Sept. 29--This week's coming-out party for the health insurance marketplaces also represents a second unveiling of sorts of the federal Patient Protection and Affordable Care Act, the most sweeping health care initiative in decades.
The Affordable Care Act has hit several notable mileposts since President Barack Obama signed it into law in March 2010, from allowing young adults to stay on their parents' plans until age 26 to offering discounted prescription drugs and free preventive care for Medicare beneficiaries as well as ending lifetime limits for insurance coverage.
All along, though, 2014 has been held out as the year that the ACA, more popularly known as Obama-care, really will start to take hold -- with insurance marketplaces opening where the uninsured can buy coverage, the possible expansion of Medicaid and the start of the personal mandate requiring everyone to either get insurance or be fined.
For the business world, the traditional fount of U.S. employees' health coverage, the picture of what's headed their way is slowly coming into focus -- and what they see worries many.
"They are concerned. There are a lot of unknowns from an impact perspective," said Chris Shipley, assistant vice president in employee benefits for Henderson Brothers, Downtown, one of the region's largest insurance brokerages whose clients cross all business sectors.
"We are doing everything we can to prepare them for this major change, and we have spent the better part of the last three years preparing for it."
But with regulations and federal guidance still coming out, sometimes on a daily basis, it's not always clear what they should prepare for.
Last week, the U.S. Department of Health and Human Services announced that enrollment for the Small Business Health Options Program -- a program meant to simplify the insurance buying process for businesses with 50 or fewer employees -- would be delayed to November. That follows an announcement in July that the ACA employer mandate, under which employers who don't offer adequate and affordable health coverage face penalties, would be pushed back a year to 2015.
The delays give employers a little breathing room, but they are not entirely helpful, said Mr. Shipley.
Had employers known about the delayed employer mandate in January, "They could have had a completely different approach to their multiyear strategy."
The uncertainty, the changes and the still-in-process rule making aren't just minor inconveniences, said M. Christine Whipple, executive director of the Pittsburgh Business Group on Health.
For example, the law says employers have to put out information on quality of care and transparency of care beginning in 2014, she said, "and nothing's been issued on it" to explain what that means or what it will entail.
"This is time and effort and expense that an employer has to expend to comply, which is time taken away from the job of managing their benefits and helping their employees," she said. "It involves not just human resources, but information technology and your tax department. It's impacting all departments within a corporation.
"It just becomes another expense to operate your business."
In a recent survey done by the Downtown office of Buck Consultants, 68 percent of the responding employers said they expect the ACA will increase costs for their employees in 2014.
Many of them attributed that expected increase to the additional taxes and administrative costs borne by employers under ACA that will be passed along to their workers through higher premiums, deductibles and copays.
"It's going to be very challenging for employers, as well as employees, until the exchanges are rolled out and there is some clear understanding what the prices are and how it will impact them," said Tom Tomczyk, a health benefits specialist at Buck.
"I just think there's going to be a lot of confusion."
Steve Twedt: firstname.lastname@example.org or 412-263-1963.
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Distributed by MCT Information Services
Original headline: Business world wary of health-care overhaul
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