On The Eve of the ACA Enrollment: There Are Issues Other than Enrollment

Now here is a terrific idea thanks to ConsumerReports!  Demand warranties of medical devices, such as knees and hips,  just as we do for dishwashers, refrigerators and cars. Isn’t something in our bodies, or robots doing things to our bodies, every bit as important as warranting a refrigerator? You can buy a new refrigerator; it is not as easy if faulty hips need replacement or shredded metal in your body.   This would be an excellent idea to hold the FDA more accountable!


An intriguing idea for hospitals with uninsured patients who are in and out of hospital ERs:  http://www.healthleadersmedia.com/content/HEP-296819/Can-Hospitals-Pay-Patients-Health-Insurance-Premiums

There is no one business case for Health Care: So Be Cautious About Stories on the business reaction to the ACA

I am reluctant to run this particular piece, but some of the interviews have merit.  The article does epitomizes the challenges on reporting on the ACA.  Where I have an issue is that two of the groups lamenting the ACA’s impact on businesses are the NFIB:  The National Federation of Independent Business and the US Chamber of Commerce.   What is not mentionned is that the NFIB has a conflict of interest here because they offer their own health insurance exchange: http://www.nfib.com/member-benefits/insurance/nfib-health-plans  and so do most local chambers of commerce: http://www.uschamber.com/issues/health/how-ahps-benefit-state-and-local-chambers-commerce Which also was not mentioned in the article:


There is no one business voice for health care. Large and small employers play by different rules and regulations. Small business insurance is regulated at the state level, and small employers pay insurance premiums, which includes a state premium tax.  Their health care spending does not come out of pre-tax dollars.

Large employers–generally 500+ employees–although that number gets smaller all the time–are not subject to state regulations (especially their mandated benefits provisions). Since they self-fund their health insurance, they are still employers, not insurance companies, therefore they are not subject to state premium taxes either; and, of course, they can deduct their health insurance costs from their pre-tax dollars, thereby lowering the revenue that is subject to taxation.  Beware, therefore, who says they are speaking for employers.

The ACA is big and complicated and subject to vastly different interpretations.  I try to chose articles that are not necessarily reported on frequently and that shed light on various aspects of the debate and implementation provisions.

Kathleen O’Connor, Sept. 30, 2013 (c)


About Kathleen

Kathleen O’Connor: 30+ year health care consumer advocate, non-profit executive and author. For more information about Kathleen, please see "About" on the main content bar above.
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