VA to be slammed by Obamacare

| April 24, 2013

The Navy Times has a story about the coming implementation of the Affordable Care Act, or Obamacare, and the impact it will likely have on the Department of Veterans Affairs.

Starting in 2014, the law punishes those without health insurance, and the VA’s health plan meets the minimum requirement for coverage – which means that there may be an increase in the number of people seeking health care from the VA.

It is unclear how many veterans might turn to VA, but the 2014 budget includes $85 million to cover increased medical care costs, plus $3.4 million to cover administrative costs because VA would have to provide a written statement to each enrolled veteran about their coverage.

The VA’s 2014 budget estimates coverage for 6.5 million veterans, an increase of 1.3% over fiscal year 2013 – about 100,000 more veterans than this year.

There’s a problem there:

Kenneth Kizer, director of the Institute for Population Health Improvement at University of California Davis Health System, estimates 1.8 million uninsured veterans will be looking for coverage when the Affordable Care Act requirement kicks in next year.

Last time I checked, 1,800,000 is a whole hell of a lot greater than 100,000, so there are going to be issues with VA health care next year, as if there weren’t already.

Cross posted from After the Army

Category: Veteran Health Care, Veterans' Affairs Department

Comments (24)

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  1. 2/17 Air Cav says:

    Not a problem. The death panels will take care of it.

  2. Arby says:

    Those motherf*ckers. A few years ago, my company offered a TRICARE supplement policy to those of us who were retirees and had our own healthcare. They grossly overpaid a company to offer the policy and the price we paid was the exact same price as one we could buy from MOAA on our own. The difference was that we could use pre-tax dollars to pay for the policy and save a few bucks in taxes.

    However, Uncle Sam quickly ruled that the company could not offer any TRICARE supplement policy unless it was 100% paid for by the individual – in other words, they could not share any of the costs like they would and do for a normal healthcare plan. The reason was that some employers, notably state and local governments were paying retirees money to get off their healthcare plans and use TRICARE instead. Somehow, the feds did not like people who were entitled to all the benefits of TRICARE actually using those benefits.

    So, now we have 0bamacare doing the exact same thing they told my employer not to do.

  3. PintoNag says:

    I think we’ll see everybody get slammed by Obamacare.

  4. 2/17 Air Cav says:

    “Starting in 2014, the law punishes those without health insurance….” Read that again, slowly. It will be against the law not to have healthcare. Against the #@!*&%$&#$@^!! LAW! And those death panels? Oh, they are real all right. Files will not be stamped “LET DIE” but it they may as well be when life-sustaining but costly drugs, treatment, and surgery are not be approved by the Federal medical bureaucrats.

  5. OWB says:

    No surprise at all here.

  6. Hondo says:

    Arby: Uncle Sam did that because by law Tricare is 2nd payer to any employer-sponsored health insurance or individual health insurance plan except for individual Tricare supplement plans. Your company was trying to dodge that legal requirement by facilitating a “company-sponsored” Tricare supplement plan. It would have saved the company big bucks in insurance premiums while shifting that bill to Uncle Sam – and thus the rest of the US taxpayers.

    Tricare still pays – as second payer – if you have employer-sponsored insurance. And in practice, it generally covers most or all of what an employer-sponsored plan doesn’t.

  7. Arby says:

    @6 Hondo – I never took part in any healthcare plan offered by my company. As a retiree, I have TRICARE as my primary. I had TC supplemental policy from MOAA. My company decided since they were subsidizing everyone elses’ healthcare policies to the tune of hundreds a month, that they would do something for the folks (military retirees mostly). What they did was to offer a TC supp policy. They paid some company obscene amounts of money to offer us a TC supp policy. They were losing money now on every retiree who was using TRICARE in the first place and decided to purchase the supplement. They gained NOTHING.

    The only real benefit to me was that I could pay for it by payroll deduction and use pre-tax dollars. We (the other retirees and I) would have much rather the company just give us a significant amount of the money they used to subsidize a normal healthcare policy.

    The government frowns on any company doing anything that appears to be pushing people out of their healthcare plan and into TRICARE. Which, when you think about it is BULLSH*T because the person earned the benefit and is entitled to do whatever they want with it. I was never on my company’s policy to start with. The only benefit I got was maybe $150 savings in taxes a year. Big whup.

    The real reason the feds did this was that many municipal governments with cadillac healthcare plans were trying to cut their costs by getting TRICARE eligible employees out of the system.

  8. Hondo says:

    Arby: all employers would prefer military retirees “opt out” of their employer group coverage. It costs employer big bucks to subsidize individual insurance. That’s true whether the employer is private-sector or public-sector.

    What your employer was trying to do was end-run the legal requirement for Tricare to be second-payer to an employer-sponsored health plan. Uncle Sam couldn’t allow them to establish that principle, because in that case every other employer in the company would cry foul using that case as precedent. Some dumbass judge somewhere would buy the argument, and Uncle Sam gets hit with paying for it all – and thus you and I pick up the tab.

  9. Arby says:

    @8 hondo – I never participated in my company’s health plan, nor did anyone else who took advantage of the offer of a TC supp policy. So, the company was saving money on each and every one of us from the start. They had no reason to give us a supplemental policy in the first place.

    Now, I do know there were some people who were TC eligible and chose instead to pay $250 – $300 a month for the company policy. If they were already willing to pay five to six times the cost of a TC supplement, they were not going to be bought off by the offer of a TC supplement for $45 if they returned to TC Prime or standard.

  10. Hondo says:

    Arby: I understand all of that. The problem is not with the particular case you describe, but with the precedent it sets that Tricare is not always second-pay to employer-sponsored insurance.

    Yes, the plan you describe was a Tricare supplement. Doesn’t matter. It’s still an employer-sponsored plan. And by design, it would have been second-payer to Tricare as a supplement.

    If allowed, it would have established precedent that Tricare is not always 2nd pay to employer plans. And I can guarantee that every other insurance plan in existence would have challenged the Tricare-2nd-pay requirement had this one stood, using this one as precedent. And they’d likely have prevailed in court.

    The effect would have been to shift a fair chunk of every insurance company’s current healthcare payouts to Uncle Sam under Tricare Sure, employer plans would go down in cost and in price – because Uncle Sam would now be subsidizing not only Tricare, but other participants as well through paying costs that formerly were paid by private insurance. Tricare’s already in trouble financially. Do you really want to see it raise fees and/or cut service even more?

    And the taxpayer would now be the one footing that particular bill – not employers.

    Tricare is 2nd pay by law for a good reason. If it was primary, it would end up subsidizing a load of private insurance plans exactly as I describe above.

  11. RunPatRun says:

    Following along Hondo and Arby’s topic, Virginia began offering a Tricare supplement last year. I couldn’t see any financial benefit based on the $120 monthly premium, perhaps because we haven’t been booted from Prime yet and are relatively healthy. Am I missing something?

  12. RunPatRun says:

    Not sure if this is an unintended consequence to the law, but our student healthcare premium has more than doubled. Perhaps Congress wanted premiums to double?

  13. A_Proud_Infidel says:

    Apparently the Obamatollah is still trying to defecate on as many of us Vets as he can. As if most of the VA Healthcare system isn’t slow and incompetent enough already. Maybe it’s B. Hussein 0bama & Co.’s way of telling elder Vets to hurry up and die?

  14. Arby says:

    @12 runratrun – the best tori are supp policy is from MOAA. UDer $50 a month for a family of four on TC Std. I suspect the price of the VA policy is so high because they are paying another third party company big buck. That third party company then turns around and buys the same policy from The Hartford, the same company MOAA uses.

  15. Ex-PH2 says:

    I saw this rise in premiums coming when this was first run by the public in that 15 minute speech Bodaprez gave in 2009 on the subject of national health care.

    Here’s the reason, plain and simple:

    The entire business of insurance is based on fear of loss and nothing else. You pay for coverage for your house or car, based on the possibility that you might suffer damage/loss to either or both of them. A statistical database called a risk pool is what partially determines your premiums, in addition to your own history as an insured risk. This applies to you, whether you are a long-term client of an insurance carrier, or new to the carrier.

    Statistics are available that can and do provide data for insurance carriers to use for every kind of risk from homeowners coverage to health care coverage. There’s a formula for calculating these statistics. I learned that a long time ago, taking the CPCU classes to keep my broker’s license. Discovery of (prior undisclosed) losses also plays a role in premium calculations. This means that your prior or existing condition will be covered, but at a greater cost than before.

    Because this health care coverage is going to be required for everyone effective 2014, that means that for the statistics applied to specific risk pools (people with specified health conditions such as heart disease, cancer and diabetes), the premiums collected are meant to cover ALL of the population, whether they have insurance or not.

    If you think people will not slip through the cracks on this, think again. Those who do slip through the cracks will still get coverage, but it will be at the expense of you and your employers. Why? Because your insurance coverage will be extended to cover uninsured individuals. Just as you carry uninsured/underinsured auto insurance, you will also be paying for uninsured people who require health care but can’t pay for it.

    Also, your premiums are going up, not so much because the actual premiums are rising, but because many employers are dumping the health insurance programs they once offered to their employees and instead, may or may not provide a supplemental amount to you, the employee, to help you pay for your coverage as an individual, instead of as a member of an insured group.

    The estimated cost for this, per person, is around $20,000.

    So much for affordable health care. I still can’t believe anyone swallowed that BS.

  16. Ex-PH2 says:

    There is an alternative, but it’s somewhat risky. As a veteran, you’re entitled to VA health care benefits. Depending on where you are, they should be good. If you have a service-connected claim and it’s been approved, you have coverage for that, which costs you nothing. Other services require some kind of payment, either directly from you or from your health insurance carrier.

    I spoke last summer with a DAV field service officer about the other health care benefits, such as hospitalization for injuries in an auto accident, and he said that as long as you have PI/BI coverage on your policy, which should include comprehensive coverage, that will pay for your care at a VA hospital. Otherwise, you will have to pay for it yourself. In fact, as veterans, you can receive any needed medical service (should be outlined in the booklet they send to you), but if it is not service-connected, you have to pay for it. Your employee insurance should address that. You will get care, however, even if you have no coverage, and you can make arrangements with the VA to pay the bill yourself.

    Unfortunately, the VA is not allowed to charge Medicare for health care services to veterans, although we are allowed now to substitute VA prescription services for Medicare Part D. This could be changed by getting some dufuses in Congress to enact legislation allowing the VA to charge Medicare Parts A, B, and C for services to veterans.

    So if you don’t have or can’t afford the national health care twaddle that Obamacare represents, and you can find a credit union that will help you set up a health care savings account, I would do so very quickly. It may not be tax-exempt but you can find out about that by asking.

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  21. Jonn Lilyea says:

    Thank you that was well-phrased and well-reasoned and you didn’t sound insane not even a little.

  22. NHSparky says:

    In the words of George Takei, “Oh my!”

    @22–go to the DMV. Hate it there? Those are now the people running your healthcare. Sleep well.