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If you happen to see it, there's a hot new conservative meme rocketing around the net which is apparently that the WarlMart's Health Care plan is "Better" than Obama Care.

Yes, Really.

http://washingtonexaminer.com/...

For many years, the giant discount retailer has been the target of unions and liberal activists who have harshly criticized the company's health care plans, calling them “notorious for failing to provide health benefits” and "substandard.”

But a Washington Examiner comparison of the two health insurance programs found that Walmart's plan is more affordable and provides significantly better access to high-quality medical care than Obamacare.

See that, now if simply everyone were working minimum wage at WalMart, they'd clearly be so much better off than if they had Obamacare.  And we all have the Washington Examiner, which of course is not-at-all partisan, to thank for this revelation.

But does it hold up?

So here's the core of the claim.

Walmart offers its employees two standard plans, a Health Reimbursement Account and an alternative it calls "HRA High" that costs more out of employees' pockets but has lower deductibles. Blue Cross Blue Shield manages both plans nationally.

Also offered is a Health Savings Account plan that includes high deductibles but allows tax-free dollars to be used for coverage.

For a monthly premium as low as roughly $40, an individual who is a Walmart HRA plan enrollee can obtain full-service coverage through a Blue Cross Blue Shield preferred provider organization. A family can get coverage for about $160 per month.

Unlike Obamacare, there are no income eligibility requirements. Age and gender do not alter premium rates. The company plan is the same for all of Walmart's 1.1 million enrolled employees and their dependents, from its cashiers to its CEO.

That sound pretty good?  Sure, it does if you only assume that you can judge a plan merely by looking at it's premium, as it turns out - there are quite a few other costs to these plans which make them functionally unusable.

http://makingchangeatwalmart.org/...

Walmart’s 2011 health care offerings include cheap premiums of $32.70 per pay period for family coverage – or $850.20 per year – however, this plan has a high annual deductible of $4,400. In addition, Walmart Associates covered by the health plan face a $10,000 out-of-pocket maximum. This is greater than the average of $7,096 for other plans of this type in 2010, the last year for which data is available.
So that's not really as awesome as it seems.

How do they claim ObamaCare stacks up?

A Journal of the American Medical Association analysis from September showed that unsubsidized Obamacare enrollees will face monthly premiums that are five to nine times higher than Walmart premiums.

JAMA found the unsubsidized premium for a nonsmoking gouple age 60 can cost $1,365 per month versus the Walmart cost of about $134 for the same couple.

The medical journal reported a 30-year-old smoker would pay up to $428 per month, in contrast to roughly $70 each month for a Walmart employee.

A family of four could pay a $962 premium, but the same Walmart family member would pay about $160.

The first problem is the assumption that the average Walmart worker would only be eligible to "unsubsidized" care.  Chances are that they would certainly be eligible for subidies.  Just as an example I went to Healthcare.gov and selected a list of plans for a 60/61 year-old couple earning $35,000 in Allegheny County North Carolina.

This is what I received: https://www.healthcare.gov/...

Health plans for two individuals, ages 60 and 61, living in Alleghany County, NC.

Based on a household size of two and income of $35,000, you may qualify for a $1,225/month tax credit you can choose to apply to your premium for these plans. This tax credit has been applied to the premiums below.

As result i received a listing of 13 different plans, the first two were as follows:
Blue Advantage Bronze 5500
PPO | Bronze
Blue Cross and Blue Shield of North Carolina
Monthly premium
 $0/mo
2 enrollees
Premium before tax credit: $1,186/mo
Deductible

$11,000/yr

Family total
$5,500/yr

Per individual
Out-of-pocket Maximum
$11,000/yr

Family
$5,500/yr

Per individual

Copayments/Coinsurance:

Primary Doctor: No Charge after Deductible
Specialist Doctor: No Charge after Deductible
Generic Prescription: No Charge after Deductible
ER Visit: No Charge after Deductible

Blue Advantage Bronze 2700
PPO | Bronze
Blue Cross and Blue Shield of North Carolina
Monthly premium

$56/mo
2 enrollees
Premium before tax credit: $1,281/mo

Deductible

$5,400/yr

Family total
$2,700/yr

Per individual
Out-of-pocket Maximum
$12,700/yr

Family
$6,350/yr

Per individual

Copayments/Coinsurance:

Primary Doctor: 50% Coinsurance after deductible
Specialist Doctor: 50% Coinsurance after deductible
Generic Prescription: 50% Coinsurance after deductible
ER Visit: 50% Coinsurance after deductible

As you can see, if you include the subsidies you can potentially have a plan under ObamaCare that has a ZERO Premium, with ZERO Copays and Deductibles that are about the same as the WalMart plans.  Still the problem here is that you can't do an exact apples-to-apples match because the plans that are available on the Exchange in any particular State and in any particular county are controlled by the insurance plans themselves, and are not a "One-Size-Fits-All" solution in the way that the WalMart plan is. Depending on circumstances you can get very different results even for plans in he same location.  And as Media Matters points out, these plans are not intended to be replacement for existing employer healthplans, they are intended to be an extension and a support net for people who - due to low income and/or pre-existing conditions - have been Locked Out of the Insurance Market.

http://mediamatters.org/...

The January 9 editorial joined a chorus of conservative voices promoting a report published in the Washington Examiner which claimed that Walmart's employer based insurance offers better coverage than what is available on the ACA-established health care exchanges:

...

But the ACA was never meant to compete with affordable employee-based coverage, and it is difficult to compare one company's health care plan to the hundreds of options available to different consumers depending on their state, income level, and type of insurance they want.

Beyond the central goal of extending coverage to the uninsured, the ACA also established a set of essential benefits that all insurance plans, even Walmart's, need to have in order to improve coverage for all patients. Many of those previously uninsured before the ACA's passage were unable to find insurance due to pre-existing conditions that made them risky to cover. Thanks to the ACA, those people living with chronic conditions cannot be denied affordable insurance coverage.

For example, the Associated Press reported that a Michigan woman hasn't been able to find affordable insurance since 2007 because of a pre-existing condition but with the ACA "will now pay about $175 a month." In addition, the law also ensures that men and women are treated equally in the insurance market by banning higher premiums on women solely because of their gender.

Third problem, if WalMart's own healthcare is so great, why exactly is it that only 52% of their associates actually make use of their care?

http://makingchangeatwalmart.org/...

Walmart’s health care plans fail to cover hundreds of thousands of associates. In 2009, Walmart claimed that 52% of associates were covered under their healthcare plan. The company has refused to disclose coverage rates for its 1.4 million U.S. employees since then.[4]
The Washington Examiner Report states that WalMart Care is the same for all associates to the CEO, but it doesn't note that it's Not Available to all associates if they only work part time.
Walmart stopped offering health insurance to part-time employees (working less than 24 hours per week) in 2012.
As a result many of WalMart part-time, and even many of it's full-time associates, are not earning enough to pay for their plans because the majority of them are making less than $25,000/year.
According to [Walmart CEO] Simon's presentation, under the heading "Great job opportunities," he noted that more than 475,000 Walmart associates earned a salary over $25,000 last year. Using Walmart's statistic of 1.3 million U.S. associates, OUR Walmart members said that would leave 825,000 workers -- or nearly two-thirds -- who earned less than $25,000 for the year.
Even if you were to limit the term "associates" only to those working in the stores and excluded truck drivers, distribution centers and those working at the companies Bentonville Headquaters - that would still leave over 1 Million employees meaning more the 52% of them are living at the poverty line or below.

So it only makes sense that rather than using WalMart's own Plan, they instead get their Healthcare from the Government, via Mediciad.

Taxpayers are forced to provide healthcare for Walmart’s Associates. Hundreds of thousands of Associates and their family members qualify for publicly funded health insurance.[6] Indeed, according to data compiled by Good Jobs First, in 21 of 23 states which have disclosed information, Walmart has the largest number of employees on the public rolls of any employer.[7]

Recent Analysis:

  •    Missouri: In early 2011, Walmart led all employers with 10,028 employees and their dependents enrolled in Missouri’s Medicaid program, known as MO HealthNet (MHN). Enrollees included 2,403 employees, 827 employee spouses, and 6,798 children of employees.[8]
  •    Massachusetts: In FY09, Walmart led all employers with 10,171 employees and their dependents using publicly subsidized health care. Enrollees included 5,072 employees and 5,699 dependents.[9]
  •    Connecticut: In 2011, Walmart topped the list of Medicaid employers.the costs of the plans that the company offers are unaffordable for many hourly associates, who earn an average of just $8.81 per hour
So, yet again we have equivalence fail.

And guess which HealthCare Bill expanded access to Medicaid which would increase the availability of coverage of exactly those same WalMart workers under the poverty line?  ObamaCare did (in those states without recalcitrant Republicans in control, that is.)

But then the Washington Examiner report goes on to say that the thing that makes WalmartCare better than ObamaCare isn't just cost (even though it's not true if they qualify for subsidies or Medicaid - which 52% of Walmart worker should), it's access.

http://health.usnews.com/...

Many top hospitals are simply opting out of Obamacare.

Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.

And that's not because their exchanges don't offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states' premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.

Let's think this though, WalMart has 2 plans - TWO -  and a Health Saving Account that have access to these hospitals.  In this report, the exchange may have 13-15 different plans available and only ONE - or maybe TWO - will have the top-tier hospitals available.  So, uh, what exactly is the problem - the fact that people have 12-13 other choices that they wouldn't have otherwise? Too much choice is a bad thing now?

In fairness, their complaint for most exchange plans may be true, as this is the first year that these plans roll out - they may not include every option available.  Of course, this argument is like saying the person that previously couldn't get a drink of water, should now be disappointed and disgusted that they can't get a Cristal at every restaurant in their neighborhood.

The main rationale given for these plans not granting access to the top-tier hospital networks is the "cost controls", but the only real control of this type is the 80/20% Medical Loss Ratio requirement for plans offered on the exchange.  However, that requirement now applies to ALL PLANS in the individual and small group, but not for large groups (like WalMart), so if this is truly the problem, it's not restricted only to the ObamaCare plans. The thing here is that when these plans are apparently restricting access to the premium hospitals because on their inability price gouge on Co-Pays and Deductibles when providing those premium services.

Certainly it's a worthwhile subject to examine how Plans available on the Exchanges stack up in terms of price and services vs those that are already available from other providers in the individual, small and large markets - but we have to understand that they are NOT ALL INTERCHANGEABLE.  People working at large companies like Walmart are - and have already been - required to provide health care to their full time employees.  That was already that law, that is still the law.

ObamaCare doesn't change that, in fact WalMart's 24 hour requirement is lower than the ACA's 30 hour work week requirement  People who are getting their Healthcare through WalMart don't have to change, and will not be required to shift to an ObamaCare plan unless.. They Weren't Able to Get Care Previously.

So it's not Apples to Apples, it's more like Apples to not having ANY Apple, then finally being able to get a few slices of an Apple.  We shouldn't be comparing one whole Apple versus the few slices that might be missing, we should be comparing it against the fact - NOW THEY HAVE SOME APPLE because before this, they didn't have one.

Look, I'm just one guy who took an hour with an iMac to Google research this because I've been writing about the ACA since the first version of the bill hit Congress. Just imagine if someone in the professional media, who gets paid for this stuff, were to do an analysis of how well this WalmartCare is better than ObamCare stuff really works out.

Or maybe they could pay me to do it, I could use the money and I'm available.

I'm just sayin'.

Vyan

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