by Dana Goldstein
I want to say a little more about the "free rider" provision in the Baucus health plan, which Tim highlighted this morning. The HELP Committee and House bills require most employers to provide health insurance for their workers. But the Baucus plan does not include such an employer mandate. Instead, it requires companies to partially reimburse the government for the insurance affordability credits of uninsured workers and their dependents.
This creates some very perverse incentives. It discourages companies from hiring single people, who don't have a spouse whose employer-provided insurance will cover them, thus offering the employer an "out" on the subsidy payback. It encourages employers to pressure married, uninsured workers to go into their spouse's health plans, even if the worker feels they'd get better coverage for a lower cost on the exchange. And worst of all, it particularly discourages firms from hiring single people with children, because they'd have to pay for the children's subsidies, as well.
We know who'll be affected most by this bad, bad idea: low-income women, who are already pushed into "pink collar" jobs with more unstable hours, less benefits, and less pay than similarly educated men. Now even those jobs will be harder for single moms to get, as employers weigh whether a worker earning $15,000 or $20,000 a year is worth paying an extra several thousand dollars for, because of this subsidy payback requirement. Why not just hire someone without kids? Or someone married?
None of the health reform bills in front of Congress do enough to dismantle the link between work, marriage, and health insurance. This system especially hurts women, since only 38 percent of women have health coverage through their own job, compared to 50 percent of men. It is unjust for women to have to consider what will happen to their health coverage -- and their children's -- if they leave an abusive relationship, for example. But while the House and HELP bills mostly maintain the status quo, the Baucus bill would make things much worse. Source: The American Prospect
The McKinsey Quarterly - health care costs income disparity US - Economic Studies - Country Reports
Over the past 50 years, US workers have come to expect employers to pay for some part of employee health insurance; many consider this an important part of overall compensation. However, recent economic trends have resulted in a growing disparity in health care coverage and affordability. A study by the McKinsey Global Institute (MGI) identified three divergent categories of workers that are emerging from trends in health care coverage and income growth.
The top-income category (earning on average $210,100 annually1) has enjoyed rising incomes and growing employer-paid health care benefits, which have made their out-of-pocket spending on health care a relatively small and affordable portion of total spending. The higher-middle-income category (earning an average of $84,800 annually) and the lower-middle-income group (earning on average $41,500), have also seen increasing benefits and incomes—but at a much slower rate, making the uncovered portion of their health care costs ever-more expensive. In the bottom-income category (earning an average of $14,800 a year), incomes have been stagnant, and their employers are less likely to pay for their health insurance. This group is finding any health care difficult, if not impossible, to afford.
"'They are laying off older workers to reduce their pension exposure and their health-plan exposure,' he said. 'The young people are being hired in without medical plans and pension plans.'"
"Now here's the kicker. The employer, a health care corporation, provides disability insurance. And here's how it works. There's short-term disability and long term disability. Short-term, you get part of your salary and your medical benefits (for 3 months). Next comes long term disability Now what do you think 'long term disability' means? For a health care corporation. It means 15 months! After that, you're terminated. But there's more! Just 3 months into the long term disability, your medical benefits will disappear - unless you pick up the entire cobra amount!
You got that right: A health care corporation cuts off medical benefits for a disabled employee! (unless they can pay for cobra.... maybe from their home equity... if they still had a home... with equity) And ultimately terminates them.
Let's think this through: (A) Stay on your meds. You'll be alive. But you can't work due to side-effects. (B) Go off your meds. And you'll want to die. (C) Stay on meds long enough and you'll lose your health insurance. Then how do you pay for meds? Or your doctor? (D) No meds, you'll want to die again - especially if you contemplate your impossible situation.
This is an impossible situation."
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