Sunday, July 7, 2013

Health-Care Rule’s Delay Is Applauded By Business Groups - Stay Informed!



As Perry Castro contemplated implementing the Affordable Care Act at his business in Virginia, he feared he would need a new full-time employee to handle all the requirements.

In mere months, Allied Associates International would have to tell the government how many hours each of its 70 employees worked, whether they were enrolled in the company’s health plan, and numerous other facts. Such extensive recordkeeping was the last thing the defense contractor needed as it struggled to navigate federal budget cuts and a halting economic recovery, Castro said.

Complaints from small businesses across the country influenced the Obama administration’s decision Tuesday to delay a requirement that all employers with more than 50 workers provide health insurance to employees who log more than 30 hours a week.
 
In the months before the administration’s decision, companies have said they would stop hiring or cut some workers’ hours to part time to avoid the law’s bureaucratic burdens. Others anticipated spending more to keep up with the law’s reporting requirements and to beef up their health insurance offerings.
 
So for many companies such as Castro’s, the one-year delay came as a relief, if only a temporary one.
“Sure, it gives me one more year to operate without the added costs of the new reporting requirements, but other than that, it doesn’t really help us,” said Castro, whose company provides cyber-intelligence and training services to the Defense Department. “As long as that hammer is still cocked and ready to fall, we’re going to get hit with it sometime. It’s just a matter of when.”
The requirements were confusing, burdensome and more work than his staff could handle, Castro said. It is frustrating given that the company already provides health insurance that most employees use, he said.

“I run a very lean back office, which helps me keep my costs down [and] my employees well compensated,” he said. “The more reporting requirements they add, the more my administrative costs go up, and that’s a shame.”

Since the 2010 enactment of the health-care overhaul, business owners have railed against many of its provisions, including the “employer mandate” and its financial penalties for noncompliance.

Businesses said the reporting requirements that come with the law will eat away at valuable staff time or, in cases such as Castro’s, require a new employee.

They say the work would be especially burdensome in many retail and service jobs, where employee hours often shift from week to week and turnover is high.

In addition, many businesses were concerned that the federal reporting systems used by employers to report on their employees’ health benefits were untested. Many complained that the law’s regulations have yet to be fully fleshed out.

At a minimum, business advocacy groups said, the delay will give employers time to learn more about how the health-care marketplace is being reshaped by the law.

Employers said they would benefit by seeing how the new health insurance exchanges are working and what options are available from insurance plans before they make crucial decisions about health-care offerings for their workers.

“It is a welcome relief for most employers, especially for those who had to make some decisions about benefit changes and maybe even workforce changes for 2014,” said Steven Wojcik, vice president of public policy at the National Business Group on Health, a nonprofit association of more than 360 large employers. “We should know a lot more a year from now.”

Although the employer mandate is delayed, other parts of the law are moving forward, creating new tasks for employers.

“This type of ad hoc, individualized reporting beginning this fall and continuing through 2014 is still likely to be administratively challenging for many employers,” said Brian Haile, senior vice president for health policy at Jackson Hewitt Tax Service.

Many opponents of the Affordable Care Act have argued that the law will be a disincentive to create new jobs in a struggling economy, particularly for firms that have just fewer than 5o workers.

Some employers said they would cut workweeks below the 30-hour threshold to avoid the mandate.
The National Federation of Independent Business is among the organizations that have predicted that the law will prove to be as unworkable next year as they believe it is now.

“Temporary relief is small consolation,” said Amanda Austin, director of federal public policy for the business group. “We need a permanent fix to this provision to provide long-term relief for small employers.” 

Original Article By Michael A. Fletcher and J.D. Harrison via http://articles.washingtonpost.com/2013-07-03/business/40344147_1_health-insurance-requirements-employees

Obamacare's Medicaid Expansion Shortfall Shuts Millions Out of Health Care - Must Read!



Rose Ruiz earns $8 an hour taking care of a 67-year-old diabetic on Medicaid in Austin, Tex. At an annualized rate of $16,640, she can’t afford to buy her own medical insurance. Her best shot at getting coverage was through the expansion of Medicaid mandated under the Affordable Care Act. But because of a U.S. Supreme Court decision that the law’s Democratic authors in Congress never anticipated, millions of low-wage workers who were supposed to be helped by Obamacare will probably end up without coverage.

Obamacare set aside billions of dollars for states to expand their Medicaid programs. Twenty-four of them, most led by Republican governors, have opted out since the Supreme Court ruled a year ago that states could choose not to participate in the expansion. That’s left their low-wage workers in a bind: They make too much to qualify for Medicaid in its present form, but too little to afford a plan their employer might offer. And they don’t earn enough to qualify for subsidies available to help the uninsured buy plans on the state-run Obamacare marketplaces opening in October. These subsidies are available to people with modest incomes—$24,000 to $94,000 for a family of four. Democrats in Congress who wrote the law figured anyone making less would get coverage through the Medicaid expansion.

States dictate the rates they pay companies for providing Medicaid services. The companies then decide the hourly wages they pay home-health aides like Ruiz, which average less than $10 an hour nationally, says William Dombi, vice president for law at the National Association for Home Care & Hospice. Many health aides in states that aren’t expanding Medicaid could need pay raises equal to triple their current wages or more to qualify for the Obamacare subsidies. “It’s one of those things that I’m sure nobody thought about when they were putting this together,” Dombi says.

The problem leaves employers with their own predicament. Those who don’t offer coverage face fines of as much as $3,000 per employee. Yet if an employer offers a new health plan for workers who can’t afford the existing one, and the new plan is deemed “affordable” under the law—meaning it would cost an employee no more than 9.5 percent of his income—then the employee becomes ineligible for Obamacare subsidies to buy a potentially cheaper plan offered through a state-run marketplace. “Lots of employers are really agonizing with the decision,” says Steve Wojcik, vice president for public policy at the National Business Group on Health, a lobbying group. They’ll now have more time to figure it out. On July 2, the Obama administration pushed back the penalties, set to take effect next year, to 2015.

The snafu might hurt low earners in Texas the most. The state has the highest rate of uninsured people in the U.S.; expanding Medicaid would have extended coverage to 1.5 million Texans by 2017, according to the state health department. Many home-health aides would have qualified, says Jennie Baird, president of the Texas Association for Home Care & Hospice in Austin.

Only days after the Supreme Court ruled last June, Governor Rick Perry vowed not to let the state expand Medicaid, saying it would “make Texas a mere appendage of the federal government when it comes to health care.” State lawmakers considered a proposal to press ahead with the expansion, but Perry threatened a veto and it died. His spokeswoman, Lucy Nashed, says the governor prefers to make “common-sense” changes to the existing program. He wants Texas to have more authority to limit eligibility for Medicaid, and to charge Medicaid patients co-pays.

Shantelle Williams, a home-health aide who makes $7.25 an hour caring for Medicaid patients near Dallas, is one of the many Texas health-care workers who’s likely to go without any coverage at all. “The politicians don’t know where I’m coming from,” she says. “That decision was for them, it wasn’t for me.”
The bottom line: Because nearly half of U.S. states aren’t expanding Medicaid, poor workers are likely to end up without insurance.