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Health Care.
LABI encourages a cost-effective, competitive health care market as an incentive to economic growth, while assuring that consumers in Louisiana continue to receive high-quality, accessible and affordable health care.
LABI opposes the adoption of a single-payer, government-run health care system and takes an active role in public policy that would affect health care costs and outcomes, an employer’s right to contract, or an employer’s flexibility to determine and provide employee benefits.
Recognizing the importance of the health care industry to Louisiana’s economic development, LABI supports creative iniatives to grow a qualified allied health workforce and strong in-state capacity for medical research.
Current Issues.
Health Care Delivery: Support the continued development of sustainable approaches to health care delivery and financing that:
• Acknowledges individual responsibility to improve health status;
• Actively manages care to be efficient, affordable, high quality, and accessible – the right care, at the right price, in the right setting, without adversely affecting the private health insurance market;
• Is based on accurate information and data that are electronically accessible, including systems to enable consumer comparison of health care cost and quality information;
• Allows employers and their agents, as well as government bodies, to negotiate contracts for lower-cost plans that reward quality and improved health;
• Promotes a value-based model of health care delivery that rewards performance (quality, cost, access), including managed care programs and other measures that enhance quality and contain health care costs;
• Reduces the rate of increases in health care costs without cost shifting or price controls;
• Do not shift payment responsibility from the state to employers or providers; and
• Focuses on well-being and improvements in health status; provides for employee education, health and wellness promotion; and encourages appropriate public and private wellness programs to prevent, reduce, and manage chronic diseases which lead to substantial direct and indirect costs including increased emergency room visits and hospital admissions and readmissions.
Managed Care: Support the continued development of cost-effective managed care that assures quality and access to appropriate medical services. Support efforts to allow for contracting for lower cost plans and oppose attempts to exclusively contract for services when appropriate. Oppose regulatory efforts to impose unnecessary restrictions on utilization review. Oppose attempts to circumvent appropriate managed care cost containment strategies or controls.
Alleviate Shortages: Support efforts to alleviate shortages of primary care physicians, nurses and other allied health care professionals as appropriate through, but not limited to, scholarships, increase graduate medical education, training and continuing education. Support and urge the legislature to reduce the regulatory burden and prioritize investments, including the annual funding of dedicated funds, which are designed to meet the current and growing demands for nursing and allied health professionals.
Premium Tax Credit: Support efforts to preserve premium tax credits for insurers investing in qualified Louisiana investments and assessments paid to the guaranty associations.
Provider Taxes or Premium Taxes: Support legislative efforts to reduce local taxation on providers and health care plans. Oppose taxes, fees or assessments on health plans or health care providers that do not directly increase funding to the health plan or provider industry and therefore may increase the cost of employer-sponsored health care benefits. Support efforts to design protected fees or taxes that will enhance Medicaid funding to the industry group thereby reducing cost-shifting to consumers and employers.
Regulation of Private Organizations: Oppose burdensome regulation of private health care organizations that are not necessary to protect consumers and that increase administrative costs ultimately borne by patients and health plan members. Monitor the state’s efforts to implement changes required by federal law and oppose efforts that make those requirements more costly or burdensome on businesses. Oppose governmentally mandated price controls for private sector medical products, health care provider services, and health insurance, including interventions such as price setting. Oppose state imposition of restrictive licensing, regulations, or similar requirements that raise the cost of care. Oppose legislation or rulemaking that imposes burdensome bureaucratic regulations with no cost savings to employers, consumers or the state.
Professional & Civil Liability: Support efforts to promote the affordability and availability of professional liability insurance for health care providers that is reasonably balanced with the adequacy of recovery by patients injured due to negligence. Support mediation as an alternative to legal action to resolve disputes. Support and protect the Medical Malpractice Act, and oppose judicial and legislative attempts to weaken the Act or raise its cap. Oppose legislation that would create civil liability for employers and their health plans.
Technology and Innovation: Support and encourage the use of technology and innovation to deliver effective health care services.
Cost Shifting: Oppose changes to state health care programs that would shift payment responsibility from the state to employers, providers or insurers.
Fraud: Encourage and support efforts to hold providers and employees accountable for the misappropriation of funds by using fraudulent practices in their provision of services.
Immunizations: Oppose legislation that seeks to eliminate, alter or undermine the annual administration of vaccines requires for all students entering elementary school in accordance with the Louisiana Department of Health’s approved schedule. Oppose legislation that prohibits employers from requiring vaccinations as a condition of employment.
Ongoing Policy.
Mandated Benefits: Oppose new or expanded governmentally mandated benefits under employer health plans, unless it is demonstrated to employers through an objective, actuarial study to be a cost-effective mandate. Oppose new or expanded governmentally mandated payments by health plans for the benefit of a limited population or specific providers, unless it is demonstrated to employers through an objective, actuarial study to be a cost-effective mandate. Support state legislation that minimizes any adverse impact of federal health care mandates. Support legislation to provide employers with a tax credit for every mandated health care benefit they are required to provide.
Public/Private Partnerships: Support public/private partnerships in lieu of higher state taxes to restructure and improve the indigent health care system in Louisiana. Support meaningful restructuring of Louisiana’s health care delivery system, stressing solutions that provide efficiency while providing quality care, improved health care outcomes and appropriate funding to limit cost shifting. Support the use of existing public funds to empower the uninsured to access private insurance coverage.
Health Care Anti-Competitive Activity: Oppose legislation that would increase employer health care costs by allowing any health care organization to participate in any anti-competitive activity.
Indigent Care Funding: Support the concept of allowing dollars to follow the patients.
Employer Incentives: Support efforts to provide incentives for employers to offer affordable health care benefits.
Alternatives in Health Care: Support a cost-effective alternative to health care delivery which provides better access to care with an emphasis on primary and preventative care.
Contacts.
Patrick Robinson serves as Health Care Council Director. In this capacity, his responsibilities include health care insurance matters that impact employer costs.
Patrick Robinson
Director, Health Care Council | LABI
patrickr@labi.org
Beverly Moore Haydel
Chair, Health Care Council
Sequitur Consulting
Beverly.Haydel@sequiturla.com
Small business owners struggle to provide their employees with health insurance. About 8 in 10 are concerned about health care prices.
Last year, President Donald Trump took steps to change that. His administration finalized a rule that would let small businesses band together and buy less expensive health plans.
I own a small business here in Louisiana — DonahueFavret Contractors in Mandeville — and I know how beneficial such cost-saving measures can be. Unfortunately, the rule is tied up in court. That's disheartening.
When it comes to accessing affordable insurance, large employers have several advantages. They have more bargaining power when negotiating with insurers and providers because they represent so many policyholders. A larger pool of people also makes it easier for big employers to disseminate risk and absorb high-cost claims.
The recent Trump administration rule aims to level the playing field between small employers and large ones. It allows businesses in the same industry or geographic area to enroll in an Association Health Plan — or AHP — that is regulated like the plans available to larger businesses. The rule even allows self-employed workers to join an AHP.
These plans can yield huge savings. AHPs are likely to have about 30 percent lower premiums than those associated with traditional small-group coverage.
Unsurprisingly, when the rule was finalized, many Americans joined AHPs. That is expected to continue — but only if the rule makes it out of court.
Last year, a group of Democratic attorneys general filed a lawsuit claiming the AHP rule violated laws that govern the health insurance markets. A district court judge ruled in their favor this March — a decision the Department of Justice has appealed.
The district court's ruling hits Louisiana particularly hard. Our state is home to more than 430,000 small businesses. For small businesses nationwide, the average family's health insurance premium increased 20 percent from 2013 to 2018.
Louisiana's self-employed workers struggle to afford care, too. From 2014 to 2019, average individual premiums surged nearly 50%.
As board chairman of the U.S. Chamber of Commerce, I am fighting to make sure workers can benefit from AHPs. Recently, the Chamber filed an amicus brief defending the AHP rule in court. We were joined by the National Federation for Independent Business and 65 state and local groups, including the Louisiana Association of Business and Industry.
We need more choices for affordable health insurance. AHPs are a great option for small businesses and self-employed workers. Let's hope our courts realize this.
Maura Donahue
Board chair, U.S. Chamber of Commerce
Covington
By: Stephen Waguespack
Since 1975, the Louisiana Association of Business and Industry (LABI) has made it our mission to serve our diverse business membership by working towards the singular goal of fostering a climate for economic growth by consistently championing the principles of free enterprise. LABI is proud to be Louisiana’s official state chapter of the U.S. Chamber of Commerce and the National Association of Manufacturers. We have over 2,300 members, representing businesses of every size and industry sector that employ over 320,000 people.
These thousands of jobs are the backbone of the Louisiana economy, and we do all we can to protect the ones we have and attract more for the betterment of the state. On most days, you will find us working toward this mission by developing, promoting and advocating for smart policies that lead to economic growth and improved societal outcomes in Louisiana. On other days, we are hard at work convening public events and executing many other efforts behind the scenes to help employers invest in their communities, expand their operations and navigate the ever-changing landscape of complex governmental regulations and mandates.
A key tool in this effort – the LABI Benefits Center – is soon to become an even more critical asset for Louisiana employers and workers.
The LABI Benefits Center is a one-stop shop (www.labibenefitscenter.com) of employee benefits and administration tools that are among the best in the market today – all in one central location with specialized offerings for LABI companies. It helps our members get the tools they need to maintain their workforce and run their business… at a price they can afford…and at a convenience level that helps them stay focused on their products and customers. The LABI Benefits Center offers a myriad of insurance solutions to meet the unique needs of any size business, simple automation of Human Resource functions, regulatory compliance systems, COBRA management, cafeteria plans and a variety of other supplemental benefits packages.
Many LABI members have taken advantage of these services over the years, and recent action in Washington D.C. could cause demand to skyrocket.
Last October, President Trump signed an Executive Order focused on providing more competition and flexibility in the health care market. One provision of this order was to direct the U.S. Department of Labor (DOL) to issue regulations that would “expand access to health coverage by allowing more employers to form Association Health Plans (AHPs).” Those proposed rules were released last week.
AHPs are plans that allow multiple employers to pool together as a single group or association to buy insurance in a more market-driven way. This flexibility gives them stronger buying power and additional flexibility to structure benefit packages that best meet the needs of their business and employees.
The DOL’s proposed AHP regulations will be open for comment for the next 60 days, and we encourage our members to offer their input directly to the federal agency. For the specific language included in the Executive Order or directions on how to comment, click on the following link: https://www.federalregister.gov/documents/2018/01/05/2017-28103/definition-of-employer-under-section-35-of-erisa-association-health-plans.
LABI’s Director of Health Care, Renee Amar, is also available as a resource for anyone who might need or want help with the comment process. She can be reached at reneea@labi.org.
No matter what the final DOL regulation looks like, the LABI Benefits Center will be here to help.
Small businesses have enough to worry about these days. Especially when weak markets and scarce capital options are joined by predatory lawsuits, complex tax codes and ever-changing governmental mandates. The complications of running a business can seem overwhelming at times, and many employers are increasingly concerned about how they can stay afloat…which is exactly why the LABI Benefits Center was designed. We want to make it easier for them to focus on what they do best, rather than be overwhelmed by everything else.
Since 1975, it has been our goal to help employers of all sizes whenever we can…however we can…any way we can. We encourage businesses of all sizes to check out the ways LABI can help you find affordable solutions to your everyday challenges by visiting www.labibenefitscenter.com or call us at 888-816-5224.
By: Stephen Waguespack
Abraham Lincoln once said, “Give me six hours to chop down a tree and I will spend the first four sharpening the axe.”
His point is clear: take the time on the front end to adequately prepare for a task if you want to do it right and without unnecessary complication. This advice is quite relevant and timely as the new Congress and incoming Administration tackle the critical challenge of repealing and replacing Obamacare.
It should be obvious to everyone that Obamacare needs to be replaced with a better consumer-driven health care system and folks are right to be downright antsy to get it done. Since its inception, Obamacare has proven to be a market disruption of epic proportions, ushering in a new era of manipulated markets, inflated costs, limited options, distorted risk pools and bureaucratic micromanagement of personal health care decisions.
The 2010 law contained over 900 pages and was passed in typical Washington DC fashion, meaning many of the Congressional members that supported it had not even read the bill in its entirety. In fact, then Speaker Nancy Pelosi incredulously said at the time that Congress had to first “pass the bill so you can find out what is in it.”
Roughly 20,000 pages of new regulations were required to implement this massive restructuring of the critical American health care market that makes up over 15% of our national economy. In fact, last year alone, Americans spent roughly $3.35 trillion on health care, equating to $10,345 per person.
Costs have gone up due to the Congressionally mandated limitations on accounting for risk and many small businesses are finding it harder and harder to keep up with the costs. Some people with private insurance are being shifted out of the market and incentivized to drop their private coverage in exchange for a federal Medicaid plan with less robust care options, lower rates for providers and higher costs for taxpayers.
The demand from most voters for a better, smarter, more efficient and affordable approach to health care is deafening. The temptation to hastily rip Obamacare out and throw it away before thinking through what should replace it is hard for many to ignore.
Obamacare is clearly broken and the clamor for repealing it is justified. However, taking the time to do it right is critical to making sure we don’t make a bad situation even worse. Congress must first clearly articulate a more patient-centered approach for the health care markets of tomorrow if they truly want to replace Obamacare today with something better, not just something different.
If Obamacare is repealed before a suitable replacement is clearly defined and vetted, the vacuum created may open the door to a further collapse of the individual insurance market and a rush to greatly expand the very same rolls of the expensive and unreformed federal health care programs already eating up too much of our federal and state budgets. That type of scenario would not only fail to solve our Obamacare problem, but it would also disrupt the markets in ways that could even more directly affect taxpayers, providers and consumers alike.
As a smart replacement and responsible timeline is put together, a few principles must be kept in mind.
The replacement should be consumer driven and focused on empowering individuals (rather than bureaucrats) to find the care, cost and coverage that best meets their needs. It should target onerous taxes for elimination, such as the health insurance tax (HIT) and the employer Cadillac tax, that are driving up costs and unnecessarily restricting plan options. It should eliminate the employer mandates and associated reporting requirements that are creating an IRS audit trap for many employers who are fighting for survival in this recession. They should also take great caution to ensure healthy competition for a strong private individual market that can lead to better coverage and the lower prices that are necessary to give people affordable options. It should also seek to resolve the fundamental problems in the current system that proved major challenges even before Obamacare, such as the way Medicare and Medicaid pay for services based on volume, where neither the payor, the provider, nor the consumer are incentivized to keep costs under control.
The voters have spoken and the message is clear. A new Congress and President have their marching orders. The majority of Americans want Obamacare to be repealed and replaced with a more consumer-centered health care plan that puts them back in control.
As evidenced by the more than 60 bills filed thus far to repeal parts of or all of Obamacare in the House of Representatives, Congress has obviously gotten the message and has many different thoughts on how best to do so. Repealing Obamacare is a top priority. Replacing it with something better is an absolute necessity.
The chopping will soon begin. Before they swing that axe, Congress should first take the time to sharpen that blade with a smarter alternative. Taking the time to do so will ensure it is done right and without unnecessary complication.