A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Workforce and Access

CBO estimates cost of delaying employer shared responsibilty requirements to be $12 billion

Posted on July 30, 2013

In a letter addressed to Rep. Paul Ryan, the Congressional Budget Office (CBO) stated that the administration’s decision to delay the employer shared responsibility (employer mandate) provisions of the Affordable Care Act (ACA) would cost the government $12 billion over 10 years. CBO estimated that around $10 billion would be lost from the one-year delay in collecting penalties from employers that did not offer comprehensive, affordable coverage. An additional $3 billion is projected to be lost from the government over-allocating subsidies to individuals qualifying for premium assistance. CBO did, however, project the delay to generate around $1 billion in savings as a result of taxable compensation from people enrolling in Exchanges that would have otherwise received employer-sponsored coverage.

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Update: Reporting Information about Employer Coverage for Purposes of Shared Responsibility and Premium Assistance: Transitional Relief for 2014

Posted on July 23, 2013

On July 2, 2013, the Obama Administration posted a blog announcing a one-year delay (from 2014 to 2015) in implementing the shared responsibility provisions of the Affordable Care Act (ACA) applicable to large employers. The blog was followed by brief IRS policy guidance, as well as by a final HHS rule implementing the process by which Exchanges will ascertain the eligibility of individuals who apply for premium tax credits because they lack access to “affordable” employer-sponsored coverage that provides “minimum value.”

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CRS issues report on defining and calculating ACA employer penalties

Posted on July 10, 2013

The Congressional Research Service (CRS) published a report exploring the key terms of the employer shared responsibility provision and methods to calculate full-time equivalent (FTE) employees. Pursuant to the Affordable Care Act (ACA), large employers will be penalized if they do not offer affordable health insurance to their full-time employees, and if one of their employees qualifies for a subsidy in the Exchange. Large employers are defined as entities with more than 50 FTE employees. The CRS memo addressed the confusion around calculating seasonal and part-time workers, which are assessed differently, in determining the number of FTE for the purposes of assigning penalties. Additionally, the CRS report outlines the methods for determining an employee’s full-time status at hire and safe harbor provisions associated with offering affordable coverage.

 

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CRS report states small businesses enrolling employees in Exchanges would reduce adverse selection

Posted on July 10, 2013

According to a new report released by the Congressional Research Service (CRS), small businesses would benefit from enrolling their employees in the Affordable Care Act’s (ACA) state and federal insurance Exchanges. The main attraction results from the ability for risk-sharing across a larger pool. Individuals with costlier health needs would be better able to afford premiums, as the costs would be spread amongst many more plan participants. Similarly, healthier individuals would be enticed to join the market, as their costs would decrease as a result of the broader insurance pool. In addition to the information on small businesses, the CRS document discussed the penalties associated with the employer shared responsibility payment, which has been delayed until 2015, and explores potential revisions that can mitigate the concerns associated with this penalty (i.e. exempting the first 49 employees for penalty assessment as opposed to the first 30).

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SBA launches new website to educate small business about ACA

Posted on January 31, 2013

The U.S. Small Business Administration launched a website and corresponding blog featuring information about the Affordable Care Act (ACA) for employers, in attempt to correct misconceptions about the law’s impact and prepare business owners for implementation. The website reviews ACA provisions, breaking them down based on how they will impact different parties: those who are self-employed, businesses with fewer than 25 employees, those with fewer than 50 employees and those with more than 50. The site also includes a glossary of key ACA-related terms and links to an HHS timeline outlining when important provisions of the law will go into place.

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HHS announces new workforce grants

Posted on August 31, 2012

Yesterday, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced $58.7 million in grants to strengthen training for health professionals and increase the size of the American health care workforce. The 254 grants support nursing workforce development, interdisciplinary and geriatric education and training, centers for excellence health professions schools, and dentistry. For a list of grant awards by state, click here

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Deloitte survey finds 1 in 10 U.S. employers to drop health coverage

Posted on July 26, 2012

In the 2012 Deloitte Survey of U.S. Employers: Opinion about the U.S. Health Care System and Plans for Employee Health Benefits, nine percent of companies, which represent three percent of the workforce, anticipate dropping health insurance coverage sometime within the next three years. The survey reported that 81 percent of companies, which represent 84 percent of the workforce, plan to continue offering employer-sponsored health insurance. Ten percent of companies, which represent 13 percent of the workforce, reported that they were unsure whether or not they would keep employee health benefits.

According to the survey, many employers are considering sending their employees to participate in the Affordable Care Act’s (ACA’s) Exchanges. Small employers are the most likely to be interested in such an option. Deloitte’s report collected the results of a web survey of 560 randomly selected employers with 50 or more employees. Participants included chief executive officers, chief financial officers, and chief human resources officers.

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Georgetown releases comprehensive report on healthcare workforce

Posted on July 23, 2012

In Healthcare, the Georgetown University Center on Education and the Workforce provides detailed analyses and projections regarding healthcare fields, occupations, and their wages. In addition, the report provides a discussion regarding the important skills and work values associated with healthcare fields and occupations. Finally, the report addresses the implications of findings for racial, ethnic, and class diveristy of the healthcare workforce for the coming decade.

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EBRI releases report on employment-based coverage of adult children to age 26

Posted on January 12, 2012

The Employee Benefit Research Institute released an article entitled “The Impact of PPACA on Employment-Based Health Coverage of Children to Age 26″ in their January volume. This report reviews the evidence as to whether the mandate to extend coverage to adult children had an effect on the percentage of young adults with coverage in late 2010 and the first half of 2011. Data from the Census Bureau’s Current Population Survey (CPS) and Survey of Income and Program Participation (SIPP) are examined, as well as data from the Center for Disease Control’s National Health Interview Survey (NHIS). The data from these three surveys suggest that the PPACA’s coverage mandate has resulted in an increase in the percentage of young adults with employment-based health coverage as a dependent.

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NIHCR report suggests ACA will not amply address primary care physician shortages

Posted on December 20, 2011

A report released by the National Institute for Health Care Reform (NIHCR) finds that provisions under the Affordable Care Act (ACA) to increase the number of primary care physicians may not be sufficient to meet the rising demands of medical services. Such provisions under the ACA include higher payment rates and educational loan forgiveness for primary care doctors. NIHCR urges policymakers to focus on ways to expand primary care that will yield more timely results. Such improvements could include opening the field of primary care to more non-physician providers, and improving the efficiency of existing practitioners.

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