AUGUSTA, Maine — Though most people by this point accept that the Affordable Care Act is here to stay, efforts continue to tweak the historic health insurance reform law and lessen its effect on businesses, according to a representative of the U.S. Chamber of Commerce, who was in Maine on Thursday morning to discuss the subject.
Jennifer Pierotti, the U.S. Chamber’s manager of health care policy, spoke about changes to the Affordable Care Act, also known as Obamacare, the chamber will be lobbying for in the coming year at a forum on health care policy held by the Maine State Chamber of Commerce in Augusta.
The federal government has continued its implementation of the ACA, also known as Obamacare, despite the various delays and glitches its rollout has confronted. Those delays, according to Peter Gore, vice president of government relations at the Maine chamber, “have resulted in a unique opportunity for businesses to step back and seek answers and solutions to the questions they have.”
Pierotti said some individuals and businesses are facing sticker shock as they see what changes the health insurance law are causing.
“My dad even called me up the other day. He said ‘Jennifer, did you know that my retiree health plan covers up to $100,000 of gender reassignment surgery, but it will not cover my hearing aid?’” she said. “So, needless to say, there will be a lot of yelling at Christmas this year.”
Pierotti offered an update on the “infamous” website glitches that have plagued the rollout of the federal exchange marketplace at healthcare.gov. Since the beginning of October, 364,000 people have signed up for health insurance, including 137,000 through the federally facilitated exchange and 227,000 through 14 state-run exchanges.
“So, if 3 million people sign up in December the administration will hit its year-end goal,” she said, though noting that doesn’t include people who go through direct enrollment.
Full repeal of the Affordable Care Act is not a viable option, Pierotti admitted, though some diehards continue pushing for that outcome. Instead, the U.S. Chamber is lobbying for a number of changes to the law that the business advocacy group claims would improve availability of health insurance and lessen the effect on employers.
“There’s been a growing sentiment this year that there’s a huge space for people offering realistic approaches to what needs to be changed in the health care law,” she said, noting that it’s a bipartisan sentiment driven by growing concern among constituents. “These are issues affecting business in real time and there are changes that need to be made that we can do through the legislative process.”
A central topic in the discussion of how the ACA will affect businesses has been the definition of “full-time equivalents.” The employer mandate, the part of the law that requires large employers to offer health insurance or face penalties (this has been delayed until 2015), says employers with 50 or more full-time-equivalent employees must offer health insurance or face penalties. This is administratively burdensome, Pierotti said. So the chamber is lobbying for a change that would repeal the reference to “full-time equivalents” and replace it with a requirement that employers with 50 or more full-time employees to be defined as large employers.
“Once we have budget talks in early 2014, we might be able to get some of these things done,” she said.
Another change the chamber is lobbying for is the restoration of the 40-hour workweek as a benchmark for defining full-time employees under the ACA. Under the current law, a full-time employee is considered someone who works an average of 30 hours a week, a threshold Pierotti said was chosen somewhat arbitrarily. The U.S. Chamber would like to better align that with what businesses consider full-time, somewhere between 37 hours and 40 hours a week.
Other proposed changes include repealing the medical device tax, repealing the health insurance tax, allowing anyone to purchase a catastrophic plan, removing restrictions on health savings accounts and flexible spending accounts, eliminating auto-enrollment and increasing and extending the small business tax credit.
“That list is things we think are actually doable,” Pierotti said.
The bottom line is that the law will continue to change. Not only are there legislative efforts to make the above changes, but the federal government still hasn’t written all the regulations that the law creates. Pierotti said that the 2,700-page law will yield 20,000 pages of regulations, all of which need to be read and interpreted.
Brett Whitham, a partner at Verrill Dana, also spoke at Thursday’s event. The message he left the audience with was a simple sentence on his last slide: “The only constant is change.”
“You have to stay informed and up to date,” he said.