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Crowdstaffing featured as Rising Star and Premium Usability HR platform in 2019

Crowdstaffing has earned the prestigious 2019 Rising Star & Premium Usability Awards from FinancesOnline, a popular B2B software review platform. This recognition is given out annually to products[...]

May 13, 2019

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How to Help Workers Access Health Coverage if ACA Repeal Passes

President Trump campaigned on a lot of issues, but at the core of all his fiery rhetoric was a promise that every policy would, somehow, serve to strengthen American labor. His immigration bans, his retreat from NAFTA, and even his dubious, ill-fated attempts to repeal the Affordable Care Act were all pledges designed to stir support from the vanishing middle-class workforce. Repeal and replace efforts have stalled or failed at every step. So conservative lawmakers are taking one last stab, manifested as the Graham-Cassidy healthcare bill, which analysts say will “cause massive upheaval and sow uncertainty in insurance markets.” Here’s the thing. Without a healthy workforce, no business will attain its goals. Even the short-terms gains of saving on benefits costs will compound in substantial long-term losses. As Sunil wrote on September 14, we need a new social contract for talent in this gig economy. Healthcare is a vital aspect of that. Let’s look at how we can overcome the challenges.

Understanding Graham-Cassidy’s Impact on Health

As Bob Bryan explained in his recent article for Business Insider, Graham-Cassidy would not only unravel Obamacare, it would force states to establish entirely new health insurance markets -- essentially from scratch.

Matthew Fiedler and Loren Adler, health policy analysts at the Brookings Institution, said the challenges for states would be even more daunting than amid the implementation of the Affordable Care Act.

“States would have only around 15 months to get new policies in place to do so before insurers would need to begin developing products for 2020 and only about 27 months before the new rules would have to be in effect,” Alder and Fiedler wrote as part of an analysis Friday. “For comparison, the process of drafting and implementing the ACA began close to five years before the new rules would be in effect. It seems likely that many states would simply fail to meet this timeline or meet the timeline only by deploying ineffective policies.”

The researchers said the challenges would lead to an increase in the number of people uninsured due in part to the heightened uncertainty for insurers and beneficiaries.

The previous House bill unraveled amid public outcry, disagreements, and general lack of support. However, the Graham-Cassidy iteration actually goes further in pushing unpopular reforms. Here are just a few of eradications and rollbacks that could occur if the legislation passes.

  • Medicaid expansion, insurance exchanges, and income-based subsidies established under ACA would be gone.
  • Medicaid payments would be slashed by a third for pregnant women, the elderly in nursing homes, the impoverished, disabled children, etc.
  • After gutting the ACA, which was difficult and cumbersome to implement, Graham-Cassidy would then mandate that states create alternative health systems for tens of millions of people -- essentially from scratch -- without providing much guidance or a fraction of the funds.

Writing for the New Yorker, Atul Gawande, a surgeon and public-health researcher, summed up the situation facing America if Graham-Cassidy becomes a legally binding reality:

With these massive sums being flung around, it is easy to forget that this is about our health as human beings. The evidence is that health-care programs like the A.C.A. save lives. The way they do so is by increasing the number of people who have affordable access to a regular source of care and needed medications. Such health coverage has been shown to produce a substantial and increasing reduction in mortality—especially among those with chronic illnesses, such as heart disease, cancer, or H.I.V.—in as little as five years.

Virtually all of us, as we age, will develop serious health conditions. A critical test of any health reform, therefore, is whether it improves or reduces our prospects of having the continuous care and medicines we need when we come to have a chronic illness. The Graham-Cassidy bill fails this test.

There’s also a detrimental effect on diversity. What many people may not realize are the ongoing struggles for health that LGBTQ talent confront. As the Kaiser Family Foundation explains: “Lesbian, gay, bisexual, and transgender (LGBT) individuals often face challenges and barriers to accessing needed health services and, as a result, can experience worse health outcomes. These challenges can include stigma, discrimination, violence, and rejection by families and communities, as well as other barriers, such as inequality in the workplace and health insurance sectors, the provision of substandard care, and outright denial of care because of an individual’s sexual orientation or gender identity.”

Promoting Health in the Absence of Care

In its coverage of the contentious health bill, the Motley Fool observed: “But it's not just that healthcare expenses are rising; they’re also impacting workers who can’t keep up. A good 56% of people who saw their costs increase last year say their financial goals -- namely, saving for retirement and paying off debt -- are now suffering. And though not nearly as critical, two-thirds of workers whose healthcare costs went up have been forced to cut back on leisure.”

For any business to thrive, its workforce must be healthy and productive. The absence of wellness causes economic constraints from growing absenteeism, an increase in accommodations as more disabilities manifest, low engagement, high attrition, and huge declines in performance. According to a Willis survey, 93 percent of organizational leaders said healthier employees consistently produced superior results. In short, a healthy workforce means a healthy bottom line.

Even though the gig economy has spurred a larger population of contingent talent, they are still vital members of the business units and projects they support. Their health plays just as instrumental a role. Some staffing firms will continue to offer at least the minimum health overage set by ACA. For those who don’t, or for talent who find themselves without access to care, options do exist. And business leaders should help their workers understand the choices.

Prevention is always the best medicine. As we’ve written previously, using health-centric wearables across the enterprise can promote salubrity, prevent accidents and illness, and help mitigate associated costs. Mindfulness programs, already used by companies such as Google, offer another powerful alternative. Beyond that, here are two other suggestions.

Flexible Spending Accounts

Help talent open and fund a Flexible Spending Account (FSA). Health costs can be lowered because the accounts allow individuals to contribute payments with pre-tax dollars. For the current tax year, participants may save up to $2,600 and put that money toward qualified expenses such as medication, co-pays, and prescription eyewear.

”The amount of money your FSA actually saves you will correlate to your effective tax rate, and the higher that number, the more you stand to save,” Motley Fool explains. “For example, if you max out your FSA for the year, and your effective tax rate is 25%, you'll get a $650 tax break, which will help offset whatever rising costs you might otherwise encounter.”

Health Savings Accounts

Workers may also open a Health Savings Account (HSA). In essence, they are similar to FSAs, yet with different contribution limits and rules. Like an FSA, the money is pre-tax. Likewise, the actual savings depend on the individual’s effective tax rate, and the funds must go toward qualified medical expenses.

”To be eligible for an HSA,” Motley Fool writes, “you must be enrolled in a high-deductible health plan with a minimum individual deductible of $1,300, or a minimum family deductible of $2,600. You also can't be enrolled in Medicare or claimed as a dependent on another person's tax return.”

The annual contribution limit for an HSA currently caps at $3,400 for people age 54 and younger, or $6,750 for a family. Older individuals are permitted an additional $1,000 contribution over the other established limits.

We must continue to champion a thriving workforce regardless of politics, policies, or changing legislation. To compete and grow, we must push to help clients develop the most innovative, progressive, insightful, and healthy business cultures possible. The health and wellness of our talent is a critical success factor. I believe contingent workforce leaders should continue to stand as the inspirations, voices, and proponents of progress. Making it harder for workers to stay fit, stave off disease, and care for their families will not make America great again.

Casey Enstrom
Casey Enstrom
I am passionate about helping business leaders adopt crowd-based hiring solutions to hire the best talent. Through a comprehensive workforce and staffing programs assessment, I help identify areas of opportunity where having a hiring marketplace with a curated network of staffing agencies & independent recruiters​ could dramatically impact results.
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