Now that the Supreme Court has ruled that Obamacare, the so-called Affordable Care Act, can stand, we must focus on the many challenges that the law presents for Maine.
Although Obamacare is the single largest government intrusion into the private health insurance market, it is important to recognize that Maine is in a somewhat unique position. First, Maine is one of a handful of states with a regulatory framework that is in many ways already more restrictive than Obamacare.
For example, many states will experience significant rate increases when they transition to guarantee issue and community rating under Obamacare; Maine adopted these two reforms in 1993.
Maine also passed Public Law 90 in 2011, which has already helped to lower insurance premiums for many small businesses and individuals. Several reforms in PL90 have yet to fully materialize and will continue bringing much-needed relief to Maine’s insurance market. This law was specifically designed to comply with the health care overhaul.
However, we must not understate the negative effects Obamacare will have. Many provisions in this complicated law will increase insurance premiums, and many others will hurt businesses.
New taxes under Obamacare are expected to increase insurance premiums, such as a medical device tax, starting in 2013; a tax to fund comparative effectiveness research, also starting in 2013; and an annual fee on health insurers, starting at $8 billion in 2014 and increasing to $14.3 billion by 2018.
Employers now face a number of new reporting requirements. They must record the value of health benefits on employees’ W-2 forms, and they must file reports with the secretary of the Department of Health and Human Services regarding whether plans meet certain criteria. The staff time necessary to ensure compliance with these new regulations will inevitably increase the cost of providing employer-sponsored health insurance.
One of the most notable impacts of Obamacare pertains to the coverage itself, including premium contribution and eligibility criteria for their employees. Health plans must contain all required “essential benefits,” as defined by DHHS, and they must meet certain actuarial values. Mandating these benefits will result in more expensive plans than are now offered.
Under the law, waiting periods for new employees to get health plans may not exceed 90 days. This provision will be particularly acute for Maine’s construction industry, which commonly imposes six-month waiting periods. Since construction workers often come and go during their first six months, contractors will now be required to manage paperwork and expense for employees who may be gone in a few weeks.
Obamacare mandates that employer premium contributions must result
in “affordable” coverage for employees. “Affordable” is defined as employee contributions that do not exceed 9.5 percent of their family income. This is challenging for employers because they have no way to verify what an employee’s family income is.
The law also requires that employers offer health coverage or face severe penalties. This specifically affects employers with 50 or more employees. To determine the number of employees they have, employers must count part-time employees using a calculation to determine full-time equivalents.
Seasonal employees may be excluded unless they work greater than 120 days per year. This will hit Maine’s tourism industry especially hard, since most seasonal employees in Maine work more than 120 days. Seasonal businesses that do not offer coverage now will be severely affected by the cost of providing health coverage for these employees.
There is legitimate concern that some companies may choose to pay fines, rather than continue to offer health insurance coverage, to avoid the costly burden of maintaining compliance with Obamacare’s requirements. Other companies that do not offer coverage could now face penalties that will threaten their very existence.
Obamacare subsidizes a very inefficient health care delivery system, further insulates that system from market forces and mandates many provisions that will put upward pressure on insurance premiums, adding more financial challenges to businesses that are already struggling.
At the same time, Maine’s efforts to reduce insurance regulations and encourage new competition has produced lower insurance rates for many and will introduce new competition in the market. So how do we improve Maine’s health care delivery system and lower costs in this environment?
At The Maine Heritage Policy Center, several important strategies will guide our health care policy work over the next couple of years, regardless of whether Obamacare is implemented or repealed. We will promote transparency in health care cost and quality, we will identify barriers to market forces in health care and we will promote patient-centered policy reforms, including payment reform that would align incentives among patients, providers and payers.
We cannot count on the federal government to solve the health care problem. It is up to us to promote a competitive, responsive and efficient health care delivery system.
Joel Allumbaugh is director of MHPC’s Center for Health Reform Initiatives. He is also CEO of National Worksite Benefit Group, Inc., a full-service employee benefits insurance agency specializing in consumer-driven health plan strategies.
Obamacare must be repealed. It is the biggest piece of socialist legislation in the history of this nation. And we’re not gonna’ take it.
Bigger than SS, medicare?
Yes. Much bigger. And even more unsustainable.
Absolute hogwash lies you are chirping back from the sludge you listen to on Rush Limpmind and Fake-News. Anything you people can do to be corporate toadies and kiss the toes of your corporate masters and destroy the middle class, you do it. ObamaCare is the same as RomneyCare is Massachusetts, and that program is actually popular and successful. You right wingers would crawl through a snowstorm to give a tax cut to a billionaire job killer who spends his days figuring out how to ship US jobs to the third world, and then you turn around to do everything you can to give the middle class the shaft. The mandate in ObamaCare, the healthcare exchanges, and many other provisions were originally REPUBLICAN ideas before you people went TeaRadical and before Obama was elected. This is the most radical, corporate-toadie, and hypocritical Republican party we have ever seen in the history of this country, and that is exactly why, certainly here in Maine, the TeaRadical Party of LeBUFFOON is going to get smashed to pieces in November.
OhOh…no(bama) or his Russian Roulette care(some parts are needed but all needs to be repealed then restructured with Congress knowing what’s in there).
I believe it’s been over 2 years since ACA was passed. Now to my knowledge every member of Congress and the Senate has a staff of people who it is hoped know how to read. I can usually read a 500 page book in less than a week. How many pages are there supposed to be in this document? I would venture that you could get a copy and read it yourself in about a month. That is if you are interested in exactly what is in it. Or you can just take Fox News and Rush Limbaughs version as gospel.
Data please.
Yes..One Fifth of our economy…
Thanks for calling Mitt Romney a socialist, as ObamaCare is merely the federal twin of the RomneyCare law in Massachusetts. So your own candidate is obviously a socialist, and your preference is the TeaRadical health plan which is: “If you get sick, please DIE QUICKLY so we can keep kissing the toes of our corporate masters.” You might actually try writing something original and not just repeating the ignorant lies you listen to on FAKE-News and the Rush Limpmind show. Also, I will expect that you will never accept SOCIALIST Medicare nor SOCIALIST Social Security, and that you will start lobbying Congress to dramatically reduce the SOCIALIST military, and stop the SOCIALIST oil company subsidies, and that you will never call your SOCIALIST police department, nor your SOCIALIST fire department, nor drive on SOCIALIST roads, nor walk on SOCIALIST sidewalks, nor use a SOCIALIST public park of any kind, nor use the SOCIALIST U.S. postal service, nor send your kids or grandkids to SOCIALIST public schools so they can play on SOCIALIST public school sports teams. You know, come to think of it, YOU are a SOCIALIST, and underneath all your nonsense, you darn well know it.
Gosh, I guess if someone slaps the term “socialist” on anything, some people simply have to oppose it.
Watch out for “socialist” fire departments (they use our tax money to fight anyone’s fires), public schools, police departments, and of course the military and VA, all government-funded. Better not drive on “socialist” roads or cross socialist bridges, or use socialist electricity. Ooops. now you’re confined to your home in the dark…
Maine Heritage Center–working against the needs of Mainers, as usual. Romney’s own opposition to Obamacare is intriguing–First candidate to run for president with the idea that too many people have insurance coverage.
“The move to greater insurance coverage would likely result in substantial savings for state and local governments. Rather than harming the budget situation of the states, health insurance reform would improve it.” [http://www.whitehouse.gov/administration/eop/cea/Impactofhealthinsurancereform]
Full report here (The Impact of Health Insurance Reform on State and Local Governments)
: http://www.whitehouse.gov/assets/documents/cea-statelocal-sept15-final.pdf
The TeaRadical Republicans exist to LIE and to be corporate toadie hypocrites out to destroy the middle class and do anything at all possible to kiss the toes of the insurance company and corporate masters.
Who do you love, comrade?
PS,were the toes with or without dirty socks?
Th study is correct as far as it goes. The problem is that it doesn’t go far enough and therefore is fatally flawed.
All of the savings for state and local governments will not actually happen because of unintended consequences of the law. The numbers are based on applying the law to a static model when in fact many of the base assumptions will change as people and businesses react to the law.
The second major flaw is actually more serious and should be considered outright deception on the part of the authors. Almost all of the projected “savings” are not savings at all. They simply cost shift the expenses from state and local government to private individuals, business, new federal taxes, and federal borrowing. All of which ultimately falls back on people. You are just taking the money out of a different pocket.
A healthier America will be a stronger America. America can afford to improve public health. After all, there’s always plenty of money available for wars. It’s simply a matter of priorities.
Nice platitudes. No one can disagree with them. The point is that the ACA will not result in either a healthier America or in improved public health in the way you assume. Of course, by rationing and denying care to the most vulnerable of our citizens, the elderly and the very young, statistically we will be healthier. Those groups can just go home and die earlier …. Just like European countries do.
It is the for-profit insurance corporate model that rations and denies care. A woman who moved to Canada writes about “How I lost my fear of universal healthcare.”*
“When I moved to Canada in 2008, I was a die-hard conservative Republican. So when I found out that we were going to be covered by Canada’s Universal Health Care, I was somewhat disgusted…
“Fast forward… I had better prenatal care than I had ever had in the States. I came in regularly for appointments to check on my health and my babies’ health throughout my pregnancy, and I never had to worry about how much a test cost or how much the blood draw fee was. With my pregnancies in the States, I had limited my checkups to only a handful to keep costs down. When I went in to get the shot I needed because of my negative blood type, it was covered. In fact I got the recommended 2 doses instead of the more risky 1 dose because I didn’t have to worry about the expense. I had a wide array of options and flexibility when it came to my birth, and care providers that were more concerned with my health and the health of my baby than how much money they might make based on my birth, or what might impact their reputation best…
“When health care is universal, Drs are free to recommend and provide the best care for every patient instead of basing their care on what each patient can afford.
“I started to feel differently about Universal government mandated and regulated Health care. I realized how many times my family had avoided hospital care because of our lack of coverage. When I mentioned to Canadians that I had been in a car accident as a teen and hadn’t gone into the hospital, they were shocked! Here, you always went to the hospital, just in case. And the back issue I had since the accident would have been helped by prescribed chiropractic care which would have been at no cost to me. When I asked for prayers for my little brother who had been burned in a camping accident, they were all puzzled why the story did not include immediately rushing him to the hospital. When they asked me to clarify and I explained that many people in the States are not insured and they try to put off medical care unless absolutely needed, they literally could not comprehend such a thing.”
[http://www.rhrealitycheck.org/article/2012/07/12/how-i-lost-my-fear-universal-health-care]
Please don’t ask me to believe that in Canada after a car accident everyone always goes to the hospital. Or that in the US her parents did not take her brother to the hospital if he was severely burned. This whole story sounds made up from beginning to end.
Now let me tell you two true stories I PERSONALLY know of.
I was in a car accident years ago. My back was screwed up and sometimes still bothers at the point injured. I went to the hospital and I had insurance. The hospital took x-rays, looked me over and told me I was OK and everything would be fine. I went to a chiropractor about 12 years later for a different, work related injury. The chiropractor took one look at the x-rays and told me that in addition to the new injury he could see this old one at a different spot. He did fix it as well.
I have a daughter in law who married a Canadian citizen and moved to Canada years ago. She complained of abdominal problems and was put on waiting list after waiting list for tests and eventual treatment. It wasn’t an “emergency”. Finally her husband landed a job in the US and they moved. My daughter in law was seen by an American specialist for her problem in only 2 weeks. Surgery to correct the problem was 1 week after that. But because of the long delay for treatment in Canada the problem had left her permanently unable to have children.
I have a close friend who injured his shoulder, rotator cuff, while in Canada. Because of delays in treatment, (again not an emergency), it healed wrong and they had to go in and actually break it and have it heal all over again. But because of the delay he now has a 30% permanent reduction in mobility in that shoulder. Not to mention all the pain and suffering.
You’ve provided stories about poor treatment in both the US and Canada.
Here’s info from an article in the Canadian medical journal [http://www.cmaj.ca/content/181/8/E128.full?etoc]:
“Canada’s “socialist” health system is the favourite whipping boy of antireform lobbyists, who employ fear-mongering and myths about rationing, waiting lists and lack of choice to persuade the American public to accept their stat us quo as better. As Canadians, we agree that Canada’s health system is not perfect. We have said so many times in CMAJ. Nevertheless, it takes only a few comparisons to show how much better Canada’s health system is than that of the United States — and how much Americans could hope to gain from embracing reform…
“Consider the following statistics, taken from the Organisation for Economic Co-operation and Development’s health data for 2006. 1 We start with the most basic outcomes any health care system is supposed to optimize: life and death. The life expectancy of an average American is nearly three years shorter than that of an average Canadian (78.1 v. 80.7 years). That survival gap starts from the moment of birth: infant mortality is higher in the US than in Canada (6.7 v. 5.0 deaths per thousand live births). Yet the US economy spends — or increasingly, borrows — more than half again as much for health care as does Canada’s (16% v. 10.1% of the economy). And despite spending so much more, Americans get to see their doctors a third less often than Canadians (3.8 v. 5.8 doctor visits a year).
While these differences result from many factors, the inescapable truth is that, compared to Canada, America is achieving poor value for money from its health care system, and that is killing Americans. The potency of that truth is the reason why antireform lobbyists are now turning to attack Canada’s system.
“As Republican strategist Dr. Frank Luntz puts it, the opposition’s strategy rests on “health care denial horror stories from Canada.” Yet the attacks are so absurd and full of fantasy that they would be laughable — if not for the fact that many Americans believe them.”
The statistics on longevity and infant mortality are suspect at best.
Lets take infant mortality.
conferenceboard.ca/hcp/details/health/infant-mortality-rate.aspx
Especially read the part titled “Why is Canada’s infant mortality rate higher than those of most peer countries?” The same factors apply even more to the US. And do you even know that in several European countries, (I have not looked at all), infants born alive but under a certain gestational age or birth weight are given only palliative care and are NOT counted as a live birth therefore neither is their death included in infant mortality.
theglobeandmail.com/news/politics/canadas-reputation-for-low-infant-mortality-takes-stunning-decline/article1211391/
Life expectancy statistics are equally skewed by not analyzing the causes of death. For one thing accidental deaths need to be adjusted for since these have NOTHING to do with the quality of health care.
As for your doctor visit statistic. It is a fact that in countries with “free” health care people visit doctors more. Duh, it’s FREE. That doesn’t mean that those additional visits are either necessary or warranted. And how about the many Canadians who have to enter a lottery just to get an appointment with a doctor?
The genius of corporate America is its ability to enlist Republican voters to advocate against their own best interests, using whatever propaganda comes to hand.
Do you really WANT to be denied health insurance due to a pre-existing medical insurance?
If you have insurance through your employer, do you realize that if and when you lose your job, your health insurance vanishes along with it?
Do you get a kick out of your insurance premiums subsidizing corporate PROFITS that include CEO salaries that amount to more in one day than most Americans make in a year?
Do you hope that one day, when you or someone you love are desperately ill, a for-profit insurer will declare a lifetime cap on benefits, starting immediately?
Are you delighted that the for-profit insurers can rescind (cancel) your insurance coverage once you get sick, after years of paying premiums, because they’ve combed your records looking for an excuse to avoid paying for your care, and discovered some minor and irrelevant error in your original application?
If you have a young adult child or grandchild who can’t find a job that includes health insurance do you hope to NOT be able to keep them on your own policy?
The ACA prevents these and other atrocities.
Suppose everyone in your family is healthy, and some can’t afford for-profit insurance rates . Do you grasp that if they become the victim of a violent crime they could end up with bills in the millions of dollars, and friends will end up posting appeals for donations? Caleb Medley is one of the victims of last Friday’s shooting at a midnight showing of The Dark Knight in Aurora, Colorado. Medley was shot in the eye and remains in a coma in intensive care. Medley doesn’t have health insurance, and his medical bills may total more than $2 million.
[http://healthcareforamericanow.org/2012/07/25/when-victims-of-violent-crime-lack-health-insurance/]
Oh yes, such good care. How would you like to have to wait 6 months or more to see a specialist for a non emergency condition? While in severe pain the whole time? And then to be told you would have to wait another 3 months for the MRI necessary to diagnose your problem and then the doctor will see you again? Where he will schedule the treatment or surgery to help you…. another few months later….
Do you even consider the number of Canadians who die of cancer or have much poorer treatment results because of delayed care?
Well, I guess this corporate liar hates ROMNEYCARE just as much and so hates his own candidate’s plan.
I just love watching the MHPC try to ice skate up hill, don’t you ?
Even if this slanted oped piece were true it would still be worth it, given that our nation has long cast American citizens with pre-existing conditions or catastrophic illnesses to the wolves. After all these years of double-digit increases that benefitted insurers and healthcare providers, why not have an increase that actually benefits many consumers? However, the author conveniently ignores the numerous aspects of the ACA that actually will start driving costs down, as he probably didn’t bother to research any of them. Ideology is a terrible burden when commenting on complex legislation containing multiple economic factors that don’t lend themselves to back-of-the napkin analysis.
This administration is trying to destroy the middle class for political gain and attacking small business is the most effective way to attain that goal.
My thoughts on the encroaching communist menace that is Nobamacare:
appellatesky.blogspot.com/2012/07/prying-my-insurance-card-from-my-cold.html
Wow, you really had me going there! The first several paragraphs of your blog sounded so much like typical right-wing rants. Then you got to the heart of the issue:
“there are currently 48 countries with a lower infant mortality rate than us, 37 with a higher life expectancy, 41 with a lower child mortality rate, that half of our health care spending goes to treat 5% of the population, that lack of health insurance is associated with more than 40,000 deaths in the U.S. each year, that nearly two-thirds of our bankruptcy filings are due to illness or medical bills, that 23 countries have a higher healthy life expectancy, and that 36 countries are deemed by the World Health Organization to have overall better health care systems.”
MHPC, that’s all I need to know about this piece.
Unfortunately, I didn’t read who wrote this (and from where) until the next to last paragraph. MHPC? And what sort of a “plan” do they have to replace ACA? The gang that can’t shoot straight (or accuratly)?