In a recent report, the Congressional Budget Office said the American workforce will shrink gradually, dropping about 2.3 million full-time jobs by 2021. It's not that employers will be cutting jobs. This reduction will be largely voluntary -- normal retirements, some early retirements, and some pre-retirement folks deciding to work less because now, finally, they can. How so? In part because Obamacare's subsidized premiums are affordable, and full coverage is no longer tied to a full-time job.
Some say the subsidized premiums, based on income, will be a disincentive to work. It's slightly possible, I guess, but it would take some pretty sharp figuring by a bunch of low-income, full-time workers who calculate they can actually cut their hours and their income, lose their company health insurance, pick up cheap coverage at HealthCare.gov, and somehow come out ahead. I just can't see much of that happening.
What I can see is some financially secure people who need health insurance more than they need full-time income, and I can see some of them cutting back or taking early retirement due to the benefits of the ACA. I'll give you a personal example:
Twenty-six years ago, I took a deep breath and walked into my boss's office to tell him I was quitting and going out on my own. We worked for a small auto-related insurance company which we both knew was obviously self-destructing. Being a good boss, he tried to talk me out of it.
I respected my boss. He was a tough little bastard and also a walking mass of pre-existing health conditions. At age 60, he was still five years away from Medicare, had already suffered a number of heart attacks and had undergone two open-heart surgeries. Yet he continued to eat deep-fried chicken gizzards and smoke a couple packs a day. Stupid, but his choice.
When he asked me to reconsider leaving, I said, "Glenn, this is a sinking ship and I'm getting off now. The only reason you're staying is because you need the health insurance." (Back then, had he left the shelter of the company policy, his medical history would have made him totally uninsurable in the individual marketplace. Today, he could not be denied coverage.) He just smiled at me and replied, "You're right."
He didn't really need to work at that point, not at that doomed job anyway. If Obamacare had been available, he'd have jumped at the chance to do something else or retire early. And that choice would have harmed exactly no one.
And another thing . . .
As a mechanism to expand health care access to the many millions of uninsured, Obamacare mandated that employers of 50 people or more offer health insurance to those workers who put in 30 hours per week or more. This mandate goes into effect in 2015 for most, 2016 for others. There's a fear that some employers might cut hours to less than 30 per week just to avoid the coverage requirement.
Most companies offer health benefits to their full-time workers, but until now it was the company who decided what constituted full-time. White Castle Systems, for example, says full-time for them is 35 hours per week. And you can bet your ass that most of their 10,000 fry cooks get 34 hours a week max! Come 2015, it'll be decision time, and what will those poor White Castle execs do? Oh, the horror!
So in D.C., the Ohio GOP Congressional delegation has come up with a bright idea. All of our Republican House reps have co-sponsored a bill to re-define full-time work as 40 hours per week or more. And what will that accomplish? Nothing good. It would let more employers off the hook and would reduce access to health care. It's a step backwards which must not be implemented.
It's time for conservatives to realize that, although the ACA is the law of the land, they're still getting their way in most respects -- for now. Obamacare is not single-payer, universal coverage, government-run socialized medicine. It's still an employer-provided, market-based, profit-driven system without cost controls and is still being run by Big Insurance, Big Hospital/Medical, and Big Pharma. Which is precisely what the GOP seeks to preserve, no matter what.
But within that creaky old capitalistic framework, Obamacare does indeed expand access. It's a moral imperative, and for starters, we're gonna at least do that. We'll play in your ballpark for now, but we're not going backwards. So goddam it, cut the B.S., play ball or shut up!
And one more thing . . . actually, two more things . . .
"We must open up a debate about whether we consider health care a basic right rather than a commodity. If so, then we must move toward some sort of universal single-payer system. If not, we should resign ourselves to further encroachments by the corporations and invite the executives into bedside rounds each morning." -- Dr. Prameet Singh, Bronxville, NY, in the NY Times, 2/9/14
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