Senate Passes Amendment to ACA’s Full-Time Employment Definition
April 1, 2015 07:51 AM
Last week, the US Senate passed a budget resolution that included an amendment, introduced by Senator Susan Collins (R-ME), addressing the definition of full-time employment under the Patient Protection and Affordable Care Act (ACA). Budget amendments do not have the force of law. However, the amendment’s success demonstrates the strong support in Congress to amend the ACA’s definition of full-time employment.
Senator Collins (R-ME), in January, also introduced stand-alone legislation, the “Forty Hours Is Full Time Act” (S. 30), with bipartisan original cosponsors: Senators Donnelly, Manchin, and Murkowksi.
The Collins amendment was adopted as part of the Senate budget resolution by unanimous consent. Due to parliamentary rules for budget amendments, the amendment is different than S. 30. Rather than specifically changing the definition from 30 to 40 hours, the amendment expresses support for restoring a “sensible” definition of a full-time employee.
The purpose of the budget resolution is to establish the level of discretionary spending for the coming fiscal year. It also provides an opportunity for Congress to voice its priorities through nonbinding policy proposals, such as the Collins amendment.
The National Association for Home Care & Hospice (NAHC) strongly supports both Senator Collins’s amendment and S. 30.
Currently, the ACA imposes penalties on employers with more than 50 full-time equivalent employees that do not provide health insurance for a “full-time” worker—defined as those working just 30 hours or more a week. NAHC believes this definition is out-of-keeping with standard employment practices, and that it will harm many home care agencies and the patients they serve.
While the vast majority of home care agencies are small businesses according to the Small Business Administration, the ACA defines them as “large employers” based on the fact that they have 50 or more employees. Many home care agencies do not provide health insurance to home care workers for reasons that are fairly unique to the industry. The agencies are reliant on government programs such as Medicaid, which provides low payment rates that do not cover the costs of providing health insurance. Home care workers typically work widely varying hours, based on the needs of their home care clients.
Of concern, home care agencies that are unable to provide health insurance or pay the ACA penalties will be forced to cut their employees’ hour to less than 30 in order to avoid the health insurance requirement.
According to a NAHC survey from December 2014, the full-time definition in the ACA would weaken patient access to care, reduce wages and working hours of home care staff, and force home care companies to restructure their operations to rely on part-time caregivers:
82.54% of home care and hospice companies do not provide health insurance to all of their employees because of reliance on government program payments and service to individuals with limited incomes
46.2% of those companies face a financial penalty under the employer mandate ranging as high as $4.5 million
73.3% of the companies would reduce the working hours of employees to under 30 per week in order to avoid the cost of health insurance or financial penalties that they cannot afford
22.16% of the businesses expect to close because of the financial penalties
83.2% of the companies expect that access to home care in their community would be reduced with fewer providers of care, more restrictive patient admission criteria to fit a part-time workforce, and restrictions on service areas.
88.46% expect that access to Medicaid home care will no longer be sufficient to meet client’s needs
Please contact your members of Congress using NAHC’s Legislative Action Center to cosponsor legislation defining 40 hours as full-time.