The Affordable Care Act, President Barack Obama's sweeping health care reform, is set to roll out by the end of this year.
And in east Pierce County, business owners are trying to understand the new law, and they hope it will work out.
The Puyallup-Sumner Chamber of Commerce on Thursday presented its February luncheon, "Can we learn to love health care reform?" The organization aimed to help its members navigate the 900-page bill with the assistance of Glenn Kasman, president of MultiCare Good Samaritan Hospital, and Jim Leonard, vice president of market development for the Tahoma, West Sound and South Sound Group Health Cooperative.
Kasman was blunt as he summed up the legislation.
"It's a very complex topic, and there are no easy answers," he said.
After that opening remark, Kasman laid out what the Affordable Care Act will do for consumers, and how it will affect delivery of care and the associated costs.
Starting next year, the Affordable Care Act will expand coverage to 819,000 in Washington, about 12 percent of the state's population. It will implement Medicaid expansion to 325,000 new enrollees and 53,000 in Pierce County. It will enforce an individual mandate for insurance coverage and will create a health insurance exchange in the state to allow individuals with low and medium incomes to choose between subsidized insurance plans.
Kasman said there are 94,000 uninsured people who live in Pierce County, and 42,000 are living at or below the federal poverty level.
He added that, with an influx of patients into the system, there will be an increased demand on primary care.
"More people having coverage is positive," he said. "However, there is an expected decline in reimbursement to care providers."
Through 2011, Kasman said expenses per hospital admission at Good Samaritan were growing faster than revenue.
"In 2012, we were actually able to continue to provide quality and accessible care while reducing costs so that our expenses per hospital admission decreased slightly," Kasman said.
He said the hospital found ways to be more efficient by reducing supply costs and using lean principles for delivering care.
"The Affordable Care Act will force health care providers to be more efficient and focus on delivering value," he said. "Providers will need to find balance between quality service and cost so health care is affordable and accessible to the community."
Leonard said the U.S. spends more on health care than any other industrialized country, ranking 37th in the world. He said the need for the Affordable Care Act is to deliver better quality care to more people at lower costs.
"This is a major sea change for all of us in health care and for patients in health care," Leonard said. "This is an exquisitely good time to begin the dialogue (with employees)."
Leonard acknowledged the uncertainty that may be there for business owners, but he encouraged the importance of holding on.
"It is going to be a bumpy road," he said.
Representing that uncertainty was Monique Trudnowski, owner of the Adriatic Grill Italian Cuisine and Wine Bar in Tacoma.
Now closing in on five years of business, Trudnowski said she and her husband, a co-owner, said they are just now able to provide health benefits for their executive team. But providing benefits for their entire staff will cost them $125,000, and she said that will be hard to find in their budget.
Trudnowski said she is uncertain of where her restaurant will be in 2014. She said health care is not a cookie-cutter fit for restaurants.
"I hope that this new Affordable Care Act will not harm single-owner restaurants," she said.
One benefit for small business owners with 50 or fewer employees who purchase health insurance is the tax rebate of up to 50 percent starting next year. Small businesses also will be able to purchase coverage through Washington's new Health Benefit Exchange.
Small businesses will not be required to purchase health insurance. However, it will be required for employers of 50 or more. A penalty will apply if they do not offer affordable health insurance to their employees.
With 51 employees, the Adriatic Grill is considered a large business.
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