Pay Cut "Because of ObamaCare and Jerry Brown"

[i_love_patient_care]

My boss just let me know that my rate of pay is going down a couple of dollars an hour because of obamacare and a new law from Jerry Brown. (I'm in CA) Has anyone else heard or going to be affected by this? I pretty much told her if that's the case I won't be working there much longer.

[wirehead]

Of all the health care professions, the ACA will hit nurses & CNA's the hardest because all providers (our employers,) will be seeing less reimbursement while their expenses are increasing. As nurses and CNA's we all know we spend the most time caring for our patients, and are not compensated nearly what we're worth. Florida and Texas are 2 great alternatives as far as not having a state income tax, and every little bit will help nowadays! I too did homecare, I left and went to sub-acute, but will be going back to home care because the ACA will essentially push patients out of the hospital, sub-acute setting into home care as much as possible because it simply costs less to care for patients at home. While this can be a good thing in some cases, it can be very risky in others because I think more borderline patients, and patients who should not be discharged will be to save a penny! Wound care certification is on my radar too, there aren't that many around, and they are in high demand.

[redhead_NURSE98!, ADN, BSN]

It's the same as most of the insurance cancellation b.s. - Obamacare is a convenient excuse to do whatever they feel like doing this week.

[brandy1017, ASN, RN]

I know of people working as CNA's who were given pay cuts by management long before the affordable care act. Nursing homes run on a tight profit margin and have been known to do this to save money at the workers expense. It may be unfair and unethical but it is perfectly legal. The only way to fight this is to either unionize or vote with your feet and find a new employer and hopefully get a pay raise, not a cut!

[BostonRN13]

The Jerry Brown reference is most likely Proposition 30 which passed in Nov of 2012 causing California State to have the most progressive income tax rates of all the US states. Not only are taxes high but fuel, and utilities add the cost of doing business as well. As for the Obama Care reference, if you consider that one-third of all the people on welfare in the nation reside in California, and the effect of the expansion of the Medi-Cal under the new ACA guidelines, the cost has to be made up somewhere. I believe that California has lost the most private insurance policies under the ACA because the burden is too great on employers to cover the increased premiums, and many small business owners will prefer to pay the penalty rather than cover their employees. It's not surprising that your rate of pay has decreased, and if you pay for insurance, don't be surprised if you lose it, or pay a higher premium. California will not be unique in this aspect, eventually it will affect us all, our pay rates will decrease or stay the same, and the work load will increase when you add all these new people to the system. There are some good aspects of the ACA, but it was rushed through, not well planned out, and the billions wasted on the junk website is disgraceful. [/quote']

Well said!

[wirehead]

Sure cuts have been made before the ACA, because the overall reimbursement rate has gone down, and the cost of doing business has increased, cuts are going to be made somewhere, it's the nature of the beast. The ACA will exacerbate this exponentially, not just for CNA's, but for LPN's, RN's, MD's, you name it. It's surely unfair, but not unethical, the business needs to make a profit to stay afloat. In my area, many hospitals have shut down because they could not make ends meet with all the reimbursement cuts, all the Medicaid expansion, and all those who use the ER to treat a sinus infection and never pay their bills. Not to mention the strain illegal immigrants have placed on the health care system, while this may be a sensitive subject, it is reality nonetheless. All of our scopes of practice will increase under ACA, but the salary will not, so if you're in the business just for the money, then it may be time to look for a new career.

[sneeds]

I see alot of strip malls starting primary care and visiting doctor businesses..... Where can RNs fit into the primary care role without paycuts except for getting Master's or Doctorates?

[wirehead]

I see alot of strip malls starting primary care and visiting doctor businesses..... Where can RNs fit into the primary care role without paycuts except for getting Master's or Doctorates?

This is the trend that will continue to grow, it will lead to great opportunity for the NP and PA, but not so much for the RN. This is sad because RN's and even LPN's are already so undervalued. The future of the RN will be an expanded role, not sure how at the moment, but for the same or less money. Look into home care, it will be the largest growing segment of health care for the RN.

[Student Mom to Three]

Wirehead-

You state that all of our scopes of practice will increase under the ACA. Source for this?? Does not each state BON set their own scopes of practice?

[smmorgan1]

wow i wonder if i need to change my major!

[wirehead]

Wirehead-

You state that all of our scopes of practice will increase under the ACA. Source for this?? Does not each state BON set their own scopes of practice?

Hi Mom, there are a few states who have already voted to expand the nurse's role, created new fields of specialization that I doubt will increase pay, but at some point adding millions of people to a system without the ability to care for them, the RN role will logically be expanded. I don't mean that as an RN you will all of the sudden be able to write prescriptions. I do think each state will decide how the role will change, and what the new expectations will be of RN's in the future. Read the articles from the links I've provided, this is not going to happen overnight, but definitely in the near future. Most states will also require BSN as a minimum educational requirement as well. Hope this helps.

Divided Mich. Senate votes to expand nurses' role | www.ktvu.com

[COLOR=#0066cc]American Nurse Today

Landmark Report on Nurse Roles and the Affordable Care Act Released: Identifies Top New Roles for California's Registered Nurses

[wirehead]

It's the same as most of the insurance cancellation b.s. - Obamacare is a convenient excuse to do whatever they feel like doing this week.

Don't forget, Medicare was cut 716 billion dollars in order to fund the ACA. That's a ton of money that directly affects us across the board. Keep in mind as well, there is a new protocol where a patient in the hospital can be kept in what they call an "observational status," rather than being admitted, the issue there is a patient discharged on observational status cannot go to a nursing home where Medicare would allow for 100 days per year of care, instead they are sent to home care in which the rules are very strict! Medicare requires "skilled nursing care," and you have to show progress each visit or they will not cover their care. These are very critical blows to the delivery of care, it's no longer about what's in the patients best interest, but the quickest, cheapest way to get the patient relatively independent. So there is a lot to blame on the ACA for people losing jobs, getting salary cuts, hospitals and nursing homes closing, and we have only just begun.

[VivaLasViejas, ASN, RN]

Governor Moonbeam is still nuttier than a squirrel, and I can't believe the people of California actually gave him a third term. But he's small potatoes compared with the Titanic failure that Obamacare is becoming. This is going to affect every American no matter what field he or she works in, but the biggest impact will be felt in healthcare as more will be expected of us and less will be given in return. It's inevitable, especially as reimbursements continue to be cut, and Baby Boomers keep getting older (and in many cases sicker; half of the patients on my SNF unit are in their 60s, and a few are my age and even younger). Hang onto your hats, my friends, it's going to be one heck of a bumpy ride.