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Posts Tagged ‘AHCA’

The House GOP health care bill is a job killer, says a new report

Wednesday, June 21st, 2017

 In addition to potentially increasing the number of uninsured by 23 million and being unequivocally unpopular, House Republicans’ Obamacare replacement plan could leave nearly a million people unemployed.

That’s according to a new study published Wednesday by the Milken Institute School of Public Health at George Washington University and The Commonwealth Fund projects, which finds that the U.S. economy could see a loss of 924,000 jobs by 2026 if the American Health Care Act (AHCA) becomes law.

The study concentrated on coverage-related and tax repeal policies included in the AHCA. Some of the key provisions it said could add to job losses would:

  1. Phase out enhanced funding for Medicaid expansion by restricting eligibility in 2020, and imposing either a block grant or per capita caps.
  2. Replace premium tax credits with age-based tax credits. The premiums can be five times higher for older individuals, compared to the current threefold maximum.
  3. Allow states to waive key insurance rules, like community rating and essential health benefits. (The study does account for the Patient and State Stability Fund, a $8 billion grant meant to relieve states of high-cost patients.)
  4. Eliminate the individual mandate tax penalty and premiums hikes for people who do not maintain continuous coverage.
  5. Repeal numerous taxes and tax increases, like a tax on high-cost insurance (i.e. the “Cadillac tax”).

Short-term gain, long-term pain

Federal health funding stimulates the economy and job creation. Health funds pay hospitals, doctor’s offices, and other providers, and these facilities pay for their own respective employees and other goods and services, like rent and equipment. Health care employees and private businesses then use their earnings to purchase consumer goods like housing and transportation, circulating this money through the larger economy.

The GWU study found government spending or subsidies stimulate the economy more than tax cuts. Tax cuts do help, but only in the short term. The way AHCA is set up is that the tax cuts take effect sooner than federal funding cuts, which is why some states see net job growth by 2018. Then, when federal dollars are eventually pulled, states begin to see job losses by 2026.

Who’s most affected:

The employment rate among states that expanded Medicaid eligibility could disproportionately be affected, because those states received more federal dollars. New York, a state that expanded Medicaid, could be among the hardest hit with 86,000 job losses by 2026.

Between April 2016 and April 2017, New York added 76,800 jobs and the educational & health services sector saw the largest job gains, at 46,600 jobs. “The Affordable Care Act [ACA] contributed to that [growth],” Ronnie Kauder, senior research director at the New York City Labor Market Information Service, told ThinkProgress.

Kauder emphasized that the ACA wasn’t solely responsible for New York’s job growth, even in the health care sector. Uncontrollable factors like the state’s growing aging population and increasing life expectancy contribute to job growth as well.

New York has reaped the employment benefits of comprehensive health care, said Kauder. That’s in part because ACA encouraged states to test new models of health care delivery and shifted from a reimbursement system based on volume of services to value of services.

For example, New York received ACA grant funding to test effective ways to incentivize Medicaid beneficiaries, who struggle with chronic diseases, to participate in prevention programs and change their health risks. With that grant, New York created new programs at existing managed care organizations, which required new hires. The grant created positions like care coordinators, who connect and follow-up up with patients and providers in the program, said Kauder. “They are heavy on the training, but not licensed professionals,” she said.

But while she attributed some of New York’s job gains to the ACA, Kauder was skeptical that the GOP replacement plan would kill as many of them as the GWU study projects. “We don’t know what the state response will be,” he said. “It could be worse in Kentucky.”

The largest health care provider in New York, Northwell Health, hires on average 150 people a week. Northwell chief public relations officer Terry Lynam told ThinkProgress he doesn’t think the ACA directly contributed to a spike in job growth; however, it did help expedite the provider’s move from hospitals to outpatient care centers, also called ambulatory care, in an effort to slow rising health costs.

“What [ACA] has done was contribute to the ambulatory net growth [by cutting costs],” said Lynam. Northwell Health has 550 outpatient locations.

Northwell Health has qualms with the House GOP bill; specifically its cuts to Medicaid and change in coverage rules. “We are in a stronger financial position to survive that kind of reduction in revenue,” said Lynam. “But what about small providers serving low income areas, who need those Medicaid [dollars]?”

This blog was originally published at ThinkProgress on June 15, 2017. Reprinted with permission. 

About the Author: Amanda Michelle Gomez is a health care reporter at ThinkProgress.

A Winning Week for Corporations and Wall Street—Paid for by Your Health and Retirement

Friday, May 12th, 2017

Corporations and Wall Street won big last week, and working people will pay a high price for it. Here are three things Congress did for Big Business that will harm working people’s health care and retirement:

1. 7 million fewer people will get workplace health benefits. Last Thursday, the U.S. House of Representatives passed the so-called American Health Care Act by a vote of 217-213. This is the bill that President Donald Trump and House Speaker Paul Ryan (R-Wis.) are using to repeal much of the Affordable Care Act and that will cut health coverage for some 24 million people. The U.S. Senate now has to vote.

Professional lobbying groups that represent employers, like the U.S. Chamber of Commerce, are behind this bill because it guts the Affordable Care Act’s requirement that large and mid-size employers offer their full-time employees adequate, affordable health benefits or risk paying a penalty. According to Congress’s budget experts, within 10 years, this bill will result in 7 million fewer Americans getting employer-provided health insurance. Corporate interests also like the huge tax cuts in the House bill, especially the $28 billion for prescription drug corporations and $145 billion for insurance companies.

Big company CEOs—the people who now earn 347 times more what front-line workers earn—are probably salivating over the huge personal tax cuts they will get from the Republican bill. One estimate is that those with million-dollar incomes will receive an average yearly tax cut of more than $50,000. The 400 highest-income households in the United States get an average tax cut of $7 million.

2. As many as 38 million workers will be blocked from saving for retirement at work. The Senate voted 50-49 last Wednesday to stop states from creating retirement savings programs for the 38 million working people whose employers do not offer any kind of retirement plan. The House already had voted to do this, and Trump is expected to sign off on it.

In the absence of meaningful action by the federal government, states have stepped in to address the growing retirement security crisis. But groups that carry water for Wall Street companies, like the Securities Industry and Financial Markets Association, have been actively lobbying Congress and Trump to stop states from helping these workers.

3. More than 100 million retirement investors may lose protections against conflicted investment advice. The House Financial Services Committee approved the so-called Financial CHOICE Act on a party-line vote last Thursday. It now goes to the full House of Representatives, and then to the Senate. In addition to gutting the Consumer Financial Protection Bureau that protects working people from abusive banking practices and ripping out many of the other financial reforms adopted after the 2008 financial crisis, this bill overturns key investor protections for people who have IRAs and 401(k)s. A massive coalition of Wall Street firms and their lobbying groups has been fighting to undo these retirement protections by any means possible.

About the Author: Shaun O’Brien is the Assistant Director for Health and Retirement in the AFL-CIO’s Policy Department, where he oversees development of the Federation’s policies related to Medicare, Medicaid, Social Security, and work-based health and retirement plans. Immediately prior to joining the AFL- CIO, he held several positions at AARP, including the Vice President for the My Money Portfolio and Senior Vice President for Economic Security. O’Brien holds a Bachelor of Arts degree from American University and a law degree from Cornell Law School.

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