ACHA AND YOU

You all must be aware that I have been bemoaning what I consider to be a fatal deterioration in American Health Care.

This has not been due to a failure in the advancement in the ability to diagnose or treat disease, physical or mental aberrations. Rather it is due to the changes in the methodology of the delivery, availability and application of Health Care.

However, his blog is not focused on the impact of, and this is an oxymoron, concurrent socialistic influenced and business applications in the delivery system. There are many posts which can be accessed via the side bar in the block on those subjects.

Instead I am concerned with the potential impact of the mandatory insurance regulations mandated in the 1000+ pages of Obama Care (ACHA). Jan. 1, 2014 just 6 months and 1 week away is the implementation date.

The law mandates that individuals obtain health insurance. This I will go into in another segment. Most will not be concerned on the impact on employers, but it should be a concern for employees. There is a connection between the two; that is why this blog is focused on business and its responsibilities.

Employers are not required to offer health insurance to employees. However, there are different regulations was for larger emp0loyers; thus with 50 plus FTE and “small business” or under 50 employees.

Although it mandates individuals be covered, the new law does not require employers to offer health insurance coverage to their employees. However, for “large employers” (those with 50 or more full-time equivalents [FTEs]), the law imposes a nondeductible penalty if any of their full-time employees qualify for and receive federal subsidies.

If any worker -- even just one -- ends up getting coverage that is subsidized by the federal government, the employer will owe $2,000 or $3,000 penalty for every full-time employee on the payroll. The large employer penalty is assessed differently depending upon whether an employer offers minimum essential coverage or not.

Individuals whose employers don’t offer minimum essential coverage and whose household incomes are 133–400 percent of the federal poverty level (FPL) will qualify for federal subsidies to help them pay their insurance premiums or cost sharing obligations (e.g., co-insurance or co-payments) under a plan they ( the employee) purchase through a state insurance exchange. More about these exchanges subsequently.

Employers (those with 100 employees or fewer) will be able to buy health coverage for their employees under the Small Business Health Options Program (SHOP) Exchanges, which will be run by state government agencies or nonprofits. Smaller employers (those with 25 employees or less) can get a phased-in tax credit based on the business's contribution to payment of employees' health insurance premiums.

There is no penalty for employers who have fewer than 50 FTEs. But in order to encourage small employers to provide insurance coverage to their employees, "small business tax credits" are available to help offset the employer contribution toward employee premiums.

There is concern that many businesses will find it cost worthwhile to not offer any health insurance and pay the fines. There is no question that with required inclusion of new benefits including dental coverage the premium cost will rise; how much is unknown.

Some companies may choose to offer only a deluxe (Cadillac) type policy requiring a substantial employee contribution and/or co-pay. Some of these decisions will depend on whether the majority of employees are those with low wages or not.

The impact on “small business” is harder to figure. Many will change their employment habit to only part time, less than 20 hours per week. Others will just lay off workers.

Other Segments will follow as produced, but will take a back seat to subjects I feel more worthy.