Supreme Court Obamacare Ruling Fast Tracks Healthcare Issues

A Guest Post  By Larry Aldrich, Executive Director, Arizona Business Coalition on Health

On June 28, the US Supreme Court ruled on the federal “Patient Protection and Affordable Care Act” (“PPACA”).  Key rulings:Larry Aldrich, Executive Director, Arizona Business Coalition on Health

  • Reversed (5-4) Congress’s authority to regulate behavior (“individual mandate”) under the Commerce Clause.
  • But affirmed (5-4) the individual mandate under Congress’s taxing authority.
  • Rejected (7-2) the compelled expansion of Medicaid programs; individual States are free to participate or not.

Thus, virtually all elements of the PPACA are moving forward with very tight deadlines.  Key elements for businesses:

  • Individual mandate upheld – by 1/1/2014, most individuals will have health insurance or pay a fine.
  • Subsidies are available (incomes up to $92,200 in today’s dollars, for a family of four).
  • Current provisions (e.g., expanded appeal rights, adult children on plans until age 26, certain preventative services without co-pays) remain in place.
  • Health plans must continue to pay 80-85% of premiums on medical care, or provide rebates.
  • Health exchanges (state or federal) to be implemented by 1/1/14; insurers barred by then from rejecting applicants based on health status.
  • No employer is required to provide coverage, but businesses with 50 or more employees that don’t by 1/1/14 will pay a fee of $2,000 per FT employee (first 30 excluded from calculations).
  • Employers will fewer than 50 FTE employees won’t face any penalties; employers with 25 or fewer FTEs can get tax credits for health care plans.
  • Employers, if they offer health care, must offer an “essential health benefits package” (determined by Arizona); “mini-med” plan won’t qualify without a federal waiver.
  • Reports to employees about their plans and value (placed on W-2s) required.

Check with your attorney, accountant or broker for details.  A big question is whether Arizona decides to expand its AHCCCS (Medicaid program).  Stay tuned!

The Arizona Business Coalition is a group of employer-members that are working to improve employee health and change how health care is paid for, increasing value for employers and their employees and dependents.

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