Neil deMause

The 1099 tax form mess continues, with both the House and Senate moving to pass repeal bills. Unfortunately, the Senate’s solution for filling the resulting revenue gap is to promise vaguely to find unneeded spending it can cut; the House’s is to raise low- and middle-income earners’ health insurance premium costs; and the whole thing might still fail if the two sides can’t agree on a compromise:

There’s one legislative issue lawmakers on both sides of the aisle overwhelmingly agree on: The onerous 1099 tax-reporting mandate that snuck into the health-care reform bill has to be repealed.

The Republicans promised to eliminate it in their Pledge to America, and President Obama did the same in his State of the Union address. So nearly one year after its passage, why isn’t the law dead yet?… [read more]

A multi-year campaign to require that all employees in New York City receive paid sick time (which I first wrote about last fall) was quashed in October by city council speaker Christine Quinn. What happened, and what does it mean for worker rights and the city economy?

Last winter, it seemed all but inevitable that New York City would become the latest city to pass a law mandating that all city businesses provide paid sick leave to their employees.

A coalition of worker-rights groups, including Make the Road New York, the Working Families Party and the legal advocates A Better Balance had lined up to push for the legislation; a veto-proof majority of 37 city councilmembers had not just endorsed but co-sponsored a bill that would require at least five days of annual leave for all workers. And with the nation in the grip of swine-flu panic, visions of restaurant cooks showing up sick for work had even some small business owners admitting that some kind of sick-leave law was probably inevitable… [read more]

Home health care aides are both the fastest-growing job sector in the economy, and the last job anybody would want:

Though unemployment remains north of 9 percent in the “post-recession” city economy, there are a few bright spots for New Yorkers seeking work. If you’re a computer programmer or network systems analyst, for example, the state labor department projects that businesses will still be hiring for the foreseeable future. Or you could take advantage of the number one growth industry: home health aides, which are expected to add a whopping 5,230 jobs a year statewide. By 2016, according to the state’s projections, nearly 300,000 New Yorkers will be employed as home health caregivers, either as health aides or in the related field of “personal and home care,” which includes caregivers for the elderly or infirm who don’t handle medication.

For those without advanced technical skills thinking of a career change, there’s only one problem: Though demand for home care aides—who do everything from cooking and cleaning for home-bound patients to bathing and dressing them—is soaring, wages remain dismal… [read more]

If you’d like to hear me natter about the health care bill’s effect on small business, I’ll be on WOC-AM in Iowa at 8 am (Central time) tomorrow morning, available here streaming over the interwebs. I’ll also be be on KMED-AM 20 minutes later (6:20 am Pacific), but that doesn’t appear to be streamed, so you’ll either need to live in Medford, Oregon, or have a tin can with a really, really long string.

Now that Congress has pulled an all-nighter and finally passed a health care reform bill (or half of one, anyway), I did the same to provide a look at what the new law will mean to you — assuming you’re the owner of a small business, which might actually describe one or two of my readers here.

The sweeping health-care bill passed by the House of Representatives Sunday, and now headed for President Obama’s desk, promises a sea change in the way that small business owners purchase and provide health insurance for themselves and their employees.

But many of the provisions won’t kick in until 2014 — and the final rules could still be changed by amendments that will now be considered by the Senate… [read more]

In reading this AP story about the removal of the last remnants of a public option from the health reform bill, it occurred to me: Do journalists intentionally avoid explaining certain issues because if they did, one side would sound, you know, stupid? Take a section like this:

Many Democrats say they’d like to see a plan like Medicare to give consumers affordable choices. Republicans and some moderate Democrats fear private companies wouldn’t be able to compete. The search for a middle ground has been difficult.

That doesn’t actually explain anything, which is a bad thing in an article claiming to explain “key issues in the health care debate.” But think about how it would look if the writer had actually tried to describe what’s going on:

Many Democrats say they’d like to see the government provide health insurance, because, like Medicare, it’d be cheaper than private insurance. But Republicans and some moderate Democrats say that the only way we can have private insurance is if it stays expensive, and no one will buy expensive private insurance if there’s a better option. The first group knows this is crazy, but can’t say it out loud because then Joe Lieberman will lock himself in the Senate chamber and hold his breath until he turns purple.

Indeed, the search for a middle ground is difficult. In journalism doubly so.

As if landing the Olympics wasn’t trouble enough already, now it could come with the requirement of passing newly expanded police powers:

Countries could be barred from hosting the Olympics, starting with the 2018 games, if they don’t have laws that empower police to raid and investigate those suspected of helping athletes use performance-enhancing drugs.

Of course, that’s pretty much par for the course when it comes to the Olympics.

Meanwhile, as if the health reform bill wasn’t trouble enough already, an op-ed in today’s New York Times by the former head of Texas’ health insurance exchange spells out why such “pooling” plans, one of the few pieces of the Obama reform plan that hasn’t been gutted by the Senate, are likely to be worthless:

Private insurance companies, which could offer small-business policies both inside and outside the exchange, cherry-picked relentlessly, signing up all the small businesses with generally healthy employees and offloading the bad risks — companies with older or sicker employees — onto the exchange. For the insurance companies, this made business sense. But as a result, our exchange was overwhelmed with people who had high health care costs, and too few healthy people to share the risk. The premiums we offered rose significantly. Insurance on the exchange was no longer a bargain, and employers began backing away…

It would be smarter for Congress to revisit the idea of creating a public plan that could provide an attractive choice for consumers and real competition for private insurers, to give them the incentive to offer good coverage at affordable prices.

It’s a point I’ve alluded to before, but it’s nice to hear it from the horse’s mouth.

It’s swine flu season, which means all thoughts turn to what to do when your job won’t let you call in sick:

As the H1N1 swine flu virus starts its second major sweep through the U.S., business owners are bracing for the impact of a worse-than-usual flu season on their workforces. That’s reviving debate on a contentious issue: What kind of sick leave should companies offer employees — and should it be mandated by law?

“On the one hand, you have all of our top officials saying, ‘Do the responsible thing. If you’re sick, stay home,’” says Debra Ness, president of the National Partnership for Women and Families, a Washington, D.C.-based advocacy group that is pushing for paid sick leave laws. “You have advice from the Centers for Disease Control on exactly how many days you should stay home, and how many days we need to keep kids at home. And at the same time, we have a country where almost half the workforce doesn’t have a single paid sick day.”… [read more]

I’ve only scratched the surface of the 220 pages, but here are some lowlights:

• No public insurance option, of course. Looks like not even a trigger for a public option to be created if private insurers don’t bring their premiums down.
• The New York Times is reporting that Baucus “envisions middle-class American families having to pay” 13 percent of their family income “in health insurance premiums before co-payments, deductibles and other cost-sharing.” That’d be $1200 a month in premiums alone for a couple making $100,000 a year combined. Worse yet, what the bill actually says is that “individuals between 300-400 percent of [the federal poverty line] would be eligible for a premium credit based on capping an individual‘s share of the premium at a flat 13 percent of income.” If I’m reading that right, that means that insurers could still charge even more than 13 percent of income — just if they do, the government will pay anything above that limit. This is cost reduction?
• The standards for health plans would be divided into Gold, Silver, Bronze, and (I am not making this up) “Young Invincible” levels, with varying degrees of coverage required for each. This is apparently based on Massachusetts’ Commonwealth Connector plan, and I’m still not clear how it’s supposed to represent real standards: If your plan doesn’t cover 90% of the average person’s health costs, for example, all that happens is that it gets tagged as Silver instead of Gold. Not that any of it is likely to matter anyway, as in Massachusetts nearly half of all Connector participants are choosing the cheapest Bronze plans, with a mere 7% coughing up for Gold — no surprise, given that insurance premiums there are still sky-high.
• Even with the plan watered down to near-tincture levels, Baucus still couldn’t get a single Republican co-sponsor. This is working so much better than trying to pass a real reform bill in the first place.

UPDATE: Just saw that CJR has another good article up today on the failures of the Massachusetts plan and what it means for the nation as a whole if a Baucus-type plan passes. Required reading.

Health Savings Accounts, the Bush-spawned health insurance plans that have been derided as a mere tax dodge for the rich, are either in danger of being phased out under health reform, or likely to carry on unimpeded. You make the call:

While Washington wrangles over health care, the nation’s last big reform innovation faces an uncertain future. Health Savings Accounts, the hybrid of flex spending accounts and IRAs that President Bush created in 2003, are an afterthought in the current proposals on Capitol Hill — with strenuous debate over whether their demise would be a disaster or a welcome end to a program that never lived up to its promise…. [read more]