As college students and their parents finalize their enrollment and pay tuition and fees for fall, many face one fewer headache than in years past: no more worrying about whether they’ve waived the optional health-insurance coverage in time to avoid being charged for it.

In large part because of changes brought by the federal Affordable Care Act, a number of colleges have stopped providing student health insurance.

. . .

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.

. . .

Small businesses have been pumping the brakes on offering health benefits to their employees since 2009, according to new data from the Employee Benefit Research Institute.

“The fact is that small employers were less likely to offer these benefits to begin with,” Paul Fronstin, EBRI’s director of health research and education program and author of the report, told Bloomberg BNA July 28. “While the ACA was designed to try to get more small employers to” offer health insurance, “it hasn’t.”

The proportion of employers offering health benefits fell between 2008 and 2015 for all three categories of small employer, EBRI found: by 36 percent for those with fewer than 10 employees, by 26 percent for those with 10 to 24 workers and by 10 percent for those with 25 to 99 workers.

. . .

The Affordable Care Act continues to provide an opportunity for religious zealots to complain that someone, somewhere, might be doing something of which they disapprove. Another such case advancing through the courts is that of Missouri State Rep. Paul Wieland and his wife, Teresa, who assert that Obamacare’s contraceptive mandate tramples on their family’s religious rights even if they don’t make use of it.

St. Louis Federal Judge Jean Constance Hamilton thinks they may have a point. On Thursday she denied the government’s motion to throw out the case on summary judgment. Merely requiring individuals to buy an insurance policy that provides contraception could infringe on their religious conscience, she ruled in clearing the case for trial.

. . .

State and federal officials have negotiated a deal to delay a federal policy that threatened to destabilize health insurance rates at small businesses across Massachusetts.

Governor Charlie Baker’s administration said Tuesday that the agreement will postpone for one year a piece of the Affordable Care Act that requires a change in the way small businesses’ insurance rates are calculated. Massachusetts will have to phase out its current rules and switch to the federal formula by 2019.

The rules apply to businesses with 50 or fewer employees.

. . .

Opt-out payments offered by employers may be used to determine affordability under the Affordable Care Act, depending on whether they are conditional or unconditional, according to IRS proposed rules.

Under the proposed rules, opt-out payments, cash payments given to employees who opt-out of their employer-sponsored health insurance, will be treated as a salary reduction for the purposes of determining health insurance affordability if they are considered unconditional.

An unconditional opt-out payment refers to an arrangement where the employee declines employer-sponsored health insurance without satisfying any other requirements.

. . .

For six years, it has been abundantly clear that Americans want Obamacare to be repealed—but only if a well-conceived conservative alternative is positioned to take its place. That’s why the recent release of the House GOP health care plan is a big deal. The new plan would of course repeal Obamacare. But it would also fix what the federal government had already broken even before the law was passed and made things so much worse.

The proposal pairs an Obamacare alternative with Medicaid reforms and the crucial Medicare reforms (amounting to a kind of “Medicare Advantage Plus”) that Speaker Paul Ryan and House Republicans have long championed. As Ryan put it after the proposal’s release, “The way I see it, if we don’t like the direction the country is going in—and we do not—then we have an obligation to offer an alternative….And that’s what this is.” He called the plan not merely “a difference is policy” but “a difference in philosophy.”

. . .

The GOP House blueprint for health reform repeals these taxes. Specifically, the report cites:

  • the 3.8 percent bracket in the Medicare payroll and self-employment tax
  • the 3.8 percent “net investment income tax” (NIIT) on savings and investment
  • the additional 10 percentage point surtax for non-qualified health savings account (HSA) withdrawals
  • the “medicine cabinet tax” which denies the use of pre-tax HSA, health reimbursement arrangement (HRA), and flexible spending account (FSA) dollars for the purchase of non-prescription, over-the-counter medicines
  • the $2500 cap on medical FSA deferrals
  • the “Cadillac plan” tax of 40 percent on high cost health insurance plans
  • the “health insurance tax” (HIT)
  • the tax penalties associated with the individual and employer mandates
  • the medical device excise tax
  • the industry tax on pharmaceutical companies
  • the “high medical bills tax” which disallows an itemized deduction for medical expenses for millions of middle class families
  • a tax on employers helping their retired employees purchase Medicare Part D plans

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.

. . .

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.

. . .