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?

[wooh, BSN, RN]

You support continuing, and even increasing reliance on a dysfunctional system that has created massive healthcare inflation far out of proportion with inflation in other aspects of our economy that are free-market based, and has priced many out of the market altogether.

Actually I support a single payer system like Canada or England or Cuba. But that's not the system we have here. Until we do, then providing healthcare for employees is an expense of running a business. Just like wages. Your business would probably be more profitable if your employees would work for free. Their desperation that makes them willing to work without getting health benefits is going to cost ALL of us when they end up in the hospital and can't pay their bills. Sorry I don't want to subsidize YOUR business with MY money when your uninsured employees get sick and can't pay their hospital bills, raising MY bills, raising MY insurance premiums, raising MY taxes.

[Jolie, BSN]

Actually I support a single payer system like Canada or England or Cuba. But that's not the system we have here. Until we do, then providing healthcare for employees is an expense of running a business.

If employee provided healthcare is a moral imperative, why should it end with single payor?

Just like wages. Your business would probably be more profitable if your employees would work for free. Their desperation that makes them willing to work without getting health benefits is going to cost ALL of us when they end up in the hospital and can't pay their bills. Sorry I don't want to subsidize YOUR business with MY money when your uninsured employees get sick and can't pay their hospital bills, raising MY bills, raising MY insurance premiums, raising MY taxes.

Wow! The inaccuracy of your assumptions is simply astounding. I would love to engage in an intelligent and thoughtful discussion of the ramifications of Obamacare, but you apparently are more interested in throwing out unfounded accusations than learning the reality of those whose experiences differ from your own.

Carry on. I'll seek informed conversation elsewhere.

[SC_RNDude]

Wow! The inaccuracy of your assumptions is simply astounding. I would love to engage in an intelligent and thoughtful discussion of the ramifications of Obamacare, but you apparently are more interested in throwing out unfounded accusations than learning the reality of those whose experiences differ from your own.

Carry on. I'll seek informed conversation elsewhere.

I was about to chime in, but I think it would be useless with the group in this thread. I'll go with your strategy and go elsewhere.

[Esme12, ASN, BSN, RN]

The original poster is a per diem employee. This doesn't affect him/her as they are now a full time employee no matter how many hours they worked. The poster is per diem.

In the end...I can't say I care. My daughter with a "pre-existing condition" who last year had cheap year of $22,000 in medical expenses will continue to have medical coverage...for life.

Employers need to figure it out. Maybe those who are overpaid at the top need to find a way to take a reasonable pay.

My husband owns a small company. So we are facing this on many sides. And overall....we find that the ACA can be a positive and worked with if people are willing to open their minds and if businesses are willing to accept the need to be reasonable. So big change for many...open minds and being reasonable doesn't always come easy. So maybe bumpy for some initially but life saving for MANY...forever.

I respectfully disagree.

The original poster is a per diem employee. This doesn't affect him/her as they are now a full time employee no matter how many hours they worked. The poster is per diem

Under the ACA "perdiem" employees are counted.... unlike right now they are not.

The ACA requirements are based on FTE. If an employee is PRN they must work less that 30/hrs/week or the employer is...

mandated to offer coverage, to cover employees working 30 or more hours per week on average, starting 90 days after they are hired,” he says. Story: For Obamacare to Work, Small Employers Must Embrace Exchanges

Part-timers under 30 hours and seasonal employees who work fewer than 120 days annually do not have to be covered even if your company falls under the mandate. To avoid penalties, employers under mandate must offer insurance to eligible employees that covers at least 60 percent of the actuarial value of the cost of benefits; the employees’ share must not be more than 9.5 percent of their income.

Hence if you are a seasonal/perdiem/part time employee and work MORE than 30/hrs/week or greater than 120/days/year...the employer/facility/hospital WILL HAVE to provide insurance or face fines PER EMPLOYEE.

I NEVER SAID that the ACA was good or bad...I just sated the facts and that I can see hospitals/employers decreasing hours worked by these employees to prevent paying insurance and/or paying fines on their casual/per diem/part time/seasonal employees. So the OP is right she/he WILL have their hours cut.

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.

Unfortunately, it is the employees (as usual), who are depending on the income of a greater work week...higher hours, for their income. They will be getting their hours cut, not being to work more than 30/hrs/week, which cuts their take home pay, which decreases their income. This hurts the families bottom line. Less money at home to have for bills/wants/needs.

The employer as usual ends up with more money in their pocket. The worker will get less hours. Yet again big business wins...the little guy pays.

Don't get me wrong..the system is broken. SOMETHING needs to be done.

I have a pre-existing condition and live in fear of having my insurance cut or my husbands company terminating him because I use too many benefits raising their bottom line...so there are treatments and meds I don't take because of the cost...until Jan 1 2014. I have an appointment in Feb. I just hope he doesn't lose his job.

The cost for IVIG is $75,000.00 per dose...SEVENTY FIVE THOUSAND DOLLARS!!!! and I am not sure I can get it approved for my condition as it is an "off label use" for my auto-immune disorder.

[Esme12, ASN, BSN, RN]

And sometimes it isn't about the profession but about the individual first. The ACA has protected my child. I'll take that. The rest...stuff I think can be dealt with. My profession isn't my main priority in life.

The ACA comes with amazing benefits. Sure there are negatives but not everything is always perfect. People need to learn to find a way to work with the new system and accept it. My husband is a small business owner. The company doesn't believe their employees should ever be without insurance and has always provided high quality health insurance. So the ACA...is something they pretty much agreed with from early on when it comes to the idea of providing insurance for employees.

While you are glad for your child...what about the OP? They are accustom to working 36-48hrs/wk. They will now have 6-18 hours less per week or 24-72 hours less pay or $720.00 to $2,220.00 per month at lets say... $30.00/hr plus OT... that they counted on EVERY MONTH to make their bills AND possibly pay for their now mandated ACA insurance.

Maybe they have a sick loved one at home that they need the money for...maybe they have medical bills to pay...maybe they care for their aged parent. Are their needs any less important than theirs? Of course not.

But this thread isn't about what bills one does or doesn't have. It's about having the hours cut so the hospital can avoid increased expenses in the budget hurting the common worker....who happens to be per-diem/part time/casual/seasonal.

The hospital is not going to suddenly open up more FTE's in the budget to suddenly allow the per-diem/casual employees have a benefited position. We ALL know they are cutting their expenses not increasing them. So...they limit the hours worked to stay within the law.

The bottom line the OP is getting their hours cut under the ACA.

[Esme12, ASN, BSN, RN]

Actually I support a single payer system like Canada or England or Cuba. But that's not the system we have here. Until we do, then providing healthcare for employees is an expense of running a business. Just like wages. Your business would probably be more profitable if your employees would work for free. Their desperation that makes them willing to work without getting health benefits is going to cost ALL of us when they end up in the hospital and can't pay their bills. Sorry I don't want to subsidize YOUR business with MY money when your uninsured employees get sick and can't pay their hospital bills, raising MY bills, raising MY insurance premiums, raising MY taxes.

I think to lose the small independent businesses would be a bad thing. I think that making large companies subsidize insurance is a good thing. Is 50 employees a "large company" I don't think so. There needs to be a bigger difference as to when an independent business owner can still expand and employ more workers and provide more jobs to the economy and the big business who are being cheap.

Not alowing for these business increase and grow I believe hurts to economy. To compare this to safety standards and child labor is apples and oranges. No one should be allowed to let children set the dynamite in coal mines because they are small and cheap... then not allow them an escape....is different than paying for healthcare.

Something needs to be done and if both sides could stop bickering and really LOOK at a good solution I think one could be found. But again the common worker is harmed having their hours cut.

I think any solution will raise our bills and our taxes.

[elkpark]

While you are glad for your child...what about the OP? They are accustom to working 36-48hrs/wk. They will now have 6-18 hours less per week or 24-72 hours less pay or $720.00 to $2,220.00 per month at lets say... $30.00/hr plus OT... that they counted on EVERY MONTH to make their bills AND possibly pay for their now mandated ACA insurance.

The OP works prn. In my experience working prn, the entire point of prn/per diem positions is that you are not guaranteed a particular number of hours; you are offered the number of hours that suits the employer's needs. If the OP was depending on working 36-48 hours/week in order to keep her/her household running, that was a mistake, and the OP needs to find a regular, full-time position.

[Esme12, ASN, BSN, RN]

The OP works prn. In my experience working prn, the entire point of prn/per diem positions is that you are not guaranteed a particular number of hours; you are offered the number of hours that suits the employer's needs. If the OP was depending on working 36-48 hours/week in order to keep her/her household running, that was a mistake, and the OP needs to find a regular, full-time position.

Right....the issue here is the employer has been letting them work these hours and they are cutting them because of the ACA and the necessity that the employer will have to provide insurance to these employee under the new law that was postponed until Jan 2015...hence the hours being cut. Someone said that was baloney and it isn't that the new law changes the way the GOVERNMENT looks at seasonal/part time/perdiem workers....when in fact it is...the employer will not have that option open open if these workers work over 30 hours.

How many hours the OP does or does not work really isn't the point. The point is that the ACA changes the way the employer uses these employees and what benefits the employer is required to pay now by law. whether good or bad...it just is what it is...the employer is limiting hours or they will have to pay.

[xoemmylouox, ASN, RN]

I am still suprised when I hear of larger healthcare organizations that do not provide health insurance for their employees. To me it's just absurd and selfish on the part of the healthcare organization. Now I do not think 50 employees equals a large business, but that is the arbitrary number chosen. I also know that being PRN means that you are NEVER guaranteed hours. So while the ACA is the current excuse their employer is using, that does not mean that this is the true/only reason their hours are being cut back from what they are used to getting. I have learned that if Admin's lips are moving most likely you are only hearing half truths or biased statements, like with politics, everyone has an agenda.

[Esme12, ASN, BSN, RN]

I am still suprised when I hear of larger healthcare organizations that do not provide health insurance for their employees. To me it's just absurd and selfish on the part of the healthcare organization. Now I do not think 50 employees equals a large business, but that is the arbitrary number chosen. I also know that being PRN means that you are NEVER guaranteed hours. So while the ACA is the current excuse their employer is using, that does not mean that this is the true/only reason their hours are being cut back from what they are used to getting. I have learned that if Admin's lips are moving most likely you are only hearing half truths or biased statements, like with politics, everyone has an agenda.

absolutely...but since they were getting away with not increasing FTE's and hiring into a benefited position it actually saved them TONS of money by letting the PRN pool work the hours. Now the staff will work short for they certainly aren't going to spend money.

[caliotter3]

I noticed a trend of less available work a long time before the ACA came into focus. Gone are the days when I can walk into an office, interview, get hired, and be working within the next two days. Now, I am lucky if someone hires me and gives me any work at all, ever.

[wirehead]

The ACA has thus far been a disaster. It was rammed through in the wee hours of the morning without 1 Republican vote. We were promised the most transparent government in history under President Obama, health care reform would be televised on CNN, be a bi-partisan crafted bill, and most of all, "you can keep you health plan period, you can keep your doctor period." NOT!!

I agree with lifting the pre-existing condition rule and lifetime limits, kids are not kids at 26, and if you have a young adult who is disabled we have disability/Medicare/Medicaid for that. These issues could've been addressed through legislation, not major overhaul.

If you do the math according to the CBO, the amount of money spent on the ACA website, plus advertising, could have covered every uninsured American for 20+ years. Amazing!! All those tax dollars for an unsecure website and moronic commercials trying to drum up support wasted.

No doubt the system wasn't perfect, but to ram through irresponsible legislation that's somewhere around 2,700 pages, that nobody read, riddled with penalties, then you're simply acting out of emotion, not common sense.

On top of all that, keep in mind, more people have lost insurance than have gained insurance under the ACA, and most of those who became eligible were put into the current Medicaid system.

For the heck of it, I checked out what a plan would cost me in NJ compared to my current awesome plan who's premium has doubled since this legislation took place. The basic plan is not even worth mentioning, I went straight to the Platinum plan, for my family it had an in-network deductible of $7,500, and costs 3x's more than I pay now, with less overall coverage. In fact, in my county, there is 1 hospital that participates with ACA insurance plans, and it's not that close!

Every doctor I talk to is spending thousands to become compliant with the ACA, and others are just retiring. It's not just doctors, it's hospitals, nursing homes, and urgent care clinics all being affected, rising costs, less reimbursement equals laying off workers, and reducing hours. You can't make the cost of doing business increase and expect employers not to find loopholes to stay afloat. I don't know many places in business to lose money!