AFFORDABLE CARE ACT
“...people working in health benefits have grown
accustomed to expecting the unexpected.”
S
ince the Affordable Care
Act (ACA) became law on
March 23, 2010, the world of
employee health benefits has
been in a state of sustained
upheaval. At the beginning, the
upheaval was significant. Employers,
carriers, and brokers could be heard
saying things like the following:
• “Employers have six months to
start offering coverage to ‘adult
children’ up to age 26, even if the
adult children are married and
have their own jobs???”
• “Employers have to start including
the value of the health benefits
they provide to employees on the
employees’ W-2s???”
• “There are several new fees that
employers must pay to assist the
development of the Marketplace
Exchanges? What’s a Marketplace
Exchange?!?”
On other days, the upheaval was less
dramatic:
•
“Now we have to provide a notice
to every employee advising him
or her of the existence of the ACA
Marketplace Exchanges.
OK.”
Then upheaval resumed:
• “Healthcare.gov crashed?!?”
• “Skinny plans exist?!?”
• “Employers will be penalized for
not offering the right type of
coverage at the right rate and to
the right number of people?!?”
The bottom line is that each year for
the past eight years, the health care
benefits industry has seen quite a lot of
upheaval, and some years the changes
have been difficult to implement.
But the industry has responded,
and after the initial shock wore off,
people working in health benefits have
grown accustomed to expecting the
unexpected.
Enter President Trump.
President Trump’s penchant for saying
and doing the unexpected has been an
interesting reflection of the upheaval
in the world of health benefits. And
four days in October have shown that
surprise and upheaval are likely to
continue. After the Senate failed on two
different occasions to pass a “repeal and
replace” bill, President Trump signed an
Executive Order on October 12th which
permits small groups to join together
in “association health plans;” allows
insurance companies to sell insurance
plans to people “across state lines” and
to sell “short-term insurance plans”
outside the ACA Marketplace; and
permits employers to expand pretax
savings for health care dollars.
Upheaval potentially abated.
So after an October week of health
care reform upheaval, it appears we
may be resettling into two more years
of something similar to what we have
today. It can be stressful in the health
benefits industry to try to keep up
with the day-to-day changes, but with
health care reform, the more things
change, the more they stay the same. +
But without allowing a full news cycle
to pass, on October 13th President
Trump furthered the push to change
the ACA by announcing that the
federal government would no longer
reimburse insurers for selling the ACA’s
reduced-price plans on the Marketplace
Exchange. This announcement set
off a panic within some parts of the
health care industry, with insurers and
other lobbying groups imploring the
President to change his mind over the
weekend. Upheaval continued.
As of October 17th, the President has
not changed his mind. But it appears
that a bipartisan bill being described as
a “short-term fix” for the ACA is being
discussed in Congress. What would this
bill do if it passes? The reimbursements
to insurers by the federal government
would resume for two years, making it
much easier for the carriers to remain
in the Marketplace Exchanges and
giving the federal government more
time to address health care reform.
Jennifer J. Stein, J.D., is the Director of
Compliance at Bowen, Miclette & Britt
Insurance Agency, LLC.
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