Dr. Kantor answers some prominent questions about President Obama’s Affordable Care Act, a.k.a. Obamacare, for National Petroleum News Magazine.
What are the major, immediate provisions company owners and operators have to be aware of and get working on as it relates to Obamacare (ACA)?
Starting in January, 2014, all employers are mandated to provide insurance to full time employees if they have 50 or more full time employees. If you do not provide the insurance at the mandated level (60% or more of cost), you will receive a penalty of $2,000 per employee. If an employee does not take the insurance they are penalized. All employees must be offered the insurance regardless of pre-existing conditions.
The things employers will concentrate on to help offset the costs are getting as many employees to part time status as possible before the January 1, 2014 date since they are not covered. Another area is if you have about 50 employees, to get under the magic number of 50 so the law doesn’t affect your company.
Another area I heard discussed is splitting up companies by divisions and making each legal entity have less than 50 employees to escape the mandate and penalty.
How does the Obamacare impact different size employers?
If you have over 50 employees, you are covered by the new mandate and penalties. If you have fewer than 50 employees the new law doesn’t affect you at this time.
What’s happening with the states opting out? How are they able to do so?
In the recent Supreme Court ruling, they stated that the federal government cannot penalize states that choose not to accept the government offer to pay for the uninsured going on Medicare. At this time only 15 states have opted into the new uninsured/medicare program. Also, only 15 states have agreed to set up state medical insurance exchanges. In the rest of the states, if they do not set them up, the Federal Government will have to. This will have an unknown effect on the penalties, since the law is written based on state exchanges.
What are the issues relative to providing coverage or paying the penalty?
Right now this becomes a monetary issue for companies. Companies will have to decide which is more expensive, providing insurance to every employee and pay at least 60% of the premiums, or paying the $2,000 penalty. In most small businesses I spoke with that have over 50 employees, most appear likely to drop the insurance and pay the penalty. This can change if insurance rates go down significantly but so far, rates have just gone up and appear likely to continue that trend.
How does Obamacare work for full time vs. part time employees?
Employees that work 28 hours per week or less are considered part time and are not covered under Obamacare. They are also not counted as an employee to reach 50 employees. Many companies will be changing the status of employees from full-time to part-time so they are not covered by Obamacare or the 50 employee threshold.
How is Obamacare going to change the landscape of the health care industry?
The change will be drastic and all encompassing. First, we have to realize that Obamacare does not change our healthcare system; it only changes the insurance aspect and mandates that everyone have insurance. The problem is our healthcare system is broken. We actually do not really have a healthcare system; we have a disease and accident management system. This system is overburdened and costing the country a fortune (2+ trillion dollars per year). We currently have a shortage of Doctors and are not producing enough new ones based on our aging population and population growth. Now, add the fact that Obamacare will take $716 billion dollars from medicare, directly from the fees Doctors and Hospitals receive and the problem is exasperated.
KA Medical data studies show that approximately 1/3 of the Doctors and Hospitals that currently take medicare will be forced to stop. This will overburden the remaining 2/3 of the Doctors and Hospitals, increasing patient wait times and decreasing the quality of care. Then add 30 million more patients through Obamacare and the system literally breaks down. What will then occur will be a two tier system. Those who can afford to pay extra for Doctors that are not in the medicare system and take few patients so that they can give excellent care and the masses that must use the broken, overburdened system, have extremely long waits, very short doctor visits and poor quality care.
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