By Samantha Aster
Public Citizen supports mechanisms established under the Affordable Care Act (ACA) that will enable the movement toward state-level single-payer systems, which the law’s waiver process enables, even though we do not endorse the ACA as a whole. States that want to establish stronger programs than the federal system will be able to using the waiver process when it becomes available to states in 2017. By establishing state level single-payer systems, we hope to clear a path to eventually move toward Medicare-for- all at the federal level.
Although Public Citizen endorses moving altogether away from an employer-sponsored health insurance system and toward a single-payer system, the debate over current policies that are intended to increase Americans’ access to health care should at least be based on accurate information. The U.S. Chamber of Commerce has engaged in an aggressive messaging and lobbying campaign to delay and potentially repeal a mandate in the ACA for businesses to provide health insurance benefits to their employees.
This campaign is based on exaggerated claims and misinformation.
About 55 percent of Americans who have health insurance receive their benefits through an employer. Drafters of the ACA looked to take advantage of this widely utilized option to further expand health care coverage. Included in the law was a requirement that businesses with 50 employees or more offer affordable health insurance coverage to their employee or potentially face a penalty.
U.S. Chamber President and CEO Tom Donohue claims, “[T]he law actually jeopardizes existing jobs by changing the definition of full-time work from 40 hours to 30 hours, adding insult to injury for American workers. [This change gives] some employers little choice but to reduce employees’ hours to avoid the requirement to provide coverage.”
However, the Center for Budget and Policy Priorities found no significant shift to part-time employment in anticipation of the implementation of the employer mandate. While some employers have announced that they are cutting hours as a result of the ACA, they are the exception and not the rule. Large numbers of companies are not reducing hours to prepare for the employer mandate. In fact, recent trends have shown a decrease in the number of workers who are involuntarily restricted to only working part-time. Meanwhile, the number of employees working more than 30 hours per week rose in the first half of 2013.
The Center for Budget and Policy Priorities does predict a shift from full-time employment to part-time employment of 1 to 2 percent as a result of the ACA. Meanwhile, the Chamber advocates raising the full-time threshold to 40 hours per week from the ACA-mandated 30-hour week. This in itself would reduce the number of workers eligible for coverage. Raising the full-time threshold to 40 hours a week also would place significantly more workers at risk of having their hours reduced than the current 30-hour threshold. This is because 43 percent of the American workforce works 40 hours per week while just fewer than 8 percent of workers work between 30 and 34 hours per week.
The Chamber also argues that the employer mandate will force small businesses to hire fewer employees, but the mandate has little to no deterrent effect on the hiring of truly small businesses. Businesses with fewer than 50 employees are exempt from the mandate and are eligible for federal tax subsidies if they choose to provide insurance for their employees. Since 89.7 percent of all U.S. companies employ fewer than 20 people, few small businesses are close enough to the 50-employee threshold for the mandate to be a hiring consideration. Most small businesses are focused on getting costumers in the door, and would rather hire the people they need to best serve their customers.
The wisdom and potential effects of the employer mandate are still hotly debated by conservatives and liberals alike, but the Chamber’s campaign against implementation is based on hyperbole instead of solid data.
Samantha Aster is a health care policy fellow in Public Citizen’s Congress Watch division.