Category Archives: Health Care

Focus on Health This Summer

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What’s the state of Indiana’s health?

Unfortunately, it’s not good. In fact, Indiana ranks at the bottom in several health metrics.

One of those is opioid abuse, which has received a lot of attention recently around the state. However, Hoosiers also continue to struggle with tobacco use and obesity (and diseases related to both), as well as high infant mortality rates.

Indiana Chamber President and CEO Kevin Brinegar recently penned an article on how health is the missing piece of Indiana’s economic puzzle. For additional background and data on the issue, read it here.

The Alliance for a Healthier Indiana – made up of health care professionals, educators, business and community leaders – is aiming to educate the public and policymakers about these issues, grow local support and generally raise awareness of the dangers of our poor health, while also sharing ways Hoosiers can work together to improve these metrics.

With its State of Our Health Road Show, the Alliance is on the road this summer and fall, hosting free town hall meetings in all corners of the state.

The road show is in Fort Wayne today and will travel to Muncie tomorrow, June 13. Other June dates include Richmond on June 19 and Connersville on June 20. The complete schedule is available here; events go through October.

To see clips and video from earlier road shows, visit the Alliance for a Healthier Indiana’s Facebook page.

Founding members of the Alliance for a Healthier Indiana include the Indiana Hospital Association, the Indiana Chamber of Commerce, the Indiana State Medical Association, Anthem Blue Cross and Blue Shield of Indiana and the Indiana University Richard M. Fairbanks School of Public Health.

Brinegar and Community Health Network President and CEO Bryan Mills recently spoke about the Alliance and the state of Indiana’s health during a segment on Inside INdiana Business. The segment gives an overview of the issues:

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To learn more about the Alliance for a Healthier Indiana visit the web site at www.healthierindiana.org.

What the Senate Leadership Changes Mean for the Business Community

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The 2018 legislative session marks the first one without fiscal stalwarts Brandt Hershman and Luke Kenley, both of whom retired from the Senate – Hershman’s announcement coming just before Christmas. While it’s hard to replace such experience and wisdom, those stepping up to fill their shoes have been waiting in the wings for a while and should make for smooth transitions.

Back in mid-July, Sen. Ryan Mishler (R-Bremen) was tapped to succeed Kenley as the chairman of the Senate Appropriations Committee, which is tasked with that chamber’s budget-writing duties. Mishler was the ranking member of that group for years and worked on the school funding formula component of the budget.

Senator Travis Holdman (R-Markle), who takes over for Hershman as chair of the Senate Tax and Fiscal Policy Committee, has been the long-time ranking member there and often assumed the chairman’s role during meetings. Holdman is well versed in the matters that come before the committee and the business community will continue to be well served by his thoughtful viewpoints.

To take that post, Holdman relinquished his leadership on the Senate Insurance and Financial Institutions Committee. The “next man up” there is Sen. Chip Perfect (R-Lawrenceburg), who is a no-nonsense and intelligent legislator. He has been extremely helpful on labor issues and owns several businesses himself, so he knows the difficulties that businesses face. That perspective will likely also factor into how he handles the health insurance bills, which are now being assigned to his committee.

Short Session Starts With a Flurry of Activity

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The Governor and General Assembly have continually heard from Hoosier employers on the need for a skilled workforce – and better aligning state programs with job demand. The good news is bills are being introduced to address those concerns. While only a handful of measures have been released to date, we are seeing legislation related to training tax credits and grants, as well as efforts to streamline current workforce programs. We anticipate a comprehensive workforce bill (1002) will be introduced in the House later next week.

The Governor’s computer science bill (SB 172) requires all public schools to offer a one-semester elective computer science course at least once each school year to high school students. We expect a hearing on this measure in the next two weeks. Both this and the workforce efforts are 2018 Indiana Chamber legislative priorities.

Senate Bill 257 has been introduced by Sen. Travis Holdman (R-Markle) to serve as the beginning of discussions on clarifying the exempt status of computer software sold as a service (SaaS) – a Chamber priority. Holdman is also authoring another major piece of tax legislation, SB 242, which contains a variety of tax matters. The House bills are coming in too, with a good number already filed addressing local tax issues.

Speaking of local matters, the Chamber is very pleased to see that the House Republican agenda includes a bill that will make township government more effective and efficient by the merging of townships (approximately 300) where less than 1,200 people reside. Such local government reform has been a longstanding Chamber goal.

In addition to SB 257, other technology-related bills include Rep. Ed Soliday’s (R-Valparaiso) autonomous vehicle (AV) proposal to position Indiana to safely test and implement AV technology with automobiles. The bill also will address truck platooning, which uses GPS and WiFi technology to allow trucks to more closely follow each other for greater efficiency, on Indiana roads.

Rural broadband, high-speed internet and small cell wireless structures technology all will be topics for the Legislature to debate. Certified technology parks also will be discussed with the idea to have an additional capture of sales and income tax revenue for those complexes that perform well.

In health care, enabling employers to ask prospective employees if they are smokers not only heads the Chamber’s wish list but also appears to be gaining traction this go-round. Eliminating the special protections (currently in state statute) for smokers is found in SB 23 and will be guided by Sen. Liz Brown (R-Fort Wayne). The bill has a pretty good chance of getting a hearing in the Senate – which would be a first. Previously, a measure was taken up in a joint hearing in the House.

Increasing the tobacco tax and raising the legal age for smokers to 21 are policies that likely will be included in a bill to be introduced by Rep. Charlie Brown (D-Gary). The Indiana Chamber is supportive of both.

Nine utility-related bills are on our radar screen at this point. They range from tweaks of last year’s big legislation (like SB 309, which addressed rising energy costs and a long-standing struggle between the investor-owned electric utilities and larger consumers of energy) to compulsory sewer connection, excavation for infrastructure, regulation of solar energy systems in homeowners’ associations and new water legislation. Separately, Sen. David Niezgodski (D-South Bend) has a proposed ban on coal tar pavement sealer, which we oppose.

There are also a number of bills proposing changes to Indiana’s alcohol laws including: Sunday sales, cold beer sales by grocery and convenience stores, and increases in fees and penalties.

The Chamber will be providing more details on all of these bills as the session progresses.

For anyone who wants a refresher about how legislation becomes law, the Chamber has a handy guide free of charge. It includes a diagram of the bill process, a glossary of often-used terms and a look at where bills commonly get tripped up.

Additionally, the Chamber will be providing updates and issuing pertinent documents throughout the session at www.indianachamber.com/legislative.

Chamber Talks Workforce Needs, Impact of Opioid Addiction as 2018 Legislative Session Begins

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As the 2018 General Assembly gets underway, the Indiana Chamber is highlighting three big issues expected to be debated in the coming days and weeks: workforce needs, the opioid crisis and smoking rates.

Indiana Chamber President and CEO Kevin Brinegar says, “We’ve done so well recently from an employment standpoint that we’ve almost outstripped our ability to hire skilled workers since unemployment is so low in the state.

“It’s clear we need to raise up the skills of those who are here, but the Indiana Chamber is also suggesting that perhaps we need to pursue a parallel strategy of recruiting people from out of state. Talent is more mobile than ever before and once people gethere, they really appreciate our cost of living.”

But make no mistake, Brinegar stresses, the state’s priority should be on the potential talent pool at home. That means some major changes will need to occur – ones that hopefully start in the new legislative session.
“What we’ve been doing wrong is saying, ‘Here is our program, you come use it and we hope that it will solve your needs.’ Instead, there should be a conscious effort to truly listen to employers and then develop training programs that are demand-driven to what the needs of the marketplace are now.”

Many of those jobs today and down the road are in the middle skills area – skills that require more than a high school diploma but less than a four-year bachelor’s degree. Brinegar states this should be a focus for both Hoosier workers who need to improve their skillset and young students.

“We know from our member companies that they are reaching down to high schools and even middle schools to explore with students what job opportunities there are with their companies, what skills they need to have, what classes they need to take in high school to be eligible to take those jobs. It’s becoming a lot more focused on getting people ready with some specificity for jobs after high school.

“There will always be the need for a number of jobs requiring a four-year degree or more, but the real growth is in show me what you know, show me what you can do, show me what machinery you can operate. That’s the mindset we need to have to transform some of these government silos … along with listening to employers and creating programs that communicate to young people what those job needs are.”

Additionally, the Indiana Chamber is partnering with the Governor’s office and the state’s drug czar, Jim McClelland, to be the source for the business component of the state’s plan to combat the opioid crisis.

“We will be researching on best practices, disseminating information to employers and putting on training programs. I’ve told the Governor’s office that we want to be part of the effort and part of the solution. It’s a big problem and it’s not going to be solved overnight, but this has become an employer problem in addition to a personal and societal problem,” Brinegar offers.

“We’ve rapidly gotten to the point to where employers almost can’t fire somebody for failing a drug test because there isn’t the depth in the workforce to tap into for new workers. Employers are looking for guidance. They want more information on what they can do, how they can train supervisors to recognize signs and know where the effective treatment programs are.”

The Indiana Chamber, a founding member of the Alliance for a Healthier Indiana, would like the same urgency placed on reducing the state’s smoking rates.

“There are 10 times more people dying from smoking-related illnesses every year than opioids. And it’s the most preventable source of disease,” Brinegar notes.

“We need to improve our health metrics, including obesity, which are in the bottom third of the states. I rarely accept average for anything, but if Indiana rose to be just average when it comes to smoking, that would significantly curb health issues and save those individuals and businesses a lot of money on insurance coverage and health care costs.”

Indiana’s current smoking rate is at 21% of the population; the national average is 15%.

Enhanced workforce efforts and reducing the state’s smoking rates are among the Indiana Chamber’s Top 9 legislative priorities for 2018. The full list is available at www.indianachamber.com/priorities.

ChamberCare Business Resources (PEO) Now Available

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Who can predict the future of health insurance renewals? From major shake-ups in Washington to adjustments at the state level, the volatility of the insurance markets is leaving human resource and business professionals unsure of the path forward.

As part of the Indiana Chamber’s ChamberCare Solutions, we’re now offering the ChamberCare Business Resources (PEO). This unique program can help Hoosier companies with two or more employees manage their human resources, including compliance and reporting assistance and securing stable and affordable benefits.

ChamberCare

Indiana Chamber Senior Manager of Membership Strategy Brett Hulse notes the value of the PEO to small businesses.

“This Professional Employer Organization (PEO) program is a great option for small businesses that are looking for savings and long-term stability with regard to their health insurance, while also providing access to HR and compliance resources that you would find at a large company,” Hulse notes.

Is your company the right fit for participation? If you answer “Yes” to any of the questions below, this program might be a good match for your business:

  • Would better benefits improve your ability to attract or retain employees?
  • Do issues with employment law compliance (e.g. employee classification, ADA, FMLA, etc.) concern you?
  • Do you have a 401(k) program for your employees? Would you like to reduce the cost and eliminate the fiduciary liability associated with this benefit?
  • Have you had any employee/labor issues for which you had to hire an attorney?
  • Is your handbook up to date and functional for your business?

“The Indiana Chamber has helped thousands of small businesses save money while offering competitive benefits to their employees for nearly 15 years. We’re excited to partner with Human Capital Concepts (HCC),” Hulse adds.

For additional details, or to learn more about how a PEO might be a great option for your business, contact Human Capital Concepts; to learn more about Indiana Chamber membership, contact Brett Hulse.

Senate Health Care Reform – Act III

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A bipartisan agreement has been reached in the Senate to help stabilize health care markets – from Senate Health, Education, Labor and Pensions Committee Chairman Sen. Lamar Alexander (R-TN) and ranking member Sen. Patty Murray (D-WA).

Among other things, the Alexander-Murray agreement would:

  • fund cost-sharing reduction payments, which help lower consumers’ deductibles and co-pays, for two years;
  • broaden the pool eligible for a “copper plan” (catastrophic medical) coverage option, which would help reduce the mandate implications for essential benefits;
  • include funding to help Americans navigate signing up for health insurance, which had been cut by the Trump administration; and
  • set up high-risk pools that will allow for continued coverage for these individuals.

What this is not is a “repeal and replace”. That said, the two-year funding promise is good news for insurers and would help alleviate their unease, which would also be felt by consumers. But this bill does nothing to address the core problems in the individual marketplace that threaten its sustainability.

Indiana Sen. Joe Donnelly, who has been pushing for bipartisan fixes to the Affordable Care Act (ACA), has thrown his support behind the Alexander-Murray agreement and is a co-sponsor of the legislation. He stated, “This is the product of hard work from members on both sides of the aisle, and it’s an important step in providing much needed stability to the market. I’m proud to be part of the effort, and I will continue working with Republicans and Democrats to move this much-needed legislation forward.”

President Trump has alternately met the agreement with both optimism and skepticism. Overall, he’s indicated that he would favor a short-term subsidy fix; however, he doesn’t want to help insurers either.

It would appear the bipartisan legislation would garner most, if not all, Senate Democrat votes (as Minority Leader Chuck Schumer alluded to on Thursday), so that would leave a lot of wiggle room for passage if some, or even many, Republicans vote against it. The question is what Senate Majority Leader Mitch McConnell will do and what he says to his caucus.

Meanwhile, Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC), the authors of the Senate’s second ACA reform attempt, have been working with Alexander and Murray on ways the bill can be made palatable to the very conservative arm of the congressional Republicans – most notably in the House.

In other words, this is far from a done deal.

Open Enrollment is Here, Save with ChamberCare

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Piggybank

The end of the year is approaching, which means your organization is likely exploring health insurance options for 2018. Did you know that since 2004, the Indiana Chamber has helped thousands of small businesses receive significant savings on this ever-growing expense? As your organization makes this important decision, please consider our ChamberCare Solutions program, which includes the following options:

  • ChamberCare Business Resources: Save money by avoiding community rating and receive significant assistance with HR and payroll functions.
  • ChamberCare Savings: An excellent choice for companies with 51-99 employees. Save 5% on any Anthem plan.
  • ChamberCare Exchange: Access to quality, affordable health plans that are ACA-compliant. Also, deep discounts on dental, vision, life and disability coverage.

As you navigate these important decisions, be sure to ask your insurance agent if ChamberCare Solutions is a good option for your business. Visit our web site for more information.

Recognizing Signs of Domestic Violence at Work

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Domestic violence

October is Domestic Violence Awareness month. Unless you or someone close to you has experienced domestic violence, you might think of it as something that only impacts people at home. Unfortunately, abuse is often subtle and happening to people of all socio-economic classes, ages, races, genders, etc.

There’s a fine line to employers getting involved in the personal lives of employees. But often domestic abuse doesn’t stay within the confines of a home’s walls. And the sheer number of people impacted by domestic violence are staggering: Nearly one in three women and one in seven men are victims of domestic violence during their lifetime. Even more numbing is that 53% of people know someone who has been a victim of abuse.

Domestic violence harms the health and well-being of your employees. And it can hurt a company’s bottom line through lost productivity and missed work.

Domestic Violence Network statistics show that 74% of women who are abused were harassed by their abuser while on the job. More than half were late for work at least five times per month because of abuse. Nearly 30% had to leave work early at least five days a month. And 54% missed three or more full days of work per month due to abuse.

Abuse is estimated to cost employers over $5.8 billion a year; $4.1 billion of that is directly related to medical expenses.

In a workforce of 50 people, approximately 27 people know someone impacted by domestic violence. If the employee mix is equal (25 female and 25 male), approximately eight females and three males are victims of abuse. And the U.S. Department of Justice statistics estimate that four women and one man per day are killed by abuse from an intimate partner.

Central Indiana statistics are sobering: agencies received 22,758 calls in 2016 related to domestic violence, according to the State of Domestic Violence Report.

Employers should understand that this violence won’t always be obvious. Abused employees will not always come to work with bruises or other injuries; if they do, it’s a safe bet that they’ve been emotionally abused for much longer.

Here are common abuse signs to watch for in employees:

  • Increase in absenteeism and/or tardiness: abusers may start fights prior to work, take vehicles to prevent the abused individual from getting to work, etc. Or the absences may be due to injuries if the abuse has reached the physical stage
  • Increased distraction: someone may suffer from poor concentration, anxiety and isolation. They may always keep a cell phone nearby and answer it quickly and then appear nervous or upset after answering the call or reading the text
  • Changes in social interaction: employees may stop doing things socially with co-workers. They may stop going to lunch with others and may avoid certain people
  • Increased or frequent visits by the abuser: visits alone aren’t enough to indicate something is wrong, but if the individual has negative reactions when the abuser is there or right after, there could be a problem

What are employers able to do for employees they suspect may be in an abusive situation? If you suspect your employee is a victim of abuse, the first thing you can do is offer a safe place for discussion.

If you suspect an employee is being abused, show kindness in your approach. Ask the employee if there is anything that you can help with and avoid telling him or her you think that abuse is occurring. If the employee is showing up with physical evidence of abuse, an employer should ask, “Is someone hurting you?”

If the answer is no, accept it. The employee may not be ready to share the abuse or may not yet see themselves as victims. Let the employee know you care and that you are there to help if you can. Refer them to a local domestic violence network or shelter if necessary.

100+ Business Leaders Going to D.C. This Week for Chamber Fly-in

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A record group of more than 100 of the state’s top business leaders and government affairs executives will be attending the Indiana Chamber’s annual D.C. Fly-in on September 27 and 28. The timing couldn’t be more perfect with a potential health care reform vote, rollout of a tax reform plan and the end of the fiscal year all taking place.

This year, legislative briefings will be conducted by congressional members, who will be highlighting key public policy areas that line up with their committee assignments and expertise:

  • Tax reform – Indiana 2nd District U.S. Rep. Jackie Walorski
  • Regulatory reform – Indiana 9th District U.S. Rep. Trey Hollingsworth
  • Health care reform – Indiana 8th District U.S. Rep. Larry Bucshon
  • Infrastructure and transportation policy – Indiana 4th District U.S. Rep. Todd Rokita
  • Education policy – Indiana 6th District U.S. Rep. Luke Messer

There is still time to register for the D.C. Fly-in; go to www.indianachamber.com/specialevents.

Make sure to follow us on Twitter at @IndianaChamber or #ICCinDC for up-to-the-minute important information on what’s happening in Washington.

Zimmer Biomet is the Fly-in’s dinner sponsor. Allegion is the cocktail reception sponsor. Build Indiana Council is the legislative briefing sponsor.

Event sponsors are AT&T, The Boeing Company, Duke Energy, The Kroger Co., Old National Bank and Wabash Valley Power.

New Senate Health Care Bill An Improvement for Employers

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The U.S. Senate appears to be gearing up for another health care vote, with a measure from Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC) headed to the floor as soon as the middle of next week.

At its core, the Graham-Cassidy proposal creates a block grant program, taking much of the funding provided in the Affordable Care Act (ACA) and sending it to the states for them to set up their own health care systems and determine where to direct the funds.

It also does away with several pillars of the ACA, including the mandate for individuals to have insurance or pay a penalty. The true ramifications of that are uncertain, but could mean higher premiums for those in the health care exchanges (aka those who don’t have insurance through their workplace).

From the standpoint of employers, the Indiana Chamber believes Graham-Cassidy is an improvement over the ACA. This is primarily due to two changes:

  1. The removal of the employer mandate to offer coverage. If that goes away, so too does the ACA’s definition of a full-time employee as someone working an average of 30 hours per week; this has negatively impacted businesses and workers – many of whom saw their hours reduced.
  1. The permanent elimination of the medical device tax, which is detrimental to vital Hoosier employers like Cook Medical in Bloomington, Zimmer Biomet in Warsaw and many others.

Overall, those in favor of increased state control are more receptive to the Graham-Cassidy effort.

As Vice President Mike Pence put it on Fox News yesterday: “…The question that people ought to ask is, who do you think will be more responsive to the health care needs in your community? Your Governor and your state legislator, or a congressman and a President far off in the nation’s capital?…”

 What has opponents worked up is two-fold: affordable coverage for pre-existing conditions isn’t specifically guaranteed; and population size will determine the amount of the block grant, which will reduce funding for a number of states – including some in the Rust Belt and more rural states in general.

Republican Sen. Jeff Flake of Arizona told MSNBC on Thursday he has absolute faith that governors will keep pre-existing condition protections, because of the severe political cost if they don’t. Opponents are less convinced.

At this point, Kentucky Sen. Rand Paul is the lone Republican who has sworn opposition to the Graham-Cassidy bill publicly – in part because his state appears to be set to lose funds in this model.

Likewise, Indiana is expected to see less federal dollars, but the Hoosier state has been preparing for what it saw as an eventuality for several years – setting aside hundreds of millions of dollars to subsidize its Healthy Indiana Plan (HIP) 2.0.

The HIP model is unique in the country; it requires participants to have “skin in the game” with their health care decisions and allows for capping the number of participants. Both of these make it an inherently more nimble program. And ultimately, the state Legislature can also determine to put more funds into HIP 2.0, if it’s deemed necessary.

These facts and the lure of more state control were likely factors in Gov. Eric Holcomb’s decision to sign a letter supporting Graham-Cassidy; he was one of 15 state executives to do so. The reality is other states may not be as fiscally prepared for a possible funding reduction as Indiana is.

That leads us to who may end up being the pivotal figure in the floor vote: Sen. Lisa Murkowski of Alaska. She joined Sen. Susan Collins (Maine) and Sen. John McCain (Arizona) in voting no on the last health care reform measure. Collins is seen as a likely “no” again, joining Paul, while McCain is a predicted (or at least hoped for) “yes.”

As a result, the bill authors are pulling out all the stops and making special accommodations for Alaska in the bill to woo Murkowski’s vote – because they can’t lose her and have the bill survive for Vice President Pence to break the tie. If no specific provisions for Alaska are made, the state would be a big loser in the bill in funding because of its size vs. population and geography.

The Indiana Chamber plans to talk about health care reform with Sen. Joe Donnelly, who has announced his opposition to Graham-Cassidy, and Republican Sen. Todd Young during Wednesday’s D.C. Fly-in event.

UPDATE: This afternoon, McCain announced he would oppose the Graham-Cassidy bill, making passage of the bill seemingly very difficult.