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?

[MunoRN, RN]

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.

I'm not a big of the ACA either but let's have a little respect for math. There were about 47 million uninsured in 2012. The simplest per person cost for healthcare (total cost divided by number of people) is about $8,500 per person per year, or about $400 Billion to provided healthcare to all the uninsured every year, which is 400 times what even conservatives claim the website and advertising costs, far short of even covering the uninsured for one year much less 20.

In order for your math to work, the cost of insuring each uninsured American would have to be only one dollar per year.

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.

It was about 950 pages, although either way that seems a bit irrelevant.

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.

Assuming you trust the CBO, since you've quoted their numbers, we will not have more uninsured at the end of the enrollment period than we did before.

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!

The most expensive platinum plan I can find in NJ is $5500 per year and has no deductible and no network limitations.

[Esme12, ASN, BSN, RN]

MODERATOR NOTE:

This thread IS NOT about the ACA itself it is about the OP getting the available hours cut as a perdiem employee due to the ACA and the employer rules for supplying employes over 30hrs/week or 120days/year.

Please stick to topic.

[jadelpn, LPN, EMT-B]

OK, now my head is spinning! Is it not feasible to prove that you have health insurance from another source, and be able to work more than 30 hours a week?

And for the small business owner, would it not make sense to make additional employees independent contractors, and offer a competative wage to offset some of their individual costs? The 16 year old kids I would assume are covered under their parent's policies. There may be more than one employee who have insurance with a spouse. For those who are left to go on the ever involved website to get government sponsored insurances, they could tailor to their own needs. Which conceivably, could mean that some could be in the $60 a month mark. Or set up PTO/Heathcare funding accounts for your employees.

It is not easy, no matter how you look at it. But that someone is in a position to set up college funds and the like for their kids, and you must be turning some profit.....

[Guest757854]

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.[/quote']

I totally agree!! I was going to chime in....but as I have been following this thread reading more and more I have come to the inevitable decision that some people jus cant tolerate change.

[Esme12, ASN, BSN, RN]

OK, now my head is spinning! Is it not feasible to prove that you have health insurance from another source, and be able to work more than 30 hours a week?

And for the small business owner, would it not make sense to make additional employees independent contractors, and offer a competative wage to offset some of their individual costs? The 16 year old kids I would assume are covered under their parent's policies. There may be more than one employee who have insurance with a spouse. For those who are left to go on the ever involved website to get government sponsored insurances, they could tailor to their own needs. Which conceivably, could mean that some could be in the $60 a month mark. Or set up PTO/Heathcare funding accounts for your employees.

It is not easy, no matter how you look at it. But that someone is in a position to set up college funds and the like for their kids, and you must be turning some profit.....

I will be honest....I don't know. It is my understanding that with minors it is different as the parents are covering them by law....so it is the parents responsibility and they will be fined.

Is it not feasible to prove that you have health insurance from another source, and be able to work more than 30 hours a week?

As far as the hospital goes, it is also my understanding that the only non benefitted employees will be those UNDER 30/hrs/wk or under 120 days/year....the laws states the employer must provide insurance or be fined....but if they have insurance from elsewhere and sign a waiver can they work more? as far as I know that hasn't been addressed. Good question I will check for an answer but I am not sure there is one right now.

One of those finer points that I am sure no one thought of....good question.

[Esme12, ASN, BSN, RN]

I totally agree!! I was going to chime in....but as I have been following this thread reading more and more I have come to the inevitable decision that some people just cant tolerate change.

This has nothing to do with accepting change....the OP asked a question and the question was answered what the hospitals are saying to the managers and what the law says.

I don't see where this is not accepting change. The law is clear. Hospitals have KNOWN this for a while and the have a reprieve until next Jan. The hospitals have to give insurance to employees (that they didn't have to before) that work over 30/hrs/wk or 120/days a year. Full Time Employee FTE Calculator - Health Law Guide for Business They have to report to the government their FTE's figured by the government standards, everyone included no exceptions.... http://www.adp.com/tools-and-resources/adp-research-institute/insights/~/media/696C3879BDB14C56A98BE58C1F85E363.ashx

The employer will then be charged accordingly by the government for each employee not covered.

In the past employers LOVED perdiem's that worked a lot of hours. They didn't have to pay benefits, 401K matching, vacation or sick time. These employees filled many FTE vacancies without increasing the FTE budget...which are two different budgets by the way. Paying these employees a little more is actually cheaper than paying benefits...so the hospital saved money.

Now these employees are going to cost the facility money if they work more than 30hrs/wk or 120days/year....so the CEO/hospital don't want to increase what they spend..... so they are going to not let these employees work more that what the law allows without having to pay for them. It's simple.

You know what I see the facilities doing next? Not hiring anyone for over 30 hours...so they don't have to give them benefits which the ACA law has made completely legal to do..placing the onus of insurance on the sholders of the employee while the CEO's reap more salaries and year end bonuses to their own pocket. If anyone believes that they (the CEO's) will do the stand up thing and not take advantage of the law and crap on the head of the bedside nurse....I have some beautiful land to build on in the Florida Everglades.

[jadelpn, LPN, EMT-B]

Look at it this way. If an employer says "I am putting in $100 a week per employee into a health savings account, it is up to you to go onto the website and apply for coverage within 60 days". $400 a month per employee, $4800 a year. Then you can keep a competative wage. Or a bit more for those who already have coverage from another source.

Or you just hire independent contractors, and have at it.

[uRNmyway, ASN, RN]

I totally agree!! I was going to chime in....but as I have been following this thread reading more and more I have come to the inevitable decision that some people jus cant tolerate change.

Yes, some people can't tolerate change if it negatively impacts their lives. Can you blame them?

[Esme12, ASN, BSN, RN]

Look at it this way. If an employer says "I am putting in $100 a week per employee into a health savings account, it is up to you to go onto the website and apply for coverage within 60 days". $400 a month per employee, $4800 a year. Then you can keep a competitive wage. Or a bit more for those who already have coverage from another source.

Or you just hire independent contractors, and have at it.

Thank you for the analogy...I just don't understand why it is confusing. Maybe because I do budgets and hospital finances...but it is pretty clear if it costs them money...they WILL find a way around it right now because nurses are a dime a dozen...it's a shame.

This WILL come back to bite them in the behind because the bad behavior will chase many away the second the economy really make a good turn for the better....making an even greater shortage at a bad time. I plan to have my daughter is a good spot by that time to reap the benefits.

[ixchel]

It is not BS...... 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.It affects the over all cash outflow where there was not one before...so yes I can see facilities doing this to save money.[/quote']

I live in a smallish town and we have so many small mom and pop shops being run out by big retailers like walmart and target. And now these changes in healthcare are making the more medium sized small employers have to adjust to accommodate this. Thank you for posting these quotes because yes, it is not BS, and it is hurting businesses. This, and the price of the premiums, are the two things about the ACA that I have deep negative feelings about. It is not "affordable", as the name of it implies.

[ixchel]

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.

Agreed. And I believe this would be slightly less of an issue if the expense of it were not so massive. You're looking at thousands per year PER EMPLOYEE in businesses that may not be able to afford this expense. I don't know if there is a better solution to the problem, but this one does make me cringe.

I haven't read through the entire thread yet, so forgive me if this has already been posted, but after watching this video, it makes me much more in favor of socializing the entire system. (

) I feel like expanding a broken system isn't going to help costs much at all. I like the reforms put into this bill, but the COST is what I hate.

[ixchel]

MODERATOR NOTE: This thread IS NOT about the ACA itself it is about the OP getting the available hours cut as a perdiem employee due to the ACA and the employer rules for supplying employes over 30hrs/week or 120days/year. Please stick to topic.

Ack! My apologies. I am just now reaching this part of the thread. I really need to not reply as I read!