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Mercer

Raise your hand if you’ve recently had a thoroughly positive conversation about healthcare in America, like one where people were smiling and talking about how great it is. No one mentioned the soaring costs, 3-minute doctor visits, confusing bills, or any other negative experience.

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You’ve been providing health benefits to your retirees for years. You’re glad you can: It rewards loyalty, protects people that you consider to be valued colleagues, and promotes engagement within your business. But as health reform adds to administrative burdens and the need to control cost intensifies, it feels like each day there’s less time to manage the retiree program.

 

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A plethora of Federal, state and local leave laws and regulations has made employer compliance and leave administration increasingly complex. It’s not surprising, then, that improving FML administration is the top priority for employers’ absence and disability programs. Employers are increasingly relying on outside vendors or licensing software to administer and manage these leaves and attempt to keep up with the ever-changing leave landscape. We’re seeing the fastest growth in outsourcing leave administration among small and mid-sized employers.

 

FMLA OUTSOURCING

EMPLOYER SIZE

2007

2010

2013

2015*

All respondents

14%

25%

38%

40%

100 – 999 employees

5%

13%

13%

19%

1,000 – 4,999 employees

11%

29%

37%

48%

5,000 or more employees

25%

37%

57%

60%

 

*Co-sourcing was included as an option in the 2015 survey and results for both co-sourcing and outsourcing are included in the overall outsourcing figures

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Rep. Tom Price (R-GA) was confirmed early Friday morning as Health and Human Services Secretary in a 52-47 vote down party lines. The vote comes at the end of a contentious confirmation process, which raised questions from Democrats about his healthcare stocks, his plans for Medicare, and his opposition to the ACA. President Trump said last month that he would file a plan to repeal and replace the ACA “as soon as the Secretary is approved,” but has more recently indicated that a replacement plan could take until next year. Many are now looking to Tom Price’s confirmation for clues about the new administration’s commitment to an ACA repeal-and-replace timetable. According to this Wall Street Journal article, Price is “expected to follow through on an executive order, issued by Mr. Trump on the first day of his administration, directing federal agencies to pare back regulatory elements of the ACA.” The article also speculates that he could overturn the mandate that health plans include contraceptive coverage at no cost to the patient, “a protection that isn’t explicitly written into the law.” More to come on this – we’ll be watching Price’s first days closely.

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G.O.P. Campaign to Repeal Obamacare Stalls on the Details

Robert Pear and Reed Abelson, The New York Times

  • The campaign to repeal the Affordable Care Act has stalled as Republicans struggle to come up with a replacement and a key senator, Lamar Alexander (R-TN), has declared that the effort is more a repair job than a demolition. *A must read*

 

Today in Obamacare: Here’s why it’s so hard for Republicans to agree on replace

Sarah Kliff, Vox

  • This article shines a light on the disconnect between Republican statements criticizing high deductibles and cost sharing and their support for policies that promote high-deductible health plans paired with health savings accounts. Sarah Kliff argues that until Republican rhetoric and policy positions align, it will be hard for the party to coalesce on a plan. *Interesting perspective*

 

Math geniuses size up 5 ACA change ideas

Allison Bell, LifeHealthPro

  • Here’s what the actuaries have to say about some popular health law proposals. *Worth the time*

 

The G.O.P.’s Health Care Death Spiral

J.B. Silvers, The New York Times

  • This op-ed by a former health insurance executive covers the ramifications of “repeal and delay” for the individual insurance market. He agrees that the ACA has its flaws, but repealing it without a viable replacement is not an option if the replacers really want to use private insurers to meet society’s goals of access, affordability and quality in healthcare. *Interesting perspective*

 

How Trump’s immigration ban threatens health care, in 3 charts

Julia Belluz and Sarah Frostenson, Vox

  • Our interest in this article is the reminder that broader immigration reform efforts could impact provider access. It’s certainly a topic to watch since provider shortages present challenges for health plan sponsors. *Skim this one*

 

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The path Congress will take to repeal and replace the ACA has been anything but clear. Since the election, many approaches have been discussed, some that could take up to two years to implement. Trump is asking Congress to move more quickly. Last week, a committee of House Republicans released four bills that suggest a new direction. In an article in Health Affairs, author Timothy Jost says “…they are not aimed at destroying the ACA, but rather at trying to calm insurers and a nervous public. Some may even pass on a bipartisan basis. This is a very interesting development.”

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President Trump and congressional Republicans left last week’s planning meeting in Philadelphia still divided over the timing and substance of how to repeal and replace the Affordable Care Act. The effort continues this week in Washington as congressional committees hold a spate of hearings and work on writing legislation.  

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You’ve heard it before: It takes great health benefits to attract a great pool of talent. But as an SMB (Small or Midsize Business), you’re scratching your head over how to offer the buffet of options new employees expect.

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Almost immediately following the swearing in, President Trump signed his first executive order directing HHS, DOL, Treasury and other agencies within the government to waive, defer, grant exemptions from or delay provisions of the ACA that impose financial or regulatory burdens, to the extent allowed under the law. So what exactly is allowed? Here are the three main ways the administrative branch can exert influence over the ACA:

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With President Trump promising an ACA replacement bill of his own “very soon” and congressional Republicans struggling to reach agreement, two GOP senators – Bill Cassidy of Louisiana and Susan Collins of Maine – are proposing to let states choose their own path. Under the newly-proposed “Patient Freedom Act,” states would have three choices: To continue to operate under the ACA, to implement their own reforms with some federal funding and strings attached, or to design their own reforms without federal help.

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A founding member of the House Freedom Caucus, Rep. Mick Mulvaney (R-SC) is known as a budget hawk -- a deficit hardliner and one of the key Republicans who led the charge to oust former Speaker of the House John Boehner in 2015. As President Trump’s pick to lead the Office of Management and Budget, Mulvaney will be tasked with keeping tabs on government revenue and spending and overseeing the Trump administration’s regulatory actions, which also means he’ll play a central role in health care and entitlement policy.

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The Trump administration has tapped Andrew Puzder, chief executive of CKE Restaurants (parent company of fast-food chains Carl’s Jr. and Hardee's) for the next head of the Department of Labor (DOL).  While many see Puzder’s years spent in the restaurant industry as an asset, critics complain about his tendency to oppose regulations that would increase workers’ pay and benefits.

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