retirement money

10 Ways Millennials are Saving for the Future

Have your millennial employees started saving for their retirement? Check out this article by Marlene Y. Satter from Benefits Pro and see what millennial across the country are doing to prepare themselves for retirement.

They’re called spendthrifts by other generations, are laden with student debt and burdened with lower-paying jobs.

But that doesn’t mean that millennials aren’t thinking about the future and saving for it.

And they could certainly use a little help—from human resources and from plan sponsors—to be more successful at it, since both the debt and the jobs don’t leave them much to work with when all expenses are accounted for.

Both HR and sponsors might want to consider how retirement savings plans and their features—auto-enrollment, auto-escalation, employer matching funds—could be tweaked to give millennials a boost in meeting major life goals and in saving for retirement, as well as for the health expenses it undoubtedly will bring along with it.

In the meantime, they can consider how millennials are already trying to stretch every dollar till it snaps—some in very unconventional ways.

In a survey, digital banking app Varo Money, Inc. has uncovered a range of methods millennials are using to make those paychecks go farther.

And while retirement is certainly on their radar, that’s not the only goal they’re pursuing; of course they have a whole life to live first. Some of their prime goals are travel, buying property and dreaming about a new car, while

Here are some of the strategies to which millennials resort in the quest to fund their futures. Can plan sponsors be less imaginative than some of these? Surely not….

10. Half of millennials surveyed save automatically.

While respondents say they aren’t fond of spreadsheets—they don’t track their money constantly, or input figures into programs like Excel or Mint to create detailed, category-based budgets—they do watch their bank balances regularly and are pretty aware of what they spend monthly.

They view it as “hands-off” money management.

What they do, however, is save automatically out of each paycheck, with 50 percent socking away a percentage every payday. So they’re prime candidates for savings plans with auto features—enrollment, escalation, etc.

report from the Society of Human Resource Management points to multiple studies indicating that auto escalation in particular—but to a high level such as 10 percent—results in higher savings for employees, since few actually opt out of a rate higher than they might have chosen for themselves.

9. Millennials are looking to climb the corporate ladder—to a higher paycheck.

An impressive 39 percent of millennials are on the prowl for a better-paying job opportunity, which is yet another reason that HR personnel and plan sponsors hoping to retain good staff might want to keep an eye on millennials’ rate of pay, as well as their rate of savings.

Reviewing other benefits wouldn’t hurt, either, since the more attractive an existing job is, the more likely an employee is to stay.

Considering the cost of finding, hiring and training replacements, a raise and better benefits might be cheaper in the long run.

8. Millennials know food is cheaper at home, especially with a partner to share it.

Millennials, despite their spendthrift reputation, are willing to skip little luxuries like the much-vaunted avocado toast or make coffee and meals at home.

In fact, 36 percent stick with the coffeepot on the counter instead of the barista at the corner, while 11 percent of men and 3 percent of women are willing to abandon the avocado toast—after all, everyone has his, or her, breaking point when economizing.

And 26 percent of respondents point out that cooking for two is cheaper than dining solo at home—much less in a restaurant.

7. Millennials recognize how much cheaper it is to live as a couple.

While 75 percent of millennials are conscious of the financial benefits in being half of a couple. 44 percent point to the cheaper rent when there are two to share the load.

And that helps them both save more.

Even those who aren’t part of a couple are looking for roommates, according to Mashable, which reports on a SmartAsset study finding that in high-rent cities like San Francisco, New York and Boston a person can save at least $700 a month by having a roommate.

Cue in the cooking-at-home technique for group meals, and the savings grow even more.

6. Millennials go on fewer dates to save money.

Being in a relationship, say 16 percent of millennials, is cheaper than still looking, since they save money by not going out on so many dates.

5. They save on taxes if they’re married.

Ever-practical, these millennials. They recognize that being half of a married couple can save on their tax bill—and they don’t forget that either when looking for cash to stash for the future.

4. They bargain-hunt for credit card perks.

Make no mistake, among millennials travel is a big deal: 58 percent said travel destinations are their favorite topic of conversation.

And asked what they would purchase with $2,000 if they could only spend it on one thing, 25 percent said plane tickets.

As a result, they tend to be particularly savvy when it comes to being able to travel, with 16 percent seeking out credit cards that provide big mileage bonuses.

3. They leverage perks to pursue other little luxuries without having to lay out cash for them.

In fact, they’re fond of doing it for travel, with 7 percent using airline miles to upgrade to business class.

In addition, 7 percent use status from premium credit cards for hotel upgrades, and 6 percent use premium cards for lounge access.

2. They’re planning on grad school.

While that may not seem like saving—even though it’s definitely ahead of the 11 percent of male millennials who are saving for a new luxury car and the 12 percent of female millennials saving for a new wardrobe—they’re looking toward an advanced degree for a leg up the job ladder.

Oh, and 27 percent are saving for a place of their own.

1. They stay away from credit cards.

Mashable reports that, despite their spendthrift reputations, millennials are actually opting for other types of technology—digital wallets, for instance—but not so much credit cards.

It cites a BankRate finding that in fact, 67 percent of millennials don't have credit cards—the lowest amount of people without credit cards in any demographic, among adults.

And they’d rather be paid in cash, thank you very much. So say 58 percent, and they’re smart; it wards off unnecessary purchases and helps keep them out of credit card debt.

See the original article Here.

Source:

Satter M.  (2017 June 29). 10 ways millennials are saving for the future [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/06/29/10-ways-millennials-are-saving-for-the-future?ref=mostpopular&page_all=1


Rising Healthcare Costs Hurting Retirement Contributions

The rising costs of healthcare are starting to have a negative impact on employees. Find out how employees are having trouble saving for their retirement thanks to the rise of healthcare costs in the interesting article by Paula Aven Gladych from Employee Benefit News.

Rising healthcare costs have had a dramatic impact on the ability of workers to save for retirement and other financial goals.

The latest Bank of America Merrill Lynch Workplace Benefits Report finds that of the workers who have experienced rising healthcare costs, more than half say they are contributing less to their financial goals as a result, including more than six in 10 who say they are saving less for retirement.

What’s more, financial stress also is playing a big role in employee physical health with nearly six in 10 employees saying it has had a negative impact on their physical well-being. This stress weighs most heavily on millennials at 68%, compared with baby boomers at 51%, according to the research.

Because of these dire statistics, more and more employees are looking to their employer to help them through financial challenges.

“We spend a lot of our waking time working and a lot of our finances are made up of the compensation and benefits our employer provides,” says Sylvie Feast, director of financial guidance services for Bank of America Merrill Lynch. “[Employer’s] healthcare and 401(k) plans are really valued by employees. I don’t think it’s surprising that they are looking to their employer that provides essential benefits to help provide access to ways to better manage their finances.”

And because employers offer healthcare and retirement benefits, it isn’t a stretch for workers to expect their employers to offer financial wellness as a benefit as well, Feast says.

“There’s no silver bullet, but a continuing evolution of trying new things to see what works and has an impact with the workforce,” Feast says. “Culture has something to do with it.”

Online tools, educational content, professional seminars in the workplace and personal consultations can be especially effective offerings, Feast says, adding that those options can help employees get more comfortable talking about their finances at work and at home with their family.

“People are pretty private about their finances,” Feast says. “I think there’s this access the employer needs to provide, but there also needs to be an arms-length distance so it is not the employer delivering it.”

Retirement savings is the area most workers want help with, according to Bank of America Merrill Lynch’s survey. More than half of baby boomers (54% ), 53% of Generation X and 43% of millennials say they need help saving for retirement, with 50% of all respondents ranking it as their No. 1 financial issue.

For millennials, good general savings habits and paying down debt were their next most important financial priorities. For Generation X, paying down debt, good general savings habits and budgeting all tied for second, and for baby boomers, planning for healthcare costs and paying down debt were their next biggest financial priorities.

Eighty-six percent of employees surveyed say they would participate in a financial education program provided by their employer, according to Bank of America Merrill Lynch.

Financial education is a slow, but worthy process, Feast says.

“People don’t just automatically start to show an immediate impact to their behavior,” she says. But, “if [employees] take steps, [they] will start to gain control and get more confidence.”

See the original article Here.

Source:

Gladych P. (2017 June 7). Rising healthcare costs hurting retirement contributions [Web blog post]. Retrieved from address https://www.benefitnews.com/news/rising-healthcare-costs-hurting-retirement-contributions


Coverage Losses by State for the Senate Health Care Repeal Bill

The Congressional Budget Office has just released its score on the Better Care Reconciliation Act (BCRA).  Find out how each state will be impacted by the implementation of BCRA  in this great article by Emily Gee from the Center for American Progress.

The Congressional Budget Office (CBO) has released its score of the Senate’s health care repeal plan, showing that the bill would eliminate coverage for 15 million Americans next year and for 22 million by 2026. The CBO projects that the Senate bill would slash Medicaid funding by $772 billion over the next decade; increase individual market premiums by 20 percent next year; and make comprehensive coverage “extremely expensive” in some markets.

The score, released by Congress’ nonpartisan budget agency, comes amid an otherwise secretive process of drafting and dealmaking by Senate Republicans. Unlike the Senate’s consideration of the Affordable Care Act (ACA), which involved dozens of public hearings and roundtables plus weeks of debate, Senate Republican leadership released the first public draft of its Better Care Reconciliation Act (BCRA) just days before it hopes to hold a vote.

The Center for American Progress has estimated how many Americans would lose coverage by state and congressional district based on the CBO’s projections. By 2026, on average, about 50,500 fewer people will have coverage in each congressional district. Table 1 provides estimates by state, and a spreadsheet of estimates by state and district can be downloaded at the end of this column.

The coverage losses under the BCRA would be concentrated in the Medicaid program, but the level of private coverage would also drop compared to the current law. The CBO projects that, by 2026, there will be 15 million fewer people with Medicaid coverage and 7 million fewer with individual market coverage. Our Medicaid numbers reflect that states that have expanded their programs under the ACA would see federal funding drop starting in 2021 and that the bill would discourage expansion among states that would otherwise have done so in the future.

Like the House’s repeal bill, the Senate’s version contains a provision allowing states to waive the requirement that plans cover essential health benefits (EHB). The CBO predicts that half of the population would live in waiver states under the Senate bill. The CBO did not specify which states it believes are most likely to secure waivers; therefore, we did not impose any assumptions about which individual states would receive waivers in our estimates. Even though the demographic composition of coverage losses would differ among waiver and nonwaiver states, for this analysis we assume that all states’ individual markets would shrink.

CBO expects that state waivers could put coverage for maternity care, mental health care, and high-cost prescription drugs “at risk.” CBO projects that “all insurance in the nongroup market would become very expensive for at least a short period of time for a small fraction of the population residing in areas in which states’ implementation of waivers with major changes caused market disruption.” Note that health insurance experts have noted that in addition to directly lowering standards for individual market coverage, waivers would also indirectly subject people in employer coverage to annual and lifetime limits on benefits.

The CBO’s score lists multiple reasons why out-of-pocket costs for individual market enrollees would rise under the bill. One reason is that bill’s changes to premium subsidies means that most people would end up buying coverage resembling bronze-level plans, which today typically have annual deductibles of $6,000. In addition, EHB waivers would force enrollees who could not afford supplemental coverage for non-covered benefits out of pocket while also allowing issuers to set limits on coverage.

In summary, the CBO projects that the effects of the Senate bill would be largely similar to those of the house bill: tens of millions of people would no longer have coverage, and those who remained insured see the quality of their coverage erode substantially. In just a few days, the Senate will vote to turn these dire projections into reality.

Methodology

Our estimates of coverage reductions follow the same methodology we used previously for the House’s  health care repeal bill. We combine the CBO’s projected national net effects of the House-passed bill on coverage with state and local data from the Kaiser Family Foundation, the American Community Survey from the U.S. Census, and administrative data from the Centers for Medicare & Medicaid Services (CMS).

Florida, North Carolina, and Virginia redrew their district boundaries prior to the 2016 elections. While the rest of our data uses census estimates corresponding to congressional districts for the 114th Congress, we instead used county-level data from the 2015 five-year American Community Survey to determine the geographic distribution of the population by insurance type in these three states. We matched county data to congressional districts for the 115th Congress using a geographic crosswalk file provided by the Kaiser Family Foundation.

Our estimates of reductions in Medicaid by district required a number of assumptions. CBO projected that a total 15 million fewer people would have Medicaid coverage by 2026 under the Senate bill: 5 million fewer would be covered by additional Medicaid expansion in new states, and 10 million fewer would have Medicaid coverage in current expansion states and among pre-ACA eligibility groups in all states. The CBO projected that, under the ACA, additional Medicaid expansion would increase the proportion of the newly eligible population residing in expansion states from 50 percent to 80 percent by 2026. It projected that just 30 percent of the newly eligible population would be in expansion states. Extrapolating from the CBO’s numbers, we estimate the Senate bill results in a Medicaid coverage reduction of 3.3 million enrollees in current expansion states by 2026.

We then assume the remaining 6.7 million people who would lose Medicaid coverage are from the program’s pre-ACA eligibility categories: low-income adults, low-income children, the aged, and disabled individuals. We used enrollment tables published by the Medicaid and CHIP Payment Access Commission (MACPAC) to determine total state enrollment and each eligibility category’s share of the total, and we assumed that only some of the disabled were nonelderly. We then divided state totals among districts according to each’s Medicaid enrollment in the American Community Survey. Because each of the major nonexpansion categories is subject to per capita caps under the bill, we reduced enrollment in all by the same percentage.

Because we do not know which individual states would participate in Medicaid expansion in 2026 in either scenario, our estimates give nonexpansion states the average effect of forgone expansion and all expansion states the average effect of rolling back eligibility. We divided the 5 million enrollment reduction due to forgone expansion among nonexpansion states’ districts proportionally by the number of low-income uninsured. We made each expansion state’s share of that 3.3 million proportional to its Medicaid expansion enrollment in its most recent CMS report and then allocated state totals to districts proportional to the increase in nonelderly adult enrollment between 2013 and 2015. For Louisiana, which recently expanded Medicaid, we took our statewide total from state data and allocated to districts by the number of low-income uninsured adults.

Medicaid covers seniors who qualify as aged or disabled. Although the CBO did not specify the Medicaid coverage reduction that would occur among seniors under per capita caps, applying to elderly enrollees the same percentage reduction we calculated for nonexpansion Medicaid enrollees implies that 900,000 could lose Medicaid.

Lastly, our estimates of the reduction in exchange, the Basic Health Plan, and other nongroup coverage are proportional to the Kaiser Family Foundation’s estimates of exchange enrollment by congressional district. The House bill reduces enrollment in nongroup coverage, including the exchanges, by 7 million relative to the ACA. To apportion this coverage loss among congressional districts, we assumed that the coverage losses would be largest in areas with higher ACA exchange enrollment and in states where we estimated the average cost per enrollee would increase most under an earlier version of the AHCA.

The CBO projects that the net reduction in coverage for the two categories of employer-sponsored insurance and “other coverage” would be between zero and 500,000 people in 2026. We did not include these categories in our estimates.

See the original article Here.

Source:

Gee E. (2017 June 27). Coverage losses by state for the senate health care repeal bill [Web blog post]. Retrieved from address https://www.americanprogress.org/issues/healthcare/news/2017/06/27/435112/coverage-losses-state-senate-health-care-repeal-bill/


The American Health Care Act: Economic and Employment Consequences for States

Could health insurance reductions under the American Health Care Act (AHCA) cause problems for employment in the future? Check out this article from The Commonwealth Fund to learn more.

Abstract

Issue: The American Health Care Act (AHCA), passed by the U.S. House of Representatives, would repeal and replace the Affordable Care Act. The Congressional Budget Office indicates that the AHCA could increase the number of uninsured by 23 million by 2026.
Goal: To determine the consequences of the AHCA on employment and economic activity in every state.
Methods: We compute changes in federal spending and revenue from 2018 to 2026 for each state and use the PI+ model to project the effects on states’ employment and economies.
Findings and Conclusions: The AHCA would raise employment and economic activity at first, but lower them in the long run. It initially raises the federal deficit when taxes are repealed, leading to 864,000 more jobs in 2018. In later years, reductions in support for health insurance cause negative economic effects. By 2026, 924,000 jobs would be lost, gross state products would be $93 billion lower, and business output would be $148 billion less. About three-quarters of jobs lost (725,000) would be in the health care sector. States which expanded Medicaid would experience faster and deeper economic losses.

Background

On May 24, 2017, the U.S. House of Representatives passed the American Health Care Act (AHCA, H.R. 1628) to partially repeal and replace the Affordable Care Act (ACA), also known as Obamacare. The U.S. Senate is currently developing its own version of the legislation.

A January 2017 analysis found that repealing certain elements of the ACA—the Medicaid expansion and premium tax credits—could lead to 2.6 million jobs lost and lower gross state products of $1.5 trillion over five years.1,2 That brief focused only on specific repeal elements because other details were not available. This brief examines all aspects of the AHCA, including restructuring Medicaid and health tax credits and repealing ACA taxes (Exhibit 1).

Exhibit 1
Key Provisions of the American Health Care Act as Passed by the U.S. House of Representatives
Eliminates individual penalties for not having health insurance and penalties for employers that do not offer adequate coverage to employees. Raises premiums for people who do not maintain continuous insurance coverage.
Replaces the current income-related premium tax credits to subsidize nongroup health insurance with age-based tax credits. Allows premiums to be five times higher for the oldest individuals, compared to the current threefold maximum.
Restricts state Medicaid eligibility expansions for adults, primarily by reducing federal matching rates from 90 percent beginning in 2020 to rates ranging between 50 percent and 75 percent.
Creates temporary funding for safety-net health services in states that did not expand Medicaid.
Restructures Medicaid funding based on per capita allotments rather than the current entitlement. States may adopt fixed block grants instead.
Creates a Patient and State Stability Fund and Invisible Risk-Sharing Program.
Terminates the Prevention and Public Health Fund.
Repeals numerous taxes included in the ACA, including Medicare taxes on investment income and on high-income earnings, taxes on health insurance and medical devices, and a tax on high-cost insurance (i.e., the “Cadillac tax”); raises limits for health savings accounts and lowers the threshold for medical care deductions.
Allows states to waive key insurance rules, like community rating of health insurance and essential health benefits. Creates a fund that states could use to lower costs for those adversely affected by the waiver.

The Congressional Budget Office (CBO) reported the AHCA would increase the number of uninsured Americans under age 65 by 14 million in fiscal year 2018, eventually reaching 23 million more by 2026.3 A RAND analysis of an earlier version of the bill was similar: 14 million more uninsured in 2020 and 20 million in 2026.4

This report examines the potential economic effects of the AHCA from calendar years 2018 to 2026, including:

    • employment levels, measured as changes in the number of jobs created or lost due to policy changes
    • state economic growth, as measured by changes in gross state products in current dollars, adjusted for inflation; an aggregate measure of state economies, analogous to the gross domestic product at the national level

state business output,

    as measured by changes in business receipts in current dollars at production, wholesale, and retail levels, encompassing multiple levels of business activity.

Our estimates are based on changes in federal funding gained or lost to states, consumers, and businesses. The AHCA significantly reduces federal funding for Medicaid. It lowers federal match funding for the 31 states and District of Columbia that expanded Medicaid, encouraging them to discontinue their expansions. It gives states an option to either adopt per capita allotments for Medicaid or fixed block grants; either option lowers federal Medicaid expenditures. Eliminating the tax penalty for individuals without health insurance reduces incentives to purchase insurance, raising the number of uninsured people. Restructuring premium tax credits and widening age-related differences in premiums are expected to shrink nongroup insurance coverage and reduce federal spending for health insurance subsidies. The AHCA is designed so that tax cuts take effect sooner than reductions in health insurance subsidies. Thus, state employment and economies could grow at first but shrink in later years as the coverage reductions deepen.

How Federal Health Funding Stimulates Job Creation and State Economies

Federal health funds are used to purchase health care. Then, fiscal effects ripple out through the rest of the economy, creating employment and other economic growth. This phenomenon is called the multiplier effect. Health funds directly pay hospitals, doctors’ offices, and other providers; this is the direct effect of federal funding. These facilities use revenue to pay their employees and buy goods and services, such as rent or equipment; this is the indirect effect of the initial spending. In addition, there are induced effects that occur as health care employees or other businesses (and eventually their workers) use their income to purchase consumer goods like housing, transportation, or food, producing sales for a diverse range of businesses. Similarly, when federal taxes are reduced, consumers or businesses retain income and can purchase goods and services, invest, or save. Due to interstate commerce, each type of effect can flow across state lines.

Both government spending increases and tax reductions can stimulate job creation and economic growth. The relative effects depend on how the funds are used. Government spending or transfers, like health insurance subsidies, typically have stronger multiplier effects in stimulating consumption and economic growth than do tax cuts. Tax cuts usually aid people with high incomes who shift much of their gains into savings, stimulating less economic activity.5,6,7 A recent analysis found that 90 percent of the AHCA’s tax cuts go to the top one-fifth of the population by income.8

This report estimates how the AHCA will change federal funds gained or lost for all 50 states and the District of Columbia from 2018 to 2026. We allocate federal funding changes, based on CBO estimates, for each state. We then analyze how federal funding changes ripple through state economies, using the PI+ economic model, developed by Regional Economic Models, Inc. (REMI).9 (See Appendix B. Study Methods.)

Findings

Overall Effects

As illustrated in Exhibit 2, most of the AHCA’s tax repeals begin almost at once, while coverage-related spending reductions phase in. The net effect initially raises the federal deficit. In 2018, the number of jobs would rise by 864,000 and state economies would grow. Health sector employment begins to fall immediately in 2018, with a loss of 24,000 jobs, and continues dropping to 725,000 health jobs lost by 2026 (Exhibit 3). Most other employment sectors gain initially, but then drop off and experience losses.

By 2020, the reduction in federal funding for coverage would roughly equal the total level of tax cuts. By the following year, 2021, coverage reductions outpace tax cuts. As a result, there are 205,000 fewer jobs than without the AHCA and state economies begin to shrink.

By 2026, 924,000 fewer people would have jobs. Gross state products would drop by $93 billion and business output would be $148 billion lower. These downward trends would continue after 2026.

Looking at Coverage-Related and Tax Repeal Policies

To better understand how the AHCA affects state economies and employment, Exhibit 4 looks at the two major components of the AHCA separately. The coverage-related policies (Title I of the AHCA and sections related to premium tax credits and individual and employer mandates) generally lower federal spending, particularly due to cuts to Medicaid and premium tax credits. Some policies partially offset those large cuts, such as the Patient and State Stability Fund. The tax repeal policies (Title II, except for sections about premium tax credits and individual and employer mandates), such as repeal of Medicare-related taxes, Cadillac tax, or medical device tax, predominantly help people with high incomes or selected businesses.

Implemented alone, the coverage-related policies would lead to steep job losses over time, reaching 1.9 million by 2026, driven by deep Medicaid cuts (Exhibit 4). Job losses begin to mount in 2019.

Alternatively, the tax repeal policies on their own would be associated with higher employment and state economic growth. Gains begin with 837,000 more jobs in 2018; this rises through 2024, and leads to 1 million additional jobs in 2026. Combined, tax repeal and coverage-related changes lead to initial economic and employment growth but eventual losses.

The detailed employment results show how these two components of the AHCA affect different economic sectors. Coverage and spending-related policies are directly related to funding for health services (e.g., Medicaid, premium tax credits, high-risk pools). The reductions directly affect the health sector—hospitals, doctors’ offices, or pharmacies—but then flow out to other sectors. Thus, about two-fifths of jobs lost due to coverage policies are in the health sector while three-fifths are in other sectors. Tax changes affect consumption broadly, spreading effects over most job sectors.

Within the health sector, job losses due to coverage-related cuts are much greater than gains due to tax repeal; losses in health care jobs begin immediately. In other sectors, employment grows at the beginning but later declines.

State-Level Effects

Consequences differ from state to state. We summarize data for nine states: Alaska, Florida, Kentucky, Maine, Michigan, New York, Ohio, Pennsylvania, and West Virginia. Exhibit 5 shows the effects of the AHCA in 2018 and in 2026. Complete results for all 50 states and the District of Columbia are available in Appendices A1–A4. In this analysis, states that expanded Medicaid tend to experience deeper and faster economic declines, although substantial losses occur even among nonexpansion states:

  • Eight of the nine states (Alaska, Florida, Kentucky, Maine, New York, Ohio, Pennsylvania, and West Virginia) begin with positive economic and employment effects in 2018, but are worse off by 2026, with outcomes typically turning negative well before 2026.
  • Michigan is worse off in 2018 and continues to decline through 2026. We assume Michigan will terminate its Medicaid expansion immediately because of a state law that automatically cancels the expansion if the federal matching rate changes.10 Six other states (Arkansas, Illinois, Indiana, New Hampshire, New Mexico, and Washington) have similar legislation and experience losses sooner than other states.
  • Most job losses are in health care. In six states (Florida, Kentucky, Maine, Michigan, Ohio, and West Virginia) health care job losses begin in 2018, but all nine states have significant reductions in health employment by 2026. Looking at the U.S. overall, in most states, losses in health care jobs begin by 2020 (Appendix A2).
  • States that expanded Medicaid have deeper and faster losses. Having earned more federal funds, they lose more when Medicaid matching rates fall. While cutting funds to states that expanded health insurance for low-income Medicaid populations, the bill temporarily increases funding to states that did not expand Medicaid. Nonetheless, states that did not expand Medicaid, like Florida and Maine, experience job and economic losses after a few years. In fact, Florida has the third-highest level of job loss in the nation by 2026.
  • Other factors that can affect the size of economic and employment effects include:
    • the extent to which states gained coverage in the ACA health insurance marketplaces; states with higher marketplace enrollment tend to lose more
    • the cost of health insurance in the state; the new tax credits are the same regardless of location, making insurance less affordable in high-cost states and reducing participation
    • age structure; older people will find insurance less affordable
    • state population size; the population size of states magnifies their losses or gains
    • other factors that affect tax distribution, like number of residents with investment income or high incomes or whether medical device or pharmaceutical manufacturers are located in the state.

Overall, the 10 states with the largest job losses by 2026 are: New York (86,000), Pennsylvania (85,000), Florida (83,000), Michigan (51,000), Illinois (46,000), New Jersey (42,000), Ohio (42,000), North Carolina (41,000), California (32,000), and Tennessee (28,000). Forty-seven states have job losses by 2026; four states (Colorado, Hawaii, Utah, and Washington) have small job gains in 2026, but would likely incur losses in another year or two (Appendix A1).

Conclusions

The House bill to repeal and replace the Affordable Care Act would greatly reduce the number of people with insurance coverage, effectively reversing gains made since the law’s enactment. The AHCA would initially create more employment and economic growth, driven by a federal deficit increase in 2018 and 2019, but the effects turn negative as coverage reductions deepen, with job losses and lower economic growth beginning in 2021. By 2026, 924,000 jobs would be lost, gross state products would be $93 billion lower, and business output could fall by $148 billion.

Health care has been one of the main areas of job growth in recent years.11 Under the AHCA, the sector would lose jobs immediately, with a loss of 24,000 jobs in 2018. By 2026, 725,000 fewer health sector jobs would exist. This would be a major reversal from current trends. While our analysis shows other employment sectors grow initially, most other sectors would experience losses within a decade.

It may be useful to look at these findings in a macroeconomic context. The U.S. unemployment rate for May 2017 was 4.3 percent, the lowest in 16 years and about half as high as during the recent recession. When unemployment is low, additional job growth creates a tighter labor market, so that businesses often have greater difficulties filling job vacancies. In turn, this can accelerate inflation.

It is likely that the business cycle will eventually slow down again. In that event, the AHCA could accentuate job loss and economic contraction. Combined with major increases in the number of uninsured, this could contribute to a period of economic and medical hardship in the U.S. The AHCA could exaggerate both the highs and lows of the business cycle. From a national policy perspective, it may be more useful to develop countercyclical policies that strengthen employment and the economy during times of contraction.

This analysis finds that the net effect of the AHCA would be a loss of almost 1 million jobs by 2026, combined with 23 million more Americans without health insurance, according to the CBO. In late May, the Trump administration released its budget proposal, which appears to propose an additional $610 billion in Medicaid cuts, beyond those included in the AHCA.12 Such deep cuts would further deepen the employment and economic losses discussed in this study.

This analysis has many limitations. We do not know whether or when the AHCA or an alternative will be enacted into law. Alternative policies could yield different effects. We focus only on the consequences of the AHCA. Other legislation, such as infrastructure, trade, national security, or tax policies, may be considered by Congress and might also affect economic growth and employment.

These projections, like others, are fraught with uncertainty. Economic, technical, or policy changes could alter results. In particular, the AHCA grants substantial discretion to states, such as in Medicaid expansions, waivers of federal regulations, and use of new funds like the Patient and State Stability Fund. While this analysis is aligned with CBO’s national estimates, we developed state-level projections, introducing further uncertainty. Our approach conservatively spreads changes across states and may underestimate the highs and lows for individual states.

See original article Here.

Source:

Ku, L., Steinmetz, E., Brantley, E., Holla, N., Bruen, B. (14 June 2017). The American Health Care Act: Economic and Employment Consequences for States. [Web Blog Post]. Retrieved from address http://www.commonwealthfund.org/publications/issue-briefs/2017/jun/ahca-economic-and-employment-consequences


us capitol

Senate Health Bill Would Revamp Medicaid, Alter ACA Guarantees, Cut Premium Support

The Senate has just released their version of the American Health Care Act (AHCA).  Here is a great article by Julie Rovner from Kaiser Health News detailing what the Senate's version of the AHCA legislation means for Americans.

Republicans in the U.S. Senate on Thursday unveiled a bill that would dramatically transform the nation’s Medicaid program, make significant changes to the federal health law’s tax credits that help lower-income people buy insurance and allow states to water down changes to some of the law’s coverage guarantees.

The bill also repeals the tax mechanism that funded the Affordable Care Act’s benefits, resulting in hundreds of billions of dollars in tax cuts for the wealthy and health care industry.

Most senators got their first look at the bill as it was released Thursday morning. It had been crafted in secret over the past several weeks. Senate Majority Leader Mitch McConnell (R-Ky.) is seeking a vote on the bill before Congress leaves next week for its Fourth of July recess.

Senators had promised that their ACA replacement would be very different than the version that passed the House in May, but the bill instead follows the House’s lead in many ways.

At lightning speed and with a little over a week for wider review, the Republicans’ bill could influence health care and health insurance of every American. Reversing course on some of the more popular provisions of the Affordable Care Act, it threatens to leave tens of millions of lower-income Americans without insurance and those with chronic or expensive medical conditions once again financially vulnerable.

Like the House measure, the Senate bill, which is being called a “discussion draft,” would not completely repeal the ACA but would roll back many of the law’s key provisions. Both bills would also — for the first time — cap federal funding for the Medicaid program, which covers more than 70 million low-income Americans. Since its inception in 1965, the federal government has matched state spending for Medicaid. The new bill would shift much of that burden back to states.

The bill would also reconfigure how Americans with slightly higher incomes who don’t qualify for Medicaid would get tax credits to help pay insurance premiums, eliminate penalties for those who fail to obtain insurance and employers who fail to provide it, and make it easier for states to waive consumer protections in the ACA that require insurance companies to charge the same premiums to sick and healthy people and to provide a specific set of benefits.

“We agreed on the need to free Americans from Obamacare’s mandates, and policies contained in the discussion draft will repeal the individual mandate so Americans are no longer forced to buy insurance they don’t need or can’t afford; will repeal the employer mandate so Americans no longer see their hours and take-home pay cut by employers because of it,” McConnell said on the floor of the Senate after releasing the bill. He also noted that the bill would help “stabilize the insurance markets that are collapsing under Obamacare as well.”

It is not clear that the bill will make it through the Senate, however, or that all of it will even make it to the Senate floor. The Senate (like the House) is operating under a special set of budget rules that allow it to pass this measure with only a simple majority vote and block Democrats from dragging out the debate by using a filibuster. But the “budget reconciliation” process comes with strict rules, including the requirement that every provision of the bill primarily impact the federal budget, either adding to or subtracting from federal spending.

For example, the legislation as released includes a one-year ban on Medicaid funding for Planned Parenthood. That is a key demand of anti-abortion groups and some congressional conservatives, because Planned Parenthood performs abortions with non-federal funding. But it is not yet clear that the Senate parliamentarian will allow that provision to be included in the bill.

Also still in question is a provision of the Senate bill that would allow states to waive insurance regulations in the Affordable Care Act. Many budget experts say that runs afoul of Senate budget rules because the federal funding impact is “merely incidental” to the policy.

Drafting the Senate bill has been a delicate dance for McConnell. With only 52 Republicans in the chamber and Democrats united in opposition to the unraveling of the health law, McConnell can afford to lose only two votes and still pass the bill with a tie-breaking vote from Vice President Mike Pence. McConnell has been leading a small working group of senators — all men — but even some of those have complained they were not able to take part in much of the shaping of the measure, which seems to have been largely written by McConnell’s own staff.

So far, McConnell has been fielding complaints from the more moderate and more conservative wings of his party. And the draft that has emerged appears to try to placate both.

For example, as sought by moderates, the bill would phase down the Medicaid expansion from 2020 to 2024, somewhat more slowly than the House bill does. But it would still end eventually. The Senate bill also departs from the House bill’s flat tax credits to help pay for insurance, which would have added thousands of dollars to the premiums of poorer and older people not yet eligible for Medicare.

A Congressional Budget Office report estimating the Senate bill’s impact on individuals and the federal budget is expected early next week. The House bill, according to the CBO, would result in 23 million fewer Americans having health insurance over 10 years.

For conservatives, however, the Senate bill would clamp down even harder on Medicaid in later years. The cap imposed by the House would grow more slowly than Medicaid spending has, but the Senate’s cap would grow even more slowly than the House’s. That would leave states with few options, other than raising taxes, cutting eligibility, or cutting benefits in order to maintain their programs.

Defenders of the health law were quick to react.

Sen. Ron Wyden (D-Ore.) complained about changes to coverage guarantees in the ACA.

“I also want to make special note of the state waiver provision. Republicans have twisted and abused a part of the Affordable Care Act I wrote to promote state innovation, and they’re using it to give insurance companies the power to run roughshod over individuals,” he said in a statement issued shortly after the bill was released. “This amounts to hiding an attack on basic health care guarantees behind state waivers, and I will fight it at every turn.”

“The heartless Senate health care repeal bill makes health care worse for everyone — it raises costs, cuts coverage, weakens protections and cuts even more from Medicaid than the mean House bill,” said a statement from Protect Our Care, an umbrella advocacy group opposing GOP changes to the health law. “They wrote their plan in secret and are rushing forward with a vote next week because they know how much harm their bill does to millions of people.”

See the original article Here.

Source:

Rovner J. (2017 June 22). Senate health bill would revamp medicaid, alter ACA guarantees, cut premium support [Web blog post]. Retrieved from address http://khn.org/news/senate-health-bill-would-revamp-medicaid-alter-aca-guarantees-cut-premium-support/


women's health icon

Here's What The GOP Bill Would (And Wouldn't) Change About Women's Health Care

What will change about women's healthcare and what will stay the same? Danielle Kurtzleben explores the potential changes in the following article for NPR.

The Affordable Care Act changed women's health care in some big ways: It stopped insurance companies from charging women extra, forced insurers to cover maternity care and contraceptives and allowed many women to get those contraceptives (as well as a variety of preventive services, like Pap smears and mammograms) at zero cost.

Now Republicans have the opportunity to repeal that law, also known as Obamacare. But that doesn't mean all those things will go away. In fact, many will remain.

Confused? Here's a rundown of how this bill would change some women-specific areas of health care, what it wouldn't change, and what we don't know so far.

What would change:

Abortion coverage

There are restrictions on abortion under current law — the Hyde Amendment prohibits federal subsidies from being spent on abortions, except in the case of pregnancies that are the result of rape or incest or that threaten the life of the mother. So while health care plans can cover abortions, those being paid for with subsidies "must follow particular administrative requirements to ensure that no federal funds go toward abortion," as the Guttmacher Institute, which supports abortion rights, explains.

But the GOP bill tightens this. It says that the tax credits at the center of the plan cannot be spent at all on any health care plan that covers abortion (aside from the Hyde Amendment's exceptions).

So while health care plans can cover abortion, very few people may be able to purchase those sorts of plans, as they wouldn't be able to use their tax credits on them. That could make it much more expensive and difficult to obtain an abortion under this law than under current law.

Planned Parenthood funding

This bill partially "defunds" Planned Parenthood, meaning it would cut back on the federal funding that can be used for services at the clinics. Fully 43 percent of Planned Parenthood's revenue in fiscal year 2015 — more than $550 million — came from government grants and reimbursements.

Right now, under Obamacare, federal funds can be spent at Planned Parenthood, but they can't be used for abortion — again, a result of the Hyde Amendment and again, with the three Hyde Amendment exceptions. But this bill goes further, saying that people couldn't use Medicaid at Planned Parenthood.

To be clear, it's not that there's a funding stream going directly from the government to Planned Parenthood that Congress can just turn off. Rather, the program reimburses Planned Parenthood for the care it provides to Medicaid recipients. So this bill would mean that Medicaid recipients who currently receive care at an organization that provides abortions would have to find a new provider (whom Medicaid would then reimburse).

Abortion is a small part of what Planned Parenthood does: The organizations says it accounted for 3.4 percent of all services provided in the year ending in September 2014. (Of course, some patients receive more than one service; Planned Parenthood had around 2.5 million patients in that year. Assuming one abortion per patient, that's roughly 13 percent of all patients receiving abortions.)

Together, providing contraception and the testing for and treatment of sexually transmitted diseases made up three-quarters of the services the organization provided in one year.

That means low-income women (that is, women on Medicaid) could be among the most heavily affected by this bill, as it may force them to find other providers for reproductive health services.

Of the other government money that goes to Planned Parenthood, most of it comes from Title X. That federal program, created under President Richard Nixon, provides family planning services to people beyond Medicaid, like low-income women who are not Medicaid-eligible. Earlier this year, Republicans started the process of stripping that funding.

What wouldn't change (yet):

Republicans have stressed that this bill was just one of three parts, so it's hard to say definitively what wouldn't change at all as a result of their plan. But thus far, here's what is holding steady:

Maternity and contraceptive coverage

Because this was a reconciliation bill, it could cover fiscal-related topics only. It couldn't get into many of the particulars of what people's coverage will look like, meaning some things won't change.

The essential health benefits set out in Obamacare — a list of 10 types of services that all plans must cover — do not change for other policies. Maternity care is included in those benefits, as is contraception, so plans will have to continue to cover those. The GOP bill also doesn't change the Obamacare policy that gave women access to free contraception, as Vox's Emily Crockett reported.

In addition, maternity and contraception are still both "mandatory benefits" under Medicaid. That doesn't change in the GOP bill. (Confusingly, the bill does sunset essential health benefits for Medicaid recipients. But because there is overlap and these particular benefits remain "mandatory," they aren't going away.)

However, all of this won't necessarily remain unchanged. In response to a question about defunding Planned Parenthood this week, Health and Human Services Secretary Tom Price said that he didn't want to "violate anybody's conscience." When a reporter asked how this relates to birth control, Price did not give a definite answer.

"We're working through all of those issues," he said. "As you know, many of those were through the rule-making process, and we're working through that. So that's not a part of this piece of legislation right here."

So this is something that could easily change in the second "phase" of the health care plan, when rules are changed.

"Preventative services [the category that includes contraception] hasn't been touched, but we expect those to be touched probably via regulation," said Laurie Sobel, associate director for women's health policy at the Kaiser Family Foundation.

The end of gender rating

Prior to Obamacare, women were often charged more for the same health plans as men. The rationale was that women tend to use more health care services than men.

However, Obamacare banned the practice, and that ban seems unlikely to change, as the GOP cites nondiscrimination as one of the bill's selling points:

"Our proposal specifically prohibits any gender discrimination. Women will have equal access to the same affordable, quality health care options as men do under our proposal."

See original article Here.

Source:

Kurtzleben, D. (10 March 2017). Here's What The GOP Bill Would (And Wouldn't) Change About Women's Health Care. [Web Blog Post] Retrieved from address http://www.npr.org/2017/03/10/519461271/heres-what-the-gop-bill-would-and-wouldnt-change-for-womens-healthcare


Kaiser Health Tracking Poll - May 2017: The AHCA's Proposed Changes to Health Care

Find out how the American public feels about the American Health Care Act in this great article by Kaiser Family Foundation.

KEY FINDINGS:
  • With Congress currently discussing the American Health Care Act (AHCA), a plan that would repeal and replace the 2010 health care law, this month’s Kaiser Health Tracking Poll finds that more Americans have an unfavorable view of the plan than a favorable one (55 percent vs. 31 percent, respectively). The share with favorable views of the AHCA is about 20 percentage points lower than the share with favorable views (49 percent) of the 2010 Affordable Care Act (ACA). The majority of Republicans (67 percent) have a favorable view of the AHCA.
  • This month’s survey finds the public has increasingly negative views of how their health care will be affected by proposed changes. In December 2016, after the presidential election but before the release of the Republican plan, less than one-third of the public thought their health care would get worse if the 2010 health care law was repealed. This month’s survey, fielded after House Republicans passed the AHCA, finds larger shares say the cost of health care for them and their family (45 percent), their ability to get and keep health insurance (34 percent), and the quality of their own health care will get worse if Congress passes the AHCA (34 percent).
  • About one in ten (8 percent) think the Senate should pass the AHCA as is, without making any changes to the plan passed by the House. Similar shares – about one-fourth of the public – think the Senate should make either major changes to the legislation (26 percent) or minor changes to it (24 percent), while about three in ten (29 percent) say they do not think the Senate should pass this bill.

The American Health Care Act

On May 4, 2017, the U.S. House of Representatives passed the American Health Care Act (AHCA), the House Republicans’ plan to repeal and replace the Affordable Care Act (ACA).1 With the Senate currently debating the plan and discussing their own approach, the most recent Kaiser Health Tracking Poll finds more Americans have an unfavorable view of the AHCA than a favorable one (55 percent vs. 31 percent, respectively). There is also a considerable enthusiasm gap with a larger share saying that they have a “very unfavorable” view (40 percent) than saying they have a “very favorable” view (12 percent).

MAJORITY OF REPUBLICANS HOLD A FAVORABLE VIEW OF THE AHCA

The AHCA has solid support among the Republican base. Two-thirds of Republicans say they have a favorable view of the plan including three in ten (29 percent) who say they have a “very favorable” view.

FEW SEE AHCA AS FULFILLING PRESIDENT TRUMP’S PROMISES ABOUT HEALTH CARE

Three-fourths (76 percent) of the public thinks the health care plan recently passed by the House does not fulfill most of the promises President Trump has made about health care while 14 percent say it fulfills most or all of his promises.

This viewpoint is shared regardless of party identification with majorities of Democrats (86 percent), independents (79 percent), and Republicans (59 percent) saying the AHCA fulfills some or none of the promises President Trump has made about health care.

MORE AMERICANS VIEW THE ACA FAVORABLY THAN THE AHCA

The Kaiser Family Foundation has been tracking public opinion on the ACA since its passage in 2010. This month’s survey continues to find the public leans more favorable than unfavorable in their views of the 2010 health care law, with 49 percent expressing a favorable view of the ACA compared to 42 perecent expressing an unfavorable view.

In fact, more of the public is favorable in their overall views of the ACA than in their views of the Republican plan to replace the 2010 health care law. About half of Americans have a favorable view of the ACA compared to about three in ten who have a favorable view of the new Republican plan.

Partisanship is the main driver behind support for either the ACA or the AHCA, with a majority of Republicans viewing the AHCA favorably (67 percent), while a majority of Democrats view the ACA favorably (78 percent). More independents view the ACA favorably (48 percent) than view the AHCA favorably (30 percent).

Despite the lack of support for the House Republican plan, a majority of the public (74 percent) say they think it is either “very likely” (37 percent) or “somewhat likely” (36 percent) that the president and Congress will repeal and replace the ACA. About one-fourth of the public say it is either “not too likely” (15 percent) or “not likely at all” (9 percent).

MOST AMERICANS WANT CHANGES TO THE AHCA BEFORE SENATE PASSES THE BILL

About one in ten (8 percent) think the Senate should pass the AHCA as is, without making any changes to the plan passed by the House. Similar shares – about one-fourth of the public – think the Senate should make either major changes to the legislation (26 percent) or minor changes to it (24 percent), while about three in ten say they do not think the Senate should pass this bill.

Attitudes toward what the Senate should do when it comes to the AHCA are largely driven by partisanship with most Republicans (60 percent) saying they think it should pass as is (15 percent) or with minor changes (45 percent) while half of Democrats (51 percent) say the Senate should not pass this bill. Independents are more divided but one-third (34 percent) say the Senate should make major changes to the bill.

ATTITUDES TOWARDS AHCA PROVISIONS

The AHCA – like other health care plans – includes complex policies that the public may not fully understand or pay attention to. In an effort to examine general attitudes towards several of the more well-known provisions, we ask respondents whether after hearing about the specific provision they are “more likely” or “less likely” to support the plan. Much like overall attitudes towards the AHCA, various provisions of the law asked about in this survey do not garner large levels of support from the public. When asked whether individual elements of the Republican replacement plan would make them “more likely” or “less likely” to support the plan, none of the elements receive a majority of the public saying it would make them “more likely” to support it.  The only provision that has a larger share of the public saying it makes them “more likely” than say it makes them “less likely” to support the law is allowing states to implement a Medicaid work requirement (42 percent compared to 28 percent).

There are several provisions currently included in the plan that a majority of the public say makes them “less likely” to support the legislation. These include allowing states to decide if health insurance companies can charge sick people more than healthy people if they haven’t had continuous coverage (65 percent), eliminating the individual mandate and instead allowing insurance companies to charge people 30% higher premiums for a year if they haven’t had continuous coverage (62 percent), allowing states to eliminate the essential health benefit requirement (60 percent), and making changes that would generally decrease what younger people pay for insurance and increase what older people pay (58 percent).

REPUBLICAN SUPPORT FOR SOME ASPECTS OF THE AHCA

There is some support for aspects of the AHCA among Republicans. For example, a majority of Republicans say that the Medicaid work requirement (75 percent) and federal funding for states to set up high-risk pools (59 percent) makes them more likely to support the plan. In addition, about four in ten Republicans say the same about the provisions which stop federal Medicaid payments to Planned Parenthood (45 percent), change Medicaid funding to a per capita cap or block grant system (45 percent), allow states to change the essential health benefits (42 percent), and end the funding for Medicaid expansion (40 percent).

PERCEIVED EFFECTS OF THE AHCA

Overall, about half of Americans say the quality of their own health care (48 percent) and their own ability to get and keep health insurance (47 percent) will stay about the same if the president and Congress pass the health care plan currently being discussed. When it comes to the cost of health care for them and their family, almost half say it will get worse (45 percent) while about one-third say it will stay about the same (36 percent) and 16 percent say it will get better.

Immediately following the 2016 presidential election and prior to the release of the Republican plan, most Americans thought that their health care would stay about the same if the 2010 health care law was repealed. Yet, in this month’s survey which was fielded after House Republicans passed the AHCA, larger shares say the cost of health care for them and their family, their ability to get and keep health insurance, and the quality of their own health care will get worse if Congress passes the AHCA.

See the original article Here.

Source:

Kirzinger A., Dijulio B., Hamel L., Sugarman E., Brodie M. (2017 May 31). Kaiser health tracking poll - may 2017: the AHCA's proposed changes to health care [Web blog post]. Retrieved from address http://www.kff.org/health-costs/report/kaiser-health-tracking-poll-may-2017-the-ahcas-proposed-changes-to-health-care/


HR Pros Were Relieved When Obamacare Replacement Bill Got Pulled

Find out how HR professionals really felt about the fall of the AHCA in this great article from HR Morning by Tim Gould.

Everybody knows that the GOP’s attempt to repeal and replace Obamacare came to a rather ignominious end. But how did the HR community feel about that outcome?  

HR powerhouse Mercer addressed that question in a recent webcast, and the results were eye-opening.

Here are some stats from the webcast, which asked a couple key questions of 509 benefits pros.

On how they felt about the American Health Care Act being pulled:

  • Very relieved it didn’t pass — 24%
  • Relieved it didn’t pass — 32%
  • Very disappointed it didn’t pass — 5%
  • Disappointed it didn’t pass — 16%, and
  • No opinion — 23%.

So (utilizing our super-sharp math skills here) considerably more than half of the participants were not in favor of the AHCA, while just slightly more than one in five were disappointed it was shot down. Looks like Obamacare isn’t as deeply disliked as we’ve been led to believe — at least with benefits pros.

Mercer also asked participants to rate priorities for improving current healthcare law — using 5 as the top rating and 1 as the lowest. Those results:

  • Reduce pharmacy costs — 4.4
  • Improve price transparency for medical services/devices — 4.1
  • Stabilize individual market — 4.0
  • Maintain Medicaid funding — 4.0, and
  • Invest more in population health and health education — 3.7.

Perspective? As Beth Umland wrote on the Mercer blog, “Policymakers should view this health reform ‘reboot’ as an opportunity to partner with American businesses to drive higher quality, lower costs, and better outcomes for all Americans.”

A glance back

In case you’ve been hiding in a cave somewhere for the past several months, here’s a quick recap of the fate of the American Health Care Act.

Why did the AHCA fail, despite Republicans controlling the House, Senate and White House?

The answer starts with the fact that the GOP didn’t have the 60 seats in the Senate to avoid a filibuster by the Democrats. In other words, despite being the majority party, it didn’t have enough votes to pass a broad ACA repeal bill outright.

As a result, Senate Republicans had to use a process known as reconciliation to attempt to reshape the ACA. Reconciliation is a process that allows for the passage of budget bills with 51 votes instead of 60. So the GOP could vote on budgetary pieces of the health law, without giving the Democrats a chance to filibuster.

The problem for Republicans was reconciliation severely limited the extent to which they could reshape the law — and it’s a big reason the why American Health Care Act looked, at least to some, like “Obamacare Lite.”

Ultimately, what caused Trump and Ryan to decide to pull the bill before the House had a chance to vote on it was that so many House Republicans voiced displeasure with the bill and said they wouldn’t vote for it.

Specifically, here are some of what conservatives didn’t like about the American Health Care Act:

  • it largely left a lot of the ACA’s “entitlements” intact — like government aid for purchasing insurance
  • it didn’t do enough to curtail the ACA’s expansion of Medicaid
  • too many of the ACA’s insurance coverage mandates would remain in place
  • the Congressional Budget Office estimated that the bill would result in some 24 million Americans losing insurance within the next decade, and
  • it didn’t do enough to drive down the cost of insurance coverage in general.

See the original article Here.

Source:

Gould T. (2017 April 14). Hr pros were relieved when obamacare replacement bill got pulled Ob[Web blog post]. Retrieved from address http://www.hrmorning.com/hr-pros-were-relieved-when-obamacare-replacement-bill-got-pulled-off-the-table/


Healthcare Services: Employees Want to Find Less Costly Care, but Need HR’s Help

Have your employees been looking for new ways to reduce their healthcare cost? Check out this article from HR Morning on how HR can be a great tool for helping your employees find the best healthcare for their budget by Jared Bilski.

HR pros have been urging employees to ask questions and shop around for less-costly, high quality health care for years now — and it looks like many employees are finally heeding the call.

That’s the good news regarding healthcare cost transparency.

Step in the right direction

Specifically, 50% of individuals have tried to find out how their health care would cost before getting care, according to a recent report by the Public Agenda and the Robert Wood Johnson Foundation.

A little more than half (53%) of the individuals who compared the prices of common healthcare services did, in fact, save money.

The report also broke down the various places employees turned to for price info before getting medical care and found:

  • 55% went to a friend, relative or colleague
  • 48% went to their insurance company (by phone or online)
  • 46% went to their doctor
  • 45% asked a receptionist or other doctor’s office staffer
  • 31% went to the hospital billing department
  • 29% asked a nurse
  • 20% relied on the Internet (other than their insurance company’s website), and
  • 17% used a mobile phone app.

Another encouraging finding from the report: Employees don’t think saving money on healthcare services means receiving lower quality care. In fact, 70% of individuals said higher prices aren’t a sign of better quality healthcare.

The bad news

But the report wasn’t all good news.

For one thing, many employees are painfully unaware of the disparity in pricing for similar healthcare services. In fact, fewer than 50% of Americans are aware that hospitals and doctor’s prices can vary.

There are also problems when employees do inquire or shop around for less costly health care.

Sixty three percent of Americans say there isn’t enough information about how much medical services cost.

And when employees do at least inquire about cost before seeking treatment, most don’t think the next and most critical step: comparing multiple providers’ prices. Just 20% of the study respondents who asked about pricing went on to compare pricing.

Where HR comes in

Overall, the report is good news for employers, and firms should take the findings as evidence employees are finally ready to help find ways to lower the company’s overall health costs.

But it’s up to HR pros to help them succeed.

One way: Rolling out “how to” session on healthcare service comparison tools and finding providers — and this is especially important for small- and mid-sized companies. Employees at these firms are more likely to seek medical services based solely on location.

As Tibi Zohar, president and CEO of DoctorGlobe put it:

“The reality for most small to mid-size companies is that their health plan members tend to continue to seek health care at the nearest hospital or the one recommended by their doctors or friends.”

Another effective tactic: Adding incentives when employees use cost transparency tools in the form of premium discounts, contributions to HSAs or FSAs or even old-fashioned gift cards.

Remember, the transparency tools are those that employees can relate to personally and show exactly how much they will pay out-of-pocket for medical services.

See the original article Here.

Source:

Bilski J. (2017 April 21). Healthcare services: employees want to find less costly care, but need HR's help [Web blog post]. Retrieved from address http://www.hrmorning.com/healthcare-services-employees-want-to-find-less-costly-care-but-need-hrs-help/


Are Healthcare Cost-Shifting Efforts at a Tipping Point?

Are you having trouble controlling your healthcare cost? Take a look at this interesting article from Employee Benefits Advisor on how rising healthcare costs are affecting employers by Bruce Shutan.

With the fate of healthcare reform in limbo, new research suggests employers are moving forward with a host of incremental changes to their health and wellness plans in hopes of curtailing costs on their own.

Kim Buckey, VP of client services at DirectPath, an employee engagement and healthcare compliance technology company, has noticed a slowdown in adoption of high-deductible health plans and cost-shifting strategies that aren’t quite living up to expectations. DirectPath’s 2017 Medical Plan Trends and Observations Report, based on an analysis of about 975 employee benefit health plans, found employers applying creative methods for cost control.

Buckey noted greater use of health savings accounts, wellness incentives, price transparency tools and alternative care options.

Slightly more than half of the employers studied by DirectPath offer a price transparency tool, while another 18% plan to do so in the next three years. Price-comparison services were found to save employees and employers alike an average of $173 and $409, respectively, per procedure.

In an effort to reduce costs and the administrative burden of tracking coverage for dependents, surcharges on spouses who can elect coverage elsewhere soared more than 40% within the past year to $152 per month.

The number of plans that offer wellness incentives rose to 58% from 50% between 2016 and 2017. Rewards included paycheck contributions, plan premium discounts, contributions to HSAs and health reimbursement arrangements and reduced co-pays for office visits. HSAs were far more popular than employee-funded HRAs (67% vs. 15% of employers examined), while employer contributions to HSAs increased nearly 10%.

Barriers to care and cost containment
A separate survey conducted by CEB, a technology company that monitors corporate performance, noted that although as many as one-third of organizations offer telemedicine, more than 55% of employees aren’t even aware of their availability and nearly 60% believe they’re difficult to access.

DirectPath and CEB both found that the average cost of specialty drugs increased by more than 30%. This reflects research conducted by the National Business Group on Health. Nearly one-third of NBGH members said the category was their highest driver of healthcare costs last year.

The pursuit of a panacea for rising group health costs has been meandering. When Buckey’s career began, she recalls how indemnity plans gave way to HMOs and managed care, then HDHPs, consumer-directed plans and private exchanges. “There is no one silver bullet that’s going to solve this problem,” she explains, “and I think employers and their advisers are starting to understand that it’s got to be a combination of things.”

More employers are now realizing that cost-shifting isn’t a viable long-term solution and that “whatever changes are put in place will require a well thought-out, year-round and robust communication plan,” she says.

There’s also a serious need to improve healthcare literacy, with Buckey noting that many employees still struggle to understand basic concepts such as co-pays, deductibles and HSAs. Consequently, she says it’s no wonder why they often “just shut down and do whatever their doctor tells them.

“So I think anything that advisers and brokers can do to support their employers in explaining these plans, or whatever changes they choose to implement,” she continues, will help raise understanding and eventually have a positive influence on behavior change. This, in turn, will help lower employee healthcare costs.”

See the original article Here.

Source:

Shutan B. (2017 April 5). Are healthcare cost-shifting efforts at a tipping point? [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/are-healthcare-cost-shifting-efforts-at-a-tipping-point