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Unions Should Support The Health Insurance and Retirement Savings Needs Of All Workers

Organized labor deserves a lot of credit for its early efforts at getting health insurance and retirement benefits for workers. But labor also has a history of being slow to adapt to economic, social and political changes that challenge its mission. This has led to a slow erosion of labor union membership in the private sector. It has also resulted in attacks on the health and retirement benefits labor fought so hard for.

I applaud labor's support for the Affordable Care Act (aka Obamacare), and its wider support for universal health care. However, ironically, some of labor's biggest concerns these days involve provisions of Obamacare it sees as unfavorable to its members--the perceived threat to
multiemployer health care plans and the "Cadillac tax" (an excise tax on high value health plans). Granted, these provisions are not favorable to unions as they currently operate. But that's the public policy point. Union friendly policy makers are less concerned with the role of unions and more concerned about health and retirement plan access and affordability for everyone. I'm concerned that labor's historical reality of focusing on its narrow interests and its members may cause it to miss out on an opportunity to help achieve the universal health and retirement benefits it claims it wants.

There are several health insurance and retirement plan issues unions can support, and that are growing in economic, social and political importance.

Health care price transparency. Doctors, hospitals and insurance companies have given little substantive attention to the need for providing prices for medical care to consumers. Even as consumers are forced to assume a greater share of the cost of care by way of large deductibles, the medical care establishment consistently pushes back on real price transparency.

  • Labor unions should advocate for a change to the Employee Retirement Income Security Act (ERISA) to mandate real medical price transparency by insurers and health care providers. ERISA is a federal law that sets standards for private health and retirement plans. Currently, many insurers provide limited tools that give questionable estimates of cost for some care. Providers offer even less assistance and routinely prescribe care without any consideration of its price and if a cheaper alternative is available.
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Obamacare Individual Mandate Requires Affordability


I recently asked a group of independent contractors if they could design a health insurance plan, what would it look like. After a long moment without a response, I asked a few more questions.

  • What kind of health plan would you like to have?
  • How would you like to pay for the care you receive?
  • What, if any, information would you like to have before seeking medical care?
Below are the health care plan wants the group articulates:

  • Want a plan that allows you to visit any medical provider
  • Want a health plan without a deductible and coinsurance
  • Want medical care cost estimates
  • Want a health plan I can understand
  • Want to know why health care cost so much
  • Want help paying for health insurance and health care
  • Want an easier way to choose a health plan
  • Want to pay health insurance premiums via tax (like Medicare)
What I learned from this conversation is that it is hard to discuss a subject you don't understand, and people don't understand health insurance and health care plans. What they do understand is that it's a struggle to afford health insurance without the assistance of an employer or government subsidy. They know that health care pricing is hidden from them until it is too late to do something about it. They know that health plan jargon and design is complex and confusing. And they know that the health plan information they receive is not too helpful.

Oh, one more thing that I picked up on talking to this group of ladies in their late 40s to early 50s is that they're afraid and frustrated. They don't know how long they will be able to participate in the current health insurance system. I understand their frustration because no one is offering solutions for people in their situation. Instead they hear government defending how they are helping so many others afford health insurance and health care. They also have to endure the anti-reformist defend the health care status quo.


Government and the health care industry are ignoring the people who are on the hook for paying the most in health insurance premiums and deductibles. Ironically, many of these folks are the biggest supporters of government-led and health care industry supported health care reform. They don't object to paying health insurance premiums and deductibles. However, they do object to paying more in health insurance premiums than their traditionally employed counterparts. They also object to the possibility of having to pay thousands upfront in deductibles.

The government may feel like it has done all it can at the moment by simply increasing access to health insurance. But it has also made buying health insurance mandatory, with a few exceptions. And because of this mandate, access without affordability is an issue firmly in the government's court.

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Obamacare, Open Enrollment and Health Plan Recommendation Tools

It’s November 3, 2105, the third day of open enrollment season for the Affordable Care Act (aka Obamacare). This is the third open enrollment season for the federal health care program. Consequently, every health insurance writer and blogger is trying to prepare an original, standout article on the subject. Many will monitor the healthcare.gov site to report any glitches; others will focus on Medicaid expansion and affordability issues. And some of us who actually use the site to purchase health insurance will talk about our experiences comparing and buying health insurance coverage.

I’m part of the last group that purchases individual coverage without any employer or government subsidies. I haven’t chosen a health plan for 2016 yet—I have until January 31, 2016. However, I did start reviewing the various websites that list “Obamacare Plans.” I’ll look at non-Obamacare plans later in the week, which is okay since I don’t receive a subsidy.

I reviewed four (4) websites that allow you to enroll in an Obamacare plan. All four sites provide some type of health plan recommendation tool. You input your zip code, age, gender and smoker status and the tool recommends a health plan. Three of the tools (by Healthcare.gov, HoneyInsured.com and eHealthInsurance.com) allow you to estimate your out-of-pocket medical expenses for 2016; StrideHealth.com uses a built-in estimator that you cannot change.

Confession: Healthcare.gov was not the first sight I visited to review my 2016 health plan options.

I discovered HoneyInsured.com when I was researching health plan comparison tools for my free eBook—
What Employees Want This Open Enrollment: Health Insurance Plan Recommendations. The site became operational on November 1, just in time for the Obamacare open enrollment season. After inputting my zip code, age, gender, smoker status, estimated health care expenses (which they told me were way below average for a woman my age), I received a plan recommendation. I also had the option of enrolling in the plan on their website, which they claim takes less than five (5) minutes to do. Oh, the tool also allows you to indicate if you are okay with a limited network of health care providers. I am. Continue Reading...


Republican Presidential Candidates On Health Care Reform. Oy Vey!

This week health care policy watchers are focusing their attention on the Affordable Care Act (aka Obamacare) alternatives put forth by Senator Marco Rubio and Wisconsin Governor Scott Walker. I can’t say that I was eager to read another Republican health care reform proposal. But as someone who makes a point of reading all publicly available health care reform proposals, I took the time to read them. And although short in length, reading them was exhausting.

All the major conservative health care reform boxes are checked…

I didn’t see anything in the Rubio and Walker proposals that I haven’t seen in other conservative health care reform proposals. Tax credits. Check. HSAs. Check. Employer tax-preference reform. Check. Medicaid block grants (state-controlled). Check. Allowance of bare bones medical plans. Check. State high-risk pools. Check. Interstate insurance plans. Check. Return to the pre-Obamacare status quo. Check.

Bottom line with these two proposals is that they contain very little detail but are clearly making the point that they are okay with the pre-Obamacare health care environment of crappy health plans but want major changes in health insurance plan tax treatment.

But as these two proposals are being dissected, another health care reform conversation is taking place among Republican presidential candidates that is more interesting and worrisome. At least three candidates have discussed raising the Medicare eligibility age beyond age 65 and/or privatizing the program. Republican presidential candidates Jeb Bush, Chris Christie and Marco Rubio have all proposed these types of changes to Medicare. But to be fair many Republican lawmakers in the House and Senate support these types of changes to Medicare and it was on the table when the Democrats drafted Obamacare.
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Forget Trying To Defend Obamacare With Talking Points, Just Enroll More People

This past July 4th weekend the Obama Administration launched a mini PR campaign urging Affordable Care Act (aka Obamacare) supporters to defend the law at the family barbecue. Of course opponents of the law mocked the Administration’s efforts to counter their relentless negative attacks. They especially made fun of the suggested responses to typical complaints about the law. And although I sympathize with the frustration the Administration must feel about the criticism the law still receives, this campaign shows that they really don’t get it.

One look at any comment thread for any Obamacare article on sites like New Republic Online or Wall Street Journal Online and you know that defending the law with facts is a waste of time. Pointing out that opponents were wrong about everything is a waste of time. Why? Because different people interpret “the facts” about Obamacare differently and Obamacare opponents really hate and distrust President Obama. You ever try defending yourself against someone who hates you to the core? You can’t. So stop trying.

Repeal and Replace, Meet Enroll and Evolve

More Americans are familiar with the message of repeal and replace than are aware of the most important features of Obamacare, such as the availability of subsidies to help pay for health insurance coverage. Obamacare foes never miss an opportunity to say something negative about the law. Meanwhile, those who support the law often work behind the scenes. The work they do is great, but low-key and minimal. Ads on trains and buses and in medical facility waiting rooms are no match for consistent national news sound bites calling for repeal of the law.
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We Can't Wait For Americans To Understand Health Insurance To Fix It

A quick look at the headlines of the latest polls on the Affordable Care Act (aka Obamacare) and you may conclude that Americans don't know what kind of health care system they want.

Most Americans like the fact that people with preexisting medical conditions have a legal right to purchase health insurance. Unlike the bad old days when insurers could deny them coverage... They also like that parents can keep their adult children on their health plans up to age 26. And they are not opposed to the poor receiving government subsidies to pay for health insurance.

Yet a simple majority of Americans still oppose Obamacare. And, they don't like the mandate to obtain health insurance or pay a penalty, despite the fact that this feature provides for the things they like about the law.

As policymakers, pollsters and the media try to understand and explain these clearly disengaged poll responses, employee benefit professionals in the trenches are happy someone finally feels their pain. For decades employers and their human resource departments have tried to provide workers with a comprehensive understanding of health insurance and the health care system. For decades they have failed to accomplish this. And it’s partially their fault, but mostly the average American citizen’s fault. Here’s why.

Employers Failed To Educate Workers About Health Insurance

Employers have to admit that they never shared the behind the scenes process of obtaining health insurance with workers. Plans just magically appeared and all workers had to do was choose one. But not before sifting through a multitude of jargon-filled, legalese mumble jumble about tax advantages and life status events. It wasn’t until the cost of health insurance started getting scary for employers did they start sharing more information about their health insurance plan design and purchasing decisions. However, by then it was too late. After years of receiving confusing insurance information, employees tuned out, keeping the same plan year after year.
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Three Reasons The Affordable Care Act Will Survive


Some republican lawmakers, conservative intellectuals, and their constituents will never stop excoriating the Affordable Care Act (aka Obamacare). They will never admit they were wrong about its negative impact on businesses, but will instead wait and hope for its collapse. A time, no matter how far in the future where they can say, we told you it was the worse legislation ever passed. But by all indications their I told you so moment won't come anytime soon, if ever. And here are three simple reasons why:

  1. It’s Working
  2. It’s Not Failing
  3. It’s Better Than The Alternative(s)
It's Working. Obamacare recently marked its five-year anniversary, but it will take many more years before anyone knows its real impact. But what is certain is that for every pronouncement of Obamacare success, there is a rebuttal.

Claim: Sixteen million Americans gain access to healthcare
Rebuttal: It’s due to Medicaid expansion

Claim: Health insurance premiums are increasing at a lower rate…
Rebuttal: It’s due to government subsidies to large health insurers

Yet Obamacare can legitimately claim some success. More people do have access to health insurance. People are receiving physicals and have access to needed medications. Hospitals are experiencing a reduction in unpaid bills.
And states that previously rejected Medicaid expansion are finding ways to accept it.

It's Not Failing. Obamacare opponents want to have it both ways. First they complain that the law is the largest piece of legislation ever created by far at almost 11,000 pages. They say it is too complex for individuals and businesses to understand and comply with its many provisions. They label it a job destroyer and say it will lead to even higher health insurance premiums.

Meanwhile, as the Obama administration tries to work around the many complications that this unprecedented legislation was bound to encounter, Obamacare opponents try to use these difficulties to prove the law is unworkable. However, their efforts are failing. They are failing because for every problem there is a solution. The first open enrollment demonstrated how ill-prepared the Administration was to handle enrollment through the federal exchange, but by the second open enrollment, basic enrollment issues were resolved. Because fixing even large computer systems is doable. The postponement of the individual mandate is also interpreted as a failure, but by taking more time and addressing challenges sooner rather than later, the chances of successful implementation increase.

Obamacare opponents waste so much energy and credibility predicting Obamacare failures, only to learn that they can all be overcome.

It's Better Than The Alternatives. Obamacare opponents refuse to genuinely acknowledge the amount of suffering people experienced under the pre-Obamacare healthcare system. No amount of data or anecdotal stories about people struggling with medical debt, physical and emotional pain or even dying moves them. In fact, many go so far as to claim the prior system worked fine.

But it is this mean-spiritedness that will help Obamacare survive. People receiving medication to alleviate the pain of chronic illnesses because of Obamacare will feel the cruelty of having it taken away. Despite what the opposition may say, it's not merely the fact of not being able to take something away once given, it's about what they are trying to take away. Trying to take away a life without debilitating pain is not just anything--it's the difference between compassion and a lack of compassion.

Now I am not saying that everyone who opposes Obamacare is a cold-hearted monster. I know that people genuinely think the law encroaches on free enterprise, or interferes with the employer-employee relationship, or costs too much. But what all Obamacare opponents forget or ignore is that human suffering outweighs all of these concerns. And I think the reason the opposition struggles to come up with a supportable alternative to Obamacare is this focus on the non-human costs of the law. That and they have the disadvantage of being the alternative. President Obama and his supporters already had a leg up on the opposition by addressing the healthcare issue first.


Not all opposition to Obamacare is born out of hatred for the man who bears its name and his supporters, but a lot of it is. This negativity along with a visible lack of compassion for those in need of affordable health care, and a focus on perceived but unreal failures almost guarantees that Obamacare will survive. The opposition refuses to acknowledge how personal and powerful access to health insurance and health care is to those who never had it or struggle to keep it. Bottom line, they’re wrong on their predictions of doom and they’re wrong on why the law is increasing in popularity and the real human reasons it is here to stay. It’s not about free stuff; it’s about having important, even life-saving needs met.

Will Obamacare Challenge Employer’s Total Compensation Models?


It is difficult to know how American business owners really feel about the Affordable Care Act (aka Obamacare). It’s difficult because most of what you hear on the issue comes from politicians, public policy researchers, academics and professional associations. They all have opinions and predictions about what Obamacare means for businesses.

For some, Obamacare is viewed favorably because it gives businesses health insurance options that never existed before. Small businesses especially know how complicated and expensive individual and group health insurance was to obtain pre-Obamacare. But for others, Obamacare is viewed as a huge regulatory burden. Somehow worse than the before model… Meanwhile nearly all of these proponents and opponents neglect to discuss probably the biggest challenge businesses face because of Obamacare. That challenge is how to maintain traditional compensation structures that favor businesses.

Employee Benefits As A Form Of Compensation

For more than half a century employers were able to include “benefits” as a form of compensation they provided to workers. And as employer-provided health insurance became increasingly expensive, employers started to share just how much they were paying for these benefits with workers. They wanted to make sure that workers understood that compensation didn’t just come in the form of a paycheck. So, large employers in particular started distributing annual total compensation statements.

These total compensation statements include pie charts dividing up all of the compensation employees receive. And while cash compensation remains the biggest chunk of the compensation pie, the health insurance, and to a lesser extent, retirement plan funding slices are significant. But Obamacare has the potential to change how employees view their total compensation and how they want to carve it up.
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What Does Being "Lazy" Have To Do With Health Insurance? Nothing.


Yesterday one of the kindest individuals I know made some horrible comments implying Obamacare favors the "lazy" at the expense of the motivated. He does not think it fair that the rest of us should pay for health insurance for these "lazy" individuals. As if not being able to afford the high cost of health insurance means you are lazy.

Unfortunately, this is the typical argument of the uninformed or those with a vested interest in maintaining the status quo. He was a member of the former group (but currently informed and reformed). But it is the latter group who was clearly shaping his opinions about who is "entitled" to healthcare in America. Even though these individuals have been wrong about nearly everything they said would happen under Obamacare, they continue to repeat their distortions. Obamacare has not:
  • Caused employers to lay-off millions of workers
  • Increased the costs of health insurance above previous trend levels
  • Created death panels, etc.
Facts mean nothing to these angry opponents of Obamacare. Instead of railing against over priced medical care or wealthy doctors and health insurers, they direct their anger at the poor. But maybe I'm giving these folks too much of my time. Only a change of heart can change their opinion about Obamacare, because factual information sure isn't working. So let's just leave these curmudgeons to their indifferent beliefs. They have little to no power to change the direction of Obamacare.

I’ll save my disdain for the uncaring and self-interested politicians and their ilk that do have the power to make changes to Obamacare—like the newly announced candidate for President of the United States, Ted Cruz. It wasn’t until yesterday when I read “the comments” and learned of Cruz’s announcement that I started to think about what American health care would look like under a Cruz White House. Until then the only thing I knew about Cruz’s stance on health care is that no one in the world wants to repeal “every word” of Obamacare more than this guy. (Well, maybe a few conservative intellectuals who would rather set themselves on fire than live in a world where a law enacted by President Obama defines the nation for years to come… But I digress.)
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Let's Start A Campaign To Get Rid Of Confusing Health Insurance Jargon


Last week Sylvia Burwell, U.S. Dept. of Health and Human Services Secretary, gave a speech at the American Health Insurance Plan’s (AHIP) health policy conference. The speech was scheduled for half an hour. Secretary Burwell shared 2015 enrollment statistics and discussed future goals of her Department.

The primary focus of the Secretary’s speech was to outline her Department’s goals following the second Affordable Care Act (Obamacare) open enrollment. One of the goals she articulated is to work with the health insurance industry and other partners to increase Americans’ understanding of health insurance and health care.
And I agree with Secretary Burwell that the focus needs to be on education—it should have been from the start. But I understand that getting people enrolled in a health plan and fixing the enrollment system had to come first.

I also understand why HHS is asking for help with this goal. Their “Coverage to Care” initiative is not likely to help too many people understand their health benefits, especially newbies. For example, the one to two minute, 11-part video series on topics such as:
  • understanding health plan terms,
  • finding a provider, and
  • making an appointment, etc.,
uses the same jargon and unintuitive concepts that already existed. Continue Reading...

Americans Know Workplace Health Insurance Is Subsidized By The Federal Government, They Just Don't Care


I’m a big fan of the Vox.com website. The writers at Vox are good at making a point and supporting it with relevant data. Another reason I like the site is because they write a lot about health care in America and abroad. They cover Obamacare better than all the major news outlets because they focus on informing readers and not the latest headlines. However, when Vox writers use the results of a poll to make a point, I kind of wish they didn’t.

Polls ask simple questions without providing examples or definitions of the terminology it uses. So when Vox writer, Matthew Yglesias,
wrote an article based on the results of a poll question in which nearly all of the respondents said that they did not receive a government subsidy to pay for health insurance, I was like, ‘meh.’ But because it came from Vox.com, I decided to look at all of the results from The Economist/YouGov poll referenced in the article.

Now, as an employee benefit professionals, I know that a lot of workers:
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3 Things That Insurance Agents/Brokers And The Obama Administration Can Agree On


Despite relentless criticism, the Obama administration continues to propose and create policies and programs relating to health insurance and retirement savings plans. For sure, much of the criticism is due to fear of change by an industry that is doing well for itself. If brokers are able to briefly contain their fear of the unknown, they will see that they have a lot to gain from the Administration’s many proposals.

There are three main themes to the White House’s health insurance and retirement plan proposals:
  1. Increase Access
  2. Increase Legal Protections
  3. Increase “Tax” Fairness
Increase access to health insurance and retirement savings plans for all workers

It’s a fact that more Americans have access to health insurance because of the Affordable Care Act (aka Obamacare). And while most everyone agrees that increasing access to health insurance is a good thing, Obamacare was a challenge for one group in particular—insurance brokers. After Obamacare, many insurance brokers expressed concern for their livelihood and if they could transition to a new, more drawn-out way of doing business. They also had legitimate concerns about their commissions. There is talk that some independent agents transitioned to other professions or retired, but for the most part insurance brokers did not lose their livelihood and now have a larger customer base to assist.
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The Better Mind and Body Obamacare Alternatives


I am committed to discovering and learning from every Obamacare alternative available. So far I uncovered two conservative proposals—The 2017 Project Proposal and the Save Our Healthcare Proposal. But after reading two proposals from conservative elites, one (2017) a lot more detailed than the other (SOH), I am already feeling distracted. So I went searching for something else, something different, and something unique. And I found it—two very different “alternatives” to Obamacare… The first alternative comes from Whole Foods (supermarkets) co-founder and libertarian, John Mackey. The other alternative is health care sharing ministries.

Whole Foods

Everyone who visits a Whole Foods market knows it is an experience. The staff is nice, friendly and helpful. The food is super fresh and a lot of it is organic. They offer products you cannot find elsewhere. And you can easily spend $100 and not have enough food for one meal, but still walk away smiling. Now Whole Foods is not the only high-price supermarket, but it’s owner is the only corporate big shot that has his own health care reform plan.

John Mackey, Whole Foods co-founder, got in a lot of trouble for his comment that Obamacare is fascism. He later apologized for his poor choice of words, but he no doubt still believes them to be true. In true libertarian fashion
his health care reform plan calls for more personal responsibility and less (really, no) government intervention, unless it is pro-market intervention.

The Mackey (8-point) Health Care Reform Plan
  1. More high deductible health plans and health savings accounts (HSAs)
  2. Same tax treatment for individually purchased and employer-provided health insurance
  3. Right to purchase health insurance from any state
  4. Abolish all health insurance plan mandates (these are benefits that a state or the federal government requires a health plan to offer. For example, alcohol and drug treatment, hearing aids, mental health benefits, etc.)
  5. Implement medical tort reform to limit the amount of damages patients can collect
  6. Health care costs transparency
  7. Reform Medicare (that’s all it says…)
  8. Allow tax deductible charitable donations to help others who do not have private or publicly provided health insurance
Mackey’s plan has some of the same elements as the 2017 Project health care reform, proposal, including equalizing tax treatment for employer and individual health insurance, using HSAs and purchasing coverage across state lines. It also has a few things in common with Dr. Ben Carson’s Save Our Health Care proposal, including tort reform, HSAs, and charitable contributions. Continue Reading...

Dr. Ben Carson’s Alternative to Obamacare Suffers From Status Quoitis


It was my mother who introduced me to Dr. Ben Carson's personal life story. Because of her, I read his autobiography, Gifted Hands: The Ben Carson Story. And several years later I watched some of the made for TV movie based on the book (I lack the patience to watch an entire movie). The book is the tale of how he overcame poverty and anger and became a renowned pediatric neurosurgeon.

Before his retirement as a physician I would hear his name or see him on the news as one of the doctors performing groundbreaking surgery to save someone's life. And I would think to myself, oh that's the guy who... I have to admit I was proud of him and his accomplishments. So I was eager to read his alternative plan to Obamacare.

Where to begin?
  • First, the name of the project is Save Our Healthcare
  • Second, it is a “partnership” between Newt Gingrich’s American Legacy Political Action Committee (PAC) and Dr. Carson, who serves as the project’s Chairman
  • Third, there are five parts to Dr. Carson’s health care reform project
Dr. Carson’s Five Health Care Reforms

Dr. Carson outlines his health care reform proposal in a
five-part video series on the Save Our Healthcare website. Here is a summary of his reforms:

Part 1 – Creation of personal, tax-free health savings accounts (HSAs) established at birth. Account funding can come from you, the accountholder; a family member, employer, charity, and even Medicaid Continue Reading...

The 2017 Project's Health Care Reform Proposal - Obamacare Alternative?


America’s health care system is among the most muddled, expensive and unfair health care systems in the world. There is medical care rationing based on ability to pay. Medical care prices are set indiscriminately and are rarely available in advance of service. And some groups pay much less for much better health insurance than others.

Fixing such a complicated and costly system does not come easy or quick. So when I hear the criticisms about how the Affordable Care Act (aka Obamacare) got so much wrong, I question their motives. Does any sensible person honestly believe that any law could address all the issues that plague our health care system on the first try? No. People who hate Obamacare are either looking out for their own self-interest, hate government intervention even when warranted, or have an intense resentment for a certain person or persons.

Still, I never dismiss criticism of Obamacare outright. It needs improvement and even the most hateful opponents may have some ideas worth incorporating into the law. Or they may have ideas that make us grateful that Obamacare came first.

The 2017 Project - Health Care Reform Proposal

The 2017 Project’s health care reform proposal is the conservative alternative to Obamacare. The entire
proposal is on the 2017 Project website. The proposal has a three-legged strategy. The three (3) legs are: Continue Reading...

Who Really Wants To Repeal Obamacare


It’s 2015 and the Republicans have a majority in both the U.S. House of Representatives and the Senate. And I, like a lot of people, want to know what they plan to do to the Affordable Care Act (aka Obamacare). Will they try to repeal it? Will they chip away at it by revoking components they especially do not like? Will they sit back and wait for the Supreme Court to gut the law by eliminating most of the subsidies? Will they pass their own version of Obamacare? Or, and it’s a big or, will they just leave it alone.

Well, we don’t have to wait and see what the new majority will do, they are already doing it. Senate Majority Leader Mitch McConnell and House Speaker John Boehner are going the chip away route. The House recently passed legislation to change the law’s 30-hour workweek threshold to 40-hours. A few other provisions of the bill the Republican leadership plan to change include elimination of the employer and individual mandates. They also want to ditch the medical device tax and the Independent Payment Advisory Board (IPAB).

But how will the newly elected majority’s constituents react to this approach of eliminating only parts of Obamacare. Will that be enough to satisfy their multi-year thirst for absolute repeal of the law? Probably. Survey after survey has shown that while self-identified Republicans and conservatives claim to want to repeal Obamacare they do like some of its provisions. Components of the law they like include covering adult dependents on their parents’ health plan up to age 26 and preventing insurers from denying coverage due to a preexisting condition.
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2015 - There's More To Say About Health Insurance and Retirement Savings


I created the BenefitsAll website several years ago but it was not until January 2014 that I added the BenefitsAll blog. My three main reasons for writing the blog are:
  • to impart what I have learned over the years handling challenging employee benefit situations
  • to point out the skills every top benefits pro needs to be effective, including good writing, analytical and technology skills
  • to promote continuous learning that encourages questioning the status quo
But now it is time for me to open up more and even champion the changes I want to see in the employee benefits field. For example, real health care price transparency is extremely important to me and I am so over the medical care industry’s excuses for not providing it. And the huge variation in prices for the same medical procedure is also unacceptable and worthy of my protest. However, my greatest concern with group and individual health care plans is the cost of purchasing and using them, as well as the trend of passing on even more of the costs to consumers.


Seeing all the high deductible health plans (HDHP) listed on the federal exchange (healthcare.gov) makes me reevaluate my unconditional support for the Affordable Care Act (aka Obamacare). But because I know that we need an alternative to and an eventual replacement of employer-sponsored health care, I am not promoting repeal of Obamacare, just some major revisions. Non-subsidized Obamacare coverage is too expensive and does not meet the objective of freeing up entrepreneurs to pursue their passions. The not-too-poor but also non-too-rich, healthy young professionals that may be the entrepreneurs of the present and future, are the ones paying the most for health care coverage under Obamacare. We need a fix.
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If One of Obamacare’s Biggest Critics Wants to Use It To Save His Business, Can It Really Be That Bad?

I read a ton of employee benefit articles everyday. And when you read as much as I do you start to think you can predict where the field is going. Of course not everyone agrees with my opinions. But that doesn't stop me from sharing them...

For example, it's my opinion that some of the biggest Obamacare critics will eat their words. I'm not just talking about these critics being proven wrong because that happens daily. I mean they will embrace the very law they claimed was the worst thing to ever happen to America. Don't agree? Well, how about this as an example...

In 2012 Donald Trump
said this about Obamacare,

I know so many people who have companies where they are going to close them up as soon as it [Obamacare] really starts kicking in, which is in '14."

Irony of ironies, Trump Entertainment plans to stop paying for health care for thousands of union workers as it tries to avoid going out of business. And here is the kicker,
Trump Entertainment wants to provide these workers with a $2,000 stipend to purchase coverage on the federal exchange. Yes, instead of ruining companies, one of Obamacare's greatest foes is trying to use it to save one of his. Continue Reading...

Top Health Insurers Are Changing The Way They Do Business And Employers Should Too


Health insurance companies are fresh out of ideas on how to save employers money. But saving employers money was never their primary purpose anyway. Their primary purpose is to maximize their own profits. So after teaching employers all of their best cost-shifting tricks over the last few decades, they are exploring other revenue-generating options.

Whats Going on With the Big Health Insurance Companies?

The rollout of Obamacare provided large health insurers with a glimpse of their future. This future includes greater competition and less bargaining power with providers. There are several telltale signs of these changes, but here are four that get my attention.
  • They no longer have the benefit of price secrecy as their competitors can now see how they price their products on federal and state exchanges
  • They are struggling to maintain their networks and bargaining position with medical providers and hospitals as these entities consolidate
  • They let private employee benefit consulting firms like Aon Hewitt, Towers Watson and Mercer take the lead in the private exchanges movement. I am not convinced their hearts are in it and believe the only reason they are creating their own exchanges is because their competitors are, and
  • They are looking more like IT companies than health insurers...
Now I know that health insurers need to rely on robust and sophisticated technology to perform everyday functions. And it is no surprise to anyone that they use technology to gain a competitive edge. It is also no surprise that they are using their IT know-how and storage capacity to create new lines of business. But they are also sitting on another IT cash cow and this is mostly thanks to their employer clients. That cash cow is googobs of data.
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