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House passes health care reform bill

1 points by dantheman 17y ago

dantheman 17y ago
In general I don't like politics on HN; the beauty of capitalism is that we can cooperate and work together by only agreeing on a few basic tenants -- politics be damned, but this does have a significant impact on business. Here is a link to the bill: http://docs.house.gov/rules/health/111_ahcaa.pdf http://docs.house.gov/rules/health/111_ahcaa.pdf
- DanielBMarkham 17y ago
  And startups especially. Key question: So you and two other guys just got $15K in seed funding for your startup for the next three months. Do you have to use that to buy health insurance or face a fine? Does this scenario sound familiar to anyone?
  - tptacek 17y ago
    As a startup founder and operator with a relatively large payroll, let me just clear some stuff up here. First, you can look at the bill text on OpenCongress right here: http://www.opencongress.org/bill/111-h3962/text You'll find that it does not require "you and two guys who just got $15k in seed funding" to purchase company health insurance. Employers with payrolls in excess of $500,000/yr are required to cover their employees. Most responsible companies with payrolls like that already do. In fact, the bill does two things to make it easier for small businesses to handle health insurance: * It provides grants to small business to provide health insurance, based on a dollar formula per qualified employee * It allows companies with fewer than 25 employees to participate in the public health care exchange. These are all just details, though, because the big picture issue here is that this is extremely good news for startups. The fact that health insurance is tied to employers is a major challenge for the kinds of companies people on Hacker News try to start. For the first year or so of our company, we didn't offer health benefits, and that cost us candidates. Plenty of A-players need to cover families, and can't do it on the individual market. To understand how severe this problem is, work from the assumption that you simply cannot buy individual insurance at any reasonable rate. The current system distorts both the health care market and the job market, and makes it harder both to start and grow new companies.
    - DanielBMarkham 17y ago
      I'm going to ignore the parts I'd argue with and follow-up with this question about what I don't understand: Your answer addresses this from the established startup side. My question is about people who are either not in business or who have just signed papers of incorporation. Perhaps they are just working under a memorandum of understanding. As I understand it, these folks are responsible for their own health insurance and are required to purchase it assuming they are able. If an Angel provides them with 100K for business development does that count as income? Do they then have to purchase insurance for themselves? For those guys, supposedly concentrating on finding a market and servicing it, are you saying there is a grant application process? Some forms to fill out? What, if anything, do they need to do that they are not doing now? Because there's obviously going to be something new for them to do, or they wouldn't have health care at all, right?
      - tptacek 17y ago
        Accepting $100k in angel funding does not obligate your Corporation to cover its employees. Neither would $500k, since you certainly wouldn't spend every cent of it on payroll. I think it's a safe approximation of the bill on the table that the founders of your hypothetical startup would need to have health insurance. But they need health insurance now, for the same reason that they need to incorporate (eek! more big government regs!) before they start accepting money: because otherwise, there's a large number of plausible misfortunes that could bankrupt them personally. Have your appendix burst, or get hit by a car. No insurance? BK. Your hypothetical founders make fuck-all in their first year anyways, and so it's likely they could pay whatever nominal fine the plan ends up with, which would be cheaper than insurance. But that's a false economy. Because of the market distortions created by the health insurance companies, pharma, and hospitals, all of which set prices in collusion with the HR teams at big companies, you need insurance to have any meaningful access to health care in this country.
        DanielBMarkham 17y ago
        I read this twice and I still don't think you answered my question. They would have to do something. Either you don't know what or can't explain it in a way that I got it. At one point they have grants. At another it's all just the same as now. Nothing to see here, please move along. If you get a better answer I'd like to hear it. Because I'm thinking that insurance requirements for sole-dual founders will occur before expenses, especially due to their independent nature. You give me 50K and I'm broke, guess what? I'm not broke any more. Suddenly I can afford health insurance and don't need special help. That's all fine and dandy, but it means initial funding will need to be a little higher, that's all.

1 points by dantheman 17y ago

In general I don't like politics on HN; the beauty of capitalism is that we can cooperate and work together by only agreeing on a few basic tenants -- politics be damned, but this does have a significant impact on business. Here is a link to the bill: http://docs.house.gov/rules/health/111_ahcaa.pdf http://docs.house.gov/rules/health/111_ahcaa.pdf

DanielBMarkham 17y ago
And startups especially. Key question: So you and two other guys just got $15K in seed funding for your startup for the next three months. Do you have to use that to buy health insurance or face a fine? Does this scenario sound familiar to anyone?
- tptacek 17y ago
  As a startup founder and operator with a relatively large payroll, let me just clear some stuff up here. First, you can look at the bill text on OpenCongress right here: http://www.opencongress.org/bill/111-h3962/text You'll find that it does not require "you and two guys who just got $15k in seed funding" to purchase company health insurance. Employers with payrolls in excess of $500,000/yr are required to cover their employees. Most responsible companies with payrolls like that already do. In fact, the bill does two things to make it easier for small businesses to handle health insurance: * It provides grants to small business to provide health insurance, based on a dollar formula per qualified employee * It allows companies with fewer than 25 employees to participate in the public health care exchange. These are all just details, though, because the big picture issue here is that this is extremely good news for startups. The fact that health insurance is tied to employers is a major challenge for the kinds of companies people on Hacker News try to start. For the first year or so of our company, we didn't offer health benefits, and that cost us candidates. Plenty of A-players need to cover families, and can't do it on the individual market. To understand how severe this problem is, work from the assumption that you simply cannot buy individual insurance at any reasonable rate. The current system distorts both the health care market and the job market, and makes it harder both to start and grow new companies.
  - DanielBMarkham 17y ago
    I'm going to ignore the parts I'd argue with and follow-up with this question about what I don't understand: Your answer addresses this from the established startup side. My question is about people who are either not in business or who have just signed papers of incorporation. Perhaps they are just working under a memorandum of understanding. As I understand it, these folks are responsible for their own health insurance and are required to purchase it assuming they are able. If an Angel provides them with 100K for business development does that count as income? Do they then have to purchase insurance for themselves? For those guys, supposedly concentrating on finding a market and servicing it, are you saying there is a grant application process? Some forms to fill out? What, if anything, do they need to do that they are not doing now? Because there's obviously going to be something new for them to do, or they wouldn't have health care at all, right?
    - tptacek 17y ago
      Accepting $100k in angel funding does not obligate your Corporation to cover its employees. Neither would $500k, since you certainly wouldn't spend every cent of it on payroll. I think it's a safe approximation of the bill on the table that the founders of your hypothetical startup would need to have health insurance. But they need health insurance now, for the same reason that they need to incorporate (eek! more big government regs!) before they start accepting money: because otherwise, there's a large number of plausible misfortunes that could bankrupt them personally. Have your appendix burst, or get hit by a car. No insurance? BK. Your hypothetical founders make fuck-all in their first year anyways, and so it's likely they could pay whatever nominal fine the plan ends up with, which would be cheaper than insurance. But that's a false economy. Because of the market distortions created by the health insurance companies, pharma, and hospitals, all of which set prices in collusion with the HR teams at big companies, you need insurance to have any meaningful access to health care in this country.
      - DanielBMarkham 17y ago
        I read this twice and I still don't think you answered my question. They would have to do something. Either you don't know what or can't explain it in a way that I got it. At one point they have grants. At another it's all just the same as now. Nothing to see here, please move along. If you get a better answer I'd like to hear it. Because I'm thinking that insurance requirements for sole-dual founders will occur before expenses, especially due to their independent nature. You give me 50K and I'm broke, guess what? I'm not broke any more. Suddenly I can afford health insurance and don't need special help. That's all fine and dandy, but it means initial funding will need to be a little higher, that's all.