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Here it comes! Ready or not! Patient Protection and Affordable Care Act

By Joan Galletta

The Patient Protection and Affordable Care Act, together with the Health Care and Education Reconciliation Act (commonly referred to as Obamacare, or generically, as healthcare reform) was signed into law March 23, 2010. This broad-sweeping federal statute focuses largely on the insurance aspects of our healthcare delivery system, much to the dismay of those who recognize the need for addressing factors that actually drive the cost of healthcare in America. The law creates new government-regulated markets, restricts plan design, dictates rating-structure changes, creates a complex federal entitlement program, and imposes penalties on employers and individuals who don’t comply. Healthcare reform impacts every business in America, regardless of size; and every individual, regardless of income.

Ah, but the law, complicated and voluminous, is only the blueprint for the government’s intervention. As with any law, regulations dictate how the requirements under the law are actually implemented–seemingly endless regulations, written subsequent to the law, and inking out every detail. We have proposed regulations and final regulations, then revised final regulations, and of course, sub-regulation–not to mention clarifications to regulations, addendums to regulations, and don’t forget, the Frequently Asked Questions. We are currently at 20,000 pages and counting.

While some hoped the Supreme Court would derail this crazy train, and still others banked on the election changing its course, it is clear that not only has this train left the station, it is moving full-speed down the track. Will anything on the horizon in Congress or the courts slow its forward progress? Perhaps. But that remains to be seen as this continuing saga unfolds. Right now, however, as a business owner, large or small (not an easy question in itself under PPACA), you need a plan. You need a strategy. To use a favorite analogy of mine: this is chess not checkers, and ladies and gentlemen, it is game-on.

By identifying your obligations under PPACA, understanding your options, recognizing the factors that affect your business’s market position, and acting in an appropriate manner now, you can save yourself substantial time, money, and anguish. There are deadlines to be met with transitional relief from PPACA obligations available to businesses who qualify. Does yours? There are plan compliance issues to assess, and doing so now, rather than later (i.e., at renewal, or worse, after January 1, 2014), can yield overwhelmingly different results. There are options available now that might evaporate with the passage of the next few weeks. So act now.

Most importantly, in order to move forward with some level of surety in a world of uncertainty, you need someone who knows the rules. You need someone who has followed this law from its inception, watched it morph through the volumes of regulation, painstakingly read every regulator release, attended the multitude of seminars, and sat in on the endless webinars. You need an employee benefits consultant that has invested the time to become a subject matter expert: a PPACA chess master, if you will. Be certain that whomever is giving you advice has this level of expertise. At this juncture, this is nothing short of crucial if you want to avoid going off the rails on this fast-moving train.

 

By Joan Galletta

Joan Galletta earned her law degree from The University of Florida College of Law, and has been an Employee Benefits Consultant with JP Perry Insurance, Inc. for the past 10 years.  She is currently Chairperson of the National Legislative Council for the National Association of Health Underwriters, and has served on that Council for four years.  The Council is responsible for reviewing and commenting on PPACA regulations on behalf of NAHU.  Joan also serves on the Florida Health Insurance Advisory Board.  She was appointed to that board by Insurance Commissioner Kevin McCarty in 2006. Joan can be contacted at jgalletta@jpperry.com

 


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