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Posts Tagged ‘obamacare’

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.

Employers Keep Shifting Costs to Workers Under Obamacare

Wednesday, December 3rd, 2014

in these timesObamacare enrollment season is here again, and people with insurance through the Affordable Care Act’s marketplaces are being urged to look at their options.

It’s been a year since the exchanges originally opened. Despite spectacularly incompetent website design and poor management by the federal and many of the state exchanges, most of the glitches were finally resolved, and 7.3 million people signed up and paid for private insurance through the marketplaces.

Seven million more people also gained coverage under Medicaid in the past year—despite the fact that 23 states continue to refuse to accept federal funds to expand Medicaid to their own residents, affecting 11 million more Americans.

Late last year, the Labor Campaign for Single Payer posted our Briefing Paper, ”10 Things Unions Need to Look Out for When Bargaining Under Obamacare.” We asserted that, “because it relies on employment-based coverage to provide the lion’s share of healthcare insurance while, perversely, undermining key aspects of that coverage, we have concluded that the ACA will place new stresses and pressures on collective bargaining.”

Resources for Bargaining

Are you preparing to bargain health care? The Labor Campaign for Single Payer has just posted a new video, “How to Negotiate Healthcare under the Affordable Care Act,” a 30-minute tutorial for union activists and staff.

As we predicted, the assault on employment-based benefits continues unabated. A recent survey reports that 71 percent of Fortune 500 companies plan to raise employee contributions for their health insurance, and 73 percent have already moved or plan to move to so-called “consumer-directed health plans,” a fancy catchphrase for skimpy plans that shift costs onto the consumer.

In addition, 30 percent report that they plan to dump pre-65 retirees onto the health insurance exchanges, and 24 percent are moving to keep part-time hours under 30 per week. Employers are required to provide health insurance for all full-time employees (counted as those working 30 hours or more) or pay a penalty under yet-to-be-enforced ACA rules.

Walmart recently announced it was eliminating health care benefits for 30,000 part-timers who work less than 30 hours per week. It’s joined by dozens of other major corporations in the retail and hospitality industries who are eliminating employer-provided benefits for their low-wage and part-time workers.

These actions highlight the contradictory and unstable consequences of the ACA. Many of these workers may be able to access more affordable benefits in the health care exchanges, while Walmart gets away with a huge shift of its employment costs onto the backs of taxpayers.

Cost shifting isn’t only affecting low-wage workers. In Philadelphia, an unelected School Reform Commission unilaterally cancelled its contract with the Philadelphia Federation of Teachers, pulled out of the existing Health and Welfare Fund, eliminated retiree benefits, and imposed a 10 to 13 percent co-pay on working teachers.

Bargaining Advice

Unions are wrestling with the new bargaining environment created by the Affordable Care Act. The Labor Campaign for Single Payer understands that the only long-term solution is to take health care off the bargaining table by making it a right for everyone in America. In the meantime, we stand in solidarity with workers everywhere fighting to defend hard-won benefits.

Getting ready for contract negotiations? The Labor Campaign for Single Payer has just posted a new video, “How to Negotiate Healthcare under the Affordable Care Act,” a 30-minute tutorial for union activists and staff.

The video was prepared by the United Electrical, Radio and Machine Workers union (UE), based on their extensive bargaining experiences under ACA. It includes recommendations for contract language, as well as language to avoid.

Until we win single-payer Medicare-for-All, health care benefits will continue to be the biggest cause of strikes, lockouts, concession bargaining, and givebacks. We need to finish the job. The best way to guarantee health care for every worker is to guarantee health care for all.

This story was first posted at Labor Notes and then reposted on Inthesetime.com on December 2, 2014. Reprinted with permission. http://inthesetimes.com/working/entry/17409/employer_costs_obamacare

About the author: Mark Dudzic is National Coordinator of the Labor Campaign for Single Payer.

Nurse's Role Protecting Healthcare Law More Critical than Ever

Monday, October 13th, 2014

Dian PalmerIt’s already October and we are in full swing organizing, educating and mobilizing for Election Day. I am sure many of you are too with so much hanging in the balance!

Again, nurses find themselves in the familiar role of protecting and defending the ?Affordable Care Act. More and more evidence backs up what nurses already know–the healthcare law works. Thanks to the law, the number of uninsured Americans is expected to decline by nearly half from 45 million in 2012 to 23 million by 2023, according to a recent report from CMS actuaries. A new report from the Kaiser Family Foundation further shows the healthcare law is not only working for the millions who have coverage now, especially parents, but it is also working for the nation by slowing down spending on healthcare costs.

Nonetheless, the successes of the healthcare law does not mean the “Party of No” has given up on making Obamacare a polarizing issue in the midterm elections. Make sure you check out the 2014 Healthcare Law SEIU Member GOTV Toolkit to use for member outreach and education in advance of the election.

This blog originally appeared in SEIU.org on October 9, 2014. Reprinted with permission. http://www.seiu.org/2014/10/nurses-role-protecting-healthcare-law-more-critica.php

About the author: Dian Palmer has been a nurse for 25 years, and a member of SEIU for 17 years. “Before I joined SEIU, I was disgusted by the numerous abuses suffered as healthcare providers. We were forced to work for seven days in a row, required to do double-shifts, and had no voice in the workplace. I organized my workplace not for better wages, but because as a way to counter the abuses. Before SEIU, I thought we just had to deal with the hand we were dealt, joining a union gave us a voice and a platform to stand up for ourselves.”

Palmer is actively involved in improving working conditions and patient care. Currently, she is President of SEIU Healthcare Wisconsin and an Executive Board Member of SEIU. She is a member of the Milwaukee Chapter Black Nurses Association, and a Governor’s Appointee to the State of Wisconsin Minimum Wage Task Force. In addition, she serves as a member of the Democratic Party of Wisconsin Board, the UWHCA Public Authority Board of Directors and the Wisconsin Citizen Action Board of Directors.

GOP Pitch to Women: Forget Equal Pay, Let's Talk About Repealing Obamacare

Monday, March 31st, 2014

Laura ClawsonHeading into the 2014 elections, the Republican position on women’s votes and women’s issues is nothing so much as incoherent. They’re defensive about their poor record, so they want to rebut it, but they mostly seem to do so by dismissing every specific issue as a distraction from the real issues. When you get right down to it, the Republican position appears to be “we’re not worried about no stinkin’ women’s issues because OBAMACARE. And we really do care about women’s issues … like OBAMACARE. And besides, we’re not really running as women, but you may want to vote for some of us because we are women.”

For instance, Joni Ernst, a Senate candidate in Iowa, leads her bio with “Mother. Soldier. Conservative for U.S. Senate.” The word “mother” is all over her website. But she says she’s not running on gender:

“It would be historical, but it’s not part of my pitch,” she said of potentially becoming Iowa’s first female senator. “I don’t believe we should vote for somebody based on gender, we vote for the right person and I’m the right person to go to Washington, D.C.”“Of course I’m always very diplomatic in the way that I attack any issue and I think that’s appealing to women. Be straight-forward about [issues], but be compassionate, show them that this is something that really matters to Iowans, not just female but also males,” she said.

It would make history, but I’m not running as a woman, and I’m super diplomatic like a woman, but I’m not running as a woman, and I’m compassionate like a woman, but I’m not running as a woman, and did I mention I’m a mother, but I’m definitely not running as a woman.

So what about equal pay, an issue that women care about? Forget that, Republicans say, because Obamacare:

Republican pollster Kellyanne Conway said reminding both genders of the problems with the Affordable Care Act would trump Democratic attacks on the equal pay issue.“Republicans recognize that this is also the Democratic party’s latest attempt to cry ‘squirrel!’ so women in this country, who control two out of every three health care dollars that are spent and are disproportionately health care consumers and providers… divert their attention from the unspooling of Obamacare,” Conway said.

Ah, yes, the unspooling of more than six million private insurance enrollments, plus themillions covered by Medicaid expansion, plus young people who’ve been able to stay on their parents’ insurance. I think unspooling is what Republican arguments against the law have done. And how’s this as an argument for ignoring equal pay concerns? “Listen, ladies, we know you don’t want to be distracted by a little thing like equal pay. Let us explain how we’d like to take away your affordable health care.”

In the end, this may be one of the greatest (and admittedly one of the few) examples of Republican commitment to equal opportunity. For women, just as for men, their answer to everything is “repeal Obamacare.”

This article was originally printed on Daily Kos on March 31, 2014.  Reprinted with permission.

About the Author: Laura Clawson is the labor editor at the Daily Kos.

Florida Governor Inflates Cost Of Medicaid Expansion By 2,500% To Avoid Implementing Obamacare

Wednesday, January 9th, 2013

Internal email messages uncovered by Health News Florida reveal that Gov. Rick Scott (R-FL) is knowingly citing inaccurate cost estimates to justify his refusalto expand Florida’s Medicaid program. Though the governor’s office is fully aware that the numbers are wrong, Scott continues to use them anyway, the documents show.

Florida, which has one of the highest rates of uninsurance in the nation, could extend health coverage to about one million low-income residents by accepting Obamacare’s optional Medicaid expansion. But the governor — an ardent Obamacare opponent — has repeatedly said that expanding Medicaid would just be too expensive, claiming it would cost the state $26 billion over the next 10 years.

As Health News Florida reports, however, that figure from Florida’s Agency for Health Care Administration (AHCA) is inflated because it doesn’t take into account the full amount that the federal government will reimburse states for choosing to expand Medicaid. A more accurate analysis found that expansion would cost the state around $1 billion:

But those numbers are based on a flawed report, state budget analysts say. A series of e-mails obtained by Health News Florida shows the analysts warned Scott’s office the numbers were wrong weeks ago, but he is still using them. […]

The Act says the federal government will pay the lion’s share of the cost for new Medicaid eligibles if a state agrees to expand its program — a decision the Supreme Court left up to the states. The federal contribution for the new eligibles would be 100 percent between 2014 and 2016, then would taper after that to 90 percent by 2020 and stay there.

But the AHCA report assumes the federal match for the new patients would be much lower, about 58 percent. It came up with that by averaging the match amount over the past 20 years. The report doesn’t say why the authors made that assumption. […]

As Health News Florida reported on Dec. 21, the AHCA estimates were huge in comparison to a study released by the Urban Institute and Kaiser Family Foundation, two neutral research groups that specialize in Medicaid studies. Their study estimated that if Florida agreed to expand Medicaid, about 1 million uninsured people would gain coverage at a 10-year cost to the state of around $1 billion.

According to the email chain that Health News Florida obtained, state officials began calling the AHCA’s $26 billion cost estimate into question as early as December 20. One member of the House Health Care Appropriations Subcommittee even pointed out that, since the health reform law specifies that the federal government will help fund Obamacare’s Medicaid expansion, it would actually break Florida state law to expand Medicaid without using the federal dollars mandated for that purpose.

Nevertheless, Scott has continued to repeat his false claim that Florida can’t afford to provide its low-income residents with the health coverage they need. Scott met with U.S. Health and Human Services Secretary Kathleen Sebelius on Monday to express his concerns about what expanding Medicaid would mean for his state’s bottom line. “Growing government, it’s never free,” Scott explained to reporters. “It always costs money.” Just not as much money as Scott says it does.

This article was originally posted on Think Progress on January 8, 2013. Reprinted with Permission.

About the Author: Tara Culp-Ressler is an editorial assistant at ThinkProgress.org. Before joining Think Progress, Tara deepened her interest in progressive politics from a faith-based perspective at several religious nonprofits, including Faith in Public Life, the National Religious Campaign Against Torture, and Interfaith Voices. Tara first came to D.C. to study Communications and Spanish at American University, where she also wrote for the student newspaper and advocated for women’s issues on campus. She is originally from Lancaster County, Pennsylvania.

Wendy's Franchise Cutting Worker Hours to Avoid Obamacare, Despite Backlash to Other Chains

Tuesday, January 8th, 2013

An Omaha, Nebraska, Wendy’s franchise owner is joining the list of restaurants vowing to cut worker hours rather than have them qualify for employer-provided health coverage under Obamacare. That’s endangering the livelihoods of around 100 workers who are having their hours cut (managers, of course, are remaining full-time):

The company has announced that all non-management positions will have their hours reduced to 28 a week. Gary Burdette, Vice President of Operations for the local franchise, says the cuts are coming because the new Affordable Health Care Act requires employers to offer health insurance to employees working 32-38 hours a week. Under the current law they are not considered full time and that as a small business owner, he can’t afford to stay in operation and pay for everyone’s health insurance. There are 11 Wendy’s restaurants in the metro. “It has a huge effect on me and pretty much everybody that I work with,” says [hourly worker T.J.] Growbeck, who understands the reasoning and says other part-timers at other fast-food restaurants are facing the same problem. “I’m hoping that I can get some sort of promotion because then I would get my hours, but everybody is shooting for that because of the hours being cut.”

This Wendy’s owner has apparently not learned the lesson of Olive Garden and Red Lobster parent company Darden Restaurants, Papa John’s, or the Denny’s franchise owner who made similar plans, only to have Darden’s profits drop 37 percent in the wake of those threats, Papa John’s suffer in a brand reputation survey, and the CEO of Denny’stell the franchise owner to quit making the chain look bad.

And all of these threats to workers’ livelihoods are coming over what would be tiny increases if the costs were passed directly to customers. When Papa John’s CEO John Schnatter was trying to really scare people, he said his chain would pass along a 10 to 14 cent increase in the cost of a pizza—less than $22 a year if you ate Papa John’s three times every single week. But when Forbes‘ Caleb Melby did the math on Schnatter’s claims, it worked out to less than 5 cents per pizza. Mind you, all of the wailing these chain executives and franchise owners do about how they can’t afford health care is suspect to begin with. But when they’re not willing to contemplate even the smallest price increases rather than cutting already poorly paid workers down below 30 hours a week and risking what’s now been shown to be significant public relations costs, that’s a clear statement that this isn’t some kind of pure, rational business decision. It’s an ideological stance against anything that might benefit the low-wage workers on whom the fast food industry relies.

This post was originally posted on The Daily Kos – Labor Blog on January 8, 2013. Reprinted with Permission.

About the Author: Laura Clawson has been a Daily Kos contributing editor since December 2006. Labor editor since 2011.

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