H.R. 3200 – Affordability Credits & Shared Responsibility
I am truly amazed as I continue to read through the bill how anyone could interpret this bill as one that would not increase medical costs, insurance premiums and taxes. Each section only adds more responsibility to the government, which falls again upon the taxpayer. This section alone creates a whole new welfare system intended to not only support people requesting assistance, but the bill actually calls for the government to recruit (by identification methods) people to in order to assist them, even when they have not asked for it!
Employers must offer health insurance to all employees, full and part-time, or face penalties, often for actions out of their control. The pressure on employers could cause adverse consequences in the workplace. Does the employer start basing hiring decisions on the likelihood that a candidate may or may not participate in the company offered insurance plan? Will part-time employees now become less of an asset to employers since they too will require benefits? How does this impact the job market and availability of jobs when the country already has high unemployment? What appeared to be fairly straightforward (what was I thinking!) turned into many “what if “scenarios. I’m sure you will develop your own. If you have any questions regarding the bill, please contact your representatives.
This portion of the bill covers how individuals who cannot afford health insurance coverage or their portion of cost-sharing (co-pays, deductibles) will receive medical insurance and care. Ultimately these costs have to be absorbed by someone. The government is going to expand the medical welfare system and pay for premiums, as well as any out of pockets expenses for medical treatment, in the form of affordability credits. Since it is a known fact that people who have insurance will use medical services more often, then one might expect an increase in medical treatment for newly insured individuals covered by the taxpayer – financed by increased premiums for those who can purchase insurance and higher taxes.
The bill will give eligible individuals affordability credits consisting of affordability premium credits to be applied toward the cost of insurance premiums purchased through the Health Insurance Exchange, and affordability cost-sharing credits to reduce the cost-sharing responsibility of these individuals.
Individuals can apply to the Commissioner for these credits through the Health Insurance Exchange. The Commissioner can further deem individuals eligible on the basis on information otherwise obtained. It doesn’t specify what information or how it will be obtain, but somehow the Commissioner is going to get information on individuals without their application or consent, to determine if they may also qualify for affordability credits. The Commissioner must also establish effective methods that ensure individuals with limited English proficiency are able to apply for affordability credits. Interpreted by many as a means of providing health insurance and related costs to illegal immigrants or amnesty immigrants – all at the taxpayers expense.
The Commissioner may also determine that a State Medicaid agency has the ability of determining eligibility for affordability premiums and credits, and if that agency does so they will be reimbursed for the costs in conducting those determinations. So now the intrusion into our private lives is being expanded, not only to the Federal government,. but the state government; and guess who is paying the bill – the taxpayers.
If it is determined the individual is eligible for Medicaid, they will be enrolled under the State Medicaid plan. No option. I thought Medicare and Medicaid were already having financial problems, so now the government will add how many more to a failing system?
For the first two years of the plan the affordability premium credits may only be used for the basic plan. But, beginning in year three the Commissioner will establish a process allowing affordability credits to be used to purchase enhanced or premium plans, but the individual is responsible for any difference in premiums. So under this new plan we (the taxpayer) will be giving money in the form of affordability credits so these uninsured individuals can purchase a plan through the exchange. If these individuals decide the basic plan just isn’t good enough for them, they can then use their own money to upgrade their plan to a better one – while the rest of us subsidizing these plans may only be able to afford the basic plan. Excuse me, but if you can afford to upgrade your plan, then you can afford to pay for the basic plan out of your own pocket. Why should taxpayers pay for these people to upgrade to a BMW when they are driving a Ford?
The bill describes an Affordable Credit Eligible Individual as one who is lawfully present in the US (other than as a nonimmigrant), enrolled under an Exchange-participating plan and not enrolled under another plan through an employer, with a family income below 400% of the Federal poverty level for the size of the family involved and who is not a Medicaid eligible individual. So when Obama grants amnesty to 12 million illegal immigrants they then become eligible for all the benefits of this program covered by the taxpayers.
If you are a full-time employee and your employer offers employee coverage (for the employee and dependents) then you may not qualify as an affordable credit eligible individual. Exceptions can be made in cases of divorce or separated individuals. But, beginning in year two, if the cost in obtaining coverage under that employer-based plan exceeds 11 percent of your current family income, then that is considered unaffordable employer coverage. This has the potential of expanding the current problem and government spending, resulting again in the increase in premiums and taxes. If a family or individual currently has insurance and is paying for those premiums now, regardless of the cost, under this exception, those premiums could be determined as unaffordable employer coverage and then the government (taxpayer) would also subsidize this coverage!
Affordability Cost-Sharing Credits will also be distributed. Eligibility is based on the income for the most recent tax year, verified by information requested from the Secretary of the Treasury. The Federal poverty level will be applied for determining eligibility. There are some requirements in cases where the family income is significantly different from the income used. It also requires the reporting of significant changes in income.
There is the clause stating, “nothing in this subtitle shall allow federal payments for affordability credits on behalf of individuals who are not lawfully present in the US.” However, there is nothing to enforce this clause and does not exclude immigrants if an amnesty law is passed. Again, with the intention of Obama granting amnesty to 12 million illegal immigrants, they will be eligible for coverage AND affordability credits under the new law.
Employers will have the responsibility to offer health insurance coverage to all employees, including individual and family coverage, under a qualified benefits plan (which currently includes employer-based plans until year 5 when all plans must go through the Health Insurance Exchange). The employer must make contributions toward that coverage. If an EMPLOYEE declines the coverage offered, the EMPLOYER must make contributions to the Health Insurance Exchange for this employee anyway (unless the employee declined because they are a spouse or dependent of a primary insured with another policy). This penalizes the employer even though they may be doing everything required just because an employee declines benefits. It also does not clarify the employer’s responsibility if the employee is holding two jobs and declines coverage with one employer because he/she is covered with another employer.
The employer is required to make premium contributions for employees equal to 72.5 percent for individuals and 65 percent for family coverage. These percentages are based on the LOWEST plan offered by the employer. Families may be the hardest hit by these changes, especially if employers opt for the minimum responsibility available. So the possibility is very real that with a low cost basic plan and these percentage rates, especially for a family, the insurance offered by an employer could be classified as unaffordable employer coverage as stated above, making them eligible for affordability credits for insurance premiums – expanding the cost of health care to the taxpayers.
Part-time employees must also be covered under this new bill with employers having to contribute. The employer share is based on a formula.
Employers will automatically enroll employees into the employment-based health plan for individual coverage at the lowest premium level unless the employee specifically opts out.
Employers must pay an amount equal to 8 percent of the average wages paid by the employer for any employee that does not accept the employer-based insurance plan. While the employer is being penalized for an employee not enrolling, the employee also does not receive any benefit from this penalty, as it cannot be applied to any premiums the employee may already be receiving from the Health Insurance Exchange. Special rules apply to small employers as they have adjusted penalty rates ranging from 0% if their annual payroll is under $250,000 to 6%. Any employer who has an annual payroll of over $400,000 will have to comply with the 8% penalty. This is just an abuse of the system, taking money from both ends (employer penalties and employee premiums). This could result in serious employment consequences, from not hiring part-time employees, to hiring employees that will participate in the employer-based plan.
The Commission has the authority to set standards determining whether employers or insurers are taking any actions that may affect the risk pool within the Health Insurance Exchange by inducing individuals to decline coverage under a qualified plan offered by the employer and instead enrolling in an Exchange-participating plan. If all plans have to go through the Exchange, then what benefit would an employer have in not enrolling employees, especially since they would have to pay the 8% penalty for those who didn’t purchase the employer plan? Does this not also encourage employers to force employees to join the plan so they aren’t accused of such actions rather than giving the employees a true choice?
Amendments to ERISA (Employee Retirement Income Security Act) of 1974 are being made, including civil penalties against employers of $100 for each day in the period in which they fail to satisfy health coverage participation to any employee.
This portion of the bill is no different than the previous two. It calls for expanded government, creates a new welfare system to support the health care industry, and will cost taxpayers more money.
Not only can individuals apply for affordability credits, but the Commissioner is also supposed to identify people by other means to get them affordability credits. How does increasing the government’s responsibility, and therefore the taxpayers’ burden, by covering insurance premiums and out-of-pocket costs decrease cost overall and not result in higher taxes? Why would a government actively recruit people to give them credits? What information is the Commissioner obtaining and by what means to carry out this task? We’ve already had the White House sending out emails from email addresses obtained in a questionable manner. We need to expand this type of activity to the health care industry – one that is supposed to be protected under HIPAA.
Although Obama and the democrats are claiming this bill does not cover illegal immigrants, there are no provisions to ensure they don’t participate. They also fail to disclose that once they also pass the amnesty bill for these illegals, they then become eligible and the American people are again burdened with supporting them.
I have not yet seen any projected costs related to the affordability credits for insurance premiums and cost-sharing, so this huge outlay of money will be a surprise to the American public when the bills start rolling in! These costs have to be covered somehow; which can only result in higher premiums for those who pay for coverage in addition to higher taxes. At the rate this bill is going, NO ONE will be able to afford health insurance premiums! Oh, was that the intent – to create the one-payer system that everyone participates in, under total government control, with substandard care, long lines, and denied services – can we say “rationing.”
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