Never Mind Washington; Here's How to Moderate Health Insurance Premiums

Posted by Rick Lord on Mar 12, 2017 3:09:56 PM

You’ll excuse Massachusetts employers for being cynical as they watch the health-care debate in Washington unfold while they struggle to manage the crushing financial burden of providing good medical insurance to their employees.

health_care.jpgThe truth is that federal health-care reform, whatever its final structure, will do little to moderate the accelerating premium increases that employers and workers alike now face. Trumpcare, like Obamacare and Romneycare before it, is primarily about extending coverage rather than addressing the underlying drivers making health insurance more expensive for companies.

That’s why employers – a results driven group if ever there was one – want to know how the nation is going to solve the cost problem so that business owners don’t get knots in their stomachs every time they receive their insurance premium renewals.

The good news is that Massachusetts is beginning to identify some answers. And there appears to be enough common ground and political will on the issue to pursue some solutions.

New research conducted by the Massachusetts Health Policy Commission suggests that Massachusetts employers, insurers and policymakers could reduce total health-care expenditures anywhere from $279 million per year to $794 million per year, or 0.5 to 1.3 percent, by making seven improvements to the health-care system.

The improvements:

  • Shift community appropriate care to community hospitals – Reduce by 5-10 percent the number of cases treated at teaching hospitals that would be more appropriately treated at community hospitals. Savings: $43 million to $86 million.
  • Reduce hospital readmissions – Cut the 2015 hospital readmission rate from 15.8 percent (78,000 readmissions) to a range of 15 to 13 percent. Savings: $61 million to $245 million.
  • Reduce avoidable emergency room visits – More than 900,000 emergency room visits during 2015 were considered avoidable. Shift 5-10 percent of those avoidable visits to lower-cost settings. Savings: $12 million to $24 million.
  • Reduce use of institutional post-acute care – Redirect 5-21 percent of the patients who currently leave hospitals to go to institutional rehabilitation facilities into home care. Savings: $46.6 million to $186 million.
  • Provide incentives for consumers to choose high-value primary care providers.
  • Increase the use of alternative payment methods -The commonwealth wants to increase the percentage of HMO participants covered by alternative payment methods from 58.5 percent in 2015 to 80 percent this year. Savings: $23 million to $68 million.
  • Reduce the growth of prescription-drug spending – Cut the growth-rate of spending on prescriptions from 5.0 percent in 2016 to 3.6 percent to 4.3 percent. Savings: $57 million to $113 million.

The Health Policy Commission is considering one major proposal that would encourage these improvements. The proposal would tighten the state’s benchmark for health-care spending growth from 3.6 percent to 3.1 percent annually. AIM supports the measure.

The spending growth benchmark, established as part of the health-cost control law of 2012, is a critical component for understanding year-over-year increases in health- care spending. AIM has always favored an aggressive goal – the organization joined with the Greater Boston Interfaith Organization in 2012 to support setting the health-care cost growth benchmark at two percentage points below the growth in the state’s economy.

The association ultimately supported the establishment of a 3.6 percent benchmark because we recognized the vital importance of creating a standard to measure cost-containment efforts.

But we have not yet seen sufficient progress. Massachusetts has exceeded the 3.6 percent benchmark in two of the past three measurement periods. Total Health Care Expenditures (THCE) grew by 4.2 percent from 2013 to 2014, and by 4.1 percent from 2014 to 2015.

These unsustainable cost increases are occurring in an industry where experts agree that at least a third of all care is unnecessary – delivered in the wrong setting; marked by a lack of coordination; provided with an inadequate emphasis on prevention; harmed by medical errors; burdened with rules and fraud; or just plain excessive.

AIM remains committed to pursuing the seven solutions outlined by the Health Policy Commission as a method of addressing the health-insurance premium crisis facing employers. It’s an approach that is sure to pay more immediate dividends than anything that will come out of Washington.


Topics: Health Care Reform, Health Care Costs, Health Insurance

Health Reform Repeal and Replace - What Does It Mean to Employers?

Posted by Russ Sullivan on Mar 7, 2017 11:33:38 AM

Republican members of the U.S. House of Representatives yesterday released their long-awaited alternative to the Affordable Care Act (ACA).  The proposed law retains some of the more popular features of the ACA while modifying or outright repealing others.

Health.Energy.jpgWhat would the proposal mean for employers in Massachusetts? Here is a quick, initial review of key provisions:

Employer-Provided Health Insurance:

  • Eliminates the employer mandate retroactive to December 31, 2015.
  • Eliminates taxes on prescription drugs, over-the-counter medications, health-insurance premiums, and medical devices.

Employer-Provided Health Insurance and the Individual Health Insurance Market

  • Retains ACA provision allowing parents to retain dependents on their plan until they are 26. 
  • Health Savings Accounts - Allows individuals to contribute at the current family amount and allows families to contribute at twice the current family amount

Individual insurance market

  • Eliminates the individual mandate retroactive to December 31, 2015. 
  • Retains ACA prohibitions on pre-existing conditions, but effective in 2019 imposes a 12- month surcharge equal to 30 percent of the premium for enrollees in individual market who had a 63-day or more lapse of coverage in prior 12 months.
  • Effective January 1, 2020, repeals cost-sharing subsidies, currently available to individuals with incomes from 100 percent to 250 percent of the federal poverty level (FPL) to assist with out-of-pocket expenses
  • Effective January 1, 2020, eliminates the Premium Tax Credit for individuals purchasing health insurance in state exchanges, replacing that credit with tax credits for qualified plans on individual market.
  • Repeal of plan tiers based on actuarial value.
  • Increase age ratio for plan costing from 3:1 to 5:1, allowing aged-based cost variations to differ by as much as five times based on enrollee’s age.

Tax credits for Qualified Plans on the Individual Market

  • Annual credits begin at $2,000 for 20 year olds, and increase by $500 per decade, capping at $4,000 for people in their 60s; reduced by 10 percent of modified adjusted gross income (MAGI) over $75,000 ($150,000 for joint filers); reduced by amount received under a small-employer health reimbursement plan; penalties on erroneous filers.
  • Effective January 1, 2020 payments may be made in advance and on behalf of eligible individuals directly to health plan provider.
  • Applies to plans on individual health insurance market and COBRA.
  • Qualified plans do not include those that cover abortion, except in case of rape, incest or when mother’s life is threatened.

The bill also establishes a Patient and State Stability Fund, which provides states with $100 billion over nine years to design programs promote participation and stabilize risks in the individual health insurance market.

That provision has a down side for Massachusetts -15 percent of the funds are available only to states that either experienced an increase in the uninsured population from 2013-2015 among people below the poverty level; or to states that have fewer than three health insurance plans available on their state exchange in 2017.  Massachusetts would forfeit 15 percent of the available funds for not meeting either of these requirements.

There are also provisions that would roll back the expansion of Medicaid, the federal health insurance program for low-income people, and change the manner in which Medicaid funds are allocated to states:

  • Effective January 1, 2020, repeals Medicaid eligibility expansion from individuals with incomes at or below 138 percent of federal poverty level; and to children, pregnant women, and breast cancer and cervical cancer patients with incomes at or below poverty level.
  • Effective January 1, 2020, changes state funding from claims-based allocations to “per capita” allocations, potentially reducing funding to eligible recipients in Massachusetts.
  • Eliminates ACA requirement that Medicaid provide “essential health benefits.”
  • Requires state to verify Medicaid eligibility every six months.

Expect animated discussion and debate on both the federal and state level as advocates and opponents dig into the details over the coming weeks.

Topics: Health Care Reform, Health Care Costs, Health Insurance

Employer Confidence Hits 13-Year High

Posted by Christopher Geehern on Mar 7, 2017 8:45:12 AM

Confidence among Massachusetts employers hit a 13-year high during February, fueled by optimism among manufacturers and an increasingly positive view of the national economy.

BCI.February.2017.jpgThe Associated Industries of Massachusetts Business Confidence Index (BCI) rose 0.7 points to 62.1 last month, seven points higher than its level of a year earlier and the highest reading since August 2004. Driving the increase was the U.S. Index of national business conditions, which has risen 11.5 points during the past year, and the Manufacturing Index, which surged 9.1 points.

The results came amid increasingly mixed economic signals that included a 2.8 percent Massachusetts unemployment rate and a significant slowdown in economic growth both in Massachusetts and nationally during the fourth quarter.

“The increase in confidence was more modest than we have seen in previous months. Employers projected a generally positive view of the economy, but were also taking the measure of potential economic policy changes in Washington,” said Raymond G. Torto, Chair of AIM's Board of Economic Advisors (BEA) and Lecturer, Harvard Graduate School of Design.

“Employers remain more optimistic about the future than about the present - a good indicator of the potential for continued growth and investment both in Massachusetts and nationally.”

The AIM Index, based on a survey of Massachusetts employers, has appeared monthly since July 1991. It is calculated on a 100-point scale, with 50 as neutral; a reading above 50 is positive, while below 50 is negative. The Index reached its historic high of 68.5 on two occasions in 1997-98, and its all-time low of 33.3 in February 2009.

The index has remained above 50 since October 2013.

Almost all of the sub-indices based on selected questions or categories of employer were up during February.
The notable exception was the Massachusetts Index, assessing business conditions within the commonwealth, which declined 0.2 points to 63.2. The state index nevertheless remained 6.8 points higher than in February 2016.

Meanwhile, the U.S. Index of national business conditions gained ground for the fifth consecutive month. Employers appear encouraged by the possibility that Congress and the new administration will pass growth measures that could include tax and regulatory reform.

February marked the 82nd consecutive month in which employers have been more optimistic about the Massachusetts economy than the national economy.

The Current Index, which assesses overall business conditions at the time of the survey, increased 0.5 points to 59.9 while the Future Index, measuring expectations for six months out, rose 1.1 points to 64.4. The future outlook was 8.5 points better than a year ago and higher than at any point since May of 2004.

The sub-indices bearing on survey respondents’ own operations were mixed.

The Company Index, reflecting overall business conditions, rose 0.9 points to 62.8 while the Employment Index gained two points to 60.4. The Sales Index lost 0.4 points to 62.6.

The AIM survey found that nearly 39 percent of respondents reported adding staff during the past six months while 19 percent reduced employment. Expectations for the next six months were stable – 37 percent hiring and only 10 percent downsizing.

Michael Tyler, Chief Investment Officer, Eastern Bank Wealth Management, and a BEA member, noted that the traditional confidence gaps between manufacturing companies and non-manufacturers, and between companies located in the eastern and western portions of Massachusetts, have closed in recent months.

“Confidence among Massachusetts manufacturers has risen 9.1 points during the past year and now stands at 61.2 compared to 63.0 for non-manufacturers. And confidence among companies in western and central Massachusetts hit 61.8 in February compared to 62.6 for companies in the eastern part of the state,” Tyler said.

"Those results suggest that the benefits of economic growth are finally spreading from Greater Boston to the entire state. What's more, as the dollar's rise has stabilized, manufacturers are finally sharing the positive view that service sector employers have felt for several years."

AIM President and CEO Richard C. Lord, also a BEA member, said the 2.8 percent unemployment rate in Massachusetts and the commonwealth’s designation last week as the best state in the nation by US News and World Report underscore the fact the Bay State economy remains strong.

At the same time, Lord said, employers face an uncertain mix of policy initiatives in Washington.

“Employers are certainly enthusiastic about lower corporate taxes, streamlined regulation and a meaningful infrastructure program. They are not as enthusiastic about withdrawing from trade agreements and once again having to process major changes in health reform,” he said.

Topics: AIM Business Confidence Index, Massachusetts economy, Massachusetts employers

AIM, Advocates Reach Deal on Protections for Pregnant Workers

Posted by Brad MacDougall on Mar 1, 2017 3:56:22 PM

Associated Industries of Massachusetts has reached agreement with the advocacy group MotherWoman on compromise legislation to extend employment protection to pregnant workers in Massachusetts.
The contours of the agreement were established late last year and affirmed recently when Senator Joan Lovely of Salem and Representative David Rogers of Belmont refiled the compromise bill.

The Pregnant Workers Fairness Act would require employers to make reasonable workplace accommodations for pregnant employees — more frequent or longer breaks, temporary transfer to a less strenuous or hazardous position, a modified work schedule, or seating for those whose jobs require extended standing. Businesses would not have to provide those accommodations if doing so would create an undue business hardship, defined as something “requiring significant difficulty or expense.”

AIM opposed early versions of the bill during the 2015-2016 legislative session because of concern among employers that the legislation provided an applicant or employee with unlimited power to reject multiple and reasonable offers of accommodation by an employer. The compromise bill addresses that concern and others

Richard C. Lord, president and CEO of AIM, said “AIM was pleased to work together respectfully on this bill with Senator Lovely, former Representative Ellen Story, and advocates from MotherWoman.  It is easy to confuse opposition to a draft of a bill with opposition to the issue itself. AIM is always willing to work with those seeking honest and effective compromise. That is exactly what happened with this legislation.”

Other AIM concerns addressed by the bill:

  • Provides clarity regarding definitions and terms related to current employees in need of accommodations related to pregnancy.
  • Aligns state and federal laws regarding reasonable accommodation as it relates to the essential functions of the job.
  • Provides flexibility rather than a mandating specific types of accommodations for employers and employees.
  • Provides a reasonable mechanism for employees and the employer to achieve a reasonable accommodation by engaging in a defined process, eliminating a concern by businesses that an employee could reject multiple reasonable offers of accommodation.
  • Adds language allowing the employer to evaluate undue hardship of an accommodation and the ability of employee to perform the essential functions of the job as it relates to an employer’s program, enterprise or business.
  • Provides opportunity for an employer to request documentation for certain cases to ensure that accommodations are reasonable for both employees and employers.
  • Limits provisions to current employees instead of employees and job applicants.
  • Reduces unnecessary burdens and allows for electronic or other means other than a “poster” for notifying employees.
  • Allows for certain accommodations to be either paid or unpaid.

MotherWoman said in a statement: “We are excited that we've reached agreement on how to level the playing field for the hard-working women of Massachusetts.

"Through a great collaborative effort among legislative sponsors, Rep. Dave Rogers, Rep. Ellen Story and Sen. Joan Lovely, our dedicated legal advocates at A Better Balance, and the team at AIM — who were so generous with their time and their attention to detail — we have a better proposal, which led to the refiling of this bill. It’s an important support for moms, children and families, and it makes good sense for both employers and employees."

The compromise faces a long process of legislative consideration. Senator Lovely expects the refiled bill will go before the Joint Committee on Labor and Workforce Development and its new chairs - Representative Paul Brodeur of Melrose and Senator Jason M. Lewis of Winchester - with a hearing scheduled later this year.

AIM and MotherWoman expect to support the measure at that time and hope that the bill will be considered by the full Legislature later in the session and sent to the governor for his approval.

Topics: Massachusetts Legislature, Employment Law

'Day Without a Woman' Poses Issues for Employers

Posted by Tom Jones on Feb 28, 2017 10:00:00 AM

Political activists are calling for women to stay home from work on March 8 as part of “A Day Without A Woman” general strike.

Womens March.jpgThe “one-day demonstration of economic solidarity” comes three weeks after a similar “Day Without Immigrants” caused thousands of people to remain out of work or to close their small businesses to protest Trump Administration policies on immigration. Some employers supported the walkout but at least 100 employees around the country who took part in the job action were fired.

Associated Industries of Massachusetts has taken no position on A Day Without a Woman, but since these strikes are expected to continue, the association believes it should help employers prepare to respond.

There are more questions than answers at this point, so our suggestion to employers is to proceed cautiously in dealing with employees who participate in the strike.

Issues to consider include:

  • Do employees have a legally protected right to skip work to protest or to support a political cause? If not, may an employer discipline employees who participate?
  • Are these employees on strike as defined under the National Labor Relations Act (NLRA), making it concerted - and thus legally protected - activity?
  • Does disciplinary action against immigrant employees equate to national-origin discrimination under federal and state law?
  • What, if anything, can an employer do to prevent employees from walking out?
  • How far may an employer go in monitoring employee political activities on/off the job?
  • May an employer terminate an employee for social media posts or for joining political groups?
  • Are there different rules for management versus non-management employees?
  • May employee use Paid Time Off or earned sick time to participate in the protest?
  • What constitutes reasonable advance notice for employees seeking to use Paid Time Off, vacation time or sick time?

The ability of employers to respond to workers who miss work to join political protests revolves largely around interpretation of the National Labor Relations Act (NLRA).

The act extends legal protections to non-union employees joining together to achieve a common end. So employers covered by the NLRA (i.e. nearly all employers in the U.S.) who take disciplinary action against employees for participating in a demonstration may expose themselves to a legal challenge.

The impact of losing an unfair labor practice case can be far reaching and expensive. It can also, in the extreme, result in a union being awarded representation even in the absence of an election.

Although disciplining an employee who doesn’t work a scheduled shift may be appropriate, employers need to make certain that it is consistent with company policies and practices and not impacted by the politics of the issue.

“The answer is somewhat murky,” says Charlotte Garden, an associate professor at the Seattle University School of Law in The Atlantic Magazine.

“The National Labor Relations Act protects workers’ rights to engage in concerted activity for mutual aid or protection, and the scope of what falls under that umbrella is quite broad. So it is likely that some forms of worker protest about the likely effects of Trump Administration policies on immigrant workers would be protected. But that protection would not necessarily include every tactic that workers might use.”


Are your hands completely tied? No.

Employers still have the right to enforce their existing attendance and notification policies. If someone fails to appear for work and does not to comply with the attendance policy, employers may take appropriate disciplinary action. Just be sure to avoid any possible action that may be construed as disparate treatment against one or more employees based on their legally protected status.

Employers should carefully review their attendance policy and determine if it achieves its intended purposes. Also, does the management team currently enforce the attendance policy as written? If not, it may be time to update and correct the practice and make sure all employees are aware of the policy. 

Please contact the AIM Employer Hotline at 800-470-6277 if you have questions.


Topics: Employment Law, Massachusetts employers, Donald Trump

Immigration Chaos Poses Unique Threat to Massachusetts Economy

Posted by Christopher Geehern on Feb 24, 2017 3:15:37 PM

The ongoing chaos surrounding US immigration policy poses a unique threat to the Massachusetts economy in its role as a global center for technology and medical science. Employers should be concerned.

FinancialServicesGraph-1.jpgThe Boston Globe published two compelling articles this week illustrating the vulnerability that knowledge-economy states like Massachusetts face amid potential travel bans, visa limitations and expedited removal proceedings.

The first article detailed how limits on H1B visas for skilled foreign workers hinder the growth of technology and other companies in Massachusetts. The Globe told the story of Brightcove, a high-flying video cloud services company and its fruitless attempts to obtain an H1B visa for a British software engineer who worked for 18 months to create the company’s new media delivery platform.

The H1-B program, as most employers know, is capped at 65,000 visas, with an additional 20,000 available to graduates of US universities with advanced degrees. Employers sought more than 236,000 H1B visas last year, so visas are awarded through a highly competitive lottery run by the US Citizenship and Immigration Services.

Technology companies fear that President Donald Trump, who has called the H1B a “cheap labor program,” may reduce the already strained visa cap.

The issue is an important one for Massachusetts. Brightcove employs 500 people and added 100 new employees last year, according to the Globe, but finds it increasingly difficult to attract skilled people in an economy running at 2.8 percent unemployment.

Brightcove ended up sending its key engineer back to England and creating a five-person product team overseas.

“If you want to go hire someone out of a top engineering school like MIT, by the time you get there, they’ve got five offers from big software companies that are many times larger than us,” Brightcove CEO David Mendels told the newspaper.

The second article reported that Massachusetts’ teaching hospitals are under intense pressure to reject qualified international medical students applying for residencies in the United States because of fears that President Trump’s immigration policies may bar the students from entering the country. Those fears escalated after an Iranian scientist who had obtained a visa to conduct research at Brigham and Women’s Hospital was twice prevented from entering the United States under President Trump’s initial immigration order.

Dr. Darrell G. Kirch, chief executive of the Association of American Medical Colleges, said “hospitals are being given an impossible choice” between hiring the best candidates, regardless of nationality, and ensuring they have residents ready to care for patients in July.

“This has served our country so well,” he said of the system used to funnel foreign medical graduates into the United States, “and it’s a tragedy that it’s being disrupted by uncertainty.”

Massachusetts has a significant stake in the issue not only because health care represents a significant contributor to the economy, but also because a shortage of primary care physicians put upward pressure on health-insurance premiums.

Both articles provide vivid reminders that the global industries upon which the Massachusetts economy is built are particularly sensitive to federal policy changes and budget decisions. And immigration issues will be child’s play compared to the potential fallout of changes to federal health care reform and Medicaid funding.

Should be an interesting spring.

Topics: Massachusetts economy, Donald Trump, Immigration

Massachusetts Exports Rise; Trade Policy Remains Unclear

Posted by Kristen Rupert on Feb 16, 2017 9:16:13 AM

Recently-released year-end 2016 trade statistics tell a positive story for Massachusetts.

Product exports from the commonwealth increased 2 percent last year, outperforming many other US states.  Massachusetts exports totaled nearly $26 Billion in 2016.

international.flagssmall.jpgAt the same time, the relationship with our top three trade partners—Canada, Mexico and China—is likely to change as a result of new trade policies sought by the Trump administration.  What might this mean for Massachusetts companies?

The new president and his executive team have committed to renegotiating long-standing trade relationships and agreements.  First in line is NAFTA—the trilateral North America Free Trade Agreement among the US, Canada and Mexico that took effect 23 years ago.

 Many experts agree that changes to NAFTA are long overdue.  However, there is concern that the Trump administration may abandon NAFTA altogether and pursue separate bilateral agreements—one with Canada and a separate one with Mexico.  This would create significant disruption for many companies with global supply chains across North America. 

The new Trump trade team is not yet installed, which will likely delay negotiations about NAFTA.  Advocates within the manufacturing community, however, are already gathering stories about how individual US companies have grown jobs as a result of business with Canada and Mexico.   Getting this data to Congressional leaders and the new presidential administration will be critical in persuading Trump trade professionals to tweak, and not eliminate, NAFTA. 

Another proposal in play is the border tax.  Imports would be taxed at a rate up to 20 percent.  A complementary plan to reduce the overall US corporate tax rate is being touted as a potential offset.  The border tax would mean that large importers such as Walmart and Target would suffer and likely pass along cost increases to customers, while big exporters—Caterpillar, GE, Boeing - would benefit.  Small companies dependent on components produced in China or Mexico would also be hard hit by an import tax.  As with all tax rate changes, we’ll see winners and losers. 

No China trade announcements have been made since President Trump was inaugurated.  His telephone call last week with China president Xi Jinping was a first step toward repairing the damage caused by Mr. Trump’s earlier denunciation of the US’ long-standing “one China” policy.  Mr. Trump had suggested imposing tariffs of up to 45 percent on imports from China, but that proposal has not yet gained traction.

In a promising development, Mr. Trump last week signaled his support for the US Export-Import Bank, which has been operating for more than a year without a board quorum and unable to approve loans of more than $10 million.  Mr. Trump’s statement represents a departure from his previous skepticism about Ex-Im Bank. The president may make a statement about Ex-Im during his visit to Boeing in South Carolina tomorrow. 

If you are one of the more than 10,000 exporting companies in Massachusetts and you have concerns, praise or questions about proposed federal trade policy, please let AIM know.  We are in regular communication with industry and government leaders and your insights are invaluable as we convey what’s important about trade and growing the Massachusetts economy. 

Topics: International Trade, Massachusetts economy, Donald Trump

Employers: Federal Health Reform Must Change

Posted by Katie Holahan on Feb 8, 2017 10:00:00 AM

Massachusetts employers believe overwhelmingly that federal health-care reform must change, but their opinions about how to do so vary widely.

Health_Care_Reform.jpgA new AIM survey finds that 43 percent of Bay State employers think that Congress and President Donald Trump should make changes to the existing Affordable Care Act, or Obamacare. Forty percent favor repealing the law and replacing it with an alternative program.

Eleven percent want to leave the current system in place while seven percent would repeal the reform law without an alternative.

The president and the Republican-controlled Congress have made “repeal and replace” a centerpiece of their governing priorities for the first 100 days. Republicans have yet to agree upon an alternative, but appear to favor eliminating the tax penalties imposed on people who go without insurance and on larger employers who do not offer coverage to employees.

The AIM survey was taken in January and is based upon responses from 162 employers from all sectors of the Massachusetts economy.

“The paperwork for Obamacare is ridiculous and terrifying for the regular person,” wrote one employer.

“We used to get one bill and now you get a bill from each doctor and have to wait for explanation of benefits and pre-register for everything. They have made health care so many layers it's no wonder the prices are through the roof.”

Another employer echoed that frustration.

“Trying to make changes to a 2,700-page bill with over 40,000 pages of accompanying regulations is bizarre. Start over,” the employer wrote.

Richard C. Lord, President and Chief Executive Officer of AIM, said employers supported the 2006 Massachusetts health-care reform as a first step to controlling the cost of providing health insurance to workers. Federal reform caused upheaval for many small employers in Massachusetts, but Lord also warns that an ill-considered repeal might put at risk billions of dollars in federal Medicaid funding that made the Bay State reform so successful.

“The expansion of Medicaid is exerting significant financial pressure on the state budget. Our hope is that policymakers in Washington can agree on some common-sense tweaks to Obamacare that would work to everyone’s benefit.”

Republican leaders formulating a replacement health reform have talked about eliminating tens of billions of dollars provided each year to states that have expanded eligibility for Medicaid. They have also discussed repealing subsidies for private health insurance coverage obtained through the public marketplaces known as exchanges.

The 2010 federal reform imposed taxes and fees on certain high-income people and on health insurers and manufacturers of brand-name prescription drugs and medical devices, among others. Republicans have not said for sure which taxes they will scrap and which they may keep.

The policy debate in playing out amid growing signs of accelerating health-insurance premium costs.

“My insurance premiums increased 24 percent this year. That is a little excessive,” one employer wrote.

Topics: Health Care Reform, Health Care Costs, Health Insurance

Employer Confidence Rises for Fifth Consecutive Month

Posted by Christopher Geehern on Feb 7, 2017 8:42:41 AM

Confidence among Massachusetts employers rose for the fifth consecutive month during January despite a marked slowdown in economic growth during the fourth quarter of 2016.

BCI.January.2017.jpgThe Associated Industries of Massachusetts Business Confidence Index (BCI) rose one point to 61.4 last month, a full 5.6 points higher than a year earlier and the highest reading since December 2004. The confidence increase came during a month when the Massachusetts unemployment rate fell to 2.8 percent and Bay State employers created more than 72,000 new jobs for the year.

At the same time, national economic growth slowed to an annual rate of 1.9 percent during the final three months of 2016, while the Massachusetts economy downshifted to a 0.5 percent growth rate from 3.1 percent during the third quarter.

“The good news is that unemployment in Massachusetts remains well below the national rate of 4.7 percent, but that low jobless rate may also be creating labor-force capacity constraints that are slowing output,” said Raymond G. Torto, Chair of AIM's Board of Economic Advisors (BEA) and Lecturer, Harvard Graduate School of Design.

“Employer confidence seems to be tracking the overall optimism of financial markets that continue to hit record highs. It will be instructive to see how that enthusiasm holds up as Congress and the new administration get down to the business of governing.”

The AIM Index, based on a survey of Massachusetts employers, has appeared monthly since July 1991. It is calculated on a 100-point scale, with 50 as neutral; a reading above 50 is positive, while below 50 is negative. The Index reached its historic high of 68.5 on two occasions in 1997-98, and its all-time low of 33.3 in February 2009.

The index has remained above 50 since October 2013.

Constituent Indicators Uniformly Higher

All of the sub-indices based on selected questions or categories of employer were up to start 2017.

The Massachusetts Index, assessing business conditions within the commonwealth, rose to 61.8, leaving it 5.2 points ahead of the same time last year.

The U.S. Index of national business conditions inched up 0.1 points to 57.6 - 7.5 points higher than in January 2016. January marked the 81st consecutive month in which employers have been more optimistic about the Massachusetts economy than the national economy.

The Current Index, which assesses overall business conditions at the time of the survey, increased 0.3 points to 59.4 while the Future Index, measuring expectations for six months out, rose 1.6 points to 63.3. The future outlook was 6.1 points better than a year ago and higher than at any point since March 2015.

Operational Views Strengthen

The sub-indices bearing on survey respondents’ own operations also strengthened.

The Company Index, reflecting overall business conditions, rose one point to 61.9 while the Employment Index gained 1.2 points to 58.4 and the Sales Index 0.7 points to 62.1.

The AIM survey found that nearly 39 percent of respondents reported adding staff during the past six months while 18 percent reduced employment. Expectations for the next six months were stable – 37 percent hiring and only 10 percent downsizing.

“One of the elements driving the overall increase in employer confidence is a rapidly brightening outlook among manufacturers,” said Katherine A. Kiel, Ph.D., Professor of Economics, College of the Holy Cross in Worcester and a BEA member.

“The AIM Manufacturing Index has risen 8.5 points during the past five months, driven by a positive outlook on sales and hiring. Manufacturing optimism also bodes well for capital investment and research and development going forward.”

Companies in the eastern part of the Massachusetts were more optimistic at 63.0 than those in the western part of the state at 59.0.

AIM President and CEO Richard C. Lord, also a BEA member, said the emerging labor-force constraints underscore the importance of maintaining a world-class training and education system in Massachusetts. He noted that in the area of manufacturing, AIM has filed legislation to provide a 50 percent tax credit for eligible expenses for employees who receive certification through the Massachusetts Manufacturing Advancement Center Workforce Innovation Collaborative’ s (MACWIC) Applied Manufacturing Technology Pathway Certification Program.

“As employers find it increasingly difficult to locate appropriately skilled employees, we are reminded that our economic future depends upon the ability of Massachusetts to educate all children and all incumbent workers with the knowledge our companies need to prosper in a complex global economy,” Lord said.

Topics: AIM Business Confidence Index, Massachusetts economy, Economy

New Solar Subsidy Program Gets It Right

Posted by Robert Rio on Feb 2, 2017 2:00:00 PM

The Massachusetts Department of Energy Resources (DOER), after months of public comment, released on Tuesday its proposal for a new solar-energy incentive program to replace the complex and overly expensive program now in place.

solarpanels.small.jpgWe think the state got it right. And employers and other electric customers will be the better for it.

The proposal adopts suggestions made by AIM to rely on market competition to establish the amount of incentives that developers will receive to install solar energy. The result will be a program that costs half as much as the current one and still encourages the development of solar installations throughout the commonwealth.

Total savings to employer and other electric ratepayers: $250 million per year.

The new program will eliminate Solar Renewable Energy Credits (SREC), one of two methods through which solar developers currently collect subsidies. The other, net metering credits, will remain unchanged.

While some of the details are still being worked out, the new program, called the Solar Massachusetts Renewable Target program or SMART program, will establish a solar tariff rate only after bidding is complete for an initial 200 megawatt block of solar projects. Developers will receive that bid price for 20 years.

That incentive rate will remain the same for all solar projects and will automatically decline 4 percent for every 200 MW block in the future. There will be some “adders” to the base price - for building-mounted systems, solar canopies, and cases in which solar is combined with storage technologies - that would add small amounts to the baseline price.

Projects may still receive net metering credits, but those will offset the tariff to determine the final subsidy. So if the base rate is established at 15 cents and the developer receives net metering credits of 10 cents, the utility will make up the 5-cent subsidy through the tariff.

AIM opposed the scope of the current solar program and was concerned that early proposals for the new program relied on government officials to set tariff levels for solar incentives without using the competitive market to drive down costs to the ratepayer. Such a system would fail to pass along to the ratepayer the 50 percent reduction in solar installation costs that have occurred over the last few years. 

Driving down costs is important for the future of the Massachusetts economy. Massachusetts not only has one of the highest electricity costs in the country, but one of the most generous solar and renewable incentive programs, adding up to nearly $1 billion in 2016 and $2 billion by 2020. Those subsidies add up to nearly 4 cents per kilowatt hour for individual customers even before the new solar incentive program kicks in.

AIM, in a series of comments, urged DOER to adopt a model based on competition. Other states where solar installations cost half as much as Massachusetts already use the competitive model.

Read First Set of AIM Comments

Read Second Set of AIM Comments

Competition reduces prices. Competition is also the hallmark of the recently passed Massachusetts energy bill, which requires utilities to solicit market proposals for hydropower and offshore wind, a notion AIM supports.

The solar proposal still needs to go through public comment and any tariff needs to be approved by the Massachusetts Department of Public Utilities. During the transition period between now and the point at which the new program is approved by the Department of Public Utilities (DPU) – expected January 2018 - the existing solar incentive program will remain in place at a lower incentive rate.  

DOER has developed a program that is well thought-out and enjoys wide support. AIM commends DOER for this step in the right direction and we look forward to working with the Baker Administration and others to get this program approved and implemented as soon as possible. 

If you are interested in following this issue and engaging with AIM on Massachusetts electricity prices, contact me at or 617-262-1180

Review the DOER Proposal

Topics: Energy, Solar Subsidies

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