An informative panel forum titled “Doing Business in the Affordable Care Act Era” was hosted by Inside Business at The Founders Inn on June 27. The event was presented by the Virginia Business Coalition on Health. Hampton Roads Chamber of Commerce President & CEO Bryan K. Stephens was one of the five panelists. Joanne Grossi, Regional Director for the U.S. Department of Health and Human Services served as the keynote speaker and Neil McNulty, President of the Virginia Business Coalition on Health, moderated the event.
One of today’s biggest concerns for businesses is a healthy workforce, so this presentation and panel dialogue was timely. The Affordable Care Act (ACA) is the national health reform, which includes new responsibilities and opportunities for employers. The Affordable Care Act was passed by Congress and then signed into law by the President on March 23, 2010. On June 28, 2012 the Supreme Court rendered a final decision to uphold the health care law. All aspects of the ACA went into effect as of January 2014.
Director Grossi provided an overview of the ACA, Health Insurance Marketplace implementation and what it means for businesses. “Health care for everyone is a right,” said Grossi. To date, she explained that 8 million people have signed up for private insurance, 3.1 million young adults gained coverage, 6 million enrolled in Medicaid and CHIP, the uninsured rate dropped to 13.4% and the gross domestic product (GDP) rate dropped to 17.2%.
Grossi said the goal of the Health Insurance Marketplace was to make healthcare affordable for the middle class and for small businesses. States had three models to choose from. Virginia is currently a federally-facilitated marketplace. Grossi said, “On October 1, we think there were about 900,000 Virginians who were uninsured and we estimated that about 400,000 of them would qualify to get insurance in the marketplace. The other 400,000 qualified for Medicaid. We got over 216,000 enrolled in the marketplace in Virginia. This surpassed our goal, so we’re really happy about what happened in Virginia.” She added, “Over 36,000 enrolled in Medicaid and CHIP programs.” Virginia has received $6.5 million to date.
Director Grossi reminded the audience that this is private insurance, such as Optima and Anthem. She emphasized that people have choices and levels to choose from depending on your financial and physical health.
In 2015, employers with 50 full-time employees or a combination of full-time and part-time employees, will be subject to the Employer Shared Responsibility Provision (ESR). She explained that businesses with fewer than 50 full-time employees are exempt from any requirement to contribute towards employee health coverage. More than 96% of employers with 50 or more employees already offer their employees health insurance coverage. The ESR is not effective until January 1, 2015.
For businesses that want to offer coverage and have less than 50 employees, Grossi said, “We did create a separate marketplace for small businesses called the Small Business Health Options Program, we call it SHOP. You can now have leverage because you have all these insurance companies competing for your business and you’re in the pool with everybody else. You have lower premiums than you would have in the past.”
A small business can apply for SHOP anytime of the year and will work through a broker. Once an employer chooses a plan, the employees use that plan. There is a tax credit offered for those using SHOP.
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Grossi’s presentation was followed by a panelist dialogue with Richard Keatley, Principal of Mercer, John Peterson, Attorney with Kaufman & Canoles, Bryan K. Stephens, John Castleberry, Vice President of Beskin Associates and Mary Mitchell, Wellness Director for the Virginia Business Coalition on Health.
Bryan K. Stephens, the Chamber’s President & CEO, shared with the audience that CNBC recently ranked Virginia 8th in the nation for doing business. However, last year, Virginia was 5th. Small business friendliness has dropped from 1st to 5th in the country. Virginia ranks 26th for its tax environment.
Stephens said, “If you relate this back to the cost of doing business, and your number one cost is salaries and benefits, we need to do something.” Stephens added, “There are around 250,000 Virginians in what we call a ‘coverage gap.’ They are employed but they don’t have health insurance. They are making money so they are not eligible for Medicaid. So what do they do when they need medical care? They go to the emergency room. The hospitals are absorbing these costs. These emergency room visits are costing hospitals in Virginia somewhere around $600,000,000 or $700,000,000 a year. That is unsustainable. What they’re doing is passing those costs off to employers.” He emphasized, “We have to get something in place. The Chamber came out with a marketplace Virginia private option Medicaid expansion to insure that those in the coverage gap and other uninsured Virginians are insured. We think it’s what’s best for businesses and Hampton Roads and in Virginia.” He said, “A healthy employee is paramount to the success of your business.”
Director Grossi stressed employers to educate employees on the ACA and take advantage of webinars and other resources the U.S. Department of Health and Human Services offers.