Losing Sleep Over Benefits Technology? Get Over It!
Are you having a hard time figuring out all the different technologies associated with your benefits program? Read this great article by Linda Keller from SHRM on how to navigate through the different technologies accociated with you employee benefits program .
It’s easy to get caught up wanting to deliver a sophisticated platform to engage your workforce. Many benefits technology solutions promise to make employees smarter consumers of health care through slick recommendation engines, bots, and avatars delivered on smart phones.
I advise you to keep these three things in mind when you evaluate benefits technology:
See the original article Here.
Source:
Keller L. (2017 May 23). Losing sleep over benefits technology? get over it! [Web blog post]. Retrieved from address https://blog.shrm.org/blog/losing-sleep-over-benefits-technology-get-over-it
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 It initially raises the federal deficit when taxes are repealed, leading to 864,000 more jobs in 2018.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).
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 https://www.commonwealthfund.org/publications/issue-briefs/2017/jun/ahca-economic-and-employment-consequences
401(k) Borrowing Isn’t Free
Have your employees been dipping into their 401(k)s to support their financial needs? Then take a look at this article by David Sherman from Employee Benefit Adviser on why employees shouldn't dip into their 401(k)s and what employers can do to help employees support themselves financially without having to use the money saved in their 401(k)s.
When dire financial need strikes, employees often tap their retirement accounts. While there are cases in which a 401(k) withdrawal makes sense, these loans should be viewed as an absolute last resort.
There are significant downsides related to 401(k) loans such as including penalties, administration and maintenance fees as well as “leakage” from retirement accounts. This occurs when an employee takes a loan on their 401(k), cashes out entirely or leaves their job and rolls over their account to their new employer.
Borrowing from retirement plans presents hazards to the employer, as well. More employers are minimizing the ability of employees to dip into their 401(k) savings by limiting the number of loans from 66% in 2012 to 45% in 2016, according to SHRM. Despite this, the bottom line is that employees need access to low cost credit.
More than 1-in-4 participants use their 401(k) savings for non-retirement needs, according to financial education provider HelloWallet. That amounts to a startling $70 billion of retirement savings that employees are siphoning away from their future.
There are hidden costs to 401(k) loans. One of the perceived benefits of a 401(k) loan is that the borrower isn’t charged any interest. That’s a fallacy: 401(k) loans typically include interest rates that are 1 to 2 points higher than the current Prime Rate plus administrative fees. While the borrower pays this money to him or herself rather than to a bank, these “repayments” don’t take into account penalty of taking money out of a 401(k) for months or years when it might have enjoyed market gains.
The downside of the interest rate is that it makes paying back the loan more difficult and this will likely lead to 401(k) leakage. In some cases, loopholes that allow employees to raid their 401(k)s before retirement reduce the aggregate wealth in those accounts by 25%. Simply put, this translates into having the most senior and highest paid employees stay on the job because they do not have enough funds in their account to retire. From an HR administrator’s standpoint, that can increase overall costs, since employees who cannot afford to retire are drawing higher-than-average salaries. And thanks to their advanced age, they also run-up costs on the employer’s medical plan.
The financial wellness alternative
Employers should offer socially responsible alternatives to borrowing from their 401k. Not only to ensure that older workers can afford to retire and make room for younger, less-expensive hires, but to ease the financial burden for employees when emergencies do happen. This should be offered as a voluntary benefit with no risk to employers. In a recent Wall Street Journal article, “The Rising Retirement Perils of 401(k) ‘Leakage’” Redner’s Markets made that leap offering a low-cost Kashable loan to its employees. It stopped leakage and offered employees of the online grocer much needed relief from financial stress.
Adding a financial wellness solution to the employee voluntary benefits package that provides access to responsible credit is a first step in untangling employees’ financials. For employees struggling with college loans and credit card debt, this financial-wellness benefit allows them to borrow when needed at a low rate. For the 35% of employees surveyed by PWC in 2016 that said they had trouble meeting their monthly household expenses and the 29% that said they had trouble meeting their minimum credit card charges each month, this voluntary program provides multiple benefits. For the employee, it is an opportunity to build or improve their credit score, and provide relief from financial stress. To the employer, it’s a risk-free solution to stop the leakage from retirement accounts.
See the original article Here.
Source:
Sherman D. (2017 June 5). 401(k) borrowing isn't free [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/401-k-borrowing-isnt-free?feed=00000152-1377-d1cc-a5fa-7fff0c920000
Would States Eliminate Key Benefits if AHCA Waivers are Enacted?
If lower premiums were a possibility, would states actually enact waivers to exclude certain essential health benefits? Check out this article from the Kaiser Family Foundation to learn more about the possible result of giving states the power to use waivers when it comes to healthcare coverage.
As the debate over amending health insurance market rules continues, proponents of changing the law have proposed reducing the health benefits provided by non-group plans as a potential way to lower premiums in the market. The Affordable Care Act (ACA) prescribes 10 categories of essential health benefits that non-group and small-group policies must cover, and provides in most cases that the scope of these benefits should be similar to those in employer group health plans, which cover most non-elderly Americans. The American Health Care Act (AHCA), which passed the House of Representatives on May 5, would permit states to seek waivers to amend the required benefits if doing so would achieve one of several purposes, including lowering premiums.1 We look below at the benefits covered by non-group plans before the ACA as a possible indication of how states could respond to the waiver authority under the AHCA.
Background
The lack of coverage for benefits such as maternity and mental health care in many nongroup plans, which was a frequent point of criticism when the ACA was debated, was one (but not the only) reason why non-group coverage was less expensive before the ACA was enacted. In the pre-ACA market, certain benefits were excluded to make coverage more affordable and to guard against potential adverse selection by applicants with more predictable, chronic health care needs. Even with the ability to medically screen applicants for non-group policies, some insurers excluded coverage for conditions such as mental health and substance abuse care unless states required that they be covered.
States determined coverage requirements for health insurance policies prior to the ACA. A few states defined a standard benefit package to be offered by insurers in the nongroup market. Most states adopted some mandates to cover or offer specific benefits or benefit categories – such as requirements for policies to cover maternity benefits or mental health treatments. In addition to deciding which categories of benefits must be included or offered, states might also specify a minimum level or scope of coverage; for example, a few states required that mental health benefits have similar cost sharing and limits as other outpatient services (sometimes called parity).
Pre-ACA non-group plans varied considerably in scope and comprehensiveness of coverage, with some plans limiting benefit categories or putting caps on benefits, while others offered more comprehensive options. For example, some plans did not cover prescriptions, others covered only generic medications or covered a broader range of medications subject to an annual cap, while still others covered a more complete range of medications. This diversity was possible because insurers generally were able to decline applicants with pre-existing conditions, and could require their existing customers to pass screening if they wanted to upgrade to more comprehensive benefits. This prevented applicants from selecting the level of coverage they wanted based on their known health conditions, but also prevented many people from being able to obtain non-group coverage at all.
To look more closely at the benefits provided in pre-ACA non-group plans, we analyzed data submitted by insurers for display on HealthCare.gov for the last quarter of 2013. Beginning in 2010, insurers submitted information about their non-group plans to be displayed on HealthCare.gov; the data includes information on benefits, coverage levels for each benefit, benefit limits, premiums and cost sharing parameters, and enrollment. We focus here on the benefits and benefit limits. We use data from 2013 because it is the most current year prior to when the ACA’s major insurance market changes went into effect, provides more benefit categories than some earlier years, and has more information about benefit limits for each category. We note, however, that the ACA prohibition on annual dollar limits took effect shortly after enactment and was phased in between 2010 and 2013, so these types of limits would likely not be reflected often in data we received. This means that our analysis likely misses some of the limits (for example, dollar limits on prescriptions) that existed in nongroup policies before the ACA was enacted. We limit the analysis to plans where insurers report enrollment in the product upon which the plan is based. Our methods are described in more detail in the appendix.
Results
The data include 8,343 unique plans across 50 states and the District of Columbia. We looked at the percentage of plans that included coverage for major benefit categories. Not surprisingly, all of the plans covered basic benefits such as inpatient hospital services, inpatient physician and surgical services, emergency room services, and imaging services, while virtually all (99%) covered outpatient physician/surgical services, primary care visits, home health care services, and inpatient and outpatient rehabilitation services.
Certain other benefits, however, were covered much less often (Figure 1). Large shares of plans did not provide coverage for inpatient or outpatient mental/behavioral health care services (38% each), inpatient or outpatient substance abuse disorder services (45% each), and delivery and inpatient care for maternity care (75%).2 In addition, 6% of plans did not provide coverage for generic drugs, 11% did not provide coverage for preferred brand drugs, 17% did not provide coverage for non-preferred brand drugs, and 13% did not provide coverage for specialty drugs.
Even when coverage was provided, some policies had meaningful limits or restrictions for certain benefits. Mental/behavioral health care is a case in point. Among plans with coverage for outpatient mental/behavioral health services, 23% limited benefits for some or all mental/behavioral services to fewer than 30 visits or sessions over a defined period (often a year) and 12% limited it to 12 or fewer. A small share (about 5%) of plans providing coverage for outpatient mental/behavioral health services provided benefits only for conditions defined as severe mental disorders or biologically-based illnesses or applied limits (such as visit limits) if the illness was not defined as severe or biologically based. The definitions of these terms varied by state.3
Similarly, for plans covering outpatient substance abuse disorder services, 22% limited the benefit to fewer than 30 visits or sessions; 12% limited it to 12 or fewer. In many of these plans, visits for either mental health or substance abuse care were combined to apply toward the same limit.
Among the relatively few plans that provided coverage for delivery and inpatient maternity care, a small share (3%) applied separate deductibles of at least $5,000 for maternity services and some plans (6%) applied a separate waiting period of at least year before benefits were available. A few plans restricted benefits to enrollees enrolled in family coverage or required that the enrollee’s spouse also be enrolled.
Discussion
The ACA raised the range of benefits provided by non-group policies such that the benefits now offered by non-group plans are comparable to those offered in employer group plans. The desire to lower non-group premiums, however, has led policymakers to consider allowing states to roll back the essential health benefits prescribed by the ACA.
Among the pre-ACA policies we reviewed, virtually all included benefits for certain services: hospital, physician, surgical, emergencies, imaging, and rehabilitation. Other services were covered less often, including prescription drugs, mental/behavioral health care, substance abuse disorder care, and coverage for pregnancy and delivery. This latter group of services all have some element of predictability or persistency that make them more subject to adverse selection. For example, many people use drug therapies over long periods and would be much more likely to select policies covering prescriptions than people who do not regularly use prescription drugs. If states were to drop any of these services from the list of essential health benefits for non-group plans, access to them could be significantly reduced.
The difficulty is that insurers would be very reluctant to offer some of these services unless they were required in all policies because people who need these benefits would disproportionately select policies covering them. In the pre-ACA market, insurers were able to offer products with different levels of benefits because they generally were able to control who could purchase them by medically screening new applicants. Even existing customers faced medical screening if they wanted to change to a more comprehensive policy at renewal. Through these practices, insurers were able to avoid the situation where people could choose cheaper policies when they were healthy and upgrade to better benefits when their health worsened. The proposed AHCA market rules, however, would not guard against this type of adverse selection, because people with pre-existing health conditions would be able to select any policy offered at a standard premium rate, and change their selection annually without incurring a penalty, as long as they maintained continuous coverage. This means that the range of benefits provided by insurers in states with essential health benefit waivers would likely be more limited than what insurers offered in the pre-ACA non-group market. Benefit choice might be particularly limited in states that specify only a few benefits as essential.
It is hard to imagine that insurers would cover certain benefits if they were not required. For example, some insurers before the ACA did not offer mental health benefits unless required by a state, even when they could medically screen all of the applicants. And given the current problems with substance abuse in many communities, insurers would be reluctant to include coverage to treat them unless required. Offering these benefits as an option (for example, including them in some policies but not in others), would result in very high premiums for optional benefits because people who know they need them would be much more likely to choose them.
The AHCA presents state policymakers with a dilemma: they can reduce the essential health benefits to allow less expensive insurance options for their residents, but doing so may eliminate access to certain benefits for people who want and need them.
See original article Here.
Source:
Claxton, G., Pollitz, K., Semanskee, A., Levitt, L. (14 June 2017) Would States Eliminate Key Benefits if AHCA Waivers are Enacted? [Web Blog Post] Retrieved from address https://www.kff.org/health-reform/issue-brief/would-states-eliminate-key-benefits-if-ahca-waivers-are-enacted/
Rising Health Care Costs Threatening Employees’ Financial Goals
Did you know that the rising costs of healthcare could be having a negative effect on your employees' financial goals? Check out this great read by Marlene Y. Satter from Benefits Pro on how your employees' finances are being impacted by the costs of healthcare.
Employees are under financial stress — big time. In fact, 56 percent of them are stressed about their financial situation, and more than half of them say it’s taking a toll on both their ability to focus and their productivity on the job.
That’s according to the latest Bank of America Merrill Lynch Workplace Benefits Report, which finds that not only are 53 percent of stressed employees having trouble concentrating on their work, the cost of health care is a big shadow cast over workers’ financial situations. And that’s already an issue, with 43 percent of employees owning up to spending 3 or more hours a week while at the office dealing with personal financial matters.
As more employees find themselves shelling out more from their own pockets to pay health care bills — 69 percent of workers said so in 2015, but 79 percent said so in 2016 — it’s no surprise to hear that health care costs are up 10 percent since 2015. No wonder they’re stressed; salaries certainly haven’t risen to match.
Those rising health care costs are taking a bite out of most employees’ other financial goals — among workers who have experienced increasing health care costs, 56 percent are having to save less toward other objectives.
Women in particular are abandoning more discretionary spending and debt management to cover health care costs than men, with 72 percent chucking spending on recreation or entertainment, compared with 59 percent of men; 63 percent saving less for retirement, compared with 62 percent of men; and 50 percent paying down less debt, compared with 46 percent of men.
And the more expensive health care becomes, the more employees appear to appreciate employer-provided health coverage — with workers ranking health benefits as their top employer benefit (40 percent), followed by their 401(k) plan (31 percent).
Even among employees who class themselves as optimists about their financial futures, worries about health care and its cost are weighing them down. And as might be expected, money woes weigh more on women than men, even — or perhaps especially — when it comes to health care. While 52 percent of men say that becoming seriously ill and unable to work is a major concern (even larger for men than having to work longer than they planned), 58 percent of women fear illness and subsequent absence from the workplace.
And more than half of employees say that financial stress is negatively affecting their physical health. Different generations feel the effects more, with 51 percent of boomers, 56 percent of Gen Xers and 68 percent of millennials saying money worries are literally making them sick. Employers need to be aware of this and take steps to deal with it, particularly since it translates into a toll not just on workers but on the employer’s bottom line — via higher absenteeism rates and higher health care costs.
See the original article Here.
Source:
Satter M. (2017 June 1). Rising health care costs threatening employees' financial goals [Web blog post]. Retrieved from address https://www.benefitspro.com/2017/06/01/rising-health-care-costs-threatening-employees-fin
Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse Most Often Uncovered by Non-Group Health Plans
What would happen to the non-group insurance market under the American Health Care Act (AHCA)? Read this article from the Kaiser Family Foundation to learn more.
Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the Affordable Care Act (ACA) essential health benefits requirement took effect, finds a new Kaiser Family Foundation analysis.
Other major benefits most often left uncovered before the ACA include substance abuse disorder services (inpatient and outpatient services each not covered by 45% of 2013 non-group plans) and mental/behavioral health services (inpatient and outpatient services each uncovered by 38% of the plans).
Additionally, some plans that covered maternity, substance abuse or mental health care services included meaningful limits or restrictions, the analysis finds.
Since 2014, the ACA has required non-group plans to cover 10 categories of essential health benefits comparable to those offered in employer group plans. The new analysis offers a window into how insurers could respond if the essential health benefits requirement is rolled back, a change being considered by Congressional leaders and allowed through state waivers by the House-passed American Health Care Act as a potential way for lowering premiums.
Without the requirement, however, insurers in the non-group market would likely be reluctant to offer coverage for some expensive services that have an element of predictability and persistence, as people who needed these benefits would disproportionately select policies covering them. Unlike in the pre-ACA market, insurers would not be able to exclude from coverage altogether people with pre-existing conditions.
The new analysis finds that all 2013 non-group plans covered basic benefits, such as inpatient hospital services, inpatient physician and surgical services, and emergency room services. Some plans didn’t provide various levels of prescription drug coverage, however.
The analysis uses data insurers provided for the Health Plan Finder on HealthCare.gov for the last quarter of 2013. Certain provisions of the ACA, such as the prohibition of annual and lifetime dollar limits on benefits, had already begun to be phased in by that point, so the data does not reflect all of the types of limitations in non-group policies prior to the ACA.
See original article Here.
Source:
(14 June 2017) Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse, Most Often Uncovered by Non-Group Health Plans. [Web Blog Post]. Retrieved from address https://www.kff.org/health-reform/press-release/analysis-before-aca-benefits-rules-care-for-maternity-mental-health-substance-abuse-most-often-uncovered-by-non-group-health-plans/
High-Deductible Health Plans Promote Increased Wellness Program Participation
Are you looking for a new way to increase participation in your wellness program? Take a look at this interesting article by Nick Otto from Employee Benefit News on how offering high-deductible health plans can be a great way to boost enrollment into your wellness program.
Employer-provided healthcare continues to be the most common access to health insurance in the U.S., and as employers continue to look for ways to cut costs, consumer-driven high-deductible health plans continue to grow with the added benefit of increased employee engagement in healthcare choices.
Fourteen percent of the U.S. population was enrolled in a CDHP and 14% was enrolled in an HDHP, a slight increase for both from the previous year, according to the 2016 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey.
And the number of workers who were in a CDHPs or HDHPs was more likely than those in a traditional plan to exhibit cost-conscious behaviors, according to a recent report from the non-partisan Employee Benefit Research Institute.
“This survey found that high deductibles are associated with new behaviors [that are] often encouraged by employers and insurers,” says Paul Fronstin, director of EBRI’s Health Research and Education Program and co-author of the report.
The theory behind CDHPs and HDHPs is that the cost-sharing structure is a tool that will be more likely to engage individuals in their health care, compared with people enrolled in more traditional coverage, the study suggests.
And with the employees taking a bigger interest in their healthcare planning, employers are noticing their wellness programs taking a bigger role.
The study focused on three types of wellness programs: a health-risk assessment, a health-promotion program to address a specific health issue, and a biometric screening.
“CDHP enrollees and HDHP enrollees were more likely than traditional-plan enrollees to report that they tried to find cost information. They are also more likely to participate in wellness programs.” Adds Fronstin.
Specifically, 45% of CDHP enrollees reported that their employer offered a health risk assessment, compared with 34% of traditional-plan enrollees and 30% of HDHP enrollees. When asked about the availability of health-promotion programs, 53% of CDHP enrollees, 32% of HDHP enrollees and 41% of traditional-plan enrollees reported that their employer offered such a program.
Additionally, when asked about biometric-screening programs, 45% of CDHP enrollees reported that their employer offered such a program, compared with 36% among traditional-plan enrollees and 33% among HDHP enrollees.
CDHP and HDHP enrollees were also more likely than traditional-plan enrollees to report that their employer offered a cash incentive or reward for participating in a biometric screening program. Seventy percent of CDHP and 67% of HDHP enrollees reported a cash incentive or reward for a biometric screening, compared with 51% among traditional-plan enrollees.
While these numbers represent self-reported awareness of available health and wellness programs and cannot be cross-referenced with objective data from employers and insurers, it is significant that, across the board, CDHP enrollees are aware and participate at higher rates in wellness programs, the author notes.
Another trend the study found was the increased interest in health savings accounts.
Among individuals enrolled in CDHPs, 56% opened an HSA, 19% were in an HRA, and 25% were enrolled in an HSA-eligible health plan but had not opened an HSA.
It’s more common for employers to contribute to HSAs than in the past, and the dollar amount is also increasing, EBRI says. Seventy-eight percent of CDHP enrollees reported that their employer contributed to the account in 2016, up from 67% in 2014.
Additionally, 20% of CDHP enrollees reported an employer contribution of at least $2,000 in 2016, up from 10% in 2014.
See the original article Here.
Source:
Otto N. (2017 June 1). High-deductible health plans promote increased wellness program participation [Web blog post]. Retrieved from address https://www.benefitnews.com/news/high-deductible-health-plans-promote-increased-wellness-program-participation
An Update on Health Care and Tax Reform
Make sure you are staying up-to-date with all the recent changes happening in healthcare. Here is a great article by Joseph Minarik from the Committee for Economic Development to help you stay informed with everything going on with the new healthcare legislation.
The status of what may be the Administration’s two highest legislative priorities, health care reform and tax reform, remains uncertain.
The overwhelming consensus in Washington is that the Administration and the Congress have virtually no alternative but to either complete or abandon health care reform before taking up tax reform. That is because both an Administration health care reform (to “repeal and replace” Obamacare, more formally known as the Affordable Care Act, or ACA), and any Administration tax reform, can be enacted only under reconciliation procedures in the Senate (which prevent a filibuster that would require 60 votes to break). By budget process rules, there can be only one reconciliation process in progress at one time. The current process was designed expressly for health care reform. The health care reform process cannot continue if tax reform is begun.
A decision to abandon health care reform would be extremely painful to the many Republicans in Congress who made repealing Obamacare their signature campaign promise. This would certainly be an admission of failure in the current environment, with Republicans controlling the White House and both chambers of the Congress. But that delays and reduces the time available to complete any attempted tax reform. Of course, the relevant policy players can have tax reform conversations among themselves, but that is not the same as actually engaging in a public debate over actual legislative language.
So the current debate over health care legislation is time-sensitive. And passing the House health care bill, the American Health Care Act (AHCA), was extraordinarily difficult. The Senate cannot pass the AHCA, and their passing any similar bill would likely be even more difficult than was the process in the House.
To begin, Democrats will provide zero votes to “repeal” what they hold as the signature achievement of the Obama Administration. Republicans have 52 votes in the Senate, and thus, even under the reconciliation procedure, can afford to lose only two votes. (The Vice President would be called on to break a 50-50 tie.) Thus, the Senate Republicans’ margin for error is extremely small, and the ideological spread of their membership is probably wider than is that of their caucus on the House side.
And under these daunting arithmetic constraints, the Senate health bill must thread several very small substantive needles.
The bill will be under very tight fiscal constraints. The Republicans want the health bill to reduce the deficit, so that the money it saves can be used to pay for tax reform. This is expected even after the repeal of many of the taxes and fees and some of the spending cuts that Obamacare used to finance itself.
The programmatic expectations on the bill will be considerable. Opinion surveys showed “Obamacare” to be highly unpopular. But when not identified with the bill, many of Obamacare’s key features were found to be resoundingly popular – even among Republicans, and even in the very same surveys. One such feature was eliminating discrimination against persons with pre-existing conditions. At the same time, one of the highest House Republican priorities was reducing premiums. The House Republicans could find no alternative way to reduce premiums but to water down the protections for those with pre-existing conditions, in some instances through provisions that were less than totally transparent. The Senate Republicans are likely to be less accepting of such provisions.
The House Republican AHCA sought to attract younger, healthier households to purchase insurance (without the mandate that their Members abhor) by raising the relative premiums of older enrollees. That is unlikely to sit well in the Senate – or at least well enough with a margin of only two votes.
Next on what could be a very long list of concerns is the repeal of Obamacare’s Medicaid expansion. There are 20 Republican Senators who represent states that have expanded Obamacare. As much as some Republicans opposed the Medicaid expansion, the same Senators are unwilling to impose a sudden reduction in their states’ federal funding to repeal it. Many of those Republicans also do not want to remove health care coverage from the working families who were covered by the expansion.
In the broadest terms, Republican Senators will not want to take away a benefit that has been given to the citizens of their states – even though those Senators may have on a principled basis opposed granting that benefit in the first place. But achieving everything that they want to achieve in this bill, subject to a rigorous budget constraint, may prove impossible.
And then, assuming the Senate manages to pass a bill, it will then have to reconcile its very different bill with that of the House. It is always possible that many House and Senate Republicans will decide to sacrifice their preferences to that the Administration can have its first-year victory to set a positive tone (and avoid a highly negative one). But the first instinct of a Member of Congress is almost always self-preservation, and the fondest hope and expectation is that the next election will see the triumph of his or her ideological view and thus the ability to achieve all of the goals that cannot be obtained in the present because of the service of doctrinal purity.
Whether health care reform succeeds or not, the President and the Congress are sure to find that tax reform is every bit as complex as is health care reform. Again, they will begin with the tightest budget constraint, along with a lengthy list of priorities. They already have discussed tax cuts for large businesses and small businesses, public corporations and LLCs, and of course a massive tax cut for the middle class. How all of that happens without widening the already excessive and growing budget deficit is a true puzzle. At present, the House Ways & Means Committee chair continues to maintain that he will put forward a revenue-neutral bill by relying on the so-called “border-adjustment tax” which CED has discussed in a recent policy brief, and which has proven highly unpopular in the Senate. This makes the prospects even more murky.
If all of this fails, which it may or may not, the Administration and the Congress will find themselves at the end of the year with no particular legislative achievement. There is some possibility that they would respond to that conundrum by following the path of least resistance and proposing a large net tax cut, forcing the political opposition to vote against it and thus cross many taxpayers. But that, of course, would worsen the already troubling budget outlook.
See the original article Here.
Source:
Minarik J. (2017 May 17). An update on health care and tax reform [Web blog post]. Retrieved from address https://www.ced.org/blog/entry/an-update-on-health-care-and-tax-reform
7 Morning Rituals To Make Your Day 8 Times More Productive
Are you looking for a way to make your morning more productive? Take a look at this great article by Karen Reed from Positive Health Wellness and check out these 7 great tips for boosting your productivity in the morning.
“You will never change your life until you change something you do daily. The secret of your success is found in your daily routine. ” — John C. Maxwell
Rituals make you who you are. The morning ritual is rediscovering productivity at the start of the day. You need not wake at the crack of dawn to have a productive start to your day. Instead, you need to take a close look at how you start your day and figure out how to get more from it. One way to do that is establishing a morning ritual.
What Is Morning Ritual?
A morning ritual is something you do daily as part of your morning.It must be a right blend of both physical activities and mental activities.If you start your day with a few simple tasks, it helps you to begin a cycle of results that will increase your vigor to be productive through your day.
The morning ritual gives you a chance to center yourself and embrace your day instead of fleeing from it. It will help you to enjoy the luxury of time you’ve given yourself by rising at an appropriate time.
Why Creating A Morning Ritual Will Make You More Successful?
Establishing healthy habits and morning routine are critical for a lifetime of success. Your morning routine sets the right tone for the whole day. If you do each day right, you’ll do life right. If you don’t have a good morning routine, you may feel overwhelmed and disorganized.
The first step to work smarter and not harder is that you need to create healthy habits. The personal ritual that you set up for yourself will put you in the right mindset and offset any morning procrastination.
The other reason to create a morning routine is to avoid mental fatigue. We have only certain amount of energy and willpower when we wake up each morning. It slowly gets drained away with decisions. It is especially true if you have hundreds of small decisions to make in the morning that means nothing, but will affect how you make decisions for the rest of the day.
So try to have the first hour of your day vary as little as possible with routine. Knowing how the first few minutes of your day looks like, is powerful and it helps you to feel “in control” and “non-reactive.” This action, in turn, reduces anxiety and ensures that you’re more productive throughout the day.
Steps To Put Your Morning Ritual Into Place
- Write down a list of things you do every morning and what you like to add.
- Estimate the time it’ll indeed take to do everything on your list.
- Adjust your wake-up time to fit in your new ritual.
- Familiarize your list each morning for at least 2-3 days before making adjustments.
- Once you’ve got used to your changes, start enjoying your morning rituals.
You could work on “Habit Stalking” to craft yourself a good morning routine that works for you. Habit Stalking is a way to build a new practice into your life by stalking it on top of something that you’re currently doing.
Avoid designing something long and complicated when you’re starting off. Start with an easily manageable chunk of time. You can start with a five or 10-minute ritual and move your way up. Just take your time to build a balanced morning schedule. There’s nothing like starting your day off fabulous both mentally and physically.
Benefits Of Having A Morning Ritual
- A morning routine helps you to feel more grounded and embodied.
- It helps you to slow down and tune into your intuition.
- Enables you to batch your energy sources and self-care in a defined amount of time.
- Makes you less reactive and more intentional as you start your work day.
- Helps you feel more productive without feeling fragmented.
- Promotes more space and pause to make choices that nourish you.
- It syncs with your natural feminine rhythms and those of nature.
- It optimizes your decision making power for creative and productive work.
7 Morning Rituals You Should Adapt
Here are seven tips to build your morning routine that will help to become the best version of yourself and will make you take on your day confident and energized.
Meditation
Meditation helps you to start your day on a positive note. It helps you to be more at peace with yourself. Research has shown that meditation can enhance your:
- Attention
- Creativity
- Working memory
- Emotional regulation
- Immune function
- Cognitive performance
- Self-control
- Healthy habits
- While reducing stress
Researchers from the Carnegie Mellon University have found that meditation reduces Interleukin-6 an inflammatory health biomarker found in highly stressed individuals. If you begin your day with meditation, it calms your “busy mind syndrome,” which results if you don’t activate your mental spam filter.
Meditating helps to filter out the internal and external noise and negative self-talk that can sabotage your otherwise sharp, clear, perpetual acuity. Meditating as a morning ritual helps you to tame your emotions and keeps your emotional brain in check.
A study published in the American Journal of Psychiatry says that patients who were suffering from an anxiety disorder or panic disorder underwent three months of meditation and relaxation training. And at the end of the three-month period, their panic attacks had substantially reduced.
Meditation also improves empathy and positive relationships. It enhances feelings of competence about one’s life and promotes environmental mastery, ego resilience, and purpose in life.
What a beautiful way to start your day, filling your soul,mind, and body from the “Higher Power” to embark on your day’s journey.
Gratitude
Robert Emmons, the world’s leading scientific expert on gratitude,writes, “it’s an affirmation of goodness. We affirm that there are good things in the world, gifts, and benefits we’ve received.”
In the second part of gratitude, he says, “we recognize that the sources of this goodness are outside of ourselves. … We acknowledge that other people—or even higher powers, if you’re of a spiritual mindset—gave us many gifts, big and small, to help us achieve the goodness in our lives.”
After you’ve completed your meditation just take a few minutes and be thankful for all the positive things that happened to you. You might be grateful for an unexpected visit from an old friend, a beautiful encounter with a kind stranger, or a new opportunity that shines your way.
Practicing gratitude as a morning ritual can have tremendous benefits for your overall health. Being grateful increases your self-esteem makes you more optimistic and less materialistic and self-centered. It increases your happiness, makes you more relaxed, resilient and less envious.
Gratitude increases your energy, longevity, improves your sleep quality and immunity. It boosts your career growth by increasing your goal achievement, productivity and decision making. It results in better management and improved networking.
Your social relationships get a boost by being grateful. It results in healthier marriage, more friendships and deeper relationships. The real power of gratitude is that it helps you to pick out and focus on what is working in your life –what is in tune with your being as a whole. If you have time, you can also practice gratitude journaling.
Writing Down Your Tasks
Journaling your important tasks is a practical ritual. It helps you to focus your day and life on what is essential. It helps you to prioritize and manage your time better.
Start the ritual by identifying and writing down one to three essential tasks you need to complete during that day. They may be the tasks that support your long-term goals that are related to your purpose, passion or the general direction of life.
You can also write down mundane tasks which David Allen, productivity speaker and author of Getting Things Done calls “core dump.”this involves writing down every project, task, and activity you need to address.
You can write down every “to do” item you can think of. It clears the space in your head for more important topics.
Morning Pages is a technique developed by Julia Cameron, author of The Artist’s Way. It involves writing approximately 750 words of conscious writing. If you follow this practice as a morning ritual, it clears your head for the day’s most important thinking.
Writing down your tasks helps you to process your emotions, gives a record of your past, gains you a sense of achievement, helps you think big and makes you more committed.
Positive Affirmations
Barrie Davenport writes in live bold and bloom that affirmations are a form of auto suggestion. If you practice it deliberately and repeatedly, they reinforce chemical pathways in the brain and strengthen neural connections.
If you practice positive thought patterns or affirmations regularly, you create neuroplasticity in the area of the brain that processes what you’re thinking about.
Some of the positive affirmations you can say are:
- I awake in the morning feeling happy and enthusiastic about my day.
- I can tap into the wellspring of inner happiness anytime I wish.
- I have healthy boundaries with my partner
- Success is my natural state,and I expect to be successful in all of my endeavors.
- I am energetic and enthusiastic. Confidence is my second nature.
- I always attract only the best of the circumstances and the best positive people in my life.
- I choose to be proud of myself.
- I am talented.
- I am attractive and beautiful.
- Every cell in my body quivers with energy and good health.
- I breathe in peace. I breathe out chaos and disorder.
Exercise
Morning is a great time for exercise. It’s quiet and peaceful in the morning.You can go for a mindful run and have little interruptions. Even a simple 5-minute exercise workout will wake up your muscles and get them ready for the day ahead.
A quick morning exercise jumpstarts your cells.You could jog, walk, dance, do yoga- anything to get your blood flowing. The options are endless. If you’re on a weight-loss mission, a brisk morning walk is a key to shedding a few pounds.
According to researchers from Northumbria University, people can burn up to twenty percent more body fat by exercising in the morning when they are on an empty stomach.
Researchers say that the morning light helps synchronize your body clock. Researchers, from Northwestern University’s Feinberg School of Medicine in Chicago, say that light is the most potent agent to harmonize your internal body clock that regulates the circadian rhythms. This aspect, in turn,controls energy balance. It is not rocket science to understand that including exercise as a morning ritual keeps you productive and energetic the whole day.
Listen To Uplifting Music
Music uplifts your physical and mental health in numerous ways. When you combine music and your exercise together,you get stunning results. Researchers found that participants pedaled faster when riding stationary bicycles while listening to music. Listening to pumping music helps you to run faster, and increases your workout endurance.
Music makes you feel happier because it enhances blood vessel function. It reduces stress levels and relieves depression. It improves your cognitive performance and helps you perform better in high-pressure situations. If you’re hard pressed for time, just combine this ritual while doing your morning exercise or while driving to work.
Detoxify With Lemon Water
Drinking warm water first thing in the morning helps flush the digestive system and rehydrates the body. Drinking lemon water acts as a natural flush and cleanses your liver. Lemon juice enhances stomach acid production and bile production. It results in a clean liver and lymph system.
Lemon contains vitamin C and potassium. When you drink lemon water first thing in the morning, it helps your body to absorb these vitamins and provides a little immune boost. Vitamin C is good for your adrenals and contributes to reducing your stress levels.
Since lemon water flushes your body, you enjoy a cleaner skin. The vitamin C helps in collagen production and makes your skin smooth and healthy. If you drink lemon water first thing in the morning, it will help you maintain a healthy weight.
Conclusion
You are what you frequently do everyday. If you include special routines in your daily schedule, you can turn your life around for the better. The main thing about rituals is that you can start your own and train yourself through practice.
Be conscious because routines work both in positive and negative ways. So be smart and choose the right ones. If you follow the ones that we’ve discussed above, we are positive that these morning rituals will bring only good things to your life.
See the original article Here.
Source:
Reed K. (2017 June 11). 7 morning rituals to make your day 8 times more productive [Web blog post]. Retrieved from address https://www.positivehealthwellness.com/fitness/7-morning-rituals-to-make-your-day-8-times-more-productive/
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 https://khn.org/news/senate-health-bill-would-revamp-medicaid-alter-aca-guarantees-cut-premium-support/