Is some DU'er an Afordable Health Care Act wonk?

[Ninga]

If so, here is my question.

Small business owner hires a new employee, and said employee has health care coverage through their spouse.

Is it true, that if the employee is covered by another plan, that the small business owner will have to "pay" into the system, as though he were providing the employee insurance - even though he will not????

I was bullied into a corner by a GOP'er and am not smart enough to know the answer.

Thanks for any help anyone can provide.

[Ms. Toad]

1. Now, or once it is fully implemented? n/t

[cynatnite]

2. Small business owner as in less than 50 employees? n/t

[Cleita]

3. I'll take a shot at this.

Even without the ACA, a dependent has to be named on the policy. Some companies pay and some companies make the employee pay for their dependents. But no one has to pay for a dependent that isn't named on the policy. I can't see why the ACA would be any different.

[Ms. Toad]

5. Not quite the question being asked.

The question is whether the small business has to pay into an insurance pool (so to speak) if it doesn't provide insurance for a new employee, even if the new employee has insurance elsewhere.

The answer is that a small business (as defined in the act) never has to pay into the pool. Large businesses may, if their employees actually purchase insurance through the exchanges (once they are set up) and claim a tax credit for the purchase.

[Cleita]

6. True, but I don't have an answer to the direct question.

Since the poster never defined whether the small business was less than fifty employees, I tried to introduce a common sense argument into this. I doubt anyone will be forced to cover a dependent that is covered by another employer's insurance. It would not be cost effective from any POV and since insurance companies are still involved and employers still have to prop up the system, I think the prevailing way of doing things would still hold true.

I personally favor Medicare for all, which would take the employer responsibility for providing health care out of the equation.

[Ms. Toad]

8. There actually isn't any forced coverage at all -

but there is a shared responsibility imposed on large employers...which of course the Republicans have morphed into an obligation to provide insurance and fees imposed on all employers.

I ran across a new variation on the death panels a couple of days ago. Now once you hit 80 or 85, the government has to approve all of your care (or at least all surgeries). So they are not actively killing you (according to this idiot), but they just deny you care.

I would prefer Medicare for all, as well. But this is a step in the right direction - and I think we'll get there once we get used to most people having access to insurance. Cutting out the middleman will be the next logical step.

[Cleita]

11. Cutting out the middle man is the only step in the long run.

It's the only way to make universal health care sustainable in the future. Hopefully, we will change the face of Congress by then so it can be done.

[Ms. Toad]

4. Nope. Assuming they were using small business the same way the act does.

Under the law’s employer responsibility provision, if a large employer does not provide affordable health insurance - and an employee of that organization uses a tax credit to help pay for insurance through an Exchange - the employer must pay a fee to help cover the cost of the tax credits. These rules apply only to employers with at least 50 full-time equivalent employees. (To read relevant portions of the law, go to the Affordable Care Act (PDF – 2.6 MB) and search on “1513\4980H”.)

Smaller employers are not subject to these penalties. Instead, small employers are eligible for tax credits that can make coverage more affordable. Businesses with 25 or fewer employees may qualify for these credits.

http://answers.healthcare.gov/categories/1701

Bottom line: The fees only apply to large employers, and only if their employees purchase through an exchange and use a tax credit to pay for that purchase (which wouldn't happen if the employee is using a family member's plan, but might if the other plan was one the employee purchased on his or her own).

http://www.healthcare.gov/using-insurance/employers/small-business/index.html

ETA these provisions go into effect after the exchanges are created in 2014 - they are not currently in effect (although there are tax credits available for small businesses already).

[Ninga]

7. Thank you all!! I love you guys! The business is less than 50. So the links are tremendously

helpful and will get me out of the corner and back into the ring!

[Ms. Toad]

9. I'm working hard to fight the ignorance on this.

I really wish the administration had realized that people won't stop being scared of it until (1) it is fully explained or (2) fully implemented.

They pretty much stopped working on the former until way too many rumors were running around - and the latter doesn't happen for a few years yet. I run into so much ignorance (and deliberate misinformation) it is like playing a game of Whack-A-Mole. Bat one rumor down, and another pops up.

[TheKentuckian]

10. Best guess is the covered spouse would need a certificate of credible coverage from

the employee plan and present it to HR at least yearly and that should clear both the employee and employer from any consequence of the mandate.

Now if the other plan is subsidized exchange coverage then the secondary employer may be liable but not from another "traditional" coverage through the spouse's employer.