1,000,000 a year. Given that in almost any realistic scenario a business with 50 staff will have managers and supervisors making a good bit more than minimum wage, and the owner will be paying himself significantly more than that, running a tight ship in a low wage service sector business likely gets you to a payroll, all expenses, of closer to $2,000,000, professional sector businesses obviously far more than that.

Deal with all the other expenses of any likely business, office space, retail locations, utilities, cost of materials... a gross in the range of 5 to 10 million is probably involved here. This just puts 100 to 180K in some perspective.

[bornskeptic]

27. Is your bank CFO an idiot? Just wondering.

I talked to a bank CFO, who calculated that it would be
cheaper to pay the $2000pp,per year penalty than to pay
for insurance for everyone. This bank already pays for insurance, but
is considering the option not to.


so now and at any time in the past they could have quit providing their employees with health insurance without paying a fine, but they're considering doing so in 2014 when it will cost them $2000 per person per year?

[Mimosa]

34. IT IS CHEAPER TO PAY PENALTY.

One of my long time buddies -age 60- who works for a small business 'shop' (maybe 8 employees) recently lost health insurance he'd had as an employee for nearly 19 years. A 60 year old man with diabetes now can't get any affordable coverage anywhere. That state program would cost him 30% of his take home which isn't enough ...

This country is screwing the working class.

[bornskeptic]

45. Of course it's cheaper to pay the penalty.

Before the 2014, it's cheaper yet to just drop the insurance for everyone immediately. The OP is suggesting that they might stop covering employees because it became more expensive to do so. That makes no sense at all. Adding a penalty for not providing insurance only affects companies which don't provide insurance.

[Vinca]

31. The "uncertainty" re the healthcare law is manufactured baloney.

Businesses, hospitals, individuals can all read the thing on line so there is no "uncertainty" whatsoever. People are not hiring because we have no money to spend. It's like hamsters on a wheel. The "job creators" need to get off their fat piles of cash and earn their tax breaks.

[Laura PourMeADrink]

33. You are so wrong...but I won't demean you and call it baloney. nt

[quakerboy]

37. I wouldnt call either of what you say bologna

But I think he is more right than you. I do not believe the Health care issue is the prime issue behind unemployment. At worst, hiring a new person means they have to factor in an extra 2 grand per year for the penalty. In the overall costs of having an employee, that is not really much. Especially when so many of that sort of "self made" small business tea party types believe that the law is going to be proven unconstitutional anyway.

But businsesses do not have any reason to hire if they are not going to make money doing it. And right now everyones a bit scared, so willing to do a bit more work for a little less pay. Why would corporate hire new under those circumstances? The small companies are a bit scared too, so why would the outlay any money if they can avoid it, either. Especially if business is not seeming to require it.

[Cigar11]

40. Correct!

I have several friends who have well established business and they all agree … the concept of giving them more Tax Breaks in an effort to hire more people is Clear BS! What Business wants and need are purchasers coming through their doors! If that happens, everything else will be solved. In addition, the fable of Health Care cost preventing them from hiring is also BS. So give the middle class the money and they will spend it ... always has and always will ... that's what the middle class does!

Cash Flow resolves all Business Wows; take it from actual Business Professionals … Not Professional Politicians.

[Laura PourMeADrink]

42. Right! Cash Flow! For a company with 51 employees paying half

of their premiums will negatively affect cash flow by $100k+

Think we have to define the business segment

25 or fewer employees - less effect - they are not subject to the law and if they
do chose to offer, they can get a tax credit and deduct the remaining as a business
expense

25-50 employees - not subject to penalty for not offering insurance, but not
eligible for a tax credit

51 + employees - are subject to penalty for not offering (if employees seek
insurance through exchange). If they do offer, they must pay half the cost.

The more I dig into this, the more complex it is.

From a CPA's website:

Penalty for employers not offering coverage. An applicable large employer who fails to offer its full-time employees and their dependents the opportunity to enroll in minimum essential coverage under an employer-sponsored plan for any month is subject to a penalty if at least one of its full-time employees is certified to the employer as having enrolled in health insurance coverage purchased through a state exchange with respect to which a premium tax credit or cost-sharing reduction is allowed or paid to the employee. The penalty for any month is an excise tax equal to the number of full-time employees over a 30-employee threshold during the applicable month (regardless of how many employees are receiving a premium tax credit or cost-sharing reduction) multiplied by one-twelfth of $2,000. For example, if an employer fails to offer minimum essential coverage and has 60 full-time employes, ten of whom receive a tax credit for the year for enrolling in a state exchange-offered plan, the employer will owe $2,000 for each employee over the 30-employee threshold, for a total penalty of $60,000 ($2,000 multiplied by 30 (60 minus 30)). This penalty is assessed on a monthly basis.
http://www.pscpa.com/publication/tax-changes-affecting-small-business-in-the-2010-health-reform-legislation/

[BlueIris]

43. The healthcare FUBAR screwed him, many Democrats who enabled that mess,

and this country's future. It was the worst political catastrophe I have seen my party create. I think there is the real possibility it killed the Democratic Party.

[Laura PourMeADrink]

47. Can't really tell if you are being sarcastic or serious...Seems to me

good and bad...but the overall impression by the public has been allowed to
matasticize into something equal to genocide.

to me, the good is that businesses will have to bite the bullet and
start covering people. Once they figure it out, start factoring in the cost and
get used to it- probably around 2016. But for them, a specific business segment, it's certainly no incentive to grow, IMHO

the non-denial of existing condition aspect is good except that I don't think
there's a premium control - so all a healthcare company has to do is jack up the
price so high - the person can't afford it anyway.

Would love to hear you expound on your post.

[kjackson227]

46. I agree that the Obama Administration has done a poor job...

in fully explaining how Health Care Reform will affect everyone, but it's all written out for EVERYONE to read (including businesses). Some businesses are using this as an excuse not to hire.

http://www.whitehouse.gov/healthreform/downloads

[Laura PourMeADrink]

48. I agree...but some of it is not really a known until you actually get

to 2014. The whole thrust is to make sure people have insurance in any way possible:
(1) covered by a spouse or (2) pay outright individually or (3) have employer pay or
(4) person buys into the state exchange.

If I am understanding correctly, a company only pays the penalty if their employees
actually buy into the state exchange. So, you wouldn't really know that until
2014. If a company decides to offer coverage, they won't really know the cost of
that conclusively either because people will have to compare cost against what they
pay now - or what their spouse pays - or what the state exchange costs.

My only point is that there is uncertainty

[kjackson227]

52. Yes, there is a lot of uncertainty, but I think there are agencies...

out there that can help with some of the questions that businesses and individuals need to have answered. Do you know if any of these businesses/individuals have contacted the Department of Health and Human Services, IRS, and their state insurance commissions to see how HCR will affect them personally? Supposedly, these are the agencies that we need to contact for information.

[Laura PourMeADrink]

53. No, but thanks so much for passing that on, I will tell them - a good

CPA that's up on the subject will help too. Think the IRS haven't really
been out that long.

[WI_DEM]

49. Actually Obama spent much of his first two years focused on health care when he should

have been focusing on the economy and jobs. If he had done that we might have not lost congress.

[Laura PourMeADrink]

51. If you put it in the setting at the time -"We are on the verge

of the Great Depression II", in retrospect, it was bad timing. Unfortunately
people won't worry about others when they are worried about themselves.

I think that the scaring people to death shortly before and after Obama's
election was the absolute worse thing to do since it spooked everyone so
bad...and they are still spooked.

Then, the debt ceiling scare....and now people think we can't spend a
cent. Exactly where the repukes want a Democratic presidency to be