Health Law Delay Puts Exchanges in Spotlight

Written By Unknown on Kamis, 04 Juli 2013 | 13.57

Nathan Weber for The New York Times

Bill Petersen, owner of an in-home assistance program in South Elgin, Ill., was relieved by the delay in employer requirements.

Employees who now have to wait another year to get health coverage through their employer will have little recourse but to buy their own insurance at the newly created state exchanges.

The Obama administration's decision, announced on Tuesday, to delay for a year a requirement that larger employers provide insurance or pay a penalty has made the operation of the state exchanges — where individuals can shop for insurance starting Oct. 1 — more critical to the success of the new health care law.

The delay is viewed as an unspoken acknowledgment by federal officials of the size of the task ahead, according to policy experts and benefits consultants. By putting off the employer requirements, officials are in a position to concentrate on making sure the state exchanges work.

"The real focus is now getting the individual exchanges and premium tax credits up and running," said Timothy S. Jost, a law professor at Washington and Lee University who closely follows the new law, known as the Affordable Care Act.

In addition to the creation of the exchanges, the law's broad market reforms of the insurance industry and the expansion of Medicaid will continue, Mr. Jost said, adding, "I just don't see this as a game changer."

Also still in effect is the requirement that people without insurance buy it by 2014 or face fines. Subsidies will be available for people who meet income requirements.

The companies affected by the delay — those with 50 or more full-time employees — were increasingly anxious about their ability to meet the law's requirements, given the delay by the administration in issuing the final rules for the companies to follow to ensure they were in compliance, said Helen Darling, the president of the National Business Group on Health, which represents employers that offer health benefits.

"This is a recognition that they were not going to meet some key deadlines," she said.

Companies that employ fewer than 50 workers have already been given a reprieve from the law's requirements.

Many of the companies being granted the latest reprieve either offered no coverage or provided it only to certain workers — like managers or those working 40 hours a week. Some employers had been expected to pay the law's penalty of $2,000 a worker for every employee rather than provide insurance, while others said they would go ahead and offer it.

"We don't know how many people would have gained coverage or won't because of the delay," said Paul Fronstin, a senior researcher at the Employee Benefit Research Institute. "It's not a big deal because it doesn't affect many people, but it's a big deal if it affects you."

A large majority of larger employers — 94 percent — already offer coverage, according to the Kaiser Family Foundation, which studies the market. "We do believe the practical effect of this will be really quite modest," said Drew Altman, the foundation's president.

The reprieve will give companies more time to consider what they should do over the next year. Bill Petersen, who owns a franchise of the elder-care business Visiting Angels in South Elgin, Ill., outside of Chicago, for example, does not offer coverage to his 100 full-time employees and had been deciding whether to cut back their hours to avoid the law's requirement or start providing health benefits.

When he heard about the delay, Mr. Petersen, who celebrates any good news by ringing a bell in the main office, said he "went down there and rang the bell."

"It was just a relief to know that we had some time to be able to look at our options and understand the act just a little bit more," he said.

Others say they plan to proceed with their plans to expand their coverage, although they are waiting for final guidance from the administration before deciding what benefits they will offer. "I still want to stay on the same time line," said Don Fox, the chief executive of Firehouse Subs, a chain of restaurants based in Jacksonville, Fla. At the company-owned restaurants, only general managers and headquarter personnel are now offered coverage, and Mr. Fox said the company was going to cover the additional 90 to 100 employees required under the law. "I've been setting an expectation with our employees," he said.

Thom Mangan, the chief executive of United Benefit Advisors, described the delay as "a nice gift that the government gave." He said that companies that employ many part-time and hourly employees would probably delay providing additional benefits in the next year. "They would be crazy not to," he said.


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