It's taken 5 years, but the fight is happening. I'm surprised it's talking about Parkland. The bigger for profit hospital chains want that money, and if people are insured, there's a chance they are getting it over Parkland in the patient gets to choose.
Couple this with Arkansas's expansion of Medicaid where they sent their working poor into the exchanges and the Republicans in Texas could be a model for fixing the holes in Obamacare that eventually, if I had my way, would push everyone into the exchanges and allow them a credit based system generated through a "payroll tax" except the tax is paid for by you and your employer and it's yours to spend on the exchange...like a healthcare savings account.
First, any CFO worth his/her salt knows exactly how much is spent on premiums vs how much is paid out as a indicator of future expenses. This shouldn't be under the review of your employer. A basic investigation could allow the employer to determine who's eating up your premiums and allow them to build a case against your employment while you're dealing with cancer treatments. The company is taking your sick time or FMLA absence as a hit to productivity already. Couple that with lost premiums if you're the reason they don't get a refund from the Obamacare 80/20 rule, and suddenly you're too expensive to employ.
Second, the Cadillac portion of Obamacare needs repealed. If, as a way of cultivating and keeping talent, your company agrees to a larger percentage "payroll tax" so that you can purchase better coverage with less out of pocket, there's no reason to punish those companies who are already doing the right thing. You can't (or shouldn't) exact ridiculous punishments on the private sector because they are already compromising their bottom line for better employee retention.
It should be a flat administrative fee for using the exchange...a real tax to Uncle Sam...for the amount you have to spend. If you and your company pays 6k a year and the administrative tax is 3%, you now have the first $5820 of your premiums covered.
If you're company decides to make a larger contribution as a result of their business model and pays a total of 12k then the 3% administration tax would double to $360 but with you able to spend upto $11640 in premiums.
Now, go to Marco Rubio and talk to him specifically about his ideas on the regular distribution of the earned income tax credit instead of a lump sum payout, and you can add the predetermined amount of that credit to your available premium...
Say a family gets an tax refund of 7k this year because of the earned income tax credit, but their child had no health coverage. If the family has a large lump sum, they are likely to spend it on things not really considered for the reason of the credit...a giant TV?
Now, I get the argument it's their money and they can do spend it how they want, but first, it's not their money. It's money they never paid in taxes, and every Republican says they like to reduce the waste of the EIC. Rubio wants it to go to the things it should go to...food & child care being big ones...both categories where the money is directly pumped back into the economy.
Now, if just 25% of the EIC was paid as a portion of the total available funds towards your families premium, and your company has to pay 9% of your salary to the exchange premium while you make minimum wage, you have a total premium credit available of about $3100. Hardly a reasonable amount, but the working poor have medicaid expansion to help pick up the rest of the tab.
If you make $12 an hour, the amount prior to the EIC application of funds jumps almost a $900 for a total available premium of just under 4k. The more you make, the less of a medicaid stipend you get until eventually some people are off the medicaid option entirely. To those who aren't, well the working poor need more protection anyway.
You have to remove the determination of full time/part time status for the employer portion (pipe dream I know) unless otherwise noted at time of employment. If you get hired under the guise of full time status and your employer purposely keeps you in part time hours as a way to avoid paying their portion, then you have to have recourse.
If, for any reason, you accept employment but do not require full-time status, the employer should offer you what hours they intend to use you a week, to which you can agree, and their portion becomes a percentage of that hourly agreement.
Since kids are being covered through their parents, there's no reason to require their wages to be deduced for healthcare premium availability. There's always talk about how minimum wage is just fine because it's all a bunch of kids working at McDonald's. Well if that's true, even the minimum wage employers in this country can get behind a plan like this.
Finally, there's also a decent probability most people will never spend their entire premium. Sure, employees are likely to use as much as possible knowing they may never see that money in care, but it's unlike most people, in the context of insurance coverages, to take more than the minimums meaning Uncle Sam gets to keep the administrative tax and the leftover whether it's a dollar or a $1000. Specifically earmark the overflow for EIC or Medicaid funding and everyone wins.