Posts Tagged ‘Unemployment’

Employer-Susidized Healthcare Insurance at a New Low

Wednesday, November 23rd, 2011

Fewer than half of  America employers – just 44.5 percent in the 3rd quarter, a decline of more than five percent in three years, — contribute to their employees’ healthcare coverage, according to a Gallup and Healthways Inc., poll.  The firms, which surveyed more than 90,000 adults, blamed the decline on high unemployment, under-employment and an increased number of employers who do not offer health insurance to their workers.

Employer-sponsored health insurance is one of the pillars of the $2.6 trillion U.S. healthcare industry.  Unfortunately, companies have scaled back benefits and raised employee charges to cope with fast-rising healthcare costs and anemic economic growth.  The latest figure was 5.3 percent below the 2008 high of 49.8 percent, when the companies began tracking trends in employer-sponsored health insurance.  “The health insurance system in the United States is experiencing numerous changes.  Governments and businesses have and will continue to cut back and/or reform their health coverage offerings,” according to the pollsters.

There was also an increase in the ranks of those covered by government plans from Medicaid, Medicare and military programs, which was up 2.2 percentage points since 2008 at 25.1 percent but off a 2010 high of 25.7 percent.

According to the Kaiser Family Foundation, there were 41 million uninsured American adults and 24 million adults under retirement age receiving the Medicaid program for low-income people and other public insurance plans last year.  Medicare covers an estimated 48 million beneficiaries.  The survey found higher levels of health insurance coverage among young people aged 18 to 26, which the pollsters attributed to a provision of the ACA that allows parents to cover grown children under their insurance plans.  Other portions of the law, including tax credits for small businesses, did not appear help those aged 25 to 64, whose uninsured ranks increased.

One large employer cutting back on healthcare coverage is Wal-Mart, the nation’s largest private employer.  Citing rising costs, the retailer told its employees that all future part-time employees who work less than 24 hours a week will no longer be eligible for any of the company’s health insurance plans.  Additionally, new employees who average 24 hours to 33 hours a week will no longer be able to include a husband or wife as part of their healthcare plan, although children can still be covered.  This is a massive shift from a few years ago when Wal-Mart expanded coverage after being criticized because so many of its 1.4 million workers could not afford or did not qualify for coverage — sending many of them to Medicaid.

“Over the last few years, we’ve all seen our healthcare rates increase and it’s probably not a surprise that this year will be no different,” said Greg Rossiter, a Wal-Mart spokesman.  “We made the difficult decision to raise rates that will affect our associates’ medical costs.  The decisions made were not easy, but they strike a balance between managing costs and providing quality care and coverage.”

There’s also some good news on the employer-subsidized healthcare front. Nearly 75 percent of medium-to-large employers plan will continue to offer their workers health insurance once the major provisions of the ACA take effect, according to a survey by consulting firm Towers Watson.  According to the survey of 368 mid-to- large-sized companies, 71 percent plan to continue to offer healthcare benefits to their employees through 2014, the year that everyone will be required to have health insurance and state-based health insurance exchanges will kick off.  Approximately one-third of the companies are not certain if they will continue offering insurance, or, if they stopped providing insurance, whether they would compensate employees by offering pay raises.

“With so much still unknown regarding both the short- and long-term impact of healthcare reform, most employers will not make wholesale changes to employer-sponsored health plans in 2012,” said Ron Fontanetta, senior healthcare consulting leader at Towers Watson.

I Just Graduated in Nursing. Where’s My Job?

Monday, May 9th, 2011

This spring’s class of nursing school graduates are running into an unexpected roadblock.  The dream jobs that they thought would be waiting for them are hard to find.  According to Rhys Gibson, “I mean I thought I was the cat’s meow and everything, because I’m an African-American guy coming out of here – I was waiting for the red carpet, I had the grades, had the experience, to an extent but not the practical experience as a nurse working on the floor.  There isn’t a whole lot of money, even on my unit, I was lucky enough to make it in when I did because there hasn’t been another RN1 since and that was December ’09 when I got that job offer.”  Gibson has applied for hundreds of jobs and finally founded a job as a nurse on a geriatric psychiatry ward at Rush University Medical Center.  He is just one of thousands of people who entered nursing schools in Illinois in recent years, many in response to a drumbeat of news about a looming nurse shortage.

According to Cathy Grossi of the Illinois Hospital Association, “There’s been a concerted effort led by the Illinois Center for Nursing to expand the capacity of the educational programming across Illinois to accommodate student interest for nursing education. So we’ve increased capacity around the state about 25 percent.  That’s since 2006. But then the recession hit in 2007.  And while it’s officially been over since 2009, the effects have been deep and long-lasting, even in healthcare – one of the brighter growth areas of the economy.  We are now experiencing an increase in the number of graduates coupled with the time temporarily where there’s probably not as much opportunity as there was in the past.”  According to Grossi, nurse vacancies at Illinois hospitals fell by more than half from 2008 to 2010.

Although the nursing shortage has eased slightly for the time being, it is not going away. The recession brought a temporary reprieve because nurses who were close to retirement have seen their 401(k) portfolios decline.  As a result, they are postponing retirement a few more years until the economy — and their portfolios — recover.  Other nurses have seen their spouses or partners laid off and so have increased their hours to make ends.  Some who left the profession to care for children or for other reasons have started working again to pay the bills.  Additionally, many hospitals are not hiring.  The recession brought hiring freezes to healthcare facilities, and many are still in effect.  Help wanted ads for healthcare professionals dropped by 18,400 listings in July of 2010, even as the overall economy saw a modest increase of 139,200 in online job listings.

Even so, healthcare remains one of the economy’s healthiest industries. On April 1, 2011, the Bureau of Labor Statistics (BLS) reported that the healthcare sector is growing, despite significant job losses in recent months in nearly all major industries.  Hospitals, long-term care facilities, and other ambulatory care settings added 37,000 new jobs in March 2011, the largest monthly increase recorded by any sector.  As the largest segment of the healthcare workforce, registered nurses will be recruited to fill many of these new positions.  The BLS confirms that 283,000 jobs have been added in the healthcare sector in the last 12 months.

The nursing shortage will regain momentum because of the impending baby boom retirement crisis.  When you consider that the majority of registered nurses are over the age of 55, and that they will soon be retiring as well, the terms ‘crisis’ and ‘nursing shortage’ will become even more significant in coming few years.  The nursing shortage is expected to also be influenced by the fact that nursing jobs will grow by 22 percent from 2008 to 2018, according to the BLS.  Add in the fact that the nursing work force is aging and nursing schools aren’t graduating nearly enough nurses to fill the healthcare industry’s requirements, and the growing nursing shortage can be described as a “perfect storm”.

“Moving into the future, we see a very large shortage of nurses, about 300,000,” said Peter Buerhaus, a nurse and health-care economist and a professor at Vanderbilt University.  “That number does not account for the demand created by reform. That’s a knockout number. It knocks the system down.  It stops it.  I think the big story is…the future of nursing is dominated by aging baby-boomer nurses who are going to retire, and we are looking at massive shortages,” Buerhaus said.

Nine Million Americans Lost Healthcare Coverage During the Recession

Monday, April 4th, 2011

The financial crisis not only robbed nine million Americans of their jobs – but also their healthcare insurance. According to a new study by The Commonwealth Fund, only 25 percent of Americans who lost employer-sponsored healthcare coverage succeeded at finding another source.  As a result, an estimated 52 million Americans did not have healthcare coverage in 2010.  Even though the federal government provides a subsidy, just 14 percent of people who lost their jobs continued their coverage through COBRA.

According to The Commonwealth Fund Biennial Health Insurance Survey of 2010, “Using data from The Commonwealth Biennial Health Insurance Survey of 2010 and prior years, this report examines the effect of the recession on the health insurance coverage of adults between the ages of 19 and 64 and the implications for both their finances and their access to healthcare.  The survey of 3,033 adults, conducted by Princeton Survey Research Associates International from July 2010 to November 2010, finds that in the last two years a majority of men and women who lost a job that had health benefits became uninsured.  Adults who sought coverage on the individual insurance market over the past three years struggled to find plans they could afford and many were charged higher premiums, had a health condition excluded from their coverage, or were denied coverage altogether because of a pre-existing condition.  Meanwhile, Americans with health insurance had higher deductibles and consequently greater exposure to medical costs.  And millions were struggling to pay medical bills, facing cost-related barriers to getting the care they need, or skipping or delaying needed care, including prescription medications, because of the cost.”

Just 50 percent of adults aged 64 or less are current with preventive care.  Fully 49 million employed Americans spent 10 percent or more of their yearly income on out-of-pocket costs and insurance premiums, a sharp increase from the 31 million reported in 2001.  Once the Patient Protection and Affordable Care Act (ACA) goes into full effect in 2014, the situation is likely to improve dramatically.  “These reforms have enormous potential to begin solving the problems identified in this report,” said Sara Collins, vice president of The Commonwealth Fund, a private foundation that promotes a high performing healthcare system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, children, and the elderly.

“The report tells the story of the continuing deterioration of healthcare accessibility, efficiency, safety and affordability over the past decade,” said The Commonwealth Fund president Karen Davis. “All this despite the fact that the United States spends more than any other country on healthcare.  Most recently it has failed the millions of Americans who lost their jobs during the recession and lost health benefits as well, leaving them with no place to turn for affordable healthcare coverage.  The silver lining is that the Patient Protection and Affordable Care Act has already begun to bring relief to families,” Davis said.  “Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security.”

Of those people who attempted to buy an individual plan during the study’s timeframe — 19 million individuals – or 71 percent found it difficult or impossible to locate a plan they could afford and met their needs, were denied coverage or charged extra because of a pre-existing medical condition.  Adults with family incomes of less than $22,050 for a family of four were hardest hit with 54 percent having no healthcare insurance.  An additional 41 percent of families with incomes of between $22,050 and $44,100 had no coverage.  Of higher-income families, just 13 percent lacked healthcare coverage in 2010.

Conservative groups such as the Heritage Foundation are critical of the healthcare reform law.  The Washington, D.C.-based think tank wants changes made to the healthcare system to make it less reliant on government and to have individuals “own and control their own healthcare policies.”  Additionally, Heritage believes that the healthcare law will increase government spending.  “Of course there’s some people who will benefit from the law, but just focusing on individuals with benefits is misleading,” said Brian Blase, a policy analyst in health studies.  “You have to look at the law in its totality.”

Majority of Baby Boomers Under 65 Will Be Covered by Healthcare Reform

Tuesday, December 21st, 2010

Approximately 8.2 million of the 8.6 million uninsured baby boomers (Americans between the ages of 50 and 64) will have access to healthcare coverage in 2014, thanks to the passage of the Patient Protection and Affordable Care Act.  This is just one finding of a new study by the Commonwealth Fund, entitled Realizing Health Reform’s Potential:  Adults Ages 50 – 64 and the Affordable Care Act of 2010.

According to the study, 3.5 million insured boomers will be eligible for subsidized private insurance; another 3.3 million will qualify for Medicaid; and 1.4 million will be able to access non-subsidized private insurance.  Those without coverage will include approximately 377,000 undocumented immigrants.

Unemployment drives much of the baby boomers’ need for healthcare coverage.  The Commonwealth Fund study notes that “Losses in coverage in the 50 – to — 64 age group have been driven by record high unemployment.  Approximately 2.2 million workers aged 55 and older were unemployed in November 2010.  Unemployed workers between the ages of 55 and 64 had been jobless for an average of 45 weeks, the highest unemployment duration for any group under age 65 in this time period.  As a result, the number of uninsured people in this age group climbed in 2010 as options for affordable healthcare dwindled and family budgets became more constrained.”

The Commonwealth Fund said early provisions in the health reform law that could benefit baby boomers  also include the following:

  • Create high-risk pools for people with pre-existing conditions
  • Impose a ban on lifetime coverage limits and gradually eliminate annual limits
  • Cover preventive services
  • Create an early retiree reinsurance program
  • Create a new long-term care insurance program