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ADP's annual survey of health benefits for large employers reveals that just eight percent of part-time workers participate in their company health insurance plans, most because they can't afford the coverage on part-time wages. That's precisely the problem that the Affordable Care Act was intending to address—extending health care to the working poor—but is also one of the major challenges for the law. That's because employers are going to be figuring out whether to open their plans to more employees or to cut workers hours further to avoid having to provide coverage for them.

Companies that employ more than 50 full-time workers will be required by the law to offer coverage to their full-time employees or pay a $2,000 per uncovered worker fine. Some companies could decide that the $2,000 annually is cheaper than paying their share of a health plan for the employee, and pay the fine. But some companies instead are considering slashing hours for full-time (30 hours/week is considered full-time under the law) to skirt the requirement.

Employers that can't or don't want to add low-wage and part-time workers to their employee health plans are considering their options. [...]

One way to avoid the law's requirements is to reduce employees' hours to below the 30-hour threshold that marks them as full-time. Retail and food-service firms like Darden Restaurants, which owns the Olive Garden and other chains, have publicly weighed this approach, as have some universities and other employers.

The IRS is developing “anti-abuse rules” to discourage employers from trying to exploit loopholes; doing things like slashing full-time employees' hours so that they no longer meet the 50 full-time employee threshold. The rules will stipulate that "employers could still fall under the mandate if they employ enough part-time workers to equal 50 full-time workers." They will also prevent companies from using primarily temp workers in an effort to try to circumvent the law. But for some of these large employers, circumventing the law and screwing over their employees is just business as usual, so it'll be a challenge for regulators to close every possible loophole.

That will make the universal access to health insurance goal of the law harder to achieve, particularly in those states that refuse to expand Medicaid to cover more of the working poor.

Originally posted to Joan McCarter on Mon Feb 04, 2013 at 08:41 AM PST.

Also republished by Daily Kos Labor, In Support of Labor and Unions, Unemployment Chronicles, and Daily Kos.

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Comment Preferences

  •  Tip Jar (20+ / 0-)

    "There’s class warfare, all right, but it’s my class, the rich class, that’s making war, and we’re winning." —Warren Buffett

    by Joan McCarter on Mon Feb 04, 2013 at 08:41:30 AM PST

  •  The 50 employee rule is 50 FTEs (6+ / 0-)

    If you have 100 employees who each work 15 hours a week, that is the equivalent of 50 employees working 30 hours a week so that employer falls inside the ACA regulations. The FTE rule will prevent any large employer from skirting the rule. Where it will likely have an impact is in small businesses, or single restaurants, who employ slightly more than 50 employees and can adjust hours to fall under the 50 FTE requirement. On a separate note I do think you will see some companies, who now provide some level of healthcare coverage for employees, to toss all the employees on to the exchanges, and pay the fine.

    "let's talk about that"

    by VClib on Mon Feb 04, 2013 at 09:11:43 AM PST

    •  You're spot on. Mr. Mollie's company (a major (5+ / 0-)
      Recommended by:
      VClib, denise b, ferg, randallt, simple serf

      multinational corporation) said as much--though official word's not come down,yet--during the Oct-Nov 2012 "Open Enrollment" (health insurance) period.

      Mr. M would rather that I not "blab" his business all over the internet, so I won't name his company.  But I assure everyone, it would be 'beyond imagination' that any blogger at DKos would NOT know their name.  I just hope that a lot more of the very major companies won't jump in and drop their employees, and their families.

      The DKos community will be among the first to hear, if we are spared the axe, LOL!

      Frankly, I'd say that this is one reason that the ACA was not implemented before the Presidential election.  [In addition to court cases winding their way through the courts.]

      After all, Medicare was signed into law, and implemented in a year (almost to the day) in a era where computers were not even in play that much.

      I'd say that we haven't seen nothing, yet.  [Which is not to say, that years down the road, the ACA can and will be much improved, and therefore helpful to many folks.  As it stands today, however, it seems to mostly benefit small business folks, and young people ages 26 and younger.  Which is "good," as far as it goes.]

      Mollie

      "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

      "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

      by musiccitymollie on Mon Feb 04, 2013 at 09:53:14 AM PST

      [ Parent ]

      •  If companies do drop coverages (6+ / 0-)

        the ramifications will be huge.

        Number 1 it will rally a lot of people to the Republican "repeal Obamacare" side - Primarily those losing what they perceive to be good coverage that their employer pays for.

        If companies do drop insurance, and I have to ask myself, why wouldn't they jump at the chance to get the health insurance monkey off their backs, what will be interesting is to see what they do with the savings.

        According to this from the Bureau of Labor Statistics, health insurance accounts for approximately 8.2% of employee salary and benefits in private industry. According to this the average annual cost for individual employee health coverage annually is $8688.

        Let's assume the companies dropping the coverage pay the 2K per employee fine. That would still leave them almost $7000 PER EMPLOYEE in savings. What are they going to do with that 7K? If they turned around and simply gave it to each employee in the form of a raise, then that employee could apply it to the cost of a plan on the exchange. Plus there would be government subsidies for any employee for whom the cost on the exchange was more than 8% of their gross pay. So, the employees would probably be fine IF the employer transferred the savings to them.

        Now, raise your hand if you think that will happen. Ha! These savings will be hoovered up and delivered to the CEO's and upper management tier quicker than you can say "Bob's your uncle!" in my opinion.

        In my opinion, employer policies will be dropped and people will blame Obamacare. Many may vote for Republicans in the future because of this. This was all predicted during the healthcare debates, so it should be no surprise to anyone. If employers do drop coverage at high rates, Obamacare will have a very hard time keeping itself afloat because the demands for the subsidies will be greater than reckoned on.

        We could have been spared all this angst and drama if TPTB had simply defaulted to the much easier and much more obvious solution to covering America's uninsured - Medicare for All, an option to opt into the Government run single payer system we already have in place and just let it run parallel to the private system.

        The answer to stopping the employers from dropping coverage would have been to design the fine in a way that was punitive and not remunerative. The fine should have been the cost of current premiums so that the employer would have had no incentive to drop coverage.

        “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR

        by Phoebe Loosinhouse on Mon Feb 04, 2013 at 10:33:05 AM PST

        [ Parent ]

        •  I hope companies do drop (7+ / 0-)

          everyone.

          One of the unintended consequences of tying insurance to employment is that employers discriminate against older workers.

          The banks have a stranglehold on the political process. Mike Whitney

          by dfarrah on Mon Feb 04, 2013 at 12:25:46 PM PST

          [ Parent ]

        •  'Right on' that the ramifications will be HUGE! (2+ / 0-)
          Recommended by:
          shrike, HeyMikey

          Here's an excerpt from a piece entitled "CBO:  Obamacare Will Leave 30 Million Uninsured."

          Currently, accoriding to CBO, there are 53 million uninsured persons in the United States, including uninsured illegal aliens. The CBO estimates that in 2022--8 years after the Affordable Care Act has been fully implemented--30 million people will remain uninsured.

          Under Obamacare, 8 percent of legal U.S. residents will remain without health insurance in 2022, according to CBO.

          The report was done to assess the fiscal impact of the Supreme Court June Obamacare decision.

          Here's the link to the full piece.

          Mollie

          "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

          "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

          by musiccitymollie on Mon Feb 04, 2013 at 01:48:01 PM PST

          [ Parent ]

        •  May I suggest an alternative reaction? (2+ / 0-)
          Recommended by:
          DSPS owl, Odysseus

          If employers continue to cut back work hours so in order to avoid paying for healthcare, the public might instead react by  pushing for the COMPLETE ELIMINATION of the arbitrary distinction between having to provide benefits to full-timers, but not to part-timers.

          With the growth in computerized record keeping, there is no longer any logical reason that healthcare benefits shouldn't simply be proportional to the hours worked. Work 40 hours a week; get full benefits. Work 8 hours a week; get 20% benefits. And because there are additional costs for the employer to schedule a staff of part-timers, employers would have an incentive to offer full-time employment.

          A possible spin off could well be a reduction in the population of working poor, which would in turn reduce the demand for public assistance.

          Personally, that's what I'm hoping for. It would be better for employees, better for employers, better for the economy, and better for the nation.

          "The case, my friend, is that the world has been over-run with fable and creeds of human invention, with sectaries of whole nations against all other nations, and sectaries of those sectaries in each of them against the other." - Thomas Paine

          by carbonman1950 on Mon Feb 04, 2013 at 11:38:02 PM PST

          [ Parent ]

          •  Or even better, this whole crappy reaction (1+ / 0-)
            Recommended by:
            Odysseus

            and response by some employers could lead us to finally sever the tie between employment and health coverage.

            I know those who had "Cadillac" coverage may scream, but I think the private for profit insurers could focus their markets on niche healthcare markets, perhaps supplemental policies that the wealthier can purchase to up their level of healthcare back up to "Cadillac" status. It is inevitable that one will get the healthcare they can afford and a 2 tier system will develop as in England.

            “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR

            by Phoebe Loosinhouse on Tue Feb 05, 2013 at 05:13:41 AM PST

            [ Parent ]

      •  My company (1+ / 0-)
        Recommended by:
        musiccitymollie

        Also a very large international and I am also keeping eyes peeled for the axe...
        Jacked up all the deductibles, everyone (w/family) needs to meet almost 5K before any insurance kicks in.

        Basically all the plans do now is cover you in case of a major medial crisis

        My wife (smaller company) said next year her company will just give everyone some money and they are all on their own to find health insurance.

        sigh

    •  VClib, Large employers are not required to offer (1+ / 0-)
      Recommended by:
      HeyMikey

      health insurance to part time employees regardless of company size.  The incentives in the law for large businesses are to convert current full time employees who do not currently get health insurance to part time, as there is no penalty for not providing insurance for these employees.

      The purpose of the "Full Time Equivalent" employee is to determine if the business is under small company rules or large company rules under PPACA.

      See my more detailed comment below.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Mon Feb 04, 2013 at 11:42:11 AM PST

      [ Parent ]

  •  Just one more reason why linking access to (15+ / 0-)

    health insurance to employment is stupid and has always been stupid. We are the only stupid country that does it.

    And once again, for the 2 billionth time I have to wonder why business itself isn't leading the push for a single payer system. Why do they want all these headaches? Why should providing access to health insurance be their responsibility in the first place? Why should their bottom lines be burdened with the cost of health care?

    Healthcare and access to it is a fundamental societal NEED. Once a country is wealthy enough to function like all the industrialized modern countries, it should be recognized as a RIGHT.

    The ACA is a beginning, but health insurance capped at 8 0r 9% of income will STILL be unaffordable for a great many people living paycheck to paycheck. While many currently uncovered will be helped, one of the big shocks when it's fully implemented will be the number of people it DOESN'T help due to the affordability factor.

    There will be a large group of low wage workers,who will make too much to be covered by Medicare, but they won't make enough to cover themselves with Obamacare. And then of course, the unemployed will also fall through the cracks.

    “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR

    by Phoebe Loosinhouse on Mon Feb 04, 2013 at 09:15:33 AM PST

    •  Phoebe, please read the excerpt and IHT article (2+ / 0-)
      Recommended by:
      Tinfoil Hat, ahumbleopinion

      that I've linked to.

      The 9% is linked ONLY TO the cost of individual group health policies, not the MUCH MORE EXPENSIVE family policies.

      So, many more folks than you're referring to, will not be able to afford health insurance, and /or will not qualify for "subsidies."

      Here's an excerpt:

      [H/T to Lambert at Corrente.]

      Editorial:  A Cruel Blow to American Families

      Published: February 2, 2013

      The Internal Revenue Service has issued a hugely disappointing ruling on how to calculate the affordability of health insurance offered by employers. Its needlessly strict interpretation of the Affordable Care Act could leave millions of Americans with modest incomes unable to afford family coverage under their employers’ health insurance but ineligible for subsidies to buy coverage elsewhere. . . .

      Both the I.R.S. and the Congressional Joint Committee on Taxation have interpreted the law to consider only the cost of covering the individual employee in calculating the 9.5 percent, not the much higher cost for a family plan. . . .

      There is no doubt that this pinched approach will put a significant number of workers and their dependents in a bind. A Kaiser Family Foundation survey found that in 2012, employees’ annual share of insurance premiums averaged $951 for individual coverage and $4,316 for family coverage. Under the I.R.S. rule, such costs would be considered affordable for an employee with a household income of $35,000 a year — making the employee’s spouse and children ineligible for a public subsidy on a health exchange, even though that family would have to spend 12 percent of its income for the employer’s family plan.

      Please folks, if any of this could apply to you or yours, take time to check out this entire article.

      Does anyone (Joan, whomever) know WHY they didn't try to amend the ACA, or issue an executive order to ameliorate this situation?  Families USA and other health care advocacy groups have been screaming about this since the law passed in 2010.  So, it's not like no one was aware of the situation.

      Mollie

      "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

      "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

      by musiccitymollie on Mon Feb 04, 2013 at 10:06:51 AM PST

      [ Parent ]

      •  musicc - my guess is that this is how the CBO (2+ / 0-)
        Recommended by:
        musiccitymollie, Pluto

        scored the ACA and the budget for the program does not include helping families with premium support. This is a guess but the only thing I can think of.

        "let's talk about that"

        by VClib on Mon Feb 04, 2013 at 10:34:13 AM PST

        [ Parent ]

        •  Sounds logical to me, VClib. You're (1+ / 0-)
          Recommended by:
          VClib

          probably right.

          Mollie

          "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

          "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

          by musiccitymollie on Mon Feb 04, 2013 at 12:24:06 PM PST

          [ Parent ]

          •  Familes WILL get premium support under the ACA (3+ / 0-)
            Recommended by:
            VClib, peregrine kate, HeyMikey

            The families being discussed who won't are those where there is employer provided coverage, but they can't afford it, but the very fact that employer coverage is available makes them ineligible for the exchanges and the ACA subsidies. These families fall through the cracks. This really needs to be corrected.

            For a long time employers used to offer even family coverage to their employees, but rising costs made many of them decide to pay for only the employed individual and then family coverage was that individual's option to pay at their own expense.

            The exchanges and subsidies are supposed to be for those who currently are not eligible for employer health coverage, small businesses who have not been able to offer health coverage previously, and the self-employed and the unemployed.

            As an idea of what family coverage under the ACA looks like: here

            Notice how this theoretical family of 4 making 40K gross a year STILL can pay 6K a year under the ACA even WITH the subsidies if they max out on deductibles and co-pays. Compare that to a family in British Columbia who pays 1200 a year for everything under the Canadian system. That's why I always say the the ACA can only be considered to be a STEP in the right direction, but it's hardly the entirety of the reform that is needed.

            “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR

            by Phoebe Loosinhouse on Mon Feb 04, 2013 at 12:41:06 PM PST

            [ Parent ]

            •  Well, yes, I understand that many other families (0+ / 0-)

              who make below 400% of FPL, and who don't fall into this category, will receive subsidies.  Actually, aside from excerpting the article and providing the link to it for clarification, I did qualify using "many folks," when I referenced the particular situation that the article discusses.

              I apologize if I was unintentionally misleading.  I guess that I expected the actual piece to further explain, or clarify, the particular "glitch" in the law.

              Thanks for all your good information on this topic.  I had quit following this topic for a while, but now that our insurance is on the line, will definitely start paying closer attention to "news" about the ACA.

              Mollie

              "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

              "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

              by musiccitymollie on Mon Feb 04, 2013 at 01:57:49 PM PST

              [ Parent ]

    •  Phoebe - why employers don't support single payer (4+ / 0-)
      Recommended by:
      nextstep, musiccitymollie, Pluto, HeyMikey

      No one has outlined a plan to pay for single payer that guarantees employers it will save them money. Employers now believe, rightly or wrongly, that if we went to a single payer plan through some combination of fees or taxes they would pay more than they do now. One other factor is that the people who make decisions at major corporations have true Cadillac coverage, and access to the best medical care the US can provide. They worry that under a single payer program their special access to the best care would be compromised.

      If someone put together a single payer plan where businesses paid significantly less than they did today, and like the UK there was a separate private pay system available for the wealthy, I think you could see a groundswell of business executives who would support it.

      "let's talk about that"

      by VClib on Mon Feb 04, 2013 at 10:31:10 AM PST

      [ Parent ]

      •  Business could potentially support single payer (1+ / 0-)
        Recommended by:
        Rube Goldberg

        if it was done in a way that would very clearly significantly reduce the share of GDP being spent on healthcare - the exception would be businesses closely tied to healthcare.

        The most important way to protect the environment is not to have more than one child.

        by nextstep on Mon Feb 04, 2013 at 11:51:26 AM PST

        [ Parent ]

        •  nextstep - I think that's an additional issue (1+ / 0-)
          Recommended by:
          DSPS owl

          To really shift the cost curve will require two key changes.

          1. A dramatic increase in the number of primary care physicians which requires expansion of our medical schools and support for medical students with primary care residencies so they have no/lower debt after they graduate. We need to change the fundamental supply v demand of physicians and patients. Expanding our supply of nurse practitioners and physician assistants can help, but we need many more doctors.

          2. A change in our decades old custom of teaching and practicing defensive medicine.

          Without those changes, which will take commitment, resources and time, people will be tinkering with the "price" of healthcare, but we aren't going to shift the actual cost of providing care in any material way. Single payer might provide enough savings to provide care to the currently uninsured, but we will still be in the same fundamental position as we are now.

          "let's talk about that"

          by VClib on Mon Feb 04, 2013 at 01:54:35 PM PST

          [ Parent ]

      •  Nailed it twice in the same thread. Is there an (1+ / 0-)
        Recommended by:
        VClib

        award for that, LOL!

        Seriously, "One other factor is that the people who make decisions at major corporations have true Cadillac coverage, and access to the best medical care the US can provide. They worry that under a single-payer program their special access to the best care would be compromised," sums it up, as well as I've ever seen it parsed out.

        I rarely see articles on "designer drugs," anymore.  But for a while, there was a spate of them.  And I believe that this is another reason that the PtB don't want Medicare-For-All, or any system that treats all Americans the same.

        I can't recall all the details, but apparently there are several designer drugs that have been developed, that can considerably prolong life, even for those terminally ill, but at a cost of "a cool million dollars" or so, a year!

        Anyway, I suspect that this is one reason that the PtB took a single-payer (equalitarian-type) plan off-the-table.  Whereas most of us "common folk" are not even particularly aware of designer drugs, in time, their cost will surely drop, and their use will be more common.  Which, in turn, will run up the cost of medical treatment considerably (as many of the run-of-the-mill drugs have already done).

        Just my Two Cents . . . (and idle speculation, for sure).

        Mollie

        "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

        "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

        by musiccitymollie on Mon Feb 04, 2013 at 01:15:40 PM PST

        [ Parent ]

      •  VClib, that has been done time and again: (8+ / 0-)
        If someone put together a single payer plan where businesses paid significantly less than they did today....
        Every country with national health care is a living example for them.

        From the perspective of the economics of global trade -- businesses in the US come into the global marketplace with a 15 to 20 percent cost hit when they compete with nations with national health care.

        For some reason, Americans do not have the neurotransmitters that allow them to hear, process, or retain this information. I have cited it dozens of times.



        Denial is a drug.

        by Pluto on Mon Feb 04, 2013 at 02:39:30 PM PST

        [ Parent ]

        •  Pluto - I have never seen the detail (1+ / 0-)
          Recommended by:
          Pluto

          In countries with single payer programs its my understanding that in some countries employers pay a portion of the cost and employees pay a portion. In other countries the single payer is paid from general tax revenues, however in those countries both total actual taxes and effective tax rates paid by both employers and employees are higher than in the US.

          I haven't seen a US single payer model that would demonstrate that the total tax burden to employers would decline with the implementation of single payer in the US. If such proposals and business and tax models exist they haven't received broad distribution because I think they would be well received. If you could keep the effective US corporate tax rate the same and allow employers to offload healthcare costs, it's hard to see why corporations wouldn't embrace that program. Corporations are about after tax cash flows and if you are lowering costs, and not raising taxes, they should like that.

          "let's talk about that"

          by VClib on Mon Feb 04, 2013 at 04:52:23 PM PST

          [ Parent ]

          •  I agree with your logic. (1+ / 0-)
            Recommended by:
            tb mare

            In nations where employers participate in sharing costs of keeping the working stock alive -- they pay a tax equal to a percentage of the total amount paid to all employees. For example, 7 percent. Employees pay a percentage of wages earned, as well, incorporated as income tax. In all cases, we know that such nations enjoy superior health care outcomes at one-third the costs of the US.

            According to deeper analysis of this conundrum -- in the New Yorker, for example -- you'll find the Boards of Directors of the big capitalist employers cross pollinated with the Boards of Directors of the mega health insurers and Wall Street casino operators -- where the health care premium pool is the biggest player in the room.

            That's how everything works in predatory capitalism.

            But like I said:  The victims do not have the neurological array to process such information. Even when it's right out there in the open, as this is.



            Denial is a drug.

            by Pluto on Mon Feb 04, 2013 at 06:09:54 PM PST

            [ Parent ]

          •  Regarding effective tax rates on businesses (2+ / 0-)
            Recommended by:
            peregrine kate, tb mare

            ...in nations that provide human rights, such as health care and a guaranteed living wage to all workers, regardless of the job -- the costs of for-profit US health insurance that is paid by US employers is not part of the effective tax rate figures.

            Thus you cannot compare effective tax rates between the US and human-rights-granting nations -- using employer's health care cost participation as a common denominator.

            The fact remains, that US made widgets or cars have a 15 percent cost ding going into the global market place because of the health insurance cartel. But it's all made good on the executive back-end via the nation-killing tax loopholes and health insurance deductibles.



            Denial is a drug.

            by Pluto on Mon Feb 04, 2013 at 06:37:56 PM PST

            [ Parent ]

            •  I am just trying to understand this from the corps (1+ / 0-)
              Recommended by:
              Pluto

              perspective. If we held all the other variables (revenues, GOGS, etc) static, except for taxes and healthcare costs, and we lined up two identical companies in the UK and the US. Which one would have the higher after tax cash flow?

              "let's talk about that"

              by VClib on Mon Feb 04, 2013 at 07:36:56 PM PST

              [ Parent ]

              •  All I can tell you is that it is a fact (1+ / 0-)
                Recommended by:
                HeyMikey

                ...US producers take a 15 to 20 percent ding in the global marketplace.

                You can see it yourself. Just fill in the red line over the US to represent the additional costs of health insurances that are already incorporated in the UK line representing effective tax rates (2009):

                Clearly, there are getting something else they want on the back-end.

                There have been a few papers on this. Look it up.



                Denial is a drug.

                by Pluto on Mon Feb 04, 2013 at 07:57:19 PM PST

                [ Parent ]

    •  Not only stupid and cruel (6+ / 0-)
      ...linking access to health insurance to employment is stupid and has always been stupid. We are the only stupid country that does it.
      ...but violates the UN Declaration of Human Rights Treaty -- which all modern constitutions have incorporated:

      Health care is a human right.

      Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
      The US Constitution directly confers no human rights upon the American people.

      Tying health care to jobs is an artifact of slavery and must be made illegal before Americans can enjoy national health care.



      Denial is a drug.

      by Pluto on Mon Feb 04, 2013 at 02:21:54 PM PST

      [ Parent ]

  •  We're going about this all wrong. (12+ / 0-)

    Health insurance should not be tied to employment.  Period.  I always take a deep breath when people talk about the number of children uninsured.  Well, they don't work, do they?  

    This diary highlights why the private sector can not be trusted for something as important as access to health care.  It's not their business.

    The private sector is in the business of making money.  It's their sole motivation.  As a business owner I completely understand why these businesses are trying to cut costs.  You don't get a cookie for doing the right thing in business.  You only do the right thing when it means more profit at the end of the day.  And let's face it when we buy a product or a service the way the company treats it's employees isn't even a factor for most us because unless we work there how will we really know?

    Sure some companies have politicized their unwillingness to go along with the spirit of the law and damaged their brand in the process.  But most of them are doing what businesses do - quietly cutting costs at the employees' expense.

    •  Hear, hear! Hushes. N/T (0+ / 0-)

      Mollie

      "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

      "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

      by musiccitymollie on Mon Feb 04, 2013 at 10:07:34 AM PST

      [ Parent ]

    •  There are financial advantages to big companies. (2+ / 0-)
      Recommended by:
      shanesnana, musiccitymollie

      They get a tax deduction for providing the insurance which their employees do not have to claim as income.  They use their clout to negotiate low prices from providers that benefit their employees and lower the bill for the company.

      Providing health insurance is a bit of a golden handcuff for companies to attract and hold their best employees.  Talented employees who might otherwise leave to start a business, move to a small company, or even stay at home with their kids for a few years continue working for an employer that provides health insurance.

      “The future depends entirely on what each of us does every day.” Gloria Steinem

      by ahumbleopinion on Mon Feb 04, 2013 at 10:34:38 AM PST

      [ Parent ]

      •  The benefit is to the employees (2+ / 0-)
        Recommended by:
        nextstep, Pluto

        It makes no sense from a tax policy perspective that health insurance costs paid by your employer isn't income. The key benefit is to the employees. There is some handcuff associated with employer provided health insurance, but that relates primarily to families with preexisting conditions or other older or uninsurable family members.  

        "let's talk about that"

        by VClib on Mon Feb 04, 2013 at 10:39:15 AM PST

        [ Parent ]

        •  Well, tax policy perspective aside, LOL, I (1+ / 0-)
          Recommended by:
          peregrine kate

          am definitely in the camp of continuing to allow the employer paid premium (portion) to be "shielded" from being taxed as employee income.

          And part of the reason is because that in many instances (certainly for many union folks), this tax expenditure is part of an employees negotiated pay package, and represents a sort of indirect compensation.

          If the Dems want to lose in 2014, and 2016, just let them take this tax exemption away from the masses.  Political suicide, I say!

          {This, on top of the "catastophe" that the ACA is beginning to look like for some folks--like moi, LOL!  I don't know, but I believe that they should really think twice about it.}

          I know that I'll be shouting it from every roof top, if they pull it off.  

          It's part of the Bowles-Simpson proposal, of course.  So, I bet that both the corporatist Dems and Repubs are angling for it!

          You know, taking away this tax expenditure would much more adversely impact the working and middle classes, than even the mortgage interest tax exemption.

          I guess time will tell.

          Mollie

          "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

          "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

          by musiccitymollie on Mon Feb 04, 2013 at 02:27:37 PM PST

          [ Parent ]

        •  The benefit is also to the employers because (3+ / 0-)
          Recommended by:
          musiccitymollie, VClib, Pluto

          they can essentially pay their employees with discounted money - the health insurance is more of a benefit to the employee than it costs the employer which is not the same as regular salary.  The clout to squeeze providers makes it even more valuable to the employee with minimal cost to the employer.

          “The future depends entirely on what each of us does every day.” Gloria Steinem

          by ahumbleopinion on Mon Feb 04, 2013 at 03:35:57 PM PST

          [ Parent ]

  •  Question to Anyone: Does the ACA make it (1+ / 0-)
    Recommended by:
    Pluto

    "mandatory" for physicians to accept all Medicaid beneficiaries as patients?  

    Or, is it still left up to the physician's discretion?

    Thanks.

    Mollie

    "Only he who can see the invisible, can do the impossible." --Frank L. Gaines

    "If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

    by musiccitymollie on Mon Feb 04, 2013 at 10:18:00 AM PST

  •  Joan, your source made an important error. (6+ / 0-)

    Diary says:

    Companies that employ more than 50 full-time workers will be required by the law to offer coverage to all of their employees or pay a $2,000 per uncovered worker fine.
    There is no requirement to offer health insurance to part time employees regardless of company size. The 50 "Full time Equivalent" issue is only to determine if the business is subject to the rules for small companies or large companies as defined in PPACA.

    The actual penalty calculation is more complex than $2000 per uncovered employee.

    See this in the actual text of PPACA at http://housedocs.house.gov/...

    Go to the page 155 as marked on the top of the page, not pdf page. for Section marked "‘‘SEC. 4980H. SHARED RESPONSIBILITY FOR EMPLOYERS REGARDING
    HEALTH COVERAGE"

    ‘‘SEC. 4980H. SHARED RESPONSIBILITY FOR EMPLOYERS REGARDING
    HEALTH COVERAGE.

    ‘‘(a) LARGE EMPLOYERS NOT OFFERING HEALTH COVERAGE.—
    If—
    ‘‘(1) any applicable large employer fails to offer to its fulltime
    employees (and their dependents) the opportunity to enroll
    in minimum essential coverage under an eligible employersponsored
    plan (as defined in section 5000A(f)(2)) for any
    month, and

    ‘‘(2) at least one full-time employee of the applicable large
    employer has been certified to the employer under section 1411
    of the Patient Protection and Affordable Care Act as having enrolled
    for such month in a qualified health plan with respect
    to which an applicable premium tax credit or cost-sharing reduction
    is allowed or paid with respect to the employee,

    then there is hereby imposed on the employer an assessable payment
    equal to the product of the applicable payment amount and
    the number of individuals employed

    The most important way to protect the environment is not to have more than one child.

    by nextstep on Mon Feb 04, 2013 at 11:35:19 AM PST

  •  ACA is such (0+ / 0-)

    a waste of time and money.  What an administrative headache.

    Of course it will be cheaper to pay the fine than to insure employees. $2000 is only 166 per month.

    And I can't wait to get fined for not buying insurance.

    The banks have a stranglehold on the political process. Mike Whitney

    by dfarrah on Mon Feb 04, 2013 at 12:22:15 PM PST

    •  That $90 per year tax penalty (3+ / 0-)

      ...assures you that you can buy insurance when you get sick or critically injured. No questions asked.



      Denial is a drug.

      by Pluto on Mon Feb 04, 2013 at 02:31:47 PM PST

      [ Parent ]

      •  ? I don't see the logical consistency here (1+ / 0-)
        Recommended by:
        Pluto

        between your earlier posts and this one--unless the exchanges will be open to ALL who are otherwise uninsured, and premiums will be set at a reasonable cost. I seem to recall some indication that older folks can be expected to pay up to three times the rate a younger person would be charged. That may be fine from an actuarial point of view, but it doesn't make it affordable.

        Some DKos series & groups worth your while: Black Kos, Native American Netroots, KosAbility, Monday Night Cancer Club. If you'd like to join the Motor City Kossacks, send me a Kosmail.

        by peregrine kate on Mon Feb 04, 2013 at 06:47:06 PM PST

        [ Parent ]

        •  The question is not about affordability (0+ / 0-)

          ...as I read it, Kate.

          This may be someone with assets who can afford to buy insurance -- but chooses to pay the $90 penalty (year one) instead.

          Should that someone suddenly develop a chronic illness like diabetes -- at that time, they can buy insurance and be covered.

          Sometimes, we think the exchanges are about affordability. But they are designed to serve ALL people who can afford insurance. No one will be turned away. Not even part time workers (with big commissions). No one will be blocked from buying insurance. Now or when they get sick. That's actually an improvement, since people who can afford standard insurance are currently blocked due to a wart they had when they were seven years old, etc.

          There will be three age level prices -- but one is not three times higher than the other. They are much more modest.



          Denial is a drug.

          by Pluto on Mon Feb 04, 2013 at 07:05:03 PM PST

          [ Parent ]

  •  The day when the number of medical bankruptcies (5+ / 0-)

    ...filed in the United States equals zero -- is the day when you can say that there is a national health care plan in place.

    Nations with national health care do not have medical bankruptcies.

    Until then, you have a profit-churning, asset-stripping health care system which cannot control costs and which will do one of two things:

    1)  Drag out the day of default/collapse for as long as possible.

    2)  Allow the nation to hit bottom as quickly as possibly, so that it wakes up and takes care of its people.

    The Association of Family Practitioners predicts that premiums will equal 100 percent of family income by 2030 under the ACA.



    Denial is a drug.

    by Pluto on Mon Feb 04, 2013 at 02:51:26 PM PST

  •  AKA why high unemployment is a feature, not a bug (4+ / 0-)
    Recommended by:
    peregrine kate, coral, Pluto, DSPS owl

    With unemployment so high, it's easy for employers to put people on as part-time workers without benefits. People are willing to take what they can get. It's an employer's job market these days.

    "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

    by xaxnar on Mon Feb 04, 2013 at 06:27:09 PM PST

  •  My wife's company is one of the good ones (1+ / 0-)
    Recommended by:
    Pluto

    My wife is a massage therapist by trade.  In her business, the physical nature of the work means that it is damn near impossible to have a full-time, 40-hour a week job with a spa or other service.  At most, she'll be scheduled for about 24 hours during the week, and she'll actually give about 16 - 20 hours of massages in that time.  Because of this, she has never worked for a company that has even bothered to offer benefits of any kind to these permanent part-time staff.

    When we moved to Los Angeles, though, she got hired by a well respected, though very high-end (read: expensive) group in and around SoCal.  We were amazed that they offered ALL employees, full-time and part-time, the ability to purchase health and dental insurance.  The premiums were on the expensive side, but the coverage seemed pretty good for what you paid for.  

    Ultimately, we have insurance through my work (which is a much larger international company), but we were very impressed that the owners of her spa went this extra mile even before the law said they had to.

    "If you don't stick to your values when tested, they're not values! They're hobbies" - Jon Stewart

    by LivingOxymoron on Mon Feb 04, 2013 at 06:30:31 PM PST

  •  My nephew works for Carrs/Safeway Alaska... (2+ / 0-)
    Recommended by:
    Pluto, Odysseus

    ...Safeway is a huge employer, but even if an employee is part-time they still get covered. Not the greatest insurance, but far better than nothing.  Walgreens is another one who provides pretty good insurance. They paid for my brother's liver transplant, in total. His wife is a stocker/cashier.

    Generally I don't care for most corporate entities. But there are some good guys out there.

    "Wealthy the Spirit which knows its own flight. Stealthy the Hunter who slays his own fright. Blessed is the Traveler who journeys the length of the Light."

    by CanisMaximus on Mon Feb 04, 2013 at 06:34:47 PM PST

  •  This is such a waste (2+ / 0-)
    Recommended by:
    DSPS owl, tb mare

    of time and effort just to keep the insurance industry in business. Someday we'll have Medicare for all I guess...

  •  This Can Be Fixed (5+ / 0-)

    The way to fix it is with nationwide publicly-funded healthcare. The federal government should pay for all essential healthcare out of a progressive tax. Problem fixed. That's it. That's all. That's the whole story.

  •  This is a pisser because it's unnecessary (3+ / 0-)

    We own a small business and have ALL part-time employees. We can testify it is possible for almost any small business to offer health insurance at small or no cost to the employer.

    Because we need health insurance ourselves and so we also offer it to our employees on a small business group plan. We only pay for a small part of their coverage, they pay the rest. (I wish we could pay more.) But the rates they pay with our plan are far lower than they would be for them as individuals and in many cases they would not have gotten insurance at all as individuals in the past because of pre-existing conditions.

    Now our costs and their costs for this have been going up like crazy. And so we are waiting for Obamacare 2014 and the exchanges, oh yes we are, because our choice of plans is limited.

    But it is just sheer mean and greed that keeps employers from offering some insurance for their employees. It only takes TWO employees for a group plan, even if they are part-time. And if you are a small business owner likely you do need insurance for yourself anyway, so that means only ONE other employee. You don't even have to pay for it all but you can still give your part-timers coverage and a rate advantage with a small business plan.

  •  Medicare for all (3+ / 0-)
    Recommended by:
    musiccitymollie, Pluto, holocron

    That's the solution waiting for those with courage to persist until it is done.

    Why employers aren't pushing for this is beyond me. It's ideological not economically-based position for employers to oppose single-payer system that is separate from job.

    How to pay for it? Medicare tax on both employees and employers. If it were progressive it would be great, but even a flat percentage would be better than what we have now.

    All physicians should be required to accept Medicare.

    Skepticism of all the elite institutions, not trust, is what required for successful leadership in this era. Digby

    by coral on Mon Feb 04, 2013 at 06:56:29 PM PST

  •  There could be a silver lining (2+ / 0-)
    Recommended by:
    Pluto, Odysseus

    maybe not a very bright one, but...

    If a company has 50 employees working 40 hours a week and cuts them all back to 20 hours, then they need 50 new employees.  It sucks for the people who have their hours cut, but it could mean a huge boost in jobs. If 20 - 29 hour work weeks become the norm, then the economy will adjust to support it. People will be able to demand higher wages, because there wouldn't be a surplus of workers anymore.

    In a few years it should come into equilibrium and people will be making the same living working fewer hours. Maybe.

    •  In a practical sense (1+ / 0-)
      Recommended by:
      Odysseus

      ...you are quite right. 29 hours can keep a family together and in their homes. A lot more of those jobs would be a godsend.

      (Also, with robotics and automation, fewer people hours are required to sustain life.)



      Denial is a drug.

      by Pluto on Mon Feb 04, 2013 at 07:15:06 PM PST

      [ Parent ]

  •  Corporations were using adverse tactics... (1+ / 0-)
    Recommended by:
    Odysseus

    ...back in the 90s to get around covering some workers health benefits coverage...such as hiring temps vs f/t employment. This was two fold benefit for corps because if temp worker was hired on f/t and temp came from agency corps had to pay 'finders fee'.  Some corps would go so far as "tell" temp worker to pay finder's fee or they would let the temp go while knowing they would hire same temp in different position short while later...etc.. All in the name of cost savings while the hourlys  were putting in controlled hours to keep them from going too far into overtime catagory.  Back then, unions watched closely for white-collar / admin hourlys clocking too many o/t hours...then would negotiate  for additional hires vs o/t.  Funny thing, union rarely would complain about too much o/t for factory workers o/t hours.  Point is, corps have always looked for ways to minimize "overhead" costs.  But rarely did that thinking transend above mid-mgmt level.  just saying

    Our nations quality of life is based on the rightousness of its people.

    by kalihikane on Mon Feb 04, 2013 at 07:03:32 PM PST

  •  Employment increase (0+ / 0-)

    There is a valet company that has 1000 employees most are part-time at appox 34 hours a week. They have determined they can not afford to add healthcare so are planning on reducing employee hours to 28hr/wk in effort to skirt the ACA. doing the math, they will have to increase their number of employees by 20% to cover the reduced p/t hours. the dollar loss to the existing employees will be appox 6%
    Granted these minimum wage jobs are not the best way to reduce the US employment rate,but combined with an increase in the minimum wage it may be a good bump for the economy.

  •  Why are we pushing for employer coverage? (3+ / 0-)
    Recommended by:
    denton310, DSPS owl, holocron

    I'm one of those part-time workers who is offered coverage but it isn't subsidized as much for us, so it's much too expensive. I am looking forward to having better access to a more affordable policy through the exchanges.

    Seems to me that if a lot of employers vote with their feet against covering people, that provides a powerful push for putting everyone into the exchanges which starts looking more and more like single payer, or at least a viable public option.

    I see this as a plus.

    It also avoids all the issues about employers imposing their beliefs about contraception, same-sex marriage, or whatever on their employees.

    Pushing hard to keep insurance as an employer responsibility seems to me retrograde -- guaranteed to alienate especially smaller businesses, wasting a lot of time and resources, and keeping us all locked into the insane system where health insurance is linked to employment.

    Instead, why not push for a deal: give your employees a living wage, and we'll buy our own insurance through the exchanges.

  •  A Certain national bookstore chain... (0+ / 0-)

    ...used to offer health insurance to part-time workers, but they announced one year ago that they will no longer do so. They also announced that part-time employees then covered would be able to keep their coverage until the end of 2013, at which time they would be dropped.

    Meanwhile, the company has drastically reduced its full-time hires, actively pushing stores to hire only part-time.

    In other words, they are weasling out of providing health insurance for the vast majority of their workers, and I see nothing in the law or the IRS regulations that will change that.

    "The people have only as much liberty as they have the intelligence to want & the courage to take." - Emma Goldman

    by DebtorsPrison on Mon Feb 04, 2013 at 07:33:28 PM PST

  •  Home health care is a particularly perverse (0+ / 0-)

    industry for low wages, changing hours, and no benefits.

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