In coming weeks, we can expect the Republican-controlled Congress to push two Obamacare bills that would hike profits for some businesses. What we can’t expect, from either Republicans or Democrats, unfortunately, is any effort to help families, even those with insurance, to stay out of bankruptcy court because of mounting medical bills.
Another inevitable attempt to repeal the whole law won’t go anywhere because there are still enough Democrats in the Senate to block it. But the bills to assist businesses—especially those that make generous campaign contributions—just might reach the President’s desk.
One of those measures would redefine a full-time worker under Obamacare’s employer mandate provision from someone who works 30 hours a week to one who works 40 hours weekly. The other piece of legislation would repeal the 2.3 percent tax on medical devices that helps pay for expanding coverage to the previously uninsured.
Republicans and some Democrats contend that both bills are intended to restore jobs they claim have been lost or will be lost as a result of those Obamacare provisions.
The law currently requires employers with 50 or more workers to provide health insurance to most of their full-time employees. The mandate will go into effect this year for employers with 100 or more workers and next year for employers with 50 or more. It does not apply to small businesses with fewer than 50 employees.
The reason drafters of the reform law set the threshold at 30 hours a week was to bring more people into coverage. Changing it to 40 hours would mean that many folks would likely lose their health insurance.
The tradeoffs are complicated, but ultimately, people needing insurance are a loser. The Congressional Budget Office and the Joint Committee on Taxation estimate that changing the definition to 40 hours a week would reduce the number of people receiving employment-based coverage by about a million. But it would increase the number of people getting coverage through Medicaid or the health insurance exchanges by between 500,000 to 1 million. And about half a million would likely return to being uninsured.
Shifting that many people to the taxpayer-financed Medicaid program or to the exchanges, where most would be eligible for federal subsidies, would increase the budget deficit by nearly $74 billion between now and 2024, both the CBO and JCT say.