Loopholes on Employer Mandates of Obamacare Killing Low Wage Workers

ACA-Employer-Mandate1Shreveport    The devil is in the details, and lower waged employers, like large nursing home chains, have figured out a way to be the devil with the details when it comes to making a mockery out of the employer mandate to provide healthcare coverage. Bargaining a renewal contract for Local 100 United Labor Unions at a nursing home in Shreveport that we had represented for almost thirty years was a case study in the travesty of the law and the tragedy for the workers.

In fulfilling the information request and providing details on the health insurance offering for the workers, this company, the second largest nursing home chain in Louisiana, gave us a mishmash of materials forcing the bargaining committee to ask a number of questions hoping for a glimmer of hope that didn’t seem obvious from the materials, but no such luck.

We saw two plans. One that covered some our bargaining unit, including the activities director and maintenance staff. The other for all of the certified nursing assistants.

The first plan was no Cadillac plan, believe me. The deductible was $2500 for an individual in or out of the network. The examples of coverage were cautionary. If you had a baby costing $7540 from the hospital, the plan would pay for $3530 and you would be out $4010. The second plan was from land of Simon Legree. The deductible was a whopping $6350 per person, the highest we have seen or heard of anywhere, no matter the low wage employer! Worse, it covered almost nothing. Having a baby with the same cost would have the plan paying less than a grand and in fact only $940 while the patient paid $6600 with the deductible now stated to be $6400 and something called “exceptions” adding another $200. Managing diabetes was another example where if the cost were $5400 on the first plan, the worker would pay $3280 and the plan $2120. On the second plan we devolve into farce, where on the cost of $5400, the plan would pay a measly $20 bucks and the worker would pay $5380. Yes, $20.

This is more than enough to describe the horrors here, but adding insult to injury, remember that the worker would also be paying for this sorry story. The rate of payment was not fixed which was a first for in our experience, but was calculated to the wage of each individual worker so that the company could squeeze the last penny of the 9.5% allowable for an Affordable Care Act plan from the worker. The cap was $175 per month at the highest worker’s wage and the minimum was around $111 per month figured at the individual worker’s hourly wage times 130 hours for a regular employee times 9.5%. No math shaming here but if you are a certified nursing assistant to elect this plan the employer begrudgingly was providing under the employer mandate of Obamacare, you would be paying anywhere from about $1300 to $2100 for the ability to claim health insurance on your job where you would then have to pay more than $6000 before you got the first dollar worth of health insurance benefit. The math is daunting. These are workers making less than $20,000 per year and closer to $18000 annually who would be paying up to $8000 out of their income to access any benefit from the policy! Incredible!

The employer insisted that the plan qualified, despite our objections, and, frankly, it may. The employer had no answer to the question of why all workers were not put in the first plan which was hardly a gift. The employer pretended not to have available the number of workers who had elected to pay for this travesty of insurance, even as the union asked if it was more than one and less than ten workers.

Meanwhile the workers are blocked from the subsidies and cost sharing payments provided under the Affordable Care Act, because their employer supposedly provides health insurance if that is what you call what is described here. And, to pile on since none or next to none are foolish enough to join this so-called plan that means beginning in 2016 the workers will pay a 2.5% penalty on their gross income or $450 to $500 for not having insurance, so their boss can take more money to the bank.

Needless to say there’s no Medicaid expansion yet in Louisiana – and many other states. This is not a health care solution for lower waged workers who desperately need health care protection!