TPG’s Healthcare Review: July, 2014
“Are We Still On?”
Welcome to the seventh edition of TPG’s Healthcare Review, a forum to keep our clients, candidates and prospective clients apprised of the ever-changing landscape of healthcare in a post-reform world. Tracking the iterations, implementations, extensions and exemptions of the Patient Protection and Affordable Care Act of 2010 (PPACA) can be a full time job. Each new day seems to bring a wave of information which needs to be fully digested before the next news cycle starts. Again, it is our intent to update this newsletter monthly through the end of 2014 to keep you well-informed of the latest developments and their implications. We thank you in advance for your interest, and welcome your comments and questions throughout the year.
In early July of 2013, an announcement came that the effective date of the “Employer Mandate” written into PPACA was postponed for a year. Many of us took a collective sigh of relief as there were so many unanswered questions regarding the implementation of new insurance exchanges, full-time vs. part-time status, compliance issues, etc. Some of those questions have been answered, yet “final rules” under the regulatory process are still forthcoming. As we consider what may be best for us as individuals and businesses, the continued lack of news is a bit disconcerting. This month’s focus will be on some of the unanswered questions, the most poignant being, “Are we still on?”
Over the past month, the Supreme Court ruled on the Hobby Lobby and Conestoga Wood Specialties combined case. In a 5 to 4 decision, the Court upheld the rights of the company owners over the mandates of HHS under PPACA in regards to covering the cost of contraception within qualified plans. The ruling brought an immediate reaction from activists on both sides of the decision. Although this clarified one issue within the PPACA debate, a larger decision looms in the D.C. Circuit Court regarding the legality of the subsidies paid to individuals using the Healthcare.gov website. The text of the law states that subsidies would be available for people enrolled through “an Exchange established by the State.” The IRS issued a regulation expanding the pool of enrollees who qualify for the subsidies. Opponents of the law have argued that the IRS does not have that authority. The decision is due soon and will most likely be appealed to the Supreme Court either way, but it could unravel the strides which have been made in implementing the law. At a minimum, it will require that the law be reexamined and amended to adjust many of the glaring weaknesses in PPACA as it was originally drafted.
Back in April, Robert Gibbs’ shocked the political world when he predicted that the “Employer Mandate” would, and perhaps should, be dropped from the legislation. But as the months have passed, he is no longer alone in his call to drop this contentious part of PPACA. More and more Democratic activists have concluded that penalizing businesses if they don’t offer health insurance is unnecessary. Leading Democrats in Congress have not yet given up on the Mandate, especially before the November election, however the White House has sent signals that its commitment to the mandate is wavering. The administration has twice delayed its implementation within the past year and has labeled it “not critical” as it intends to phase the mandate in slowly beginning in January.
Of course Republican leadership has always opposed the mandate, so it could be a good place to start when overhauling the law. Due to election year politics, it is unlikely that any cooperative effort to amend the law will emerge. Democrats are promising to improve the law while Republicans are vowing to kill it, a rather hostile environment to work together and compromise. So no real action is expected until after the election, and another delay in the implementation date would foreshadow the end of the line for the mandate. Therefore we all wonder “Are We Still On?”
How TPG Can Help Your Business
At The Performance Group, we will do our best to keep you informed of any changes in PPACA which could impact your business/employment. Next month we will discuss our PPACA solution for insurance coverage of temporary employees. Thank you for your continued interest in the TPG Healthcare Review.
Thomas E. Readdy
President
The Performance Group
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