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White House: Get ACA Insurance Coverage, Launch Start-Ups 578

Posted by timothy
from the have-your-neighbors-pay-the-rent-too dept.
dcblogs writes that the Obama Administration is urging tech entrepreneurs "to sign up for health insurance under the Affordable Care Act, and said having the coverage will give them the 'freedom and security' to start their own businesses. 'There is strong evidence that when affordable healthcare isn't exclusively tied to employment, in more instances people choose to start their own companies,' wrote White House CTO Todd Park in a post to launch its #GeeksGetCovered campaign. Bruce Bachenheimer, a professor of management at Pace University and director of its Entrepreneurship Lab, said the effort is part of a broader appeal by the White House to get younger and healthier people to sign-up for Obamacare, and is in the same vein as President Obama's recent appearance on Between Two Ferns." Removing the tax structures that make companies by default intermediaries in the provision of health insurance, and allowing more interstate (and international) competition in health finance options would help on that front, too, aside from who's actually footing the insurance bill.
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White House: Get ACA Insurance Coverage, Launch Start-Ups

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  • I was on my own with a full-time consultancy, but I scaled it back to off-hours and went back to a forty-hour-a-week corporate job for the health insurance. The cost of individual health care plans was insane, and the crappy ACA plans provide worse coverage with fewer providers - and they're even more expensive!

    I really think what the feds are up to here is trying to kill off as many individual and small business operators as possible. After all, it's a lot easier to monitor and tax large corporate entiti

    • Re: (Score:3, Interesting)

      by cayenne8 (626475)
      I found a few years ago...while doing 1099 through my S corp, that it wasn't that bad for insurance.

      I had (at the time) a high deductible plan, basically what used to be called "major medical", for needs if I got hit by a bus, etc.. The deductible was only about $1200.

      I coupled that with a HSA (Health Savings Account) which unlike the FSA's are not use it or lose it, they roll over annually. I socked away about $3K pre-tax annually and out of that, I paid my routine med visits and drugs.

      I really liked t

      • by cy (22200) on Thursday March 13, 2014 @08:53AM (#46472727) Homepage

        Minimums are needed because cross subsidisation is rather integral to having affordable healthcare for everyone. Meaning those who are in the stage of their life that don't need much medical care pay more, but those that do are able to afford it.

        I definitely agree with the suggestion that you need to break the link between healthcare and employment. Because there's obviously a very strong link between unemployment and needing medical care. I love living in a country with universal healthcare funded by taxation. Sure it means that I end up paying a lot more than I otherwise would, but it provides a safety net for everyone - including me should I happen to get unlucky and end up sick and unemployed. People don't end up having to declare bankruptcy because of medical bills or go without life saving medical care. And everyone is able to access a reasonable standard of healthcare (and the wealthier are not restricted from getting gold plated service if they wish to pay for it). But hey I realise that for a lot of Americans that concept is just communism so it'll never happen

        • by Jane Q. Public (1010737) on Thursday March 13, 2014 @11:36AM (#46474271)

          "Minimums are needed because cross subsidisation is rather integral to having affordable healthcare for everyone."

          Yes. Cross-subsidization (also known as "socialism") has resulted in most people I have spoken to paying 40% to 60% more on their premiums, with a higher deductible.

          It has also resulted in fewer young people with insurance, because their premiums went way up. It's DUMB to raise rates on the demographic that (A) is essential to funding the program, and (B) needs it the least.

          I grant that it is a good thing to get insurance away from ties to "traditional" employment. But doing so through Obamacare is kind of like cleaning your windows by taking a sledgehammer to them.

      • by jeff4747 (256583)

        Keep in mind deductibles are not the same as they used to be.

        The deductible you're talking about in your old plan would pay nothing until you reached the deductible.

        The deductible in an ACA plan does not apply to a large number of routine procedures. Those are covered with a co-pay instead. For example, instead of paying full price for a check-up because you haven't hit the deductible, you pay around $10-40 depending on plan.

        • by cayenne8 (626475)

          The deductible in an ACA plan does not apply to a large number of routine procedures. Those are covered with a co-pay instead. For example, instead of paying full price for a check-up because you haven't hit the deductible, you pay around $10-40 depending on plan.

          This does not seem to be the case for any of the plans I looked at. And even when I hit deductible, the insurance on most of these plans seem to only pay about 70% tops of the bills.

          • The absolute maximum yearly out of pocket allowed under the ACA is $6700 iirc. So your insurance company is required to cover 100% of any bills once you've hit that cap.
            • by nbauman (624611)

              The absolute maximum yearly out of pocket allowed under the ACA is $6700 iirc. So your insurance company is required to cover 100% of any bills once you've hit that cap.

              The best way to understand the ACA is that your maximum of (premiums + out of pocket) is ~$8,000 for an individual. So whatever crazy policy you gamble on, your worst case is $8,000/year.

      • by zarthrag (650912) on Thursday March 13, 2014 @09:13AM (#46472939)

        The government doesn't set prices for procedures. The fed could extend the medicare pricing list to everyone instead of having to deal with each insurance company's "negotiated pricing" and arcane "most favored nation" contract rules. Or maybe employers could be required to offer up the cash that would have been spent on the company health plan so you can shop for yourself. Shopping for insurance across state lines would certainly be nice! Also, repealing state regulations that limit the size/capacity of hospitals.

        My HSA should stay that way, if it's my money, no one should be able to take it but me! ...Actually, I wish my HSA could be grown and used as some kind of bond-like health insurance that also lowers my own premiums over time.

        There are lots of political problems that could be fixed without repealing the ACA. 99% of it is removing greed, the #1 killer in America.

      • by pnutjam (523990)
        $240 a month is pretty close to $3k a year. Where you including your HSA payments?
      • I'm looking to go that route again, but man...I looked at the health sherpa site that shows what obamacare offers in my area, and deductibles on anything but near gold plans is over $3K?!?!?

        I got a technically silver PPO plan (effectively gold if I stay in network with Blue Cross) that is compatible with an HSA. (HSAs are great) Cost to me is about $300/month and I get no subsidy. $4800 out of pocket max and $3K deductible. Everyone worries about the deductible but that isn't the important bit. The important bit is the out of pocket max. Health insurance isn't supposed to be to pay for your regular checkup. It's to keep you from going bankrupt if something serious happens.

        I would end up on many plans paying about $3K a year in premiums AND $3K+ in deductibles before I started having any insurance kick in. WFT?

        That's what an

    • I'm skeptical of any anecdotes I hear about obamacare. On top of the fact that anecdotes aren't real evidence, there have been several well-publicized obamacare horror stories that have turned out to be far-right funded lies.

      The other way is also true. The "strong evidence" that obamacare is going to make many more startups doesn't seem to be much more than a theory. Here's the study they're referring to. [rwjf.org] Seems odd that they don't show self-employment increasing in Massachusetts, given that Romneyca
    • by sjbe (173966) on Thursday March 13, 2014 @09:02AM (#46472829)

      The cost of individual health care plans was insane, and the crappy ACA plans provide worse coverage with fewer providers - and they're even more expensive!

      I have exactly the opposite experience. I got a better plan for roughly the same cost and I had numerous to choose from. I also was able to get a Health Savings Account which is a great deal if you are eligible for one. My out of pocket maximum is around $4800 per year which I can easily manage if I have to. Most importantly my ability to get and keep health insurance is no longer tied to a specific employer which is LONG overdue. It should never be the case that losing your job should cause you to lose your health insurance. That's just morally wrong.

      I really think what the feds are up to here is trying to kill off as many individual and small business operators as possible.

      I run a small business (a manufacturing company) and the Affordable Care Act has been hugely helpful to us. Our employees were able to get similar coverage to what they had with our company plan, usually for less money out of pocket. Plus the company did not have to pick up any of the cost which saves our company roughly $10,000 per year. Basically we were paying roughly $550 per employee per month and the company picked up half the cost for an HMO. Now our employees are paying between $130-250/month out of pocket and the company doesn't have any of the cost.

      • by pnutjam (523990)
        Any of those savings (which could be considered part of an employees salary) get passed on to the employee?
        • Passing on savings (Score:5, Informative)

          by sjbe (173966) on Thursday March 13, 2014 @10:05AM (#46473437)

          Any of those savings (which could be considered part of an employees salary) get passed on to the employee?

          Any of those savings (which could be considered part of an employees salary) get passed on to the employee?

          We were able to give raises we couldn't before. The company kept some of the savings and some of it got passed on.

          The challenge is that we offered health coverage to everyone but not everyone took it. That was their choice to forego the insurance. It's unfair (and can create legal problems) to give raises only to those who took insurance through our company when others are doing the same job just as well. Any time you have two people doing the same job you have to have a justification if you are going to pay them differently based on responsibilities or performance. We also offer an IRA with an employer match but not everyone chooses to participate. We don't give raises to those who don't participate.

    • by nbauman (624611) on Thursday March 13, 2014 @09:43AM (#46473251) Homepage Journal

      Here's what Krugman had to say. If you say you did the math, you might be right, but there are a lot of BS health care stories out there. The big benefit of Obamacare is that it limits your (pemium+copayments) to ~$8,000. One big weakness of Obamacare is that when you find an "affordable" plan, it might have a small pool of doctors, it might not have a doctor that you've been using, and it might not have an competent doctors at all. Single payer would have been better, but, as Uwe Reinhardt says, the American political system is too corrupt for that.

      http://www.nytimes.com/2014/02... [nytimes.com]
      Health Care Horror Hooey
      Paul Krugman
      FEB. 23, 2014
      (Right-wingers convinced Americans that farms are being broken up to pay "death tax" estate liabilities, but there is not one single example. Now the Republicans are creating Obamacare horror stories, which don't hold up upon fact checking. In the GOP response to the State of the Union address, Rep. Cathy McMorris Rodgers claimed "Bette in Spokane" had lost her good insurance and was forced to pay $700 a month more. Local reporters found the real Betty, and found out [Bette Grenier had a catastrophic plan, and she refused to look on the ACA web site.] In Michigan, Americans for Prosperity, funded by the Koch Brothers, is running an ad about Julie Boonstra, who has leukemia, saying that her new policy will have unaffordable out-of-pocket costs. But Glenn Kessler of the Washington Post found that she will be saving more than she will be paying in out-of-pocket costs. [The Obamacare out-of-pocket maximum is $6,350. Her premiums were cut in half, from $1,100/mo to $571/mo.])
      [T]he true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.

    • by hey! (33014)

      How high is "insanely high"?

      For a family with two 40 year-old non-smokers and two children under 21, making the median household income of $50,054/year, the average annual silver plan premium, nation-wide would be $9700/year. That's a lot, but not unreasonable given what a silver plan covers. But here's the kicker: Uncle Sam cuts your taxes to the tune 65% of your premium, so effectively you only pay $3373/year. If you were getting anything close to silver plan coverage for much less than $281/month, I'd b

  • by Anonymous Coward

    Spreading the government propaganda.

    Get paid for that?

    You know what would help startups?

    LOWER TAXES, LESS REGULATION and a government doing its job by enforcing the laws equally between the little guy and the mega corp... rather than giving preferential treatment to whomever pays the most.

    Like advertising for Obamacare.

    • by Ksevio (865461) on Thursday March 13, 2014 @11:01AM (#46473951) Homepage
      So we're shifting the tax burden off of the businesses - are you then in favor of higher property taxes? A larger income tax? Maybe you'd like to cut programs to help poor people? Is there any evidence that shows lower taxes make the economy stronger or the country better?

      Now which regulations are we going to get rid of? Typically the government adds regulations in response to abuse of the system. Maybe we should let companies pollute the rivers as long as they promise not to do it too much? How about lower the safety requirements as long as not many people get chewed up by machinery. Or maybe just let people discriminate against the handicapped.

      But yeah, let's worry about getting people health care because it was working perfectly before Obama came along and ruined it for everyone.
  • There is strong evidence that when affordable healthcare isn't exclusively tied to employment, in more instances people choose to start their own companies

    Worker gets laid off, loses employer-provided health plan. Worker can't find full-time employement; becomes consultant to pay bills; buys health insurance. Conclusion: buying health insurance motivates worker to become consultant!

    Removing the tax structures that make companies by default intermediaries in the provision of health insurance, and allowing more interstate (and international) competition in health finance options would help on that front, too

    Translation: if we can remove one of the incentives for companies to provide health care plans, then more people will be forced to buy private health insurance! Yay!

  • by JWW (79176) on Thursday March 13, 2014 @08:49AM (#46472687)

    We'll provide you with health care through the ACA and you'll be able to start your own business!

    Then after you realize that government regulations are so onerous that its really difficult to get a business started, you'll have to go back to working for a big company.

    • by DogDude (805747)
      Then after you realize that government regulations are so onerous that its really difficult to get a business started, you'll have to go back to working for a big company.

      Like what regulations, exactly?
    • by Overzeetop (214511) on Thursday March 13, 2014 @10:49AM (#46473839) Journal

      Congratuations, you've just found out what the Republicans felt was the best system for healthcare. If the Democrats had had there way, it would be single payer - not "how much profit can we make" insurance companies.

      • by microbox (704317)
        The ACA was the conservative alternative to Bill Clintons attempt at health reform in the early 90s. It was supported by key conservatives up until.... the election of Obama.
  • A failed web site launch, failure to meet their initial sign-up goal, failure to meet their predicted sign-up goal, continual fudging of implementation dates for random portions of the ACA.

    It's just like having Bush all over again.

    Hopefully people have finally gotten the message and aren't handing over their money to private companies just because the government says you have to.

  • by jeff4747 (256583) on Thursday March 13, 2014 @08:52AM (#46472717)

    allowing more interstate (and international) competition in health finance options would help on that front, too

    Yeah, how'd that work out for banking? Interstate competition was supposed to do things like drive down credit card interest rates.

    Instead, almost every credit card in the US is issued out of Delaware or South Dakota. And interest rates are quite high. Why? Interstate competition also means competition between state legislatures for laws that are most favorable to banks.

    So what would happen with interstate health insurance? Legislatures would compete for the most insurance company-friendly laws. Which would be the least consumer-friendly laws.

    • You need to ask yourself your own question. Competition works out really well for so many things that you take for granted here. And instead you cherry pick one small aspect of one industry that you feel supports your opinion.
    • Interest rates on credit cards are high for a reason - they're a high risk loan. People that carry credit card debt are at high risk for declaring bankruptcy. The system is working correctly. Meanwhile, I love my bank. Free checking, great service. Interstate competition in banking has been fantastic. I've got 6 separate banking options within walking distance of my house. 2 national, 2 local, 2 credit unions. Heck, there are only 4 liquor stores in walking distance.

      In any event, separating health i

  • Because the crisis, by exposing the clubby and monopolistic nature of the current healthcare process, will cause its economic model to collapse. The feds will undoubtedly try to impose price controls, because this is the only way they know how to respond in such a situation. At that point, healthcare will FINALLY have to accept the more open-market approach that so many of us have suggested: prices "on the wall" for all procedures so the consumer can make open choices, freedom to shop around worldwide for b

  • Is the day I'll sign up for my own insurance.

    Right now, the market is so muddled I can't even tell from my non-functioning state website whether I qualify for subsidies or not, let alone be willing to put 1/6th of my paycheck towards health insurance that has such a huge deductible it will only pay if I get in a major accident.

  • by PPH (736903) on Thursday March 13, 2014 @09:27AM (#46473087)

    People, particularly young people, who want to start their own businesses, usually have to scrimp and save to come up with the initial capital. One method of doing this was to forgo health insurance for a few years, or to buy catastrophic medical coverage.

    No more. Cheap, high deductible policies are no longer allowed. And if you forgo coverage, the gov't will take it out of you in the form of a penalty.You can sign up for low income assistance, but forget trying to amass any startup capital or you'll run afoul of the means test.

    I feel sorry for young people who are trying to get ahead. I've been self insured for years and now, thanks to the ACA, my medical insurance costs will be passing my housing costs. And I don't live in a cheap area. I can practically spit on Bill Gates house from here.

  • Back when I worked for one of the top defense contractors, they really didn't pay us very competitively. I was looking around, and encouraged a good friend of mine to do so as well. He was a really good engineer, and deserved better. Unfortunately, he told me he couldn't.

    You see, a few months after hiring on right out of college, he discovered he had diabetes. Our employer's insurance continued covering him (because they had to), but if he tried to go anywhere else nothing diabetes-related would be covered

  • by mr_mischief (456295) on Thursday March 13, 2014 @09:42AM (#46473229) Journal

    How about instead of cost shifting and purchase pooling we actually work on what medical care costs in the first place? In the US you can got to Cook County or the US Federal court in the Eastern District of Texas and drive up a drug company's everyday costs by suing them in a class action for side effects they already disclosed before you bought their drug. There should be some sort of grand jury or board of people with a clue who decide the merit of these things before millions are spent on lawyers.

    The for-profit speculative commission-only trial lawyers are a big part of service and product costs for drug companies, hospitals, clinics, doctors, nurses, and even medical assistants and medical techs. If you want to make healthcare more affordable through insurance cost changes, change the cost of malpractice insurance so that only people who actually screw up need to pay exorbitant premiums. When I lived in Illinois it was really difficult to get a doctor's appointment within six months without crossing state lines because the malpractice rates caused several of the doctors in the area to retire early or move to more sensible states.

    Also, why do we have federal and state funds going into basic research at universities that gets patented and sold to corporations to turn into products? If research comes from a largely government-funded school then the NIH or someone should be licensed to then sublicense any of those patents to all comers for a reasonable fee.

    Also, why do the drug companies pay the FDA to fast-track drugs? The PDUFA [fda.gov] means that in order to get faster drug trials, the deeper pockets get faster times to market. If we're spending billions of dollars to improve healthcare, why don't we fund the FDA sufficiently to get the best drugs approved fastest rather than the most heavily promoted ones? Why don't we partner with other developed countries to do joint trials that meet the standards of the FDA and its counterparts in, say, the UK, Germany, France, Japan, South Korea, Canada, Finland, Sweden, and Brazil with all the agencies reviewing all the data and making decisions for their own constituencies rather than repeating the trials over and over?

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