Affordable Care Act: Thoughts on the Law with 2014 Almost Here

Started by RubySlippers, February 26, 2013, 02:51:51 PM

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RubySlippers

Quote from: ValthazarElite on March 23, 2013, 11:31:59 AM
I realize I am a bit of a late entrant to this conversation, but I figured I would add my two cents.  Like many others here have stated, while ACA is a step in the right direction, the wording of the law may actually end up hurting more Americans, than helping.

For example, the ACA defines a "full-time" employee entitled to health benefits as anyone working over 30 hours a week.  "For purposes of section 4980H, a “full-time employee” is an employee who is employed on average at least 30 hours per week." [[ Source ]]

As a business owner, this would either prompt me to keep more of my employees in part-time positions, or it would cause me to reduce the number of employees.  Just some food for thought.

Employers were trending this way in many major lower wage industries in my area retail, hospitality and food service as well as some skilled areas like nursing are generally under 30 hours or temporary workers in the case of nurses as one of several areas of more skilled workers. I suspect this trend will continue. But put it this way employers will need to hire more people to do the work the hours still need to be filled so it will lower the unemployment rate.

Its not a big issue people and industry just needs to adapt to the new law the odds of a repeal are remote.

Valthazar

Quote from: RubySlippers on March 23, 2013, 01:07:56 PMBut put it this way employers will need to hire more people to do the work the hours still need to be filled so it will lower the unemployment rate.

This is a good point, I think ACA will increase the number of jobs (even if that means an increase in the number of part time jobs, and a decrease in the number of full time jobs).  But overall, I think it will mean a decrease in the number of "good" jobs that provide benefits, which is needed to support a family.

Pumpkin Seeds

People will probably have to work two sets of jobs in order to make their money while also relying on government insurance for their benefits.  This will have the added bonus of less expensive benefits as the person is not paying the increasing insurance rates that are now coming out due to the AFA.  Also I don't think nursing is seeing a decline in the amount of hours offered.  If anything I see nurses working more hours.  Traveling has grown in size but that is because of the national shortage which is predicted to grow drastically over the next decade.

RubySlippers

Its not that big a deal in my area Target has for ten years set hours no more than 29 hours and when they want to get rid of an older employee they just gut the hours right now one worker is getting four hours a week so part-time hours are oddly warped in the employers favor in many ways. But I tend to see this as value to the employer a highly skilled worker say a nurse with a masters degree is worth more than a nursing assistant and the former is far more likely to work full-time over the less skilled worker.

In simple terms a cashier is worth less to an employer than a pharmacist in a Target and benefits and hours will be considered based on that.

Pumpkin Seeds

See, I’m not so certain the cutting back on hours will have as much of an impact as people are thinking.  As Ruby has pointed out many such employers have already cut back hours anyway to avoid paying for insurance coverage and benefits.  Those that have not tend to be smaller stores that were not obligated to provide insurance anyway and I believe under the AFA are still not required to do so.  Harder to come by employees such as nurses (which are harder to come by due to the massive shortage not from educational background since they only need an associate’s degree) and as listed pharmacists will not have their hours cut back since to attract such employees a decent benefits package is necessary.  So even with a few additional employers cutting back hours, the ones who had benefits before will likely keep them at the higher end and those that were teetering or had none will receive government insurance.

RubySlippers

Actual in the case of Target they just don't want to go over 40 hours a week now so set hours at 30 hours a week so shaving off a few hours is not a big leap and they will have to hire more people. In fact I'm seeing the shift to under 30 hours now at most places with low skill workers. Burger King, Taco Bell, McDonald's and Target I know for sure.

On the other hand a friend who is a commercial truck driver who is hazard cargo qualified is working over 40 hours a week for a company, its hard to replace drivers right now at that level. He likely will be fine.

But what matters is whether your state or mine is expanding Medicaid in some way since most of the workers will not likely earn at 138% of the poverty line or fairly low income and will get into an exchange. Its just the important part.

AndromedaDevonshire

I have a high skilled job myself, and work at a good company that is trying their best to keep our coverage.  Though, ::laughs::  Where I live, I applied for Medicaid.  Hell I even applied for food stamps too.  Want to know what's funny, I got approved for Medicaid and food stamps to my surprise.  I believe in working hard for a living, though hey... if the Govn't is gonna give me hand outs, why the hell not!?  So I dropped UCH health insurance, and transferred to Hosier Health, the state's Medicaid program. 

Here are the numbers....

Through work I was paying a month $215.00 with an 90/10 split, and three tier Prescription Drug at $10 / $30 / $70 .. oh and there was a $250 deductible, as well as $25 co-pay and $50 Specialist Co Pay visits. 

Through Indiana Medicaid I pay now...

$90 a month with 100% coverage, no 90/10 split, Prescription Drugs, (All) for only $3.00... no more three tier pay system, no Deductible, no Co Pay's ever again for me.... I can go to any major hospital and all cost covered. 

$300 in food stamps a month which don't ask me how, somehow I have Obama to thank for that too.  :\ 

So in a nut shell, I'm in my mid 30's great health.  Do I need Medicaid?  Nope.  Do I need food stamps?  Nope.  I got on them because hell, I see it as a hand out that I will thankfully take while it is around.  What's the lesson here? 

Learn the Law inside and out.  Hell, how do you think companies get out of paying taxes and skirting around the ACA, or Obama Care?  Easy, they study and learn the law page by page, then find loop holes in which to exploit.  High Health Cost got everyone down?  Did your premiums go way up because of Obama?  If so, then invest in hiring a lawyer who can sift through the dense papers, and trust me, you can find ways to Cheat the System.  Hell big companies do it all the time, why not the little guy too? 

This is not bragging as some might think that is what I'm doing here, though I'm giving you a real world reality check, and that if you think you're somehow getting screwed by all of this, chances are... you probably are.  Do research, and if you have money, seriously hire a lawyer to help you sift through the legal loop holes. 

Now, How do you honestly, lower health care cost?  Not by passing the ACA, nope..... you do something a bit different.  How about limiting the amount a person can sue a hospital or doctor for.  I have my doctor, and I know he is human, and can he make a mistake?  Yes.  He knows his art form as I call it, has been practicing for over two decades, yet I know, even he can still mess up.  Nurses, they have also been taught an art themselves, and can they also make mistakes?  Yes.  Now seeming that we have established everyone is human... and can be flawed, left open the gate for lawsuits to pour in.  You take into account that medical lawsuits have no cap value placed on them, and one wrong needle prick can cost not only the Doctor's Insurance, though the Hosiptal he works for Millions upon Millions of dollars.  High cost for an ambulance ride?  Wanna know why that is?  Again, their driving a Commercial Vehicle, and as such you know the insurance on Ambulances is extremely high.  This is why a single ambulance ride can cost between $500 - $1500 respectively depending on where you live. 

Just food for thought I guess. 

A.D.           

Trieste

That kind of skips over the fact that litigation and settlements are most often not actually about punishing the medical personnel. Um.

AndromedaDevonshire

Quote from: Trieste on March 29, 2013, 09:17:53 AM
That kind of skips over the fact that litigation and settlements are most often not actually about punishing the medical personnel. Um.

In most cases, it all adds up to money one can get.  I'm speaking about, someone who makes an -honest- mistake, because you know there are times, honest mistakes happen, and yes there are those quacks out there who shouldn't be practicing anyways. 

Trieste

That's because medical mistakes are expensive. It's not about punishing the provider and I'm having a hard time believing you're trying to make some sort of point about greed considering your previous post (you are aware that the money you don't need but you're accepting from the government anyway comes out of your nice doctor's taxes, too, right?) So the only objection I can figure is that you find the amounts staggering.  I assure you, if Jane Doe goes into the hospital and they make an honest, human mistake that makes her unable to work, she is not being outrageous suing them for millions. Most especially if she is a young woman who can expect to have to survive for 50+ years of living expenses and medical bills.

Ephiral

Quote from: AndromedaDevonshire on March 29, 2013, 08:56:05 AM
Now, How do you honestly, lower health care cost?  Not by passing the ACA, nope..... you do something a bit different.

Are you sure about that? The analyses are not on your side.

Trieste has the malpractice-caps bit covered, which brings me to...

Quote from: AndromedaDevonshire on March 29, 2013, 08:56:05 AMHigh cost for an ambulance ride?  Wanna know why that is?  Again, their driving a Commercial Vehicle, and as such you know the insurance on Ambulances is extremely high.  This is why a single ambulance ride can cost between $500 - $1500 respectively depending on where you live. 

Just food for thought I guess. 

This is not an argument for lawsuit caps, it is an argument that health care should not be a commercial venture. I've had to pay for an ambulance ride before. Want to know the cost that I found outrageous and unjustifiable at the time? $60. Because health care is considered an essential public good here, not a business.

Now, you want an idea that will really make a difference in health care costs, other than the ACA? Try cutting down the amount of administrative overhead in your health system. The US is basically setting one dollar in three on fire under the current system.

Valthazar

Quote from: Ephiral on March 29, 2013, 10:11:22 AM
Are you sure about that? The analyses are not on your side.

Just to point out, this analysis is a Congressional release written by the same Congress that passed ACA.

Quote from: Ephiral on March 29, 2013, 10:11:22 AMThis is not an argument for lawsuit caps, it is an argument that health care should not be a commercial venture. I've had to pay for an ambulance ride before. Want to know the cost that I found outrageous and unjustifiable at the time? $60. Because health care is considered an essential public good here, not a business.

What you say here is good in theory, but there will be unintended consequences.  People say the same thing about higher education in the US - and how it should be a "public good" for society.  The reason why American colleges have cutting edge research, and offer some of the best programs in the world is because they are all private business (apart from state/community colleges, who they themselves often function autonomously with their own internal budgets).  In order for each business, or college, to excel, they need to funnel grants and funding for research, and hiring the best professors, etc.  It is the same for healthcare in the US.  We have the best hospitals, the best medical equipment, and the best doctors - and that is the result of healthcare being a business.  For better or for worse, people are motivated by money, and money creates opportunities for services to flourish.

However, I do agree with you that the administrative overhead is the primary cause for the high cost of healthcare in the United States.  The problem is not the privatization of healthcare.

Avis habilis

Quote from: ValthazarElite on March 29, 2013, 03:40:05 PM
Just to point out, this analysis is a Congressional release written by the same Congress that passed ACA.

Nope. CBO is a nonpartisan body that in fact has nothing to do with any politician from either party.

Valthazar

Quote from: Avis habilis on March 29, 2013, 03:44:41 PM
Nope. CBO is a nonpartisan body that in fact has nothing to do with any politician from either party.

Thank you for the clarification - my mistake.

Ephiral

Quote from: ValthazarElite on March 29, 2013, 03:40:05 PMWhat you say here is good in theory, but there will be unintended consequences.  People say the same thing about higher education in the US - and how it should be a "public good" for society.  The reason why American colleges have cutting edge research, and offer some of the best programs in the world is because they are all private business (apart from state/community colleges, who they themselves often function autonomously with their own internal budgets).  In order for each business, or college, to excel, they need to funnel grants and funding for research, and hiring the best professors, etc.  It is the same for healthcare in the US.  We have the best hospitals, the best medical equipment, and the best doctors - and that is the result of healthcare being a business.  For better or for worse, people are motivated by money, and money creates opportunities for services to flourish.
You keep saying "the best", and yet it keeps looking like you haven't actually bothered comparing. Quite a few other countries have amazing research programs - many of them coming out of universities. As for health care, the central point at issue here... well, if the US's is the best in every category, why are you paying more for lower standards of care and reduced life expectancy? That's... an odd definition of "best".

Quote from: ValthazarElite on March 29, 2013, 03:40:05 PMHowever, I do agree with you that the administrative overhead is the primary cause for the high cost of healthcare in the United States.  The problem is not the privatization of healthcare.
These statements contradict each other. High administrative overhead is a direct result of privatization.

Trieste

I know this isn't statistical data or any such thing, but incidentally I found it interesting that Christopher Reeve, who by all rights should have had the money and the celebrity to gain access to pretty much the best that the US medical system had to offer, repeatedly praised places that have 'socialized healthcare' - Australia and Isreal are the ones he specifically names in this transcript.

While he was an activist, the man had a clear and burning desire to walk again. If the most effective medicine was going to be found in the US, he would have pursued it in the US. So... there's that.

(I could probably look up the statistics or something but I'll let someone else do that. I'm going to sit here and sigh over pictures of Superman.)

Valthazar

#41
Quote from: Ephiral on March 29, 2013, 07:20:12 PM
You keep saying "the best", and yet it keeps looking like you haven't actually bothered comparing. Quite a few other countries have amazing research programs - many of them coming out of universities. As for health care, the central point at issue here... well, if the US's is the best in every category, why are you paying more for lower standards of care and reduced life expectancy? That's... an odd definition of "best".

The reason we are in disagreement is because we have different perspectives of "best."  From what I understand, your concept of the best healthcare system is the one which offers average medical care to all its citizens at a low cost.  If you are using that as the standard of measure, then the US ranks 37th [[ Source ]]  On the other hand, my definition of "best" is a healthcare system that provides high quality services with easy access to those willing to pay.  [[ Source ]] 

The quote I liked was, "When Italian Prime Minister Silvio Berlusconi needed heart surgery, he didn't go to an Italian hospital. He didn't go to Austria or the Netherlands. He had his surgery at the Cleveland Clinic in Ohio." [[ Source ]] 

In addition, "They come here because they know that despite its flaws, the U.S. health care system still provides the highest quality care in the world. Whether the disease is cancer, pneumonia, heart disease or AIDS, the chances of a patient surviving are far higher in the U.S. than in other countries." [[ Source ]] 

In the United States, the traditional philosophy has always been that no one is inherently entitled to any commodity or service.  I personally believe that healthcare is a privilege, and not a right.  If people feel that their healthcare is a priority, then by buying heath insurance, they are guaranteed access to the best medical resources and cutting edge technology.  With my medical insurance right now, I know that if I ever wanted an elective procedure or to see a doctor, I will have no problems booking an appointment.

The ACA is a subtle move towards a single payer healthcare system, similar to England.  While it is certainly true that private insurances exist even in countries like England, it would be much more difficult for a person like myself to purchase it.  Because the tax rate is so high in England compared to the US, I simply wouldn't be unable to afford private insurance - and would be bundled along with everyone else.  In other words, regardless of one's priorities in saving, everyone gets the same medical care.

Ephiral

Yes, I believe that the best course of action is the one that maximizes pleasure and minimizes pain across the entire group of affected people. This is... kinda morality 101 for me. So you'll have a pretty hard time convincing me that a health care system founded on "Screw the majority, and overcharge even the minority" is anything but a bad idea. That's not the only issue I see with what you're saying, though:

Quote from: ValthazarElite on March 29, 2013, 07:48:25 PM
In the United States, the traditional philosophy has always been that no one is inherently entitled to any commodity or service.  I personally believe that healthcare is a privilege, and not a right.  If people feel that their healthcare is a priority, then by buying heath insurance, they are guaranteed access to the best medical resources and cutting edge technology.  With my medical insurance right now, I know that if I ever wanted an elective procedure or to see a doctor, I will have no problems booking an appointment.
There are a lot of assumptions being made here that have already been debunked in this very thread:
-That health insurance, particularly without ACA, is remotely affordable for the average person.
-That all, or even most, health insurance provides anywhere near the resources required.
-That "the best" services will be in-network for all insurance.
-That purchasing health insurance is a guarantee of access to the services the insurance does provide.
-That those of us who live under government-funded single-payer systems have any problem with going to the doctor just for shits and giggles, if we so choose.

If your insurance is covering all of your needs adequately, is not an unreasonable burden on your income, and provides a high quality of care, you are not the average US citizen. If you are arguing that this is a perfectly acceptable situation... well, that looks basically like "I got mine, screw everyone else". Which is a decidedly poor position to argue legislation from.

Kythia

Quote from: ValthazarElite on March 29, 2013, 07:48:25 PM
The reason we are in disagreement is because we have different perspectives of "best."  From what I understand, your concept of the best healthcare system is the one which offers average medical care to all its citizens at a low cost.  If you are using that as the standard of measure, then the US ranks 37th [[ Source ]]  On the other hand, my definition of "best" is a healthcare system that provides high quality services with easy access to those willing to pay.  [[ Source ]] 

The quote I liked was, "When Italian Prime Minister Silvio Berlusconi needed heart surgery, he didn't go to an Italian hospital. He didn't go to Austria or the Netherlands. He had his surgery at the Cleveland Clinic in Ohio." [[ Source ]] 

In addition, "They come here because they know that despite its flaws, the U.S. health care system still provides the highest quality care in the world. Whether the disease is cancer, pneumonia, heart disease or AIDS, the chances of a patient surviving are far higher in the U.S. than in other countries." [[ Source ]] 

In the United States, the traditional philosophy has always been that no one is inherently entitled to any commodity or service.  I personally believe that healthcare is a privilege, and not a right.  If people feel that their healthcare is a priority, then by buying heath insurance, they are guaranteed access to the best medical resources and cutting edge technology.  With my medical insurance right now, I know that if I ever wanted an elective procedure or to see a doctor, I will have no problems booking an appointment.

The ACA is a subtle move towards a single payer healthcare system, similar to England.  While it is certainly true that private insurances exist even in countries like England, it would be much more difficult for a person like myself to purchase it.  Because the tax rate is so high in England compared to the US, I simply wouldn't be unable to afford private insurance - and would be bundled along with everyone else.  In other words, regardless of one's priorities in saving, everyone gets the same medical care.

OK, pedantry of the highest order, but England isn't a country in the strictest sense.  UK is what you're aiming for.

/pedantry

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We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.
(Emphasis mine - obviously)

Quote from: ValthazarElite
I personally believe that healthcare is a privilege, and not a right.

I get teh the DoI has no legal weight.  But I can't imagine a single purpose of government MORE important than maintaining the health of its population.  If you don't think thats what a government is for, to help give a healthy, well and happy populace, then honestly I can't see how you can think the government has any point at all.
242037

Valthazar

#44
Quote from: Ephiral on March 29, 2013, 08:09:32 PM
Yes, I believe that the best course of action is the one that maximizes pleasure and minimizes pain across the entire group of affected people. This is... kinda morality 101 for me. So you'll have a pretty hard time convincing me that a health care system founded on "Screw the majority, and overcharge even the minority" is anything but a bad idea.

I agree with you.  I think any sane person would say that universal coverage is an absolutely priority.  Don't confuse my position on this.  Where we differ is in HOW that is achieved.  You believe that it is the role of government to provide health insurance, whereas I believe that it is the role of the government to create an atmosphere where people can voluntarily choose to buy affordable private insurance on their own.  In other words, eliminate corruption in healthcare, and eliminate the overhead costs, as we discussed earlier.

ACA unfortunately puts sanctions on private businesses that coerces them to purchase private insurance plans for their employees.  As a small business owner, this is taking a terrible toll on my business - and it is not at all solving the high cost of healthcare.  You're basically giving more people coverage, but taxing our economy to death.  I am struggling to stay afloat in preparation for 2014.

For example, the idea of eliminating pre-existing conditions clauses is one that I support.  In no way am I saying that it is desirable for people to be uninsured.

Quote from: Kythia on March 29, 2013, 08:12:56 PMI get teh the DoI has no legal weight.  But I can't imagine a single purpose of government MORE important than maintaining the health of its population.  If you don't think thats what a government is for, to help give a healthy, well and happy populace, then honestly I can't see how you can think the government has any point at all.

Again, I also fully support the idea of providing healthcare to all Americans - we just differ in how it is achieved.  I think all of us can agree that corruption, greed, and flawed capitalism have created the high costs of health insurance in the US.  I support greater sanctions on health insurance companies to create affordable plans that people can voluntarily opt into or out of.  In other words, I'm sure both of you would agree that charging $150-250/month for health insurance is a fair premium for an average single person, right?  Right now, it's well over $1000 dollars, and it's ridiculous.  We should aspire for a climate where everyone has the opportunity to afford healthcare as a choice - since that maintains individual liberty and responsibility.  Should someone who squanders all of his money on fast food and beer really be utilizing our tax dollars for health care?

Oniya

Hate to break it to you, but those are exactly the people that our tax dollars have been providing health care for.  When Joe Schmoe smokes so much his circulation starts to be affected, he doesn't go to 'a doctor' right away - no insurance, after all, and he can put up with tingly fingers.  He waits until his fingers are turning black and gangrenous and gets a ride to the ER - that he can't pay for, but 911 doesn't check your wallet along with your vitals.  After he's gotten the dead stuff cut off, and he's recovering, he starts getting bills - that he also can't pay.  Then it goes to collections and so forth and so on.  Joe Schmoe ends up dying of a heart attack walking 6 feet from his car to the McDonald's door, and there might be enough in his combined assets to pay for that initial ER trip, but probably not.  Where does the cost get paid from? Higher costs, higher insurance rates.
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Valthazar

Quote from: Oniya on March 29, 2013, 08:45:57 PM
Hate to break it to you, but those are exactly the people that our tax dollars have been providing health care for.

Yes, very true point.  I agree with all of you that there are some real problems with our current healthcare system - it's just that I don't feel ACA is the right solution.  I'm seeing the effects first hand - as I am unfortunately having to turn a lot of my full-time employees into part-time employees because I simply cannot afford the insurance mandates.


Ephiral

Quote from: ValthazarElite on March 29, 2013, 08:31:53 PMACA unfortunately puts sanctions on private businesses that coerces them to purchase private insurance plans for their employees.  As a small business owner, this is taking a terrible toll on my business - and it is not at all solving the high cost of healthcare.  You're basically giving more people coverage, but taxing our economy to death.  I am struggling to stay afloat in preparation for 2014.
I assume you have an actual rebuttal to the studies I linked earlier? Or at least some grounds to assert that it's not reducing the cost of care?

Quote from: ValthazarElite on March 29, 2013, 08:31:53 PMAgain, I also fully support the idea of providing healthcare to all Americans - we just differ in how it is achieved.  I think all of us can agree that corruption, greed, and flawed capitalism have created the high costs of health insurance in the US.  I support greater sanctions on health insurance companies to create affordable plans that people can voluntarily opt into or out of.  In other words, I'm sure both of you would agree that charging $150-250/month for health insurance is a fair premium for an average single person, right?  Right now, it's well over $1000 dollars, and it's ridiculous.  We should aspire for a climate where everyone has the opportunity to afford healthcare as a choice - since that maintains individual liberty and responsibility.  Should someone who squanders all of his money on fast food and beer really be utilizing our tax dollars for health care?

No, I would not say that. Health care is an essential public service, and I don't think that a business model is a good one at all. Flat rates are wildly unfair toward the poor - that rate would be crippling to my family. By comparison, let's look at the progressive model I'm under. My province, as always, keeps shitty books, but if we assume the province's numbers are the same as the federal ones, my wife is currently paying approximately two percent of her income for health care. If we look at the top marginal tax rate in the country, only applying to income over $150k, then that works out to a whopping 4.25%. Yes, that's a lot more than your $150-$250/mo, but it's still a completely negligible burden.

Should someone who blows all their money on fast food and beer have access to government-supported health care? Absolutely - they're paying into the system too. This is how it works.

Valthazar

#48
Quote from: Ephiral on March 29, 2013, 09:21:20 PM
I assume you have an actual rebuttal to the studies I linked earlier? Or at least some grounds to assert that it's not reducing the cost of care?

First and foremost, the healthcare that is provided by an employer who provides benefits for full-time employees is at a subsidized cost, usually at a very affordable rate for most employees.  This is because the employer fronts most of the premium for full-time workers.  For example, as part of the full-time benefits package I offer my employees, I pay a portion of the premium, and the employee pays a small portion of it as well.  This is the case with most businesses that currently provide health insurance for their employees.  This issue about the high premiums for health insurance applies for people who want to autonomously purchase private insurance (outside or independently of an employer) - or if their employer does not offer a benefits package. 

With ACA, myself, and many other business owners will be forced to convert many of our full-time positions into part-time positions.  Any employee working over 30 hours qualifies for the affordable benefits package under ACA.  Because this is simply unaffordable for me, I will need to get rid of many of these positions - so these individuals will have to now autonomously purchase heath insurance (which even though the price of private insurance may fall slightly with ACA - does not gain help from their employer in paying for for the premium).  In other words, my point is that ACA will reduce the # of full time employees, and thus remove employer support for health care premium payments.  If anything, it will cause more people to turn to Medicaid.

Like I have said repeatedly, I completely support the goals of ACA - but I feel it will end up hurting the economy to a far greater degree than it will reduce the cost of healthcare (which is something I am less familiar with).

Edit: typo correction

RubySlippers

We need more people employed if you need to hire more people more people have jobs, lowering unemployment. Does it matter if they get insurance from you, on an exchange or going onto Medicaid?