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Home  On the Horizon for Healthcare
On the Horizon for Healthcare
Also this year, another bill that became law is the Health Care and Education Reconciliation ACT (HCERA). This law includes provisions, addendums/"fixes" to PPACA.
The changes to the most recently passed PPACA law are regarding Medicare prescription drug coverage, Medicare Advantage, Stark Law self-referral policy and Medicaid matching payments, and other provisions.
Many of the provisions from both laws will affect almost every aspect of the healthcare system from the provider and insurers, to every individual American citizen.
What We Know
There are many different aspects to the Law provisions that do not start at the same time. One main requisite beginning in 2014 is, individuals will be required to have heath coverage for themselves and family members under the age 18.
This coverage must cover "minimum essential benefits" (which are not currently defined, however, if under employer insurance the person is covered). There will be "state based exchanges" or plans, individuals or small groups can purchase through insurers licensed through the state. The federal government will develop the standards and require the states to oversee the programs.
There will be penalties (fines) for individuals who do not "sign-up" for health insurance. These monthly penalties will be a flat dollar amount for adults, $95 in 2014, $325 in 2015 and $695 in 2016 (half these amounts for children) or 300% of adult penalty, or an applicable percentage of household income (1% in 2014, 2% in 2015 and 2.5% in 2016).
These penalties will not apply to those with income below tax filing threshold, with affordability waivers, or who were not covered for less than three months. Click here to calculate a projected cost of your 2014 annual premiums if purchasing individual/family health insurance.
Requirements and Subsidies for Employers How the two Acts impact employers is basically a "tax game". Employers with less than 50 full time employees (FTE's) will be exempt from providing coverage. However, if the employer decides to provide coverage there will be tax incentives.
Employers with more than 50 full time employees are not required to provide coverage, but will be penalized if they don't. Along with the financial impact, there will be administrative requirements for businesses. In order to keep track of the provisions, employers will be required to provide reporting and statements that keep track of who and how many employees participate within the plan and with what kind of coverage the employee is using.
Time Lines
Current health plans are to be "grandfathered" so there is a gradual transition into the new laws. There are some provisions that are effective 2010. Other provisions will be added consecutively between now and 2018. Because the laws are read and reviewed, checked and revised, updates will be made regularly. Click here for the timeline.
How it will impact all of us is the answer that will not appear for quite a few years. We can only speculate. One "take-away"... the onus of healthcare will be directly on individual Americans more so than employers. Click for a Health Care Reform summary.
MEBS is looking forward to being your healthcare solution and a resource for new healthcare reform. |
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