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Author Topic: Obamacare Predictions for May 2015
JoshuaD
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Funean: Could you email me or message me the information you gave to your employees? It might help me find the appropriate insurance, and I'd be interested to read it in either case.
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Funean
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You bet. Is the email attached to Ornery still good?

NM, messaging because I don't think I can send attachments through the Ornery mail link.

[ December 25, 2013, 08:02 PM: Message edited by: Funean ]

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JoshuaD
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Thanks. [Smile]
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Seriati
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quote:
Originally posted by Greg Davidson:
Millions of men, women and children are about to get better health care than they would have if McCain or Romney would have been elected, or if Republican sabotage would have been more successful in throwing impediments.

Out of curiousity why do you believe this? The most likely result even if you sign everyone up on the new plans is not millions of people receiving better health care. The deductibles and costs on these plans mean for practical purposes those who could not afford plans in the old model are still not going to be flocking to doctors, and when they do it'll largely be paid out of pocket. Plus they'll have less money in pocket because of higher premiums, which even for those receiving subsidies will be a concern if they ever increase their income and exist from subsidies.

Out of curiousity, what will be the result if the Dems push through their minimum wage increase? Will it push people working 40 hours off of subsidies?

The only real gains that are oblivious are for catastrophic coverage (where the deductibles are still going to cause pain) and for those who were already sick and have a chance to convert a known crippling cost level into a subsidized payment stream (and that's whether or not they get an official subsidy since all-in they will pay less than the cost of treatment).

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AI Wessex
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It's unknown what the actual effects will be, but providing the opportunity for better health care to people who sometimes avoided it in the past can't be a bad thing.

It doesn't seem likely that the Congressional push for an increase in the minimum wage will happen. Localities will decide for themselves if they want it. Personally, I don't think it's reasonable for someone working full time to be in poverty.

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cherrypoptart
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I just saw this on the internet and have no idea if it's true or not:


"Comps of the top ceo's after Obamacare became law of the land in 2012.

Wellpoint ceo salary and bonus---- $48,566,512 This years increase 65.70 %

Tenet ceo salary---- $11,200,000 This years increase 5%

Aetna ceo salary--- $48,000,000 300% increase

Lifepoint hospitals ceo salary--- $23,544,715 21.03% increase

Health South ceo salary---$15,950,223 10.07% increase

HCA ceo salary--- $46.3 million 800% increase in salary"


but if it is true that seems quite excessive considering that we are now being forced to pay their salaries against our will and they get a guaranteed government bailout if they lose money on health insurance.

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TomDavidson
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In general, it is good to be a CEO.
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MattP
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Just picking one at random:
quote:
"Bertolini received no salary increase in 2012 and his bonus was down 55%," Aetna spokeswoman Cynthia Michener said. "The long-term stock payouts reported in 2012 actually include two years' worth of equity grants from prior years. No long-term equity grants are scheduled to pay out in 2013."
He wasn't given a bunch more money - he just cashed in his chips.
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G3
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quote:
(Reuters) - Health insurer Humana Inc said on Thursday that it projected its enrollment mix in private plans through the exchanges created by President Barack Obama's healthcare law will be, "more adverse than previously expected."

Humana attributed the enrollment trend to regulatory changes allowing people to remain in previously existing plans not sold on the exchanges. Obama proposed allowing insurers to keep selling plans that did not comply with the Affordable Care Act after political fallout that he was not keeping his promise that people can keep insurance plans if they like them.

It gonna be glorious!
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edgmatt
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quote:
but providing the opportunity for better health care to people who sometimes avoided it in the past can't be a bad thing.
- The opportunity was already there for those that were avoiding it.

- It could be real bad depending on the cost of providing such a thing.

It's so easy to shrug one's shoulders and say "well, we tried to do good, that can't be bad".

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G3
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quote:
“The Departments’ mid-range estimate is that 66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013,” wrote the administration on page 34552. All in all, more than half of employer-sponsored plans will lose their “grandfather status” and get canceled. According to the Congressional Budget Office, 156 million Americans—more than half the population—was covered by employer-sponsored insurance in 2013.

Another 25 million people, according to the CBO, have “nongroup and other” forms of insurance; that is to say, they participate in the market for individually-purchased insurance. In this market, the administration projected that “40 to 67 percent” of individually-purchased plans would lose their Obamacare-sanctioned “grandfather status” and get canceled, solely due to the fact that there is a high turnover of participants and insurance arrangements in this market. (Plans purchased after March 23, 2010 do not benefit from the “grandfather” clause.) The real turnover rate would be higher, because plans can lose their grandfather status for a number of other reasons.

How many people are exposed to these problems? 60 percent of Americans have private-sector health insurance—precisely the number that Jay Carney dismissed. As to the number of people facing cancellations, 51 percent of the employer-based market plus 53.5 percent of the non-group market (the middle of the administration’s range) amounts to 93 million Americans.

Glorious.
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Seneca
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No wonder King Obama is delaying the employer mandate until after the midterms.

Those are horrifying numbers.

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D.W.
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Is it not common to change providers or plans every 1-2 years? I assumed most firms shopped around pretty much every year for the best deal.

Is this shock/outrage/panic real or was I just inoculated against it by a frugal employer?

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Seneca
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Not every year or even 2.
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LetterRip
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DW,

most individuals have their policy cancelled every year, though that doesn't necessarily mean a change in providers. ANY change in policy has always required a cancellation of the old policy and signing up with the new policy - I think there were some sort of administrative notification changes though so people who were previously unaware that that is what happened for each minor change to their policy suddenly believe they are losing their coverage.

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G3
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We're having a little word game. Policies were not "cancelled" every year. Insurance policies may expire and require renewal. Most employers keep the same insurance provider from year to year. It's not really a cancellation any more than any other service you contract for over a set time period. Terms remain relatively consistent as do providers.

What is happening now is real cancellations. The policies people wanted to renew are frequently gone. In their place are new, expanded policies (like pregnancy coverage for men) with dramatically higher deductibles and premiums that people don't want and that very often exclude their preferred providers.

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Seneca
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Semantics, the not-so-new battlefield of the progressives.
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D.W.
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True I haven't changed provider AS frequently as that. (but possibly more often than normal?) I have had my plan changed or had the plan cease to exist and we adopted something similar to it.

quote:
What is happening now is real cancellations. The policies people wanted to renew are frequently gone. In their place are new, expanded policies (like pregnancy coverage for men) with dramatically higher deductibles and premiums that people don't want and that very often exclude their preferred providers.
This has been my experiance already the last decade of employment. Though typically the trend has been higher deductibles and premiums in exchange for less coverage. [Smile]

[ January 13, 2014, 06:45 PM: Message edited by: D.W. ]

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AI Wessex
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Obama certainly didn't create the trend toward higher premiums and out of pocket expenses combined with less coverage. The rate of growth in premiums has far outpaced inflation or wage growth every year for decades. What critics fail to acknowledge is that since the passage of the ACA that rate of growth is slowing and more people are getting coverage.

I don't understand why the issue of men having to have pregnancy coverage is being raised. That's not new at all, since I believe there's no such thing as "men only health insurance".

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TomDavidson
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quote:
That's not new at all, since I believe there's no such thing as "men only health insurance".
It is actually new, as women used to -- on some plans -- have to pay extra for riders for "woman-only" medical issues. Interestingly, men did not generally have to carry riders on "man-only" coverage.
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G3
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Finally getting a little breakdown on the demographics ... and it's bad. It looks like a onesie clad hipster sipping cocoa on Mom's couch did not inspire enrollments any more than slutty chicks or keg standing drunks. The 18-35 enrollment is a bust at just 24% - Barry needed it to be 39%. If these numbers hold, it's the "death spiral". Of course, what will most likely really happen is a bail out of the insurance companies.

They're counting about 2.1 million people enrolled. But again, we have to have some definition challenges to make that number work. Traditionally "enrolled" meant they'd paid their first premium and actually had insurance. Now it apparently means you just went through the sign up process. This is like Amazon counting something as a sale if you put it in your shopping cart.

How many have enrolled in the traditional sense? Well, that number is, shall we say, obscure. Estimates from insurance industry range as low as 10% and the administration puts it quite a bit higher at 50%. Uh, yeah. It's all about the level of suck on these numbers. Does it epically suck or just really suck?

Of the "enrollees", a full 79% will qualify for subsidies. Great.

55% of "enrollees" are over the age of 45 and a whopping 37% are over 55. I suspect some of you wonder why that's so bad ... take a guess at who requires more medical care and the most expensive medical care. Yeah, that's right, older people.

Add this little factoid in: 80% of the plans selected are the Silver, Gold or Platinum Plans. They took the most expensive plans. Any guesses why they'd do that? Come on, you know. The did it because they plan to get their money back and then some.

This is about as bad as it gets from a demographic perspective.

[ January 14, 2014, 10:03 AM: Message edited by: G3 ]

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geraine
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quote:
Originally posted by D.W.:
True I haven't changed provider AS frequently as that. (but possibly more often than normal?) I have had my plan changed or had the plan cease to exist and we adopted something similar to it.

quote:
What is happening now is real cancellations. The policies people wanted to renew are frequently gone. In their place are new, expanded policies (like pregnancy coverage for men) with dramatically higher deductibles and premiums that people don't want and that very often exclude their preferred providers.
This has been my experiance already the last decade of employment. Though typically the trend has been higher deductibles and premiums in exchange for less coverage. [Smile]
This generally depends also on the size of the company you work for. The company I work for has utilized Aetna and Blue Cross / Blue Shield for at least 15 years. We also have over 13,000 employees. The previous company I worked for had about 6,000 employees and had also utilized Aetna for over a decade.

Health insurance companies used to have HUNDREDS of different plans available. Health Insurance brokers would only offer a certain amount of plans....usually those that gave them the biggest commission. Those plans were not always the most expensive, they simply paid the broker more.

Over the past 10 years or so many payroll companies started to provide health insurance administration services. The company I work for has Health Insurance benefits that will literally shop the hundreds of plans out there for a client, not just the ones that provide a commission. I have clients that switch health insurance plans and companies on an annual basis, simply because we find a company that provides slightly better rates they had the previous year.

These are NOT forced cancellations, but a choice the employer makes. On the other hand, I had a client that operates in 16 states that planned on keeping their insurance with Aetna from 2013. Many of the plans they were offered in 2013 were cancelled and were no longer offered by Aetna in 2014 due to not meeting the "Minimum requirements." The requirement it didn't meet? The deductible. Everything in the plan complied with the ACA MRB (Minimum Required Benefits) except the deductible, which was $100 more than the maximum set forth in the ACA.

We had to shop around for the client and was able to get them a comparable plan close to the price they were paying. The real kicker is that while they were able to get a comparable plan with a deductible that met the deductible requirement, the employees now pay $400 more a year for employee only coverage.

Their employees are young and healthy, so understandably they were not too pleased.

ETA: I should mention that prior to the cancellation the client was told by Aetna that the premium increase for the plan that was cancelled would have increased $120 for employee only coverage, which was about $10 a month.

[ January 14, 2014, 02:02 PM: Message edited by: geraine ]

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D.W.
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quote:
These are NOT forced cancellations, but a choice the employer makes.
Fair point. A distinction I hadn't thought about previously. I'm unsure how many of the "changes" were due to the removal of an option as opposed to selecting something else upon a cost change of that option.

Also welcome. Too much information rather than opinion for our traditional greeting. [Razz]

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G3
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Staples decided in early December that effective with the week ending January 4, 2014, “part-time associates should not be scheduled to work more than 25 hours per week.” Staples has also informed managers that because of this move, they “may need to hire additional associates to ensure optimal staffing levels.”

Whole Foods is doing the same.

They join 389 other organizations as tracked by Investor's Business Daily who announced decisions to cut part-timers’ hours that can arguably be tied to the employer mandate.

So 2 predictions: 1) this will continue and more people will be forced to work fewer hours or be forced to accept that their full time positions will become part time and 2) this will be called "anecdotal" no matter how many companies do it.

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Seneca
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Underemployment is Obama's new America.
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Seneca
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Interesting comparisson between Obamacare and Walmart's health coverage

quote:
New Obamacare health insurance enrollees may feel a pang of envy when they eye the coverage plans offered by Walmart to its employees.

For many years, the giant discount retailer has been the target of unions and liberal activists who have harshly criticized the company's health care plans, calling them “notorious for failing to provide health benefits” and "substandard.”

But a Washington Examiner comparison of the two health insurance programs found that Walmart's plan is more affordable and provides significantly better access to high-quality medical care than Obamacare.


Click here to see an infographic comparing Obamacare's health insurance premiums to Walmart's

Independent insurance agents affiliated with the National Association of Health Underwriters and health policy experts compared the two at the request of the Examiner.

Walmart furnished employee benefit information to the Examiner. Neither Obamacare advocate Families USA nor the United Food and Commercial Workers, which backs anti-Walmart campaigns, responded to Examiner requests for comment.

Walmart offers its employees two standard plans, a Health Reimbursement Account and an alternative it calls "HRA High" that costs more out of employees' pockets but has lower deductibles. Blue Cross Blue Shield manages both plans nationally.

Also offered is a Health Savings Account plan that includes high deductibles but allows tax-free dollars to be used for coverage.


Click here to see an infographic comparing Obamacare's health access to Walmart's

For a monthly premium as low as roughly $40, an individual who is a Walmart HRA plan enrollee can obtain full-service coverage through a Blue Cross Blue Shield preferred provider organization. A family can get coverage for about $160 per month.

Unlike Obamacare, there are no income eligibility requirements. Age and gender do not alter premium rates. The company plan is the same for all of Walmart's 1.1 million enrolled employees and their dependents, from its cashiers to its CEO.

A Journal of the American Medical Association analysis from September showed that unsubsidized Obamacare enrollees will face monthly premiums that are five to nine times higher than Walmart premiums.

JAMA found the unsubsidized premium for a nonsmoking gouple age 60 can cost $1,365 per month versus the Walmart cost of about $134 for the same couple.

The medical journal reported a 30-year-old smoker would pay up to $428 per month, in contrast to roughly $70 each month for a Walmart employee.

A family of four could pay a $962 premium, but the same Walmart family member would pay about $160.

Low premiums are not the only distinguishing feature of the Walmart plan. The retailer's employees can use eight of the country's most prestigious medical facilities, including the Mayo Clinic, Pennsylvania's Geisinger Medical Center and the Cleveland Clinic.

At these institutions, which Walmart calls "Centers of Excellence," Walmart employees and their dependents can get free heart or spinal surgery. They can also get free knee and hip replacements at four hospitals nationwide.

Many top-rated Walmart hospitals — such as the Mayo and Cleveland clinics — are left out of most Obamacare exchange plans.

But the real difference between Obamacare and Walmart can be seen in the levels of day-to-day access to doctors and hospitals.

Robert Slayton, a practicing Chicago independent insurance agent for 11 years and the former president of the Illinois State Association of Health Underwriters, described to the Examiner the differences between Walmart and Obamacare provider networks.

Slayton said the BlueChoice exchange network for President Obama's hometown has very limited hospital participation. “In downtown Chicago, the key is the number of hospitals: 28,” he said.

“Now we’re going to the national network — this is what the Walmart network would most likely be — and you have 54 hospitals. That’s a big difference,” he said.

Former New York Lt. Gov. Betsy McCaughey, a Republican who is now a health care advocate, said Obamacare's lack of first-class hospitals is a big problem.

“It’s not just the number, but who they are. You’ll find under the Obamacare exchanges that the academic hospitals have declined to participate, along with the specialists who practice at those hospitals. The same is true of cancer hospitals,” she said.

“People who are seriously ill need to stay away from these exchange plans,” McCaughey said.

Slayton said the gap between doctor availability in Chicago under the Obamacare and Walmart plans is dramatic.

“You will notice there are 9,837 doctors [under Obamacare]. But the larger network is 24,904 doctors. Huge, huge difference,” he said.

Walmart also offers a free preventive health plan that mirrors the Obamacare plan. Its employees can take advantage of a wide range of free exams and counseling, including screenings for colorectal cancer, cervical cancer, chlamydia, diabetes, depression and special counseling for diet and obesity.

Their children can get more than 20 free preventive services, ranging including screenings for genetic disorders, autism and developmental problems to obesity, lead poisoning exposure and tuberculosis. There are also 12 free vaccinations, and free hearing and vision testing.

Walmart employees pay as little as $4 for a 30-day supply of generic drugs and only $10 for eye exams through a separate vision plan.

“It’s a lot better program than people, I think, might assume without looking, just because Walmart has gotten such a bad reputation by some of the labor groups and other groups for its general activities,” said Gail Wilensky after reviewing the retailer's plan.

Wilensky was head under President George H.W. Bush of the federal Health Care Financing Administration, the predecessor to the the Centers for Medicare and Medicaid Services. CMS is the agency in charge of implementing a large part of the Affordable Care Act, and it oversaw the rollout of the troubled healthcare.gov website.

David Todd, an independent insurance agent based in Little Rock, Ark., also compared the health plans for the Examiner. Walmart’s corporate headquarters is in Bentonville, Ark., and the company has 58,000 workers in the state.

Todd pointed to stark differences between the government plan and Walmart: “If I buy a family plan on the exchange, it’s still $1,000 a month. And I can buy this for ... [$160] on Walmart.”

Walmart also gives cash to its employees for any health care expense. The annual payments run from $250 to $1,000 and are given at the beginning of the enrollment year in an account that can only be used for health care expenses.

Walmart individuals face a $2,750 deductible and families need to pay $5,500 under the HRA plan. Individuals pay $1,750 and families pay $3,500 deductibles under the HRA High plan.

The deductibles are high, but Obamacare deductibles are higher, going up to $6,300, according to Todd.

Todd looked at a 30-year-old woman who could qualify for the government subsidy. “The nonsubsidized premium is $205 a month for this 30-year-old. If they get a subsidy, then the premium is zero. But that person has to come up with $6,300 if something catastrophic happened,” he said.

The Walmart monthly premium for the same 30-year-old woman would be about $40. Her deductible would be $2,750, minus $250 in cash advance, for a total net deductible of $2,500.

Todd said some Obamacare exchange family plan deductibles can go as high as $12,000 before benefits kick in.


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Greg Davidson
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quote:
A Journal of the American Medical Association analysis from September showed that unsubsidized Obamacare enrollees will face monthly premiums that are five to nine times higher than Walmart premiums.
Why did this article choose a comparison with unsubsidized Obamacare enrollees? Anyone equivalent to a Walmart employee would be making so little money that they would have a substantial subsidy.
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Seneca
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Evidence?
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TomDavidson
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The majority of Walmart employees earn less than $25K per year. While some of them no doubt have other jobs, that's firmly in subsidy territory.
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Seneca
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Well, this must be one of those "conservative biased" news sources, right?

http://www.nytimes.com/2014/02/05/us/politics/budget-office-revises-estimates-of-health-care-enrollment.html?_r=0

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LetterRip
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Seneca,

actually that is a reading comprehension fail for the NYT reporter.

What the CBO is projecting is that full time workers will voluntarily reduce the amount of overtime they work due to threshold effects. Ie if you work enough overtime that you cross a subsidy threshold you can lose a substantial amount of federal subsidy for your families health insurance.

Here is an example with numbers for illustration that I just did on facebook for a friend,

quote:
As an example let us assume someone earns 8$ an hour (and works four hours of overtime a week), and gets a subsidy of 600$ per month on health care. The subsidy drops to 300$ if they exceed an income threshold. 4hr * 12 (8$ at time and a half) * 52 = 2496$ But the loss of 300$ is 3600$ - so 2496-3600 = -1104$ Ie the individual is 'paying' to work overtime if they exceed the threshold (note example numbers above are just illustrative but convey the idea). So it is irrational for them to work overtime that exceeds certain thresholds due to the reduction in subsidy.
So the actual effect will likely an increase in total number of people employed as corporations hire people to do the overtime that their existing full time employees are unwilling to accept.

[ February 04, 2014, 09:38 PM: Message edited by: LetterRip ]

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Seneca
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That's absurd. If anything I'd say it's a reading comprehension fail because half the article is predictable spin and smoke from the NYT, that is always covering for Obama, on how it's not ALL bad news...

This isn't about overtime, this is about the loss of 2.5 million FULL TIME jobs because of the worst effect of socialism: people lose the incentive to work when things are provided for them for free.

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NobleHunter
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I think the CBO is saying that it's the equivalent of 2.5 million workers, not jobs. The work still needs to be done so the jobs will still exist. Since we're looking at a a long term surplus of workers, isn't fewer workers a good thing?

The unemployment rate is down because so many people are being driven completely out of the labour market; so freeing up jobs for people who want to work is good. Especially since the report doesn't seem to be saying people will stop working, but that they will instead work less. I'll agree with the implication that's it's good for people to have full time jobs; I think hours above fulltime (35 or so) to be value neutral.

It also doesn't say much about what effect the employer mandate will have. It doesn't seem to have had one yet, but it hasn't turned on.

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PSRT
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Seneca-
THe CBO is saying that many people will CHOOSE not to work because elderly and new parents will not be forced to to work in order to maintain health care coverage.

The only way I can see this as a bad thing is through reading comprehension problems.

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Pyrtolin
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quote:
Originally posted by Seneca:
That's absurd. If anything I'd say it's a reading comprehension fail because half the article is predictable spin and smoke from the NYT, that is always covering for Obama, on how it's not ALL bad news...

This isn't about overtime, this is about the loss of 2.5 million FULL TIME jobs because of the worst effect of socialism: people lose the incentive to work when things are provided for them for free.

It's only a "worst" effect if it's a net negative, rather than a net positive. (This also has nothing at all to do with Socialism, which, to remind you, is about public or popular ownership and control of productive property and industry. Public support programs are completely orthogonal to socialism, capitalism, or any other economic designation of public vs private ownership)

In out case this is a highly desirable effect, because it celars the market of a vast oversupply of excess workers, leaving more empoyment opportunities for those who are seeking work and better self sufficiency to those that we do not need or otherwise have more productive uses to put their time to than competing for private sector employment, such as education, child rearing, education and training, arts, entrepreneurship, retirement, etc..

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G3
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quote:
Originally posted by PSRT:
Seneca-
THe CBO is saying that many people will CHOOSE not to work because elderly and new parents will not be forced to to work in order to maintain health care coverage.

The only way I can see this as a bad thing is through reading comprehension problems.

How can this possibly make sense to anyone? It's bizarre. People will simply choose not to work and it's gonna be great! They'll have all the "free" health care they need so working is totally optional now? Yeah, just go on welfare, food stamps, etc and now see the doctor any time you want. That's great. Full time job? Go part time! Part time job? Quit or work even less! Everyone can simply work part time because they're gonna just be so damn many part time jobs available!!! Great.

The only way I can see this as a good thing is through economic comprehension problems.

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TomDavidson
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quote:
They'll have all the "free" health care they need so working is totally optional now? Yeah, just go on welfare, food stamps, etc and now see the doctor any time you want.
I know you're being histrionic and tongue-in-cheek about this, but it's actually quite possible that a full dole of this sort would be considerably more efficient and less expensive than the mish-mash of stopgap measures we have now.
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JoshuaD
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I'm starting to think a dole might not be a bad idea. I think I have to turn in my conservative credentials just for having the thought.
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PSRT
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Well, I think a lot of conservatives recognize that a dole could simplify the tax code, while providing a solid safety net for everyone. If implemented with actual bipartisan compromise, a dole could meet a lot of the goals of conservatives and liberals, without becoming a political hot potato. I've seen other principled conservatives endorse the idea.
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NobleHunter
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quote:
How can this possibly make sense to anyone? It's bizarre. People will simply choose not to work and it's gonna be great! They'll have all the "free" health care they need so working is totally optional now? Yeah, just go on welfare, food stamps, etc and now see the doctor any time you want. That's great. Full time job? Go part time! Part time job? Quit or work even less! Everyone can simply work part time because they're gonna just be so damn many part time jobs available!!! Great.
It seems like an awfully pessimistic view of human nature that given a chance not to work, most people will lapse into parasitic idleness. I think despair causes more people to chose not work than laziness. Why take a job if all it does is make most of your waking time more unpleasant without improving the rest?
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