Congress Considers Revisions to ACA to Help Small Businesses

Attempts to repeal a tax on insurance companies in the new healthcare reform law are picking up steam in Congress, driven by worries that the fee would affect small businesses especially hard.

The legislation would get rid of the fee on health insurance companies set to go into effect when the law does in January 2014. Referred to as the health insurance tax (HIT tax), the fee will be calculated based on the plans insurers sell right to individuals and companies, known as the fully insured market, but doesn’t include plans established and managed by companies themselves, known as the self-insured market.

The majority of big companies self-insure their workers; as a result, experts forewarn that insurance companies will pass the added costs of collecting the fee to small businesses, which are inclined to buy coverage in the fully insured market.

“It’s pretty straightforward, what’s going to happen, that the tax is going to be passed along,” Rep. Jim Matheson (D-Utah) said in an interview, observing that insurance agents and underwriters have told him as much. “It isn’t really taxing the insurance companies, it’s taxing the people paying the premiums, and in this case, that’s small business owners.”

Matheson is one of several democrats who have pledged their support to the legislation repealing the HIT tax, uniting with almost every Republican in the House. Recently, the bill, H.R. 763, hit the 218-cosponsor mark, which is enough to guarantee its passage in the lower chamber; the tally has since increased to 221.

Sam Graves (R-Mo.) attributed the bill’s momentum to trepidations expressed by small business owners, including many who have testified during hearings before the House Small Business Committee, over which he officiates.

“We keep hearing that from small businesses; that they’re premiums keep going up, keep going up, and now this thing’s coming along, and they’re going to go up even more,” said Graves. “That’s the reason you’re hearing so much about this tax and why you’re seeing such bipartisan efforts to repeal it.”

Those efforts, however, are fighting against the political current on the Hill, where lawmakers have been reluctant to consider proposals to modify the health care law.

This hasn’t discouraged small business advocates from pursuing small fixes, and their efforts are starting to yield signs of progress. Recently, Sens. Susan Collins (R-Maine) and Joe Donnelly (D-Ind.) introduced legislation that would change the health care law’s definition of full-time employee from 30-hour workers to 40-hour workers, a shift meant to keep labor laws more steady for businesses.

Prepare for Affordable Care Act: Tips for Employers

With the Affordable Care Act (ACA) set to go into effect in January 2014, many employers supporting group health care plans are rushing to get ready for the impending changes. Here are some tips on how to prepare for the upcoming implementation of the ACA:

1. Figure out how the ACA will affect your business. According to Forbes, when the ACA is ratified, it will oblige businesses with over 50 full time workers to offer affordable healthcare to them. The ACA is demanding employer coverage just for those who work over 30 hours per week for a period of a month. Corporations who wish to avoid providing this medical insurance for their workers and who are on the verge of having 50 employees may then look to temps and staffing agencies in order to evade being forced to obey the law or create more part-time jobs as another way to shirk the ACA’s policies. Companies doing this will undermine the legislation and its intentions of increasing coverage to more American employees.

2. Choose whether to “pay” or “play” and make decisions about your insurance. To “pay” is to pay employer-shared-responsibility penalties of around $2,000 per employee per year. To “play” is to offer employer-sponsored coverage to fulltime employees.

3. Think about adding wellness program incentives. According to a recent survey by the Midwest Business Group on Health, more than 80% of the country’s biggest employers are looking to implement a penalty and reward system to encourage their workers to get healthy.

4. Organize and give out obligatory employee communications like a summary of benefits and coverage, plan descriptions, etc.

5. Amend your Health Insurance Portability and Accountability Act privacy and security rules and processes before the Sept. 23, 2013, deadline for acquiescence with final regulations.

6. Pay the first comparative effectiveness research fees by July 31, 2013, and plan for future reinsurance charges.

The Affordable Care Act: 5 Changes Healthcare Organizations Must Know

Recently, the U.S Department of Health and Human Services (HHS) has issued final rules applying some crucial consumer protections from the Affordable Care Act (ACA). The intention of lawmakers and government bureaucrats when drafting the Affordable Care Act legislation was to enrich health care benefits. Under the final rule, all individuals and employers will have the ability to buy health insurance coverage no matter what their health status may be.

Insurers will also be stopped from charging discriminatory rates to people and small employers based on reasons like health status or gender. The HHS is now demanding that most health plans include the following requirements by 2014:

1. Reasonable Health Insurance Premiums
Coverage offered to individuals by health insurance companies will only be allowed to vary their premiums based on age, tobacco use, family size, and geography; to base the premium on factors other than those will be illegal.

2. Availability
Almost all health insurers that offer coverage to individuals and employers will have to sell health insurance policies to all consumers; no one can be deprived of health insurance because of a current or past sickness.

3. Renewability
Under the new rules, health insurers will not be able to refuse to renew coverage due to a person becoming sick. Consumers hold the power to choose to renew coverage.

4. Single Risk Pool
Health insurance companies won’t be able to charge higher premiums to higher cost consumers by placing them into separate risk pools. The insurers will need to have a single statewide risk pool for the individual market and one for the small group market.

5. Catastrophic Plans
Consumers will have the right to a catastrophic plan in the individual market. The plan will typically have lower premiums, protection against high out-of-pocket costs, and include recommended preventive services without cost sharing.

When these ACA requirements go into effect in 2014, expect a substantial increase in patient volume. Whether you view healthcare reform as positive or negative, it could prove beneficial to nurse staffing and other forms of healthcare staffing.

Healthcare Options for Small Businesses are Limited until 2015

The Obama administration recently verified that part of the 2010 health-care law geared toward helping small businesses offer insurance to their employees will be pushed off by a year.

The department overseeing Medicaid and Medicare announced that the launch of the federal SHOP Exchange, an online marketplace where businesses with less than 50 workers would be able to buy insurance for their employees and get a tax credit, would be on track for Oct. 1. However, the initial expectation that employees would be able to choose from a variety of plans has been quelled as they will only have one option for a plan. The full selection of healthcare plan options won’t be available until 2015.

The postponement recommended earlier in the year upset some business supporters and provoked questions about whether the administration was lagging on the implementation of the healthcare law.

While large companies will be obligated to provide insurance starting next year under the law, it will be optional for those with less than 50 employees. John Arensmeyer, head of the Small Business Majority, an advocacy group that supports the health law, said the news would probably deter some companies from offering insurance to their employees.

States that already established their own health insurance exchanges won’t be impacted by the delay.

Health Care Reform Will Lead to Stricter Workplace Wellness Programs and Harsher Penalties

The Obama administration recently announced the final rules on employee wellness programs under the Affordable Care Act (ACA). The U.S. Department of Health and Human Services issued the regulations, which were enacted under the ACA on May 29. The program allows employers to increase the incentives they give workers to get them into a wellness program or other means of promoting healthier choices and behavior. It supports workplace health encouragement and deterrence as a way to decrease chronic sickness, better health, and regulate growth of health care costs while making sure workers are safe from unfair underwriting methods that could lessen benefits based on health status.

Employers also get clarity on applying penalties for unhealthy employees. Under the new regulations, employers have greater flexibility to charge higher premiums to workers who do not meet certain health goals.

According to a recent survey by the Midwest Business Group on Health, more than 80% of the country’s biggest employers are looking to implement a penalty and reward system to encourage their workers to get healthy.

The rules support “participatory wellness programs,” which are typically accessible no matter the individual’s health status. Included are programs that compensate employees for the cost of membership to a gym or fitness center, rewards for those who attend a free monthly health education meeting or who undergo a health risk assessment.

The final rules protect users by demanding that health-contingent wellness programs be logically planned, equally available to all similarly situated people, and that they accommodate suggestions made at any time by an individual’s doctor founded on medical appropriateness.

Due partially to the ACA, 82% of almost 100 global and national businesses are lowering premiums and offering gift cards for healthy living or charging higher co-payments and fees for poor health choices like smoking. The final rules will go into effect starting on or after Jan. 1, 2014

Read the official news release from the U.S. Department of Health & Human Services here: http://www.hhs.gov/news/press/2013pres/05/20130529a.html

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