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I've been interested in what the numbers say about increases in independent contracting as a form of employment so I went looking on bls.gov. Here are two charts (one is seasonally adjusted) that track the monthly stats for non-ag workers (caveat: a huge number of ag workers are self-employed): If I'm reading it correctly, there were a half-million more non-ag independent contractors this January than there were a year ago January, whether seasonally adjusted or not. I could only find stats (on kff.org) for type of insurance coverage from 2013 through 2016, and employer-provided insurance was pretty static: 50 percent of Americans were covered by employer-provided insurance in 2013, which figure dropped to 49 percent for 2014, 2015 and 2016.
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Feb 6, 2018 18:05
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Crashrat posted:Since you work in the industry, if you know enough to answer - is there any data on the increase of independent contractors and a decrease in the overall size of the large group market? I focus on large group coverage in my current role, and from what I've seen there has not been a significant reduction in covered members due to shifting from true employees to independent contractors. It is something that would show up on our radar though, like when Oil & Gas companies were taking it really hard and laying people off it was something that we saw in the data and looked in to. One thing to keep in mind is shifting people from full-time to contractor positions for the sole purpose of avoiding providing health benefits most likely violates ERISA Section 510. Dave & Busters had to settle a lawsuit because they cut people's hours to avoid having to provide them coverage under ACA. http://www.hrmorning.com/no-answer-on-legality-of-cutting-hours-under-aca-dave-busters-settles-erisa-suit/ quote:“It shall be unlawful for any person to discharge, fine, suspend, expel, discipline, or discriminate against a participant or beneficiary for exercising any right to which he is entitled under the provisions of an employee benefit plan, this subchapter, section 1201 of this title, or the Welfare and Pension Plans Disclosure Act [29 U.S.C.A. § 301 et seq.], or for the purpose of interfering with the attainment of any right to which such participant may become entitled under the plan, this subchapter, or the Welfare and Pension Plans Disclosure Act. 29 U.S.C. § 1140.”
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Feb 6, 2018 18:37
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Update re: proving future income - the healthcare.gov verified my household income for next year after seeing w-2s from last year. This is exactly as stupid as it sounds.
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Feb 6, 2018 18:52
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mastershakeman posted:Update re: proving future income - the healthcare.gov verified my household income for next year after seeing w-2s from last year. This is exactly as stupid as it sounds. Devil's Advocate: What should they be using to project your household income for 2018?
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Feb 6, 2018 19:06
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Reik posted:Devil's Advocate: What should they be using to project your household income for 2018? nothing; and tying subsidies and cost sharing reductions to roleplaying nostradamus is one of the failures of the law
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Feb 6, 2018 19:27
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One of the various suggested changes to the ACA in congressional proposals last year (I think it was in one of the Republican bills) was tying current-year subsidy eligibility to one's *prior* year's income. Since so many subsidy-eligible people are either self-employed or in jobs that don't provide insurance that would be great, but such a change would have to include mechanisms (as exist now) to report change in employment status and a qualifying life event to enroll or re-enroll in an individual plan.
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Feb 6, 2018 19:56
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Willa Rogers posted:One of the various suggested changes to the ACA in congressional proposals last year (I think it was in one of the Republican bills) was tying current-year subsidy eligibility to one's *prior* year's income. I am not a tax lawyer, but having part of your 2018 tax return (since the subsidies are technically a tax credit) off your 2017 taxable income seems problematic.
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Feb 6, 2018 19:59
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https://twitter.com/usofcare/status/960860727471992832 Heads up, we've got an AstroTurf group that refuses to disclose its donors slinging centrist "above politics" pablum in an effort to get ahead of increasing support for Medicare For All.
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Feb 6, 2018 20:03
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Reik posted:I am not a tax lawyer, but having part of your 2018 tax return (since the subsidies are technically a tax credit) off your 2017 taxable income seems problematic. Only if your goal is to keep people from accessing the subsidies. The only way that someone would 'scam' it would be to make most of their money every other year. I don't think that someone voluntarily structuring their income to 30k - 200k - 30k - 200k is a realistic problem. They'd be paying much higher tax rates in the 200k years, after all. And if it turned out to be a real problem, Congress could always revisit the issue. The alternative is having your 2018 beginning-of-year subsidy work based off your future 2018 tax return (which we obviously can't do) so we end up looking at 2017 anyway.
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Feb 6, 2018 20:12
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Crashrat posted:Since you work in the industry, if you know enough to answer - is there any data on the increase of independent contractors and a decrease in the overall size of the large group market? At least for some jobs, like engineering, you're paying engineers something like 1.5x the pay their salaried peers get. In addition, you bill by the hour, so while a salaried engineer will work 50-60 hours a week with no overtime pay, a contractor will be billing you time and a half for those extra hours. If you're specialized, you command even higher rates for those companies that really need you, so when you get time and a half on that, it gets really lucrative really fast.
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Feb 6, 2018 20:41
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Rhesus Pieces posted:https://twitter.com/usofcare/status/960860727471992832 I certainly feel better knowing that "bipartisan solutions" for healthcare are being sussed out by the likes of Bill Frist and led by a 10-year executive of UnitedHealth.
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Feb 6, 2018 21:11
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From the Bloomberg story about the new astroturf group:quote:Mark McClellan, a top health official in the administration of president George W. Bush and director of the Margolis Center for Health Policy at Duke University, is working with the group and anticipates focusing on curbing costs and improving quality, particularly in state Medicaid programs. Just lol that they're going after Medicaid, the costs of which are about half of those that the government spends to subsidize private insurance, rather than mentioning the possibility of pharma, provider or private insurance price controls. I guess it figures inasmuch as obamacare exchange plan enrollment is about one-third of that under expanded Medicaid (even with states opting out) and that Medicaid recipients are more satisfied with their insurance than those covered by private insurance (including that provided by employers). Gotta nip that single-payer cost reduction & overall satisfaction in the bud! Looking forward to the "difficult discussions" that determine that Medicaid recipients "need more skin in the game" (as Gov. Northam recently claimed), less mental health or dental care, and more workfare-type draconian solutions.
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Feb 6, 2018 21:45
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lol "difficult discussions" this always means "taxing my wealth is preemptively off the table and solutions must revolve around strategies that help me retain my wealth at the expense of everyone else, which I fully realize makes me look heartless but I don't loving care." Rhesus Pieces fucked around with this message at 21:56 on Feb 6, 2018 |
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Feb 6, 2018 21:50
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In the interests of cutting costs we've made some tough decisions here. We've now reclassified Uber as an ambulance service. All existing ambulance drivers have been terminated but they're free to apply as 1099 workers as soon as they buy their own ambulance to participate in the new ambulance entrepreneur economy. #bipartisanship
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Feb 6, 2018 22:06
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https://twitter.com/kthalps/status/960945581320437761 lol yup that's exactly what they're doing Hopefully this gets exposed fast enough to discredit it among people who care about this sort of thing
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Feb 7, 2018 00:29
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I don't get why you don't just get to say "this is how much subsidy I qualify for" and if you over-report you pay it back with a little interest, like tax withholding.
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Feb 7, 2018 01:01
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I got some insurance through the marketplace because it said my previous doctor took the insurance company I was looking at. I later found out that despite this being stated on the healthcare.gov website, while that doctor did accept that company, they did not accept plans offered through the marketplace. So I don't know what the gently caress I'm doing or supposed to do. But at least I don't have to wait in line for healthcare, or something, I dunno!!!! USA USA USA
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Feb 7, 2018 18:59
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signalnoise posted:I got some insurance through the marketplace because it said my previous doctor took the insurance company I was looking at. I later found out that despite this being stated on the healthcare.gov website, while that doctor did accept that company, they did not accept plans offered through the marketplace. So I don't know what the gently caress I'm doing or supposed to do. This happened to me last year and my wife barely caught it in time. I think you can reapply to a different plan even though you're past the deadline due to this, but if your doctor doesn't take any of the plans you're out of luck. In Chicago the two major hospitals don't accept a single plan off the marketplace.
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Feb 7, 2018 19:06
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Reik posted:I am not a tax lawyer, but having part of your 2018 tax return (since the subsidies are technically a tax credit) off your 2017 taxable income seems problematic. Speaking as a tax preparer, a hell of a lot of stuff is based off your previous year's return and AGI already really, including penalties for under-withholding (under the principle if what you withheld would have covered last year's taxes they don't penalize you for that not being enough to cover this year). Crashrat posted:Since you work in the industry, if you know enough to answer - is there any data on the increase of independent contractors and a decrease in the overall size of the large group market? In theory you can't call somebody an independent contractor under IRS rules if you control too much about how they work (hours, rules, etc.) because that's just a way to dodge paying social security and Medicare (among other) taxes for businesses. Obviously it's not being enforced well enough and more and more people are hacking away at the edges, but companies just flat out going "LOL, everybody's a contractor now" would make it a little too easy for the IRS to nail them at the moment. Of course if they don't try to go full IC, companies still can and are also turning to temp agencies, which are the ones handling the W-2/related issues. And since that's their only business, they're much more experienced at bending the rules to screw people over in those areas to make more money so the hiring company doesn't need to keep that skillset in-house  .
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Feb 7, 2018 19:06
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Rhesus Pieces posted:https://twitter.com/kthalps/status/960945581320437761 god dammit Andy Slavitt what the gently caress are you doing?
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Feb 7, 2018 19:06
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DC Murderverse posted:god dammit Andy Slavitt what the gently caress are you doing? Jon Favreau from Pod Save America is on board too and catching a ton of poo poo on twitter for it, rightfully so. There are some supposedly well-meaning people on it but when the rest of the board and founders are center-to-hard-right politicians and insurance/hospital CEOs you need to open your loving eyes and think critically about what exactly you're involved with.
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Feb 7, 2018 19:19
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Rhesus Pieces posted:Jon Favreau from Pod Save America is on board too and catching a ton of poo poo on twitter for it, rightfully so. he's trying to explain that he's still for MFA and will leave the group when it becomes more obvious that they're against it but boy howdy it's not a good look regardless. He's clearly someone who worked under Barack Obama and absorbed the whole "we must work together" thing to the point of blind optimism in the face of Bill Frist. https://twitter.com/jonfavs/status/960909680175235072 https://twitter.com/jonfavs/status/961280379276599297 https://twitter.com/jonfavs/status/961294541235003392
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Feb 7, 2018 19:26
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signalnoise posted:I got some insurance through the marketplace because it said my previous doctor took the insurance company I was looking at. I later found out that despite this being stated on the healthcare.gov website, while that doctor did accept that company, they did not accept plans offered through the marketplace. So I don't know what the gently caress I'm doing or supposed to do. It seems like one of two things is going on: 1. The plans on the exchange use a narrower network that the provider isn't on. 2. The provider is in the appropriate network but denying patients with marketplace coverage for discriminatory reasons (inability to pay, etc) Your marketplace plan is required to have a list of in-network providers. If your doctor is on that list, call the insurance company and confirm with them the doctor is in that network. If they confirm they are, have them call their office and hash it out between the two of them. If they say the list is wrong, you can sign up for a different plan. If they say the list is right, the doctor should see you. If the doctor isn't on the list, I'd recommend finding another doctor that is in the narrower network. Reik fucked around with this message at 19:35 on Feb 7, 2018 |
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Feb 7, 2018 19:30
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It’s a good thing I’m not a doctor because I would never take poor patients.
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Feb 7, 2018 19:53
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DC Murderverse posted:he's trying to explain that he's still for MFA and will leave the group when it becomes more obvious that they're against it but boy howdy it's not a good look regardless. He's clearly someone who worked under Barack Obama and absorbed the whole "we must work together" thing to the point of blind optimism in the face of Bill Frist. Considering public support for Medicare For All evaporates the minute people hear the words "higher taxes" and nobody in DC is really rushing to fall on their own swords over it... Yeah I'm gonna go ahead and assume a pragmatic bipartisan solution is the only way we're fixing healthcare in this country. Blame idiotic American voters.
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Feb 7, 2018 19:54
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There is no such thing as a pragmatic bipartisan solution when one of the parties is the Republicans.
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Feb 7, 2018 19:59
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Virtue posted:It’s a good thing I’m not a doctor because I would never take poor patients. This is actually why we need universal healthcare: providing a service that costs $TEXAS to someone without two pennies to rub together is commercially insane. But since society (at least the non-libertarian part of it) finds it unacceptable to just let people die if they are broke, the only solution is social healthcare (or private insurance so heavily regulated and subsidized it might as well be socialized medicine.)
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Feb 7, 2018 20:29
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Reik posted:It seems like one of two things is going on: It is always #1 as far as I know. I have marketplace health insurance, and if I need to see a doctor I need to phone them up and have the following conversation "Do you take X? Great, you take all X's plans - do you take X from the healthcare exchanges - you know, Obamacare? Oh, you don't? Thanks." Fortunately I live in an urban area with a lot of doctors so I can always find someone. But if I was in a one-horse one-doctor town it might be a problem.
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Feb 7, 2018 20:32
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BarbarianElephant posted:It is always #1 as far as I know. I have marketplace health insurance, and if I need to see a doctor I need to phone them up and have the following conversation "Do you take X? Great, you take all X's plans - do you take X from the healthcare exchanges - you know, Obamacare? Oh, you don't? Thanks." I know when we put narrow networks together the cost savings in urban areas is higher than in rural areas because of this. If there's only one hospital system in an area you need to include them in your network to meet network adequacy standards. I agree it's much more likely to be #1 as opposed to #2.
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Feb 7, 2018 20:37
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BarbarianElephant posted:This is actually why we need universal healthcare: providing a service that costs $TEXAS to someone without two pennies to rub together is commercially insane. But since society (at least the non-libertarian part of it) finds it unacceptable to just let people die if they are broke, the only solution is social healthcare (or private insurance so heavily regulated and subsidized it might as well be socialized medicine.) Despite people singing their own praises for knowing all about economics (meaning they have heard the terms "supply" and "demand" but know them as "supply and demand") surprisingly few people recognize price inelasticity https://www.investopedia.com/terms/e/inelastic.asp
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Feb 7, 2018 20:56
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signalnoise posted:Despite people singing their own praises for knowing all about economics (meaning they have heard the terms "supply" and "demand" but know them as "supply and demand") surprisingly few people recognize price inelasticity https://www.investopedia.com/terms/e/inelastic.asp It's hard to reach market equilibrium when the alternative good is death.
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Feb 7, 2018 20:58
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The Phlegmatist posted:Considering public support for Medicare For All evaporates the minute people hear the words "higher taxes" and nobody in DC is really rushing to fall on their own swords over it... remember all those pragmatic republican amendments in the ACA remind me how many republican votes we got out of it your fantasy world where bipartisanship is a thing sounds cool as hell, though, is trump also President there
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Feb 7, 2018 21:08
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No, but I do remember Lieberman killing the public option. And a GOP wave causing a lot of Democrats to lose their seats. I am sure they are very eager to repeat this 
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Feb 7, 2018 21:19
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The Phlegmatist posted:No, but I do remember Lieberman killing the public option. And a GOP wave causing a lot of Democrats to lose their seats. I am sure they are very eager to repeat this yeah, once upon a time there were provisions for signing up for obamacare to also register you to vote. republicans on committees said "hey, no, that would be partisan" and democrats instantly caved. fortunately, the republican votes garnered by surrendering without a fight were enough to pass it without lieberman, proving that bipartisan compromise in establishing health care policy is real, strong, and definitely a thing that happens
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Feb 7, 2018 21:38
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The last big expansion to Medicare was almost entirely Republican driven, and HIPAA and COBRA were both bipartisan. If a bipartisan work group offers a chance to make the R's behave like adults again then it's a shot worth taking.
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Feb 7, 2018 21:55
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esquilax posted:The last big expansion to Medicare was almost entirely Republican driven, and HIPAA and COBRA were both bipartisan. If a bipartisan work group offers a chance to make the R's behave like adults again then it's a shot worth taking. COBRA was 1985 and HIPAA was 1996. Not exactly modern era Republicans. Letting the current Republican party touch health care policy is inviting the fox into the henhouse.
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Feb 7, 2018 22:02
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Especially Bill loving Frist of all people. I don't care that he's an MD, he shouldn't be anywhere near this and the fact that he is completely discredits it.
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Feb 7, 2018 22:11
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Hieronymous Alloy posted:COBRA was 1985 and HIPAA was 1996. Not exactly modern era Republicans. The MMA was 2003, and McCain actually had a rough health policy during the 2008 election. The current rot in the Republican party on health policy really started in opposition to the ACA and does not have to be permanent - it's something that other R's can try to fix. Frist for example voted to expand medicare entitlements to cover prescription drugs for seniors.
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Feb 7, 2018 22:19
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Rhesus Pieces posted:Especially Bill loving Frist of all people. I don't care that he's an MD, he shouldn't be anywhere near this and the fact that he is completely discredits it. I always wonder what actual doctors in politics think about some of this poo poo. Like, when Ron Paul heard "the female body has ways of shutting that all down" with regards to pregnancy in "legitimate rape" I hope he just went nuts
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Feb 7, 2018 22:40
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esquilax posted:The MMA was 2003, and McCain actually had a rough health policy during the 2008 election. The current rot in the Republican party on health policy really started in opposition to the ACA and does not have to be permanent - it's something that other R's can try to fix. At the same time there is no reason to trust that any future Republican House, Senate or President will ever fully fund any annular funding of a health care program. Any future UHC program needs to have permanent funding to prevent future fuckery.
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