A majority of voters back the idea of tying Medicaid eligibility to employment status as the Trump administration weighs whether to give more states the power to impose work requirements on the government health program.

In an Aug. 10-14 Morning Consult/POLITICO poll, 1,997 registered voters were asked whether they generally support requiring individuals to have a job in order to be eligible for the program. Fifty-one percent of voters said they support that proposal, while 37 percent said they oppose it. The survey has a margin of error of plus or minus 2 percentage points.

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Although the GOP’s plan to repeal the Affordable Care Act industry taxes died with the party’s health care bill, it’s conventional wisdom that some of the taxes will still be delayed. But there’s no plan to do so yet.
Lobbying campaigns to repeal or delay the health insurance tax and the medical device tax are ramping up, yet there’s no clear vehicle for Congress to take action. Well-wired lobbyists and Hill aides say the appetite for doing anything major on health care isn’t really there.

“It is a have-to-get-done that’s really hard to get done,” said one lobbyist.

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The federal share of national health spending grew by about one-eighth between 2008 and 2016 and by the year 2025 is projected to have increased by nearly one-fifth. By 2025, federal, state and local taxpayers will be financing fully two-thirds of American health care . Some might say “not bad for government work.”

Careful readers might also note that the state and local government share of national health spending shrank slightly during the same period–a reflection of President Obama’s vision to give Uncle Sam a bigger role in health care, displacing decisions formerly made by stat and local governments and the private sector in the process.

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Business groups were hoping a quick repeal of the Affordable Care Act would give employers more flexibility on health care and create momentum for priorities like a tax overhaul.

Friday’s decision by House GOP leaders and President Donald Trump to abandon a vote on the Republican health plan left them less certain on both fronts.

“This is a dismal failure,” said Juanita Duggan, chief executive of the National Federation of Independent Business, a group representing small businesses. “NFIB is officially unamused, and we’re not going to let them off the hook.”

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The 40% “Cadillac” Tax on expensive employer-sponsored health insurance is on a deathwatch because both parties in Congress dislike it. It would be best if Congress were to replace the Cadillac Tax with a simple and clear limitation on the tax preference for employer-paid premiums, as is called for the House GOP’s “Better Way” health plan. For decades, economists have complained that the open-ended tax break for employer-paid health insurance premiums is a major distortion in the marketplace. This approach is fair and promotes more transparency in the health care marketplace.

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Obamacare is collapsing. Its utter failures become more obvious by the day. We all remember the promises of Obamacare, chief among them that the “Affordable Care Act” would lower health care costs. The opposite has occurred. Despite the offer of subsidies through the exchanges, enrollment in Obamacare has been dismal. Younger, healthier individuals have little interest in paying exorbitant premiums for insurance plans that come with $5,000 deductibles. The result has been an unbalanced insurance pool where insurers must charge ever-increasing premiums to continue offering coverage.

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The Kaiser Family Foundation’s most recent Employer Health Benefits Survey found that among firms with 50 or more full-time-equivalent workers (i.e., the one’s subject to Obamacare’s employer mandate):

“four percent of these firms reported changing some job classifications from full-time to part-time so employees in those jobs would not be eligible for health benefits”

and

“four percent of these firms reported that they reduced the number of employees they intended to hire because of the cost of providing health benefits” . , and 10% of firms reported doing just the opposite and converting part-time jobs to full-time jobs”

This is unequivocal empirical evidence that Obamacare has had some of the adverse effects on employment predicted for years by Obamacare critics: a shift towards part-time work and even a reduction in hiring.  But according to the same survey, the latter impact was offset due to the 10% of employers who converted part-time jobs to full-time jobs in order to make them eligible for health benefits.

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Today, after years of hearings and speeches and debates, the Paul Ryan-led House of Representatives has done something it has not done before: it has released a comprehensive, 37-page proposal to reform nearly every federal health care program, including Medicare, Medicaid, and Obamacare. No proposal is perfect—and we’ll get to the Ryan plan’s imperfections—but, all in all, we would have a far better health care system with the Ryan plan than we do today.

The first thing to know about the Ryan-led plan — part of a group of proposals called “A Better Way” — is that it’s not a bill written in legislative language. Nor is it a plan that has been endorsed by every House Republican.

Instead, it’s a 37-page white paper which describes, in a fair amount of detail, a kind of “conversation starter” that House GOP leadership hopes to have with its rank-and-file members, and with the public, in order to consolidate support around a more market-based approach to health reform.

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House Speaker Paul Ryan’s policy plan for health care, as expected, leans heavily on market forces, more so than the current system created by Obamacare. The proposal contains a host of previously proposed Republican ideas on health care, many of which are designed to drive people to private insurance markets.

Importantly for conservatives, as part of a full repeal of the Affordable Care Act, the current law’s mandates for individuals and insurers would disappear under the GOP plan. It would overhaul Medicare by transitioning to a premium support system under which beneficiaries would receive a set amount to pay for coverage. The plan also would alter Medicaid by implementing either per capita caps or block grants, based on a state’s preference.

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The number of part-time workers in jobs for economic reasons shot up by 468,000, apart from the 458,000 that left the workforce altogether.  Slack work or business conditions accounted for 181,000 of these jobs, while another 77,000 could only find part-time work.

Analysts at Goldman Sachs have noticed this trend for some time, and put the blame on Obamacare.

“The evidence suggests that the [Affordable Care Act] has at least modestly elevated involuntary part-time employment,” Goldman Sachs economist Alec Philips wrote in a research note published on Wednesday. Obamacare had the greatest impact on industries that traditionally do not offer strong health insurance coverage, such as retail stores and the hospitality industry. Phillips noted that these have the highest levels of involuntary part-time workers, and believes that the ACA has forced “a few hundred thousand” to take cuts in hours or accept part-time work as a result.

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