2013
Let’s say you are one of the millions of Americans who work for a large company which I will define as 1,000 or more employees and let’s include government jobs as well. Whatever health insurance premium you pay, it is virtually certain you are not paying a premium based on your age or gender or health status. In relatively few cases your portion of the premium may be based on your pay level. In other words you and your fellow workers are in one pool of risk where the healthy, low utilizers are subsidizing the the high utilizers of health care. If everyone paid strictly according to their individual situation, it wouldn’t be insurance.
Now, under Obamacare a similar principle is being applied, it’s called community rating. While there are some variations in premium based on age (unlike your employer plan), in the end it means the young and healthy are going to pay a greater portion of the cost and those who use a lot of health care are going to get a break, especially those with pre-existing conditions. This has caused some observers to shout and scream about skyrocketing premiums caused by Obamacare, but upon closer observation, most of the extraordinary increases are caused by the new application of community rating within the health insurance exchanges.
You may or may not see all this as fair, but in any case it is not new. In addition to employer groups, Medicare uses the same idea. Except for income adjustments, you don’t pay more for Medicare if you are chronically ill compared with a person who uses little or no health care.
Rather than being obsessed with short-term premium adjustments, we should be concerned with the long-term impact on premiums and total costs including the tax subsidies offered in the marketplace plans. Obamacare is setting the stage for rising demand, less concern about individual expenses and as a result, rising costs and premiums along with higher subsidies to keep insurance “affordable” (the winner for the most overused word award in this decade). Obamacare is insurance reform, a short-term benefit for millions of Americans. Fundamental changes in the health care system are next to be dealt with.🙈🙉🙊
QUINNSCOMMENTARY 
Keep in mind that when compared to the impact on take home pay, most workers with employer sponsored coverage pay less for their own coverage than they pay in taxes for:
FICA-med, part a,
General revenue/income taxes for part b and d coverage, and
General revenue/income taxes for Medicaid coverage.
So, most workers have earned, thru taxes, a right to complain when the costs to further expand coverage to others affects their costs , their take home pay – short, intermediate or long term.
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The employer contribution is generally sufficient to create the “community” here. Individual ee’s can exit – generally once a year or by quitting.
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