But let's take a hypothetical employers--we'll call them AlmartWay--that employs aroung 1.4 million people in the US.
AlmartWay pays such shitty wages that a huge proportion of their employees would actually be eligible for Medicaid, particularly with the eligibility for Medicaid boosted to 133% of poverty. So those employees could just enroll in Medicaid; AlmartWay wouldn't pay a dime, and you and I would therefore be subsidizing the gutting of our local economy so that the descendants of Sam AlmartWay could continue to get disgustingly rich.
But say that only covers about 500,000 of AlmartWay's employees. That would leave 900,000 employees. Enough that AlmartWay might want to offer health care to avoid the 350 million dollar fine it might get. So AlmartWay offers a plan that has a huge deductible and pays 60% of costs that employees have to buy into. According to Bad Max's plan, after all, employer health care plans don't have to meet any of the standards that single enrollee plans have to meet, save for making preventative care available.
Coverage offered by an employer of any size, including fully insured and self insured plans, is not required to comply with the list of benefits required of plans in the non-group and small group markets. Employers must provide first dollar coverage for prevention services (except where value-based insurance design is used), however, and cannot have a maximum out-of-pocket limit greater than that provided by the standards established for Health Savings Accounts (HSAs).
Because of AlmartWay's size, everyone would be automatically enrolled.
Employers with 200 or more employees must automatically enroll employees into health insurance plans offered by the employer. Employees may opt out of employer coverage, however, if they are able to demonstrate that they have coverage from another source. Additionally, states would have the option of establishing a process for auto-enrollment of individuals and families into policies offered in the non-group and small group markets
Which means AlmartWay's employees can only get out of paying for such crap is if they can prove that they're enrolled in something else. But unless AlmartWay's insurance cost more than 13% of their employees' salary, then that employee couldn't get a subsidy they'd otherwise qualify for.
As a general matter, if an employee is offered employer-provided health insurance coverage, the individual is ineligible for the tax credit for health insurance purchased through an exchange. An employee who is offered unaffordable coverage by their employer, however, can be eligible for the tax credit. Unaffordable is defined as 13% of the employee’s income.
Hell, if I were a rapacious manager like AlmartWay's completely hypothetical managers were, I'd turn employee health care into a profit center because (if I read this right) you could require employees to pay back 12.9% of their income for health care, and the only thing you'd really have to promise in return is preventative care. So I predict, if this bill passes in anywhere near this form, that AlmartWay will start making its own employee health care a big profit center because they will be stuck.
http://emptywheel.firedoglake.com/2009/09/08/incenting-shit-plans/
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