Healthcare reform: Delay in mandates

Published 12:26 pm Thursday, July 18, 2013

Postponed too are the penalties for not providing health care that meets PPACA’s definition of quality.  However, in preparation for the mandate, most carriers had already responded by eliminating these non-compliant plans from their menu.  Employers will still be forced to choose from higher cost, compliant plans because the market no longer has the less robust options available.

Further, employers will not be required to report data that was to be used to double check availability of affordable group coverage and employee wages for those applying for individual subsidies in the marketplaces.

While the employer penalty is delayed, the individual mandate to purchase health insurance is still on track for Jan. 1, 2014 and still imposes penalties for those who don’t.

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Inevitably, some employers who have been offering coverage may quit doing so, forcing their employees to flee to the individual market and joining those applying for a subsidy to offset ever-rising individual premiums.

Without the employer reporting requirement in place, those applying for individual medical coverage will be allowed to self-report salaries to determine subsidy eligibility. While the federal government has said they will randomly sample enrollment in states where the federal marketplace is operating, this entitlement program will be operated primarily on the honor system until January 2015.

In dollars, the effect of delaying the employer mandate is clear. Five billion dollars was expected as federal income from employers found to be out of compliance with the mandate.  This income would have helped offset some of the 28 billion expected to be spent on individual subsidies in 2014.