Category: New Health Care Law

The Path We Are On

Current law requires:

  • Medicare to slash physician fees by 25 percent next January (under the BBA).
  • Additional (ObamaCare-required) cuts to physician fees so severe that by 2030, Medicare will be paying doctors 60 percent less than private health insurance plans (and nearly one-third less than Medicaid pays!).
  • ObamaCare-mandated reductions in payments to hospitals so drastic that hospital prices for both Medicare and Medicaid will be around half those paid by private health insurers by the year 2040.
  • Eventually, payment reductions to hospitals will mean they are paid 61 percent less by Medicare and Medicaid than by private health insurers; physicians eventually will be paid 74 percent less under Medicare than private insurance.

More from Chris Conover.

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Mar 27, 2013 | 11 comments | by

Unintended Consequences of ACA

The rush to implement the Affordable Care Act, which is generating billions for insurers, hospitals and technology vendors, also looks like a boon for staffing companies, whose share prices have soared. But some suggest that exceptions for temporary employees could leave holes in the health law’s expanded coverage…

[I]n regulations issued last year the IRS left an opening for employers of “variable-hour” labor such as temp agencies. If it’s not clear upon hiring that an employee will consistently work more than 30 hours weekly, companies get up to 12 months to determine whether she is full time and qualifies for health benefits — even if she does end up working full time. Few temps last 12 months.

“The overwhelming majority of temporary help workers, even if they were working full-time on a weekly basis for a number of months, wouldn’t be covered because of that 12-month look-back period,” said the Upjohn Institute’s Houseman. The rules, she added, “were written in a very favorable way for the temporary help industry.”

Source: Kaiser Health News.

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Mar 26, 2013 | 11 comments | by

You May Have to Cook Your Own Burger

And fry your own fries. This from the Hudson Institute:

Our report shows that [ObamaCare] will have negative effects on the franchising industry’s ability to grow and create much-needed jobs for the U.S. economy. We estimate that the law will negatively affect tens of thousands of franchise businesses, adding more than $6.4 billion in increased costs, not including the cost of regulatory compliance. Further, we estimate that the jobs of more than 3.2 million full-time employees in franchise businesses would be put at risk.

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Mar 25, 2013 | 4 comments | by

Quotations I Wish I Hadn’t Seen

CMS officials on the ObamaCare Exchanges, courtesy of Avik Roy:

“I’m pretty nervous — I don’t know about you.”

“It’s only prudent to not assume everything is going to work perfectly on day one.”

“As we move closer to October, my hopes are the range of things that could go wrong gets narrower and narrower.”

“Let’s just make sure it’s not a third-world experience.”

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Mar 22, 2013 | 10 comments | by

Signing Up For ObamaCare: The Chart Version

This is courtesy of Sarah Kliff. (Click here for a larger version). See our previous post on the 21-page form.

Signing up for ObamaCare

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Mar 20, 2013 | 10 comments | by

Why the ObamaCare Application Form is 21 Pages Long

Sarah Kliff explains:

ObamaCare is tricky business. In order to figure out how much Americans will pay, the federal government needs to collect lots of information, everything from the size of the family to its income to whether any family members are Alaska Natives (which would make them eligible for additional services through the Indian Health Service). It’s hard to collect all that data in a way that isn’t a bit complex.

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Mar 15, 2013 | 9 comments | by

A Telling Map

Less than 2 % of existing health plans meet the new ACA essential health benefits standards.

Essential Health Benefits Coverage in Existing Health Insurance Plans

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Mar 11, 2013 | 15 comments | by

Can H&R Block Make Health Reform Work?

Long before there was ObamaCare, my colleagues and I argued that H&R Block is an ideal organization to administer health insurance tax credits. The reason: almost all of H&R business these days is helping people get Earned Income Tax Credit “refunds.” Actually, the organization gives the “taxpayer” the money upfront and then files and cashes the IRS check when it arrives.

But withholding tax refunds is about the only way the IRS can enforce ObamaCare’s mandate. So the company is now considering how to help its clients enroll in Medicaid or in a plan sold on a health insurance exchange to avoid those withholds.

See Sarah Kliff’s blog on this issue.

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Mar 08, 2013 | 10 comments | by

ACA Effects on the Labor Market: Is Massachusetts a Guide?

“Yes” says the Dept. of Health and Human Services. So does the Urban Institute. Both sources are predicting only modest effects from an expensive ObamaCare mandate, backed by a $3,000 potential penalty and very high implicit marginal tax rates. But Casey Mulligan says not so fast:

As long as they do something like the 125 plan to help their employees use the federal tax exclusion, Massachusetts employers are only nominally responsible for the “affordability” of health insurance or for failures of their employees to take advantage of the plan offered. The Massachusetts penalty is only $295 per employee-year (as far as I can tell, it is business tax-deductible, which makes the $295 less than one-tenth of the federal penalty); it can be avoided by an employer that makes nominal contributions to its employees’ premiums and induces enough employees to participate…

[T]he federal law will put very different pressures on employers and employees than the Massachusetts law does. It would be unwise to assume that next year’s national labor market will follow the patterns that the labor market in Massachusetts experienced after 2006.

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Mar 05, 2013 | 10 comments | by

We-Have-To-Pass-It-To-See-What’s-In-It Fact of the Day

Employer penalties are not deductible. Casey Mulligan explains:

Thus you might think that the new $2,000 penalty would reduce wages by about $2,000 per employee per year. But unlike employer payroll taxes, the employer responsibility levies are not deductible from employer business taxes (see page 74 of this I.R.S. document). To have the same after-tax profit, an employer in the 39 percent bracket (a typical state-plus-federal bracket for corporations) would have to cut wages by $3,046.

An employer paying the $3,000 penalty would have to cut wages by $4,569. That would push someone working full-time at $10 per hour down to minimum wage.

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Mar 01, 2013 | 13 comments | by
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