Friday, August 30, 2013

Small Business Guide to Obamacare Available on Amazon

We did it!  The Small Business Guide to Obamacare is now available on Amazon.  You can use Amazon's sneak peek feature to take a look inside.  We aimed to provide a book that provides practical business guidance, not a bunch of political rhetoric.

Also, as one of the newest books on the market, we've been able to incorporate many of the most recent developments.  For example, we updated the book to include the recently announced delay in enforcement of the employer mandate.

So, to get your business ready for the coming health insurance changes, get yourself a copy of the Small Business Guide to Obamacare today.

Have a joyful and safe Labor Day weekend.

Now for today's Obamacare headlines.

Rightwing Rants
Welcome to the Unaffordable Careless Act by Karl Rove.  (Why didn't I think of that?)

Even the AFL-CIO doesn't like Obamacare.

Struggling small businesses pass on Obamacare costs to employees.

Leftwing Cheerleading
DeMint's desperation to keep defunding proposal alive.

Employers cut benefits and play the blame game.




Hard News
Study indicates health insurance rates won't spike.

About half of Louisville's uninsured will get Medicaid.

Average workweek approaches all-time low.

Poll indicates people expect confusion in exchanges.

Obamacare leads to cutbacks in employee benefits.

Ex-McDonald's CEO warns of Obamacare's pressure to cut workweek to 25 hours.


For Industry Insiders
Most employers say they are ready for PPACA.  Thinking you're ready may not be the same as being ready.

Half of Americans can't identify basic health insurance terms.

An explanation of whether employers can offer different health benefits to different classes of employees.

Employers are not communicating benefits of Obamacare to employees.

What you need to know about grandfathered plans.

Thursday, August 29, 2013

Obamacare Gets Personal--My Wife Will Lose Her Coverage

We Will Lose Our Current Coverage

We've all heard this over and over, but the President's own words bear repeating:


"If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what."


At least he didn't say, "let's be clear."

My wife Heidi has a policy through Blue Cross Blue Shield of Michigan.  Although expensive, the big attraction is that they have no pre-existing condition exclusion.  That was true before Obamacare made that the rule for all policies.  She has extensive relationships built up with several doctors in their network.

We received a curious call from our broker a few weeks ago.  We called back and he said BCBSM will not be renewing these policies in 2014 and all policyholders will need to go to the exchanges.

I had not heard that BCBSM was pulling out of Michigan's individual insurance market so I called them directly.  Yesterday, I was told that although it is true that the current policies will not be renewed, they are working on new policies.  At this time, it is unknown even to them what the policies will be like or how much they will cost.  I asked whether a family policy might make sense for us, but they said don't bother until it becomes known what the policies will be.

I asked why the policies were being changed and they said the current policies are not compliant.  I asked if the problem was state or federal law.  They said state, but I'm not sure if that's right.  It seems more likely Obamacare's mandates have made certain aspects illegal and they have to fix them.  Apparently they don't qualify for grandfathered status either.

If you have a BCBSM policy, get ready for change, whether you want it or not.

Michigan Senate Approves Medicaid Expansion

Eight Michigan Republicans joined Democrats to approve a bill expanding Medicaid under Obamacare.  Obamacare expands Medicaid to many low income individuals, regardless of whether they have children.  The federal government promises to grant the state for the first few years but after that no one know what will happen.

Last year in the Sebellius case, the Supreme Court ruled that states are free to accept of reject the federal government's offer.  The Court found that it was unconstitutional to tie the Medicaid expansion to the threat of withdrawing all Medicaid funding (including existing grants not related to Obamacare).

With Republicans controlling both houses and the governorship, it was not clear whether Michigan would participate in the Medicaid expansion.  Now, the bill will move to the House.

What if They Gave an Obamacare and Nobody Came--Part 4


On my MichiganStartupBusiness blog, I had been running a series playing on Bertolt Brecht's poem asking "What if They Gave a War and Nobody Came?"  What if they gave an Obamacare and nobody came?

Part 1: Delays in implementation, states failing to accept the Medicaid expansion, exemptions for big business, and other delays and special deals.

Part 2:  What if employees are offered insurance but don't sign up?

Part 3:  Treasury Department announces delay in enforcing the employer mandate.

I didn't even get to Congress' evasion of Obamacare's requirements.

I also did not write anything about the delay in enforcing the out of pocket maximum rules.  The "affordable" part of the Affordable Care Act was annual limits placed on what a policyholder had to pay in a year.  For example, let's say you got really sick and had $10,000 of otherwise uncovered medical expense.  If your out of pocket maximum was $7000, the insurance company would pick up the additional $3000.  Under Obamacare, that limit was set by law and had to be the same for everyone in a given class.  Now, the government is allowing insurers to set those limits as high as they want or even have no limit at all.

It was just announced that agreements between insurance companies and the government regarding exchange-based policies will be delayed.  The policies to be sold on the online exchanges have to be approved by the government.  That has not happened yet, but needs to happen soon if the exchanges are to open on October 1.

I wonder what the odds are that the federal exchanges will not open on time.  If I were a betting man, which I'm not, I'd bet no.

Now, for Today's Obamacare headlines:

Right Wing Rants


Sen. Vitter (R, LA) found a town hall full of people supportive of delaying Obamacare.

Kentucky business owners don't like Obamacare.

Forsyth County Republicans want Obamacare repealed.

Obama's statement that policies will be cheaper than cell phones is a farce.

Left Wing Cheerleading

MLK would have liked Obamacare.

At least one person in Utah thinks Obamacare is a good thing.

Pres. Bill Clinton will help sell Obamacare.

Obamacare to be a work in progress for years to come.

Hard News

Michigan Senate approves Medicaid expansion.

Kaiser provides information in a user-friendly Q&A format.

Obamacare backers target back to school audience.

IRS issues final regulations on individual mandate penalties.

Starbucks CEO says they won't cut hours or coverage.

For Industry Insiders

ACOs are found to save money in Massachusetts.

Final regs on the individual mandate are out.

Do you need a good introduction to Obamacare?  Check out the brand new Small Business Guide to Obamacare.

PPACA $100/day/employee penalties can really add up.

Co-ops worried about established players.

Wednesday, August 28, 2013

Obamacare Defunding Effort Gains Momentum

Free market Republicans like Sen. Ted Cruz and Sen. Rand Paul are leading an effort to end Obamacare by "defunding" it.  What does that mean?  Well, basically, government programs need money to operate.  One way Congress can stop a program is by refusing to pay for it.

In the links below, various Republican politicians and activist groups are working toward defunding Obamacare.  Here's how what they are trying to do might work.

Obamacare relies heavily on federal spending.  Many people will be eligible for tax credits or subsidies if they buy health insurance on the exchanges.  That takes federal money.  In addition, the federal government has promised to fund the states' Medicaid expansion programs for the first few years.  That takes a lot of federal money.  And of course, there are thousands, maybe millions, of federal employees paid to administer Obamacare.  They probably won't do that work if they don't get paid.

Democrats, of course, oppose the defunding effort.  In addition, some Republicans do not want to be painted as obstructionist.  The real danger to them is that sending a federal budget bill to the President without funding for Obamacare would get vetoed, meaning there would be no funding for anything in the government.  Republicans would get blamed for not paying forest rangers, military personnel, and other popular government workers and programs.

We've seen a lot of polling on both sides of Obamacare.  Most people oppose Obamacare.  Other polls ask about specific features, like new rules governing adult children up to the age of 26 and bans on pre-existing conditions exclusions.  Liberals point to those polls as proof of the law's popularity.

What I'd like to see is a poll asking people what they think Obamacare is.  My guess is that many people think they will get free health insurance.  That's true for some, but not many.  When people find out Obamacare places mandates on them to buy insurance while creating enormous pressure on employers to drop their health plans, they'll really understand what it's about.  We'll see how popular the law is when people see the bills and get no free health insurance.

We'll have to wait and see.  Having spent a considerable amount of time thinking about the strategies businesses should take regarding Obamacare, I believe the law will be even less popular this time next year than it is now.  Some people will lose their health insurance and will find even subsidized policies unaffordable.  Others will find themselves on Medicaid and find that although it is free, you get what you pay for.  More people will find themselves cut to part time as their employer seeks to avoid paying for insurance.   Not a pretty scene.

My two cents.  Right now, Obamacare is still 100% the responsibility of Democrats.  If it fails, it's their problem and entirely their fault.  I believe there's a very high probability of serious problems with the new law and Republicans should not allow Democrats to shift the blame.  That means letting it happen.

So let the train wreck happen, just stay out of the way.  Hopefully I'm wrong, but it seems that the more cynical I get the more right I become.

Now, around Today's Obamacare world!

Rightwing Rants




Leftwing Cheerleading




Hard News




For Industry Insiders


Tuesday, August 27, 2013

Today's Obamacare--UPS Drops Coverage for Spouses

UPS announced that it would be dropping coverage for 15,000 spouses under its health plan.  A bit cryptically, UPS's announcement indicated that Obamacare (aka PPACA) was a factor in the decision.

It's not clear to me how Obamacare affects this decision.  The IRS regulation detailing the employer mandate requires large employers like UPS to offer health insurance to employees and dependents.  The regulation does not require companies to offer insurance to spouses, but does not forbid them from doing so.  So what gives?

There are a few factors which could be at play, which we cover in detail in The Small Business Guide to Obamacare.  Paradoxically, UPS may honestly believe that the spouses are better off without the offer of insurance.  If someone is offered insurance through an employer, that person is ineligible for subsidies on the Obamacare exchanges.  A spouse offered an expensive UPS policy, therefore, would be denied a cheaper subsidized policy on the exchanges.  A UPS spouse might be better off getting a policy on the exchange, or even Medicaid, than accepting the UPS policy.

Another possibility is that Obamacare has many expensive mandates.  One of the freedoms it allows is the choice to offer or not offer health insurance to spouses.  If the only way to save money is to drop coverage for spouses, then a company seeking to save money has little choice but to do so.

That's speculation, but at least it's informed speculation.  My book will inform you about how to make just these kinds of decisions.  If you're an employer worried the law could wreck your business or just interested in Obamacare, you need to read the Small Business Guide to Obamacare.

Now, around the Today's Obamacare world.

Rightwing Rants







Leftwing Cheerleading




Straight News




For Industry Insiders


Monday, August 26, 2013

Today's Obamacare

I've spent a lot of time trying to keep current on Obamacare (PPACA).  I figure that other people would like a summary of developments as we get closer to full implementation.  To start, we'll have a few categories:


  • Rightwing Rants
  • Leftwing Cheerleading
  • Straight News
  • For Industry Insiders

I'll try to filter the daily news so that you can keep current and read only what you want to read.  I've saved some stories from over the weekend, so this first installment may be longer than what we'll have in the future.  Here goes:

Rightwing Rants

The inimitable Mark Steyn demonstrates how Obamacare is not a law--it's a hierarchy of privilege.

Obamacare opponents' greatest ally is Obamacare itself.

Obamacare concentrates personal information making life easier for identity thieves.

Three out of four new jobs are part time and won't be required to provide health insurance.

Yuval Levin details the problems with implementation of Obamacare.

The Oklahoma case, challenging the employer mandate and the payment of subsidies in violation of PPACA, continues to wind its way through the courts.

Obamacare will lead to insurance death spiral.

Obamacare detectives are on their way!

Leftwing Cheerleading

Republican efforts to defund Obamacare are like blowing up the Bridge Over the River Kwai (with the American economy being the bridge).

Obamacare provides fairness, not socialism.

President Obama criticizes Republican threats to shut down government over Obamacare.

People will love Obamacare once they get on the exchanges and get Medicaid.

Millions with bare bones policies will upgrade under Obamacare.

Straight News

Delta Airlines says Obamacare will cost it an extra $100m.

CBS reports that Sen. Cruz admits Republicans lack the votes to defund Obamacare.

Montana has information on expected insurance costs through their exchange.  A good deal for some, not for other.

The Athens Herald dedicated an entire section to Obamacare stuff, seeking to reduce confusion.

The uninsured face tough choices under individual mandate.  Those who do not have employer provided insurance must get coverage somehow.  Many state won't expand Medicaid and it's anyone's guess how much the exchange policies will cost.

Cities cut employees to part time to avoid Obamacare mandates.

Large employers drop spousal coverage.

California may delay opening health insurance exchange.

For Industry Insiders

There are not enough doctors for Obamacare.

Obamacare creates uncertainty in medical device industry.

Young people key to making Obamacare work, but many don't know their options.

40% of companies change health plans to deal with Obamacare.

If you got this far, I hope you found this useful.  We're always looking for feedback so let us know what you think.  For more information, check out the Small Business Guide to Obamacare.


Small Business Guide to Obamacare Now Available

Welcome to our new blog on all things PPACA and Obamacare.  We are planning regular columns on developments as Obamacare is implemented.

I'm proud to announce the publication of my new book, The Small Business Guide to Obamacare: Solutions to the Looming Health Law (Without the Politics).  The goal of the book was to lay out the basics of Obamacare (real name Patient Protection and Affordable Care Act or PPACA) without a political bias one way or the other.  The law is there and if you run an American organization you're going to have to comply with the law one way or the other.

If you are an employer and are baffled by what obligations Obamacare is placing on you, you've come to the right place.  Check out the Small Business Guide to Obamacare for straightforward explanations, examples, and strategies to help your company navigate the new law.  For the sake of yourself, your organization and your employees you need to get ready.

The book will be available on Amazon shortly.  In the meantime, you can buy the book at Createspace at the links above.