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The Impact of Repealing PPACA on Your Business – Are We Numb to the Present Pain?

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Update April 2017
Given the failure of the U.S. Congress to replace the PPACA, we are republishing this to remind everyone where we have been and what it is we are replacing.

By nature, people are resistant to change, even when what they are living through at the moment is consistently providing a lot of pain in their lives — the impact of PPACA on businesses as well as personal finances is already well known as well as the magnitude of the surprises many have shared.

Obamacare was passed by the Senate on December 24th, 2009, the House on March 21st, 2010, and signed into law 2 days later. The HRIS World had provided research to various clients on the impact it would have to their organizations, most of which were negative. What positives could be found were with a very small percentage of their employee population – the rest were negative impacts to the bottom line of every client. Somehow, all are still with us, though the same can not be said to the total number of employees they once had. We are reposting this with an update in the comments section. The only word of advice we can offer now is to be discerning as to whose voice you listen.

We can’t avoid mistakes nor keep from repeating them when we choose to ignore history (the content) — as well as choose to remain ignorant of what lead up to the decisions and actions that formed that history (the context). As long as enough influential leaders are pretending not to

As long as enough influential leaders are pretending not to know what is really needed by the people then their constituents are going to consistently experience pain points that are entirely unnecessary.

The complexity of any situation is always the result of lost focus, lost priorities, missed opportunities and in many cases appeasement being practiced at one or more levels.Until we return our focus to sound ethics, the building of character and holding ourselves as well as others accountable and responsible for their decisions actions while ignoring any level of political correctness, we are going to have the sam results no matter what we do.

Until we return our focus to a sound and a singular set of ethics, return to the building of character, return to holding ourselves as well as others accountable and responsible for their decisions actions while ignoring any level of political correctness and ignoring oppressed identity politics, then we are going to have the same results no matter what we do, no matter what we rename it, no matter how we repackage it.

We can not and never will solve the problems we have created with the same thinking we used to create our problems in the first place — and that will only happen when we abandon being told what to think and start learning how to think.

PPACA – Obamacare – Is Already Affecting Every Level of the USA

Questions still abound: How much more don’t we know about? Why is this thing so BIG?

A recent question was posed on the blog, which is owned and operated by Mark and Carolyn Sokol, concerning the impact of PPACA (aka Obamacare) to independent medical insurance brokers.

What probably prompted this is the thoughts and nervousness of the PPACA leading to a single-payer system.

This, for many, is a very legitimate concern on every level.

The question posed was this…

“Do you feel there is any validity to the claim that independent medical insurance brokers will be a thing of the past, be put out of business, by the ACA?”

Carolyn requested a short response from us as we are viewed as impartial to the subject.

Our response was sent as follows…

“Any time there are set of dynamic and a broad spectrum of changes, everything always appears worse than it really is.

“Will the Independent Health Insurance Agents Association (IHIAA) and its brokers will become thing of the past?

“Like most things that the government tries to implement that affects free enterprise negatively, the brokers will find ways to not become a thing of the past but given the magnitude of PPACA they will probably suffer heavy damage.

“Recovery from this will be possible only if an action to defund PPACA takes place.

“This recovery, if it takes place, would take several years to regroup and rebuild – and most likely place the IHAIAA and its members in a stronger position, resulting from lessons-learned before and during the hopefully short-lived reign of PPACA.”

This request got us thinking as well since we are sitting a pile of information we have yet to share.

So, we share…

The government has already proved that the PPCAC is going to strictly embrace policy and unless you are in Congress and Senate, everyone will be forced to find whatever means they can to find the treatment they need at whatever country they can afford.

India has already seen a drastic increase of people making inquiries as well as arriving from the USA and don’t see it slowing down anytime soon.

The PPACA has also proven to be Pandora’s Box as the Senate and Congress will have their own health insurance plans,

which slaps the 28th Amendment in the face — though recently a bill was introduced to put the Executive and Legislative branchs on PPACA as well.

From a few recent interviews with the members of the bench, the Supreme Court is waiting for this to arrive to their dockets (as a court they cannot bring this upon themselves but must wait for it to be brought to them).

The policies of the PPACA has caused many businesses to shift and mold their operations differently in order to survive…

  • the PPACA mandated IHIAA and its brokers to provide free insurance to 18 to 22 year olds but as the PPACA couldn’t mandate they not make any changes to policy, the age eligibility was changed from 18 to 22
  • 33 states will not setup SHOP or exchanges is already a major blow to the implementation of PPACA – allowing free enterprise to be exercised by their brokers
  • the government makes a claim that the 45 million uninsured will be covered. the CBO as well as independent research groups have claimed this will be more towards 27 million – given the level of integrity of past government claims, business owners and CEO’s are paying much attention to the government
  • there is concern over a combination of factors, including
    • the readiness of exchanges to provide a broad array of new insurance options
    • the ability of state Medicaid programs to absorb new beneficiaries, and
    • the over all response by the populace to the availability of the new coverage
  • as many as 8 million people will lose health care plans now offered through their employers, the CBO estimates
    • part of this lose of health care plans comes from exemption within the PPACA — employees that work 29 hours or less do not need to be covered
    • many employers are opting to change their entire workforce from full-time 40-hour weeks to part-time 29-hour weeks – this may mean more part-time jobs but to what end?
  • the IRS is now involved with your healthcare as well, needing to hire 16,000+ agents to monitor and enforce this legislation (and anything related to it), as well as prosecute those that don’t abide
  • Under the new bill and with the latest analysis by CBO, a single insured can look forward to paying $800 per month while family insured will be paying $4000+ per month

How big is PPACA?

A process flow was performed by several research agencies.

The current general process could be placed on one free-standing whiteboard of standard size (1200x900mm or 47×35 inches).


The process flow for PPACA required between 7 and 8 whiteboards of same size, depending on how it was interpretted and apparently how small one wrote on the boards.

Why such a drastic difference?

Well, for starters, PPACA creates

That’s for starters…

The National Association of Insurance Commissioners (NAIC) represents the regulators who oversee each state’s insurance market.

The NAIC came up with the following flowchart in an attempt to draw up the most basic, simple questions to determine eligibility for insurance subsidies or Medicaid

NAIC PPACAflowchart
click on image for larger presentation (pop-up blocker off?)

These are just a few of the changes happening now.

Once PPACA goes into effect, there more aspects of this bill that many are not aware of that will be implemented – and any policy implemented by the government is always full of it challenges compared to the private sector.

For now, the PPACA has added nearly $1 trillion to the federal government spending, and is estimated to go as high as $10-12 trillion in the first 10 years… (per CBO)

Now the icing on the cake: the PPACA is funded only for the first 10 years, after that, the government has to foot the entire bill — that means more taxes…

Here’s a look at the diagram to flow the PPACA (click the image for a closer view – a new window will open, you may need to let your blockers permit this to open)…

Obamacare chart
click on image for larger presentation (pop-up blocker off?)

Broken Promises

We all act and react according to promises made, even if cautiously. When the promises don’t pan out, we know from experience there is always a cost that is going to be painful associated to the broken promise. According to the Energy and Commerce Committes in a report release March 2013, here’s the scorecard of promises made and promises kept or not kept…


Promise: “Coupled with comprehensive reform… that could save families $2,500 in the coming years – $2,500 per family.

Reality: Despite President Obama’s repeated promises that families could save $2,500, the average family premium has instead grown by over $3,000 since 2008.


Promise: “If you like your current health care plan, you will be able to keep it.

Reality: Obamacare incentives employers to drop coverage in response to new regulations and the availability of subsidized insurance in the new exchanges.

According to a new economic report from the Congressional Budget Office, 7 million people will lose their employer-sponsored coverage, nearly double the previous estimate of 4 million.


Promise: “I will not sign a plan that adds one dime to our deficits—either now or in the future.”

Reality: In 2010, the Congressional Budget Office calculated that the ten-year cost of Obamacare, in terms of its spending increases, was $940 billion. In 2013, CBO’s ten-year spending estimate was $1.88 trillion. By 2015, the CBO’s ten-year spending projections are likely to exceed $2.5 trillion. Our federal debt exceeds $16 trillion today. A recent report by the GAO suggests that, under the most realistic scenarios, Obamacare will end up adding $6.2 trillion to the deficit over the next 75 years.


Promise: “Under my plan, no family making less than $250,000 a year will see their taxes increase…not any of your taxes.”

Reality: According to a March 5, 2013, Joint Committee on Taxation report, Obamacare includes 21 new or higher taxes that will cost taxpayers roughly $1.1 trillion over the next decade. The IRS will impose new and higher taxes on medical devices, prescription drugs, health coverage, high-premium health plans, and health savings accounts that will affect the average American.


Promise: The president promised to help Americans with pre-existing conditions, stating that a “temporary program makes health coverage available and more affordable for individuals who are uninsured and have been denied health insurance because of a pre-existing condition.

Reality: The Obama administration just announced sick Americans would be shut out from the “Pre-Existing Condition Program.” House Republicans said that health reform should tackle the biggest problems first – lowering health care costs, increasing access to patient care, and prioritizing funding for chronically ill Americans. House Republicans reiterated that priority in a recent letter to the president.


Promise: So this bill is not only about the health security of America, it’s about jobs. In its life it will create 4 million jobs, 400,000 jobs almost immediately.”

Reality: According to the Congressional Budget Office, Obamacare will reduce the labor force by 800,000 over the next decade and the cost to American businesses due to inability or failure to comply is estimated to be $52 billion. Additionally, a 2012 Gallup poll revealed that 48 percent of business owners cite the potential cost of health care regulations in their decision not to hire additional workers. A March 2013 Federal Reserve report on Current Economic Conditions acknowledges the health care law slows hiring, stating, “employers in several Districts cited the unknown effects of the Affordable Care Act as reasons for planned layoffs and reluctance to hire more staff.”


Promise: “I will protect Medicare.”

Reality: Instead of making the program stronger, Obamacare raided $716 billion from Medicare to fund its $1.9 trillion in new health spending over the same period. Included in these cuts are significant reductions in payments to Medicare Advantage plans, which could disrupt coverage for the 14 million Americans enrolled in the program today.


Promise: “No federal dollars will be used to fund abortions, and federal conscience laws will remain in place.”

Reality: HHS released a mandate that requires employers to provide access to abortion-inducing drugs, contraceptives, and sterilization procedures at no cost to their employees. The latest proposed rule expands the definition of institutions that could qualify for “religious employer exemption,” but does nothing to fundamentally alter the mandate itself. The administration’s proposal makes a minimal change to the mandate’s religious exemption, but it still allows only formal houses of worship and their integrated auxiliaries a reprieve from the mandate. This change does nothing to help countless individuals and employers who will now be forced to violate their conscience as a direct result of this Obamacare mandate.


Promise: “You see, part of the genius of our Founders was the establishment of a federal system in which each of our states serves as a laboratory for our democracy…our approach has been to give you the flexibility that you to need to find your own innovative ways forward.”

Reality: Obamacare tramples state flexibility. States that have or wish to implement market-oriented exchanges cannot because of Obamacare. State exchanges must comport with what HHS dictates and comply with hundreds of pages of rolling requirements coming from bureaucrats in Washington.


Promise: “I’m willing to look at other ideas to bring down costs, including one that Republicans suggested last year: medical malpractice reform to rein in frivolous lawsuits.”

Reality: The president did not include medical liability reform in his massive overhaul of the health care system, and he has repeatedly ignored attempts by congressional Republicans to work together on this issue. He ignored the fact that defensive medicine contributes as much as $200 billion a year to rising healthcare costs. According to the CBO, comprehensive medical liability reform would reduce the budget deficit by at least $48.6 billion and as much as $57 billion over 10 years.


Promise: “The Affordable Care Act is designed to make it easier for younger Americans to obtain and maintain health insurance.”

Reality: Young adults can stay on their parents’ plan until the age of 26, but those without access to a parent’s plan or those between 27-39 are facing steep increases. Young, single adults who make about $25,000 a year or more will face premium hikes of 42 percent in the individual market. Single thirtysomethings who are ineligible for exchange subsidies will be affected as well, with their premiums likely to increase by 31 percent.


Source: Just Days Ahead of Obamacare’s 3rd Anniversary, Committee Releases Scorecard of the Law’s #BrokenPromises

From Our All About PPACA Playlist on Our Career YouTube Channel

if video is not visible, click here

Some Closing Thoughts
Is the concept of a better health care possible without being a burden on both the government as well as the people? without rationing care, medications, as well as allocating certain procedures to those of a certain age and/or fitness?

So far, the answer seems to be no — every country that has taken on a national health care system has strapped the government as well as the people at some or many levels.

Those that saying some countries are doing well with a national healthcare system are only partially correct — liberties had to be sacrificed as well as funds collected above what is already burdening any countries budget, it still was not possible without causing higher taxes and a controlled environment for care and medications.

We need to remember, once a program has been implemented and is under their control and management, decisions are never based on emotions — it is purely analytical and the analysis has to fall within policy, not the other way around.

Governments will, however, rely on appealing to your emotions to have such programs in place — and unless the facts are out on the table, in full view for all to see, without distorting any analysis, then many times the happy emotions of having gained something like this soon becomes a bitter pill to swallow.

Money does not grow on trees nor in bushes — and unless construction companies, personnel, and utilities are all providing their services and materials for free, then healthcare is not free either: someone has to foot the bill and that means the people, and that means limited resources which leads immediately to rationing at any but mostly all levels.

Some may not mind this – but they are also are ignoring the liberties of those that do mind, which has only lent itself to liberties lost.

When we are not protecting the liberties of those we disagree with, those we do not like and even those we hate, then we will only lose our own liberties in the process — liberty is all or nothing, and once lost it has always been lost entirely.


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What Are Your Thoughts?

   Obviously there are more thoughts healthcare than there are pages to the PPACA bill — even the OMB and CBO can’t agree on what this bill has cost the taxpayer. What impacts are you seeing now that is necessitating a change in operations?

   As this bill gets older, 2 things have become painfully obvious — it is costing more than what we had previously, and there are going to be fewer people that are going to be covered, due to the size of the workforce shrinking. What are your recommendations?

   What research can The HRIS World provide you concerning a healthcare replacement?

Please share your thoughts with us and our audience in the comments section below! Or you can reach us directly from our contact page.

From the ADP Playlist on Our YouTube Channel

if video is not visible, click here

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Garrett O'Brien

CEO, Chairman, Publisher, Editor at The HRIS World Research Group

Garrett is the publisher, editor, writer forThe HRIS World Research Group, which includes The HRIS World, The HRIS World Research, The HRIS World Jobs, The HRIS World News, and The HRIS World Videos

With more than 20 years in roles as a client executive sponsor (#thwCES), project manager as well as functional / technical lead, Garrett is sought for his expertise for project insights, thought leadership, and team management globally.

He has been involved in large-scale and complex implementations since 1991 and has recently moved his operations to be with his wife in Brazil.

Garrett has had the pleasure of working with some of the greatest talents in the industry, and constantly shares his experiences and knowledge through content and webinars.

He maintains his fluency in Portuguese, German, French, and English with his various endeavors and contacts..

When not working, you will have to be adventurous to stay up with him as Garrett loves motorcycling, gunnery, boating, sailing, flying, and sports fishing -- and accompanying his wife on her various likes

About The HRIS World Research Group

The HRIS World blog, which is read by more than 50,000 from more than 160 countries monthly, manages to have more than 550,000 pages viewed monthly. 40%+ of the audience are decision-makers in their organization (and about half of that being C-levels!).

As CEO for CGServices USA Inc, he focuses on multi-provider, multi-line implementations consultation for HRIS systems

Council and Education Member of Gerson Lehrman Group Council, helping institutions of the world leaders meet, engage and manage experts across a wide range of sectors and disciplines.

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