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Truth
vs. Spin: |
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SPIN: “Thanks to Massachusetts ‘health care reform,’ you can rest assured that you will always have access to affordable, quality coverage." TRUTH: All state plans have stringent "redetermination" rules and procedures. Any change of income must be reported within 10 days. All coverage will be lost for failure to do so. That means if you make more or less money one week from the last, you must report it. As there is such close inter-departmental and employer monitoring, you will be penalized for failure to do so. This means if you make more money for just one week, you may be either be shunted into another payment/benefit bracket or dropped altogether and may start to accrue monthly penalties. See involuntary disenrollment. You may re-apply and after much paperwork and struggle and you may be reinstated, or you may not. In the meantime, you will be uninsured and may very well have to pay penalties for not being insured. See the law about eligibility review. In
the insurance business, this is called "churn" and obviously
uses a large amount of state resources - not to mention yours! |
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SPIN: "Employers can afford the mandated contributions and extra administrative costs" TRUTH: Most small employers already have a great burden of state and federal paperwork being dumped on them. They may not tell you, but it is time-consuming and distracts from the work of running a business in general. See Berkshire Eagle article here.
The mandate stipulates that employers of 11 or more "full-time" employees must provide state approved health insurance to all full-time or full-time
"equivalent" employees. No matter how you slice it, this amount of extra work eats deeply into the already hair-thin profit margin of small (and some medium) employers and could become a burden which the employer may choose to avoid by reducing employees and/or employee hours.
There is anecdotal evidence that this is already happening. Even large scale businesses are stricken by the cost of employee Health care. One need look no further than the automotive icons Ford and General Motors and their recent, urgent buy-out by the U.S. government (we, the taxpayers) to see what these burdens mean to businesses. And, don't forget businesses make jobs, jobs make money that pay salaries and and this money buys food, pays for housing, education, consumer purchases and the rest of life’s necessities. As to the claim that the mandate is a success because there is little evidence that employers have dropped ESI, well of course they haven't. It's against the law to drop it. It is beyond the scope of this website to explain every nuance and detail of this complicated subject, but there is ample information available elsewhere on the internet. Here is an excellent article on this topic that pretty much says it all - Life, Liberty and Employer Provided Health Insurance - by Dean Baker - July 6, 2009 |
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SPIN: "Employees whose jobs offer insurance can afford it and must accept it or face penalty that is perfectly affordable to them" Truth: Employees may or may not be able to afford employer-sponsored coverage, but if they don't buy it, they will be fined. Businesses can offer prohibitively expensive coverage that they know most of their employees will decline. Thus, the employer can avoid fines and save money on insurance at the same time. Most employers are good people and would not do this, but we did hear about a few that went this route. There were also businesses that found other ways out but may have had to do so to keep their doors open. See “Firms find ways around state health law .”
The
law says that employees whose employer sponsored health insurance does not
meet "minimum creditable coverage" are not eligible for Comm. Care. |
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SPIN: "The Massachusetts "Health care reform law" has successfully reduced the use of "free care". The Health Safety Net ensures health care for all. TRUTH:
As of March 2008, use of the formerly-named "Uncompensated Care Pool" (now called the "Health Safety Net") has shown about a 16% decrease due to the insurance law. This appears to be a victory for the mandate until a closer look reveals that as people have shifted from "free care" to subsidized, commercial insurance, the cost to the state and Federal governments has increased significantly.
A higher income individual (400% of the FPL) with an income of up to $43,320. may be
eligible for a program called the Health Safety Net (HSN) if they are deemed "unaffordable" for buying insurance and do not have an employer-sponsored plan. This might seem like a good thing until we see that the reality is that this person will have an
out of pocket deductible of $8,664. per year before any medical expense will be covered. This is equivalent to 20% of that person's before-tax income. A couple in this same 400% FPL bracket will have an out of pocket
deductible of $11,655. Significant medical debt or avoidance of care are
certain. |
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