JRG Health Sector Analysis: Health Jobs Explode Versus Non-Health Jobs

January 6, 2017

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.

Source: JRG Health Sector Analysis: Health Jobs Explode Versus Non-Health Jobs


The Cadillac Tax and Its Potential to Transform How Americans Purchase Health Care Services by Richard L. Kaplan :: SSRN

December 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.

Source: The Cadillac Tax and Its Potential to Transform How Americans Purchase Health Care Services by Richard L. Kaplan :: SSRN


The Kauffman Index 2016: Main Street Entrepreneurship National Trends by Robert W. Fairlie, Arnobio Morelix, Inara Tareque, Joshua Russell, E. J. Reedy :: SSRN

December 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.

Source: The Kauffman Index 2016: Main Street Entrepreneurship National Trends by Robert W. Fairlie, Arnobio Morelix, Inara Tareque, Joshua Russell, E. J. Reedy :: SSRN


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

November 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


The Broken Promises of the Affordable Care Act | Mercatus Center

October 6, 2016

More than six years after the ACA’s passage, these promises can be measured against reality.

  • It turns out that while the percentage of individuals without insurance has declined, enrollment in the exchanges is far below projections;
  • exchange enrollees are much older and poorer than expected;
  • competition in the individual market has decreased, rather than increased;
  • rather than falling, premiums have increased significantly in both the individual and employer-sponsored markets;
  • the law’s Medicaid expansion, which is responsible for the vast majority of rate decline in uninsured Americans, came at a far higher cost than expected;
  • the law has increased, rather than decreased, overall healthcare spending; and
  • the ACA has negatively affected economic growth, despite promises to the contrary.

Source: The Broken Promises of the Affordable Care Act | Mercatus Center


ObamaCare Mandates Are Dead — Even If Hillary Wins | Stock News & Stock Market Analysis – IBD

September 28, 2016

If Clinton takes office next January, when ObamaCare’s next enrollment period is falling flat, as it inevitably will, the writing will be on the wall and Clinton will have to dangle the law’s controversial mandates to bring Republicans to the table. That means the only way that the mandates will survive is if Republicans are unwilling to deal. That can’t be ruled out, but it’s not the most likely outcome. To understand why, just recall the outcry when ObamaCare was about to launch, and millions of people started getting notices that their plans were being canceled. GOP policymakers understand that they can’t take away the coverage that 10 million people, many relatively old and not in robust health, have come to count on. That’s why they crafted a GOP plan to kill ObamaCare softly, vowing that if you like your ObamaCare plan, you can keep it.

Source: ObamaCare Mandates Are Dead — Even If Hillary Wins | Stock News & Stock Market Analysis – IBD


JAMA Network | JAMA | Eligibility and Coverage Trends in Employer-Sponsored Insurance

May 4, 2016

This Visualizing Health Policy infographic looks at eligibility and coverage trends in employer-sponsored health insurance. Since 2000, the share of workers covered by employers’ health benefits at both offering and nonoffering firms has dropped to 56%, with the biggest decrease among employees working for small firms (3-199 workers). Among people younger than 65 years, those with lower incomes continued to be less likely to have coverage from an employer-sponsored health plan, as has been the trend since 1999. In 2015, larger firms were more likely than smaller ones to offer health benefits, as were organizations with more higher-wage employees, fewer lower-wage employees, and fewer workers 26 years or younger. Most large employers offered coverage to spouses and other dependents, while fewer than half of these firms offered coverage to same-sex or opposite-sex domestic partners. Few firms took action in 2015 in response to the Affordable Care Act’s employer mandate, including changing some jobs from part-time to full-time so employees would be eligible for coverage.

Source: JAMA Network | JAMA | Eligibility and Coverage Trends in Employer-Sponsored Insurance