Governor Charlie Baker of Massachusetts has proposed a tax of $2,000 per worker on businesses which do not offer health coverage to employees who become dependent on Medicaid.
The first state in the nation to require residents to carry health insurance is grappling with escalating Medicaid rolls, but a fix floated by Massachusetts’ Republican governor is drawing pushback from employers.
Gov. Charlie Baker will propose in his annual budget on Wednesday a $2,000 penalty per worker on businesses that don’t shoulder enough of the health-insurance cost. The governor is aiming to solve what he sees as a flaw in the national health law: Medicaid ends up being more appealing to low-income workers than insurance offered by employers, raising the costs for the state.
Research from the American Action Forum (AAF) finds regulations from the Affordable Care Act (ACA) are driving up health care premiums and are costing small business employees at least $19 billion in lost wages annually. These figures varied by state, but in 2015 the ACA cost year-round workers $2,095, $2,134, and $2,260 in Ohio, New York, and North Dakota, respectively. Premium increases, a prospect regulators predicted when issuing the first ACA regulations, also significantly diminished the number of business establishments and jobs nationwide. Across the country, small businesses (20-99 workers) lost 295,030 jobs, 10,130 business establishments, and $4.7 billion in total wage earnings. Florida lost 17,950 jobs; Ohio lost 19,000; Pennsylvania lost 15,680; and Texas lost 28,010 jobs due to higher sensitivity to rising health care premiums and the ACA.
Health jobs exploded in this morning’s jobs report, growing more than three times faster than non-health jobs (0.28 percent versus 0.09 percent). With 43,000 jobs added, health services accounted for over one quarter of 156,000 new nonfarm civilian jobs.
The disproportionately high share of job growth in health services is a deliberate outcome of Obamacare. While this trend persists, it will become increasingly hard to carry out reforms that will improve productivity in the delivery of care.
The Cadillac Tax and Its Potential to Transform How Americans Purchase Health Care Services by Richard L. Kaplan :: SSRNDecember 23, 2016
This Article examines one of the most contentious provisions of the Affordable Care Act – namely, the 40% excise tax on high-value health insurance provided by employers. This levy, commonly denominated the “Cadillac” tax, is scheduled to take effect in 2020 but has already induced many employers to raise annual deductibles on the health insurance they provide to reduce the value of such insurance and thereby lower their exposure to this new tax. After analyzing the administrative guidance proposed since the Cadillac tax’s enactment, this Article considers how that tax’s effective encouragement of high-deductible health insurance plans has inadvertently made the Health Savings Accounts that President George W. Bush promoted 15 years earlier much more appealing.
The Kauffman Index 2016: Main Street Entrepreneurship National Trends by Robert W. Fairlie, Arnobio Morelix, Inara Tareque, Joshua Russell, E. J. Reedy :: SSRNDecember 1, 2016
The Kauffman Index of Main Street Entrepreneurship is a comprehensive indicator of small business activity in the United States, integrating high-quality sources of timely information into one composite indicator. The Index captures business activity in all industries and is based on both a nationally representative sample size of roughly 900,000 responses each year and on the universe of all employer businesses in the United States on a dataset covering approximately five million businesses. The focus here is on business owners based on location, survival rates of firms, and established small businesses — employer firms older than five years and with fewer than fifty employees. As such, we examine both the business owners and the businesses they own.
Main Street entrepreneurship is an important aspect of the U.S. economy and society. Established small businesses make up almost 68 percent of all employer firms in the United States and are a source of local economic activity.
This report presents trends in Main Street entrepreneurship over the past two decades for the United States. Two separate reports look at these same trends in all fifty states and the forty largest U.S. metropolitan areas. Some Main Street Entrepreneurship Index components, when available, also are reported by demographic groups.
Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and Affordability by Paul Fronstin, Ruth Helman :: SSRNNovember 4, 2016
The EBRI/Greenwald & Associates Health and Voluntary Workplace Benefits Survey (WBS) examines a broad spectrum of health care issues, including workers’ satisfaction with health care today, their confidence in the health care system and the Medicare program, and their attitudes toward benefits in the workplace. It is co-sponsored by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates with support from eight private organizations. This paper identifies the key findings of the 2016 survey. The 2016 WBS finds that, when asked to rate the U.S. health care system overall, many workers describe it as poor (27 percent) or fair (33 percent); only a small minority rate it as excellent (3 percent) or very good (12 percent). Dissatisfaction with the health care system is focused primarily on cost. Workers tend to be more favorable about their own health plans than they are about the health care system overall. One-half of those with health insurance coverage are extremely or very satisfied with their coverage, while only 12 percent are not satisfied with their current health plan. One-half of all workers report having experienced a health care cost increase in the past year, down from 61 percent in 2013. Those experiencing an increase report they are changing the way they use the health care system, such as trying to take better care of themselves, choosing generic drugs, or delaying going to the doctor. Twenty-five percent of workers report that they are extremely confident their employers or unions will continue to offer health coverage in the future, 38 percent are very confident, and 28 percent are somewhat confident. While 48 percent of workers indicate they are extremely or very confident about their ability to get the treatments they need today, only 34 percent are confident about their ability to get needed treatments during the next 10 years, and just 29 percent are confident about this once they are eligible for Medicare. Thirty-two percent of workers say they are confident that they are able to afford health care without financial hardship today, but this percentage decreases to 25 percent both when they look out over the next 10 years and when they consider the Medicare years.
Source: Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and Affordability by Paul Fronstin, Ruth Helman :: SSRN