A couple of non-political clarifications…
To the OP:
1) ACA can be very expense, depending on one’s income. I do not believe it is cheaper, except maybe low wage earners with families, than the Xerox plan. The reason is that Xerox would have to pay a penalty if that was the case, i.e. ‘minimum value.’ When I was laid-off a few years back at a different company, ACA was a lot cheaper for me that the COBRA plan that was offered, which is common.
2) I am not a benefits experience, but I do deal with the financial side. You are correct that Xerox’s health plan is primarily self-insured, which means the company carries the financial risk of higher or lower claims versus an insured plan. But, under IRS rules, the company is required to pay a minimum percentage of the money it collects to the actual claims and a vast majority of the rest goes to the health insurer that manages the claims. It is not a profit center for Xerox or anyone else.
3) That’s true from what I have seen. From what I know, basically the day that Icahn & co. took over, they pushed to set Xerox’s health contribution level to the minimum allowed under law without being penalized.
To others:
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I have been responsible for colleagues in Canada (pre-Xerox) and have traveled their extensively. Overall, the quality of healthcare, including primary and emergency care, is just as good there as it is in the US and way cheaper and more accessible. The challenge in Canada is voluntary stuff, like repairing a knee, they the wait times can be significant, say 6 to 12 months.
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Looking at neutral studies, i.e. those not tied to the GOP nor Democrats, which is what I do when doing financial modeling for group/employer health plan costs, the market-wide annual average cost increase has been 6% increase since ACA went into effect through 2019. Prior to ACA, costs increases were 10% per year for about a decade. While insuring those who can’t afford healthcare contributed to approximately 10% of that ACA increase according to those same studies along with 10% from removing pre-existing exclusions, which we will all have at one point or another. The largest chunk of the increase came from the spectacular rise in pharmacy costs, which is about 45%. Another 35% can be attributed to an aging population (think baby boomers) and an increasingly sedentary population.