Category Archives: Laws/Legislation

Potential Employer Penalties Under the Patient Protection and Affordable Care Act (ACA)

Source: Janemarie Mulvey, Congressional Research Service, CRS Report for Congress, R41159, July 22, 2013

On Tuesday July 2, 2013, the Obama Administration posted a blog on employer requirements and the Patient Protection and Affordable Care Act (ACA, P.L. 111-148), as amended. Based on the White House blog, the administration (1) plans to revamp employer reporting requirements, and therefore suspend employer reporting requirements for 2014, and (2) because employer payments are dependent on the reporting requirements, no payments will be collected in 2014. The Administration noted that these changes were in response to employers’ concerns about the reporting requirement.

On July 17, 2013, H.R. 2667, the Authority for Mandate Delay Act, passed the House. H.R. 2667 would delay by one year the applicable effective date for the employer requirements, employer penalties, and related reporting requirements specified under ACA.

This report provides information on the statutory requirements and the proposed regulations issued to implement these statutory requirements in December 2012. This report does not yet reflect the proposed Administration changes. The report will be fully updated once additional information becomes available…

Health Impact Assessment of Proposed Changes to the Supplemental Nutrition Assistance Program

Source: Health Impact Project, White Paper, July 2013

From the press release:
The Health Impact Project has released a white paper that examines the potential health impacts and health-related costs of proposed changes to the Supplemental Nutrition Assistance Program, or SNAP, contained in legislation now under consideration by Congress…. The House and Senate have proposed several changes to how the program’s eligibility and benefit levels are determined. The Health Impact Project conducted a comprehensive, nonpartisan, scientific analysis to introduce a rigorous assessment of the potential health effects of those proposed changes.

Key findings:
– SNAP has large and long-term influences on health, especially through its impact on food insecurity, or difficulty getting enough to eat.
– SNAP reduces household food insecurity by 18 to 30 percent. Under the proposed changes, as many as 160,000 to 305,000 more people could become food insecure.
– Adults who do not have enough to eat are more likely to have heart disease, high blood pressure, and diabetes.
– Children who do not have enough to eat are more likely to be hospitalized and have a greater risk for a range of health problems, including asthma and depression.
– Research shows that low-income children with access to SNAP are less likely to have problems such as obesity, high blood pressure, heart disease, and diabetes as adults.
– Poverty increases the risk of many illnesses. Under the proposed changes to SNAP eligibility, the U.S. poverty rate would increase by just over half a percent. Our analysis found that, based on current rates of diabetes in relation to poverty in U.S. communities, this increase in poverty could translate to a growth in government and private-sector medical costs of nearly $15 billion over 10 years. Thus, the costs associated with diabetes—only one of the many diseases that could be affected—could approach the Congressional Budget Office’s estimate of $20 billion in savings over 10 years from implementing certain changes to SNAP eligibility. These figures must be interpreted with caution, however: The fact that rates of diabetes correlate with poverty rates does not prove that a policy that increases poverty will necessarily cause an increase in diabetes. Nevertheless, the scientific evidence is strong enough to support considering the health-related cost implications of these proposed changes as part of the policy discussion.
As many as 5.1 million people could lose SNAP eligibility under proposed legislative changes to how states determine eligibility; among these are 1.4 million children and nearly 900,000 older adults. Under other proposals, 500,000 people could receive lower benefits, two-thirds of whom are children, people with disabilities, or older adults. These proposed changes would be likely to increase health risks for low-income Americans.
SNAP Findings in Support of The Pew Charitable Trusts’ Health Impact Assessment of the 2013 USDA Farm Bill
Source: Joshua Leftin, Allison Dodd, Kai Filion, Rebecca Wang, Andrew Gothro, Karen Cunnyngham, Mathematica Policy Research, Draft Report, March 1, 2013

Some States Improperly Restrict Eligibility for Medicaid Mandatory Home Health Services

Source: U.S. Department of Health and Human Services, Office of Inspector General, OEI-07-13-00060, July 1, 2013

From the summary:
Federal regulations prohibit the arbitrary denial or reduction of the amount, duration, and scope of a required service on the basis of a beneficiary’s diagnosis, type of illness, or condition. In a 2000 policy letter, CMS notified State Medicaid agencies that restricting eligibility for mandatory home health services to homebound individuals violates these regulations. In July 2011, CMS published a Notice of Proposed Rulemaking that would revise Medicaid regulations to clarify that home health services cannot be restricted to individuals who are homebound or to services furnished in the home; the rule had not yet been finalized at the time of this report. At least one State was known to have improper homebound restrictions on its mandatory home health benefit from 2005 to 2010. We determined how many States nationwide had such improper restrictions in their policy documents in January 2013…. Eleven States have language-one in its State plan and 10 in other State policy documents-that restricts eligibility for the mandatory home health benefit to homebound individuals in violation of CMS’s interpretation of the applicable statute and regulation. These 11 States are: Alabama, Arkansas, Indiana, Montana, Nebraska, New Mexico, North Dakota, Pennsylvania, South Dakota, Utah, and West Virginia. Two of the eleven States, New Mexico and Utah, stated in their responses to our request that although their policies restricted eligibility for home health services to homebound individuals, those policies were incorrect and the restrictions were not being enforced. …

A Better Affirmative Action: State Universities That Created Alternatives to Racial Preferences

Source: Richard D. Kahlenberg, Halley Potter, Century Foundation, October 3, 2012

From the summary:
The U.S. Supreme Court case Fisher v. Texas could dramatically alter or eliminate race-based admissions policies at colleges and universities. In a new report, A Better Affirmative Action, Senior Fellow Richard Kahlenberg and Policy Associate Halley Potter look at alternatives to racial preferences in Affirmative Action.

An Overview of the Local Control Funding Formula

Source: Mac Taylor, Legislative Analyst’s Office, July 29, 2013

Chapter 47, Statutes of 2013 (AB 97, Committee on Budget)—enacted as part of the 2013‑14 budget package—made major changes both to the way the state allocates funding to school districts and the way the state supports and intervenes in underperforming districts. The legislation was the culmination of more than a decade of research and policy work on California’s K‑12 funding system. This report describes the major components of the legislation, with the first half of the report describing the state’s new funding formula and the second half describing the state’s new system of district support and intervention. Throughout the report, we focus primarily on how the legislation affects school districts, but we also mention some of the main effects on charter schools. (This report does not cover the new funding formula for county offices of education [COEs], which differs in significant ways from the new district formula.) The report answers many of the questions that have been raised in the aftermath of passage regarding the final decisions made by the Legislature and the Governor in crafting new K‑12 funding and accountability systems for California.

Are Shrinking Unions Making Workers Poorer?

Source: Emma Green, Atlantic, July 24 2013

Growing income inequality is a fact, but its cause is unclear…. The causal chain is so tempting: As unions get smaller, collective bargaining gets weaker, worker wages go down, and evil profiteers cackle…. But other factors muddy the issue. Some experts argue that growing workforce automation, the global reach of the economy, and the need for high-skill labor has diminished the power of collective bargaining and cut into workers’ wages. If there’s cheap labor available in Bangladesh, why would an American company pay workers significantly more to do the same work? In the face of a cheap global labor pool, unions have less ammunition against employers, and U.S. workers also get paid less, regardless….

…Still, the fact remains that full-time workers who belong to unions make more money than those who don’t: On average, union members make about $200 more per week than their counterparts. This figure is influenced by lots of factors, including differences in average salary in regions with low levels of unionization. But even bearing that in mind, research shows that in “right to work” states, where employees cannot be required to pay union dues as a condition of their employment, workers get paid less than the rest of the country. That was true even when business grew in “right to work” states, indicating that weakening unions might help business owners, but it doesn’t do much for workers. (This Washington Post article gives a great overview of the economic effects of “right to work” legislation). …

State Regulatory Oversight of Certified Nursing Assistants and Resident Outcomes

Source: Alison M. Trinkoff, Meg Johantgen, Nancy Lerner, Carla L. Storr, Kihye Han, Kathleen McElroy, Journal of Nursing Regulation, Vol. 3 No. 4, January 2013
(subscription required)

From the abstract:
This study aimed to describe state regulatory certified nursing assistant (CNA) oversight in two domains—use of registry or licensing for credentialing and initial CNA training and continuing education (CE) requirements—and to evaluate whether CNA oversight is associated with resident outcomes in nursing homes. This cross-sectional secondary analysis combined 2004 data on state-level regulatory requirements for CNA oversight, training, and CE with nursing home resident outcomes data collected in 2004 from 16,125 U.S. facilities in 49 states. Though 26 states required CNAs to have more initial training hours than the federal requirement of 75 hours, only four states required additional yearly CE hours to maintain CNA certification. The combination of increased initial training and annual CE hours was significantly associated with nursing homes reporting lower antidepressant and antipsychotic use and lower average medication use. Use of a registry or licensing board for credentialing was significantly related to lower catheter use, and CNA licensure was significantly associated with lower odds of falls. Findings suggest that regulatory modifications could be beneficial to improve resident care outcomes in nursing homes.

A Progressive Alternative to Austerity

Source: Fred Glass, In These Times, July 23, 2013

Passing steeper taxes on the rich isn’t as hard as you’d think…

….So how did Proposition 30 succeed? This measure, passed by California voters last November, raises $6 billion a year for schools and services—and in a supposedly “anti-tax” state. The money comes mostly through an income tax hike on rich people, along with a tiny sales tax increase of 0.25 percent. The story should be better known, because with the right preparation, you could make it happen in your state, too….