A Guest Post By 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.