Whole Foods is cutting medical benefits for hundreds of part-time workers

https://www.businessinsider.com/whole-foods-cuts-medical-benefits-for-part-time-workers-2019-9?fbclid=IwAR1rCZfjB2rg8xRy7SzoYE51-JtpCYvD8iggWEB7Jc97ly8P3G_29-YjTAA

Whole Foods

  • Whole Foods is cutting medical benefits for hundreds of part-time workers.
  • The Amazon-owned company told Business Insider it was cutting benefits “to better meet the needs of our business and create a more equitable and efficient scheduling model.”
  • “I am in shock,” one Whole Foods worker said. “I’ve worked here 15 years. This is why I keep the job — because of my benefits.”

Whole Foods is cutting medical benefits for hundreds of part-time workers, the company confirmed to Business Insider on Thursday.

The changes will take effect on January 1 and affect just under 2% of Whole Foods’ total workforce, a Whole Foods spokesperson told Business Insider.

Whole Foods has about 95,000 employees, so it means about 1,900 people will lose benefits.

The benefits that the company is cutting are offered to part-time employees who work at least 20 hours a week. The changes will not affect full-time employees.

Whole Foods said it was making the change “to better meet the needs of our business and create a more equitable and efficient scheduling model.”

“The small percentage of part-time team members … who previously opted into medical benefits through Whole Foods Market’s healthcare plan — less than 2% of our total workforce — will no longer be eligible to buy into medical coverage through the company,” the Whole Foods spokesperson said.

“We are providing team members with resources to find alternative healthcare coverage options, or to explore full-time, healthcare-eligible positions starting at 30 hours per week. All Whole Foods Market team members continue to receive employment benefits including a 20% in-store discount.”

A 15-year employee of Whole Foods said she was devastated by the news.

She told Business Insider in an interview that her family was covered by the health-insurance plan she is enrolled in through her job at Whole Foods.

She said she would have to increase her hours to become eligible for full-time benefits and pay for childcare, or shop for a new and potentially more expensive health-insurance plan on the private marketplace. She spoke on condition of anonymity for fear of retribution.

“I am in shock,” she said. “I’ve worked here 15 years. This is why I keep the job — because of my benefits.”

 

 

 

Rate of uninsured people increases for first time since ACA rolled out

https://www.axios.com/uninsured-rate-increases-first-time-since-obamacare-ec6dbd6d-fffc-446d-be4c-02bed0d3ea3e.html

Image result for uninsured health care

Roughly 27.5 million people, or 8.5% of the U.S. population, had no health insurance at some point in 2018, according to new figures from the Census Bureau.

Why it matters: Last year’s uninsured rate increased from 7.9% in 2017 — the first time the uninsured rate has gone up since the Affordable Care Act has been in effect.

Between the lines: The uninsured population does not include the “underinsured,” or people who have medical coverage but face prohibitively high deductibles and out-of-pocket costs.

  • The figure also does not include people who have short-term plans, association plans and religious-based sharing ministries — policies the Trump administration has promoted, but that have holes in coverage that could leave people on the hook for high costs.

The intrigue: The type of coverage that witnessed the largest decline in 2018 was Medicaid, which fell 0.7 percentage points.

  • 4 states where the uninsured rate had a statistically significant increase were Alabama, Idaho, Tennessee and Texas, all of which have not fully expanded Medicaid under the ACA.

The bottom line: The uninsured rate is still markedly lower before the ACA became law, but it’s an odd paradox to see more people lose health coverage even though the economy created more jobs.

 

 

Biden, Sanders, Warren clash over Medicare for All in Houston

https://thehill.com/homenews/campaign/461229-biden-sanders-warren-clash-over-medicare-for-all-in-houston

Image result for Biden, Sanders, Warren clash over Medicare for All in Houston

The battle over health care that has dominated the Democratic race for the White House took center stage in Houston, where for the first time the top three candidates tangled over whether the nation is ready for sweeping reforms.

Former Vice President Joe Biden went back and forth at the opening of Thursday’s debate with the two progressives who are his leading challengers atop the polls, Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.).

Arguing that the “Medicare for All” proposal championed by Sanders would cost people their insurance, Biden called out the Vermont senator as a socialist and said his proposals would be too costly.

At one point in the debate, Biden said of Warren and Sanders that “nobody’s yet said how much it’s gonna cost for the taxpayer.”

He also pointed to the taxes that would have to increase for middle class people to pay for Medicare for All.

“There will be deductible in your paycheck,” Biden said, referencing the chunk that taxes would take out of people’s pay.

Sanders said most Americans were getting a raw deal in terms of their present health care costs compared with countries that have systems more similar to his Medicare for All approach.

“Let us be clear, Joe, in the United States of America we are spending twice as much per capita on health care as the Canadians or any other major country on earth,” Sanders said. 

“This is America,” Biden retorted. 

“Yeah, but Americans don’t want to pay twice as much as other countries and they guarantee health care to all people,” Sanders responded. 

Health care is a top issue in the race according to polls, and Democrats believe they can win the White House if the general election against President Trump is focused on the issue.

But it is also the issue that divides the Democratic candidates the most, with Biden and other centrists proposing more modest steps, such as reforms to ObamaCare.

The battle over health care is intertwined with the debate Democrats are having over which of their candidates is best positioned to defeat President Trump, with some in the party worried that Warren and Sanders are too liberal to win a general election. Others say their bold ideas are what is needed for the party to defeat Trump.

Biden argues Medicare for All means scrapping former President Obama’s signature achievement, the Affordable Care Act, instead of building on it.

While Sanders touted that everyone would have coverage under his plan and that it would be more generous, with no premiums or deductibles, Biden countered with the cost of the proposal, which estimates put at around $32 trillion over 10 years.

In the debate’s first hour, Biden was already hitting Sanders and Warren over the cost of the plan.

“The senator says she’s for Bernie,” Biden said of Warren’s support for Sanders’s Medicare for All plan. “Well I’m for Barack.”

Warren, pressed by host George Stephanopolous on whether middle class taxes would rise from Medicare for All, did not directly answer, pivoting to argue that overall costs for the middle class would go down once the abolition of premiums and deductibles is taken into account.

“What families have to deal with is cost, total cost,” Warren said, adding: “The richest individuals and the biggest corporations are going to pay more, and middle class families are going to pay less.”

Other candidates were also in the middle of the Medicare for All exchanges.

Sen. Kamala Harris (D-Calif.), who drew flak in the early months of the campaign for seeming to change her position on health care several times, touted the plan she eventually developed, to allow some private insurance to remain under Medicare for All by allowing private companies to administer some plans in a tightly regulated way.

“I want to give credit to Bernie. Take credit, Bernie,” Harris said, while adding, “I wanted to make the plan better, which I did.”

At another point in the debate, Biden dismissed the idea that employers would raise workers’ wages if employers no longer had to provide health insurance under a Medicare for All system. 

“My friend from Vermont thinks the employer’s going to give you back what you’ve negotiated as a union all these years … they’re going to give back that money to the employee?” Biden said.

“As a matter of fact they will,” Sanders interjected.

“Let me tell you something, for a Socialist you’ve got a lot more confidence in corporate America than I do,” Biden responded. 

While all of the Democrats advocate large additional government spending to expand health insurance coverage, the debates over whether private insurance should remain as an option has proven to be a particularly fierce source of debate.

Republicans have sensed an opening on that point as well, eagerly bashing Democrats for wanting to take away employer-sponsored coverage that millions of Americans have. Sanders and Warren counter that Medicare for All coverage would be better insurance, with no deductibles at all, so people would not miss it.

“I’ve actually never met anybody who likes their health insurance company,” Warren said, noting people like their doctors, which they would be able to keep. 

Sen. Amy Klobuchar (D-Minn.), who has staked out a more moderate ground, tore into Sanders, though, over his plan’s elimination of private insurance.

“While Bernie wrote the bill, I read the bill, and on page eight of the bill it says that we will no longer have private insurance as we know it,” Klobuchar said.

“I don’t think that’s a bold idea, I think it’s a bad idea,” she added. 

Amid the division, Harris tried to strike a unifying note.

“I think this discussion is giving the American people a headache,” she said. “What they want to know is that they’re going to have health care and cost will not be a barrier to getting it.” 

 

Rhode Island: A Most-Improved State in Health Performance

https://www.commonwealthfund.org/blog/2019/rhode-island-most-improved-state-health-performance

Rhode Island health care improvement

States use the Commonwealth Fund’s 2019 Scorecard on State Health System Performance to identify places where their health care policies are on track and areas that need improvement. Using the Scorecard, states can compare their improvement to others, and see how they stack up. In the most recent edition, released in June, Rhode Island improved on the most health system performance indicators tracked over time, followed by Missouri, Washington, West Virginia, and Arkansas.

Rhode Island particularly made strides in the areas of coverage and behavioral health. The state uninsured rate among adults dropped from 17 percent in 2013 to 7 percent in 2015 and 6 percent in 2017. In addition, the percentage of adults with any mental illness reporting an unmet need dropped from 27 percent in 2010–11 to 18 percent in 2014–16. The state also saw significant reductions in the percentage of children with unmet mental health needs.

These improvements did not happen by chance. What actions did policymakers take to drive progress and what work lies ahead?

Making Progress Through Clear Priorities and State Leadership

In 2014, Governor Gina Raimondo came into office fully committed to the Affordable Care Act, including Rhode Island’s state-based health insurance marketplace and expanded Medicaid eligibility.

Another early administration priority was making sure behavioral health care was as available and affordable as medical care. The opioid epidemic was hitting Rhode Island hard, making access to treatment for mental health and substance use disorder a top concern.

Coverage expansion. The decision to create a state-based marketplace, HealthSource Rhode Island (HSRI), was instrumental in helping the state make gains in coverage and affordability. The state has its own funding for marketing and navigators who help people understand and choose health plans. This has helped shield residents from federal outreach cuts. The state’s commitment also helped when the Trump administration decided to end marketplace cost-sharing-reduction subsidies. The state’s Office of the Health Insurance Commissioner (OHIC) worked with the state marketplace HSRI to protect consumers by building price increases to cover the loss of subsidies into silver-level health plans and keeping premiums lower in the other plans. HSRI plans offered among the lowest state-based marketplace premiums in the country. During last year’s open-enrollment period, HSRI saw a 5 percent increase in new and overall customers.

Access to behavioral health. In 2015, Governor Raimondo issued an executive order to establish the Overdose Prevention and Intervention Task Force, which has guided state reforms. The opioid crisis also has led to more open conversations about mental health and to improved relationships between first responders and communities. To facilitate these relationships, Rhode Island now requires police officers receive training to recognize behavioral health issues and help connect individuals with the care they need.

Rhode Island experienced a decline in overall overdose deaths, from 336 in 2016 to 314 in 2018. Community programs and pharmacies have worked hard to get naloxone, used to counter the effects of opioid overdose, into the hands of people who need it. Rhode Island was also the first state to offer medication-assisted opioid treatment in prison. Community health workers follow up on inmates after release to ensure treatment is continued. Fatal overdoses declined by 60 percent among people leaving detention from 2016 to 2017, and continued to drop in 2018.

OHIC also has prioritized integrating behavioral health into the primary care setting as a cost-effective way of increasing access to such services. Studies have shown that integrated care improves depression and anxiety outcomes, along with quality of life, while reducing the total cost of care.

Additionally, OHIC has been working on encouraging parity between medical and behavioral health in the insurance market by reviewing insurers’ coverage documents. It is focusing on limiting mental health benefit exclusions and ensuring the states’ major carriers are in compliance with the laws related to coverage for mental health and substance use disorder treatment. As a result, the four major insurers have agreed to discontinue prior authorization requirements for certain medication-assisted treatments.

Maintaining Momentum

In 2018 an HSRI/OHIC workgroup was formed to develop policy options to mitigate the potential impact of federal changes on health coverage costs, consumer choice, and access. The group recommended pursuing a Section 1332 waiver to establish a reinsurance program to reduce premium increases in the individual market; implementing a state-level requirement that individuals have health insurance to offset the impact of the federal health insurance mandate penalty repeal; and establishing OHIC’s regulatory authority over short-term limited duration plans. All three recommendations were signed into law on July 5.

In addition, recent state legislation has expanded OHIC’s authority related to establishing behavioral health parity, such as a law giving it authority over health plans and third-party organizations that conduct benefit reviews.

Addressing population health challenges demands a concerted effort. Rhode Island is fortunate to have a culture of collaboration among health care leaders, coupled with strong political commitment to health system improvement.

 

 

 

 

The latest on US health insurance coverage, income and poverty

https://www.politifact.com/truth-o-meter/article/2019/sep/11/latest-health-coverage-income-and-poverty-us/

Protesters gather across the Chicago River from Trump Tower to rally against the repeal of the Affordable Care Act on March 24, 2017. (AP)

New numbers from the U.S. Census Bureau show an uptick in Americans who are uninsured but modest progress on poverty and income — handing Democrats and Republicans data for talking points.

Overall, the percentage of Americans lacking health coverage at any point in the year rose from 7.9% in 2017 to 8.5% in 2018. That’s according to annual numbers released Sept. 10.

The rise in the uninsured spanned demographic groups. Uninsured rates rose between 2017 and 2018 for whites, African-Americans, Hispanic Americans, Asian Americans, native-born Americans, foreign-born Americans, people with disabilities, people without high school degrees, and those under 18.

The 2017 and 2018 figures are not directly comparable with previous years due to changes in how the data is calculated. But a different data set showed that the small rises in the uninsured rate for 2017 and 2018 marked a change for a number that had improved every year since its peak in 2010, when the Affordable Care Act was passed. The law created a national marketplace for individual insurance and allowed states to expand Medicaid to more people.

Democrats pounced on the data release, with House Speaker Nancy Pelosi, D-Calif., blaming “President Trump’s cruel health care sabotage,” including his efforts to pare back the Affordable Care Act through regulations and in court.

But the Trump administration could point to modest gains in other statistics reported by the Census Bureau.

“Americans of all backgrounds are experiencing economic success in the Trump economy,” the White House said in a statement that cited media coverage of the new numbers on income and poverty.

The U.S. poverty rate fell for the fourth consecutive year, from 12.3% in 2017 to 11.8% in 2018. The national poverty rate is currently lower than it has been in any year since 2000, as this chart indicates.

Meanwhile, median household income rose for the fourth consecutive year after adjusting for inflation. It was a small rise, however, from $62,626 in 2017 to $63,179 in 2018, or an increase of less than 1%. And the pace of growth has slowed somewhat since the middle of this decade.

A leading measure of income inequality known as the GINI coefficient dipped slightly between 2017 and 2018. But its decades-long rise toward greater inequality was not greatly slowed.

Under this measurement, a score of 0.0 represents total income equality, while a score of 1.0 represents total inequality.

The overall statistics for poverty and income also mask significant differences by race and ethnicity.

In 2018, for instance, the poverty rate for whites was 8.1%. But it was much higher for African-Americans (20.8%) and Hispanic-Americans (17.6%) and modestly higher for Asian-Americans (10.1%).

The poverty rate fell slightly in 2018 for whites, African-Americans and Hispanic-Americans, while rising slightly for Asian-Americans.

 

 

 

Many Americans clueless about out-of-pocket medical costs, study finds

https://www.beckershospitalreview.com/finance/many-americans-clueless-about-out-of-pocket-medical-costs-study-finds.html?origin=cfoe&utm_source=cfoe

Image result for cartoon clueless on out-of-pocket medical costs

When it comes to out-of-pocket medical costs, many people are unaware of their potential financial burden, according to a new study released by Discover Personal Loans, a provider of banking tools and resources across various financing options.

For the study, researchers examined the average cost of certain medical procedures and compared them to perceptions of costs from 969 surveyed U.S. residents.

Four takeaways from the study:

1. Researchers found that a three-day hospitalization, knee replacement surgery and an appendectomy had the greatest variation of average actual costs compared to average perceived costs.

2. For example, surveyed Americans perceived the average cost of a three-day hospitalization to be $11,013, while the actual average cost posted on Healthcare.gov is about $30,000. That’s a variation of 63 percent.

3. The variation between average actual cost and average perceived cost for a knee replacement surgery and an appendectomy were 34 percent and 32 percent, respectively.

4. Surveyed Americans anticipate spending $2,016 for an emergency room visit, up 5 percent from the average actual cost from the Health Care Cost Institute and cited by CNN, $1,917.

Read more about the study here.

 

 

 

Recession could come in 6 to 9 months, Morgan Stanley says

https://www.beckershospitalreview.com/strategy/recession-could-come-in-6-to-9-months-morgan-stanely-says.html?origin=cfoe&utm_source=cfoe

Image result for cartoon recession

Recent moves from President Donald Trump to raise tariffs on Chinese goods are leading the global economy closer to the brink of recession, according to a Morgan Stanley note cited by Newsweek.

In a recent research note, Morgan Stanley said if President Trump goes through with proposals to raise existing tariffs and China responds, the global economy would fall into recession in the next six to nine months. Specifically, Morgan Stanley’s U.S. public policy lead, Michael Zezas, said the tariffs would be what pushes the global economy into recession.

“Friday’s escalation of tariffs between the U.S. and China suggests they’ve not moved any closer on the key negotiation points that have separated them since May 5,” he said, according to Newsweek. “Neither side sees the benefit to cooperating as better than hanging tough. … We expect that tensions will continue to escalate at least until the costs of doing so are too big to ignore.”

The president said Aug. 23 that he plans to raise existing tariffs to 30 percent from 25 percent on $250 billion of Chinese goods starting Oct. 1. Additionally, he proposed tariffs on another $300 billion of Chinese imports to increase from 10 percent to 15 percent over the coming months. The president’s proposals come after China said it will impose tariffs on another $75 billion of U.S. imports, and that it would reinstate tariffs on auto products that were previously suspended.

Read more here.