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-   -   The health care bill is past by just 7 votes! (https://britishexpats.com/forum/usa-57/health-care-bill-past-just-7-votes-660510/)

Michael Apr 4th 2010 12:19 pm

Re: The health care bill is past by just 7 votes!
 

Originally Posted by Boiler (Post 8472401)
I have not read all the details, it will be many years before it hits. Any I doubt if it will be the same as it is now.

But I can see there will be a lot of business's restructuring and with CIR in the air it makes employing those missing their documents more attractive.

We could certainly split our business into 2 if need be.

The bill states that the regulations have to be written within 1 year after the bill passes. This will give companies almost 3 years to understand and prepare for the new regulations.

scrubbedexpat099 Apr 4th 2010 12:23 pm

Re: The health care bill is past by just 7 votes!
 
And Congress to change it.

Michael Apr 4th 2010 12:27 pm

Re: The health care bill is past by just 7 votes!
 

Originally Posted by Boiler (Post 8472456)
And Congress to change it.

I doubt that very much. I don't think it is realistic that there will be Repeal and Replace and I can't see the democrats messing with it until after it is up and running unless there is some major flaw.

Michael Apr 4th 2010 1:21 pm

Re: The health care bill is past by just 7 votes!
 
I noticed in the health care reform bill that starting in 2011, employers will have to report employee health insurance costs on the W2. I suspect they will report the total cost for the employee, the employees premium cost, and maybe the estimated actuarial percentage.

I suspect the government will initially use that to try to verify that small businesses that are receiving subsidies are actually complying with regulations and providing regulatory health insurance.

In 2015 it will probably be used for compliance for all companies.

There is also supposed to be a form similar to a 1099 issued in 2015 that allows the IRS to determine how much of a subsidy (for tax credits) was authorized or given through a health insurance exchange and whether a required individual was required to purchase insurance. Since the form will be issued to both the IRS and the individual, it will be difficult for an individual to claim that he purchased health insurance when he did not.

Michael Apr 4th 2010 1:53 pm

Re: The health care bill is past by just 7 votes!
 

Originally Posted by Michael (Post 8472035)
The health care reform plan will likely affect a larger number employees that currently get employer sponsored health insurance than the 31 million uninsured that is expected to be insured under the plan. Although the effect on employees will not be as great, the benefits will likely have a positive significant impact on employees health coverage.

Among other things, health care reform states that employers must provide health care benefits that is at a minimum actuarially equivalent to 60%. It doesn't just require the employer to pay at least 60% of the cost of the premiums but instead requires benefits to be actuarially equivalent to 60%. Because the definition for actuarially means that the employer must estimate the risk of the employees total health care costs and the employee must normally not exceed 40% of the total cost, employers will no longer be able to offer high deductible plans with high copays and limited care and then pay 60% of the cost of the premiums. It requires employers to offer health insurance for both the employee plus dependents which are also included in calculating the actuarial cost.

The following will likely be similar to how an employer will calculate his cost.

Age: 62 with a dependent wife.
Total Cost of Premium: $1,800 per month
Estimated out of pocket expenses: $600 per month
Cost to employer for premium: $1,440 per month ($2,400 * 60%)
Cost to employee for premium: $360 per month

A younger employees cost may be something like the following.

Age: 32 with a family of 4
Total Cost of Premium: $1,200 per month
Estimated out of pocket expenses: $200 per month
Cost to employer for premium: $840 per month ($1,400 * 60%)
Cost to employee for premium: $360 per month

A young single employees cost may be calculated as follows.

Age: 22
Total Cost of Premium: $250 per month
Estimated out of pocket expenses: $25 per month
Cost to employer for premium: $165 per month ($275 * 60%)
Cost to employee for premium: $85 per month

The exact formula will not be determine until the regulations are written.

Besides the above limitations, some employees premium costs may be capped as to the maximum percentage of family income, may be issued a voucher to purchase health insurance through an exchange, the employer opting out and paying fines that allow employees to purchase subsidized health insurance through an exchange, and many other situations.

The following are some links that explain the changes in employer requirements as well as other changes for health insurance.

http://www.nixonpeabody.com/publicat...l3.asp?ID=3233
http://www.journalofaccountancy.com/...y/20102731.htm

I think I got this wrong as I reread the mandate. It appears that the actuarial is based only on benefits and doesn't include the premium but the premium cannot exceed 9.5% of the families income.

Employers must offer 60%, 70%, 80% and 90% actuarials. There is no mention that if an employee selects an actuarial above 60% whether the premium can exceed 9.5% of the families income but seems to indicate that the 9.5% is the maximum cost for a premium.

If that is the case, then pricing could be something such as a maximum 6.5% of family income for a 60% actuarial plan, 7.5% for a 70% plan, 8.5% for a 80% plan, or 9.5% for a 90% plan.

Michael Apr 5th 2010 7:06 am

Re: The health care bill is past by just 7 votes!
 

Originally Posted by dakota44 (Post 8470304)
U.S. GDP is 14.4 trillion dollars. 5% of that is a huge chunk of change. 720 billion. Raise the taxes to that level, invest in infrastructure and health care.

I have always failed to understand the failure to invest in infrastructure, satisfied instead to let it crumble and collapse. The number jobs that would develop and businesses that would be created or significantly boosted by massive infrastructure repair would be huge. A significant portion of the investment would be returned in the form of income taxes, sales taxes, lower unemployment payouts, lower welfare payouts, FICA etc.

1% of gdp would probably be plenty. That is $140 billion per year ($1.4 trillion in 10 years) and should be able to fix up the infrastructure (roads, bridges, sewers, etc.), schools, and improve public transit/high speed trains over the next 20 years.

Currently with the stimulus package, there is $288 billion allocated for infrastructure and they will have a problem spending that much over a three year period.

dakota44 Apr 5th 2010 7:39 am

Re: The health care bill is past by just 7 votes!
 

Originally Posted by Michael (Post 8474154)
1% of gdp would probably be plenty. That is $140 billion per year ($1.4 trillion in 10 years) and should be able to fix up the infrastructure (roads, bridges, sewers, etc.), schools, and improve public transit/high speed trains over the next 20 years.

Currently with the stimulus package, there is $288 billion allocated for infrastructure and they will have a problem spending that much over a three year period.

Difficulty spending it due to a lack of shovel ready projects. Definitely need some funding for municipalities and States to evaluate the needs and develop ready to go plans with all required environmental approvals etc. With budget strapped municipalities and States the funds are not readily available for that. Give them the financial tools to prepare the project proposals and you will see construction booming in three years.

Michael Apr 5th 2010 8:00 am

Re: The health care bill is past by just 7 votes!
 

Originally Posted by dakota44 (Post 8474218)
Difficulty spending it due to a lack of shovel ready projects. Definitely need some funding for municipalities and States to evaluate the needs and develop ready to go plans with all required environmental approvals etc. With budget strapped municipalities and States the funds are not readily available for that. Give them the financial tools to prepare the project proposals and you will see construction booming in three years.

True but it is always better and more efficient to allocate the money over many years instead of large amounts at one time.

As an example, it took about 5 years to go through environmental impact and cost estimates to purchase land and construction costs to extend BART from central Fremont to south Fremont (southern end of Alemeda county) so that it could eventually be extended to San Jose. Then when the money became available, Fremont decided that they didn't want the train to go over Lake Elizabeth and that it would cost an additional $500 million to go under it (1 mile tunnel). That held up the project for 2 years and by the time BART agreed to come up with the extra money, the funds had already been allocated to another extension.

Finally now about 10 years later, funds came back and they started the extension last year. San Jose (Santa Clara county) will start on it's extension this year of about 17 miles with about a 4 mile underground project in the downtown area.

I can imagine with too much money available at one time, every community will want the project to be underground when it is not necessary tripling the $7 billion price tag.

Steerpike Apr 5th 2010 11:07 am

Re: The health care bill is past by just 7 votes!
 

Originally Posted by Michael (Post 8474256)
True but it is always better and more efficient to allocate the money over many years instead of large amounts at one time.

As an example, it took about 5 years to go through environmental impact and cost estimates to purchase land and construction costs to extend BART from central Fremont to south Fremont (southern end of Alemeda county) so that it could eventually be extended to San Jose. Then when the money became available, Fremont decided that they didn't want the train to go over Lake Elizabeth and that it would cost an additional $500 million to go under it (1 mile tunnel). That held up the project for 2 years and by the time BART agreed to come up with the extra money, the funds had already been allocated to another extension.

Finally now about 10 years later, funds came back and they started the extension last year. San Jose (Santa Clara county) will start on it's extension this year of about 17 miles with about a 4 mile underground project in the downtown area.

I can imagine with too much money available at one time, every community will want the project to be underground when it is not necessary tripling the $7 billion price tag.

Not wanting to derail this interesting healthcare topic too much, but your mention of 'shovel ready' projects reminded me that when I drove through the Caldecott Tunnel this weekend I noticed they are finally starting to dig the 4th bore. Apparently stimulus funds are involved. Yeah!

Michael Apr 6th 2010 2:03 pm

Re: The health care bill is past by just 7 votes!
 
I'm shocked. Senator Tom Coburn (R-OK) defended Nancy Pelosi, the democrats, and criticized FOX news for spreading misinformation about the health care reform bill at a town hall meeting.

http://www.cbsnews.com/8301-503544_1...27-503544.html

At a town hall meeting, Coburn suggested that a woman who said "they can put us in prison" for not obtaining health insurance under the health care reform bill is misinformed. "The intention is not to put anybody in jail," he said. "That makes for good TV news on Fox but that isn't the intention."

"I'm 180 degrees in opposition to the speaker -- she's a nice lady," he said. The crowd could be heard responding unfavorably to his characterization. "Come on now, she is a nice -- how many of you all have met her?" continued Coburn. "She's a nice person. She's a nice person. Just because somebody disagrees with you doesn't mean they're not a good person."

He then discussed his own experience of being vilified before asking the crowd not to "catch yourself being biased by Fox News that somebody's no good."

chartreuse Apr 6th 2010 3:19 pm

Re: The health care bill is past by just 7 votes!
 

Originally Posted by Michael (Post 8477679)
I'm shocked. Senator Tom Coburn (R-OK) defended Nancy Pelosi, the democrats, and criticized FOX news for spreading misinformation about the health care reform bill at a town hall meeting.

http://www.cbsnews.com/8301-503544_1...27-503544.html

At a town hall meeting, Coburn suggested that a woman who said "they can put us in prison" for not obtaining health insurance under the health care reform bill is misinformed. "The intention is not to put anybody in jail," he said. "That makes for good TV news on Fox but that isn't the intention."

"I'm 180 degrees in opposition to the speaker -- she's a nice lady," he said. The crowd could be heard responding unfavorably to his characterization. "Come on now, she is a nice -- how many of you all have met her?" continued Coburn. "She's a nice person. She's a nice person. Just because somebody disagrees with you doesn't mean they're not a good person."

He then discussed his own experience of being vilified before asking the crowd not to "catch yourself being biased by Fox News that somebody's no good."

Why are you shocked? We've known for a long time that they're all a bunch of rapacious crooks, in cahoots with each other. Or are you still peddling that party political rubbish?

Any politician, of either party will always throw you under a bus, in preference to one of his own. They are scum.

scrubbedexpat099 Apr 6th 2010 3:27 pm

Re: The health care bill is past by just 7 votes!
 

Originally Posted by chartreuse (Post 8477793)
Why are you shocked? We've known for a long time that they're all a bunch of rapacious crooks, in cahoots with each other. Or are you still peddling that party political rubbish?

Any politician, of either party will always throw you under a bus, in preference to one of his own. They are scum.

Absolutely.

But suggesting that Pelosi is nice implies he may have a sense of humour.

cindyabs Apr 6th 2010 3:32 pm

Re: The health care bill is past by just 7 votes!
 
Well then I want my uterus back!!!

scrubbedexpat099 Apr 6th 2010 4:16 pm

Re: The health care bill is past by just 7 votes!
 
http://www.bizjournals.com/boston/st...ml?jst=b_ln_hl

Health plans sue state over rate caps

Going to be a good time to be a lawyer.

dakota44 Apr 6th 2010 4:27 pm

Re: The health care bill is past by just 7 votes!
 

Originally Posted by Boiler (Post 8477897)
Going to be a good time to be a lawyer.

Isn't it always? Ambulance chasers and legislation chasers. Must be someone who doesn't like this regulation. Let's go find them and make a fortune.
I considered going to law school once. I'm so ashamed of myself. :lol:

Well, if the poor insurance companies are going to suffer so much, best to pull the plug on them and go to a single payer system. Likely they are juggling the figures anway and hiding profits elsewhere. A corporate normality.


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