Supreme Court ruling allows plan for religious limits to Obamacare contraceptive coverage

From today’s NBC News Online:

The U.S. Supreme Court on Wednesday cleared the way for the Trump administration to give the nation’s employers more leeway in refusing to provide free birth control for their workers under the Affordable Care Act.

The ruling is a victory for the administration’s plan to greatly expand the kinds of employers who can cite religious or moral objections in declining to include contraceptives in their health care plans. Up to 126,000 women nationwide would lose birth control coverage under President Donald Trump’s plan, the government estimated. Planned Parenthood said nearly nine in 10 women seek contraceptive care of some kind during their lifetimes.

The Affordable Care Act, better known as Obamacare, gives the government authority to create the religious and moral objections, said Justice Clarence Thomas for the court’s 7-2 majority. The Department of Health and Human Services “has virtually unbridled discretion to decide what counts as preventive care and screenings,” and that same authority “leaves its discretion equally unchecked in other areas, including the ability to identify and create exemptions from its own guidelines,” he said.

In dissent, Justices Ruth Bader Ginsburg and Sonia Sotomayor said the court in the past has struck a balance in religious freedom cases, so that the beliefs of some do not overwhelm the rights of others.

“Today for the first time, the court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree” and “leaves women workers to fend for themselves” in seeking contraceptive services, they said.

Women’s groups condemned the ruling. The National Women’s Law Center said more than 61 million women get birth control coverage through Obamacare.

“The Supreme Court’s decision will leave their ability to receive this critical coverage at the whim of their employers and universities,” the group said. “This decision will disproportionately harm low-wage workers, people of color, LGBTQ people, and others who already face barriers to care.”

Read the complete article here.

Employer-Based Health Care, Meet Massive Unemployment from Pandemic

From today’s New York Times:

In the early months of 2020, Americans were engaged in the perennial election-year debate over how best to reform the nation’s health care system. As usual, the electorate was torn and confused. Polling indicated that a small majority of likely voters favored a new universal system that would cover everyone. But that support evaporated when it was made clear that any such overhaul would involve abolishing the private insurance market. At the time, nearly 160 million Americans received their health benefits through an employer, and the vast majority of them liked that coverage just fine — maybe not enough to sing about it, but enough to be wary of a potential replacement.

Then came the pandemic of the century. And the highest level of unemployment since the Great Recession. And the most concentrated wave of job loss in the nation’s history — more than 40 million Americans filed new unemployment claims between mid-March and late May. It will take time to ascertain the full impact of those losses on the nation’s health insurance rate, but an early survey from the Commonwealth Fund is not encouraging: 41 percent of those who lost a job (or whose spouse lost a job) because of the pandemic relied on that job for health insurance; 20 percent of those people have not managed to secure alternative coverage.

Nothing illuminates the problems with an employer-based health care system quite like massive unemployment in the middle of a highly contagious and potentially deadly disease outbreak. For one thing, uninsured people are less likely to seek medical care, making this coronavirus that much more difficult to contain. Also, people with chronic or immune-compromising medical conditions are particularly susceptible to this new contagion — which means the people most in need of employer-sponsored health benefits are the same ones who can least afford to return to work at the moment.

“The pandemic has amplified all the vulnerabilities in our health care system,” says Drew Altman, president of the nonpartisan Kaiser Family Foundation, including “the uninsured, racial disparities, the crisis of unmanaged chronic conditions and the general lack of national planning.”

As dire as the crisis is, though, it’s also an opportunity to look at health care reform with fresh eyes — and to maybe, finally, rebuild the nation’s health care system in a way that works for all Americans, not just the wealthy and the well employed.

The first step will be acknowledging the problems of our current system. If American health care were its own country, it would be the fourth largest in the world by gross domestic product. The nation spends an average of $3.5 trillion per year on health care — more than Japan, Germany, France, China, the United Kingdom, Italy, Canada, Brazil, Spain and Australia combined — and still loses more people to preventable and treatable medical conditions than any of those countries do.

In other words, America has created the most expensive, least effective health care system in the modern world, and the most vulnerable Americans have been paying for that failure with their lives since long before the coronavirus came to town.

Read the complete article here.

How COVID-19 turned a spotlight on weak worker rights in the U.S.

From today’s Harvard Gazette:

As the economy reopens after the COVID-19 shutdowns, businesses are taking a varied, often patchwork approach to ensuring health and safety for their workers, and much uncertainty persists regarding employers’ obligations and employees’ rights. The Gazette spoke with labor law experts Sharon Block, executive director of the Labor and Worklife Program, and Benjamin Sachs, the Kestnbaum Professor of Labor and Industry at Harvard Law School (HLS), about how the pandemic has turned a spotlight on the lack of clear workplace protections in general, and in particular for women and people of color, who were disproportionately represented among those deemed essential. Block and Sachs recently co-authored a report urging that U.S. labor law be rebuilt from the ground up. On June 24, they will release the report “Worker Power and Voice in the Pandemic Response.”

Q&A: SHARON BLOCK AND BENJAMIN SACHS

GAZETTE: What do you think the COVID-19 crisis has revealed about working conditions in the United States?

BLOCK: What it has revealed is something that many of us have known for a long time, but it’s been revealed in a much more urgent way, and it is how tattered our social safety net is in this country. That plays out in in a number of ways: for example, how inadequate our supports for workers are in terms of unemployment insurance. Just look at the desperate circumstances now more than 40 million workers have found themselves in. That’s been the reality for many low-wage workers, not on a mass scale, but that’s been their lived experience, even throughout a time when we thought we were in an expanding economy. The other side that has been exposed is that for workers who have been deemed essential and have worked throughout this crisis, how little protection they have in the workplace to be able to stand up for themselves, to say that their conditions are unsafe and they’re not being paid adequately for the important work they’re doing. On all sides of the social safety net and the ability of low-wage workers to have a decent life, what we’re seeing in myriad ways is how the system has failed workers.

SACHS: I would just add how weak the protections are for workers who stand up and demand safe, healthy, and fair working conditions, and how easy it is to fire workers who do that. It has also shown how badly broken our system of labor law is, which is to say that our system doesn’t give workers a voice so that the only recourse workers have is to take to the streets, and how little opportunity they have for an institutional structure of communication and demand-making. The other thing that Sharon and I would like to stress is how the crisis is being borne disproportionately by workers of color and women, which is another failing of our labor market and our system of labor law.

GAZETTE: Why are workers of color and women bearing the brunt of the coronavirus crisis? What role do the labor market and the labor law system play in it?

BLOCK: This is the result of the broken safety net we have. These are workers who are deemed essential, but the law has not treated as essential. They don’t have basic rights or the law doesn’t adequately address their situation. For lots of low-wage workers who are in these essential industries, the current labor law is particularly broken. They really have almost no real access to being able to act collectively and have the law recognize that and thereby give them power to affect their situation at work. As Ben said, they are predominantly workers of color and women, and that’s a big piece of why this pandemic has hit them so hard. We’re really seeing this connection that a lot of people intuitively knew, but hopefully more people understand now, which is that it is hard to separate economic issues and public health issues and issues of physical well-being. It’s not an accident that most people who are getting sick are poor or paid low wages.

Read the complete article here.

‘Lives Were Lost’ as Warnings Went Unheeded, Whistle-Blower Tells House

From today’s New York Times:

The whistle-blower who was ousted as the head of a federal medical research agency charged on Thursday that top Trump administration officials failed to heed his early warnings to stock up on masks and other supplies to combat the coronavirus, and that Americans died as a result.

“Lives were endangered, and I believe lives were lost,” Dr. Rick Bright, who was removed in April as the director of the Department of Health and Human Services’s Biomedical Advanced Research and Development Authority, told a House subcommittee as he warned, “The window is closing to address this pandemic.”

Over nearly four hours of testimony, Dr. Bright told lawmakers that the outbreak would “get worse and be prolonged” if the United States did not swiftly develop a national testing strategy. He also predicted vaccine shortages if the administration did not draft a distribution plan now.

After holding back for nearly a month, President Trump and his health secretary, Alex M. Azar II, hit back at Dr. Bright, elevating the confrontation. Mr. Trump dismissed Dr. Bright as a “disgruntled employee” while Mr. Azar insisted officials followed through on the scientist’s ideas.

Dr. Bright’s testimony was the first time a federal scientist — or any federal official — had gone before Congress and openly accused the administration of endangering American lives by bungling its coronavirus response. He said Americans would face “the darkest winter in modern history” if the administration did not move quickly, as people become “restless” to leave their homes.

That came two days after Dr. Anthony S. Fauci, the government’s top infectious disease expert, contradicted Mr. Trump by warning of “needless suffering and death” if states reopened too quickly, amounting to a one-two punch for the administration.

Read the complete article here.

Thousands of health care workers are laid off as coronavirus spreads

From today’s Los Angeles Times:

Healthcare workers, championed as heroes of the COVID-19 crisis and applauded for risking their lives to protect others, have been hit especially hard by the severe economic fallout wrought by the pandemic.

In California, thousands of nurses, doctors and other medical staff have been laid off or furloughed or have taken a pay cut since mid-March. The pain has been felt broadly, from major facilities such as Stanford Health Care to tiny rural hospitals to private practitioners. Across the nation, job losses in the healthcare sector have been second only to those in the restaurant industry, according to federal labor statistics.

Hospitals and doctors’ offices lost billions in revenue when they canceled elective surgeries and non-emergent visits to prepare for a possible surge in COVID-19 patients and to reduce the spread of the virus.

Patients also began scheduling fewer appointments and avoiding the hospital, even for medical emergencies, creating another hit for providers who were already hurting. The surge, in places where it did arrive, was not enough to compensate for the losses, experts say.

American healthcare is a business, and the economics are simple: Fewer patients means less money. And though some California hospitals are beginning to schedule elective surgeries again, experts say the healthcare industry is unlikely to bounce back immediately, as large swaths of the population are now struggling to make ends meet and may continue to avoid or put off medical care.

Read the complete article here.

Experts warn GM strike not likely to be resolved anytime soon

From NBC News Online:

On this General Motors and the United Auto Workers agree — the strike that sent 50,000 workers out on the picket lines Monday is not likely to be over anytime soon.

Both sides are talking, but both sides are bracing for a long and costly fight as workers dig in on their fight for better wages, health care benefits and job security, union representatives and auto industry experts said.

“It will go on as long as it’s going to take to achieve our bargaining goals,” Chuck Browning, the UAW’s Region 1A Director, told MSNBC. “The bottom line is this company has been extremely profitable for a long period of time. Those profits have been made off the sweat and the hard work of our members, and our members want a fair agreement.”

Erik Gordon, a business professor at the University of Michigan and an auto industry maven, said the leadership of the UAW needs to take a stand against GM not just for the rank and file — but for its own survival.

UAW President Gary Jones and other top union officials are currently under investigation by federal authorities for allegedly embezzling member dues and blowing thousands of dollars on everything from fancy vacations and golf equipment to $400 bottles of Louis Roederer Cristal Champagne.

“I think the union leadership wanted a strike because they’re under attack, and when you feel like you could be losing your grip on power the age-old tactic is to go to war,” Gordon said.

And because they need to be seen as taking a hard line against GM management, union negotiators won’t seek a swift solution even though rank-and-file workers will start feeling the financial pain almost immediately.

Read the complete article here.

The Wrong Way to Do Paid Family Leave

From today’s New York Times:

Senator Marco Rubio just made a small bit of history: He became the first of his party to put forward a national paid family leave program. On Aug. 2, he introduced a bill that would allow any American to take paid time off to be with a new child.

It marks a surprising step forward: Paid family leave has become bipartisan. Unfortunately, smart policy design has not. Instead of creating a new, desperately needed benefit, Mr. Rubio’s bill would make parents cash in their retirement to take care of their children today.

All developed countries — except for the United States — guarantee at least some paid maternity leave, ranging from six weeks in Portugal to 43 weeks in Greece. Americans are only entitled to up to 12 weeks of unpaid leave.

Even securing unpaid time off was a bruising political battle. The former speaker of the House, John Boehner, called unpaid family leave “another example of yuppie empowerment,” and Representative Cass Ballenger reportedly smeared it as “socialism.” The unpaid Family and Medical Leave Act suffered two vetoes from President George H.W. Bush, a Republican, and was signed into law only after Bill Clinton, a Democrat, won the White House.

Read the complete article here.

Amazon, JPMorgan, Berkshire Hathaway team up to lower healthcare costs for their workers — and maybe everyone

From today’s LA Times:

Three of the nation’s most formidable companies — Amazon.com, Berkshire Hathaway Inc. and JPMorgan Chase & Co. — sent shock waves through the healthcare industry Tuesday by announcing a joint plan to reduce healthcare costs for their U.S. employees.

Although the companies said their focus mainly would be on providing improved healthcare for their own U.S. workers, which total nearly 1 million, the move immediately triggered speculation that any solutions they develop could spread throughout the industry.

That sent healthcare, drug and health-insurance stocks tumbling even though the three companies provided few initial details about their venture, with investors guessing that the trio’s initiative eventually could crimp sales growth and profits for others in the healthcare field.

Consumers might see a benefit if the companies could develop a blueprint for curbing the surge in healthcare and drug costs while maintaining or enhancing patient care, a scenario that government and the industry so far have struggled to achieve.

The speculation of a disruption to the industry was fueled by the stature of the three companies’ billionaire chief executives: Amazon’s Jeff Bezos, who already has radically changed the retail industry; Warren Buffett, the famed investor who also oversees dozens of companies under Berkshire’s umbrella; and Jamie Dimon, whose JPMorgan Chase is the nation’s largest bank with $2.5 trillion in assets.

Bezos and Buffett also are two of the nation’s richest people, with net worths of $119 billion and $92 billion, respectively, while Dimon’s net worth is just over $1 billion, according to Forbes.

The three said they would start “an independent company that is free from profit-making incentives and constraints” and that its early focus “will be on technology solutions” that would provide “simplified, high-quality and transparent healthcare at a reasonable cost.”

Read the complete article here.

Individual Mandate Now Gone, G.O.P. Targets the One for Employers

From the New York Times:

Having wiped out the requirement for people to have health insurance, Republicans in Congress are taking aim at a new target: the mandate in the Affordable Care Act that employers offer coverage to employees.

And many employers are cheering the effort.

While large companies have long offered health benefits, many have chafed at the detailed requirements under the health law, including its reporting rules, which they see as onerous and expensive. Now that relief has been extended to individuals, some companies believe they should be next in line.

The individual mandate and the employer mandate are “inextricably entwined,” said James A. Klein, the president of the American Benefits Council, an influential lobby for large companies like Dow Chemical, Microsoft and BP, the oil and gas producer.

“It is inequitable to leave the employer mandate in place when its purpose — to support the individual mandate — no longer exists,” Mr. Klein said. “We are urging Congress to repeal the employer mandate.”

Opposition to the employer mandate could increase as more employers are fined for not offering coverage or for not meeting federal standards for adequate, affordable coverage. Since October, the Internal Revenue Service has notified thousands of businesses that they owe money because they failed to offer coverage in 2015, when the mandate took effect.

Representatives Devin Nunes of California and Mike Kelly of Pennsylvania, both Republicans, recently introduced a bill, supported by party leaders, to suspend the mandate, canceling any penalties that would be imposed for any year from 2015 to 2018.

“The employer mandate is a job-killer, a wage-killer and a business-killer,” Mr. Kelly said.

But Tom Leibfried, a health care lobbyist at the A.F.L.-C.I.O., called the proposals to repeal or weaken the employer mandate “a very bad idea.”

“The Affordable Care Act was built on a framework of shared responsibility,” Mr. Leibfried said. “If you get rid of the employer mandate, you will see people lose coverage from their employers.”

Such a move could also increase costs for the federal government. Even though Congress has eliminated the penalties for people who go without insurance, millions of consumers are still eligible for financial aid in the form of tax credits to help them pay insurance premiums. These subsidies increase with the rapidly rising cost of insurance. If fewer people receive coverage from employers, more will qualify for subsidized coverage in the public marketplaces created by the Affordable Care Act.

“The employer mandate holds down the cost of premium tax credits for the federal government,” said Catherine E. Livingston, a tax lawyer at the law firm Jones Day who was the health care counsel at the I.R.S. from 2010 to 2013. “Any employee who receives an offer of affordable coverage from an employer is not eligible for the tax credit. And the employer mandate provides a strong incentive for employers to offer affordable coverage.”

Read the complete article here.

KY Gets OK To Require Work From Medicaid Recipients, Most Already Do

From National Public Radio:

Poor residents in Kentucky will have to work or do volunteer work if they want to keep their Medicaid benefits after the Trump administration on Friday approved the state’s request to add the requirements to its Medicaid program.

The new requirements apply only to “able-bodied” adults who get their health insurance through Medicaid, the federal-state health insurance program for the poor. People with disabilities, children, pregnant women and the elderly are exempt from the requirement.

“Kentucky is leading the nation in this reform in ways that are now being replicated all over the nation,” said Kentucky Governor Matt Bevin, in announcing the plan’s approval.

Kentucky’s program was approved a day after the federal Centers for Medicare and Medicaid Services announced it would look favorably on proposals from state to require poor Medicaid beneficiaries to work, go to school, get job training or do volunteer work to earn health coverage.

Nine other states — Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah and Wisconsin — have asked CMS to allow them to add “community engagement” requirements to their Medicaid programs.

CMS Administrator Seema Verma says the work requirement option is designed improve people’s financial status and health outcomes.

In addition to the work requirement, some of Kentucky’s Medicaid beneficiaries will have to begin paying premiums for their coverage and will have to meet certain milestones to earn dental and vision care.

Before Verma joined CMS she was a private consultant and an architect of the Kentucky plan that was approved Friday.

It’s not clear how many people would be affected by the new rules in Kentucky and elsewhere.

study by the Kaiser Family Foundation found that about 60 percent of “able-bodied” Medicaid beneficiaries already work. And a third of those who don’t have jobs say it’s because they are ill or disabled.