A short update on a crucial and current subject: Healthcare. (For the very latest follow-up  and/or dissection of the process click here) The matter is of a global and complicated interest, but at this point do US employees still care? The subject goes "over the head" of many, has become more of a political duel rather than being approached as a public health concern  with serious economic impacts.

For the sake of information and communication on the subject, I will give a quick snapshot on the matter in this post. We remember (or don't) that ACA stands for the Affordable Care Act or "Obamacare", the AHCA is the American Health Care Act, and the latest is the Better Care Reconciliation Act (BCRA).

Quick snapshot.

Quick, because a decision - to go forward, to revise, or to halt the whole process (theorically, because steps will undoubtedly, continue to be taken behind the scene to somehow dismantle Healthcare as it is now) will occur within the next few days; Hello or Goodbye to the Better Care Reconciliation Act of 2017 (BCRA)...

Also, a snapshot because information on the subject is overflowing from all sources and can become overwhelming. For a comparison chart and analysis, click here.

To those who could be confused about the debate on "employer mandate", here is a reminder on realities. Indeed, employers have already been catching up both on employer's mandate - by anticipation -, and on competition.  As of employees' cost, the heavier weight given to HSAs is a sign of a deeper shift of cost of insurance coverage from employers to employees. Click here to understand better why lifting the employer mandate and "essential" benefits are quasi-irrelevant in most cases, and how the burden of health insurance coverage is increasingly shifted to employees.

Do Employees Still Care? A Puzzle 

Those who are full-time and in organizations of over 100 might be somehow indifferent to the debate. Their major concern: cost of premiums and deductibles amid reduced income due to curtailing of hours with HSA becoming a must to actually cover heath care costs.  Part-time employees and those in organizations of 50 or less are somehow anxious with mixed feelings: are they going to keep their coverage at all now that the individual mandate would be lifted? As for those who relied on Medicare, they fear that their healthcare coverage would become practically inexistant..sooner rather than later. By now, between all the existing and tentative versions of the healthcare system, between the ACA, AHCA, BCRA, and Medicare changes, the common mortal employee can no more solve this intriguing puzzle turned into an overwhelming issue....

As for Employers and Public Health Thinkers...

... the concern should be on a healthier and more productive workforce, as well as a competitive one. How do we keep a healthy and competitive workforce without crumbling under the cost of a necessary program? Click here for SHRM resources on the topic. Also, click here for SHRM's notes on what to do and expect, as well as on-going changes.  Do and should all employees and employers have to share the cost/have the burden of an increasingly, unhealthy (working and not working) population crippled by preventable, communicable and  non-communicable diseases (NCDs) mostly caused by lifestyle and/or lack of access to health education, as well as limited/reduced income? The debate would lend into a social justice or social responsibility one with all stakeholders involved and would be beyond the scope of this blog.

Here is the full Senate bill, should you want  details.

To those who need a refresher on the subject (ACA and its replacement) click here for a previous (March) post on the topic. 

At this point we wait and see since the debate is in full swing. SHRM advocates are also at work.

Update (06/27/17) : The bill will not pass. We will have to wait past July 4th to know the fate of the BCRA. Maybe it will have another name by then? In the meantime, you may click here for facts and comparison charts on estimated impacts.
The Latest Updates:
(07/08/17): This coming week Congress will be back in Washington and the debate on Healthcare will be on the desk, again. In the meantime, here is a SHRM article that will help you better understand the potential impact of NO mandate. Employees might get tired of the subject, but will most probably see changes in eligibility conditions and redefinition of classification (FT vs. PT), and premium costs. And to stay up to date on this subject that keeps employers on their toes, feel free to click here.
(07/25/17): A procedural vote is due today with McCain coming back to Washington. To follow-up on the subject, click here, and again here for the very latest and pending development (as of 09/19/17).


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