More Healthcare Hustles as Companies Try to Scam Workers and Government

medicaid-expansionNew Orleans   We are on a countdown to the open window for enrollment and renewals under the Affordable Care Act, so now the employer hustles and scams are getting more and more scary and sketchy.   The Wall Street Journal dryly reported the other day in an article about companies scrambling to avoid penalties that “The companies worried about penalties are largely in industries with significant low-wage workforces, such as restaurants, nursing homes and hospitality.  Previously, many of these companies didn’t offer coverage to hourly workers or had mini-med plans.”  Oh, you mean exactly the companies whose workers MOST need coverage and are paid the least are once again on the sidelines as their bosses try to figure out how to game the system and keep from giving them their due?  Right, got ya!

            So, mini-med plans are now outlawed.  That’s the good news.  The bad news is that bosses and their codependent insurers are coming up with something called a “skinny” plan, I guess like a “skinny” latte or something.  These so-called “skinny” plans are sufficient to get a worker in the hospital’s parking lot so she can wave at the doctors and nurses going to work, but not good enough that they would actually provide any coverage for her if she had to go IN the hospital herself.  These plans only cover preventive care, while excluding hospital coverage.  That’s not skinny, that’s starvation!  It certainly isn’t health care insurance under any stretch of the imagination.

            But, here’s the catch-22 for the workers.  A sucky-skinny plan allows company to claim that it is covering 70% of the workers and avoid paying a penalty for not doing so, and the worker, if she swallows the bait and goes for the plan, will also escape a fine for not having insurance, even though she really doesn’t have anything worth a darn.  The only bite, and it’s a big one, is that if the worker gets smart and opts out of the scam-skinny plan and buys a federally subsidized plan in the marketplace, the boss will pay a $3000 fine.  But, you can already see this double-hustle coming.  The employer will be working overtime convincing the worker that she’s good, so she doesn’t go looking, and unless a lot of us are beating the bushes to let people know that these scam-skinny plans don’t qualify, she’ll be hanging out in the hospital parking lot, shocked that she can’t get in the emergency room door with her so-called insurance when she needs it.

            One hustle has better mixed blessings though and that’s the Medicaid scam.  When lower wage employers find that a worker qualifies for expanded Medicaid, then they are off the hook, and they pay no penalty, and obviously don’t carry the insurance weight either.  I said this was a mixed blessing, because on the good side, it means some scumbag bosses will be helping us sign people up for expanded Medicaid benefits, and that’s a great thing!  At least in my view, because it gives workers better benies, but, oh, yeah, the conservatives are also right that this just transfers the cost to the federal government and the taxpayers.  It must be tough to be a conservative and have to embrace the paradox of backing these businesses as Ayn Rand free enterprise models while also opposing Medicaid and federal expenditures and taxes.  The other side of the blessing is that this scam only works in the half of the states that have actually expanded Medicaid benefits.  Maybe these companies will finally get on board and lobby these conservative Republican governors in the rest of our states to let lower income working families have better health care coverage now that it saves them some money, doing the right thing for the wrong reason?

            As for the rest of the companies they are going for the cruelest hoax to avoid providing real coverage by offering the less-than-catastrophic option in the high deductible plan where workers will be paying $5000 and more before they see any benefits at all.

            We need real health care coverage in the USA, rather than all of these hustles and scams.