If you have not heard, the monstrous 2000 page healthcare bill has passed in the House.  It will be debated in the Senate soon, but chances are it will pass in some form.  I am not going to go on about all the things that are wrong about it because that will take too long.  Instead, I will write about who could save money if this bill passes.

First of all, this bill is going to require everyone to buy  government approved health insurance or face a penalty from the IRS.  For individual tax payers, the penalty is   2.5% of gross pay.  For businesses, the tax penalty is 8% of a worker’s pay if the business does not pay for at least 72.5% of the worker’s health insurance premium.  There are also significant government subsidies for those who make under a certain income level to pay for premiums.

Additionally, there will be cuts to FSA and HSA plans and insurance companies will no longer be able to charge more premiums for preexisting conditions.  Also, the premium difference between the young and old will be lessened greatly.  The House bill says that the premium of an elderly person cannot be more than twice than that of a young person.  So essentially these changes will raise the price of health insurance for the young and healthy and punish those who try to save for their own medical expenses.

So what should the young and healthy do if this bill passes?  First of all, stay healthy.  Next,  if employed, ask the employer to give whatever they pay for your health insurance as a part of your pay instead if your employer is paying significantly more than 8% of your pay in health insurance premiums.  You will have to pay the 2.5% in tax penalty, and your employer will have to 8%, but you will have more cash in your pocket.  If you do get sick you will still be able to get insurance since the law basically says that everyone will be able to buy the same basic coverage regardless of preexisting conditions.

How do the numbers work out?  Here is from the Congressional Budget Office that shows how much the average health insurance premiums would be under the new plan for people in different income levels.  For a single person making around $38,000 a year, the estimated premium is $6100 a year, or 16% of income.  Suppose that this person is young and healthy and  simply pays for the tax penalty the cost is only $950 a year. Meanwhile, the person could save the difference.  Of course, right now this person pays no tax penalty, so the government is simply going to redistribute his or her money in subsidies for others.   If you look at the table, it seems that not a single income bracket pays less than 2.5% of their income for the premium, so even the poorest folks would do better to just skip health insurance while they are healthy, save the cash, and simply enroll when they do need to consume health care.  Of course, this will drive up health insurance premiums for everyone who is enrolled, and give more incentive for those who are enrolled to drop their coverage.

How does the math work out for employers?  Lets use the same employee making $38,000 as an example.  The employer is forced to pay 72.5% of the average premium of $6100, which is $4422.50  or  8% of 38,000 which is $3040.  Obviously, dropping the insurance is cheaper for the employer.  If the difference in cost were given to the employee directly then the employee still comes out ahead with more cash in his or her pocket.    When you go up in the income scale, the incentive is even higher to drop insurance.  For example, an employee making $102,000 a year with a family plan would cost   an employer around $15000 a year in insurance premiums or simply $8000 in tax penalties.  If the difference were given to that employee that employee would still come out ahead by several thousand dollars a year after the tax penalty.  That money could be used to pay for preventive care out of pocket.

Finally, lets examine why we have health insurance now.  It is to cialis tadalafil genericagainst future diseases  and healthcare consumption.  Your insurance doesn’t exactly buy you anything you can use right now.  For example, I was pregnant this year, and if I didn’t have health insurance to begin with  I would have had to pay quite a bit for the treatment I received.  Since pregnancy is a preexisting condition and I would not have been able to buy health insurance anywhere while pregnant.  Now if the new law passes, I could buy health insurance while pregnant since it would be illegal to refuse insurance to patients with preexisting conditions.  This completely changes the definition of insurance and makes it almost like a coupon program you can join at anytime.  Basically, your membership fee is your taxes, and then you can pay a middle layer of insurance companies when you need health care.  So, there is really no need to carry expensive health insurance that covers everything  when you are healthy because you can enroll anytime.

If all the young and healthy knew how to do basic math, they would be dropping their health insurance and opt for more cash  pay as soon as this bill is enacted.  Fortunately (or unfortunately) for Congress most American public schools aren’t so great so many people would become new insurance company customers because they cannot figure out that 2.5% is less of a penalty than the 15 or 16% they would be required to shell out.    I don’t know if this healthcare bill would actually raise the percentage of people who are insured because a lot of people out there do have common sense, and businesses will figure out that the 8% penalty is much less than what they would be required to pay otherwise.

So could you save money with Obamacare?  You probably can if you have a preexisting condition and need to consume a lot of health care.  On the other hand, this will cost a lot more for those who are young, healthy, or make too much money.   In the end, it is just and does not do anything at all to improve the quality of healthcare in this country.

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