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.
Specializes in NICU, PICU, Transport, L&D, Hospice.
My per diem employer has many nurses who for years have been working 36+ hours a week and treating the PD position as their full time job. The employer has encouraged this and actually pays more for more hours worked. Most employees have been able to get their hours without excessive cancellation with the exception of the Christmas/New Years holidays and the surrounding weeks.
Our employer has told us that they "don't know" what is going to happen with these PD employees with the mandate takes effect next year. The employer is investigating whether they might be able to qualify for an exception from the mandate because as PD employees, our hours are not "guaranteed. If an exception is not possible, the other option will be to have a health insurance plan offered to these PD employees who consistently work FT hours, but that will likely result in a 20-20% hourly pay cut.
My per diem employer has many nurses who for years have been working 36+ hours a week and treating the PD position as their full time job. The employer has encouraged this and actually pays more for more hours worked. Most employees have been able to get their hours without excessive cancellation with the exception of the Christmas/New Years holidays and the surrounding weeks.
Our employer has told us that they "don't know" what is going to happen with these PD employees with the mandate takes effect next year. The employer is investigating whether they might be able to qualify for an exception from the mandate because as PD employees, our hours are not "guaranteed. If an exception is not possible, the other option will be to have a health insurance plan offered to these PD employees who consistently work FT hours, but that will likely result in a 20-20% hourly pay cut.
You concern is that they will offer you health insurance? How to you get insurance now?
You concern is that they will offer you health insurance? How to you get insurance now?
The nurses I wrote about who typically work full time hours as per diem employees do so because the pay is much higher, in lieu of benefits, than full time staff positions. Some get their insurance from a spouse's plan while others purchase their own on the individual market.
The concern is not that they would offer health insurance, but they would make it mandatory for anyone working full time hours, resulting in a large reduction in take-home pay.
I am actually not personally affected by this because I am too risk-averse to sit around and wait for them to decide what they are going to do in January, and then have to scramble to figure out how I am going to make ends meet. I was hired for another full time (benefited) position across town (start next month) and will just keep doing the per diem thing 1-2 days a week.
The nurses I wrote about who typically work full time hours as per diem employees do so because the pay is much higher, in lieu of benefits, than full time staff positions. Some get their insurance from a spouse's plan while others purchase their own on the individual market.
The concern is not that they would offer health insurance, but they would make it mandatory for anyone working full time hours, resulting in a large reduction in take-home pay.
I am actually not personally affected by this because I am too risk-averse to sit around and wait for them to decide what they are going to do in January, and then have to scramble to figure out how I am going to make ends meet. I was hired for another full time (benefited) position across town (start next month) and will just keep doing the per diem thing 1-2 days a week.
If they get paid more because they don't get benefits, wouldn't it make sense that they would get paid less if they do get benefits?
yes, but the point is most of them CHOOSE to work in that position for the extra money, and don't need/want the benefit.
I'm all for doing away with employer sponsored coverage and just putting us all the exchanges, or in single payer, although I don't think we're near convincing conservatives of that. In the meantime, so long as we're appeasing conservative views on healthcare coverage by requiring employers to offer coverage to full time employees, I don't see how it doesn't make sense that if you're working full time hours, even as a per diem, that you'll get insurance, whether you want it or not.
I'm all for doing away with employer sponsored coverage and just putting us all the exchanges, or in single payer, although I don't think we're near convincing conservatives of that. In the meantime, so long as we're appeasing conservative views on healthcare coverage by requiring employers to offer coverage to full time employees, I don't see how it doesn't make sense that if you're working full time hours, even as a per diem, that you'll get insurance, whether you want it or not.
It doesn't make sense because it doesn't help fulfill the intent of the ACA as I understand it which is to reduce the number of uninsured. Those individuals already have coverage. They don't need it. They don't want it. They should not be forced to take a pay cut because of it.
Specializes in NICU, PICU, Transport, L&D, Hospice.
I believe that the staff of that very large acute care hospital ought to do a couple of things.
I think they should take note of the salary and bonus packages of the top execs. I think they ought to do the math on the subject that the employer is saying will require them to cut wages by 20-25%. They ought to compile the data and offer to publish it in the local and regional press for the employer so that people will understand where their (the large acute care hospital) spending priorities and obligations are.
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?
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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?
To get "off the hook" involves government over sight and documentation. It is "mandatory" to offer but you will have to show "proof" that you are covered else where. MOST facilities are using the mandate for work reduction and cost saving without actually "decreasing" the workforce. IT is a good excuse at the moment.
It is also TON of paper work of tracking hours and government auditing (which costs money) so they are choosing to not allow their casual employees to work over 30 hours. I discussed this in the very beginning of the thread.
The mandate states......
These regulations will vary depending on employer size. Businesses classified as a “Large Employer” are determined to have more than 50 full-time equivalent employees, whereas “Small Employer” businesses have less than 50 full-time equivalent employees. Under the ACA, employees that work an average of 30 hours per week (130 total monthly hours) are considered full-time.
The ObamaCare employer mandate / employer penalty, originally set to begin in 2014, will be delayed until 2015. The ObamaCare "employer mandate" is a requirement that all businesses with over 50 full-time equivalent (FTE) employees provide health insurance for their full-time employees, or pay a per month "Employer Shared Responsibility Payment" on their federal tax return.
The employer mandate is officially part of the Employer Shared Responsibility provision. Under the Affordable Care Act, the federal government, state governments, insurers, employers and individuals are given shared responsibility to reform and improve the availability, quality and affordability of health insurance coverage in the United States.
As a per-diem/casual employee the employer does not offer benefits...they will have to beginning 2015......many facilities will be doing this to save money.
The Employer Mandate Fee / Employer Shared Responsibility Payment
The annual employer mandate fee (officially called an Employer Shared Responsibility Payment) is a per employee fee for employers with over 50 full-time equivalent employees who don't offer health coverage to full-time employees.
• The employer mandate is based on full-time equivalent employees, not just full-time employees.
• The fee is based on whether or not you offer affordable health insurance to your employees that provides minimum value (explained below).
• The annual fee is $2,000 per employee if insurance isn't offered (the first 30 full-time employees are exempt).
• If at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.
• The fee is a per month fee due annually on employer federal tax returns starting in 2015. So the per month fee is 1/12 of the $2,000 or $3,000 per employee.
• Unlike employer contributions to employee premiums, the Employer Shared Responsibility Payment is not tax deductible.
The employer mandate fee is officially referred to as a "shared responsibility payment", as the fee will help to go to help fund marketplace subsidies and to compensate for unreimbursed emergency health care provided to the uninsured.
It affects the over all cash outflow where there was not one before...so yes I can see facilities doing this to save money.
toomuchbaloney
16,080 Posts
Do you work for an acute care hospital?