Tag Archives: Affordable Care Act

Straight, No Chaser: Revisiting the Affordable Care Act – How You or Your Employer Can Save Up to 50% of HealthCare Costs


Politics aside, I’m not so sure why business owners are focusing on the angst of implementation of the Affordable Care Act instead of the opportunities to save.
Consider the following from the Small Business Association website: “The Affordable Care Act (ACA) creates new incentives for employers to promote wellness among employees by creating supportive, healthier work environments and encouraging employees to take advantage of workplace wellness programs. Health-contingent wellness programs generally require employees to meet a specific standard related to their health, e.g., decreased tobacco use or lowered cholesterol levels. Under the ACA rules that take effect on January 1, 2014, employer rewards will increase from a 20–30% refund of their healthcare coverage costs for employing health-contingent programs, up to 50% for programs designed to prevent or reduce tobacco use.”
Subscribing to www.sterlingmedicaladvice.com as an employee benefit will save companies up to half of the insurance costs they are already paying for their employees.  These savings can occur at a cost of less than 10% of current costs of insurance! For more information about the final rules’ flexibility in eligible wellness programs, visit www.dol.gov/ebsa.  Have your employee assistance program administrator contact us at 1-866-ADVICE3 (238-4233) or email us at sales@sterlingmedicaladvice.com.

Looking to cut your ACA tax in half? Sign up with SMA, reduce absenteeism, win the appreciation of your employees, and save a bundle.
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Straight, No Chaser: It's October 1st – Do You Know Where Your Affordable Care Act Health Insurance Exchanges Are? Your Top Ten Questions


No politics here folks, just facts. The bottom line is the Affordable Care Act (ACA) isn’t going anywhere prior to implementation, so let’s look at where things are. You can go here for previous comments on the ACA.
1. What changes today? The exchanges as scheduled to open for administrative business and to begin signing up customers. This is expected to affect approximately 30 million Americans who previously had not been covered by insurance plans. However, online enrollment has been delayed until November. It is still thought this won’t delay the onset of benefits.
2. Do I qualify for an exchange? You do if you are an employee of a business with less than 50 employees and have to buy your own insurance, and if you currently can’t get insurance because of a preexisting medical condition, or you can’t afford the cost.
3. So do I have insurance today if I enroll? No. Benefits begin on January 1st.
4. What about the individual mandate? It’s still in effect. Starting January 1st, most Americans must either be insured or face a fine.
5. What about the employer mandate? It’s actually been delayed until 2015. This mandate requires any company with over 50 employees to offer benefits to anyone working more than 30 hours a week.
6. Is any of this affected by the governmental shutdown? No. In short, funding for the ACA is not under the control of Congress.
7. How do I know what’s happening in my state? 16 states plus the District of Columbia are setting up their own exchanges. The other 34 states  are being run either totally or partially by the federal government. Refer to the lead picture to see what your state is doing, then go to www.healthcare.gov for details.
8. How does the insurance provided by the exchanges compare with that of traditional insurance? Different exchange plans will have different levels of coverage (eg.bronze, silver, gold and platinum). You’ll get to select a plan based on your needs.
9. What about the costs? This is tricky. Obviously, the plans differ based on the one selected. Additionally, if you’re below 400% of the poverty level (which equals $45,960 for an individual and $92,200 for a family of four), you’ll be eligible for tax credits to bring down the costs of the respective plans. In general, the costs of individual insurance within the exchanges will be dramatically lower than private insurance for those who qualify.
10. Where do I sign up and/or get more information? Try www.healthcare.gov.

Straight, No Chaser: A Dream of Equal Access to Health Care

This weekend marked the celebrations of the 50th anniversary of the famous March on Washington. During this weekend’s remembrances, I couldn’t help but reflect back on Dr. Martin Luther King, Jr.’s most famous comments on health care in America.

“Of all the forms of inequality, injustice in health care is the most shocking and inhuman.”

Why would he say such a thing? Injustice in health care has taken many forms and resulted in predictably poor outcomes for those affected. I will be frequently reviewing these considerations and addressing health care disparities in this blog. Today, I will address the inequity in insurance coverage that formed the premise for the Affordable Care Act (aka Obamacare).
According to the Kaiser Family Foundation, in 2009-2010, 41% of low-income adults were uninsured, and 45% of poor adults were uninsured. Contrast this with the fact that only 6% of those who make four or more times the poverty rate were uninsured. This pretty clearly makes the case that health care is a desirable asset for Americans who can afford it, and a choice that too often can’t be afforded for others. Now consider that 14% percent of white Americans were uninsured, while 22% of African-Americans were uninsured, and 32% of Hispanic Americans were uninsured. Whether you believe this is just a correlation, coincidence or reflection of something more damning, it is a situation that screaming to be addressed and improved.
Even more recently, the Centers for Disease Control and Prevention released a survey showing that more than 45 million U.S. residents didn’t have health insurance during the first nine months of last year. Still even more people, 57.5 million, were uninsured for at least part of the 12 months before being polled (Be reminded that the total U.S. population is just over 311 million.).
Please take a moment and ponder the enormity of the numbers just presented. It begs the question “How can such be allowed to exist?” Dr. King’s comment begged the same question. The answer of course lies in the fact that the American health care system isn’t built on producing equality of access or outcomes. You’ve heard me say before that the American health care system remains the only system among all the major industrialized nations on earth that doesn’t ensure access for all its citizens. The American health care system is a business enterprise that has captured over $2 trillion annually, representing over 1/6 (17%) of the gross domestic product, and all the while leaving more than 45 million Americans uninsured. We are number one in money spent on health care by a large margin; in fact, the U.S. spends more on people aged over 65 than any other other country spends on its entire population. The business of medicine in America is business first. It is largely expected that good health care outcomes will result from good business in the same way that good cars, computers, smartphones, etc. are produced (theoretically). It’s important to note that according to the World Health Organization (the monitor of such things), the U.S. health care system was ranked #38 in the last WHO ranking based on standard health outcomes produced.
President Barack Obama’s health care reform law aims to extend health insurance coverage to a large portion of the uninsured. According to the Congressional Budget Office, health care reform will reduce the number of uninsured people by 27 million between 2014 and 2023. The Affordable Care Act (ACA) targets its assistance to the poor and near-poor who are least likely to have health care coverage. The ACA will provide Medicaid coverage to those with incomes up to 133 percent of the poverty level ($15,282 for a single person this year) — unless their home state opts out of the Medicaid expansion. People who earn between the poverty level and four times that amount will be eligible for tax credits for private health insurance.
Access to health care is the beginning of the process by which health care disparities can be erased. As long as failure to have equal access exists to the extent that it does, the types of disparities in life expectancy, disease rates and disease survival will remain predictably dismal for certain populations. This afternoon I will revisit the Affordable Care Act and it’s efforts to improve the current system. I welcome any questions or comments.
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