With a slim majority of the popular vote and a significant victory in the Electoral College, President Barack Obama was re-elected Tuesday night, ending months of speculation from states and businesses on health care reform and whether all of the Patient Protection and Affordable Care Act’s provisions should be taken seriously, let alone implemented.
They say business loves certainty, and now it’s here: “Obamacare” is the law of the land for the foreseeable future.
“A week ago, we didn’t know what would become of health care reform,” says Jennifer Benz, founder and CEO of Benz Communications. “And that’s frustrating and confusing, not just for employers but also for employees. Now that President Obama has been re-elected, we can better anticipate the road ahead.
“Of course, that road ahead will still be challenging: almost 40 million Americans are expected to go online for health care needs in 2014. This means both federal and state health insurance exchanges will continue working to meet that deadline.”
Steve Wojcik, vice president for public policy at the National Business Group on Health, says changes will come fast and strong. Wojcik says, practically, some of the first things to expect will be regulations spelling out how to implement mandated changes.
“We’ve got some big provisions coming up and big [regulations] to spell out,” Wojcik says. “The exchanges, the individual mandate, the employer requirements, the states have to make a decision on Medicaid expansion — all of those things will go forward and the regs to spell out how to do each of those will come probably soon.”
Though Republicans retained a majority in the House of Representatives and many no doubt will continue to fight PPACA, most experts agree it’s time for even those most opposed to the law to start thinking about compliance. International Foundation of Employee Benefits Plans CEO Michael Wilson says even though health care reform will undergo a “process of review and implementation” and “we will probably still be working to adjust the ACA in 30 years,” the public has spoken.
“President Obama’s re-election provides American employers with the referendum to fully begin implementing the Affordable Care Act,” he says. “Even after this summer’s Supreme Court ruling, many of our members were still awaiting the outcome of this general election before they addressed health care reform.”
Wilson adds that plenty of work remains to be done, even in the context of approved reform. Offering coverage, he says, is only part of the battle.
“It’s important to note that the Affordable Care Act addresses just one of the three broad issues related to health care in America: access. The law provides access to health care, while providing employers and the government more time to address the other two issues: cost and quality of care,” Wilson says.
Wojcik says for businesses, the federal government can’t act fast enough to help facilitate changes.
“From the employer’s perspective, we’re actually kind of worried about the delay in issuing some of the regulations dealing with the employer mandate and the exchanges because we need to know,” Wojcik says. “Many employers are beginning planning for 2014 benefits and they need to know what the rules are to go forward with their planning. So probably an acceleration of issuing of regulations [will be coming].”
But, he adds, even the staunchest proponents of ACA might see some wisdom in delaying some of its key parts, such as the state-level exchanges. As the president and a Democratic Senate look “to cement that legacy” of the most sweeping domestic policy change in years, “there could be a bipartisan push to delay the exchanges for a year or two.”
“States, regardless of whether they have Democratic or Republican governor or a Democrat- or Republican-controlled legislature are feeling a financial as well as resource constraints and timing constraints to get everything ready for the exchanges by 2014,” he says “Especially if they have to make a decision about expanding Medicaid — if they’ve decided to do that, they’ve got their hands full.
“I think they’re going to make a persuasive case to their members of Congress from either party to say, ‘Hey, we can’t do this.’ And the administration could favor it too, because in some sense they want to make sure it’s done well. And if they rush it to 2014 and launch it when it’s not ready with all kinds of problems it could look bad.”
Such thought processes shouldn’t enter into benefit managers’ thinking, Benz says. Most have begun the work of PPACA compliance, she says, and Tuesday’s results mean full steam ahead.
“Employers have already been working with their teams to start implementing reform changes and new regulations, and they need to remain focused on communicating these changes as well. Right now, employees will need to know about SBCs, new info on W2 forms and changes to health care FSAs.” Benz says.
“We have a lot of work ahead,” she adds, “but, as an industry, we have an important opportunity to embrace reform and get people better engaged in their health and prepared for their futures.”
And for many, of course, that opportunity was welcomed.
“The election has settled key issues about the directions that our nation’s health care will take: It means that ObamaCare will be implemented, the Medicaid safety net will be strengthened, and Medicare’s guaranteed benefits will not be undermined,” says Ron Pollack, executive director of the consumer health organization Families USA. “As a result, people across America will gain peace of mind knowing that high-quality, affordable health care will be there for themselves and their loved ones .”
“For Obamacare, the big challenge will be enrolling tens of millions of uninsured people in new health coverage,” Pollack says. “Since most of the uninsured are unaware of the new coverage opportunities that begin in January 2014, this will require a broad public education campaign coupled with a strong enrollment infrastructure.”
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