Repealing the Affordable Care Act would eliminate 209,000 jobs and cost the state economy $20.3 billion in GDP, according to research from the University of California, Berkeley’s Center for Labor Research and Education. “While the nation debates whether President-elect Trump saved 730 manufacturing jobs in Indiana, nearly seven times that many jobs could be lost in Kern County (Bakersfield, California) alone if the ACA is repealed,” said Ken Jacobs, Labor Center chair and co- author of the report.
The state’s economic losses would be especially severe in the Central Valley, where unemployment is already high and residents rely heavily on Medi-Cal. The biggest blow to California would be a reduction of $20.5 billion in annual federal funding if the next Congress ends the expansion of Medi-Cal that serves 3.7 million Californians and the subsidies for more than 1 million low-and-middle income individuals purchasing health insurance through Covered California.
“California has made tremendous gains since 2014 in reducing inequities in access to health insurance. If Congress repeals the ACA, those historic coverage gains would be reversed at the same time that Congress cuts taxes for insurers and high-income households,” said Laurel Lucia, co-author of the report. Repeal of the ACA could include tax cuts to high-income individuals and insurers; and the elimination of penalties for uninsured individuals and large employers not offering affordable health insurance to employees. The impact would be felt most in California counties with high Medi-Cal enrollment. Six of the seven medium- to large-sized counties in which more than 10% of the population relies on the Medi-Cal expansion suffer from high unemployment.
Each of these high-impact counties is estimated to lose thousands of jobs with a partial ACA repeal: Fresno (6,000), Kern (5,000), San Bernardino (12,000), San Joaquin (4,000), Stanislaus (3,000), and Tulare (3,000). Los Angeles County is expected to lose 63,000 jobs. An ACA repeal would especially harm workers in the healthcare industry, which is estimated to lose 135,000 of the 209,000 eliminated jobs. Many other industries would also be hurt by an ACA repeal, including healthcare suppliers and local businesses such, as restaurants and retail outlets where health care workers spend their income. Not only would California experience substantial loss of jobs and GDP, but also state and local governments would lose $1.5 billion in tax revenue as a result of declines in income tax, sales tax, and other tax revenue. For more information, visit http://laborcenter.berkeley.edu/aca-repeal-in-california-who-stands-to-lose.
Two Years After ACA Implementation: Coverage and Affordability Gains
The uninsured rate in California reached historic lows two years after the implementation of the Affordable Care Act (ACA), according to new data from the 2015 California Health Interview Survey, now available on www.chcf.org/aca-411. Consumers also reported fewer affordability problems. The uninsured rate dropped from 15.5% in 2013 to 9.5% in 2015, which is a historic low in California. The enrollment surge in Medi-Cal was a driving force behind this drop. The percentage of Californians covered by the program grew from 20% in 2013 to 31% in 2015. All demographic groups experienced coverage gains. Uninsured rates declined significantly across most racial/ethnic and income groups. The biggest coverage gains were among those earning less than 138% of the federal poverty level (FPL), the income threshold to qualify for Medi-Cal. This group experienced a nearly 10percentage point drop in their uninsured rate, from 23% in 2013 to 13% in 2015. The uninsured rates among whites, African Americans, and Asians were all roughly cut in half. While the uninsured rate among Latinos also dropped, from 21% in 2013 to 15% in 2015, this rate is more than twice that of Asians and African Americans, and three times that of whites.
Californians were less likely to say that cost was the main reason for being uninsured — this figure dropped dramatically from 2013 to 2015, from 53% in 2013 to 29% in 2015. A decline was seen across all income levels. This finding suggests that expanded access to Medi-Cal and subsidized coverage through Covered California have had an important impact on many Californians’ ability to afford health insurance. Among those who did not get necessary care, the share who did so because of cost declined from 55% in 2013 to 49% in 2015. Early gains in coverage and affordability reported a year ago have continued to grow over time. The percentage of Californians covered by Medi-Cal grew from 20% in 2013 to 30.9% in 2015. For more information, visit www.chcf.org/aca-411.
Covered California Membership Surges
More than 11,000 new consumers signed up for health insurance coverage through CoveredCA.com or a certified enroller, bringing this year’s total to more than 139,000 new enrollees so far. Open enrollment runs through Jan. 31, 2017. Consumers who enroll after the December 15 deadline will have their coverage start on February 1 or March 1.
Humana Taps Beavin to Lead Medicare Operations in California
Humana hired Rick Beavin as the new California President for Senior Products. He will continue to lead Humana’s Medicare Operations in Nevada. Beavin will lead the development and expansion of Humana’s relationships with value-based care and delegated risk entities across California and Nevada by building relationships with health care leaders and executives and overseeing provider group performance metrics. He will be responsible for oversight of Humana’s Medicare Advantage HMO and PPO health plans, prescription drug plans, and Medicare supplement policies offered to those eligible for Medicare in California and Nevada.
Most recently, he was the Desert States Regional (Arizona and Nevada) Medicare President where he exceeded financial and operational goals for the company. Beavin led Humana’s expansion of value-based provider relationships in the region, including teaming up with Iora Health in Arizona and HealthCare Partners in Nevada, to help expand access to care and care coordination for Humana Medicare Advantage members. Beavin has more than 20 years of health care experience in the commercial and Medicare markets. He joined Humana in 2012 as the market director for senior product operations in Nevada. He was promoted to the Desert States Regional President in July 2014. Prior to joining Humana, he was Area Vice President of provider contracting and network management for Cigna in Nevada. Beavin has a bachelor’s degree in finance from the University of Oklahoma and a master’s degree in business administration from the University of Southern California.
Wells Fargo May Have Signed Up Consumers for Insurance Without Their Permission
Commissioner Dave Jones directed the California Department of Insurance to launch an investigation into allegations made by former employees of Prudential Insurance Company that Wells Fargo employees signed up consumers for Prudential life insurance without the consumers’ authorization. Commissioner Jones asked department investigators to investigate all aspects of these allegations, including possible violations of California laws that requiring persons transacting insurance to have an insurance license issued by the department.
The Los Angeles Times (http://www.latimes.com/business/la-fi-wells-fargo-prudential-20161212-story.html) reports that Jones said his investigation will focus on the insurance company and the bank, which starting in 2014 had an agreement to allow bank customers to a buy small Prudential life policies called MyTerm. New Jersey’s insurance department is also probing the companies. The following is a summary of the LA Times article:
Prudential will cancel unwanted policies and reimburse any premiums paid for them. Prudential has sold about 15,000 MyTerm policies through the bank. The Prudential employees filed a lawsuit alleging that the insurer has tried to cover up problems with how policies were sold through Wells Fargo. They say they tried to raise these problems with upper management and wanted to continue investigating but were told to put their investigation on hold because Prudential wanted to approach Wells Fargo first, “in order to maintain that business relationship,” according to the suit. As the employees persisted, they say they were chided by higher-ups, placed on administrative leave and later terminated, according to the suit, which alleges violations of New Jersey’s whistle-blower statute.
The fired Prudential employees say the survey raised red flags that were ignored by the insurer’s executives. According to the suit, Prudential had seen problems with policies originated through the bank as early as January 2015, just six months after Prudential started selling policies through the bank. For instance, the suit alleged that when Prudential sent the survey via email, more than 700 emails bounced back, indicating the addresses were no good. Regulators earlier this year said Wells Fargo workers created fake email accounts to sign up customers for online banking without their knowledge. A dozen customers who responded to the survey said they canceled their Prudential policies because they did not understand them or “even know about the policy premiums,” according to the suit. What’s more, the employees allege that Prudential’s review found evidence that Wells Fargo workers were actively involved in selling and canceling insurance policies, potentially violating state laws that require insurance sellers to be licensed. Prudential’s MyTerm policies were designed to be purchased directly by customers, either through Wells Fargo’s website or through kiosks set up at Wells Fargo branches.
California Has the Most LTCi Policyholders
In California, more than 600,000 are covered under a traditional long-term care insurance policy, according to the American Association for Long-Term Care Insurance. “This is certainly due to the size of California as well as the fact that the state has been very active in making residents aware of the importance of planning. While the California Partnership program has little relevance to consumers today, in former years it was valuable protection that I strongly advocated and which was actively marketed by insurance professionals,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance (AALTCI). Roughly seven million Americans have traditional long-term care insurance protection and another million have coverage under a linked-benefit or alternative product.
“A significant number of the inbound phone calls we handle and the online request for information come from Californians. Admittedly, there are fewer specialists today than there were a few short years ago, but there are still good avenues available for those who want to get information and compare their choices and options,” he said. For more information, visit www.aaltci.org or call 818-597-3227.
2017 Forecast: Six Trends in Non-Traditional Voluntary Benefits
Purchasing Power’s chief revenue officer, Elizabeth Halkos offers six predictions on next year’s trends:
1. Employers are offering a bigger variety of benefits: A selection of non-traditional voluntary options is a must-have for a competitive benefit package. Non-traditional voluntary benefits have become more popular because they allow employees to choose benefits that meet their changing needs and lifestyles. Examples include identity theft/cyber security insurance, financial counseling services, tuition assistance, and elder care. Since employees pay the entire cost of non-traditional voluntary benefits, there’s no reason for employers not to offer a variety. Look for more options to emerge.
2. Employers are customizing benefits by generation: 2017 will see employers taking customization to another level by segmenting the generations. Employers that embrace further segmentation of the generations will be able to attract, retain, and engage the talent they need.
3. Benefit communications and education are going digital: Now that Millennials dominate the workforce, they are driving the digitalization of benefit education and benefit communications. In 2017, look for even more use of mobile, video, social media, benefit portals and interactive tools for benefit education and communication. Optimizing benefit information and mobility to multiple screens will generate higher engagement and satisfaction with today’s employee base.
4. Companies are increasing financial wellness offerings: Companies are adding non-traditional benefits that help employees address financial questions. 2017 will see more companies adopt these types of benefits, such as financial education and counseling services, employee purchase programs, employee discount programs and short-term loans.
5. Wellness technology is becoming popular: Wearables and other wellness technology items are making wellness programs more popular. Even more employers will promote their useWith data emerging in 2016 revealing improved wellness ROI from fitness tracking devices. In the last few years, companies began subsidizing or offering wearables through payroll deduction. This will escalate with costs savings and positive health impact being shown.
6. Online educational benefits are growing: Online education benefits will come to the forefront in 2017 to reduce student debt and bolster career development. Offering educational benefits can be a valuable addition to the benefit package, especially when it is offered as a voluntary benefit at no cost to their company. Non-traditional voluntary benefits that provide options for employees or their children to access online college courses as an alternative to taking on student debt. Professional certifications and career diplomas can be available through a non-traditional voluntary benefit. Look for more use of this type of benefit in 2017. For more information, visit www.PurchasingPower.com.
Nearly Three-Quarters Of Workers Want A Customized Benefits Package
A new LIMRA Secure Retirement study finds that 73% of U.S. employees across all age groups would like the ability to customize their workplace benefits to suit their individual needs. “Consistently, our surveys have shown recruiting and retaining the best employees is a top priority for employers. With four generations in the workplace, designing an attractive benefit package for all employees is challenging. As a result, employers are considering offering their employees the ability to control how they allocate their allotted money across their benefits,” said Michael Ericson, LIMRA Secure Retirement Institute analyst.
This strategy, often called “benefits wallet,” offers flexibility to the employee but could also undermine some key features that have increased retirement savings within the workplace retirement savings plans. A benefit wallet architecture gives each employee a certain amount of money annually to allocate toward the benefits they want.
The study found that only half of workers are satisfied with their employer benefits. Married workers are more satisfied than non-married workers (55% versus 45%) and workers who use a financial advisor are more likely to be satisfied with their benefits (62% versus 46%). Recent research from Aflac finds that four in 10 employees say they are more likely to remain with their employer if they are satisfied with their benefit package.
Employees with higher household incomes are more likely to be satisfied with their benefits. Lower-income workers are less likely to be full-time employees and are less likely to have generous benefits available to them. In addition, more 54% say that their non-salary benefits play a large role in their financial security. Men were more likely to say this than women, and older employees were more likely to value benefits over salary.
Employees ranked health care coverage, retirement savings accounts, and vacation as the three most popular workplace benefits. Almost 90% of workers ranked health care coverage and retirement savings plans in their top five most important benefits. This suggests if a benefit wallet approach is adopted, employees, especially younger ones, might ignore life insurance, disability insurance, and other valuable benefits. LIMRA research finds that 37% of U.S. households rely solely on employee-sponsored life insurance.
A worker’s life stage also influences the types of benefits they value. Millennial workers favor educational benefits and paid parental leave. These benefits reflect their life stage as well as the substantial amounts of student loan debt. Generation X workers rank financial planning/wellness programs higher than do Millennials and Baby Boomers. This is the first generation relying primarily on a defined contribution plan to fund their retirement and have many competing financial priorities, making access to financial advice essential.
Baby Boomers rank disability insurance significantly higher than Millennials and Gen Xers. This benefit typically gains importance to workers as they age and the likelihood of becoming disabled increases.
“As competition for top employees increases and benefit resources tightens, employers will have to ensure their benefit program is balanced and competitive. While offering a benefit wallet approach might seem the easiest way to accommodate the different needs of employees, it may have the unintended consequence of weakening established retirement savings programs like auto-features and employer-matching contributions that promote retirement savings,” said Ericson.
The Dark Side of the Gig Economy
If you’ve ever ridden in an UBER or taken on freelance work, you have become part of the burgeoning gig economy. According to a study by the Freelance Union, as much as 35% or 55,000,000 workers of the United States’ are freelance, generating an estimated $1 trillion dollars in income per year. Some of these workers take on freelance work on the side of traditional full-time jobs while others are small business owners conducting freelance work as their full-time employment.
Cision reviewed one year’s worth of news and blog mentions or more than 500,000 posts. They then reviewed more than 132,000 social media comments about independent workers from July 1, 2015 to June 30, 2016. They tracked conversations from the media and blogs as well as the most viral topics on social channels. News outlets and blogs provide advice on how to build a career as a freelancer. Other posts, like one from BizJournal, explained the benefits of hiring freelancers over full-time employees. These types of stories, as well as discussions of ongoing legal activity between UBER and the State of California, drove the lion’s share of the online media discussion.
The picture isn’t as rosy when you dive deeper into individual groups of workers and their comments on social media. Independent workers are worried about their incomes, and their retirement. They are also confused by the tax system.Recent graduates and small business owners often discussed not earning enough. Parents talked about loneliness and isolation twice as often as did other groups of independent workers. Retirees frequently ask for help with questions about taxes and their retirement plans. Read the full report here http://www.slideshare.net/Cision/cision-study-gig-economy-media-reporting-disconnected-from-worker-reality.
HHS Finalizes New Medicare Alternative Payment Models to Reward Better Care at Lower Cost
The Dept. of Health & Human Services finalized new Medicare alternative payment models that continue the Administration’s progress in reforming how the health care system pays for care. These new approaches will shift Medicare payments to rewarding quality through incentives for hospitals and clinicians to work together to avoid complications, avoid preventable hospital readmissions, and speed patient recovery.
Under the new approaches, the hospital in which a Medicare patient is admitted for care for a heart attack, bypass surgery, or a hip or femur procedure will be accountable for the quality and cost of care provided to Medicare fee-for-service beneficiaries during the inpatient stay and for 90 days after discharge. The new models will operate over a period of five years beginning July 1, 2017. The cardiac models will apply to hospitals located in the 98 metro areas participating in the model (about one-quarter of all metro areas in the nation). The surgical hip fracture treatment model will apply to hospitals in 67 metro areas, which are the same metro areas currently included in the Comprehensive Care for Joint Replacement Model. Under all of these approaches, beneficiaries retain their freedom to choose services and their hospital or physician. CMS will monitor and evaluate the impact of the approaches on care quality and value. An ombudsman will also be monitoring the models and be available for beneficiaries. More information about the structure of these models is available in the fact sheet. The final rule can be viewed at https://downloads.cms.gov/files/cmmi/epm-finalrule.pdf – PDF
Insurance Is the Most Important Factor In Choosing A Doctor
The most important factor in choosing a doctor for U.S. consumers is that the doctor accepts their insurance, according to a HealthMine survey of 500 insured Americans. Fifty-six percent of respondents search for a doctor by choosing from in-network doctors in their health plan. Only 28% search online for doctors with expertise that meets their needs and just 20% ask a friend or relative for a recommendation. Yet 90% of consumers believe their health could be improved. Despite rising healthcare costs, many still haven’t made any changes to the way they manage their health. The results are now available in the 2016 HealthMine Health Intelligence Report: Consumer Attitudes Toward Well-being and Doctor Selection.
Here are the key findings of consumers from HealthMine’s report:
- 90% say their health could be better.
- 45% say they haven’t changed the way they manage their health—even though their healthcare costs are higher.
- 63% say that having a doctor in their insurance network trumps other criteria for choosing a doctor. Personal referrals, compatibility, and use of technology are considered far less often.
- 52% have not heard of a health score. However, 33% say that it is important for them to get a health score that offers a view of their health, similar to a credit score.
For more information, visit www.healthmine.com.
New Law Reduces Road Block for Small Employers to Offer HRAs
President Obama signed H.R. 34 into law. It allows eligible small employers to offer HRAs to their employees that are solely funded by the employer. An HRA benefits employers and employees because qualified coverage and payments are excluded from gross income, leading to significant tax savings.The HRA can be used to pay for health insurance premiums. “This new provision will be a significant new option for small employers who had more restrictions around offering HRAs to their employees. An HRA can reduce some of the burdens on small employers while covering insurance premiums and out-of-pocket medical expenses for employees,” said Jody Oliver, president and CEO of Infinisource Benefit Services. The new law opens the HRA option to millions of small employers that weren’t able to use an HRA to reimburse employees for health insurance premiums because of restrictions under the Affordable Care Act.
The HRA provision allows employers who meet certain criteria to offer an HRA to their employees in lieu of offering their own health plan. The company must:
- Have fewer than 50 full-time employees
- Not offer a group health plan
- Provide the HRA on the same terms to all eligible employees
Maximum reimbursement allowed under the plan for eligible small employers is $4,950 for individuals and $10,000 for families. The provision will go into effect for plans beginning after December 31, 2016. For more information, visit www.infinisource.com.
Provider Network Data
Vericred is adding large group provider networks to its data network platform. Vericred offers details on hundreds of millions of plan-provider relationships. Employees can see which doctors are in and out of all available plans. They can compare networks based on desired doctors and facilities. This dataset expands the company’s already extensive individual under 65 and small group provider networks. For more information visit www.vericred.com.
Alignment Healthcare Launches Care-As-A-Service Business Unit
Population health company, Alignment Healthcare, is launching a new business unit, Alignment Health Services. For the first time, the company will offer fully open access to its proprietary technology. The company has developed a clinical care model that keeps Medicare beneficiaries healthier and out of the hospital. It tracks all aspects of members’ health care – from hospitalizations to specialist visits to pharmacy visits to real-time biometrics and uses predictive analytics to alert clinicians to provide preventive care. It allows the company to scan tens of thousands of patient records for daily virtual rounds across the country. For more information, please visit http://www.alignmenthealthcare.com.
Supplemental Coverage
As health care reform and rising medical costs continue to shape the benefits landscape, Symetra has introduced GapAssist, a new package of accident, critical illness, and inpatient hospital benefits designed to complement high-deductible medical plans and help employees with unexpected out-of-pocket medical costs.GapAssist offers three plan designs—Base, Classic, and Premier. Each plan design offers the same core coverage but the benefit amounts vary. Groups may choose to offer just one plan or any combination of the three based on their needs. For more information about GapAssist, contact a Symetra representative at 800-426-7784 or visit www.Symetra.com/EmployeeBenefits.