House Bill 1047 HB 1047 – Disclosure of health care spending. Rep. Dickinson. Passed the House on Third Reading 51 to 46 along party lines.
Now here is a really interesting bill. It requires an applicant for or a recipient of medical assistance from the state to disclose the person’s employer or the employer of a person who provides them with support. If a particular employer gets listed on by 50 or more recipients of state medical assistance, the Family and Social Services Administration (FSSA) has to include the employer in a report to the legislative council, along with information about how many of the employer’s employees are relying on state medical assistance and how much that assistance costs the state. In addition, an employer with more than 1,000 employees is required to disclose to the Department of Labor the total dollar amount the employer spent on health care benefits for employees during the previous calendar year, the percentage of the payroll spent on health care benefits, and the average amount spent per employee.
To me, the part of the bill seeking to identify the employers of recipients getting state medical assistance is more interesting than the health care expenditures of large employers. What percentage of people in Indiana work for an employer with over 1,000 employees? Will such reporting tell us much about health care for Hoosier workers generally?
But, identifying employers who, for whatever reason, have a non-trivial number of employees or employee families who still need medical assistance should tell us quite a bit about how beneficial a particular kind of job is to the community generally. For example, this sort of information could be useful when state or local government is deciding whether it is getting its money’s worth out of an incentive package.
Of course, it’s something of a band-aid for the larger problem. I don’t think it makes much sense for health care to be tied to employment in any case.
[tags]HB1047-2007, health care[/tags]
My understanding is that this is a legacy of wage/price controls during World War II – since there was a tight labor market, one way for employers to attract employees was to offer complete free medical.
At the time, this was fairly cheap – remember that the medical capabilities of the day were just a fraction of what we take for granted today.
So medical coverage came to be expected, and written into standard employment agreements and union contracts, just as medical capabilities were set to grow explosively.
It’s good to have the new capabilities, of course – but the payment mechanism got firmly tied to employment and then became a much larger expense then anticipated, with the resulting disconnects between payer, provider, and patient that we are trying to address today.
Sounds as if the legislation is aimed at the Wal-Mart/big box store type employers. Major papers in other states have written stories about how Wal-Mart has the largest numbers and/or percentage of employees seeking Medicaid, CHIPS for their children, etc. I don’t know if any such story has ever run in the Indianapolis Star, however.
If the collection process doesn’t cost a lot of money, I think it’s good data to gather. For big boxes, it’ll give towns the ability to see more of the true costs they never talk about.
Towns already go in the hole on big boxes; you’re providing services on Day 1, but they don’t pay a full property tax bill (IIRC) until the third year of business.