The Doctor Will See You: Whatz Up With Health Insurance

At last,  health insurance will soon become more easily accessible to those who live in the US.  Belatedly,  we have joined the ranks of  industrialized nations by taking important steps toward providing access to health insurance for almost everyone.

The health care bill,  which was signed into law on my birthday,  is far from perfect but it is a start.  Unfortunately,  we will continue to pay too much for health plans that may not cover enough—like mammograms,  Pap smears,  prostate exams or periodontal care.  If  you should find a plan that will cover those necessities of health maintenance,  the deductible is likely to be exorbitant.

My guess is that in most instances,  we will be forced to pay more out of pocket than we would like and that we’ll pay more for our monthly premiums than we would like.  Same old story,  pay more to get less.

The insurance  companies have already begun to petition state regulators for rate increases.  Several states are bound to let them have their way because they own our political representatives—which is how we got stuck with a raw deal on health insurance in the first place (but you know that).

FYI,  here is what the health insurance roll-out will look like for Freelancers and small business owners:


Freelancers with pre-existing medical conditions will be  eligible to buy health insurance at reduced rates.  By October,  insurance companies will no longer be allowed to place lifetime benefit limits on insurance coverage for those with pre-existing conditions.

Businesses with fewer than 26 employees and average annual wages of $50,000 or less will receive a 35%  tax credit  IF  the business pays more than half of its employees’  health benefits.


Businesses with fewer than 100 employees will be eligible to set up employee wellness programs and offer either bonuses or a maximum 30%  health insurance rate discount to employees who join the wellness program.

Employers will be required to disclose the value of employee health care benefits on form W-2.  Beginning in 2018,  holders of health insurance plans deemed  “expensive”  will pay federal taxes on their value.


Tax exempt contributions to health care accounts for medical expenses will be limited to $2500/ year.  Medicare taxes will rise to 2.35%  on earnings over $200,000 for unmarrieds and earnings over $250,000/ year for married couples  (from the current 1.4%).  Employer tax deductions for the cost of retiree Medicare drug benefits will be eliminated.


All citizens and legal residents of the US will be required to purchase/possess health insurance.  Freelancers and small businesses with maximum 100 employees will be able to obtain health insurance through health care exchanges that states will be required to establish.

Small Business Health Options Programs,  called SHOP Exchanges,  will allow Freelancers and small businesses with maximum 100 employees to band together and purchase health insurance as a group to (presumably) save money.  States,  however,  will be allowed to throw a curve ball and temporarily redefine a small business as one having maximum 50 employees  (through 2016 only).

Insurers will be unable to deny health insurance to anyone with a  pre-existing medical condition.  Businesses with 50+  employees that fail to offer health benefits to employees may face penalties of up to $2000/ uninsured employee.

In the meantime,  venture capitalists are looking to fund start-ups that can streamline and improve upon health care delivery systems,  especially for chronic disease management, physician/medical practice profitability tools and patient (customer) relations management.  A woman in my CEO forum operates an employee wellness program business.  She has just hired two part time staff members and is developing a sales pitch for investors.

A votre sante (to your health),


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s