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Much at Stake for Employers in Final 100 Days of Legislative Session

Posted by Rick Lord on Apr 23, 2018 8:30:00 AM

Today marks 100 days until the Massachusetts Legislature wraps up formal business for its 2017-2018 session.

ExteriorThe end of formal sessions will bring with it the usual eleventh-hour debate on bills that will otherwise have to go back to the starting line when a new session begins in January 2019. Informal sessions continue through the end of the year, but the rules of the Legislature make it all but impossible for controversial bills to pass.

Associated Industries of Massachusetts, as the statewide employer association, looks forward to representing employers late into the evening of July 31 – perhaps into the wee hours of August 1 – as lawmakers consider bills that could have a profound effect on employers and the Massachusetts economy.

But the real Beacon Hill deadline that employers need to keep their eye on this year is the first week of July. That’s because the end of the legislative session is inextricably bound up with four potential questions that could appear on the November election ballot, and any compromise on those issues will have to be wrapped up before ballots go to print in early July.

The most important issues for AIM at the end of the session all revolve around these potential ballot questions and ongoing negotiations intended to develop compromises that could be approved by the Legislature before July 31.

AIM has been part of negotiations for more than six months on a proposal to mandate paid family and medical leave for Massachusetts employees.

The association opposes the question, which would cost $1 billion annually by allowing covered workers to take up to 16 weeks of family leave or 26 weeks of medical leave. Workers could take family leave to care for a child after the child’s birth, adoption, or placement in foster care; to care for a seriously ill family member; or to address needs arising from a family member’s active duty military service.

John Regan, Executive Vice President of Government Affairs for AIM, has been hashing out the paid-leave issues with representatives of Raise Up Massachusetts, the coalition sponsoring the proposal.  All sides remain committed to seeking a fair agreement that does not inflict significant damage to the economy.

A poll of AIM-member employers last week indicated that companies favor by a two-to-one margin reaching a negotiated settlement.

House Speaker Robert DeLeo and Senate President Harriett Chandler have convened separate negotiations on proposed ballot questions that would increase the minimum wage to $15 per hour and reduce the state sales tax from 6.25 percent to 5 percent.

And looming over all the negotiations is a pending decision by the Massachusetts Supreme Judicial Court on a challenge that four business association colleagues and I filed to a proposed constitutional amendment that would impose a 4 percentage-point surtax on incomes more than $1 million. A decision in that case is expected this spring, adding pressure to the already tight time frame for finding common ground on the other questions.

“AIM will follow hundreds of bills as the session comes to an end, but creating a better and less burdensome paid family and medical leave law will be the priority,” Regan said.

“The minimum-wage increase and graduated income tax are right behind that. The objective is to provide the Legislature with the opportunity to resolve all these issues rather than mounting multiple ballot campaigns that could cost $10 million each.”

It’s a full plate for 100 days. The clock starts now.

Topics: Minimum Wage, Massachusetts Legislature, Paid Family Leave

Summing Up, Looking Ahead: Challenges Await Employers

Posted by Rick Lord on Jan 2, 2018 8:30:00 AM

The first half of the 2017-2018 legislative session in Massachusetts was dominated by the issue of health-care costs and the role employers should play in helping to close a budget gap in the state Medicaid program.

Exterior.jpgBut larger battles await during 2018 as progressive activists seek to place three questions on the Massachusetts election ballot that would together impede economic growth for a generation. The initiatives would impose an 80 percent surtax on incomes more than $1 million for pass-through businesses, establish a $1.3 billion-per-year paid leave program and increase the minimum wage to $15 per hour.

Associated Industries of Massachusetts worked successfully during 2017 on a range of issues confronting its member employers from every sector of the economy.

The most important achievement was a compromise that transformed a proposed $700 million annual health-care surtax into a two-year, $200 million assessment to close the budget shortfall in the commonwealth’s health-insurance program for low-income people. The assessment increased the Employer Medical Assistance Contribution (EMAC) in a manner that will fall most heavily on companies where employees use MassHealth instead of an employer health plan.

The levy will be partially offset by a two-year Unemployment Insurance rate adjustment that will save employers $335 million over two years versus current rates. AIM was disappointed that lawmakers passed the assessment without making structural reforms to the MassHealth program.

“We believe, however, that the Legislature is committed to resolving the financial problems at MassHealth and employers look forward to working with lawmakers toward that goal in 2018,” said John Regan, Executive Vice President of Government Affairs at AIM.

AIM also played a key role in hammering out compromise legislation to extend employment protection to pregnant workers in Massachusetts.

The Pregnant Workers Fairness Act requires 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.  AIM opposed early versions of the bill 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.

There was no such compromise in August when the Baker Administration introduced regulations that set specific limits on sources of greenhouse gases, the emissions linked to climate change. State officials indicate that the regulations could increase costs to electric ratepayers by as much as 2 percent. The new rules aim to reduce the state’s carbon emissions 25 percent below 1990 levels by 2020, as required by state law.

The regulations, however, were ultimately unnecessary. The administration could have chosen to work with the Legislature to change the Global Warming Solutions Act to allow alternative ways for the electricity sector to meet these obligations.  The administration instead turned a blind eye to the corrosive impacts that high electric rates are having on struggling Massachusetts companies.

The three potential 2018 ballot questions would represent an unprecedented potential policy crisis for Massachusetts:

  • The constitutional tax amendment would raise from 5.1 percent to 9.1 percent the levy on income of more than $1 million per year, including income generated by subchapter S-corporations, LLPs, LLCs, partnerships, and other pass-through entities. The $1.9 billion tax increase would be paid by roughly 19,500 filers, 80 percent of whom are anticipated to file with some business income.
  • The paid leave question would mandate 16 weeks of paid family leave and 26 weeks of paid medical leave for employees for a total projected cost of $1.3 billion.
  • The minimum wage question would raise the wage from the current $11 per hour in annual $1 per-hour annual increments starting in 2019 until it reaches $15 an hour in 2022. That amounts to a projected increase of 36 percent.

Supporters of the paid-leave and minimum wage questions filed the requisite number of signatures last month to move a step closer to the ballot. Massachusetts lawmakers now have until the end of April to consider and pass the initiatives. Any initiatives that are not adopted must gather and file an additional 10,792 signatures by July 3 to make the 2018 ballot.

The income surtax constitutional amendment qualified for the ballot in 2016. In October, I joined four other prominent business leaders in filing a suit challenging the validity of the proposal, asserting that the amendment is riddled with constitutional flaws and would make the new tax essentially permanent and unchangeable. 

“It is impossible to overstate the potential threat that these three ballot questions pose for Massachusetts employers.  The advocates supporting the questions are well funded and are prepared to spend millions of dollars to get their message across to voters,” Regan said.

The ballot battle will take place just as employers begin to comply with the new Massachusetts Pay Equity Law on July 1, 2018. The law prohibits employers from discriminating based on gender in the payment of wages and other compensation for “comparable” work. Many employers are already undertaking the internal wage studies that provide a safe harbor from litigation under the statute.

Beacon Hill lawmakers will conclude the second year of their two-year session on July 31. The end of formal sessions will kick off an election season that will see Governor Charlie Baker, US Senator Elizabeth Warren and other prominent office holders face re-election challenges.

 

Topics: Massachusetts Legislature, Massachusetts employers, Charlie Baker

Paul Ryan Visits New Balance; Says Tax Reform Coming This Year

Posted by Rick Lord on Jul 28, 2017 8:16:29 AM

For a man who carries the weight of the nation’s economy, budget and health-care systems on his back, US House Speaker Paul Ryan projects the approachable air of a neighbor who shows up at your door to lend you his hedge clippers.

Paul Ryan.jpgI joined other business leaders last Thursday afternoon meeting with Speaker Ryan during an event hosted by New Balance in Lawrence. Unfailingly gracious and remarkably relaxed, the speaker toured the only major foot-ware company that manufactures product in the United States to talk about the potential of tax reform to accelerate economic growth.

The rancorous Washington political debate followed the speaker to Massachusetts as labor unions and other protesters accused Ryan of being a “traitor” and of endangering people’s health with his political agenda. But inside the plant, humming with opportunity and economic activity, people of differing political stripes, Republicans and Democrats alike, left behind the public noise and engaged in a thoughtful discussion about how to encourage companies like New Balance to put people to work.

In other words, it was an event that more closely approximated the bipartisan, collaborative tenor of Massachusetts politics than anything that usually happens on the banks of the Potomac. Not everyone agreed on what tax reform should look like (AIM members are themselves far from unanimous about their approach to taxes) but everyone agreed that the system needs an overhaul.

The final contours of the Republican tax proposal are still being hammered out among the House, Senate and White House negotiators. But most observers expect the plan to reduce taxes on corporations and small businesses from 35 percent to somewhere between 20 and 25 percent, consolidate tax brackets, reduce deductions and simplify the tax-filing process.

Ryan said that Republicans remain far more united on tax reform than on repealing health-care reform.

“We’re going to get this done in 2017,” he told reporters.

“Obviously, we’ve seen in the Senate there are a difference of opinions on how to do health care reform. We are so much more unified on tax reform, on what it looks like, and how to do it, and the need to do it.”

New Balance, a longtime AIM member, employs more than 1,700 Massachusetts residents who use intelligence, lean manufacturing and efficiency to make running shoes in a state where manufacturing  is always a challenge. The company also developed the $500 million Boston Landing project in Brighton, a 1.45 million-square-foot campus that includes a new company headquarters, state-of-the-art athletic complex, hotel, restaurants, retail space and parking.

My comments to Speaker Ryan noted that New Balance and other manufacturing companies struggle to grow and provide jobs because the cost of doing business remains higher in the United States than in many countries abroad. Those costs are particularly onerous here in Massachusetts, where employers pay more for energy, health care and other necessities than anywhere else in the country.

I told the speaker that AIM is working with Governor Charlie Baker and the Legislature to address the health-care and energy cost issues, but that both are complex, structural problems that demand long-term solutions. Federal tax reform, on the other hand, offers a unique opportunity to improve the business climate in a relatively rapid time frame.

It will also be important to help small businesses during the tax-reform process. Both President Trump and the US House appear ready to lower taxes on subchapter S corporations and other pass-through entities, just as those companies face the prospect of seeing their state tax burden increased under an ill-conceived “millionaires tax” on next year’s ballot.

We all understand the potential challenges of tax reductions on a federal deficit that reached $523.1 billion during the first nine months of the current budget year. We all understand the need to debate spending priorities, especially in a state like Massachusetts where economically important industries such as health care, defense and higher education depend upon federal funding.

But the fact remains that employers like New Balance pay federal taxes that are almost a third higher than competitors in other countries.

“Today, places like this, this is more the exception than the rule,” Speaker Ryan told the media at New Balance.

“That’s our problem. Companies are not flocking to the United States, companies are fleeing this country and taking their good jobs with them. They’re not storing up their profits and their capital here, they’re keeping them offshore.”

Topics: U.S. House of Representatives, Taxes

AIM Calls for Long-Term Cost Changes to MassHealth

Posted by Rick Lord on Jul 25, 2017 2:19:20 PM

Editor's note - Associated Industries of Massachusetts President Richard C. Lord submitted the following testimony today to the Legislature's Joint Committee on Ways & Means and Joint Committee on Health Care Financing urging lawmakers to approve long-term structural changes to the state Medicaid program. AIM's Katie Holahan (above) delivered the same message in testimony before the committees.

On behalf of Associated Industries of Massachusetts (AIM) and its 4,000 employer-members statewide, thank you for your continued engagement with the employer community on the difficult issues before you today. We are pleased that both committees have so promptly scheduled this hearing and the second hearing scheduled for this afternoon. 

AIM supports the language contained in Governor Baker’s amendment to the Fiscal Year 2018 budget, returned to you within Attachment F.  The amendment contains a complex agreement that was developed after months of intensive negotiations between the Baker Administration and the business community. We believe the comprehensive plan moderates the proposed employer assessment by coupling it with meaningful structural reforms to the public health insurance system and rate relief within the Unemployment Insurance system.   

It is vital to maintain all aspects of this package so we will not find ourselves addressing an even larger MassHealth budget deficit in two years than the one we confront today. 

AIM likewise supports language authorizing the Baker Administration to seek a federal waiver allowing Massachusetts to return to policies implemented within the 2006 Health Care Reform law, and to expand the scope of practice for certain health-care providers to facilitate lower-cost care. 

The 2006 reform law made employees who were offered employer-sponsored health insurance ineligible for MassHealth.  The intent was to balance the requirement that employers do their “fair share” in offering health insurance with concerns about the financial burden on the MassHealth system.  The Affordable Care Act (ACA) reversed that policy and allowed income-eligible employees to decline employer coverage and seek insurance through MassHealth.  

The change created a migration of newly-eligible individuals from their employer-sponsored insurance to MassHealth, substantially increasing the commonwealth’s financial burden.  The ACA made public health insurance an economically rational choice for eligible residents in a state known for its expensive health-care system.   

As MassHealth enrollment grows, the commonwealth experiences the reality that employers have faced for years: the high cost of health-care coverage in this state threatens the underpinnings of our economy.  Policymakers who have concentrated almost exclusively on access and coverage now face a renewed imperative to lower the cost of health insurance for everyone in Massachusetts. 

AIM member employers are proud to lead the nation in providing health care coverage to their employees. Sixty-five percent of Bay State companies offer health insurance coverage to their workers, compared with 56 percent of employers nationwide. A full 100 percent of Massachusetts employers with 200 or more employees offer coverage.1 

The 4,000 member employers of AIM provide health insurance to the majority of residents in the commonwealth. 

But providing that coverage has financial consequences. 

According to the most recent data available from the Centers for Medicare and Medicaid Services (CMMS), Massachusetts was the second highest-spending state for health care in 2014, 30 percent more than the national average. Personal health-care spending in Massachusetts, per capita, has increased more than 12 percent in five years – from $9,417 in 2009 to $10,559 in 2014. Cost growth like this is unsustainable and has accelerated in the face of attempts by both employers and the commonwealth to contain it. 

Businesses, in fact, have almost nothing to show in the way of cost savings and efficiencies five years after Massachusetts’ major push toward health care cost containment. 

The commonwealth has exceeded the 3.6 percent health spending growth 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. 2 

These cost increases are occurring in an industry in which 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.  

Now, the employer assessment means that business is expected to shoulder the escalating costs of the public healthcare system, as well.  More importantly, they are being asked to close the MassHealth deficit absent any of the  long-term structural reforms needed to solve the underlying financial problems with the program. 

Eleven years ago, employers joined with doctors, hospitals, patient advocates and lawmakers to forge a health-reform law that required all parties to share the responsibility for improving access to health care. The employer community calls for that same sense of shared responsibility now to solve the MassHealth shortfall. 

Thank you for considering AIM’s views and please feel free to contact me if you have any questions or need any further information.  

Topics: Massachusetts state budget, Controlling Health Care Costs, Employer Health Assessment

AIM to Governor: Send Employer Health Assessment Back to Legislature

Posted by Rick Lord on Jul 12, 2017 3:11:18 PM

Editor's note - AIM delivered the following letter from CEO Richard C. Lord to Governor Charles D. Baker this afternoon.

Dear Governor Baker:

On behalf of the 4,000 employers of Associated Industries of Massachusetts (AIM), we strongly urge you to send back to the Legislature the employer health-care assessment provisions contained in the Fiscal Year 2018 (FY18) budget, along with a recommended amendment that includes the reforms agreed to by AIM, your administration and other interested parties.

The FY18 budget now on your desk would require employers to cover the $200 million financial shortfall in the MassHealth program while omitting the long-term structural reforms essential to addressing health-care cost imbalances in both the commercial and public insurance markets.

The result is that employers – who already struggle with the rising cost of providing health insurance to their employees – will also be forced to assume the responsibility for funding an unsustainable MassHealth program.

The assessment comes at a time when Massachusetts employers have almost nothing to show in the way of cost savings and efficiencies four years after the state’s cost-containment law took effect.  In the three years that the state has been measuring the year-over-year growth in health care expenditures, we have exceeded the cost control benchmark twice.

Massachusetts employers are proud to lead the nation in providing health care coverage to employees. Sixty-five percent of Bay State companies offer health insurance coverage compared with 56 percent of employers nationwide. A full 100 percent of Massachusetts employers with 200 or more employees offer coverage.

In 2006, employers joined with doctors, hospitals, patient advocates, and lawmakers to forge a health-reform law that required everyone to share the responsibility for improving access to health care.  We ask you to insist that same sense of shared responsibility be applied now to solve the MassHealth shortfall by returning the employer-assessment provisions to the General Court and insisting that the comprehensive compromise forged by the business community and your administration be included in the final budget. 

Thank you for considering AIM’s position.  Should you have any questions please feel free to contact me directly at 617-262-1180.

Sincerely,

 Lord_Richard C.jpg

Richard C. Lord, President & CEO
Associated Industries of Massachusetts

Topics: Budget, Employer Health Assessment, health insur

Fidelity, Bright Horizons, WHOI Honored with 2017 AIM Vision Awards

Posted by Rick Lord on Mar 30, 2017 9:07:00 AM

Three organizations that have transformed Massachusetts by carving out preeminent places in their disciplines – Fidelity Investments, Bright Horizons Family Solutions and the Woods Hole Oceanographic Institution -  will be honored with 2017 Vision Awards by Associated Industries of Massachusetts.

The largest employer association in Massachusetts will present the Vision Awards at its Annual Meeting on May 5 in Boston. Accepting the awards on behalf of the honorees will be Abigail Johnson, Chairwoman and Chief Executive Officer of Fidelity Investments; Linda A. Mason, Co-Founder of Bright Horizons; and Mark Abbott, Director and President of Woods Hole Oceanographic Institution.

Governor Charles D. Baker will deliver the keynote address.

The Vision Award recognizes companies, organizations and individuals who have made unique contributions to the cause of economic opportunity in Massachusetts. The award reflects AIM’s mission to stand for jobs, economic prosperity, innovation and a government that acknowledges that the private sector has the unique responsibility to create the common wealth for the people of Massachusetts.

“The 4,000 member employers of Associated Industries of Massachusetts are delighted to honor three world-renowned organizations that have truly changed the way we live,” said AIM President and Chief Executive Officer Richard C. Lord.

“Fidelity Investments became a cornerstone of the financial industry by offering investment services to a broad set of customers from individual investors to advisors and large companies. Bright Horizons is the largest provider of employer-sponsored day care in the United States. And Woods Hole Oceanographic Institution remains both a global leader in ocean science and a key driver of the economy on Cape Cod.”

Johnson1.jpgFidelity Investments is the fourth largest investment firm in the world. With assets under administration of $6.0 trillion, including managed assets of $2.2 trillion as of February 28, 2017, the firm focuses on meeting the unique needs of a diverse set of customers: helping more than 26 million people invest their own life savings, 23,000 businesses manage employee-benefit programs, and providing more than 12,500 financial advisory firms with investment and technology solutions to invest their own clients’ money.

Founded in 1946 by Edward C. Johnson 2d, Fidelity was an early pioneer in the development of mutual funds. Fidelity was also innovator in many other areas throughout its history, including check writing for money market accounts, selling mutual funds over 800 number phone lines, the development of sector funds, the growth of the defined-contribution retirement savings industry, and using online and mobile technology to make investing quicker and easier for millions of customers.

The company has used innovation and an unrelenting focus on customer service to mold itself into a diversified financial services firm that is a leader in personal investing, workplace investing, and tools and services for financial intermediaries. Fidelity is now the nation's No. 1 record keeper of 401(k) retirement savings plans and is also the largest US online brokerage firm, with 17.9 million accounts and $1.7 trillion in client assets.  

Abigail Johnson became chief executive officer in 2014 and assumed the title of Chairman in December 2016. A recent Investor’s Business Daily article on Fidelity’s 2016 financial results praised the company’s ability to change: "Fidelity is profitable, strong, innovative and driven to growth," said Jim Lowell, editor-in-chief of Fidelity Investor, an independent newsletter. "That's not true for many financial services companies."

Mason1.jpgBright Horizons Family Solutions – Watertown-based Bright Horizons has forged a trusted global presence as an indispensable resource for employers and their workers seeking to address an increasingly complex array of work-life issues.

Linda Mason and her husband, Roger Brown, founded Bright Horizons with the goal of providing high quality child care at work sites. Together, they created a company with the mission to nurture each child’s unique qualities and potential, support families through strong partnerships, and collaborate with employers to build family-friendly workplaces.

Bright Horizons today operates more than 1,000 child-care centers in the U.S., the UK, Ireland, the Netherlands, India, and Canada. It also works with more than 1,000 employers to provide a complete family of employer solutions, including child care, back-up care for children and adults/elders, and educational advising for employees and their college-bound dependents.

And they do it well. Eighty organizations on Working Mother magazine’s "100 Best Companies" list are Bright Horizons clients. Bright Horizons itself has consistently been named to the "100 Best Companies to Work for in America" list by FORTUNE magazine and the Top Places to Work in Massachusetts by The Boston Globe.

Bright Horizons employs 2,100 people in Massachusetts and more than 20,000 worldwide. The company’s revenue jumped 8 percent during 2016 to $1.6 billion, while net income rose 1 percent to $95 million.

The company’s blue-chip client list reads like a who’s-who of global business leaders, from Allstate Insurance, Comcast NBC Universal and Booz Allen Hamilton to Sprint, Target, Discovery Communications, General Mills and Memorial Sloan Kettering Cancer Center.

Ms. Mason and Mr. Brown in 1988 also created an independent, nonprofit organization, Horizons for Homeless Children (formerly The Horizons Initiative) dedicated to providing high-quality child care and educational services to homeless children and their families.

Abbott1.jpgWoods Hole Oceanographic Institution (WHOI) is the world’s largest, private non-profit oceanographic research institution and a global leader in the study and exploration of the ocean. An unmatched reputation for intellectual discovery under the water has allowed the organization to contribute to its economic surroundings out of the water as well.

Woods Hole scientists and engineers have played a part in discoveries that form the modern understanding of the ocean and how it interacts with other parts of the planet, including human society. WHOI professionals combine access to specialized tools, ships, labs, and underwater vehicles with knowledge of how to explore the ocean to create a detailed understanding of the global ocean system.

The institution, founded in 1930, employs more than 1,000 researchers, engineers, information technology specialists, and crews for ships and underwater vehicles like the Alvin that famously explored the wreck of the Titanic in 1986. A combination of government grants and contracts, foundation and private donations and industry contracts provide the organization with an annual operating budget of $215 million.

Increasingly WHOI is involved in projects that apply the knowledge gained from basic research to societal issues, providing high-quality data and analysis across a range of topics, from climate to biodiversity to resources to natural hazards mitigation. These efforts have given WHOI’s work reach into new and important arenas.

In 2010, the Institution rapidly mobilized researchers from several different disciplines to assist the Coast Guard and other responders during the Deepwater Horizon oil spill. In response to the Fukushima disaster in March 2011, WHOI mounted another rapid response and mobilization to gather data and water samples quickly to determine the amount of radioactivity released into the ocean. That monitoring effort continues.

Engineers and scientists at WHOI worked for nearly two years to successfully locate, in May 2011, the deep-water wreckage of Air France flight 447, using the WHOI-designed and -built REMUS 6000 autonomous vehicle.

Topics: AIM Annual Meeting, Massachusetts economy, AIM Vision Award

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

Proposed Assessment Will Hurt Employers Who Provide Health Insurance

Posted by Rick Lord on Jan 26, 2017 3:00:40 PM

Governor Charlie Baker yesterday described his proposal for a $300 million health assessment on employers as an attempt “to wrestle with the fact that a huge portion of people who are working full-time are either not taking coverage that's available through their employer and going on MassHealth, or are working for people who aren't offering them coverage at all, and going on MassHealth."

health_care.jpgHe added, according to State House News Service, that “the centerpiece of this budget really is a smart and common-sense approach to address the problem of costs being shifted from private sector employers for their employees onto state government."

Set aside for the moment the questionable premise of rampant cost shifting in a commonwealth where 76 percent of employers offer health insurance compared to 55 percent in the rest of the country.

The important point is that the governor’s sweeping proposal goes far beyond targeting employers who offer no health insurance, and instead penalizes employers who already offer high-quality insurance coverage to their employees.

It appears that money, not fairness, is driving the new fair-share assessment.

The administration plan would impose a $2,000-per-employee fee upon companies at which at least 80 percent of full-time worker equivalents do not take the company’s offer of health insurance, and that do not make a minimum contribution of $4,950 annual contribution for each full-time worker. If 70 percent of a company’s employees accept company health insurance, the company would be assessed $2,000 per employee for the number of employees represented by the 10 percent difference.

The employer assessment, which would bring an estimated $300 million into state coffers, represents a revival of the so-called fair share contribution plan that was a linchpin of the 2006 universal health care law in Massachusetts before it was repealed to make way for the federal Affordable Care Act. The state employer mandate was repealed in 2013 as lawmakers and former Gov. Deval Patrick worked to bring Massachusetts into compliance with federal health-care reform.

AIM asked multiple employers of varying sizes to determine whether they would be subject to an assessment under the governor’s plan. Every one of the companies, from small manufacturers to international financial institutions to corner retailers, reported that they would face assessments. Most fell short of the 80 percent threshold because of employees using spousal health plans or because of the calculation of full-time equivalent employees.

“There is widespread concern among responsible employers that they are being dragged into an assessment intended for companies that provide no health coverage,” said Katie Holahan, Vice President of Government Affairs at AIM.

Holahan said AIM has developed an online calculator that will allow employers to determine how much they might owe under the governor’s proposal.

AIM opposes the employer assessment because the growing shortfall at Masshealth, which provides health insurance to 1.9 million low-income Massachusetts residents, is attributable solely to problems arising from the federal Affordable Care Act (ACA), a law that may well be repealed by the time Massachusetts solves its Medicaid problems. 

ACA made access to health insurance an entitlement based on expanded income eligibility.  Under the Massachusetts health care reform law of 2006, employees who were offered employer-sponsored health insurance were ineligible for MassHealth.  The ACA reversed that policy and allowed employees to decline employer coverage and still seek insurance through MassHealth.

The change created a migration of newly-eligible individuals from their employer-sponsored insurance to MassHealth, substantially increasing the commonwealth’s financial burden.  ACA made it an economically rational choice for eligible residents.

As MassHealth enrollment grows, the commonwealth experiences the reality that employers have faced for years - the high cost of health care coverage in this state threatens the underpinnings of the state economy.  This challenging moment underscores the fact that policymakers have concentrated too heavily on access issues instead of controlling the cost of health insurance, and now face a renewed imperative to lower costs for everyone in Massachusetts.

AIM looks forward to working with the administration and the Legislature to find a fair solution to the commonwealth’s challenging health-care financing issues.

Topics: Health Care Costs, Health Insurance, Charlie Baker

Dear President-Elect Trump

Posted by Rick Lord on Nov 9, 2016 2:42:14 PM

Dear President-Elect Trump,

Associated Industries of Massachusetts (AIM) and its 4,000 member-employers congratulate you on your election as President of the United States. Massachusetts employers, large and small, from all sectors of the economy, affirm our commitment to unifying this great nation and to restoring faith in our economic and government institutions.

AIM employers proudly provide jobs that allow 650,000 people to build lives for themselves and their families. We embrace the notion that private sector has the unique ability - and responsibility – to create the common wealth for the citizens of Massachusetts.

The days after a hard-fought presidential election have traditionally been a time to mend the divisions in our country, with political parties and nominees moving beyond the harshness of the campaign season and putting our nation, and our democratic system, first before all else.

We take encouragement from your words early this morning:

“Now it’s time for America to bind the wounds of division; have to get together. To all Republicans and Democrats and independents across this nation, I say it is time for us to come together as one united people.”

The rancor and divisiveness of both the presidential campaign and the general political discourse make unity not just a polite platitude in 2016, but an essential part of reinvigorating our democracy. We are reminded of the words of Abraham Lincoln: "America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves."

Associated Industries of Massachusetts looks forward to working with the Trump Administration to strengthen the United States economy and raise the economic fortunes of all Americans. We certainly will not agree on all issues, but AIM believes in the transformative power of political debate and will make our voices heard respectfully on all issues affecting employers.

We commit to maintain a constructive dialogue and an approach guided by an unwavering commitment to a greater purpose. AIM has already taken that approach by creating a long-term economic plan for Massachusetts called The Blueprint for the Next Century.

The Blueprint articulates the objectives, priorities, hopes and dreams of Massachusetts employers:

  1. Develop the best system in the world for educating and training workers with the skills needed to allow companies to succeed in a rapidly changing global economy.
  2. Support business formation and expansion by creating a uniformly competitive economic structure, a structure that must include a reliable transportation system.
  3. Establish a world-class regulatory system that ensures the health and welfare of society in a manner that meets the highest standards of efficiency, predictability, transparency and responsiveness.
  4. Moderate the immense long-term burden that health care and energy costs place on business growth.

Those objectives inform the position of Massachusetts employers on a host of issues you will confront upon taking office, from encouraging fair agreements on international trade to creating a balanced National Labor Relations Board to correcting problems with federal health-care reform that threaten the economic survival of small companies here in the commonwealth.

Most immediately, the employers who create prosperity in Massachusetts eagerly anticipate your efforts to accomplish the “urgent task of rebuilding our nation and renewing the American dream.” 

Congratulations again.

Topics: Elections, Massachusetts economy, Donald Trump

Marijuana Legalization Harmful to Business

Posted by Rick Lord on Oct 19, 2016 10:30:00 AM

A proposed law on the November ballot to legalize and commercialize marijuana in Massachusetts would reverse decades of hard-won progress by employers to create safe and drug-free workplaces.

VoteHereSign.jpgQuestion 4 would place employers in the untenable position of determining whether an employee who tests positive for marijuana, used legally under state law, is too impaired to operate a machine or drive a company vehicle safely. It would also create a legal nightmare for employers caught between a state law that permits private use of marijuana and a federal law - often the overriding jurisdiction in employment scenarios - that prohibits marijuana use.

That’s why the Board of Directors of AIM has joined an extraordinary coalition of public officials, civic leaders and businesses urging a “no” vote on Question 4. The coalition includes Governor Charlie Baker; House Speaker Robert DeLeo; Boston Mayor Martin J. Walsh; Attorney General Maura Healey; Members of Congress Joe Kennedy, III, Stephen Lynch, Nikki Tsongas and William Keating; Cardinal Seán P. O’Malley and the Roman Catholic Bishops of Massachusetts; the Massachusetts Hospital Association; the Massachusetts Medical Society; and the Massachusetts Municipal Association

A survey conducted by AIM earlier this year indicates that employers oppose Question 4 by a wide margin.

Sixty-two percent of employers said they would vote “No” on the pot legalization referendum due to appear on the November 1 ballot. Thirty-eight percent were in favor.

The proposed ballot law would authorize individuals 21 and over to possess up to one ounce of marijuana outside of their home and up to ten ounces of marijuana in their residences. It calls for taxes on marijuana sales and creates a Cannabis Control Commission to handle regulation and licensing.

If approved, the new law would take effect on December 15.

“We’re not surprised by the poll results given the concerns being expressed to us by member employers,” said John Regan, Executive Vice President of Government Affairs at AIM.

“How will an employer respond to a worker operating heavy equipment on a job site under the influence of marijuana? Many jobs, particularly those in safety-sensitive fields like transportation or manufacturing, must adhere to federal regulations that still prohibit the use of any substance that creates impairment.”

In fact, no breathalyzer-type technology exists to measure the degree of impairment suffered by a marijuana user. Question 4 not only fails to establish an enforceable legal standard as exists in other states, but also fails to establish a standard by which employers may terminate or discipline an employee who may have used marijuana and could be a safety risk on the job.

The potential consequences are significant.

In Colorado, which legalized medical marijuana in 2010 and recreational marijuana in 2012, marijuana-related traffic deaths increased by 154 percent between 2006 and 2014. Emergency room hospital visits that were “likely related” to marijuana increased by 77 percent from 2011 to 2014; and drug-related suspensions/expulsions increased 40 percent from school years 2008/2009 to 2013/2014, according to a September 2015 report by the Rocky Mountain High Intensity Drug Traffic Area, a collaboration of federal, state and local drug enforcement agencies.

Recent surveys have also indicated an increase in general marijuana use when states approve the legalization of marijuana. According to the National Survey on Drug Use and Health, between 2012 and 2013 (when marijuana was legalized but states had yet to implement a regulatory framework) the percentage of adults who reported using marijuana jumped by more than 20 percent in Washington and Colorado.

Employers remain concerned that much of the increased marijuana usage in these states has come from high-potency edibles - THC-infused candy bars, gummies, cookies and soda – many packaged to look like candy and snacks. Almost half of all marijuana sales in Colorado, which was the first state to legalize, now come from edibles and concentrates.

The appeal of edible marijuana products to teen-agers is an issue for medical and behavior health organizations like the Massachusetts chapter of the National Alliance on Mental Illness (NAMI), and the Association for Behavioral Healthcare.

“The research shows that marijuana poses a risk for the young brain — those 25 and under — that is predisposed to emotional and mental health issues,” said NAMI Mass Executive Director Laurie Martinelli.

Marijuana legalization is among a handful of November ballot questions with implications for employers. AIM favors a proposal to lift the cap on charter schools and opposes questions that would end the use of Common Core educational standards and impose de-facto government price controls on hospitals.

AIM also opposes a proposed constitutional amendment that would impose a 4 percent surtax on income more than $1 million that could reach the ballot by 2018.

Topics: Associated Industries of Massachusetts, Ballot Questions

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