A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Workforce and Access

SBA launches new website to educate small business about ACA

Posted on January 31, 2013

The U.S. Small Business Administration launched a website and corresponding blog featuring information about the Affordable Care Act (ACA) for employers, in attempt to correct misconceptions about the law’s impact and prepare business owners for implementation. The website reviews ACA provisions, breaking them down based on how they will impact different parties: those who are self-employed, businesses with fewer than 25 employees, those with fewer than 50 employees and those with more than 50. The site also includes a glossary of key ACA-related terms and links to an HHS timeline outlining when important provisions of the law will go into place.

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HHS announces new workforce grants

Posted on August 31, 2012

Yesterday, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced $58.7 million in grants to strengthen training for health professionals and increase the size of the American health care workforce. The 254 grants support nursing workforce development, interdisciplinary and geriatric education and training, centers for excellence health professions schools, and dentistry. For a list of grant awards by state, click here

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Deloitte survey finds 1 in 10 U.S. employers to drop health coverage

Posted on July 26, 2012

In the 2012 Deloitte Survey of U.S. Employers: Opinion about the U.S. Health Care System and Plans for Employee Health Benefits, nine percent of companies, which represent three percent of the workforce, anticipate dropping health insurance coverage sometime within the next three years. The survey reported that 81 percent of companies, which represent 84 percent of the workforce, plan to continue offering employer-sponsored health insurance. Ten percent of companies, which represent 13 percent of the workforce, reported that they were unsure whether or not they would keep employee health benefits.

According to the survey, many employers are considering sending their employees to participate in the Affordable Care Act’s (ACA’s) Exchanges. Small employers are the most likely to be interested in such an option. Deloitte’s report collected the results of a web survey of 560 randomly selected employers with 50 or more employees. Participants included chief executive officers, chief financial officers, and chief human resources officers.

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Georgetown releases comprehensive report on healthcare workforce

Posted on July 23, 2012

In Healthcare, the Georgetown University Center on Education and the Workforce provides detailed analyses and projections regarding healthcare fields, occupations, and their wages. In addition, the report provides a discussion regarding the important skills and work values associated with healthcare fields and occupations. Finally, the report addresses the implications of findings for racial, ethnic, and class diveristy of the healthcare workforce for the coming decade.

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EBRI releases report on employment-based coverage of adult children to age 26

Posted on January 12, 2012

The Employee Benefit Research Institute released an article entitled “The Impact of PPACA on Employment-Based Health Coverage of Children to Age 26″ in their January volume. This report reviews the evidence as to whether the mandate to extend coverage to adult children had an effect on the percentage of young adults with coverage in late 2010 and the first half of 2011. Data from the Census Bureau’s Current Population Survey (CPS) and Survey of Income and Program Participation (SIPP) are examined, as well as data from the Center for Disease Control’s National Health Interview Survey (NHIS). The data from these three surveys suggest that the PPACA’s coverage mandate has resulted in an increase in the percentage of young adults with employment-based health coverage as a dependent.

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NIHCR report suggests ACA will not amply address primary care physician shortages

Posted on December 20, 2011

A report released by the National Institute for Health Care Reform (NIHCR) finds that provisions under the Affordable Care Act (ACA) to increase the number of primary care physicians may not be sufficient to meet the rising demands of medical services. Such provisions under the ACA include higher payment rates and educational loan forgiveness for primary care doctors. NIHCR urges policymakers to focus on ways to expand primary care that will yield more timely results. Such improvements could include opening the field of primary care to more non-physician providers, and improving the efficiency of existing practitioners.

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Health Affairs article estimates that ACA would still cover 23 million without individual mandate

Posted on October 27, 2011

Many policy gurus fear that repeal of the minimum coverage provision and corresponding penalty from the Affordable Care Act (ACA) would lead to adverse selection and thus a premium spiral. However, a recent Health Affairs article highlights other ACA provisions that would mitigate the negative repercussions of an individual mandate repeal. For example, the ACA subsidies to help people purchase coverage would restrain a premium spiral by absorbing much of the impact of premium increases. The article proffers that without the individual mandate, 7.8 million people would lose coverage, as opposed to other estimates in the 16-24 million range. In sum, the ACA would still cover 23 million people who otherwise would have been uninsured. Although the individual mandate would have important effects, the article says, perhaps it is not crucial to the successful implementation of health reform.

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Health Affairs article warns of contingencies and uncertainties under Medicaid expansion

Posted on October 27, 2011

An article recently published in Health Affairs, “Policy Makers Should Prepare For Major Uncertainties in Medicaid Enrollment, Costs, And Needs For Physicians Under Health Reform,” presents findings from a simulation model using two nationally representative data sets to estimate Medicaid eligibility, participation, and population growth. The article warns that the number of Medicaid enrollments, associated costs, and number of new physicians needed could vary hugely under Medicaid expansion. The estimated number of people enrolling in Medicaid for the first time could vary by more than 10 million when the program changes are implemented in 2014. Additionally, costs could range from anywhere between $34 billion to $98 billion per year. The new enrollments could necessitate at least 4,500 and at most 12,100 new physicians. The study results indicate that policy makers should prepare for a great deal of unpredictability associated with Affordable Care Act’s (ACA’s) Medicaid reform.

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AMA’s annual survey finds competition often sparse in commercial health insurance market

Posted on October 26, 2011

The American Medical Association recently issued the 2011 edition of “Competition in Health Insurance: A Comprehensive Study of U.S. Markets.” The survey reports that four out of five metropolitan areas in the United States lack a competitive health insurance market. Those markets are rate “highly concentrated” based on Department of Justice and Federal Trade Commission findings. In approximately half of such markets, at least one commercial health insurer had a market share of at least 50 percent. In 24 out of the 48 states covered, the two largest commercial insurers controlled a market share of 70 percent or more.

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Commonwealth Fund publishes National Scorecard on U.S. Health System Performance, 2011

Posted on October 18, 2011

The Commonwealth Fund debuted the “National Scorecard on U.S. Health System Performance, 2011″ in a press briefing at the Kaiser Family Foundation on October 18, 2011. Cathy Schoen, the Senior Vice President for Research and Evaluation at Commonwealth, summarized the report, which updates a series of comprehensive assessments of U.S. population health and health care quality, access, efficiency, and equity. The report notes substantial improvement on several care quality indicators. However, the U.S. fell short on key measures as well. Across 42 performance indicators, the U.S. achieved a total score of 64 out of a possible 100, when comparing national rates with domestic and international benchmarks. Costs rose sharply, access to care declined, health system efficiency remained low, health disparities persisted, and heath outcomes also fell below target. The Affordable Care Act (ACA) targets many of the important gaps identified by the Commonwealth Scorecard.

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