The Week in Federal Affairs

  • Obama regulation on coal industry is rolled back! On Thursday, President Trump repealed the Department of the Interior’s Stream Protection Rule. The Indiana Chamber previously had signed on to a letter in support of this action. The letter stated that the Stream Protection Rule “is a one-size-fits-all federal mandate that interferes with the longstanding federal-state balance in overseeing mining operations. It will place massive amounts of coal reserves – and the affordable energy they provide – off limits.” Congressman Larry Bucshon (IN-08) also issued a statement at this welcome news.
  • On Thursday, Senators Joe Donnelly and Todd Young introduced fellow Hoosier Seema Verma to the Senate Finance Committee immediately before the hearing on her experience to become administrator of the Centers for Medicare & Medicaid Services.
  • Young met with the chief of naval operations, Admiral John Richardson, to discuss the Naval Surface Warfare Center (NSWC) Crane and its critical support for our warfighters and national defense. During the meeting, Young urged Admiral Richardson to ensure that NSWC Crane is exempt from the hiring freeze so that it can continue its important work. Young’s meeting this week with Admiral Richardson follows his letter to Secretary of Defense Mattis on January 27.
  • Previously, Sen. Joe Donnelly met with Acting Secretary of the Army Robert Speer on the same subject.
  • Young was also among a group of legislators that met last Friday in Washington D.C. with Japanese Prime Minister Shinzo Abe. Young says the gathering involved a lot of discussion on global security and trade agreements, but his time with the prime minister was focused on economic issues. Read the Inside Indiana Business story, which also includes audio from Young.
  • Congressman Todd Rokita (IN-04) on Thursday re-introduced an important piece of legislation to protect the rights of workers. The Rewarding Achievement and Incentivizing Successful Employees (RAISE) Act amends the National Labor Relations Act to allow employers to give merit-based bonuses, raises or other increases to an individual employee above the level set by the employee’s union contract. Per Rokita, a union contract should not be the ceiling on how much a good employee can earn and the RAISE Act would provide every worker with a chance to earn a bonus.
  • On Wednesday, the CEO of Aetna, one of the nation’s largest insurers echoed growing concerns that the Affordable Care Act is in a death spiral. According to a Politico report, Aetna’s CEO argued that, “More insurers will pull out of the government-run marketplaces in the coming weeks and many areas will have no insurers to provide Affordable Care Act coverage in 2018.” He went on to say, “It’s not going to get any better; it’s getting worse.”
  • On a related note, Rep. Bucshon recently introduced legislation to help stabilize the insurance markets by giving states the flexibility to meet the needs of their unique patient populations.
  • Congresswoman Susan Brooks (IN-05) introduced a measure this week to help veterans get the most from the GI Bill.
  • A honor for Rep. Pete Visclosky (IN-01): He recently received the U.S. Army’s Distinguished Civilian Service Award from Acting Secretary of the Army Robert Speer.

Learn About Alliance for a Healthier Indiana; Reducing State’s Smoking Rate First Up

The Alliance for a Healthier Indiana formed last year; it includes health care professionals, advocates, and community and business leaders from across the state who are committed to improving the health of citizens.

The Indiana Chamber is among the four founding organizations; the others are the Indiana Hospital Association, Indiana State Medical Association and Anthem Blue Cross and Blue Shield in Indiana. The group’s chairman is Bryan Mills, CEO of Community Health Network.

The group came together to jointly pursue public policy measures in several critical areas of need. Indiana ranks at the bottom in many important health metrics including tobacco use, obesity, infant mortality and opioid abuse – and these are just a few critical examples. Our progress toward improvement is impeded by Indiana’s low public health spending per capita.

This contributes to higher health care spending, challenges for employers who want to provide health insurance, premature deaths, poor work and school attendance, and perpetuation of poverty. Our terrible health measures create a negative image for Indiana, making it more difficult to recruit new businesses and professionals looking for a healthy place to live, work and raise a family.

The Alliance will ultimately tackle public health issues such as obesity, infant mortality and opioid abuse. But the first priority is to substantially reduce tobacco usage, which is the leading cause of preventable death in Indiana. The severity of the problem was reinforced just this week during a presentation to the Senate Health and Provider Services Committee by Dr. Jerome Adams, Indiana’s state health commissioner. He emphatically said: “The number one issue that the Legislature could address is smoking.“

Chamber Submits List of Federal Rules That Need Repeal to VP-Elect Pence

The Indiana Chamber is championing the repeal of “the most egregious rules, regulations and executive orders that occurred in recent years.” These targets for the Trump administration were submitted to Vice President-elect Mike Pence this week, just ahead of the inauguration.

The list, per Indiana Chamber President and CEO Kevin Brinegar, contains “issues we have repeatedly heard about from our member companies because they hinder their ability to prosper and provide more jobs for Hoosiers.”

These issues include increased EPA air quality standards leading to much higher energy bills with minimal environmental impact, the overtime rule that would jeopardize jobs and business growth, costly rules related to Obamacare, misguided workplace safety regulations and a fear that the FCC’s net neutrality position could stifle innovation.

“It was all too common for President Obama to circumvent Congress by issuing executive orders and to encourage federal agencies to overreach their authority and diminish economic growth,” Brinegar says.

“The Indiana Chamber is very hopeful this troubling pattern will change under President-elect Donald Trump, and we have encouraged his administration to take action to undo many of the detrimental measures enacted in this manner and to get our economy moving again.”

The 17 suggestions for repeal and their impacts are available at www.indianachamber.com/federal.

The Indiana Chamber also made the state’s congressional delegation aware of these priorities.

Experience Eli Lilly’s Humble Beginnings at Indiana Historical Society

If you haven’t been to an Indiana Historical Society “You Are There” exhibit, you need to rethink some things. They are always artfully done and make for an incredibly engaging way to learn history.

The new “Eli Lilly at the Beginning” experience is no different. I visited the facility in November for a “Getting to Know” feature in BizVoice (stay tuned for the January/February 2017 edition). Actor Mark McNees was quite knowledgeable, both in and out of character as Col. Lilly, and helped me see Lilly in a way I hadn’t before. Like many central Indiana natives, I’ve always heard about the company and its impact on the pharmaceutical industry — and its dedication to philanthropy — but I was admittedly ignorant about its founder and his humble beginnings. This experience allows visitors to interact with not only Lilly, but his first employees (he only had three) and his son, J.K.

He developed his lab in 1876 in what is the heart of today’s downtown Indianapolis. But the industry climate was quite treacherous.

“In the papers, they called Indiana the dumping ground for bad pharmaceuticals,” McNees explained. “So they were what we call patent medicines – not patents like Lilly would have today – patents were like snake oils. So anybody could say ‘I came up with this hair elixir’ and all you needed to advertise in the paper was a testimonial.

“A lot of times they would go to a family member, who’d say, ‘I tried Uncle Joe’s hair tonic and I grew hair,’” he adds. “So they would sell it through wagons or stores. There was zero regulation at the time. Also, people were making medicines incorrectly and often killing people. We dealt with things like belladonna (deadly night shade), opium, strychnine, things like that.”

McNees relayed that Lilly grew his business largely because of his reputation for quality and consistency.

For more on the experience, which is scheduled to run until January 2018, visit the IHS web site.

So What’s Going On With Obamacare?

NOTE: This video was recorded before Donald Trump’s election, which has likely changed the course of the Affordable Care Act going forward. But these comments are on the ACA as it now stands. 

Libertarian magazine Reason interviewed its features editor, Peter Suderman, about the status of the Affordable Care Act. He explains how the rising prices will impact consumers and taxpayers. Is this Obamacare’s “death spiral?”

Questions About Open Enrollment? The Indiana Chamber has Answers

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Open enrollment for health care insurance is now upon us, and many businesses are faced with difficult choices for 2017. Premiums are expected to increase sharply under the Affordable Care Act (ACA) according to many experts – the Department of Insurance says some in Indiana have seen premiums go up by almost 70%!

The Indiana Marketplace (Indiana’s federally mandated online health care insurance exchange) has not been the answer many were hoping for. And don’t forget about the penalty for businesses choosing not to offer insurance to their employees – a penalty that will be adjusted each year to account for inflation.

The Indiana Chamber of Commerce has been working since 2004 to provide members with reasonable health care insurance options supported by brands you trust. In 2016 and beyond, we’re excited to offer a new program called ChamberCare Solutions, with a larger portfolio of health plan options.

This partnership between the Indiana Chamber and Anthem Blue Cross and Blue Shield can help you find the coverage that is right for your business. We are committed to coverage that is simple to understand and affordable. All plans comply with the ACA.

ChamberCare Business Resources: A professional employer organization (PEO) administered by Human Capital Concepts (HCC). Why a PEO? PEOs allow employers to outsource their HR functions and employee benefits programs to ensure they’re in compliance with HR laws and the ACA. By outsourcing to a PEO, you can focus on what you do best — running your business. According to the National Association of Professional Employer Organizations, businesses that use a PEO grow 7% to 9% faster, enjoy 23% to 32% lower employee turnover and are over 50% less likely to go out of business.

ChamberCare Savings: An excellent choice for companies with 51-99 employees, with 5% savings on any Anthem plan.

ChamberCare Exchange: Access to flexible, affordable health plans for companies with 2-50 employees.

Which solution is right for you and your employees? Contact your insurance broker today or call/email Brett Hulse, Indiana Chamber, at (317) 264-6858 or BHulse@indianachamber.com.

ChamberCare Solutions Program Provides Health Care Answers

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More than six years after the Affordable Care Act was signed into law, it’s still not an easy process for companies to determine the best health care choices. Important assistance and options are now available through the ChamberCare Solutions program.

The Indiana Chamber has partnered with Anthem Blue Cross and Blue Shield since 2004 on ChamberCare – an insurance discount offering for businesses with between two and 99 employees. More than 25,000 employee lives (and 50,000 lives when spouses and dependents are included) were covered through ChamberCare.

Now, ChamberCare Solutions takes that partnership to an even higher level with a suite of solutions to help meet insurance needs.

“The Indiana Chamber-Anthem partnership has been an excellent one for our member companies, as well as their employees and families,” says Jennifer Elkin, Chamber senior vice president of marketing. “There have been more questions than answers since the Affordable Care Act was signed. We’ve been listening, discussing and searching for the right tools and products – and we’ve found them in this evolution to ChamberCare Solutions.”

The ChamberCare Solutions options include:

  • ChamberCare Savings: This is the previous ChamberCare discount program – now available for companies with between 51 and 99 employees. This was made possible by the late 2015 signing of the PACE Act (Protecting Affordable Coverage for Employees), which returned the definition of a small business back to one with fewer than 100 employees.
  • ChamberCare Exchange: For companies with fewer than 50 employees and a potentially unhealthy, higher-risk population, the exchange might be the best alternative. Important guidance and navigation is available through Anthem.
  • ChamberCare Business Resources or a PEO (Professional Employer Organization): This is an attractive option for companies that, in addition to a competitive health care product, are looking to outsource some of their human resources functions. The multiple employers in the PEO allow the advantage of using a company’s experience rating compared to the generally more volatile community rating.

The Indiana Chamber and Anthem are teaming with Indianapolis-based Human Capital Concepts (HCC) on the PEO. Harlan Schafir, CEO of HCC, started the state’s first PEO in the early 1990s; he and his team have more than 125 years of experience in the industry.

“We are in the midst of an unprecedented talent war,” Schafir explains. “A PEO allows companies to attract and retain talent by improving employee benefit offerings and helps these organizations mold an attractive culture. Working with a PEO allows companies to focus on their core mission. The PEO takes care of compliance with ever-complex laws and regulations; company leaders focus on running their business.”

  • ChamberCare Shared Savings: This is a future offering under development by Anthem. It is expected to allow for self-funding for employers with as few as 25 employees. To date, such plans have only been available for organizations with at least 100 employees.

“The Indiana Chamber has advocated and educated on health care issues for many years. We’re pleased to add this in-depth navigation benefit,” Elkin adds. “Being able to offer these choices – with more to come – will save members money and allow to further invest in their people and businesses.”

Learn more or contact Nick Luchtefeld at (800) 824-6885.

Policy Circle Co-Hosting Women’s Influence & Liberty Event September 17

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The Policy Circle – think a book club for women to discuss policy (not politics) – and the Center for the Study of Liberty will host the Women’s Influence & Liberty half-day conference September 17 in downtown Indianapolis.

Open to all women – and particularly those who are interested in business, entrepreneurship and even those researching various policy issues – the conference will include a chance for participants to discuss policy issues with each other and policy experts during roundtable discussion breakout sessions.

Nina Easton, chair of Fortune’s Most Powerful Women International Summit, will headline as the keynote speaker. A networking reception will follow the conclusion of the event, from 6 to 7 p.m.

The Policy Circle was formed in Illinois and serves as a catalyst for women to join together and share information and opinions, having read data-driven policy briefs prior to group discussions. The non-partisan, 501©3 organization encourages women to join together and discuss policy issues to educate and engage other women in their communities. Following group discussions every other month, members can take action, such as contacting lawmakers to advocate for specific policies, or following along with proposed legislation.

The group guidelines are to leave the social issues at home, however, and follow the direction of former Gov. Mitch Daniels. He urged for a pause on social issues so everyone could focus on other pressing items, such as foreign policy and immigration, education, economic growth, free enterprise and health care.

With 23 circles in 10 states – including Indiana – and almost 900 women involved so far, the organization is growing. For more information on The Policy Circle, including how to join or start a circle, visit the web site at www.thepolicycircle.org.

The registration fee for the Women’s Influence & Liberty event is $75 and includes lunch; register online.

Telemedicine Law Now Officially in Place

Virtual doctor measures blood pressure

The new telemedicine law went into effect July 1. The legislation (House Enrolled Act 1263), authored by Rep. Cindy Kirchhofer (R-Indianapolis), was enthusiastically supported by the Indiana Chamber because it increases access to care and potentially could reduce costs. Prior to the bill’s passage, Indiana was one of only four states that had not adopted telemedicine legislation.

Telemedicine is defined as the delivery of health care services using electronic communication and information technology, including: secure videoconferencing; interactive audio – using store and forward technology; or remote patient monitoring technology between a provider in one location and a patient in another location. Physicians, physician assistants who have authority to prescribe, licensed advanced practice nurses who have authority to prescribe and optometrists are all authorized to utilize telemedicine.

To provide the telemedicine service, a provider must have established a patient-provider relationship. In that patient-provider relationship, the provider, at a minimum, must obtain the patient’s name and contact info and location; disclose the provider’s name and title; obtain informed consent; obtain the patient’s medical history and other information to establish a diagnosis; discuss that diagnosis with the patient along with the evidence for and risks and benefits of various treatment options including when it is advisable to seek in-person care. The provider must also create and maintain a medical record for the patient and notify the patient’s primary care physician; issue proper instructions for appropriate and follow-up care and provide a telemedicine visit summary to the patient, including any prescriptions.

The law allows for a provider to issue a prescription through telemedicine even if the patient has not seen the provider in person previously as long as: the provider has satisfied the applicable standard of care in treating the patient; the issuance of a prescription is within the provider’s scope of practice; and the prescription is neither a controlled substance nor an abortion-inducing drug. At this time, the law prohibits ophthalmic devices such as glasses, contact lenses or low-vision devices.

An out-of-state provider may conduct telemedicine business in Indiana but must certify to the Indiana Professional Licensing Agency that it agrees to be subjected to the jurisdiction of the courts of law of Indiana and all substantive and procedural laws concerning a claim against the provider.

There was concern during session about liability in providing telemedicine services. Therefore, the General Assembly included a provision that if a provider provides telemedicine services then that provider would be held to the same standards of care as if the health service was provided in an in-person setting.

Regarding the aforementioned prohibition against providing eye glasses and contact lenses, the Indiana Chamber has recently been in discussion with a company that would like to have that provision changed during the next legislative session. This company says it has the capability, via the Internet, of providing a refractive eye exam as accurate as one completed in the doctor’s office. The way the law stands currently, this telemedicine company (based upon its business model) would be prohibited from conducting any business in Indiana.

Health Care Just Keeps Getting Bigger

16446238A few health care economic facts to consider:

  • The United States spends more on health care than any other country – $3 trillion in 2014. That equals $9,523 per person or 17% of gross domestic product
  • In the six years after the recession, health care added 2.1 million jobs, more than the next three industries combined – leisure and hospitality, professional services and education
  • Employment in health care is projected to grow by 19% from 2014 to 2014, adding about 2.3 million new jobs
  • Nearly one in 11 overall jobs is in the health care field. In 2014, that was 12.2 million jobs
  • The top five states with highest percentage of jobs classified as health care jobs: West Virginia, 11.4%; Rhode Island, 11%; Maine, 10.8%; Ohio, 10.6%; and Massachusetts, 10.4%