20 Nov 2012 Election: PPACA Is Here to Stay

The votes have been counted and the campaign signs are gone from yards and highway medians (at least most of them). Now, employers are evaluating what the election results will mean for their businesses in the coming years.

On the national level, Americans chose to keep the status quo with President Barack Obama’s re-election and split party control of Congress. For employers, the most significant and immediate impact of the election will be the preservation and advancement of the Patient Protection and Affordable Care Act (PPACA), according to a Reuters report.

“There’s sort of an immediate acceptance that this law will stay in place in some meaningful way,” Chris Jennings, who served as an advisor to former President Bill Clinton, told Reuters. “It’s sort of like a big barrier has been removed.”

Although the survival of the law now seems all but certain, its final form has yet to take shape. A number of provisions still lack guidance from federal agencies, and employers should expect an “avalanche” of regulations in the coming months, Gretchen Young of the ERISA Industry Committee told Business Insurance.

For example, the details of the penalty ($2,000 per full-time employee) on some employers that don’t offer adequate coverage remain sketchy. Also, employers are still waiting for full guidance on how much they will have to contribute to the federal reinsurance program that is mandated by the law, Business Insurance reports.

In the meantime, employers should focus on the immediate requirements that are known, according to a press release by United Benefit Advisors (UBA). Some of these include:

• Expanding first-dollar preventive care to include a number of women’s services, including contraception, unless the plan is grandfathered
• Issuance of summaries of benefits and coverage (SBCs) to all health plan enrollees
• Reducing the maximum employee contribution to $2,500 if the employer sponsors a health flexible spending account (FSA), beginning with the 2013 plan year
• Providing information on the cost of coverage on each employee’s 2012 W-2 if the employer issued 250 or more W-2s in 2011
• Calculating and paying the Patient Centered Outcomes Fee in July 2013 if the plan is self-funded (insurers are responsible for calculating and paying the fee for insured plans but will likely pass the cost on)
• Providing a notice about the upcoming health care exchanges to all eligible employees in March 2013

The issue of the exchanges — marketplaces that will allow employees and employers to shop for health care coverage represents another question mark for employers. State leaders have until mid-February to decide whether they will set up their own exchange or let the federal government run the show in their state. Nearly a half-dozen Republican-controlled states have already stated they won’t set up exchanges, and more may follow. Because the makeup of these exchanges will affect a wide range of employers, companies should keep an eye on what’s happening in their state, UBA notes.

Of course, the law still faces dozens of lawsuits, including one aimed at overturning the requirement that church-affiliated organizations must cover contraceptives for their employees, Reuters reports. Yet the reality for employers seems clear: PPACA is here to stay.

“There is no way the law is going to be repealed in the next two years, and Republicans know that,” Chantel Sheaks of Buck Consultants L.L.C. told Business Insurance.