Do You Have a Handle on Health Care Reform?

The annual open enrollment period for Affordable Care Act health coverage has begun. This year marks the third annual ACA open enrollment to date, and Americans seeking coverage through either federal or state exchanges seem to have become reconciled – if not comfortable – with the process. The popular and media perception seems to be that the ACA has stabilized, and while occasional calls for repeal are still heard in Congress, the belief is that “Obamacare” is now a settled law, and a stable program.

This isn’t entirely true. To date, there have been 14 separate modifications to the Affordable Care Act since it was enacted. The most recent of these, the “Protecting Affordable Coverage for Employees (PACE) Act,” was signed into law by President Obama on October 7.

In other words, the law is still changing only a little more than a week before the open enrollment kicks off. Perhaps it’s understandable, given the complexity of the US health care coverage system and the multiple, labyrinthine layers of bureaucracy involved, but that is small comfort to small businesses who are still struggling to meet its complex requirements. Just when benefits administrators think they’ve gotten a handle on what the ACA demands of them, the ground shifts again – upsetting plans, projections, and budgets, in addition to creating outright confusion.

In fact, the PACE Act changes stand to have a direct effect on some 150,000 small to medium-sized businesses nationwide. Originally, businesses with 51 to 100 employees had been slated to enter a small group health insurance market next year; the result was likely to be an 18% increase in the cost of per-employee coverage. The PACE Act modifies this requirement, deferring to individual states to determine the size of businesses required to enter the small group market. While this is likely to mean cost savings for some companies, it will mean additional complexity for others.

Businesses will have to depend upon individual states establishing small group market guidelines – something they may or may not be eager to do given their individual political climates. In addition, companies doing business in more than one state are likely to find themselves subject to differing regulations for employees based in different states. This stands to make negotiations with any unions more complex, not to mention requiring special measures to prevent the perception of unequal benefits for different employees of the same status and type.

As is often the case, the PACE Act “fix” seems likely to generate more problems that will require fixing in future years. It seems unlikely that the ACA is going to achieve absolute stability any time soon; until it does, businesses will just have to learn to enjoy the ride – and be ready to adapt at a moment’s notice.

Have questions about how the PACE Act is likely to affect your business – or need help arranging affordable, ACA-compliant benefits packages for your employees? Trion would be happy to help. Contact us and one of our representatives will be in touch with you as soon as possible.