March 3, 2014
Are the sky and the number of available jobs really falling?
Not surprisingly, commentators on both sides of the aisle had a lot to say about the recently released report on the economy from the Congressional Budget Office (CBO).
While the report had some good news — for example, under current laws the federal deficit is projected to drop from $1.4 trillion in 2009 to $514 billion by the end of the 2014 fiscal year — another section of the report was less positive. It concluded that a 1.5 to 2 percent reduction in the number of hours worked in the economy will result in approximately 2 million less full time workers.
The reason for the reduction in the number of hours worked? A provision of the Affordable Care Act requiring employers to offer health insurance to any worker logging more than 30 hours a week. [Update: This provision, also known as the “employer mandate,” has been delayed for a year.]
In response to the fallout from the report, Council of Economic Advisors chairman Jason Furman, pointed back to the data, saying “It puts to rest… some of the more overwrought arguments about how the sky would fall.”
There are several contentious topics within this argument. Here they are and here’s who is taking what position on them.
Topic 1: Are people “losing their jobs” or “choosing to work less”?
Position 1: Said House Majority Leader Eric Cantor, “Under Obamacare, millions of hardworking Americans will lose their jobs and those who keep them will see their hours and wages reduced.”
Position 2: According to the CBO report, the decline in work will be “almost entirely because workers will choose to supply less labor” [emphasis added]. Without the need to stay at a full-time position to retain health benefits, overworked families can work less and still get health benefits, or individuals can go part-time in order to go back to school, leave a job in order to start a business, or look for other, more fulfilling work, without losing coverage.
Topic 2: With a full time job no longer necessary to receive health insurance, will unemployed Americans “not be motivated to hunt for jobs” or “will they voluntarily reduce their hours to pursue education, alternative careers, or elder care”?
Position 1: A writer from the Daily Beast suggested that eliminating the need for full time employment to receive health care coverage will have the unintended consequence of enabling the perennially unemployed and the 30+ year old parents’ basement dwellers to not pursue full time work.
Position 2: White House Spokesman Jay Carney explained that “because of this law, individuals will be empowered to make choices about their own lives and livelihoods, like retiring on time rather than working into their elderly years or choosing to spend more time with their families.”
Topic 3: Is the employer mandate causing employers to reduce hours for workers so they don’t have to provide coverage for their employees?
Position 1: Some have speculated that another reason for a decline in jobs would be that employers — now required to provide insurance to their full-time employees — would reduce employee hours to make them part-time, thereby freeing themselves from the requirement to cover them. Recent reports indicate that some employers (at least in the public sector) are using this tactic, though it is difficult to say if the practice is widespread.
Position 2: According to a statement made by White House Press Secretary Jay Carney, “CBO’s findings are not driven by an assumption that ACA will lead employers to eliminate jobs or reduce hours, in fact, the report itself says that there is ‘no compelling evidence that part-time employment has increased as a result of the ACA.’”
There are several takeaways here. One is that one benefit to workers putting in less hours or leaving jobs they don’t like is an increase in satisfaction, which may lead to less sick days and reduce feelings of “job lock.” Another is that the vacuum left by these workers can also be filled by the unemployed or others potentially better suited for the positions vacated.
According to a piece in Politico, we can also expect more money (from subsidies) to create more demand for services among low and middle income families, as not all money will be going towards health insurance costs. This freeing up of income, they argue, ultimately stimulates economy, leading to more jobs.
Simply put, consensus is that the ACA may shrink the total number of full time jobs temporarily, but in the long term it has the potential to be responsible for greater job satisfaction among workers.
February 26, 2014
Looking back at this year’s Super Bowl, a survey revealed that about 78 percent of people polled said they were more excited about the ads than the actual matchup between the Denver Broncos and the Seattle Seahawks.
For good reason. Advertisers spend millions of dollars for a few seconds of the coveted airtime, so they try extra hard to make the ads distinctive. They often involve puppies or comically bad dance moves or both. What’s not to love?
But another type of ad has been hitting the airwaves lately: ads promoting enrollment in health insurance exchanges specifically targeted at the young uninsured.
“I don’t need those! Hah!” actress Aisha Tyler crows as she declines a set of football shoulder pads. The ad, created by humor site Funny or Die, then cuts ahead to Tyler being viciously tackled by a burly linebacker. (The actress was mercifully replaced by a stand-in mannequin for this particular shot.)
Best known for her role on the animated TV show Archer, Tyler plays out a series of scenarios — a neglected mouthguard, a snipped seatbelt and a discarded athletic cup — with all ending with Tyler crumbling to the ground as the result of some gruesome injury. The takeaway? “You never need health insurance… until you need it.”
This was just one in a series of new Funny or Die videos promoting enrollment in plans under the Affordable Care Act, following several others last year that featured Jennifer Hudson and Olivia Wilde.
Midway through last year, the creators of the Funny or Die website were approached (though notably not paid) by the Obama administration to create a series of videos aimed at encouraging young adult enrollment.
Enrollment for the coveted “young invincibles,” a demographic of uninsured individuals aged 18-34, stands at approximately 27 percent of the total enrollment as of the most recent numbers. This compares to administration targets of 40 percent for this demographic.
Connecting with young people through funny, bite-sized videos was a savvy move and hopefully it will boost enrollment closer to targets.
Check out this video in the series featuring the tagline “Everybody falls.” Pardon the pun, but this one hammers the point home about the benefits of health insurance.
February 24, 2014
Employers with 50 to 99 employees breathed a sigh of relief a couple of weeks ago when President Obama announced a second extension to the employer mandate deadline. Employers now have until 2016 before the mandate kicks in to provide health plans for their full-time employees that meet ACA standards.
The President’s announcement marked the latest in a series of delays to the start of some provisions of the ACA. While some point to these delays as evidence of the demise of the ACA, we don’t agree.
But what exactly has been delayed, how far have things been pushed back and what can we expect going forward?
Of the remaining state exchanges struggling with technical issues, Massachusetts received the longest reprieve. The exchange was recently granted a three month extension beyond the March 31st deadline marking the end of the enrollment period for 2014. The Center for Medicare and Medicaid Services granted the extension, giving the beleaguered exchange time to fix glitches that have left state residents anxious about their enrollment status as the deadline approaches.
Meanwhile, on the federal exchange, the Department of Health and Human Services (HHS) extended coverage for people in the “high risk pool” to March 31st before they lose Preexisting Condition Insurance Plan (PCIP) coverage. Those who fall into this category must select a new plan by March 15th to avoid a gap in coverage.
February 21, 2014
A lot of numbers were thrown around during President Obama’s State of the Union address last month — number of veterans hired (400,000), number of schools poised to be connected to high speed broadband internet in the following year (15,000), number of autoworkers reemployed in a Detroit manufacturing firm (700).
Perhaps the most talked about, and scrutinized, number was this one: 9 million.
According to the President, “More than 9 million Americans have signed up for private health insurance or Medicaid coverage.”
This was an impressive figure, but what does it actually mean? Let’s break it down.
According to Administration numbers reported on January 24th, 6 million people were determined eligible for Medicaid coverage, either through existing programs in their states or through expanded coverage offered under the ACA. An additional 3 million enrolled in private health insurance exchanges (the number has since risen to 3.3 million), bringing the total to the magic number — 9 million.
February 16, 2014
Welcome to our new look! The OneExchange blog.
The blog’s new name and face reflect changes that began over a year ago when Towers Watson launched OneExchange.
Building on our private Medicare exchange roots, this blog has expanded to include news, research, trends and insights for all workforce populations – from full-time and part-time employees to pre-65 retirees in addition to our original Medicare perspective.
See OneExchange everywhere
You can see the new OneExchange look at all our sites, including:
- On Twitter:
- medicare.oneexchange.com – Check out the new face of our private Medicare exchange
February 7, 2014
>> Stay tuned later this week when the Extend Health blog gets a new name and look. <<
The recent expansion of our Exchange Solutions business segment is a good opportunity to look back at the news from our private Medicare exchange over the past few years. Here are highlights from our early days to today.
It’s a new year and employers are making some resolutions of their own to improve health and wellness — not for themselves, but for their employees.
New Year, New Goals
According to the 2013/2014 Staying@Work report from Towers Watson, nearly half (49%) of U.S. employers surveyed said health and productivity programs are essential to their overall organizational health strategy and 42% said they play at least a “moderate role.” In the survey, health and productivity was defined to include “physical, psychological and emotional aspects of health.”
Meanwhile, 94% of U.S. employers surveyed said that they plan to have “an articulated health and productivity strategy” in the next three years. According to Towers Watson, programs without a cohesive, articulated strategy run the risk of inadvertently offering program elements that are not coordinated with each other, have low return on investment or do not adequately engage employees. When implemented correctly, these programs have been tied to improved employee health AND company savings.
January 25, 2014
Jim Foreman to lead Exchange Solutions, Carl Hess to succeed Foreman as managing director of Americas Region
In a move designed to help employers better navigate the dynamic health care environment, global professional services company Towers Watson announced plans to unite the company-wide expertise and resources dedicated to health care exchanges and administration within its Exchange Solutions segment.
January 20, 2014
With the advent of the ACA, the definition of “churning” in a health care insurance context has been expanded.
The term used to refer to low-income Americans under the age of 65 fluctuating back and forth between qualifying for Medicaid and then, because of an increase in their income, finding that they no longer qualify — and then sometimes back to qualifying again. Now it also encompasses shifting eligibility between Medicaid and being able to buy health plans on private exchanges with a federal subsidy based on income levels.
Prior to the ACA, the options were much more clear: a person either qualified for Medicaid or not. Options now include qualifying for Medicaid under the old rules, for expanded Medicaid in the states that opted into that part of the ACA, and public exchanges.
In 2013, we discussed in this blog the implications of states opting to expand or not expand Medicaid coverage. Since the public exchanges opened for business on October 1, 2013, some states that initially opted out have reconsidered and their governors have petitioned their state legislatures to approve the expansion, such as Ohio and Pennsylvania.
This coming year will be the proving ground for this new definition of churning and its impact on low-income Americans as they try navigate a changing health care landscape. Those who fail to stay on top of their eligibility could fall into coverage gaps, run the risk of having to pay back the federal government for subsidies used when they were not eligible, or both.
As 2013 came to a close, Americans flooded public exchanges by phone, in person and overwhelmingly online to secure health plans for themselves and their families prior to the end-of-year deadlines. While some states saw record numbers of applicants — as many as 1,000 a day in some cases — others experienced the resignations of their exchange directors and continued efforts to overcome technical issues plaguing their exchanges.
UPDATE: This will be the last “On the Public Health Insurance Marketplaces” post – we hope you have enjoyed regular updates on the exchanges across the United States. Check back throughout 2014 for blog posts on a wide variety of topics related to exchanges, both on the federal and state level.
The Public Health Insurance Marketplaces Table continues to provide the latest information on carrier participation and plan rates.
State Run Exchanges and Partnerships -
California: As of December 23rd, 400,000 Californians had enrolled in plans on the state exchange.
Approximately 53,510 people enrolled in plans on the exchange over a three day period the week before the December 23rd enrollment deadline. To accommodate the rush, Covered California enlisted the help of extra staff to man the phones and aid with in-person enrollment as Californians flocked to enroll in plans in the last days before the deadline.
Of the 11 insurers that provided plans on the state-run exchange, 96 percent of enrollees selected offerings from just four providers, raising the question of whether smaller providers could compete against giants Anthem, Kaiser, Blue Shield, and HealthNet. As of December 13th, Anthem Blue Cross dominated, with 30 percent of enrollees choosing a plan offered by that insurer.
While demographic information for enrollment were not yet available through the end of the month, it has been reported that just 1,000 Spanish-speakers have enrolled in health insurance. In previous months, less than 5 percent of the 109,296 people who enrolled in plans identified as Spanish-speakers.
As enrollment deadlines approached, Covered California has opened enrollment “storefronts” across the state to sign up individuals and families on plans. While online enrollment has been steady, an estimated 80 percent of residents interested in enrolling prefer in-person support, hence the decision to open more physical locations, often located in malls.
California’s small business exchange opened for business, with the target of enrolling 7,000 businesses next year. This successful launch comes in contrast to the federal small business exchange, which has been postponed until further notice.
Covered California sent out 114,000 eligibility letters to plan applicants that contained blank spaces or missing information due to a computer error. Missing information included federal subsidy amount and eligibility for insurance. New letters have since been sent out to correct the error.
Colorado: Colorado did not require insurers to extend cancelled health plans, joining a handful of other states — California, Washington, New York, and Vermont — that have opted out of the extensions.
As of December 23rd, Connect For Health Colorado had a total of 35,356 enrollments. While the 23rd was initially the deadline for enrollment to begin on January 1st, exchange officials extended it to December 27th, clarifying that offices would be closed over Christmas but the website would still be taking enrollments.
Boomers dominated enrollment in the first two months, with 43 percent of all enrollees being 55 to 64 years old. By contrast, only 17 percent of enrollees fell into the target demographic — the “young invincibles,” aged 18 to 34.
Connecticut: Connecticut saw a surge in enrollment, with close to 1,000 people enrolling per day in the first week of December on the state-run exchange, Access Health CT. Enrollment on the exchange more than doubled in the subsequent two weeks, with 37,000 enrolled as of December 17th.
District of Columbia: President Obama signed up for health insurance on the D.C. Health Link exchange, selecting a bronze tier plan. His enrollment was symbolic, as his health care will continue to be provided through the military.