Category Archives: Health Care

State Revenues and the Aging Population

Source: Katherine Barrett and Richard Greene, PA Times, June 13, 2017

…. Not only are older people likely to need more services, especially health care; they also are inclined to bring in smaller amounts of revenue dollars, largely because their earned incomes tend to decline. Equally important, many states have tax laws that do not fully cover income from Social Security or pensions. This issue is growing in significance as the makeup of the population shifts. The number of U.S. residents over 65 is anticipated to grow by one-third over the next 15 years, according to the Census Bureau….

Not just for the poor: The crucial role of Medicaid in America’s health care system

Source: Simon Haeder, The Conversation, June 7, 2017

Despite many assertions to the contrary, Senate leaders are now saying they want to vote on the replacement bill for Obamacare before the month is out. Front and center is the planned transformation of America’s Medicaid program, which covers 20 percent of Americans and provides the backbone of America’s health care system. …. To understand how the ACHA’s proposed changes to Medicaid would affect people and our health care system, let’s look more closely at the program….

The Rise of Wearable and Smart Technology in the Workplace

Source: Clement L. Tsao, Kevin J. Haskins, Brian D. Hall, ABA National Symposium on Technology in Labor and Employment Law, Presented by the Technology in the Practice and Workplace Committee April 5-7, 2017

….It should not be difficult to imagine that the ability to track each employee’s precise location and physiological activity could have a chilling effect on protected concerted activity under the NLRA. Depending on the type of wearable technology involved, employers could eventually, if not already, have the equivalent of a workplace ankle bracelet, i.e., GPS monitoring device, that could be used as a tool to monitor or interfere with protected concerted activity. For workplaces where there is a certified collective bargaining representative, wearable technology, or any form of a surveillance system, should be a mandatory subject of bargaining. See Colgate-Palmolive Co., 323 NLRB 515, 515-16 (1997) (where the Board held that installation and use of surveillance cameras were mandatory subjects of bargaining). Given the likely chilling effect on protected concerted activity as well as in order to reduce the risk of unlawful surveillance, employers should establish and enforce policies for disabling wearable technology and collecting wearable data outside of working hours….

…..Wearable technology excels at providing data on health. The pedometer of yesterday has been relegated to the vintage dustbin: today’s fitness trackers, like those from Fitbit, Jawbone, Garmin, and Apple, can track not only heart rate and calories burned, but sleep patterns, walking patterns, sweat, diet, and a whole host of other health attributes when paired with mobile apps for tracking mood, fertility, and medication, to name just few. Although many of these devices are designed for the consumer market, they are becoming increasingly common in the workplace, often as part of employee wellness programs. Companies are also finding wearable devices useful for enhancing worker safety: devices for monitoring a worker’s hydration, temperature, movement, and external hazards are already available, and research is continuing into how to coordinate these tools into a “technological guardian angel” for workers. Not surprisingly, the proliferation of wearable technology in the workplace raises a number of legal issues. In particular, the intersection of wearable technology and health implicates issues under the Americans with Disabilities Act (“ADA”), the Genetic Information Nondiscrimination Act (“GINA”), and health privacy laws like the Health Insurance Portability and Accountability Act (“HIPAA”)…..

A Health Care Bargain

Source: Matt Bruenig, Jacobin, June 2, 2017

Don’t believe the critics: a new report shows California’s single-payer plan is eminently affordable.

Related:
Economic Analysis of the Healthy California Single-Payer Health Care Proposal (SB-562)
Source: Robert Pollin, James Heintz, Andrew Glyn, Peter Arno, Jeannette Wicks-Lim, University of Massachusetts-Amherst, Political Economy Research Institute (PERI), May 2017

SB 562 (Lara) – The Healthy California Act (pdf)
Source: State of California, Senate Comittee on Appropiations, Senate 2017-2018 Regular Session, Version: April 17, 2017

The Trump Budget Threatens Children’s Health

Source: Thomas Huelskoetter, Center for American Progress, May 30, 2017

The Children’s Health Insurance Program (CHIP) has been a vital part of America’s health care safety net since its creation in the 1990s. Last year, it provided coverage for almost 9 million children. CHIP is traditionally considered a bipartisan success story and has played a critical role—together with Medicaid and the private market reforms in the Affordable Care Act—in reducing the rate of uninsured children to a historic low of 4.8 percent.

However, CHIP’s funding is not permanent and must be reauthorized this September. Recently, the bipartisan National Governors Association strongly recommended that Congress extend CHIP funding for five years, explaining that “access to health insurance is critical to ensuring a healthy start for our nation’s children.”

Unfortunately, the Trump budget rejects this bipartisan tradition of support by proposing to cut CHIP funding by 20 percent. At first glance, the budget’s proposal to extend CHIP funding for two years may appear to be a positive step. In reality, however, the budget pairs this extension with funding cuts and policy changes that would result in children losing CHIP coverage and potentially becoming uninsured. Even including the cost of the funding extension, the Trump budget would cut CHIP by a net $3.4 billion from fiscal year 2017 to fiscal year 2018—a 20 percent reduction….

The State Effects of the Medicaid Cuts Being Discussed in the Senate

Source: Emily Gee, Center for American Progress, May 26, 2017

As the Senate begins discussions over the American Health Care Act (AHCA), a key point in the negotiations is federal funding for the Medicaid program. The AHCA proposes subjecting Medicaid spending to per capita caps, limiting the number of dollars the federal government will provide to states for each enrollee. While per capita caps themselves are a major departure from how Medicaid has traditionally been funded, the exact effect of caps depends on unpredictable trends in state Medicaid spending and how the caps are indexed to grow over time…..

Budget of the U.S. Government – Fiscal Year 2018

Source: Office of Management and Budget, May 2017

A New Foundation for American Greatness – President’s Budget FY 2018

Major Savings and Reforms

America First – A Budget Blueprint to Make America Great Again

Analytical Perspectives
Appendix
Historical Tables
Supplemental Materials
Fact Sheets
Supplementals, Amendments, and Releases
Past President’s Budgets

Related:
Greenstein: Trump Budget Proposes Path to a New Gilded Age
Source: Robert Greenstein, Center on Budget and Policy Priorities, CBPP Statement, May 22, 2017

President Trump’s new budget should lay to rest any belief that he’s looking out for the millions of people the economy has left behind.

President Trump’s Budget Includes a $2 Trillion Math Mistake
Source: Ryan Teague Beckwith, Time, May 23, 2017

President Trump’s budget includes simple accounting error that adds up to a $2 trillion oversight.

Trump releases budget hitting his own voters hardest
Source: Andrew Restuccia , Matthew Nussbaum and Sarah Ferris, Politico, Updated: May 23, 2017

The president’s proposal for next year’s federal spending calls for more than $1 trillion in cuts to social programs, including farm aid.

What Trump’s budget cuts from the social safety net
Source: Denise Lu and Kim Soffen, Washington Post, Updated May 23, 2017

On Tuesday, President Trump released his 2018 budget proposal. It makes deep cuts across many anti-poverty programs, slashing food stamps by more than a quarter and children’s health insurance by 19 percent.

Trump budget slashes money for federal lands, needy and health care
Source: Thomas Burr, The Salt Lake Tribune, May 23 2017

President Donald Trump’s proposed 2018 fiscal budget would hit Utah’s needy and disabled, cut block grants to communities, slash funding for public lands and public transit projects and could hurt rural airport services.

How the Trump Budget Undermines Economic Security for Working Families
Source: Rebecca Vallas, Harry Stein, Eliza Schultz, Neil Campbell, Kate Bahn, Regina Willensky, Kevin DeGood, Antoinette Flores, Ethan Gurwitz, Alexandra Thornton, and Angela Hanks, Center for American Progress, May 23, 2017

With an administration chock full of self-serving millionaires and billionaires, it comes as little surprise that President Donald Trump’s proposed budget would be an enormous windfall for the wealthiest Americans. But the degree to which it privileges the 1 percent at the expense of nearly everyone else—breaking Trump’s campaign promises to restore prosperity to everyday Americans—is staggering. Notably, by calling for cuts to Social Security, the budget violates one of Trump’s most significant promises.

Indeed, his proposed repeal of the estate tax alone—a tax that only affects the wealthiest 0.2 percent of estates—would cost the same as feeding more than 6 million seniors for a year through Meals on Wheels, a program facing deep cuts under the Trump budget.

And that is just one of several massive giveaways to the wealthy that President Trump calls for in this budget proposal while slashing critical investments in education, infrastructure, jobs, and more that make it possible for workers and families to get ahead. Here are seven ways that President Trump’s budget proposal threatens to do them serious damage.

Trump’s Budget Would Hit These States the Hardest
Source: Sam Petulla, NBC News, May 23, 2017

The Trump administration unveiled a budget for 2018 on Tuesday that seeks to overhaul many of the country’s safety-net programs for low-income and struggling Americans. Though these cuts are popular among Republican lawmakers, they affect programs that are actually more commonly used in Republican-leaning states than in Democratic ones, and that in many cases benefit white voters without college degrees — a demographic group that strongly supported President Donald Trump in the 2016 election.
The programs experiencing the deepest cuts provide assistance for health care services to children, the poor and disabled, and that supplement food and housing for those with low incomes. Most of the programs were created decades ago by Democratic presidents.

H.R. 1628, American Health Care Act of 2017

Source: Congressional Budget Office, Cost Estimate, May 24, 2017

From the summary:
CBO and the staff of the Joint Committee on Taxation (JCT) estimate that enacting the legislation—which would repeal or modify many provisions of the Affordable Care Act—would reduce federal deficits by $119 billion over the coming decade.

CBO and JCT estimate that in 2018, 14 million more people would be uninsured under the legislation than under current law. After additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program took effect, the increase in the number of uninsured people would rise to 19 million in 2020 and then to 23 million in 2026.

Implementation of a resident handling programme and low back pain in elder care workers

Source: Andreas Holtermann, Occupational & Environmental Medicine, Volume 74, Issue 6, 2016
(subscription required)

From the introduction:
Low back pain (LBP) is the most important contributor to number of years lived with a disability and a major risk factor for sickness absence and work disability. Occupational groups with physically demanding work, like healthcare workers, have particularly high prevalence of LBP, and a considerable fraction of the LBP is considered to be caused by work-related factors. Moreover, LBP is a particular barrier for sustainable employment among workers with physically demanding work. Therefore, implementation of equipment (mechanical lifts or other assistive devices) for reducing the mechanical loading of healthcare workers during manual handling of residents should theoretically be efficient for preventing LBP and sickness absence among those with LBP. However, interventions implementing equipment for reducing the mechanical loading on healthcare workers during manual handling of residents show conflicting results on LBP. This might be due to the relatively short follow-up period of previous intervention studies introducing equipment for manual handling, which may need longer time before being fully implemented in an organisation. Moreover, it can be caused by lacking repetitive measures of both the implementation of the intervention as well as the often fluctuating level of LBP. Thus, there is a research gap in the documentation of the effects on LBP

Local Government Employee Health Insurance Programs, 2016: Summary Report of Survey Results

Source: International City/County Management Association (ICMA), May 2017

From the summary:
The International City/County Management Association (ICMA), in collaboration with Cigna, an ICMA Strategic Partner, launched a national survey in the summer of 2016 to learn about the current state of local government employee health insurance programs. ICMA and Cigna conducted this research in follow-up to a similar survey conducted in 2011. The 2016 survey was sent via postal mail to a sample of 3,110 local governments. An online submission option was also made available. The survey was addressed to the Human Resources Director of each selected local government. The response rate was 23.0%, with 714 local governments responding. With this response, the margin of error is +/- 3.5% at the 95% confidence level.