Patient Protection and Affordable Care Act: Estimates of the Effect on the Prevalence of Employer-Sponsored Health Coverage

The share of employers offering health coverage has generally declined in the last decade. Researchers believe that certain provisions of PPACA could affect employers’ future willingness to offer health coverage, such as the availability of subsidized coverage through new health insurance marketplaces called “exchanges” and an “individual mandate,” which will require most people to obtain health coverage or pay a tax penalty. Certain PPACA provisions are scheduled to take effect in 2014. Researchers have provided various estimates of the effect PPACA may have on employer-sponsored coverage. GAO was asked to review the research on this topic. GAO examined (1) estimates of the effect of PPACA on the extent of employer-sponsored coverage; (2) factors that may contribute to the variation in estimates; and (3) how estimates of coverage vary by the types of employers and employees that may be affected, as well as other changes employers may be considering to the health benefits they offer. GAO reviewed studies published from January 1, 2009, through March 30, 2012 containing an original numerical estimate of the prevalence of employer-sponsored coverage at the national level. These included 5 microsimulation models and 19 employer surveys. Microsimulation models can systematically estimate the combined effects of multiple PPACA provisions in terms of both gains and losses of coverage; their results are based on multiple data sets and assumptions. Surveys reflect employer perspectives; they have limits as a predictive tool in part based on varied survey methodologies and respondent knowledge of PPACA

Fair Labor Standards Act: The Department of Labor Should Adopt a More Systematic Approach to Developing Its Guidance

The FLSA sets federal minimum wage and overtime pay requirements applicable to millions of U.S. workers and allows workers to sue employers for violating these requirements. Questions have been raised about the effect of FLSA lawsuits on employers and workers and about WHD\u27s enforcement and compliance assistance efforts as the number of lawsuits has increased. This report (1) describes what is known about the number of FLSA lawsuits filed, and (2) examines how WHD plans its FLSA enforcement and compliance assistance efforts. To address these objectives, GAO analyzed federal district court data from fiscal years 1991 to 2012 and reviewed selected documents from a representative sample of lawsuits filed in federal district court in fiscal year 2012. GAO also reviewed DOL’s planning and performance documents and interviewed DOL officials, as well as stakeholders, including federal judges, plaintiff and defense attorneys who specialize in FLSA cases, officials from organizations representing workers and employers, and academics about FLSA litigation trends and WHD\u27s enforcement and compliance assistance efforts

Nonprofit Board Accountability: A Literature Review and Critique

Accountability is a buzzword in today’s nonprofit society. The press is full of stories detailing the sordid affairs of nonprofit organizations that have betrayed the confidence and trust of the public. What does accountability mean to a nonprofit organization today? What role does the board play in establishing and maintaining this accountability? The purpose of this essay is to explore the current literature on board accountability and recommend a strategy for boards to follow in maintaining their own system of accountability. Three main areas of accountability will be addressed: financial and legal accountability, moral accountability, and outcomes accountability. Self-assessment tools will be reviewed as a means of identifying areas of accountability that a board may need to work on

The Simple Analytics of Accountability

In this paper, the author offers a schematic that distinguishes the actors, interactions, and dynamics of various accountability relationships. A number of distinctions including those between responsibility and accountability, moral and legal accountability claims, and socially or governmentally generated demand for accountability are offered to assist those working on accountability policies or strategies and who may be struggling with generic conceptions of accountability that conflate all of these elements. This publication is Hauser Center Working Paper No. 33.9. Hauser Working Paper Series Nos. 33.1-33.9 were prepared as background papers for the Nonprofit Governance and Accountability Symposium October 3-4, 2006

Accountability in International Development Aid

Contemporary movements for the reform of global institutions advocate greater transparency, greater democracy, and greater accountability. Of these three, accountability is the master value. Transparency is valuable as means to accountability: more transparent institutions reveal whether officials have performed their duties. Democracy is valuable as a mechanism of accountability: elections enable the people peacefully to remove officials who have not done what it is their responsibility to do. “Accountability,” it has been said, “is the central issue of our time.” The focus of this paper is accountability in international development aid: that range of efforts sponsored by the world’s rich aimed at permanently bettering the conditions of the world’s poor. We begin by surveying some of the difficulties in international development work that have raised concerns that development agencies are not accountable enough for producing positive results in alleviating poverty. We then examine the concept of accountability, and survey the general state of accountability in development agencies. A high-altitude map of the main proposals for greater accountability in international development follows, and the paper concludes by exploring one specific proposal for increasing accountability in development aid

Health Care Coverage: Job Lock and the Potential Impact of the Patient Protection and Affordable Care Act

[Excerpt] The majority of Americans—about 55 percent in 2010—rely on employer-sponsored health care coverage, which is largely subsidized by most employers and thus less costly to employees than coverage purchased by individuals on their own. Although a valued employee benefit, many believe that having health coverage tied to employment can influence workers to stay in jobs they might otherwise leave, a phenomenon generally known as “job lock.” The Patient Protection and Affordable Care Act (PPACA), enacted in 2010, includes provisions that are designed to increase the accessibility and affordability of health coverage, particularly for individuals with preexisting health conditions. PPACA implementation is phased; though some provisions went into effect during the year of enactment, many provisions are scheduled to take effect in 2014. Some suggest that one benefit of PPACA may be a decrease in the occurrence of job lock. You asked us to examine job lock and the specific ways PPACA may affect it. Accordingly, we examined two key questions: 1. What has research shown about whether and the extent to which workers stay in jobs they might otherwise leave out of fear of losing health care coverage and the impact of those decisions on the labor market? 2. What are expert views on the ability of PPACA to mitigate job lock

Public Accountability: Performance Measurement, The Extended State, And The Search For Trust

In an Academy partnership with the Kettering Foundation, National Academy of Pubic Administration Fellows Melvin J. Dubnick and H. George Frederickson have completed a study of accountability. The study, Public Accountability: Performance Measurement, The Extended State, and the Search for Trust, is a treatment of the strengths and weaknesses of contemporary applications of accountability to public affairs. The working title of the study was Public Accountability: From Ambulance Chasing to Accident Prevention, but that title was thought to lack the dignity such an important subject deserves. Dubnick and Frederickson challenge the often assumed relationship between performance measurement and accountability. They give special attention to accountability challenges associated with the outsourcing of government work, what they call the Extended State. And, they provide examples of effective public accountability in the context of high trust public-private partnerships

An industry in crisis : risk, reflexivity, sub-politics and accountability processes in salmon farming

This paper draws upon an arena study on the accounting and accountability processes used within a business sector, under intense public and regulatory scrutiny in terms of its social, economic and ecological risks. Georgakopoulos and Thomson (2004, 2005) report on an absence of environmental accounting within the salmon farming organizations for management planning and control processes. This paper extends this analysis by attempting to theorise the social and environmental accounting observed by these organizations discharging these accountability duties using insights from the risk society literature. The interviews and documentary analysis revealed the existence of an active accountability network. However, Social and Environmental Accounting techniques did not feature in the engagement processes. We observed the existence of fragmented accountability networks, and evidence of a struggle for domination of a techno-scientific accountability process. Within these discourses, business and cost issues were evident, but they were not formally quantified or systematically integrated. We find that the accountability processes observed in our arena study, were consistent with Beck's (and others) analysis of reflexive modernity and the Risk Society Thesis This paper by evaluating accounting and accountability processes within a specific context, demonstrates the importance of locating social and environmental accounting processes within wider accountability discourses. These societal accountability discourses extend beyond social and environmental as well as conventional accounting practices. It is suggested that all accounting practices should become more reflexive in nature if they are to remain relevant in these wider societal accountability discourses