Another Obamacare delay: Out-of-pocket caps waived for a year
Source: Alabama.com
Enactment of the part of the Affordable Care Act that would cap expenses such as co-pays and deductibles has been delayed a year, according to a Forbes Magazine story.
Originally under the act, starting in 2014, deductibles were to be limited to $2,000 per year for individual plans, and $4,000 per year for family plans. Also, there was to be no lifetime limits on "the dollar value of benefits for any participant or beneficiary." In other words, you would not have a lifetime cap on insurance coverage.
Both of those provisions will be delayed until 2015 because, according to the White House, businesses need more time to figure out how to comply with the new rules.
The delay was first announced in February when the Department of Labor published the rule delaying the caps in the Federal Register. The change went largely unnoticed until The New York Times published an article about it on Monday.
Read more: http://blog.al.com/wire/2013/08/another_obamacare_delay_out-of.html
Scuba
(53,475 posts)Or worse, evidence the R's will use to "prove" that government health care doesn't work.
Harmony Blue
(3,978 posts)if the idea sinks in that government can't help they set back the chance of Universal health care reform for a generation.
Scuba
(53,475 posts)tridim
(45,358 posts)Scuba
(53,475 posts)I'd be interested in an explanation as well.
AtheistCrusader
(33,982 posts)An uncomfortable one that rings true. Excepting Medicare Part D/Prescription Drug Benefit, this issue WAS off the table for a decade, since the last president pushed it.
I don't think it unreasonable to fear it might happen again. (And that poster is clearly concerned, not cheering the fact. Nor a concern troll)
jtuck004
(15,882 posts)government is an adversary, to be gotten rid of, instead of something we use to help ourselves.
And we are gonna have a hell of a time putting that genie back in the bottle.
RC
(25,592 posts)For some reason the laws of physics are different in this country, than the rest of the universe.
Lugnut
(9,791 posts)DeSwiss
(27,137 posts)Half-Century Man
(5,279 posts)Full universal health care, al la military style health care, is the only acceptable solution. Everything else is simply stones in the road to real health care.
Freddie Stubbs
(29,853 posts)The current system is funded by future beneficiaries. If everyone is a beneficiary, who pays?
Scuba
(53,475 posts)... cut the military a whole bunch.
We have plenty of money. It's all about priorities.
wordpix
(18,652 posts)They will need more business expenses for tax deductions if the gov does that and will therefore hire more people, thus creating jobs and large clamor for infrastructure projects.
ConcernedCanuk
(13,509 posts).
.
.
Tax the Wealthy?
Cut the Military?
Wealthy and Military run the USA . . .
You already know that . .
CC
wordpix
(18,652 posts)poor corporations cannot figure out how the caps work so they need another year, and another and another
burnsei sensei
(1,820 posts)nt
Eric J in MN
(35,619 posts)It doesn't seem very complicated. The insurance companies needs to pay the bills in excess of that, and voila, compliance.
winterpark
(168 posts)atreides1
(16,067 posts)They've had time, what they were hoping for was a repeal of the law...and it might very well get repealed before implementation in 2015!
The president needs to tell them in a very public manner that they have had the time and now they have until December 31st to get it together!
RC
(25,592 posts)Jackpine Radical
(45,274 posts)4 years warning, on a %^$# bill they themselves wrote a lot of, and they need more time.
The caps are exactly the kind of provision that helps the insured, and are among the FIRST things that should be implemented to bring relief to the public.
But, I guess when you dance with the Devil, he gets to call the tune.
zeemike
(18,998 posts)And tell their employees to get their own insurance now that we have exchanges.
Because that is what they want, and probably what they will get.
Half-Century Man
(5,279 posts)...figure out how to comply to the 55 mph speed limit in the 70s? To figure out the ever escalating severity of the war on drugs?
just deal with it.
christx30
(6,241 posts)The law is the law. Force them to comply, or fine them and fire everyone. People and companies don't have the right to do what's best for themselves.
Comply or die.
Duckhunter935
(16,974 posts)years is not enough time to get ready
enlightenment
(8,830 posts)it seem like the only things that are being waived are those that protect businesses and the insurance companies?
What makes them think that people are going to be beating the doors down to buy individual coverage when they are slowly whittling away the things that make the mandate palatable? How about waiving the mandate until the businesses and insurance companies are in compliance, because this is starting to look like a one-way street.
edited for spelling
Ed Suspicious
(8,879 posts)another_liberal
(8,821 posts)Last edited Tue Aug 13, 2013, 01:37 PM - Edit history (1)
What you suggest would seem fair, if companies get a break why should we have to hold up our end of what was a fairly lopsided deal to begin with, and yes, rather one-sided as well.
Harmony Blue
(3,978 posts)and people figure out that they have been had.
tridim
(45,358 posts)City Lights
(25,171 posts)Kolesar
(31,182 posts)Why delay the mandate? I don't see what that has to do with "deductibles".
madrchsod
(58,162 posts)it`s that creeping feeling that you know something is`t quite right.
i`d say you pretty much sum up what is happening
Yo_Mama
(8,303 posts)DEFINITELY NOT.
All of this, of course, is a crushing blow to individuals who have health problems and will have been waiting four years for what they have been promised, and aren't going to be getting it.
And here I'll go a little further. I am a computer programmer and a financial systems designer. If you want to monitor this sort of thing, you establish a central database and simply update it at the end of each day. This is not rocket science, and it would be a strikingly dumb programmer who couldn't get this done in a week.
So I don't believe claims about the technical difficulties.
forestpath
(3,102 posts)chimpymustgo
(12,774 posts)burnsei sensei
(1,820 posts)much consumer interest.
I suppose that's a lesson the insurance companies and the denizens of AHIP will have to learn the hard way.
hobbit709
(41,694 posts)awoke_in_2003
(34,582 posts)the stink is starting to rise.
djean111
(14,255 posts)Bullshit.
Basically, the only part of the ACA that will be left, after a year or two, will be the requirement to buy health insurance.
The premiums and co-pays and deductibles will just keep going up.
tridim
(45,358 posts)As per the law.
The ACA is not going away, it will only get better. Your FUD-ish prediction is pretty much straight up BS.
djean111
(14,255 posts)As soon as more requirements are waived, it will be quite easy to work around that 80% or 85% rule.
I think insurance companies are just waiting to see what else will get waived. Co-pays and caps are just easily changed table entries. What the insurance companies are doing is looking at their bottom lines with the caps and digging in their heels.
I would like to be wrong - the only good thing I see is that single payer might be hastened because insurance companies just cannot imagine anything but steadily growing profit at the expense of granting health care. After the first flush of money coming in from new policyholders, they will want to keep the same amount and more of profit increasing every quarter. And now they will get taxpayer money in subsidies, guaranteed.
AllyCat
(16,152 posts)with no hope of relief now. My premiums are set to go up 10% in just a few short months unless we can bargain a better contract with management that won't bargain. Wisconsin has been royally f*cked by Walker. And this is why we need universal, single-payer or some other non-profit system. ACA was only meant to help us a little and the corporations don't even want THAT little bit.
cstanleytech
(26,251 posts)I also believe its their own fault because I will lay you odds that they were more focused on fighting the program and or trying to find loopholes to evade it than they were in implementing it.
Harmony Blue
(3,978 posts)for those that supported this frankenstein attempt at healthcare reform...you have been snookered once again.
tridim
(45,358 posts)That's pretty freaking cold dude.
These people have affordable health care for the first time in their lives, and you can't fucking stand it. Pathetic.
Harmony Blue
(3,978 posts)it is a shell game.
tridim
(45,358 posts)What is it about the ACA being the LAW that you don't understand?
Harmony Blue
(3,978 posts)as to which portions of the law can be enforced.
No different than the CWA or CAA. Give it enough time and the deal will become lopsided. I will let the audience decide which participant is left standing with a bag and a hole at the bottom of it.
The Clean Air Act and Clean Water Act had delays as well, but the reasons were very real.
Kolesar
(31,182 posts)tridim
(45,358 posts)All of our country's major social programs have had growing pains. Not because they are inherently flawed, but because half of the country is regressive.
Chan790
(20,176 posts)They're fast running out of things to exempt or rollback before healthcare under ACA is what healthcare was before ACA. Rollbacks just give the GOP another 2 years to attempt to repeal or turn-back the law before it's fully implemented.
No rollbacks should have been permitted of any section of the law, except by act of both houses of Congress. The dates specified in the law should have been enforced as written. It's really starting to seem like the Obama administration didn't want to actually pass anything...but to have the proposal that became the ACA be rejected so Obama could go back to the voters in 2012 and say "Well, I tried." Once it passed, the WH knew they screwed the only constituency they really ever wanted: big business.
A law unenforced, rolled-back, under constant threat of repeal or ignored is no law at-all. They passed ACA with specific provisions and dates, they should live with what they passed.
Doctor_J
(36,392 posts)former9thward
(31,949 posts)They will not have affordable health insurance even with subsidies.
tridim
(45,358 posts)hughee99
(16,113 posts)AND the co-pays, they might still be mandating insurance that one can't afford. There's a cost to buying the bronze plan that only covers certain things, and then there's another cost for deductibles and co-pays that one still might not be able to afford, preventing them from USING the health care they paid for.
dflprincess
(28,072 posts)There is nothing in the bill that guarantees access to care.
RC
(25,592 posts)Cal Carpenter
(4,959 posts)as it was written and passed.
And yet, here we are, yet another delay on behalf of the insurance cos and businesses.
tridim
(45,358 posts)Where "Obamacare" is a four letter word. They can't stand the 80/20 law.
You are completely WRONG.
I guess you're just another one of those people who can't stand to see 30 million poor people getting affordable health care for the first time in their lives.
enlightenment
(8,830 posts)Get over yourself.
This constant "you people are just haters" crap is so old it's growing mold. You are not going to be able to shut down the conversation, tridim - no matter how hard you try.
tridim
(45,358 posts)It's an easy question.
Like The President, my answer is yes.
enlightenment
(8,830 posts)health CARE.
Your strawman is looking a bit ragged; you use it far too much.
tridim
(45,358 posts)The 30 million number is a fact, not a strawman.
I can use it 30 million times and it'll still be a fact. Sorry pal.
enlightenment
(8,830 posts)make me understand why so many on DU simply revert to that rolling eye smilie.
Deliberate obfuscation doesn't make you sound smart, but keep on riding that one-trick pony of yours. It suits you.
Chan790
(20,176 posts)I'd argue that with the constant rollbacks, as one of that 30M...it's probable that most of them will still not have any meaningful insurance until the law is fully-implemented...or never.
Since I expect rollbacks on the tail of the current rollbacks, with additional rollbacks in the interregnum that we're looking at never.
zeemike
(18,998 posts)30% of a million people or 20 % of 10 million people that were compelled to buy your product?
Besides that is all in the accounting process, and that can be manipulated so easly...and that 4 letter word is Boom.
tridim
(45,358 posts)By making damn sure we get a spot in the exchange. However, management would rather take a hit and maintain their anti-Obama(care) ideology than gain the new revenue. It's one of the most stupid things I've ever witnessed in business.
Meanwhile, my individual insurance premiums are dropping like a rock because the provider is following the law, and taking the perks. The 80/20 law is working incredibly well.
zeemike
(18,998 posts)Please Brear Fox don't through us in that brier patch.
That because the insurance industry had the money and lobbying ability to stop the ACA but did not do it...they let it get by and were crying that is was going to be bad for them, so that we would think it was good for us...and would accept the mandate to buy their products.
geek tragedy
(68,868 posts)that it's not happening soon enough?
Puzzledtraveller
(5,937 posts)Swede Atlanta
(3,596 posts)It does seem this should not be complex and they have known about this for 3 years.
But I always expected that implementation of the ACA would encounter some bumps in the road, some delays, etc.
I don't like the delay but if we are slowly inching forward it is better than nothing. I would prefer single payer but that isn't going to happen anytime soon.
Kolesar
(31,182 posts)I would not be financially ruined if I had to cover $2000 of medical expenses. Our mortgage is paid off and our finances are in order.
Jackpine Radical
(45,274 posts)Now let's talk about the people who can't afford the $2k and won't get needed health care as a result.
Kolesar
(31,182 posts)Jackpine Radical
(45,274 posts)Kolesar
(31,182 posts)He who would have used Medicaid in my family is dead, so I quit looking into it and don't know the deductible. There is Medicaid for quite poor and disabled people. What is their deductible?
Jackpine Radical
(45,274 posts)then Medicaid recipients may not have to pay, but everyone even slightly above that line will, and in many states (e.g. Wisconsin), they're finding ways to exclude more & more people from eligibility. I think that Walker managed to kick something like 50,000 people off the Medical Assistance/Badgercare rolls.
Kolesar
(31,182 posts)A $30,000 income gets one insurance for $2,512 per year and a $500 tax credit/subsidy.
http://kff.org/interactive/subsidy-calculator/
Jackpine Radical
(45,274 posts)Kolesar
(31,182 posts)Jackpine Radical
(45,274 posts)For the Bronze plan, depending on things like the size of your family & whether you smoke, it gets into the thousands, with a pretty lousy copay along with it.
Kolesar
(31,182 posts)DJ13
(23,671 posts)antigop
(12,778 posts)Harmony Blue
(3,978 posts)so what other portion of the ACA will be "delayed"?
tridim
(45,358 posts)Sounds like you hate it.
djean111
(14,255 posts)Affordable insurance is not the same thing as affordable health care.
antigop
(12,778 posts)How can health care be "affordable" if you can't afford to get sick?
tridim
(45,358 posts)Is that what you want?
Kolesar
(31,182 posts)until something else catches his attention for the rest of the day
tridim
(45,358 posts)Welcome to ignore.
read it again
I was agreeing with you
djean111
(14,255 posts)Evidently it is not the ACA or nothing for the insurance companies.
tridim
(45,358 posts)Welcome to ignore.
djean111
(14,255 posts)historylovr
(1,557 posts)If you can barely afford the insurance on top of your other expenses, how can you afford to actually see a doctor? Obviously you can't. But Affordable Care Act sounds a lot better than Mandatory Health Insurance Act, you know, for PR purposes.
Without Single Payer, Universal Health Care and cutting out the parasitic middleman, Obamacare, ACA or whatever it ends up being called, will decay into another version of unlimited profits for the health insurance companies. It is already starting.
kestrel91316
(51,666 posts)This puts me right back in the same position I was in, except for the preventive and screening coverage. If I get sick or injured, I'll still be bankrupted because.....................
IT'S THE DEDUCTIBLES AND CO-PAYS, STUPID!
antigop
(12,778 posts)person is charged. Take a look at what an empty nester couple, age 55-64, that makes just above the 400% FPL has to pay in premiums.
400% FPL for a couple really isn't living high on the hog, especially in a state like CA or NY.
Same goes for an older single person making just above 400% FPL.
kestrel91316
(51,666 posts)greatly diminished self-employment income in recent years, thanks to the ongoing Great Recession in CA. And of course we have the highest medical insurance rates in the country right where I live.
About the only benefit I'll get from the ACA is the screening and prevention care. Like I said, if I get sick or injured, it may very well bankrupt me. I walk and bike carefully, lol, and eat like a vegan. Prevention is EVERYTHING to me.
antigop
(12,778 posts)I know--you shouldn't have to do this. But it literally is a matter of life and death.
Best of luck to you, kestrel. All of us are one job loss away from being in the same boat.
burnsei sensei
(1,820 posts)Has anything really changed?
antigop
(12,778 posts)And people won't get the care they need because they can't afford it.
Surely we can do better than this as a society.
Javaman
(62,504 posts)Triana
(22,666 posts)"Insurance companies need more time to figure out how to get around the new rules" - or some variation thereof.
Businesses had been offering high deductible insurance policies and must end them. How does your analysis work?
Triana
(22,666 posts)forestpath
(3,102 posts)people who need health insurance.
This might take away the sadness
http://www.hhs.gov/healthcare/facts/timeline/timeline-text.html
cilla4progress
(24,718 posts)In a Google search, this only came up on right-wing sites. Anyone know why?
Dreamer Tatum
(10,926 posts)Is THAT a "right wing" news source?
Does ANY news you don't like come from "right wing" news sources? Would the fact that you don't like it suddenly MAKE it a "right wing" news source?
Grow UP.
cilla4progress
(24,718 posts)Skeeter Barnes
(994 posts)cilla4progress
(24,718 posts)Waiting to hear more about this, before I jump to conclusions...
Safetykitten
(5,162 posts)More passes and delays....
kestrel91316
(51,666 posts)caps and lifetime limit coverage cut-offs will continue unabated.
Fuck this shit. May as well not have the law at all now.
Kolesar
(31,182 posts)loudsue
(14,087 posts)and enforce all parts of the law that help insurance companies.
More in line with the corporate rule we are now under.
L0oniX
(31,493 posts)ACA will be just another way to forcefully extract money for your life. No cap on co-pays? Oh wow geeze ...can you guess what that co-pay % will be? I can. Hmmmm "deductibles were to be limited to $2,000 per year" So uhmmm at least $2000 in co-pays ....well gee I can get insured for $400 a month with a $5000 yearly deductible. Problem is that I don't make make enough money to pay that nor enough to pay $2000 for an ACA deductible. If that is the deductible then I can imagine what the premium will be or can't I? Now they will delay that for another year so what happens in the mean time? I guess the IRS will be taking ACA out of my $274 a week take home pay and then let me worry about deductibles later.
Oh yea ...isn't that what insurance is all about? Take your money and not pay out? Unless you also pay for the lawyer to try to force them to pay? I don't believe or think ACA is going to allow you to use a lawyer to force them to help you.
Not only did Baucus and Obama take single payer off the table, now it's getting even farther whittled away ...and it's temporary right? Well we can't be having corporations be unprepared for ACA ...while everyone else has to be prepared to start paying in 2014?
Are they also delaying the IRS forced ACA deduction from my paycheck in 2014?
Boy oh boy ...I just can't wait for the next center right POTUS candidate telling us they will fix all this ...by compromising with the GOP enemy.
Hey ...I don't sound too pessimistic do I?
n2doc
(47,953 posts)Or at least, those provisions the HC and insurance industry don't like. Maybe the Repubs will get their dream after all.
pediatricmedic
(397 posts)I work in health care and can honestly say people need affordable coverage. About 70% of what I do now is for free because people can not pay, they simply don't have the means. This delay really sounds like they are trying to figure out how to shift the burden to the individual or family that already can't afford it.
The system is fubar'd.
mike_c
(36,270 posts)How many Americans will die or lose their livelihoods while we're accommodating "businesses?" I'm so fucking tired of leadership that puts "business" before people, the environment, etc.
The Magistrate
(95,243 posts)The limit on deductibles and the barring of lifetime caps are the chief attractions of the law, and essential to its gaining popular footing.
The companies can pound sand and eat losses....
Harmony Blue
(3,978 posts)anytime policy is put in place it is expected delays would happen. I can't think of a single policy that didn't encounter delays (especially environmental policies). However, I too believe this is an integral part of this policy that would swing public opinion positively. However, without this key portion of the law not being enforced on an earlier date the ACA is starting to lose steam before it even is showcased.
TheProgressive
(1,656 posts)People are mandated to have insurance, yet are receiving a
lesser promised product...
area51
(11,897 posts)that the waivers are all benefiting corps, not people?
And GingrichCare won't stop the following travesty from happening, which single-payer would have stopped from happening:
Woman hit with a $54k bill for snake bite treatment:
Today Show video link
WCGreen
(45,558 posts)hope the public will sour just in time for a GOP president takes over and guts the program...
leftyohiolib
(5,917 posts)Chan790
(20,176 posts)so he could go back to the voters and say "I tried" and run on it again in 2012.
When it passed, it was a serious "Oh shit!" moment. A policy they never really wanted but wanted to appear to be pursuing.
Sancho
(9,067 posts)so this is not a way for the companies to rip off everyone...
Jim Lane
(11,175 posts)I had the same reaction as TheProgressive (in #99): It seems that some of the patient protections are being delayed but the mandate will still kick in.
Does that mean that I will be compelled to buy insurance, but the for-profit health insurers will be allowed to set high co-pays and deductibles, making their product much less valuable to me, but I'll be forced to buy it anyway?
OK, I'm not forced to buy it, because I can always choose to pay the fine or surtax or whatever it's called. Depending on how the health insurers react to this latest modification, paying the fine might be the rational choice. If the fine is significantly less than the premiums I would pay, I'd have some money left over to buy actual health care, which crappy insurance might not provide to me.
I had previously thought that the worst-case scenario was that I'd essentially be buying catastrophic coverage. IOW, I'd get no value for my insurance premiums except that I'd be covered against major accident or illness that would generate a six-figure bill. If the insurers can impose a lifetime cap, though, I might not even get that.
Skittles
(153,122 posts)couldn't see THIS one coming
limpyhobbler
(8,244 posts)quadrature
(2,049 posts)dflprincess
(28,072 posts)The allowable deductible for a "bronze" plan is $6350... double that for a family.
Kolesar
(31,182 posts)burnsei sensei
(1,820 posts)my husband, who suffers from clinical depression, was compelled to co-pay three-hundred dollars for one prescription and eighty-three for another.
He is on Medicare, and in a supplemental HMO.
It is possible that he is in the doughnut hole.
So, when does this circus end?
Safetykitten
(5,162 posts)We went cheap. We were a bargain. We will have them on our backs for the rest of our lives.
Puzzledtraveller
(5,937 posts)Technically we have always had access, but unless you got it through an employer or were considerably well off to purchase your own you went without, even then the costs could be astronomical for those who had it and certain bankruptcy for those who didn't. Access. A kid has access to a cookie jar kept on top of the refrigerator if he can only reach that high. Costs? We see what the story is now. It was touted this has to be good because the insurance companies hate it, WRONG. They wrote it. Even in places where medicaid will be expanded there will be those who will fall between being eligible for their states medicaid and the subsidies to purchase on the exchange. I predict they will have nothing, just the hit on their taxes that most cannot afford as they depend on those refunds. I've been a medicaid case worker for four years. I am only speaking for myself and not as an authority. Many of us just wanted the "win" the goal. No regard or concern to what was in the law and those who questioned it were ripped for it and still are.