I promised myself that I wouldn't accidentally turn this post into something about how stupid an employer-based health care system is. (But, real quick!) We are the only country in the westernized world where you lose your health insurance when you lose your job -- and that's only for the employers that actually offer health care. And for the most the rest of America, the individual market is almost completely unaffordable. It's complete and utter nonsense. However, the legislation moving through congress could end up doing a really great job at strengthening the current employer-based system while slowly unraveling it at the same time.
I didn't think that was necessarily possible either, but they can pull it off by mandating that all employers making above $500,000 cover their employees while allowing those employees, if they choose, to take what their employer would have spent on their health care (in the form of a tax credit) and shop around on the Exchange if they feel they can find better and/or cheaper care on the individual market.
Pretty genius, right? I can almost guarantee the tax credits will be in the final legislation; it's just the employer mandate that we need to worry about.
This is all entirely contingent on the fact that the final bill adopts the House's employer mandate provision (which is, basically, fining large companies for not providing insurance to their workers). And I really, really hope that it does so. Now, ladies and gentlemen, without further ado, I introduce to you: arguably the worst provision in the entire Senate health care bill: "The Free-Rider Provision."
The thought-process behind the Free-Rider provision is simple. Some senators didn't feel that mandating employers to provide health insurance for their workers was the right thing to do, so here's a breakdown of the Senate's compromise: Say you're an employer (making over $500K) that doesn't feel like offering health coverage to your employees. The government doesn't obviously like that, because it would be better for the country and your employees if you did offer health coverage, so they naturally want to provide you with an incentive to supply health insurance to your workers. Their non-controversial idea: "Let's charge this employer $750 for each non-covered employee that is eligible for subsidies to purchase insurance. That should do it! All bases covered."
Think about that for one second. Doesn't sound too unreasonable. Those people who don't receive government subsidies have a large enough income to pay for their insurance without their employer anyway, right? They're not hurting anything. But now think about it for another second. And, yes! It sounds absolutely horrible.
All you need to do to think about the obvious faults in this provision is to think about the people who are eligible for subsidies to purchase insurance. And you've got it! Everybody below 400% of poverty -- or low- and low-to-middle income Americans will be affected.
Now, think back to just a second ago when you were that employer that didn't care enough about their employees to provide them with health insurance (even though you clearly had the money to do so). Based on that, do you really think it would be below you to discriminate against low-income Americans by not hiring anybody eligible for government subsidies to avoid this penalty? And maybe try to solely hire people that aren't eligible for tax credits? I don't think that sounds too far off.
The House, however, (worded very-well from HCAN) "requires all employers with a payroll over $500,000 to contribute 72.5% / 65% (single / family) of employee’s premium costs for health insurance purchased inside or outside the Exchange and a proportional amount for part-time employees. The coverage must meet, over time, the essential benefit standard. Employers that do not provide insurance coverage will pay a payroll tax of 8%, which is phased in for businesses with a payroll between $500,000 and $750,000" -- which is clearly what we should be striving for.
I wish we would get the House's employer mandate (that the CBO estimates will cover an extra 10,000,000 people), but even if we don't get the full mandate, we certainly have to make sure that low-income Americans aren't discriminated against based on a flawed policy because some senators don't feel like upsetting big business. This is a fight that can be won.
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4 comments:
I'm happy to talk policy, but this argument of government involvement vs. no government involvement in the private sector, as both you and I know, won't go anywhere.
There's no way, on such broad of an issue, that either of us are going to convince each other otherwise.
You think that the government has no business helping employees get things like they deserve (like health care) -- and I do think that it's the government's responsibility to make sure that everybody has available to quality, affordable health care coverage.
If that means mandating employers (who can obviously afford it [remember that small businesses are excluded]) provide coverage to their employees, then that's what needs to be done.
you used the word "deserve", defined as " to be worthy, fit, or suitable for some reward". Why do they "deserve" health care?
"[remember small businesses are excluded]"
If employees of large businesses are "worthy, fit or suitable" for this health care reward, why aren't employees if small businesses? What a dumbass conclusion to draw. And,
All people deserve health care, because nobody deserves to die or go bankrupt due to insurance being unaffordable.
You obviously don't know much about the health care bill(s). That's fine. It's a lot of reading.
But large employers (in the House bill at least) are mandated to cover their employees, because they make over $500K and clearly have the money to do so, but small businesses have no mandate, because it would put too much of a burden on a company that makes $50K a year.
However, that doesn't mean that people employed by small businesses don't deserve health care. They'll have the ability to shop on the Exchange and, pending on their level of income, be subsidized by the government, so that insurance will be affordable.
Mostly the only people that won't have health insurance after this bill is implemented are illegal immigrants and people that don't qualify for Medicaid, but payments for insurance would be more than 8% of their income.
And before you go off on a tangent about how our country can't afford this legislation, it's our current health care system that our country can't afford. We will be completely bankrupt if we leave the system as-is. The Senate health care reform legislation is pegged to reduce the deficit by over $770 billion over the next 20 years.
Big step forward.
Haha! Yes.
Agreed. You are absolutely right. Your reasoning is crystal clear against the health care bill!
The full-proof, extremely intelligent argument that my "comments are dumbass" and I am too.
I apologize for even thinking about doubting your obvious intelligence.
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