PRN hours decreased because of the ACA

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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?

Specializes in Maternal - Child Health.
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.

I understand your concern for your child's health coverage. My point is that it is not necessary to make blanket accusations about conservatives and employers evading taxes and laws in order to voice support for aspects of Obamacare that are positive, especially when doing so reveals ignorance of the actual legislation.

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.

I am happy that your husband's business is one that provides insurance to its employees. I don't know the nature of his work or his competitive environment. I can tell you that we have researched every way possible to fund healthcare for FT employees, and can't do it without spending every dime of income the business makes. Our industry is one that operates on an extremely thin margin. We don't have profits of 10-20% or more to pay additional expenses. To be forced to do so would put us out of business, because it is something that we can't, in this market, pass along to customers. Obamacare limits the amount of cost sharing with employees. The amount that we could ask employees to contribute is only a small fraction of the actual cost.

To the poster who asked who should pay for our employees healthcare: This answer is not politically correct, but it is the truth: the employee. We are currently a small enough business that we are not legally required to provide health insurance. We make this clear in our interview process. Anyone who takes a job with us does so knowing full well that they are on their own for healthcare. (Which, for the record, so is my family. Our individual insurance plan is paid fully out of our own pockets, not by the business. And I am a cancer survivor, so I know full well the difficulties and cost associated with purchasing private insurance with pre-existing conditions. Even so, our premiums went up by 33% when Obamacare went into effect.)

My point in my initial post was that the policies of this administration have solidified our decision that it is not feasible for us to expand our business, due to the overwhelming healthcare costs associated with doing so. We have proven that other costs associated with business are recoverable, by becoming profitable and repaying our start-up. In our area, there were essentially 4 well-known businesses providing the type of products and services that we do. 3 small businesses and 1 corporate conglomerate. One of the small businesses closed at the end of the year rather than attempt to compete in the Obamacare era. The 2 of us that remain are small enough to be exempted, and so continue to be competitive. Obamacare would sink us, and as much as you may judge me for not paying my employees' healthcare, they tell me they would rather have a job without employer paid insurance than no job at all, which is where our former rival's employees are right now.

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Specializes in Critical-care RN.

... my head is spinning

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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.

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Specializes in Maternal - Child Health.
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.

Do you believe that employers should pay for employees' healthcare?

Who should pay for their food, shelter, clothing and transportation?

If your answers differ, why do they differ?

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Do you believe that employers should pay for employees' healthcare?

Who should pay for their food, shelter, clothing and transportation?

If your answers differ, why do they differ?

Because employees paying for healthcare is the system we live in. Don't want to? Go to a country where that is NOT the system.

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Specializes in Maternal - Child Health.
Because employees paying for healthcare is the system we live in. Don't want to? Go to a country where that is NOT the system.

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. Thank you for your honesty. It is not the answer I expected, and you may be surprised that it is in direct contrast with one of Obama's stated goals of his healthcare plan, which was to disassociate health care from employment.

You also realize, I am sure, that employer-provided health insurance came about because of government interference in the employment market, via wage and price controls during WWII. So government mess up begets government mess up.

Rather than perpetuating this foolishness, why not engage in real reform that will give individuals true control over their own healthcare purchases, decisions and spending?

But that would require individual responsibility, which I doubt some here would embrace or support.

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Of course having to provide healthcare as part of employee's compensation is an increased cost to employers. Obviously.

One way or another, universal healthcare is the inevitable destiny that our country is being dragged kicking and screaming toward. Or would you rather the USA continue to have some of the worst health and well being statistics in the developed world? If extra cost to the employer is a price then so be it. If the end of PRN, "no-benefit" jobs are a price then so be it.

And good riddance. PRN and agency jobs that don't offer benefits are a blight on our society, one of our nation's shames. I'll be glad to see them out of business.

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Specializes in Maternal - Child Health.
Because employees paying for healthcare is the system we live in. Don't want to? Go to a country where that is NOT the system.

My last nursing job was with a community health agency, from which I was contracted into a local school district as a nurse. The agency was paid $50/hr. by the school district for my services. My pay from the agency was $25/hr. I worked full time, yet received no benefits. No vacation, sick, personal or holiday time. No insurance of any type: no health, no dental, no vision, no disability. No meals or travel pay. Zip, zero, nada.

Don't get me wrong. I'm not complaining. It was what I agreed to.

I'm curious as to whether you take issue with my employer providing no benefits of any type to any employees. If so, why? If not, why not?

How does your opinion differ of a nursing agency not providing health insurance versus my small business doing the same?

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Specializes in Maternal - Child Health.
Of course having to provide healthcare as part of employee's compensation is an increased cost to employers. Obviously.

One way or another, universal healthcare is the inevitable destiny that our country is being dragged kicking and screaming toward. Or would you rather the USA continue to have some of the worst health and well being statistics in the developed world? If extra cost to the employer is a price then so be it. If the end of PRN, "no-benefit" jobs are a price then so be it.

And good riddance. PRN and agency jobs that don't offer benefits are a blight on our society, one of our nation's shames. I'll be glad to see them out of business.

How does the loss of work hours (to under 30 per week) or the loss of jobs altogether when businesses close (as our competitors did) advance the well-being of workers. Now they are not just lacking insurance. They are lacking income and insurance.

ETA:

I'm still curious, Brandon, do you believe that your employer should also pay for your food, shelter, clothing and transportation? Why or why not?

I'm surprised at your vitriol at prn and agency jobs. Have you never met a co-worker who didn't want or need benefits and actually preferred a higher rate of pay and flexible schedule? How does forcing every worker into an inflexible full time work schedule benefit society? It sounds suspiciously like forcing everyone into a one-size-fits-no-one healthcare plan.

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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. Thank you for your honesty. It is not the answer I expected, and you may be surprised that it is in direct contrast with one of Obama's stated goals of his healthcare plan, which was to disassociate health care from employment.

You also realize, I am sure, that employer-provided health insurance came about because of government interference in the employment market, via wage and price controls during WWII. So government mess up begets government mess up.

Rather than perpetuating this foolishness, why not engage in real reform that will give individuals true control over their own healthcare purchases, decisions and spending?

But that would require individual responsibility, which I doubt some here would embrace or support.

Right, because working conditions and standards of living were sooooo much better before the government and unions screwed everything up circa WWII.

The workingman in America has done so much better since the decline of unions, haven't they? And I'm sure it'll just become a freaking worker's paradise if we eliminate that interfering government and let the free market and individual responsibility take over.

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Specializes in Maternal - Child Health.
Right, because working conditions and standards of living were sooooo much better before the government and unions screwed everything up circa WWII.

The workingman in America has done so much better since the decline of unions, haven't they? And I'm sure it'll just become a freaking worker's paradise if we eliminate that interfering government and let the free market and individual responsibility take over.

I'm not debating unions Brandon: they are irreleant to this conversation. I won't be dragged off topic, but if you'd like to discuss them, there are plenty of other threads.

I encourage you to research how and why employer-based health insurance became common. It has everything to do with government interference in wages and prices and very little to do with unions. It is important to the shifting of responsibility for health care payment (not in a good way) and set the stage for uncontrollable health care inflation.

Important lessons not to be dismissed out of hand.

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How does the loss of work hours (to under 30 per week) or the loss of jobs altogether when businesses close (as our competitors did) advance the well-being of workers. Now they are not just lacking insurance. They are lacking income and insurance.

ETA:

I'm still curious, Brandon, do you believe that your employer should also pay for your food, shelter, clothing and transportation? Why or why not?

I'm surprised at your vitriol at prn and agency jobs. Have you never met a co-worker who didn't want or need benefits and actually preferred a higher rate of pay and flexible schedule? How does forcing every worker into an inflexible full time work schedule benefit society? It sounds suspiciously like forcing everyone into a one-size-fits-no-one healthcare plan.

No, I pay for my food and rent out of the money I get paid for my labor.

My vitriol against agency and PRN jobs that don't offer benefits stem from experience. Agencies like Manpower exist because they are staffed by employees that used to have middle-class jobs that provided a livable wage. They are blood suckers benefiting from desperate people who have few options.

Companies and government agencies replacing workers who used to get good wages and good benefits with desperate bottom-dollar agency staff is rampant. I would be overjoyed to see all these agencies go out of business.

I understand that your small business was not an agency like Manpower. But I think it's socially irresponsible to have started a business that doesn't offer health benefits in the first place. With that in mind, I don't feel sorry for any business being forced to provide a benefit they should have been providing all along

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