Business groups are closely monitoring details of Tuesday’s Senate’s bipartisan agreement to restore low income healthcare subsidies for concessions that could also dramatically alter the corporate healthcare landscape.
On its face, the package by Sens. Patty Murray (D-Wash.) and Lamar Alexander (R-Tenn.) to stabilize the Affordable Care Act’s individual insurance markets have little impact on employers.
The proposal would fund for two years the subsidies that reduce costs for low income individuals while also giving states new flexibility on how their Affordable Care Act markets are run.
Details are still being worked out, but James Gelfand, senior vice president of health policy at the ERISA Industry Committee, says there are at least three very different topline scenarios businesses should monitor as the bill is finalized and begins moving through Congress. If the legislation remains narrowly focused on keeping the insurance market stable by funding those subsidies and providing states more flexibility to implement Obamacare, “it’s possible that neither would have any impact on employers,” Gelfand says.
But there are two other scenarios under which it could have substantial impacts on employers, he says.
Perhaps the biggest — and most positive change — for employers could come if any provisions are included or added to delay the so-called Cadillac-tax, a 40% surcharge scheduled to take effect in 2020 on the most expensive employer-sponsored health insurance plans.
“There has been some discussion that it could include a delay of the Cadillac taxes, Gelfand says. “For most employers that is the biggest issue. That could cause many employer groups that otherwise might ignore or be opposed to the bill to be in favor.”
On the flip side, Gelfand says changes that would make it easier for states to get waivers from ACA rules if they create their own healthcare programs — with their own rules — could create chaos for companies that operate in more than one state.
“It’s possible that a state would use the … waiver to change the employer mandate in that state,” he says, which could cause employers to have to comply with a patchwork of different sets of rules, instead of the just one.
“That should be a pretty deep concern,” Gelfand says.
And of course, in Washington, anything is possible as the multitude of stakeholders try to influence legislation as it makes its way through committee and floor debates in both houses.
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