Whether you approve or disapprove of the Healthcare Reform Bill that was passed in 2010, you have to admit that it is bringing out the best in some Americans. Good old American ingenuity is coming to the forefront of some American’s thinking as they try to devise ways to circumvent the law.
The latest attempt to avoid paying the fine imposed on employers by the Patient Protection and Affordable Care Act. (PPACA) is by small business owners with more than 25 employees. The PPACA mandates that employers with more than 25 employees to provide healthcare insurance for their employees, while employers with 25 or fewer employees are exempt from this requirement. Some small business owners are proposing that they split their company into smaller, separate companies with less than 25 employees each, thus avoiding the requirement to provide healthcare insurance for their employees.
Not so fast says the Obama administration. They point to an IRS ruling which states that if two or more companies are held beneficially by the same ownership, then the separate companies can be treated as one entity for tax purposes. The Obama administration has claimed that this ruling should apply to small businesses who try to avoid the employer provided healthcare insurance mandate by splitting up companies into smaller divisions. They claim that if several small businesses are owned by the same individuals, the total number of employees working for all the businesses should be considered the total number of employees.
This difference of opinion will set-up a court battle, and frankly, I wouldn’t bet against the government on this one. A better solution to the problem of keeping the total number of employees under the 25 employee threshold would be for a business of 90 employees to be split-up between 4 or more owners, but with each owning a ‘baby’ business individually, rather each of the 4 owners owning 25% of 4 different ‘baby’ businesses. I realize that will create a whole new set of problems, such as equitable division of the parent company, but I have faith in Americans’ ingenuity.
Another area that is causing a great deal of concern within the healthcare community is the formation of Accountable Care Organizations (ACO). ACO’s are a cornerstone of the anticipated savings that are promised by the PPACA. Doctors and hospitals are supposed to join forces and agree to treat a certain patient population for a minimum of 5 years for a fixed amount. The problem with ACO’s is that several states had passed laws banning collusion between doctors and hospitals which restricts doctors from owning and operating testing facilities and rehabilitation clinics to which they refer. Texas had to pass a new law allowing hospitals and doctors to form partnerships as required by ACO’s. Other states have to revise their existing laws to allow ACO’s to operate within the state.
Another problem that I see with the ACO’s is that they appear to be no different than the HMO’s of the 80′s and 90′s. Many people have soured on the idea of HMO’s because they, too, treated people for a set amount each year, and tried to turn a profit by decreasing service to patients and reducing salaries paid to doctors and staff. I still feel that the idea of ACO’s is to condition Americans to the idea of less treatment and less personalized treat from their doctor so that when the Federal government ends up running the healthcare system, there will not be a huge uproar as services are cut or taxes are raised to provide ‘free’ healthcare for everyone.
So, the long and the short of the result of the PPACA is that there is something for everyone to hate about it. Which, as I recall, was what some politician said indicates that that is the result of a good compromise. That’s a sad comment on the mindset of our politicians, today.
President Obama mentioned the Healthcare Reform Bill in his State of the Union Address on Tuesday. He did down play the significance of the bill, probably because of its unpopularity with the general public. Here are a couple of excerpts from the speech and the truth behind the words
“Now let’s be clear – I did not choose to tackle this issue to get some legislative victory under my belt. And by now it should be fairly obvious that I didn’t take on health care because it was good politics.”
Translation: We passed healthcare reform to put more of the American economy under control of the Federal Government, even though the American public did not want us to do so. After all, we know what’s best for the American public.
“It would give small businesses and uninsured Americans a chance to choose an affordable health care plan in a competitive market.”
Really? If that is true, then why do most Americans and small businesses oppose the Healthcare Legislation? I guess most Americans don’t want an affordable healthcare plan.
“Our approach…would reduce costs and premiums for millions of families and businesses. And according to the Congressional Budget Office – the independent organization that both parties have cited as the official scorekeeper for Congress – our approach would bring down the deficit by as much as $1 trillion over the next two decades.”
Fact: The Congressional Budget Office, which scores the cost of any bill, has to base its decision on the information supplied to it by the bill’s backers. If the information that the CBO uses to develop its cost analysis is faulty, then the conclusion reached by the CBO is faulty. The old computer adage: GIGO-Garbage In Garbage Out- fits here perfectly. The revenue increases expected by the taxes included within the Healthcare Reform Bill may not (probably won’t) be realized, and the cost cutting probably won’t be legislated into law. So the whole projection is without merit. How can adding 37 million people to the healthcare programs save the government $1trillion dollars over 20 years? See below
“More importantly, the cost of Medicare, Medicaid, and Social Security will continue to skyrocket. That’s why I’ve called for a bipartisan, Fiscal Commission, modeled on a proposal by Republican Judd Gregg and Democrat Kent Conrad.”
This statement is true. I’ll get back to my point from above…If the President now says that government spending on Healthcare will continue to skyrocket, how exactly will adding millions of citizens to Medicare and Medicaid programs save the Government money?
“The approach we’ve taken would protect every American from the worst practices of the insurance industry.”
Here, President Obama can’t help himself not to take another swipe at a private industry. No one is forcing Americans to buy healthcare insurance. Oh, wait, the Healthcare Reform Bill requires all Americans to buy healthcare insurance or be fined by the Federal Government. If President Obama were truly concerned about the ‘worst practices of the insurance industry’, then he would open up insurance competition and allow insurance companies to compete across state lines and allow the expansion of HSA’s and other alternatives. In point 2, above, that’s what he claims he wants to achieve-competition. Let’s see real competition and let the marketplace work.
Separately, last week the news reports concerning the House Republicans repeal of the Healthcare Reform Bill claimed that the Republicans were just being obstructive, offering no alternatives. The truth is that the bill was actually a ‘repeal and replace’ bill. The bill requires several committees to be setup to offer alternatives to the current provisions within the bill. Once again the mainstream media did not offer the American public all the facts, further diminishing the media’s credibility and relevance.
HOORAY!!!
Yesterday the House of Representatives voted 245-189 to repeal the Healthcare Reform Bill that signed into law last year.
SO, what does that mean to all Americans? Absolutely nothing. The Senate would have to pass a similar bill, and then the two bills would have to be reconciled in committee, re passed by both chambers of congress, and then signed into law by President Obama before any changes in the law would become official. Since Harry Reid has stated that he will not allow any bill repealing the legislation to reach the floor of the Senate, and a White House spokesperson has stated that President Obama will veto any repeal if it reaches his desk, then probability of any repeal of the bill is close to ZERO.
One needs to wonder why Senator Harry Reid does not want the bill to even come up for vote. Is the Senator trying to promote the will of the people, or the will of the government? This type of political abuse of power is exactly what the majority of Americans were voting against in November 2010.
The Republicans brought the bill to the repeal the Healthcare Reform Bill to a vote for two reasons:
1) To fulfill a campaign promise on which they ran in 2010.
2) To force Democrats to be on record as supporting the unpopular legislation, which they can then use in future political campaigns.
The vote was largely symbolic and as one political pundit stated: “There were certainly dogs, though I didn’t see any ponies” yesterday. But, it does keep the debate in the public consciousness.
There have been several Democrat spokespeople on the airwaves yesterday and today claiming that the repeal of the Healthcare Reform Bill is a matter of ‘life and death’. Really? If it were repealed today, would people be tossed out of hospitals? Would emergency patients be turned away from emergency rooms? This wasn’t happening before the bill’s passage, and won’t happen after it’s repeal. Need I remind you that most of the provisions within the bill don’t even take affect until 2014? If this were truly a matter of ‘life or death’, why wait until 2014 to implement the provisions? We should expect better from our leadership than this type of rhetoric and inflammatory statements.
The latest polls indicate that the public is fairly evenly divided on the issue of repealing Healthcare Reform, with slightly more favoring repeal. Public sentiment is still running about 60% against the current bill, but only about 46% favor repealing it, while most Americans do want the existing bill to be changed.
A more realistic approach to making actual changes concerning the legislation would to repeal some of the aspects of the bill which have nothing to do with healthcare. Places they can start are:
1) Repealing the provision which requires businesses to file a 1099-MISC form with the IRS for each vendor from which they purchase $600 or more in products or services within the year. This provision does nothing to help provide healthcare services for anyone. All it does is put another burden on businesses to comply with this regulation, kills millions of trees, and makes it more difficult for businesses to hire additional employees, because of the cost of complying with this regulation.
2) Returning the student loan program to the way it operated before the bill’s passage, where the government guaranteed student loans made by private financial institutions. The Healthcare Reform Bill changed the student loan program to direct loans from the government. While this change may seem trivial, in reality it creates a new government department, requiring thousands of new government employees and eliminates hundreds, if not thousands, of jobs in the private sector as banks are forced to close their student loan programs.
Repealing these 2 provisions will not affect anyone’s ability to receive or afford healthcare and will help to create, or at least prevent the loss, of thousands of jobs. If all the politicians really want to do whatever they can to help create jobs, then there should be very little opposition to repealing these 2 provisions. Creating new private sector jobs for Americans will go a long way to making possible for more Americans to afford their own healthcare. Isn’t that what healthcare reform should be all about in the first place? Making healthcare more affordable for Americans?
