Both the percentage of employers who offer insurance and the percentage of people covered will be important to watch as the changes brought about by the Affordable Care Act (ACA) continue to unfold. New coverage provisions and financial assistance provided in the ACA affect employers’ decision to offer coverage and employees’ decisions to take up any coverage they are offered at work. The employer shared responsibility provision, for example, requires employers with 50 or more full-time equivalent employees to offer coverage to full-time employees and their dependent children or face a financial penalty.
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On Wednesday the Supreme Court will hear oral arguments in Little Sisters of the Poor v. Burwell, a landmark case challenging the Department of Health and Human Services contraceptive mandate under the Affordable Care Act.
It is common knowledge that the Catholic Church has taught the immorality of abortion and contraceptive use for millennia. Yet the regulations in question force our institutions to pay for insurance that covers abortifacients like Ella and Plan B, plus prescription contraceptives and surgical sterilizations.
The United States was founded on the concept of religious freedom. The First Amendment says clearly that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.”
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Vermont has filed a 1332 state innovation waiver to avoid building a website for its small-business insurance exchange. The state hopes to have those employers enroll directly through insurers.
Under the waiver, beginning Jan. 1, 2017, states can request that the federal government waive basically every major coverage component of the Affordable Care Act, including exchanges, benefit packages, and the individual and employer mandates. The only requirement is that a state’s healthcare coverage remains consistent and adequate. Vermont is the first state to send a finalized request (PDF) to the CMS.
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Most of the criticism of Obamacare by its right-of-center opponents has focused on its regulatory mandates, botched implementation and rising premiums for less-favored purchasers. Far less attention has been paid to how little the new health law accomplished in fulfilling its advocates’ promises to boost the growth of small business and new entrepreneurial start-up firms.
The Bureau of Commercereports that new business formation inched up slightly for a few years from its low point in 2010 – after four years of decline. But its 2013 figure of 406,000 new businesses remains far below the recent pre-recession peak number of 560,000 in 2006.
Similar measures of entrepreneurial activity by the Kauffman Foundation find modest evidence of recent upticks, but levels still below historical norms.
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Liberals have been claiming for decades that U.S. companies are at a disadvantage because they help finance health insurance for their workers while their competitors in nations with government-run health systems don’t bear those costs.
Instead of addressing the problem, ObamaCare made it worse.
- The law mandated that U.S. firms provide their workers with health insurance or pay a fine of $2,000 to $3,000 per worker, and imposed significant regulatory compliance burdens on them.
- The American Action Forum estimates that the Affordable Care Act has imposed costs of $50.1 billion in state and private-sector burdens and added 177.9 million annual paperwork hours.
- The Congressional Budget Office estimates that the law will result in a reduction in work hours equivalent to the loss of two million jobs over the next decade.
Highmark Health is cutting reimbursement to doctors by 4 percent effective April 1 for care provided to patients with health insurance bought through the government exchange — the latest effort to trim losses in a market segment that has caused headaches for carriers nationwide.
All Pennsylvania doctors who participate in Highmark’s health insurance plans and treat patients with coverage required by the Affordable Care Act will be affected by the reimbursement cut, said Alexis Miller, senior vice president of individual and small group markets.
The doctors’ pay cut is needed to stem losses in individual health-law coverage as the insurer looks for other ways to stop the bleeding, Ms. Miller said.
The Affordable Care Act changed employers’ role in the U.S. health care system. The ACA fundamentally altered the employer-based system by making the provision of health benefits mandatory rather than voluntary for employers with more than 50 employees and establishing minimum criteria for affordability and coverage. In addition, a “play or pay” model was created, providing employers with an exit: employees would no longer become uninsured if their employers dropped benefits but could instead purchase guaranteed and potentially subsidized insurance through public exchanges.
Two financial milestones are leading employers to evaluate whether they want to play or pay. In 2015, employers with more than 100 employees became subject to a shared-responsibility penalty for coverage that didn’t meet federal standards; further down the road, a 40% excise tax on coverage over a maximum dollar value (the so-called Cadillac tax) is due to go into effect (implementation was originally set for 2018, but Congress recently voted to delay it by 2 years). Although it’s still early in the game, employers are making key decisions that affect patients, health care providers, and insurers.
House Ways and Means Committee Chairman Kevin Brady (R-Texas) on Wednesday gave a nod of approval to a proposal about Obamacare’s Cadillac tax in the White House’s 2017 budget.
“While we will disagree more than we agree today, I do believe that there are some important areas of cooperation. I’m glad that the White House has finally faced reality in one area and agreed that the so-called Cadillac tax is not workable,” Brady said during a hearing on the proposed budget.
Many contractors who provide farm labor and must now offer workers health insurance are complaining loudly about the cost in their already low-margin business.
Some are also concerned that the forms they must file with the federal government under the Affordable Care Act will bring immigration problems to the fore. About half of the farm labor workforce in the U.S. is undocumented.
“There’s definitely going to be some repercussions to it,” said Jesse Sandoval, a farm labor contractor based in Stockton, California. “I think there’s going to be some things that cannot be ignored.”
President Barack Obama is having a tough time winning friends for his Cadillac tax.
His plan to dial back the unpopular ObamaCare tax on high-cost health plans, to be detailed in the fiscal 2017 budget he’ll release Feb. 9, has won him no applause from employers, labor unions or health insurers. The tax still must be repealed, they say, not merely modified.
“The ‘Cadillac tax’ cannot be fixed,” James Klein, president of the American Benefits Council, a nonprofit representing employers, said in a statement. “We’re glad the administration recognizes the ‘Cadillac tax’ is seriously flawed. But its impact in high cost areas is just one of its many problems.”