VOL. 8 | NO. 14 | Saturday, March 28, 2015
SPECIAL EDITION Health Care Reform
By Andy Meek
Talk to almost any business owner, whether theirs is a boutique retail operation or sprawling corporate office, and a two-pronged refrain quickly begins to repeat itself: Health care costs are one of the biggest, if not the biggest, slices of our budget.
And the costs keep getting higher.
That’s long been the case, even before federal lawmakers five years ago passed a controversial, massive and landmark piece of legislation that completely reshapes the country’s health care terrain. But ever since the 2010 passage and implementation of the Affordable Care Act – with the incremental rulemaking and piecemeal rollout that’s taken place since then – there’s now another commonality that binds the business community together.
Wrapping its arms around the health care law’s implications, penalties, new mandates, fines and other components is proving to be a high-stakes game of trying to follow along with an indecipherable map. The legislation is dense, expansive and still being tussled over, with the country’s high court currently weighing a case that legal watchers say could portend any number of dramatic outcomes for the health care law’s future.
The politics surrounding the law also remain so radioactive that it poisons the well when lawmakers in states like Tennessee have considered matters only indirectly related to the legislation. That was the case a month ago, when it became clear the momentum in support of Tennessee Gov. Bill Haslam’s Insure Tennessee proposal was kneecapped by factors that included continued ideological resistance to the law commonly referred to as “Obamacare.”
Haslam had participated in a lengthy round of negotiations with federal officials, looking for a way to expand Medicaid in Tennessee under the Affordable Care Act that would be conservative enough to meet with state legislative approval.
A state Senate panel rejected his approach last month, effectively putting Haslam’s plan on ice. And while state Sen. Majority Leader Mark Norris, R-Collierville, ticked off a list of concerns that gave lawmakers enough pause to vote no on the issue, State Sen. Brian Kelsey, R-Germantown, was characteristically straightforward about his motivation.
Hours after the Senate panel action, Kelsey told The Daily News, sister publication to The Memphis News, his own “no” vote as a member of that panel was a “vote against Obamacare expansion.”
Even Norris acknowledged the political reality afterwards, noting, “My caucus was looking for a reasonable way and process to overcome basic objections to the Affordable Care Act.”
Five years after its enactment, in other words, the law remains something of a political litmus test, a rallying cry by which officials on both the right and left can plant their feet and refuse to be moved. Businesspeople, meanwhile, have no such luxury.
They have no mechanism with which to beat back elements of the Affordable Care Act, about which The Daily News is preparing to host the latest in its regular seminar series. Attendees will hear from experts about what the current rules are when it comes to the kind of health care benefits they do or don’t provide workers.
“From the employers’ standpoint, this is now pretty much the way things are,” said Julie Wells, an attorney with Evans Petree PC who concentrates her practice in health care law as well as general business matters.
She has experience working with multispecialty physician practices and came to Evans Petree from Baptist Medical Group, where she played a key role in things such as physician practice acquisitions and contracts. She’ll be a member of the panel of experts who will convene for The Daily News’ seminar on “Health Care Reform: The Effect on Small Business” Thursday, April 2, from 3 p.m. to 5 p.m. in the Memphis Brooks Museum of Art auditorium, 1934 Poplar Ave.
Among the points she and her fellow panelists will convey: that this year is when employers with more than 100 full-time employees have to cover 70 percent of those workers.
“The employer mandate is the main part of the law that’s going to affect businesses,” Wells said. “It depends on the number of employees the company has as to whether or not they have to meet certain requirements. And it’s sort of a phase-in on the actual implementation of the Affordable Care Act, which has been delayed several times over the past couple of years.”
Wells said there are definitions for full-time employees compared to seasonal, temporary or contract workers. And beginning next January, small businesses with 50 to 99 full-time employees must start insuring their workers as well.
2015 Health Care Reform Seminar
Who: Keynote speakers: Steve Dunavant, managing director, CBIZ MHM LLC, and Ken Rideout, president, CBIZ Benefits & Insurance
Panelists: Dr. George F. Wortham III, executive director, clinical services, MetroCare Physicians; Chirag Chauhan, partner and director of financial services, The Barnett Group; and Julie Wells, attorney, Evans Petree PC
What: The 2015 Health Care Reform Seminar will take a look at how the Affordable Care Act is impacting businesses and what business owners and executives need to know to ensure their companies are in compliance.
When: Thursday, April 2, 3 p.m. to 5 p.m.
Where: Memphis Brooks Museum of Art, 1934 Poplar Ave.
“So by Jan. 1, 2016, all employers with 50 or more employees must offer coverage to at least 95 percent of their workers,” she said.
That requirement then leads to the law’s mandate that coverage be “affordable and adequate,” which Wells and her fellow panelists will help unpack, along with other topics, at the seminar.
Serving as keynote speakers will be Steve Dunavant, managing director of CBIZ MHM LLC, and Ken Rideout, president of CBIZ Benefits & Insurance. Also on hand, in addition to Wells, will be Dr. George Wortham III, executive director of MetroCare Physicians, and Chirag Chauhan, partner and director of financial services for The Barnett Group.
In previewing some of the topics they’re likely to discuss, fines and penalties related to the law emerged as being among the health care legislation’s hot topics. Dunavant said this year, for example, will be the first year large employers will be subject to penalty provisions under the law.
“That was originally scheduled to be implemented last year, and, of course, that got delayed,” he said. “For employers with over 50 and under 100 employees, that begins in 2016.
“Businesses were generally planning for that a few years ago. The delay was helpful. But this year will be the first year penalties are relevant.”
To say the health care law is complicated is an understatement. In 2013, a Carnegie Mellon University study found that more than 85 percent of Americans between the ages of 25 and 64 not only didn’t understand the law, but also didn’t grasp the intricacies and implications of health insurance in general.
“I think a lot of businesses out there (are) struggling with the complexities of it,” Rideout said. “The law includes new reporting requirements, for example, and some businesses, depending on the sophistication of their infrastructure, have the ability to absorb them. The average business wasn’t necessarily prepared, though, nor could they have been.”
Wells said all "applicable large employers," which includes any with 50 or more employees, must file an annual return with the IRS, reporting whether they offered health coverage to full-time employees, and if so, what they offered.
“They’ll have to include certain things like employee names, their address and their tax ID,” she said. “They’ll have to submit a certificate confirming they offered a plan in compliance with the Affordable Care Act. They’ll have to show the premiums they offered and submit everything to the IRS.”
The law still includes a thicket of new provisions and complexities the seminar panel’s experts will try to help employers and small businesses navigate, with a period of questions and answers following the keynote presentations and remarks from the panel.