One of Medicare's biggest systemic failures (if not its biggest) is pay and chase. Claims must be processed in 15 days and payment sent, at some point down the road, usually a year or two after they get around to checking if the claim should have actually been paid. If they find out it should not have been paid they then try to recover these monies. A system only a politician could accept.
Appears that this is the plan for ObamaCare as well:
"Employers will receive notice if their employees are certified for premium tax credits and will have an opportunity to respond. The IRS will then present the employer with a notice and demand for payment. It appears that this will happen in 2015 for penalties owed for 2014."
January 1st, 2014 employees go to the exchange and gets a subsidy to buy coverage. Come some point in 2015 the IRS will send a notice to employers trying to collect the penalty. What if the employer proves the employee was not eligible for the subsidy and thus they are not subject to the penalty? Does the IRS then go after the employee to recoup the subsidy? This is money that went to buy insurance so it is doubtful the employee would have it to repay.
Can anyone dream of a system our government could implement that would accurately determine eligibility? They want individuals to instantly be able to price policies and buy online. How do you instantly gather that information from employers?
It almost seems as if there is some layer of administrative work provided at the employer level, between the worker and carrier, that accurately and timely makes these determinations, within 30 day window or so. Those arguing, mainly clueless academics, that insurance could more efficiently be offered if decoupled from employment never grasped the administrative savings of bulk buying. If employers were not contributing that would make things easier, but I have yet to see an affordable or palatable system employers did not contribute to financially. If you think individual polices subsidized through the tax system would work you would just be ignorant. 25% of owed taxes aren't collected and fraud is rampant, see refund fraud as a clear example.
Appears that this is the plan for ObamaCare as well:
"Employers will receive notice if their employees are certified for premium tax credits and will have an opportunity to respond. The IRS will then present the employer with a notice and demand for payment. It appears that this will happen in 2015 for penalties owed for 2014."
January 1st, 2014 employees go to the exchange and gets a subsidy to buy coverage. Come some point in 2015 the IRS will send a notice to employers trying to collect the penalty. What if the employer proves the employee was not eligible for the subsidy and thus they are not subject to the penalty? Does the IRS then go after the employee to recoup the subsidy? This is money that went to buy insurance so it is doubtful the employee would have it to repay.
Can anyone dream of a system our government could implement that would accurately determine eligibility? They want individuals to instantly be able to price policies and buy online. How do you instantly gather that information from employers?
It almost seems as if there is some layer of administrative work provided at the employer level, between the worker and carrier, that accurately and timely makes these determinations, within 30 day window or so. Those arguing, mainly clueless academics, that insurance could more efficiently be offered if decoupled from employment never grasped the administrative savings of bulk buying. If employers were not contributing that would make things easier, but I have yet to see an affordable or palatable system employers did not contribute to financially. If you think individual polices subsidized through the tax system would work you would just be ignorant. 25% of owed taxes aren't collected and fraud is rampant, see refund fraud as a clear example.
0 comments:
Post a Comment