I discussed the proposed Save American Workers Act of 2015, a bill passed by the House, yesterday in my, “Save American Workers?” http://conoutofconsumer.blogspot.com/. Today, I’m concerned about the relentless exaggeration used by individuals claiming the sky is falling about every single thing the Republicans say about Obamacare as if a single change to the law jeopardizes whatever imagined benefit the law has achieved.
There is good news in reasonable debate including the debate over making a change to the imposition of penalties on employers of 50 or more full-time workers where full-time is currently defined as 30 or more hours a week for the PPACA and would, if the Save American Workers bill became law be changed to 40 or more hours a week, and whether that change would in fact hurt WORKERS or simply hurt Obamacare, both, or neither.
This is how the issue is framed and I don’t believe either side is being open about their motivations but I do think we can consider, on its face, whether the change from 30 hours or more to 40 hours or more should be an issue for consumers and workers. Right now I’m not persuaded that it should be an issue for consumers.
The first thing is that there is a way out for employers, so it’s not an employer mandate per se. Cost-cutting employers have always found roundabout ways of getting their workers on the cheap. Whether it’s salaries or hours, outsourcing or furloughs, or attrition, there is no employee who hasn’t confronted a situation where they didn’t feel that they’d experienced being screwed by an employer.
Obamacare has already created new opportunities for employers who continue to devise ways to work around Obamacare to make business more profitable for themselves.
We’ve seen policies where dependent coverage has increased so much in cost that employees can’t afford to purchase health insurance for their families…Perfectly OK under Obamacare.
We have seen companies that prohibit eligibility for coverage of family members of their employees who could purchase health insurance somewhere else…Perfectly legitimate under Obamacare.
We have seen companies that offer plans requiring significant additional outlays of money in the form of deductibles, co-payments, and co-insurance. Perfectly legitimate under Obamacare.
We have seen companies decide to cut worker hours below the 30-hour threshold to avoid having to offer health insurance to their employees. Perfectly OK under Obamacare.
These situations have already occurred and the employer shared responsibility provision hasn’t even been in effect yet!
This should signal that the real concern for those against the Save American Workers Act are less concerned about employees and more concerned about the health of Obamacare the law rather than the citizens it was allegedly designed to protect. We had an inkling of this with the blatant solicitation of young and healthies justified as necessary for it to make sense for health insurance companies to offer health insurance plans on exchanges.
Many of us thought it was absurd to listen to a sales pitch that told young people to enroll so that others could benefit from them statistically not needing health insurance as much as other segments of the population. A clear case of promoting the health of the law rather than the health of individuals.
The individual mandate also illustrated a strange allegiance to bolstering the law rather than the health of our population. After all, when the mandatory expanded Medicaid provisions were stricken by the Supreme Court the “fix” was to make all those individuals EXEMPT (hardship exemption) from the obligation to purchase health insurance rather than work on a new way of providing them with health services.
Similarly, when the keep-your-plan-if-you-like-it provision proved to be an empty promise since some of those “liked” plans no longer existed, again individuals were given the opportunity to instead purchase catastrophic plans through exchanges even if they were over 30 which is not what the Act intended because catastrophic coverage is frequently inadequate in protecting either health or finances in the event of a health event requiring health services.
So, it’s not a consumer motivated concern based on all the consumer concerns that have arisen that have been ignored or inadequately addressed in terms of changes to Obamacare. So what is it?
Well, where have the Obamafans fought hardest? One place has been in over-emphasizing ENROLLMENT, trying to “prove” Obamacare works by counting, recounting, correcting and counting again the number of people who gained health insurance through the marketplace and through Medicaid and CHIP (and of course through the expense of parents willing to pay for their grown children’s health insurance through the age of 26 which is in the MILLIONS).
Enrollment was somehow convoluted into success though the government itself acknowledged that the enrollment numbers included people who should never have been counted, included fraudulent enrollments, and included people who were already insured and therefore did not reduce the 47 million uninsured number. It seems that the most significant number of new enrollees could very well people newly entitled to Medicaid under expanded Medicaid provisions in their states.
But the SAVE AMERICAN WORKERS ACT promises to INCREASE enrollment in Obamacare, so shouldn’t the Obamafans like it? While the hysterics accurately quote the Congressional Budget Office’s prediction that the SAVE AMERICAN WORKERS ACT will likely REDUCE the number of individuals with employer-sponsored health insurance by one million, it also predicts that the “…number of people obtaining coverage through Medicaid, the Children’s Health Insurance Program (CHIP), or health insurance exchanges—by between 500,000 and 1 million people.”
Common sense concerning the fact that many states have not expanded Medicaid would also indicate an increase in the number of uninsured, who qualify for the hardship exemption under the individual mandate because they earn too little leading to the CBO’s prediction that the number of uninsured would increase “less than 500,000.” Perhaps it’s less about enrollment and more about a pin to the inflated self-righteous concept that poor people can gain insurance (which is NOT what Obamacare does unless it’s through expanded Medicaid) that Obamafans see as a threat.
There would be an impact in money going to the government from employers paying penalties. This is also common sense because employers would have to offer health insurance to staff if some of those staff work less than 40 hours instead of current levels of 30 hours. But the CBO also states in their predictions that “Nevertheless, most of the affected employers would continue to offer coverage because most employers construct compensation packages to attract the best available workers at the lowest possible cost.”
The CBO notes that the reduction in collection of penalties from employers would be offset of increased revenues from taxes on individuals since they anticipate that wages will go up for some workers who are no longer offered employer health insurance. But over an 11-year period, the CBO still anticipates a cost of $30.1 billion to the Federal government from lost employer penalties after the offset of increased tax revenues.
Interestingly, another concern expressed by the CBO is the increased costs of premium subsidies currently paid by the Federal government to Obamacare entitlement recipients. This also makes sense. If more people aren’t getting employer-based health insurance then they’ll use Obamacare and they’ll likely get subsidies, Obamabucks. What’s interesting is that the Democrats who advocate that everyone enrolled in Obamacare whether through state established or federal exchanges get Obamabucks (the King v. Burwell issue) which is NOT even provided under the current Act suddenly seem concerned with the cost to the Federal government if employees no longer offered health insurance enroll in Obamacare and get subsidies.
Another sensible prediction is that more people would be eligible for Medicaid and Chip, especially in states with expanded Medicaid increasing the Federal government expense. But again, since most Obamafans support Medicaid expansion and since the law was originally written to make federal Medicaid expansion dollars available to all states, why would there be concern in expanding the number of Medicaid eligible individuals in those cases where employers don’t offer their low-wage earners health insurance? Perhaps the law is really as many think, unsustainable in its current liberal payout model in terms of Medicaid funding and premium subsidies.
I don’t think the SAVE AMERICAN WORKERS ACT matters much to consumers. We are paying for Obamacare one way or another. But I don’t believe the Republicans get away with describing their efforts as SAVE AMERICAN WORKERS, either. These indirect actions are more about government infighting than meaningful changes to Obamacare that might help American workers. Surely, changing some of the known difficulties with the law such as those listed above would be a more direct way to “Save workers.”
Actually, it’s likely what it’s been, Democrats fighting for Obamacare regardless of its impact on citizens’ health CARE opportunities and Republicans fighting against Obamacare regardless of its impact on citizens’ health CARE, with a blatant disregard for the health and welfare of the poorest Americans who are omitted from the system all together through the exemption from the individual mandate for HARDSHIP.
