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What does the Affordable Care Act 'Obamacare' do?


Health care law difficult to navigate



Open enrollment began Oct. 1. It ends March 31, 2014. Coverage can begin Jan. 1, 2014.

Most people must have health care coverage in 2014. If you don't have coverage in 2014, you'll have to pay a penalty of $95 per adult, $47.50 per child or 1 percent of your income (whichever is higher).
The fee increases every year.

Visit www.healthcare.gov for further information about the Affordable Care Act.

shadow
October 07, 2013
NORTH FULTON, Ga. – With the Affordable Care Act, otherwise known as "Obamacare," at the center of so much trouble in Washington, there is one thing among all the political-speak that keeps getting lost in the shuffle: what exactly is expected of employers under Obamacare?

Big changes are coming to both businesses and individuals regarding the way they think of health care. Eric Helman, chief executive officer of Continuous Health, has made the rounds recently trying to fill companies in on just what they need to know about the new law. He spoke Oct. 1 to the Greater North Fulton Chamber of Commerce, the same day the insurance marketplaces went live.

"It's not a right- or left-wing problem." Helman said. "It's the law.

"Many human resources departments are overwhelmed with compliance and maintenance issues and lack the tools to provide their fellow executives a strategic perspective," he said. "Health care reform has transformed employee benefits into a board-level issue."

Carefully navigating the new rule, benefits and punishments for compliance has suddenly forced companies to take a good look at their health insurance plans offered to their employees.

Between 2005 and 2010, average health insurance costs went up 47 percent, Helman said. With such increases, health care was bound to break sooner or later. As costs go up, coverage and benefits go down.

Thus, there was the need for something to fix it. That's where the ACA comes in.

"Contrary to popular belief, the health care act is not all doom and gloom," Helman said. "This is the biggest opportunity in our lifetime for employers to rethink how they allocate compensation dollars to health benefits."

The ACA has established benchmarks for whom they must cover, what they must offer and how much they can charge for health coverage.

"What is surprising to most people is that these new benchmarks are significantly below what many employers are currently providing," said Helman.

Companies could also be penalized for offering too meager coverage as well as coverage that is too good, so-called "Cadillac plans."

One of the main points of the ACA is to get everyone in the country covered in some way. This should widen the pool of people paying into the system and help control costs.

All employees who work more than 30 hours a week for large employers must be eligible for health coverage or their employer faces potential penalties. If their employers do not meet a certain level of coverage, they may be fined $3,000 per employee.

However, the employer does not have to provide affordable coverage. Instead, the workers can seek their own coverage through either Medicaid or the public marketplaces.

Ideally, no worker is paying more than 9.5 percent of their income on health insurance.

For some employers, it may make sense under the law to stop offering coverage to spouses of employees. Recently, Kroger made headlines by doing just this. However, this could end up being better for spouses of low-wage workers because they can now access subsidized coverage in the public marketplaces, Helman said.

"Kroger may have made the most benevolent offer to their employees," he said.

If the employee's spouse has coverage from the company, the spouse cannot seek coverage through the insurance exchanges. By cutting them loose, they can now seek subsidized coverage that should save them – and the company – money.

Helman stressed that employers should use Obamacare as a catalyst to create a strategy – look at their options carefully and pick a path they think will work best and stick with it.

"It's not about which strategy you pick, it's about picking one and being intentional," he said.

Editor, Milton Herald
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Tags: Business News, Government & News & Crime

  1. report print email
    Question?
    October 08, 2013 | 06:48 AM

    How does widening the pool of people who pay into the system help control costs? Doesn't this increase the pool of money available to pay for medical charges and therefore provide the temptation to increase those charges?

    If the pool of people with insurance is expanded through government subsidy of the insurance cost, how does that control costs?

    Is the proper strategy for business to follow the same as has been done with retirement benefits? By that I mean to move from defined benefit plans to defined contribution plans.

    An Observer
    Johns Creek
  2. report print email
    Healthcare costs will go down
    October 08, 2013 | 11:32 AM

    Right now all of us taxpayers are paying through the nose for those that are uninsured. We pay for their hospital and emergency room care.

    It's about time that all these people will be required to get health insurance.The Affordable Healthcare Act should have been passed decades ago.

    Marsha
    Johns Creek
  3. report print email
    Taxes
    October 08, 2013 | 11:34 AM

    And get GE, Microsoft and the NFL to start paying their taxes. These companies are tax-exempt, why?

    Marsha
    Johns Creek
  4. report print email
    Healthcare costs will go down
    October 10, 2013 | 06:05 PM

    Marsha, you might want to look a little more closely at what is going on. They are trying to add 30 or 40 million uninsured people to the government dole. They are banking on young people who never bought insurance before to start footing the bill for those people. Hence the individual mandate. So, I'd get used to paying through the nose.

    Not only are costs going to go up, I think we'll see a shortage of doctors. My mother who lives in Roswell is already having trouble finding a doctor that will take Medicare. Her current doctor stopped taking Medicare.



    Concerned
    Alpharetta
  5. report print email
    Short on facts
    October 15, 2013 | 08:36 PM

    Please do no use this article as a good piece of Clif Notes on ACA. There are many, many pieces of information missing. ACA has done very little to mitigate the cost of healthcare in the US--the TRUE cost of health care. In fact, the benchmarks they discuss above are the minimum values, but the true cost are the benefits that have not been federally mandated. Most people also do not realize that before ACA, the health care industry was already the most highly regulated industry. All benefits and their associated rates have to be filed and approved by each state DOI. So while the Federal creates a federal level, state by state insurance companies were already being kept in check on some level. So ACA mandating better benefits are going to increase costs. The Fed has stated you get better benefits, but they did not tell the insurance companies they could not charge for it. There is a part of the law that addresses insurers cost, but like any business, insurance companies can "cook the books" as they say. The numbers of younger people actually joining and not just paying the fine keeps getting lowered as well, so you cannot use that as your pawn to lower the cost. I could go on and on--but please do more research. This article is very short on information and rightfully so with a law as broad as this. Finally.....think of the financial state of SS, Medicare and the Post Office.....yay government

    The Insider
    Cumming
  6. report print email
    Short on facts
    October 15, 2013 | 08:37 PM

    Please do no use this article as a good piece of Clif Notes on ACA. There are many, many pieces of information missing. ACA has done very little to mitigate the cost of healthcare in the US--the TRUE cost of health care. In fact, the benchmarks they discuss above are the minimum values, but the true cost are the benefits that have not been federally mandated. Most people also do not realize that before ACA, the health care industry was already the most highly regulated industry. All benefits and their associated rates have to be filed and approved by each state DOI. So while the Federal creates a federal level, state by state insurance companies were already being kept in check on some level. So ACA mandating better benefits are going to increase costs. The Fed has stated you get better benefits, but they did not tell the insurance companies they could not charge for it. There is a part of the law that addresses insurers cost, but like any business, insurance companies can "cook the books" as they say. The numbers of younger people actually joining and not just paying the fine keeps getting lowered as well, so you cannot use that as your pawn to lower the cost. I could go on and on--but please do more research. This article is very short on information and rightfully so with a law as broad as this. Finally.....think of the financial state of SS, Medicare and the Post Office.....yay government

    The Insider
    Cumming
  7. report print email
    Can't beat them join them
    October 16, 2013 | 06:30 PM

    I figure if I stop being productive, I can get free health care, food, cell phone, living assistance & vacation! Only in America!!!

    Screwed
    Cumming
  8. report print email
    Can't beat them join them
    October 16, 2013 | 06:30 PM

    I figure if I stop being productive, I can get free health care, food, cell phone, living assistance & vacation! Only in America!!!

    Screwed
    Cumming
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