Tag Archives: health care law

From ‘Repeal’ to ‘Repair’: Campaign Talk on Health Law Meets Reality

Asked at a confirmation hearing two weeks ago if he was working with President Trump on a secret plan to replace the Affordable Care Act, Representative Tom Price, Mr. Trump’s nominee for secretary of health and human services, smiled broadly and answered: “It’s true that he said that, yes.”

The committee room, filled with health care lobbyists, consumer advocates and others with a vital stake in the future of the health care law, erupted with knowing laughter at Mr. Price’s careful formulation. For those following the issue closely, it has been an open secret that the fledgling Trump administration is a long way from fulfilling one of Mr. Trump’s most repeated campaign promises.

In a brief aside in an interview with Bill O’Reilly of Fox News broadcast before the Super Bowl on Sunday, Mr. Trump went further than he ever has in acknowledging the reality that any hope of quickly replacing the Affordable Care Act has been dashed.

“Yes, I would like to say by the end of the year, at least the rudiments, but we should have something within the year and the following year,” the president said.

That admission is sure to be a serious disappointment for the president’s most fervent supporters, who sent him to Washington believing that he would move quickly to dispatch the health law.

Soon after he was elected, Mr. Trump reacted to Republican suggestions of a delay in replacing the health act by insisting that repealing and replacing the law must happen at about the same time.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Senate Takes Major Step Toward Repealing Health Care Law

WASHINGTON — Senate Republicans took their first major step toward repealing the Affordable Care Act on Thursday, approving a budget blueprint that would allow them to gut the health care law without the threat of a Democratic filibuster.

The vote was 51 to 48. During the roll call, Democrats staged a highly unusual protest on the Senate floor to express their dismay and anger at the prospect that millions of Americans could lose health insurance coverage.

One by one, Democrats rose to voice their objections. Senator Maria Cantwell of Washington said that Republicans were “stealing health care from Americans.” Senator Ron Wyden of Oregon said he was voting no “because health care should not just be for the healthy and wealthy.”

The presiding officer, Senator Cory Gardner, Republican of Colorado, repeatedly banged his gavel and said the Democrats were out of order because “debate is not allowed during a vote.”

The final vote, which ended just before 1:30 a.m., followed a marathon session in which senators took back-to-back roll call votes on numerous amendments, an arduous exercise known as a vote-a-rama.

The approval of the budget blueprint, coming even before President-elect Donald J. Trump is inaugurated, shows the speed with which Republican leaders are moving to fulfill their promise to repeal President Obama’s signature domestic policy achievement — a goal they believe can now be accomplished after Mr. Trump’s election.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Health Care Law Makes Tax Season Tougher for Small Companies

As more requirements of the health care law take effect, income tax filing season becomes more complex for small businesses.

Companies required to offer health insurance have new forms to complete providing details of their coverage. Owners whose payrolls have hovered around the threshold where insurance is mandatory need to be sure their coverage — if they offered it last year — was sufficient to avoid penalties.

Even the most tax-savvy owners may find that do-it-yourself doesn’t work when it comes to fulfilling the law’s requirements. Many don’t know about the intricacies of the new health care regulations associated with the law that affect employers, says Lydia Glatz, an accountant with the firm MBAF in Fort Lauderdale, Florida.

“Most small businesses and mom-and-pop operations,” Glatz says. “They’re more involved in running their day-to-day business.”

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Health Care Law Forces Businesses to Consider Growth’s Costs

When LaRonda Hunter opened a Fantastic Sams hair salon 10 years ago in Saginaw, Tex., a suburb of Fort Worth, she envisioned it as the first of what would eventually be a small regional collection of salons. As her sales grew, so did her business, which now encompasses four locations — but her plans for a fifth salon are frozen, perhaps permanently.

Starting in January, the Affordable Care Act requires businesses with 50 or more full-time-equivalent employees to offer workers health insurance or face penalties that can exceed $2,000 per employee. Ms. Hunter, who has 45 employees, is determined not to cross that threshold. Paying for health insurance would wipe out her company’s profit and the five-figure salary she pays herself from it, she said.

The margins are not big enough within our industry to support it,” she said. “It’s not that I don’t want to — I love my employees, and I want to do everything I can for them — but the numbers just don’t work.”

The health care law’s employer mandate, a provision that business groups fought against fiercely, is intended to make affordable health insurance available to more people by requiring employers to bear some of the cost of providing it.

Without the mandate, the law’s creators feared, companies would be tempted to cancel their insurance benefits and encourage employees to move to the online marketplace exchanges created by the law, where many low- and middle-income workers qualify for government subsidies. Those who are offered insurance through their jobs are ineligible to collect subsidies if they instead choose to buy coverage through the exchanges.

The rule took effect this year for businesses with 100 or more workers, but companies with 50 to 99 employees got an extra year to comply. Those with fewer than 50 workers are exempt.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Estimated Cost of Affordable Care Act Reduced

The Congressional Budget Office on Monday again lowered its estimate of the cost of the Affordable Care Act, citing slow growth of health insurance premiums as a major factor.

Just since January, the budget office said, it has reduced its estimate of the 10-year cost of federal insurance subsidies by 20 percent, and its estimate of new Medicaid costs attributable to the law has come down by 8 percent.

Slower growth in health spending helps consumers and businesses, which shoulder most of the costs, and contributes to lower federal budget deficits.

The budget office now projects deficits totaling $7.2 trillion from 2016 to 2025, a decrease of 6 percent from the more than $7.6 trillion projected in January.

“The largest factor underlying that reduction is a downward revision in projected growth in premiums for private health insurance,” reflecting the fact that spending by private insurers in 2013 rose less than in preceding years and much less than expected, the budget office said in a new report.

The new estimates could help Democrats stave off Republican efforts to roll back the law. Even though millions of people have gained coverage, opinion polls show that unfavorable views of the law are still more common than favorable ones.

Josh Earnest, the White House press secretary, said the new estimates were “the latest in a long line of data points that indicate the Affordable Care Act is contributing in a very positive way to holding down the growth of health care costs.”

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Businesses Finding Ways to Soften Impact of Health Reform

Many businesses in low-wage industries have hired more part-time workers and cut the hours of full-timers recently to soften the impact of new health law requirements that take effect Thursday, some consultants say.

The strategies have had only a modest impact on job growth, which has accelerated substantially this year, but could take a somewhat bigger toll next year as firms gear up for an expanded health care mandate in 2016.

A majority of small businesses say the Affordable Care Act already has hurt their profits, forcing them to reduce or postpone investment, withhold raises or trim other types of benefits, according to a new survey by the top small-business trade group.

Under the health care law, businesses that employ at least 100 full-time workers — or full-time equivalents, including part-time workers — must offer health benefits to at least 70% of those working at least 30 hours a week by Thursday, or pay a penalty.

By Jan. 1, 2016, those companies must provide insurance to 95% of their workers, and firms with 50 to 99 employees must offer coverage as well.

The health coverage mandate for individuals took effect last January, but the Obama administration pushed back the effective date for businesses in 2013.

Ninety-four percent of businesses with at least 100 workers and 55% of all firms already offer health benefits to at least some employees, according to Kaiser Family Foundation and the Health Research and Educational Trust.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Small Businesses Sending Employees to The Exchange

Brian Adams, who sells fireplaces in Indianapolis, is like many of the nation’s small-business owners. As the cost of providing health benefits has climbed, he has struggled to afford coverage for his employees — a problem the new health care law was designed, in part, to address.

But a year after the law’s introduction of the insurance exchanges, provisions that were supposed to help small businesses offer employee health benefits are largely seen as a failure. And Mr. Adams, like many of his fellow business owners, is sending employees to the exchanges to buy their own coverage instead.

Nancy Smith, who runs the Great Arizona Puppet Theater in Phoenix, made a similar decision. Her business employs only a handful of people who need insurance, and she was able to offer only plans with high deductibles. She and her employees decided buying individual policies made the most sense.

“Everyone wanted to do it because our costs were too high,” she said.

Most of the focus on the Affordable Care Act has been on whether individuals can find affordable coverage through the online marketplaces. But the law also had the goal of creating a robust insurance market for small businesses by making tax credits available to businesses that provide coverage and creating small-business exchanges where companies could more easily find low-cost plans.

The small-business exchanges were barely functional in most states last year, and it remains to be seen whether the Obama administration will manage to stop the steady decline in the number of employers offering coverage to their workers. The administration is poised to try again when open enrollment begins on Nov. 15.

Federal officials say they do not know how many small businesses signed up for coverage in the small-business exchanges, but the numbers are likely to be very small. In California, for example, only 12,000 people were enrolled through the state’s small-business exchange, compared with more than a million who enrolled as individuals there. To date, few businesses have availed themselves of the tax credits available for purchasing coverage for low-wage workers.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary