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.

Gun Stocks Are Up Sharply. You Know Why.

Gun stocks trended sharply higher Monday morning, a day after the deadliest mass shooting in American history killed 49 people and wounded 53 more at a gay nightclub in Orlando. 

Given the increased frequency of these types of attacks, at this point, the sad correlation between mass shootings and gun manufacturers' stock prices surprises no one -- not even the gun manufacturers themselves.

Bloomberg via Getty Images

AR-15 rifles are displayed at the NRA annual meeting in Louisville, Kentucky, on May 20, 2016. On Sunday, a shooter in Orlando used an AR-15 to kill 49 and wound 53 more.

In a letter to shareholders early last month, Sturm, Ruger & Co. CEO Michael Fifer noted a "significant spike in demand" that "was strongly correlated to the tragic, terrorist events in Paris and San Bernardino."

A shooting early last December at a social services center in San Bernardino, California, left 14 dead and 21 wounded. A month earlier, terrorists in Paris killed 130 people and injured hundreds in coordinated attacks.

"[In the past decade] there have been some significant ups and downs in demand, as political rhetoric and threats have spurred demand above the underlying normal rate of demand," Fifer wrote. "These spikes in demand have been followed by periods when demand retreated as the threats to gun rights failed to materialize to the degree that caused the spike in the first place."

True to form, in trading Monday, Sturm, Ruger & Co. was up 8.6 percent:

Google Finance

Smith & Wesson also jumped in early trading, opening up 10 percent before relinquishing some of the gains as the day continued:

Google Finance

"The No. 1 driver of firearms sales is fear," Brian Ruttenbur, an analyst at BB&T Capital Markets, told Bloomberg in December, after the San Bernardino shooting. “Primarily, fear of registration restrictions, banning and things like that.”

Ruttenbur added that people may also fear for their personal safety.

Apparently that fear has become a dominant force. There are more guns in America than there are Americans.

Fundraising Websites - Crowdrise

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." 

Light Facebook Use At Work Could Boost Your Creativity

Do you use Facebook at work? Good news, kind of: That may be the best way to cope with the grinding banality of office life.

A team of researchers in China has published a theoretical paper that draws attention to the use of social media at work as a means of self-therapy when young workers end up in jobs that aren't right for them.

The research, which appeared in the most recent issue of the journal Employee Relations, suggests that the use of social media at work can be a positive thing, as long as it's done in moderation. A little bit of personal social media can spur creativity and give workers an outlet for their stress, the researchers say. But too much social media use, as you might guess, makes people unproductive and often signals that the person feels alienated from his or her job.

Basically, the theory goes, students who go to good schools are under the impression that they will have great, fulfilling, fascinating jobs as soon as they hit the workforce. The reality, especially for more average students, is usually quite different. When their jobs turn out not to be fulfilling, young people often turn to various coping outlets -- particularly social sites like Facebook, Twitter and Instagram -- to help mitigate the stress that comes with their new jobs. 

The researchers suggest that this isn't necessarily a bad thing. A small amount of time spent on Facebook (or the social network of your choice) can actually reduce stress, increase creativity and make young people better at their jobs. But there's a point -- and it's hard to say where exactly -- past which Facebooking becomes a negative factor and adversely affects a person's work.

Jhony Ng, one of the authors of the paper and a professor at Nanjing University of Aeronautics and Astronautics, says he can't quite define that threshold, but he knows it when he sees it.

"The line should be at where one’s non-work-related social media use does not affect their job performance," Ng told The Huffington Post in an email.

In other words, if you spend some downtime on Twitter in between projects, it's probably good for you. If you spend all afternoon on Facebook instead of finishing something your boss asked you to do, that's probably bad.

In an unscientific Twitter poll conducted by this reporter, who was definitely not using social media to slack off, nearly half of the 2,028 respondents said they use social sites to cope with their jobs. Nearly one-quarter say they do not. Another 31 percent do not take Twitter polls seriously, judging by their response of "lol." 

Do you use social media at work as a coping mechanism for dealing with the job that you hate?

— Shane (@shaneferro) June 6, 2016

When young people feel stressed out at their dull, unfulfilling jobs, the authors speculate, it's partly because no one ever told them when they were students about the kind of drudgery and indignity that usually permeate one's early years in the workforce. "How many advisors tell students that the glamorous banking jobs they see in Hollywood movies will not be available to most of them?" the paper asks. 

The paper only looks at young workers, which is deliberate. Young workers have less experience, and are therefore more likely to be in low-paying, low-prestige jobs that aren't a good fit for them temperament- or skillwise. Plus, they simply haven't yet adjusted to the realties of adult life, which for many people include too much work and too much stress for too little pay.

But Ng speculates that social media use will probably decrease as employees get older, "when young workers have truly lowered their career expectations over time, or when they have managed to find more fulfilling jobs."

There's other research that backs up the idea that young workers are particularly stressed. In a Harvard Business Review article from March, data scientist Ran Zilca wrote that one's late 20s are often the most stressful time in life. "Most people start to experience an increase in positive emotions as early as their late thirties, and a few years later also experience a significant improvement in overall satisfaction with life," Zilca wrote.

Then again, there's one thing the article doesn't mention: Sometimes, even at a good job, there's just time to kill. Antonia, a millennial who works as an immigration officer in Mexico and who asked to be identified only by her first name, told HuffPost that she loves her job and her bosses. However, her office is new, and there isn't yet much for her to do. For those times, there's social media. It's a way of coping with boredom "in the dead hours where people don't come or there [are] no appointments for special cases."

She's not the only one.

@shaneferro Sometimes I only need to work 4 hrs out of the 6 hrs I'm at work and I fill in the gaps reading your articles about millennials

— Joshua Geiszler (@joshy_the_pooh) June 6, 2016

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.)

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.”

The Latest Jobs Report Badly Misses Estimates

The U.S. added just 38,000 jobs in May, a statement from the Bureau of Labor Statistics confirmed Friday.

That figure badly missed the expected increase of about 160,000 jobs. In addition, revisions from the past two months of reports subtracted another 59,000 jobs. These show that the economy hasn't grown much at all in the past few months. 

The unemployment rate is down to 4.7 percent. That may initially seem positive, but it comes mostly from people dropping out of the labor force after deciding to give up on their search for a job. The labor force participation rate fell 0.2 percent in May to 62.6 percent, erasing some of the gains that it had made previously this year.

Huffington Post/BLS

There is a tiny bit of good news in the report: the Verizon strike, which ended this week, accounted for 35,000 job "losses" this month. That's because those workers wouldn't be counted as employed while they were on strike over their dispute with Verizon, which owns AOL, The Huffington Post's parent company. Even so, adding those workers back into the labor force still doesn't make this month's number look very good. 

On the pay front, the increase in average hourly earnings is plodding along. After a 9-cent jump in April, the rise this month was a mere 5 cents. The increase makes the average hourly wage now $25.59, up 2.5 percent on an annual basis. That's fine, but not great. 

This report might have an effect on the Federal Reserve’s decision on when its next interest rate rise will be. Fed chair Janet Yellen said in a speech last week that a rate increase may be coming in the next few months "if the labor market continues to improve." The Fed is hard to read, but this figure certainly doesn't count as much of an improvement.

The market does not seem to expect an increase in June after Friday's report. 

Market odds of June rate hike plunge to 6%, per CME Group, down from 20% yesterday. Odds for July now 42%, Sept. 52% https://t.co/P7L9u0bcm4

— Kate Davidson (@KateDavidson) June 3, 2016

University of Michigan economist Justin Wolfers, who almost always has something good to say about the jobs report, had nothing this month.

There's nothing good to say about this employment report.

— Justin Wolfers (@JustinWolfers) June 3, 2016

Unsurprisingly, presumptive Republican presidential nominee Donald Trump didn't think much of the report, either.

Terrible jobs report just reported. Only 38,000 jobs added. Bombshell!

— Donald J. Trump (@realDonaldTrump) June 3, 2016

This article has been updated with additional details and quotes reacting to the release of the May jobs report.