We're Spending Less On Health Care Than We Thought We Would Before Obamacare

WASHINGTON -- Twenty million or so more people have health insurance now than they did before Obamacare, and yet the American health care system is on track to spend $2.6 trillion less from 2014 to 2019 than before the Affordable Care Act became law.

That's right -- $2.6 trillion, which is equivalent to about 15 percent of U.S. gross domestic product. That's the conclusion researchers at the Urban Institute came to when comparing health care spending projections made in 2010 before Congress passed the ACA, and projections made later that year after President Barack Obama enacted the statute, with more recent findings.

In other words, more Americans have health coverage and greater access to medical care -- and they're getting it -- but the country as a whole is spending less money than expected, and will continue doing so for at least the next several years.

Prior to the ACA, the actuaries predicted U.S. health expenditures would total $23.2 trillion between 2014 and 2019. After Obamacare became law, the office revised that projection to $23.7 trillion, reflecting the hundreds of billions of dollars needed to pay for the Affordable Care Act's expansion of government-subsidized health coverage. Last year, the actuaries further revised the total to $21.1 trillion. 

The Urban Institute

This chart shows projections for how much the U.S. spends on health care. The top line is what government auditors predicted after the Affordable Care Act became law. The middle line is their projection from before then. And the bottom line is their new estimate.

The Urban Institute report, supported by the Robert Wood Johnson Foundation, uses data from the Office of the Actuary, an independent auditor within the federal Centers for Medicare and Medicaid Services. The actuaries are responsible every year for reporting the total amount that American businesses, the government and households spend on health care. They're also in charge of projecting how that spending will change in the future.

To be clear, the Office of the Actuary has always been extremely reluctant to attribute much, if any, of this trend to the cost-containment provisions of the Affordable Care Act, apart from the funding cuts for hospitals and other medical providers. And the Urban Institute authors don't go that far, either.

At a minimum, however, a combination of factors has resulted in a moment when the uninsured rate has reached a historic low even as the amount the nation spends on health care is turning out to be much lower than anticipated.

Whatever the cause, this country actually is making headway on a problem that's widely considered to be the biggest economic and fiscal challenge of our time.

And as the Urban Institute report notes, the Congressional Budget Office has similarly re-evaluated the Affordable Care Act's spending and also predicted that it will be less costly than originally estimated.

So what's happened since 2010?

The biggest factor is the economy itself. The damage wrought by the Great Recession squeezed down health care spending as people lost their jobs, incomes and health insurance, and subsequently had less access to care. The slow recovery in the years following the recession kept spending from quickly rebounding.

This is consistent with the pattern seen during previous economic downturns, which is why the Medicare actuaries continue to point to larger economic factors as the main cause for the slowdown in health care expenditure growth in recent years.

But historical patterns don't quite account for the fact that growth hasn't reverted to the levels before Obamacare and before the Great Recession, when annual increases could reach into the double digits, even though health care inflation has started to increase again. Instead, spending is expected to rise by about 5 or 6 percent a year from 2014 to 2019, a bit faster than the roughly 4 percent annual increase from 2010 to 2014.

And the relatively higher spending seen since 2014 doesn't represent out-of-control costs so much as it does the simple fact that more people are in the system.

Although the Urban Institute researchers stop short of crediting the ACA with the seeming shift in the health care spending trend, they do note that if the Medicare actuaries and the CBO are wrong, and if Obamacare's cost-cutting initiatives are working as Congress intended, the overall numbers could wind up smaller still.

"Even the current CMS forecast could prove too high," the report concludes. "If current CMS projections do not fully reflect this pattern, spending projections will continue to fall and it will become harder not to attribute at least some of the sustained cost containment to the ACA."

Jonathan Cohn contributed to this story.

Here's What It Would Cost Walmart To Raise Wages To $15 An Hour

CHICAGO (Reuters) - Wal-Mart Stores Inc <WMT.N> would have to spend an additional $4.95 billion if it were to raise the minimum wage for its hourly employees in the United States to $15 per hour from the current $10 per hour, according to an estimate by the UC Berkeley Center for Labor Research.

As the country's largest private employer, Wal-Mart employs nearly 1.5 million people in the United States. Of that, 1.1 million are hourly employees, according to the study. The study estimated that 979,000 employees would get an increase if Wal-Mart went to $15 per hour.

The world's largest retailer raised wages for its hourly workers to $10 per hour earlier this year, but labor groups have called the raise inadequate. They have been demanding a $15 minimum wage, and the "Fight for Fifteen" movement has been a topic of discussion during the U.S. presidential campaign.

The research was released last week and has so far not been reported widely by the media. It was conducted at the request of OUR Wal-Mart, a union-backed group.

A $15 per hour minimum wage would mean an annual hike of $4,006 for part-time employees and $5,836 for full-time employees, the study showed.

The study used government data and worker surveys rather than internal numbers provided by Wal-Mart. The study used the $10 increase in hourly wages at the start of the year as a baseline and simulated that to calculate the results for $15 an hour.

Wal-Mart spokesman Kory Lundberg declined to comment on the wage estimates. He said the retailer is investing $2.7 billion over two years in training, education and higher wages.

In the year ended Jan 31, 2016 the retailer generated $482.13 billion in revenue and posted net income of $14.69 billion.

In an online opinion piece on the study, Christine Owens, executive director of the National Employment Law Project said, "Wal-Mart can easily afford the $15 minimum wage", based on the retailer's annual earnings.

"An employee working 34 hours per week at $10 per hour still earns less than $18,000 per year and cannot meet her family's basic needs on Wal-Mart's wages alone, even in states with low costs of living," she said.

(Reporting by Nandita Bose in Chicago; Editing by Cynthia Osterman)

Gawker Media Files For Bankruptcy

Gawker Media has filed for Chapter 11 bankruptcy protection.

The filing lists the company's assets as between $50 and $100 million and says its liabilities are between $100 million and $500 million.

Gawker is currently appealing a $140 million verdict in favor of former professional wrestler Hulk Hogan, who sued the company for invasion of privacy. In 2012, Gawker published excerpts of a video showing Hogan, whose real name is Terry Bollea, having sex with the wife of his then-best friend. Last month it was revealed that Silicon Valley billionaire Peter Thiel was personally financing Hogan's lawsuit.

In a statement Friday afternoon, Gawker said it had reached an asset purchase agreement with media company Ziff Davis, but other bidders can offer a higher price as the company goes through an auction supervised by a bankruptcy court. 

The Ziff Davis bid is reportedly between $90 to $100 million, according to The New York Times.

Gawker Media's statement: pic.twitter.com/Ntf37UnUlP

— Ben Mullin (@BenMullin) June 10, 2016

"In the event we become the acquirer, the additions of Gizmodo, Lifehacker and Kotaku would fortify our position in consumer tech and gaming. With the addition of Jalopnik, Deadspin and Jezebel, we would broaden our position as a lifestyle publisher," Ziff Davis told employees in a memo announcing the agreement.

The bankruptcy filing is an effort to prevent the company from having to pay out the $140 million in damages, Recode reported.

New York Attorney General Eric Schneiderman defended the New York-based outlet on Twitter.

Freedom of the press is a cornerstone of our nation. Like them or not, sad to see NYC media giant @Gawker forced to the brink.

— Eric Schneiderman (@AGSchneiderman) June 10, 2016

Bollea, meanwhile, expressed gratitude.

What a beautiful day,and the good doesn't prevent the better! In the present I AM always grateful,only good happens to me. HH

— Hulk Hogan (@HulkHogan) June 10, 2016

Chapter 11 bankruptcy is a legal remedy that a distressed business can pursue to restructure its debts in the hopes of saving itself. A bankruptcy judge supervises a plan to make the company financially viable again, including renegotiating its debts.

The company can continue to operate as normal while seeking bankruptcy protections, but it must get the court’s permission for some decisions.

Many large corporations, such as American Airlines, have successfully emerged from Chapter 11 bankruptcy.

Crucially for Gawker, filing for Chapter 11 triggers a stay on all litigation, meaning the company would not have to worry about paying the $140 million penalty or defending against other lawsuits while they go through the process. That could give the company the time and resources it needs to prepare its appeal.

And if Gawker Media fails to reach an agreement with its creditors during bankruptcy, it could be liquidated entirely, which would likely also result in a significant reduction in the payment Bollea receives.

For these reasons, the status of being in bankruptcy actually strengthens Gawker's bargaining position against Bollea. It is "very likely" Bollea will settle for a lower payout during the bankruptcy period, posited John Pottow, a bankruptcy law professor at the University of Michigan.

CEO Nick Denton, a former Financial Times and Economist reporter, founded Gawker Media in 2002. The group now owns eight different websites, including Deadspin, Jezebel and Gizmodo. The sites receive a combined 64 million monthly readers in the U.S.

"Attracting fans and critics alike for their inimitable delivery of news, scandal, and entertainment, the Gawker Media properties are heralded as everything from 'deliciously wicked' to 'the biggest blog in the world,'" the brand's website reads.

The company has built a reputation of calling out public figures for their misdeeds. That approach has led some to accuse it of "spewing hatred" and "bullying," Gawker editors wrote this week in a piece that defended the outlet's "lengthy published record of news, essays, investigations, satire."

Gawker sold a minority stake to investment company Columbus Nova Technology Partners in January, in part to raise money for the lawsuit.

This is a developing story. Check back for details.

Michael Calderone, Willa Frej and Daniel Marans contributed reporting.

How Clothing Designer Eileen Fisher Came To Embrace The Masculine

Sometimes growing a brand means rethinking your leadership style.

Eileen Fisher ran into this problem as her eponymous clothing line approached $300 million in annual revenue. The company grew so big that she recently realized she needed to revise how it's run.

Fisher spoke to The Huffington Post's executive editor for impact and innovation, Jo Confino, at the Sustainable Brands conference in San Diego this week in the video below.

The clothing brand founder talked about the difference between what she called masculine and feminine leadership styles (around the 5:40 mark). Her company has recently become more masculine, she said.

"The feminine is more listening and receptive kind of mode. And I feel like that has sort of helped me hear others, and work with others, and create a collaborative and intuitive kind of environment," she explained. 

"I think we've done really well with this sort of feminine model, but we've kind of hit a point where we're too big almost and we need more structure. I never use the word 'structure' -- and 'strategy.' Those are sort of masculine words to me," Fisher said. 

By dubbing the two management styles masculine and feminine, Fisher noted that she didn't mean to suggest they align with actual gender: There are masculine and feminine traits in everyone. The masculine side values efficiency, she said.

Lately, Fisher said, the company has brought in more men. One man in particular started talking about the differences between masculine and feminine leadership styles. She said she hadn't thought about management that way before. 

"I always saw things moving organically and fluidly and intuitively and all of that. But now we have to be efficient and we have to be effective and we have to be focused and we have to make decisions more clearly," Fisher said. "And we have to have more definition." 

Parents Say Panera Gave Allergic Girl Peanut Butter In Her Grilled Cheese

A Boston-area family is suing Panera Bread, claiming their highly allergic 5-year-old daughter was given two dollops of peanut butter in her grilled cheese sandwich despite repeated warnings to the restaurant of her allergy.

In a lawsuit filed against the chain last week, John and Elyssa Russo of Natick, Massachusetts, claim their daughter had to be hospitalized overnight after the family ordered a meal online on Jan. 28, The Boston Globe reports.

The Russos say they specifically noted their daughter's peanut allergy on the online order form, and so were mystified as to why the extra ingredient had been added to her meal.

“Is this somebody doing this on purpose?" John Russo later asked a manager at the Natick Panera, in his own telling. "Because it’s two freakin’ tablespoons of peanut butter on this sandwich and it’s a grilled cheese."

The Russos didn't realize there was peanut butter in the sandwich until the girl had already bitten into it. She vomited and broke out in hives later that evening, the family says.

Scott Olson/Getty Images

A restaurant manager reportedly apologized for the mistake and blamed it on a "language" issue.

Russo said the manager apologized for the mistake and blamed it on a “language” issue.

A Panera spokesman declined to comment directly on the suit when reached by The Huffington Post Monday.

"Panera takes the issue of food allergens, including the reported incident at our franchise bakery-cafe, very seriously,” the spokesman said in an email. “We have procedures in place across the company to minimize exposure and risk for our guests and associates. We do not comment on pending litigation."

The suit was filed in Massachusetts' Middlesex County Superior Court on Thursday.

This Enlightened CEO Takes Every Friday Off And You Should, Too

Just in time for summer comes more evidence that the four-day workweek is good for your work and personal life.

The boss of a Vancouver-based company describes in The Wall Street Journal how he was close to total burnout five years ago. Then he made a decision that changed everything: He would take Friday as a "free day" and not work.

Brian Scudamore, who is chief executive and founder of home services company O2E Brands, also decided to designate Mondays as "think days," when he works from home and takes no meetings. 

But taking off on Friday was the most important thing he did, Scudamore writes in the article. "[Fridays are] days where I do what I love -- skiing with my children, cooking, learning languages and biking," the 40-year-old says. "When I’m away from the office, things have time to marinate. Connections bubble up and often turn into big, business-changing ideas."

Scudamore's company encourages employees to set their own schedule, too, O2E brand publicist Sarah Gray told The Huffington Post. "We can pick our own schedule -- come in when we want and leave when we want. It's not a culture of 'clock watchers,' " Gray said in an email. "We're more about setting/achieving our goals than we are about hammering home a 9-5 workweek."

O2E

CEO Scudamore out biking and not working.

There's loads of research out there that demonstrates that working longer hours is bad for your health. Working more means that there's less time to exercise, de-stress and sleep, among other things. And that causes real, physical damage. Those who work more than 55 hours per week have an increased risk of stroke compared to those who work less than 40 hours, according to a major analysis of studies that NYMag.com's Science of Us blog cites.

"Overwork and the resulting stress can lead to all sorts of health problems, including impaired sleep, depression, heavy drinking, diabetes, impaired memory, and heart disease," said Sarah Green Carmichael in Harvard Business Review last year.

Long hours are particularly hard on the health of lower-income workers, research shows. They already have more stress just coping with the anxiety of making ends meet and are even more vulnerable to the health risks that overwork brings on.

Overworked, unhealthy employees also cost companies more to insure, are absent more often and their work isn't that hot either.

Though your boss may think that working longer hours is a sign you're working super-hard and productively, the truth is managers don't often haven't a clue about who is really productive. You can't judge someone's performance by how frequently they're spotted at their desk.

The higher-ups at one consulting firm had no idea that some of their best workers were only pretending to put in 80-hour workweeks, according to a widely cited study from Erin Reid, a professor at Boston University's business school.

Scudamore says that taking Fridays off has helped him think more creatively. Anyone who's ever had an amazing idea while in the shower or just taking a walk can surely relate to this. 

And it's not just knowledge workers who see benefits from working less. A century ago, Henry Ford cut worker shifts in his automobile plant to eight hours from nine (and doubled their pay) -- and business boomed. 

Some companies are already on board with the  notion of a shorter week. Basecamp, a Chicago-based software company, does four-day work weeks in the summer. A design firm in Indiana is only open Monday through Thursday because its founder believes his workers are more motivated, according to a piece in CNN Money. The article says that about 14 percent of small companies offer employees a chance to work a compressed four-day week.

If you're at a company who hasn't yet seen the light, feel free to send a link to this piece to your boss. Good luck. (Yes, I wrote this on a Friday, but I do plan to leave early. Baby steps.)

The Obama Administration Cracks Down On Payday Lenders

For the first time, there will soon be broad rules protecting U.S. borrowers from being stuck in a spiral of debt from loans that typically have rates of 390 percent and often higher.

The Consumer Financial Protection Bureau, the agency that Sen. Elizabeth Warren (D-Mass.) conceived, announced a proposed rule covering payday loans, as well as other high-interest lending products like auto and installment loans. Previously, these high-cost loans were mostly regulated at the state level.

The rule takes direct aim at the core business of payday lenders: giving people loans that they can’t afford to pay back without refinancing.

Turning a short-term lack of cash into a chain of unaffordable loans “is the core of the payday loan business model,” payday loan expert Nick Bourke at Pew Charitable Trusts told The Huffington Post in November. “To any objective, fair-minded reviewer, that’s not in question.” CFPB research has found that more than half of payday loans are made to people as part of a string of 10 or more loans.

It's a bit "like getting into a taxi just to ride across town and finding yourself stuck in a ruinously expensive cross-country journey," CFPB director Richard Cordray said in prepared remarks, to be delivered in Kansas City on Thursday.

The CFPB’s proposal contains two key measures aimed at ensuring that borrowing once does not throw consumers into a spiral of unpayable debt. The first measure requires lenders to assess if the borrower has the income to fully repay the loan when it is due without reborrowing. This idea, known as “ability to repay,” targets at the cycle of debt that unaffordable payday loans can trap people in.

The proposed rule also prohibits lenders from making more than two unsuccessful attempts to withdraw money from borrowers bank accounts. Repeated debit attempts cause consumers to be hit with overdraft fees from their banks. Such fees hit half of all online borrowers, costing an average of $185.

In private, the payday lending industry admits unaffordable lending products that force borrowers to take out new loans to pay off old ones are core to the industry's profits. “In practice, consumers mostly either roll over or default; very few actually repay their loans in cash on the due date,” wrote Hilary Miller, a key figure in the industry’s fight against regulation, in an email obtained by open records requests in November.

A 2009 Center for Responsible Lending study found that people taking out new loans to repay old ones make up 76 percent of the payday market. And studies from the Deloitte Financial Advisory Services and Charles River Associates estimated that the CFPB’s proposed rule could reduce the volume of industry loans made by 60 to 74 percent, an indication that the rule would cut significantly into this.

However, Bourke said it doesn't go far enough and doesn't encourage banks to provide low cost loans to needy Americans. “The CFPB has an historic opportunity to encourage safe, affordable lending—and they’re missing it. Its proposal makes it too easy for payday lenders to complete additional paperwork and issue a $500 loan with $600 in fees, while making it difficult for a bank to offer the same loan for $80.”

The National Consumer Law Center said that while the proposed rule is promising, it is concerning that “lenders could make up to three back-to-back payday loans and could start the sequence again after only 31 days.”

The payday lending industry immediately attacked the rule. It "presents a staggering blow to consumers as it will cut off access to credit for millions of Americans who use small-dollar loans to manage a budget shortfall or unexpected expense," chief executive of the Community Financial Services Association Dennis Shaul said in a statement.

Democratic presidential candidate Hillary Clinton applauded the proposed rule and assailed presumptive GOP nominee Donald Trump for wanting to repeal the entire bank regulation law that, among many other things, created the CFPB. "Working families deserve a president who will look out for them -- not payday lenders and special interests on Wall Street," she said.

The agency will accept comments on the proposed rule until Sept. 14, 2016. Those comments will then be examined and considered before the final rule is released.

Here's Another Reason For Standing Desk Users To Feel Smug

Standing desks. Love 'em or hate 'em, there are plenty of articles to back up whatever opinion you have.

On the one hand, studies have shown that standing desks could help reduce your risk of obesity and diabetes. On the other, experts have said standing desks don’t help with weight loss and could give you back problems, so ¯_(ツ)_/¯. 

Now, another study has come out, this one in favor of standing desks. Researchers at the Texas A&M Health Science Center found that standing desks helped employees get more done during the day. Though the results might not translate for all types of work environments, they should give standing desk proponents reason to rejoice.

Published last week in the journal IIE Transactions on Occupational Ergonomics and Human Factors, the study followed 167 employees in a call center over six months. Seventy-four of them used standing desks, and researchers found that they were 46 percent more productive than those who sat at their desks.

The participants' employer, a health services company that's not named in the paper, commissioned the study to better understand the returns on the standing desks it had bought for the office.

Productivity was determined by the number of successful calls to clients that the health and clinical advisors made per hour. The company earned revenue for each successful call, during which an advisor checked in on a client’s progress in an exercise program, for example, or verified to see that a client was taking proper medication.

Employees typically made between 400 and 500 calls a month, and the company wanted them to average around two successful calls each hour. Those who had standing desks met that quota, while those who remained seated averaged 1.5 successful calls per hour, Gregory Garrett, a public health doctoral student and lead author on the study, told The Huffington Post. If an advisor was unable to reach a client over the phone, that was counted as an unsuccessful call. 

Interestingly, the people who stood actually made more phone calls than the ones who sat, Garrett said.

The results almost seem too good to be true -- after all, who wouldn’t want a nearly 50 percent boost in productivity just from using a standing desk?

Even the researchers were a little baffled by what they saw.

“My first thought was, ‘This couldn’t be right,’” Mark Benden, who leads the Ergonomics Center at Texas A&M and was a co-author of the study, told HuffPost. “I would expect the public to raise an eyebrow, and that’s okay. But this wasn’t a snapshot. This was every day, every call, every worker for six months.”

While these results might be unique to a call center or other types of offices where employee productivity is easily quantifiable, the researchers say that cognitive performance can still benefit from less sedentary behavior. 

“Standing has a positive impact on an individual’s cognition, and that could be transferable” to other types of work environments, Garrett said.

The researchers add that their findings could help give companies more concrete evidence of the value of their investments in standing desks.

“How do you justify ‘this desk makes me feel happier, and I feel better’? That’s not going to pay the bills,” Benden said.

But, he continued, the study shows that standing desks can in fact "affect a company’s bottom line. That’s really significant.”

Sheryl Sandberg’s Shoes Perfectly Illustrate The Hypocrisy Of Tech's 'Casual' Dress Code

The rules for dressing for the office are completely different for men and women. 

Perhaps no two people better exemplify the double standard than the most well-known executives working at Facebook: cofounder and Chief Executive Mark Zuckerberg, known for wearing the same grey T-shirt and jeans every day, and Chief Operating Officer Sheryl Sandberg, who is typically seen perched atop towering high heels.

Sandberg is arguably the most influential female executive in Corporate America, inspiring (or pissing off) many women with her book Lean In. Her frank openness about dealing with the sudden death of her husband last year was both heartbreaking and admirable. She's incredibly successful by every measure.

Yet on Wednesday, while watching her talk to Recode's Kara Swisher and Facebook Chief Technology Officer Michael Schroepfer, I caught myself staring at her shoes. Just look at them:

Here's a closer look:

Facebook/Recode

I couldn't help but marvel at the fact that while Zuckerberg slomps around in super-casual clothes every day, Sandberg is smartly decked out in full corporate power garb: towering, patent leather, red peep-toe heels.

Here's a pair of shoes Sandberg wore to the World Economic Forum in Davos in January.

Ruben Sprich / Reuters

And another from the power confab:

Ruben Sprich / Reuters

Here's a photo of Mark Zuckerberg's closet:

Here he is speaking at a recent conference in San Francisco:

Stephen Lam / Reuters

You get it.

To be sure, these two are an extreme example. Sandberg, who holds an MBA from Harvard, is a seasoned executive and considered to be the "adult" in the room who brings balance to Zuckerberg's more introverted personality. And of course, nobody is forcing Sandberg to wear her (extremely stylish) stilettos.

Still, their case highlights the fact that even in the tech world, where the concept of dressing down was invented, and even at Facebook, a progressive company run by a guy in jeans, women and men don't quite play by the same rules.

Women can't just roll out of bed, toss on yesterday's jeans, brush their teeth and do well at work. If they do, they'll struggle in the professional world. One woman I spoke with recently, who works at a private equity firm, told me that she wasn't taken seriously at work until she started wearing stilettos.

In fact, women who spend more time grooming -- including efforts like putting on makeup -- are promoted more often and make more money than their bare-faced colleagues, according to one recent study.

“Although appearance and grooming have become increasingly important to men, beauty work continues to be more salient for women because of cultural double standards with very strict prescriptions for women,” the paper says.

So if you're looking to be the next Sheryl Sandberg, better bust out that lipstick and heels. You'll be be spinning your wheels without them.

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