Count Polly Lower among those who quit their jobs because of the health-care law.
It happened in September, when her boss abruptly changed her job description. She went from doing payroll, which she liked, to working on her boss’s schedule, which she loathed. At another time, she might have had to grit her teeth and accept the new position because she needed the health benefits.
But with the health-care law soon to take effect, she simply resigned — and hasn’t looked back.
“It was wonderful. It was very freeing,” said Lower, 56, of Bourbon, Ind., who is now babysitting her 5-year-old granddaughter full time. With the help of federal subsidies that kicked in Jan. 1, she is paying less than $500 a month for health coverage for herself and her husband.
Lower is an example of the latest controversy to spring up around the Affordable Care Act: its impact on the workforce.
The equivalent of about 2.5 million Americans will quit their jobs, cut their hours or stop looking for work during the next decade because of new benefits available under the health-care law, according to recent Congressional Budget Office estimates that have renewed debate over the program’s effect on the economy.
In its report, the nonpartisan CBO says that workers, taking into consideration the new financial assistance available from the federal government to make insurance more affordable for low- and middle-income people, will scale back their productivity.
It contends that the effect on the labor force will be most pronounced among those who qualify for the subsidies — certain low-income people who make up to 400 percent of the federal poverty level, or $45,000 annually for an individual. The more money people make, the lower their subsidies.
The report cited evidence that government health-insurance programs for the poor discourage work. A study in Tennessee found that the employment rate ticked upward after the state in 2005 kicked 170,000 adults off Medicaid, the state-federal insurance program for the poor.
Economists across the political spectrum agree that workers’ decisions will have an effect on the economy. But like other debates about the law, this one divides along ideological lines and hinges on differing opinions about the fundamental role of government in the lives of Americans.
The White House and its allies argue that the government has a role in addressing a failure of the health-insurance market: the high prices and coverage restrictions that have kept health coverage out of reach for so many people. Like Social Security, which provides a safety net so people can retire, the health law may have the effect of leading some Americans to stop working, they say.
But they called the impact positive, arguing that people have for too long been stuck in jobs that are a poor fit or that they dislike, simply for the benefits. While some people may make the calculation to just work less to keep more generous benefits, many will use their time to do something more productive, such as start their own business or take care of family members, advocates of the new law say.
Conservatives say that the CBO numbers prove that the health-care law will be a drag on the economy. Moreover, they say, it makes no sense to give people subsidies to encourage them to quit their jobs.
“What the White House wants you to think is, if a person chooses to make less income, they must be doing something that makes them better off,” said former Congressional Budget Office director Douglas Holtz-Eakin, now president of the American Action Forum, a conservative policy group. “What conservatives would have you ask is, is it an appropriate use of someone else’s money to put you in that position to choose?”
The CBO acknowledged that there could be some positive economic impacts from unleashing people from their jobs but concluded that there was no good way to quantify that, and therefore left the number out.
Eddie Gonzalez-Novoa, 44, now living in Houston, last year left a full-time job in New York making $88,000 a year plus benefits to help his nephew, a cancer survivor, start a social media and video-gaming site for other teens with the disease.
The Washington Post found Gonzalez-Novoa and Lower through Families USA, a health advocacy group that supports the health-care law and maintains a database of people who have benefited from it.
Uneasy about going uninsured, Gonzalez-Novoa bought a low-cost, bare-bones private health plan last year, he said. But it did not cover his cholesterol medications, which cost $200 a month. It did not pay for the colonoscopy he needed because of a family history. He thought he would soon have to find another full-time job that offered better health insurance.
“I’d like to say that nothing would have stopped me, that I was mission-driven to this family commitment,” Gonzalez-Novoa said. But the lack of quality coverage, he said, “was really starting to wear on me mentally and physically.” He said that he thought he had about six months before he would have had to start job hunting again.
Then he discovered that his income was low enough to get a government subsidy to buy insurance under the health-care law. The plan, which costs about $170 a month, better met his needs and gave him carte blanche to stay at his nephew’s start-up indefinitely, he said — a job he is doing virtually for free.
Lower acknowledged that it has been harder to make ends meet without a steady paycheck. But she said there is no way to quantify the peace of mind she feels, now that she isn’t tethered to a job she hates and can help her daughter, a single mother who works full time, with child care.
Lower expected to miss her job. “It was definitely a scary move to make,” she said. “I’m a person who likes routine, and there definitely was an adjustment period.”
But upon reflection, she said, “I’ve adjusted well.”