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Making the Affordable Care Act Work

4:09 PM February 10, 2015

Making the Affordable Care Act Work

by John Stanford, WIPP Government Relations

In Washington, there are a few axioms on which almost everyone (Rs and Ds alike) can agree. Don't hold events in August. If the meeting is important, take a cab, not the metro. Social media can be dangerous. And of course, no law is perfect.

 The biggest law of the last decade, the Patient Protection and Affordable Care Act (a.k.a. "ACA" or "Obamacare" or "President's Health Law", and so on) is certainly a good example of the latter. The bill's authors, President Obama, and more than just a few Congressional Republicans can agree on that. But that is no different than any other major policy change - they all undergo a period of fixes, tweaks, and changes usually addressing unintended consequences. Blame it on the nature of compromise, the mistakes of over-worked underpaid Hill staffers, or, I kid you not, typos.

 If you read recent communications (or belong to the healthcare committee!) you will see that WIPP is supporting some of these changes to benefit women entrepreneurs. In our view, Obamacare is the law of the land* - but that doesn't mean we cannot change it. Here are the tweaks we have supported recently:  

 

 

Full Time is 40 Hours - Not 30

 The Issue: Obamacare defined a full-time worker as working thirty hours a week. The definition matters for defining whether a business is exempt from the employer mandate (under 50 FTEs is exempt - yes, you have to add in part time employees, but good news: calculator). Just a refresher: if you have more than 50 FTEs and don't offer health insurance, you may face penalties.   

The Fix: The Save America's Workers Act (creative license is allowed in bill names) changes 30 hours to 40 hours for the week calculation. WIPP supports the bill.

WIPP's Position: A workweek is a workweek. Dolly Parton sang 9 to 5, not 10 to 4. The law used a thirty-hour definition in an effort to make the math (i.e. $$$) work. In addition, it was a tool to increase the number of low-hour workers that might receive employer-sponsored coverage. While increasing coverage is laudable, it should not have come at the expense of an arbitrary definition at odds with working America. The Obama Administration signaled opposition to the bill because it could undo some of the coverage gained in the past years. Whether or not this is true (wonks on both sides agree, the change would have little impact either way), the principle of the matter is simple: traditional definitions should not be upended on a whim. An American workweek is forty hours. Part-time workers, who also need coverage, should be addressed, but separately.

 


Bring Back HRAs

The Issue: Some very technical guidance from the IRS last fall removed a simple way for employers to help employees pay for health insurance premiums. Basically, a Health Reimbursement Arrangement, or HRA, let the employee find their own insurance and employers could reimburse employees at their discretion.

The Fix: Two options. One, the IRS could admit this was a bone-headed move and put out new guidance. Unlikely. Two, a few bills in the past Congress would allow HRAs to be allowed for businesses with fewer than 50 employees. WIPP is working with those offices in the new Congress. More to come.

WIPP's Position: If it ain't broke, don't fix it. It worked in the past, now it's broken. Someone should fix this (so to sum up: it wasn't broken, the ACA broke it, now it needs a fix). HRAs can be a good part of a solution that gets more people covered. Often business owners look for the path of least resistance - for some businesses, HRAs can be that path. While WIPP reviews every comma of legislation before endorsing, WIPP would likely back legislation that made this change.

 

Expand Eligibility for the Small Business Tax Credit

The Issue: One of the small business carrots in Obamacare was the Small Business Health Care Tax Credit. But this carrot came with a lot of strings attached (mixed metaphors?). Currently, the tax credit is only available to businesses with fewer than 25 employees and average wages of less than $50,000. Moreover, to receive the full tax credit, which covers up to 50% of employer-paid premiums, businesses must have 10 or fewer employees and average wages of up to $25,000.

The Fix: Expand eligibility for the tax credit. Under the Small Business Tax Credit Accessibility Act, these restrictions would be relaxed to make businesses with up to 50 employees and average wages of up to $80,025 eligible for the tax credit. Additionally, it would extend the number of consecutive years a small business can claim the tax credit from two (current law) to three years. It also removes the requirement that employers claiming the credit contribute the same percentage of the cost for each employee's health insurance.

WIPP's Position: WIPP supports the bill. All these efforts stem from the idea that small businesses need help to provide coverage. Accessing that help should be easy, and not limited to a few businesses. We've heard from business owners nationwide saying that they simply don't qualify under these strict requirements.

In a law that in size 8 font is nearly 1,000 pages, with thousands more in regulations**, there are more than three needed fixes. These are a few where WIPP members' experiences drove us to advocate for these changes. Please let us know if any law is adversely affecting your business. It's what we are here for.

  

*The Supreme Court is currently reviewing substantial portions of the law. Depending on their decision, this could all be a moot point.


**WIPP recently visited with Majority Leader Mitch McConnell's office, which keeps a stack of the regulations, in case you wanted a visual

 

John Stanford is part of WIPP's Government Relations team in Washington, D.C., specializing in federal procurement and healthcare policy. When not bothering lawmakers about needed changes, he can be found in the woods at local golf courses. 

 

 


The Affordable Care Act is working to deliver affordability, access, and quality to millions of Americans across the country.

Looking for health insurance that fits your needs and your budget? Look no further than the Health Insurance Marketplace. All plans in the Marketplace cover essential health benefits, pre-existing conditions, recommended preventive care and more. Open enrollment begins November 15. Enroll by December 15, 2014 for coverage that starts January 1, 2015. To find the latest, most accurate, information about the Marketplace visit HealthCare.gov.

If you have health coverage through the Marketplace, it's time to review your plan and decide if you need to make changes for 2015. Every fall, your health insurance company sends you a letter explaining changes to premiums and benefits for the coming year. You can choose to stay in your current plan (as long as it's still offered) or make changes. If you don't take action by December 15, 2014, you could miss out on better deals and cost savings.

It's easy to renew. There are 5 steps to stay covered: 

1.     Review: Plans change, people change. Every year insurance companies can make changes to premiums, cost sharing or benefits and services they provide. Review your plan's 2015 coverage to make sure it still meets your needs and you're getting the best plan for you. 

2.     Update:  Starting November 15, visit HealthCare.gov and log into your Marketplace account. Answer a few questions to get to your 2015 application - it will be pre-filled with your latest information from 2014. Step through each page of your application and make changes if you need to. This is important - even if none of your information has changed, you might be eligible for lower costs than last year! You also can call the Marketplace Call Center at 1-800-318-2596 to review or make updates over the phone.

3.     Compare:  Log into your Marketplace account and follow the "Enroll To Do List" on HealthCare.gov to compare 2015 plan costs and benefits. New and more affordable plans may be available in your area this year. If you decide to stay in your current plan, follow the directions to search by that plan's 14-digit ID - you can find the ID on the letter from your plan. Or, call the Marketplace Call Center at 1-800-318-2596 for help.

4.     Choose:  Choose a health plan for 2015. You can keep the same plan (as long as it's still offered) or select a new one that better fits your needs. If you want to stay enrolled in your 2014 plan, use the plan ID in the letter you get from your health plan.

5.     Enroll: The Marketplace open enrolment period begins on November 15. Make sure to review, update, compare and choose by December 15 to have any changes take effect on January 1.  Stay covered for 2015! Contact your plan to confirm your enrollment. Make sure to pay your premium.

If you don't finish all of the steps by December 15, we'll try to enroll you automatically so you stay covered. But this coverage might not be your best option for 2015 and you could miss out on cost savings.

If you have questions or need to find someone who can help you in person, we can help. Find local help at: Localhelp.healthcare.gov/

Or call the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855- 889-4325. The call is free.  

On Monday the Obama administration announced another delay in rolling out the Affordable Care Act, weakening the requirement to offer coverage next year for large employers and postponing it for smaller ones. There have been other delays in health-law implementation. What's different about this one?

This is the second big change to rules for employers. The ACA requirement for employers with at least 50 workers to offer minimum coverage - or pay a fine -- was supposed to take effect in January. But after hearing complaints from business, the administration said last summer it would wait until 2015 to penalize employers that didn't offer coverage. Now the administration has moved the deadlines again. Companies with 50 to 99 employees won't have to offer minimum coverage until 2016. And companies with at least 100 employees are required to offer minimum coverage to only 70 percent of their workers in 2015, down from a previous target of 95 percent.  

WIPP recommends you check out the Kaiser Health News Afternoon report. The report answers questions on the latest delay in ACA implementation.  It has excellent information for women entrepreneurs

Join us on Monday, September 23 from 12 PM to 1 PM for a panel luncheon. The location will be at Minnesota State Capitol, Room 118. It will be hosted by Senators Sandy Pappas & Kathy Sheran. For More information, please click here or contact Sarah Paige at Sarah.Paige@senate.mn or via phone at 651-296-6153.

Come and join us for the Enterprising Women--Working with Rheumatoid Arthritis Luncheon on Tuesday, September 24th in Phoenix, AZ.


The Arthritis Foundation, Business and Professional Women's Foundation and WIPP have come together to bring you this educational and insightful luncheon with a power panel discussion on policies and issues affecting women in the workplace.

This is an event you don't want to miss and seating is very limited; contact aavishai@arthritis.org to reserve your spot today! 

For more information, Click on View image.

 

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