Thursday, February 6, 2014

2014 January/February Health & Employee Benefits


While discussing his healthcare agenda, President Obama also stressed how he’d have to go at it alone if Congress didn’t start cooperating with him more. Time after time, he promised to act via executive order or other regulatory action if Congress did not pass legislation to address his priority initiatives. The reality is that executive orders will only take you so far, but as we health nerds know all too well, if a law is already on the books on a topic, the president generally does have substantial authority to impose the technical parts of his agenda through regulations. With regard to health reform, he invited alternative approaches by saying, “If you have specific plans to cut costs, cover more people, increase choice, tell America what you'd do differently. Let's see if the numbers add up.” But the president made no pledge to support legislative changes to the law, even those that might make it work better for millions of Americans or help improve the law’s economic impact.

In contrast, during the GOP’s response to the SOTU, Representative Cathy McMorris Rodgers (R-WA) called for Congress to take action to change the law and replace it with something that works. She did not stress full repeal, as GOP leaders have in the past, but instead noted that “We’ve all talked to too many people who have received cancellation notices they didn’t expect or who can no longer see the doctors they always have. No, we shouldn’t go back to the way things were, but the president’s healthcare law is not working.” She went on to say, “Republicans believe healthcare choices should be yours, not the governments. And that whether you’re a boy with down syndrome or a woman with breast cancer, you can find coverage and a doctor who will treat you.” Senator Mike Lee (R-UT) provided a Tea Party response and called for repeal of the law and stated that the best way to stop Obamacare was to offer better healthcare solutions.

30 Hours is not Full Time

The 30-hour full-time employee issue is gaining traction on Capitol Hill. Earlier this week, the House Ways and Means Committee held a hearing on the challenges the 30-hour rule creates for employers and how it will hurt the nation’s employees in 2015. Just today, the House Ways and Means Committee announced that it will be marking up a House bill that seeks to reinstate the definition of a full-time employee to one that works 40 hours per week.

Republican Plan Options

This week when GOP Senators Orrin Hatch (UT), Tom Coburn (OK) and Richard Burr (NC)  introduced a PPACA replacement bill - the Patient Choice, Affordability, Responsibility and Empowerment Act or CARE Act - in the Senate. While the main ideas of the bill aren’t exactly new it is a complete alternative just like the president called for in his SOTU speech.

Under the Republican proposal, the individual mandate, employer mandate and minimum coverage requirements and ban on withholding coverage from people with pre-existing conditions would all go out the window. State exchanges would become optional. Medicaid expansion would shrink - pregnant women, children and families below the poverty line would still be eligible for the program, but childless adults would not. Instead, states would be given a fixed amount per person enrolled in Medicaid to reduce spending. It would also eliminate most of the taxes and fees on insurers, hospitals and medical device companies created under the law to help fund PPACA.

While the proposal gets rid of some of PPACA’s key provisions, it does keep a few, including reserving some subsidies for lower-income people to buy private insurance, though it would change the way they are calculated (families making $70,000 or below would be eligible and employees of large companies would be exempt, regardless of income). It also allows young adults under the age of 26 to remain on their parent’s health plan and keeps the ban on annual and lifetime limits.

Survey: Americans don’t know exchange sign-up deadline
More than half of Americans (55%) do not know the date by which they must purchase health insurance to comply with the Affordable Care Act’s individual mandate provision, according to a survey. In response to a multiple-choice question about the deadline of March 31, 24% thought it was Jan. 1, 2014, 11% said Dec. 31, 2014, 2% said none of these and 18% didn’t know. Only 45% correctly identified the date.

Forty-three percent of young Americans ages 18-29 — whom the Obama administration is targeting for enrollment — knew the correct date.

Regardless, the majority (62%) of all survey respondents expect the individual mandate deadline to be pushed back, while 29% expect it to stand, found.

Sandra Powers-Booth

Health & Employee Benefits

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