These are the most frequently noted misconceptions and/or comments I receive weekly on the America’s Healthcare Advocate Show which broadcasts on 86 affiliates nationally.
- With ObamaCare, I’m Going To Get Free Health Insurance WRONG. Health insurance is not free under the Patient Protection and Affordable Care Act (PPACA) also known as ObamaCare. After you fill out and submit the necessary forms to the IRS through the federal or state exchange websites, you will then find out if you qualify for a subsidy. Subsidies are available to persons whose income does not exceed 400 percent of the federal poverty level, meaning those at the top of the scale receive less; those at the bottom of the scale receive more. But it is not free.
- I Don’t Have To Take My Employer’s Health Insurance—I Can Go To The Exchange If your employer offers a qualified plan, regardless of the size of the company, meaning that plan meets minimum essential benefit requirements at the bronze, silver, gold or platinum level, and your contribution to the premium does not exceed 9.5 percent of your company’s lowest paid employee’s W-2 earnings, you cannot opt out of the employer-sponsored plan and go to the exchange.
- I’ll Accept My Employer’s Insurance But My Spouse and Children Are Going To The Exchange This is one of the biggest misconceptions about the implementation of ObamaCare in the country today. Let me clarify. If your employer offers a qualified plan and your contribution does not exceed 9.5 percent of your family income, then you cannot go to the exchange and buy health insurance for your spouse and/or children.
- I’m Not Going To Purchase Health Insurance; I’ll Just Pay The Penalty You can decide not to buy health insurance and just pay the penalty. However, if you are one of the millions of Americans who received an income tax refund from the IRS, your refund will be withheld until the IRS processes the penalty out of it. Given the IRS’s track record for speedy transactions and the deluge of people who will probably find themselves in this situation, you could be waiting a long time for your refund.
- Common Ownership If you’re a business owner with more than 50 employees (i.e. maybe you own a franchise of restaurants in multiple locations where the total number of employees is greater than 50), you may think: “I’ll form two corporations, which will give me less than 50 employees in each one, and then I won’t have to offer health insurance.” Wrong. Common Ownership as defined by Sections 414(b), (c), (m), and (o) of the Tax Code applies in this situation and precludes you from obfuscating your responsibilities by dividing your company. In other words, you are still responsible for offering health insurance and cannot divide the business. Additionally, you will most certainly raise a red flag with the IRS, Health and Human Services and the Department of Labor and can most likely expect a visit from a federal bureaucrat to audit your business.
- ObamaCare Is Going To Lower The Cost Of My Health insurance This is totally false. The Congressional Budget Office (CBO) estimates that individual market premiums are going to be between 27-30% higher in 2014. The CBO says “[new health care law market reforms will] have a much greater effect on premiums in the non-group [individual] market than in the small group market, and they would have no measurable effect on premiums in the large group market.”
- Access To Providers Will Improve With The Implementation Of ObamaCare Not Really. There are lots of unintended consequences for providers and hospitals as a result of the passage of PPACA. In Kansas City and Wichita alone, over 950 employees have been laid off by hospitals like Via Christi, Saint Luke’s and Liberty Hospital. Liberty Hospital, located in Liberty, Missouri, advised that their 150-person layoff was a direct result of the implementation of PPACA. So with 44 million new people streaming into the system for health insurance, there will be fewer providers than before.
- ObamaCare Is Good For Business Aside from hospitals and medical providers laying off personnel, we also have examples of major companies like Kohl’s, which has cut the majority of its full time employees to part time (working 28 hours or less), in order to fall below the new 30-hour definition of full time employment so it does not have to offer health insurance. Additionally, restaurateurs and hoteliers are being particularly hard hit by this legislation in having to offer these costly new benefits. Policies like this and the new 3.8 percent ObamaCare tax on employers are not helping business.
- The President Said If I Like My Health Insurance, I Can Keep It Well maybe! If you had a plan that was grandfathered in by March 23, 2010, then you can keep that plan in place after January 1, 2014. However, if your plan wasn’t grandfathered in, which probably represents 80 percent of the health insurance plans in this country, then you will be required to buy a new plan that meets the minimum, essential benefits as defined by ObamaCare.
- Don’t Worry. ObamaCare Is Going To Be Repealed The chances of this happening are slim and none. And slim just left town on the last bus. With the Democrat controlled Senate and with a Democrat in the White House, there is no way the Republican controlled House of Representatives can force the repeal of ObamaCare. Get used to it. It’s going to be with us for a very, very long time.
Health insurance has been commoditized and is now totally controlled by the federal and state governments through the ACA legislation and state run exchanges. The success or failure of this massive program rests completely with federal and state governments. Rising costs, bureaucratic inefficiencies, lack of providers and a myriad of other problems that will present themselves, cannot be blamed on the industry anymore. Welcome to a brave new world.
America’s Healthcare Advocate