PPACA-ACA-aka Obamacare Rules-Part II

It has been three months since my last update and, regrettably, there is insufficient space on this page to provide you with all of the changes and executive orders that have transpired, so I will attempt to provide you with the most material changes and updated information:

  • 11/14/13 “People who have plans that pre-date the Affordable Care Act can keep those plans if they haven’t changed”. As we all know, the carriers eliminated that option. The executive extension will now include plans that have changed since the law took effect and the carriers can extend current plans that would otherwise be cancelled but the State Insurance Commissioners still have discretion.
  • 12/19/13 Delay the Individual Mandate for those who lost (cancelled) their coverage due to Obamacare.
  • 12/28/13 Massachusetts Site struggling, only 2800 enrollees.
  • 12/31/13 Supreme Court Justice Sotomayor halts birth control mandate.
  • Obamacare contains 20 new or higher taxes on American families and/or small business. Email us if you would like to have a copy of this list.
  • 1/31/13 WSJ Reports-Nearly 50% of the 114 hospital & doctor groups in ACO slowed Medicare spending in 2012, BUT only 29 saved enough money to qualify for bonus payments according to CMMS.
  • 2/8/14 WSJ Reports-“CIGNA latest Insurer to Expect Loss on Exchange (Humana & Aetna also expect losses)”, citing significantly less enrollees than expected and trending to older enrollees.
  • 2/10/14 Businesses with more than 50 employees but fewer than 100 will have an extra year to phase in health care coverage of employees who work more than 30 hours a week.
  • Employers with more than 100 employees will be subject to employee-coverage rules under the Affordable Care Act beginning in January 2015. The mandate to provide insurance had already been delayed one year
  • Businesses with more than 100 employees must offer coverage to 70% of their full-time employees in 2015 and 95% of their employees in 2016. Employers will need to certify on a form that they did not drop employees to avoid providing coverage, under penalty of perjury.
  • Employers continue to be subject to a $3000 penalty for each worker who buys coverage on a “State” Exchange AND qualifies for a subsidy.
  • Health Care Coverage Gap-2010 Supreme Court ruled that the States could decide if they wanted to expand their Medicaid coverage and 24 States refused, thereby eliminating subsidies, fewer insured and eliminating hospital payments previously received to cover the cost of uninsured.
  • New “Copper Plans” being proposed-Lower premiums with even higher “out-of-pocket” costs, a departure from the minimum essential requirement. Backing the proposal is, The Council for Affordable Health coverage, Aetna and CIGNA.

As the weather may permit, we intend to resume our dinner meetings next month for the physicians of Union County to learn more about the ACA and how it will impact you and your practice and the new savings and benefits available through membership in the Union County Medical Society.

If you have any questions, please contact your representative or feel free to contact our office to provide you with further guidance.

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