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CPBJ Extra Blog

Health care: Lists, questions and recommendations

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Recently, big companies have started announcing that they're dropping health insurance coverage for part-timers and instead will send them to the new marketplaces, where they might qualify for subsidies.

Here's a partial list, including — when available — the numbers of employees affected.

Companies dropping coverage for part-timers:

Home Depot, 20,000

Trader Joe's, about 33 percent of employees at its roughly 400 stores

And here are companies sending their workers to a private health insurance exchange:

Walgreen Co., 160,000

IBM, 110,000 retirees

Time Warner Inc.

Sears Holdings

• Darden Restaurants

• Aon plc

And THEN there are the companies that are cutting off spousal insurance if said spouse has access to his or her own insurance:

UPS, 15,000

University of Virginia

Penn State

Lovelace Health System

Kroger Inc., 15 percent of its 11,200 Indiana employees

And I'm going to stop there because I'm tired of searching, and if you haven't gotten the point by now, you probably never will, and speaking of points, I'm ready to make some.

First, and obviously, all of these actions have ramifications. And generally speaking, giving employees more responsibility is among them.

As I noted in this story, giving employees more responsibility requires educating them. Here's hoping they want to learn.

I suspect if the issue were framed as "Should your employer be making your health care decisions?" people would say no. But really, employers making the decisions on deductibles, networks and covered services — all hefty health care choices — is the bedrock of the insurance system as we've known it. And so is the employers paying for most of it.

Is that right? Well, it's your body — but historically, mostly the employer's money. And it's hard to argue that the person who pays shouldn't make the decisions.

Now, however, as employees are shouldering more of the cost of their health care, they're also getting more of the decisions. That makes sense to me, but it doesn't mean they're going to be happy about it.

Furthermore, for the employees being sent to the marketplaces, it may be true that they can get insurance cheaper there than they could have through their employer. However, they may very well also get fewer doctors for those fewer dollars. And according to one study, what consumers really want from an Obamacare plan is hospital networks.

We come now to some burning questions I will pose for discussion's sake, because I don't have definitive answers.

• Should the feds be happy when companies send employees to the individual marketplaces? I've heard that marketplace success will be correlated with lots of people and little adverse selection, which I'd guess this would help. But it would also depend on how the cost of subsidies and any employer mandate penalties that come into play in 2015 compare to what employer-sponsored coverage costs the feds.

• Will these companies try to get the employees back on an in-house plan in 2015, when the employer mandate kicks in?

• Will getting people more involved in their own health care help stem health spending? (Horrified aside: This kind of squelches any hope in that direction.)

And now, some recommended reading:

• On private insurance exchanges: Betting on a boom in private health exchanges. Different story, same subject: Benefit firms create tremors for insurers in U.S. healthcare shakeup.

• On PSU's plan, which extended way far beyond the spousal issue: Health Plan Penalty Ends at Penn State.

• On Healthy Pennsylvania, Gov. Corbett's not-expanding-Medicaid plan which I opined on last week: PA Medicaid expansion update. Also, How Rick Perry's And Bobby Jindal's Medicaid Snubs Boost Private Insurance Costs.

• You've been reading a lot of unadorned text. Here's something easy on the eyes, by which I mean graphic: Health Care Reform - One More Issue for the Finance Executive to Juggle.

• Observation status fascinates me because it seems like such a train wreck. Here's the latest legal development: Federal Judge Throws Out Lawsuit Over Hospital Observation Care.

And now, off we go to Oct. 1 and what it holds! I'm counting on its being interesting.

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