[snuxoll]

That’s still roughly the case, I work for a medical billing company owned by a physician group, we have a pretty large group and are essentially self-insured.

I pay ~$220-ish a month for my family of three, the company pays $800+/mo. Boy am I glad to work for a company that pays such a large chunk of my benefits, many other places cover maybe 50% of your dependent costs.

[bobcostas55]

You're still the one paying the $800, the only benefit is you get to do it with pre-tax money. It's not like that money comes out of the aether, it's part of your compensation.

[snuxoll]

Yes, but taken in context it’s still a huge benefit. You have to keep in mind we have a lot of employees making much more median salaries, a medical biller or coder making in the mid 10’s to low 20’s an hour gets the same benefit I do as a $89K/yr DevOps engineer.

[mobilefriendly]

The injustice of the system is that self-employed have to pay with after-tax dollars while your employer can deduct the cost of providing those benefits.

[tptacek]

As I understand it (I hope I understand this, because I rely on it), LLC principals are allowed to deduct the cost of health insurance.

[mobilefriendly]

Unfortunately neither Christian Medishare nor our out-of-pocket health care payments are deductible.

https://www.medishare.com/blog/is-healthcare-sharing-tax-ded...

[tptacek]

Any HN conversation that starts out as a debate about Obamacare and ends up saving someone a few thousand dollars a year is a good conversation, so you are very welcome.

Health insurance prices are a nightmare. Please don't let me come off as sounding like I don't think they are. The goal of the ACA was fix that problem, and though it fixed some very important problems, it surely didn't fix that one.

[zitterbewegung]

I think personally that the ACA is a great step toward affordable health care. We really need ACA++ that would address these small issues but unfortunately we probably aren't going to get it passed within the near term.

Repealing really isn't an option (due to the near impossibility of repealing an entitlement) and the public doesn't want that either. I don't know how you would fix the issue that the loss ratios will be more skewed negative since the fact that sick people pay more attention than healthy people for insurance (even when you introduce tax penalties).

[mancerayder]

Interesting! Are there no other options available? This is clearly an inferior option for the self-employed. I'd go with another provider with a higher premium and without this curious shares thing. How is that legally not health insurance? Baffling. What state are you in?

[chrisweekly]

Tangent: people tend to fixate on "LLC" as if it were the only reasonable corp structure for small outfits. S-Corp is often a better choice.

[tptacek]

It's just the cheapest one to set up. I was assuming that if someone's self-employed and not deducting insurance, they're probably a sole proprietorship, and are probably sensitive to accounting costs.

[henrikschroder]

You can typically deduct 100% of your health insurance costs if you have a sole proprietorship. It doesn't matter how you're self-employed, as long as you have no other coverage and your business income funds the insurance, then you can deduct 100%.

https://www.irs.gov/publications/p535#en_US_2017_publink1000...

[chrisweekly]

No, that's one of the wrong assumptions / myths I'm pushing back against: LLC is _not_ necessarily the cheapest to set up. I'm the sole employee of my Massachusetts S-Corp, and it was both less expensive and better tax-advantaged.

[dustingetz]

my accountant never allowed me to do this in PA

[tptacek]

As I understand it, and your accountant is an expert while I am not, you have to be actually self-employed --- not moonlighting or doing side-work, with your money all coming in through the LLC --- and your spouse can't be eligible for group coverage through their job.

[dustingetz]

i was sole proprietor of my own pass through llc with no other income and single through oct 2017

[tptacek]

You should maybe ask your accountant why you couldn't deduct, then? I know there are conditions, but this is one of the better-known self-employment deductions.

[mancerayder]

I have the entirely opposite experience in NY. It's a Federal guideline though.

[mancerayder]

False, as a self-employed person you can consider this a business expense. I have for two years with no issues. One-person LLC.