PRN hours decreased because of the ACA

[kdhunley]

I work PRN at a hospital, usually 36-48 hours per week. We have been told that because of the Affordable Care Act (Obamacare) we can no longer work more than 30 hours a week. While this doesn't officially take effect until Jan. 2015, our hospital is choosing to implement this now.

Of course, you can imagine, we are all upset, particularly those of us who work full-time hours. I choose to work PRN because I get paid more per hour and don't need benefits because I have insurance through my husband's employer.

Our hospital heavily utilizes PRN nurses both dedicated to a particular floor and a float pool. We all feel this is really going to negatively affect patient care and adequate staffing. I am going to find another PRN job to get the hours I need to work each week.

Has anyone else had this experience?

[Esme12, ASN, BSN, RN]

10. Do the Employer Shared Responsibility provisions apply to employers with full-time employees who are eligible for health coverage through another source, such as Medicare, Medicaid, or a spouse’s employer? Yes. For purposes of determining whether an employer is an applicable large employer, all employees are counted (subject to a limited exception for certain seasonal workers), regardless of whether the employees are eligible for health coverage from another source, such as Medicare, Medicaid, or a spouse’s employer. Thus, an applicable large employer with full-time employees who are eligible for health coverage through another source, such as Medicare, Medicaid, or a spouse’s employer, will be subject to the Employer Shared Responsibility provisions regardless of whether those employees are eligible for coverage from another source. But, employees who are eligible for Medicare or Medicaid are not eligible for a premium tax credit. If no full-time employee receives a premium tax credit (for example, because all of an employer’s full-time employees are eligible for Medicare or Medicaid), the employer will not be subject to an Employer Shared Responsibility payment.

Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act

[MunoRN, RN]

For those of you who have read the ACA (ha ha) could you please clarify this point for me regarding the employer mandate:

is the mandate merely requiring employers to offer "affordable" health insurance to full-time-houred employees, or does the mandate require all FTEs to be covered by the employer-sponsored plan? Would the employer be off the hook for the fine if they were able to show that the employee declined the coverage? Would declining the coverage be an option for the employee? Does it then fall back on the individual mandate to ensure the individual does have coverage separate from the employer?

Employers are only required to offer insurance, they aren't penalized if you chose to opt out of their insurance, so long as the insurance they offered met the minimum requirements (covered at least 65% of costs and cost the employee

What Happens When Employees Decline Coverage Under the Affordable Care Act? | FrankCrum

If your coverage meets the definitions of affordable and minimum value – employees may still turn it down for a number of reasons: they don’t want coverage at all – they’re covered under a spouse or family member’s plan – or they want to choose a different kind of plan through the marketplace or elsewhere. As long as your offered coverage is affordable and has minimum value – then the responsibility falls under your employee to be covered under the Individual Mandate regulation. Think of it this way: the ACA does not penalize an employer for employees who decline an offer of coverage. The ACA penalizes the employer who fails to offer coverage. So if an employee declines your affordable minimum value coverage, they’re the ones who must get covered or face their own penalty on their 2014 federal income taxes. - See more at: What Happens When Employees Decline Coverage Under the Affordable Care Act? | FrankCrum

If all of this seems unnecessarily complicated, it is. This is what happens when set up a system that isn't intended to ensure coverage of everyone, and then try to reverse engineer it to do that. It would make more sense to use a system that's designed to do that from the beginning.

[Delicate Flower]

Thank you Muno, that answers my question perfectly. As long as the Per Diems at my hospital are given the option to decline coverage and continue to work 30+ hours (and I would think they should be since the employer would not be penalized if they decline), then I really don't have an issue with the fact that those who do need insurance will have to take a pay cut. We understood that our higher Per Diem pay is in large part a result of the fact that we do not receive benefits.

The issue I would have is if the employer either 1)required EVERYONE to take the insurance, and thus the pay cut, or 2) Changed policy to prevent any Per Diems from working over 30 hours a week to avoid the whole mess althogether. After reading Esme and Muno's comments, I am more concerned about #2 since it sounds like an "easy" way out for the hospital. I don't think it's farfetched to imagine them doing that, hiring on a bunch more staff, and keeping everyone's hours low. Then they wouldn't have to worry about the shared responsibility, providing insurance, and would save on OT too. It does seem like they have ramped up their per diem staffing, and cancellations/being put on call are happening more frequently in the last several months.

[MarkWright]

Actually, it is not a petty justification for their own greed, it is the law. I was in a unique position. My hospital wanted me to be on a full time shift in the ER because of my experience. I wanted the PRN pay because I did not need the hospital benefits due to being retired military. I was hired as a full time PRN which means I had a regular shift but PRN pay with no benefits. Enter the ACA. I was forced to either stay PRN and work 30 hr or less a week... or go full time with benefits and work the same amour of hours for less pay. That was not the Hospital but the employer mandate and 30 hr rule of the ACA. If my hospital would have let me continue to work full time with PRN pay and no benefits then It would be fined (come Jan 2015) 2 to 3 thousand dollars per full time equivalent per the ACA. For my hospital that would be a 1.6 million dollar fine per the ACA as written and as it stands right now.

For those of you on this bord who say the ACA is not to blame for this you have either not read the law and talked to the IRS and everyone in between like I have... or you choose not to believe what is true. My choice came down to loosing $8,000 a year going full time with benefits I did not need, or loose $14,000 per year staying PRN. I took the lesser of two evils brought on by the ACA and then took a second PRN job at a Urgent Care Clinic. For me, the ACA is a total loss. I lost money, and in order to make up for that loss had to take a second job so now instead of working a rotation shift that includes every other weekend... I now work the same rotating shift working every other weekend AND work a part time job that take my other weekends away from my family.

Do NOT tell me the ACA dose not cause harm because It is happening to me right now.... and if you are PRN and it has not cut your hours.. it will after January 2015 unless the employer mandate and 30 hr rule is repealed.... and No, there is not provision for if you have insurance elsewhere.

[NRSKarenRN, BSN, RN]

What Happens When Employees Decline Coverage Under the Affordable Care Act? | FrankCrum

...If your coverage meets the definitions of affordable and minimum value – employees may still turn it down for a number of reasons: they don’t want coverage at all – they’re covered under a spouse or family member’s plan – or they want to choose a different kind of plan through the marketplace or elsewhere. As long as your offered coverage is affordable and has minimum value – then the responsibility falls under your employee to be covered under the Individual Mandate regulation. Think of it this way: the ACA does not penalize an employer for employees who decline an offer of coverage. The ACA penalizes the employer who fails to offer coverage. So if an employee declines your affordable minimum value coverage, they’re the ones who must get covered or face their own penalty on their 2014 federal income taxes.... -

There was no need for your employer to change your status/hours: one just needed to sign a form declining coverage as obtained elsewhere.

[Eru Ilúvatar]

Actually, it is not a petty justification for their own greed, it is the law. I was in a unique position. My hospital wanted me to be on a full time shift in the ER because of my experience. I wanted the PRN pay because I did not need the hospital benefits due to being retired military. I was hired as a full time PRN which means I had a regular shift but PRN pay with no benefits. Enter the ACA. I was forced to either stay PRN and work 30 hr or less a week... or go full time with benefits and work the same amour of hours for less pay. That was not the Hospital but the employer mandate and 30 hr rule of the ACA. If my hospital would have let me continue to work full time with PRN pay and no benefits then It would be fined (come Jan 2015) 2 to 3 thousand dollars per full time equivalent per the ACA. For my hospital that would be a 1.6 million dollar fine per the ACA as written and as it stands right now.

For those of you on this bord who say the ACA is not to blame for this you have either not read the law and talked to the IRS and everyone in between like I have... or you choose not to believe what is true. My choice came down to loosing $8,000 a year going full time with benefits I did not need, or loose $14,000 per year staying PRN. I took the lesser of two evils brought on by the ACA and then took a second PRN job at a Urgent Care Clinic. For me, the ACA is a total loss. I lost money, and in order to make up for that loss had to take a second job so now instead of working a rotation shift that includes every other weekend... I now work the same rotating shift working every other weekend AND work a part time job that take my other weekends away from my family.

Do NOT tell me the ACA dose not cause harm because It is happening to me right now.... and if you are PRN and it has not cut your hours.. it will after January 2015 unless the employer mandate and 30 hr rule is repealed.... and No, there is not provision for if you have insurance elsewhere.

I think you are the one that needs to read the law. If you already have previous coverage there is no need for the employer to provide you with coverage. Your manager may be taking advantage of you to reduce your wages, or he/she may just be ignorant of the law.

[MarkWright]

It relats to the ACA because a lot of us are full time PRN's and can no longer be because of the ACA's Employer mandate and 30 hr rule.

[morte, LPN, LVN]

It relats to the ACA because a lot of us are full time PRN's and can no longer be because of the ACA's Employer mandate and 30 hr rule.

i think you need to read karen's post above.

[nurse2033, MSN, RN]

Yeah, and I'm sure that when fire safety laws and child labor laws came into being employers rent their clothes and gnashed their teeth and claimed they couldn't absorb extra cost then, too.

It was the same arguments with seat belts and then air bags as well.

[NRSKarenRN, BSN, RN]

It was the same arguments with seat belts and then air bags as well.

Same gnashing of employers teeth when Needle Safety legislation passed requiring sharps safety.

[MarkWright]

I did read karens post and it does not help me a whit. I have been on the phone with the IRS many times about this when I first saw it coming down the pike. I asked them many times to show me where in the law and employer would not be fined for allowing me to work more than 30 hr if I am covered some place else... and other than they telling me "because it dosent make any sense" they could not show me a place in the law that ensures my employer will not be hit with the huge fine for allowing me to work full time PRN without their benefits. You can post every 30 seconds that the law says "Offer" and I will still be in the same boat that ALL PRN's are in .... insured under another source or not ... of having my hours cut. It is easy to say you law is not harming me and hundreds of millions of working Americans.... but that does not change the fact that it is harming me right now... and people at other hospitals, and Lows, and Home Dept, and Wall Mart, and other businesses all over America.

[MarkWright]

Except needle safety and seat belts did not cut my hours at work and cause me to have to work a second job. I know all of you love the ACA and that is fine.... but for me and millions like me it is a total loss.