The people have spoken at least for now and they are saying they are unhappy. The storm clouds over Obmacare has ushered in GOP victories: +7 Senate + 13 House. 47% of those who cast ballots in the midterms said the 2010 health care law, which opened for enrollment a year ago, went too far. On the other hand, 26 percent said the law didn’t go far enough, CNN exit polls reported. Only 22 percent said Obamacare was just about right.
How will GOP use these powerful election gains on Obamacare?
GOP still will not have the needed 60 Senate Seats to repeal the Affordable Care Act. That said, they will now be able to pass budget rules on the legislation since the Courts ruled individual mandate penalty as a “tax”. Reinsurance funds such as Risk corridors could also be on the chopping block. Other examples would be the definition of “full-time” employee taxes on employer penalties (bipartisan support), medical devices & tanning salons etc.
According to Huffington Post article GOP-Controlled Congress Expected To Try To Repeal, Weaken ACA while Republicans have been “chomping at the bit to repeal Obamacare” since it was signed into law in 2010, even a GOP-controlled Congress is unlikely to undo the law. However, that won’t stop Republicans from forcing at least one vote on repeal. President Obama “would then swiftly veto it, but not before Democratic senators were forced to cast a vote very directly in support of Obamacare, which remains generally unpopular.” Additionally, the GOP might take aim at several provisions of the ACA, such as the individual mandate, the employer mandate, the Independent Payment Advisory Board, and the medical device tax. Some Senate Democrats would likely join them in eliminating or amending some of these measures.
A Democrat President governing with both Houses going GOP may not be so bad after all. The successful Clinton Presidency had to contend with the same balancing act. Two decades later, the key question is can both branches find a common ground and a productive working relationship?
For specific details on all available health plans in 2015, contact our team at Millennium Medical Solutions Corp (855)667-4621. We work in coordination with Navigators to assist with medicaid, CHIP Child Health Plus, Family Health Plus and Medicare Dual Eligibles. We have Spanish, Russian, and Hebrew speakers available. Quotes can also be viewed on our site.
Congratulations – you just signed up successfully for Obamacare! You made it right before the March 31st deadline and avoided the individual penalty and getting blocked out for 2014. Don’t relax just yet. If you’re one of the many people who applied on the first open enrollment it’s smart to expect some bumps over the next few weeks. Shifting deadlines and technical glitches have left many insurance companies scrambling to catch up to the flood of requests. To make sure you start things right, here are some easy ways to stay vigilant:
Pay the premium –Until you pay for the plan you do not truly have a plan just yet. Some states and insurance companies have extended the deadline to pay, but its best to do this as soon as possible. For maximum peace of mind, get written confirmation from your new insurance company. If you go to the doctor before you pay your premium, you may end up footing that medical bill if the insurance company doesn’t have a record of your premium payment.
Member ID Cards –in about 1–2 weeks after you receive your first bill you will receive your Member ID card from your carrier after you’ve made your first premium payment. This is the card you’ll share with medical providers and pharmacies when you receive service. Your carrier may allow you to print a temporary ID card if you need care prior to receiving your Member ID card(s). Your insurance card will (hopefully) arrive in your mailbox in early January. You’ll present it wherever you need services: at the pharmacy, doctor’s office or hospital. Since insurance companies had a very short turnaround time to process new members, you may see a delay. Don’t panic! Go to the insurance company’s website to see if you can print a temporary ID card. (This is a lifesaver!) If you turn up empty, call the company’s customer service number to confirm that you are in their system as an enrolled member.
Don’t rush to the doctors – If you have an immediate need for a prescription or an appointment, by all means take care of it asap. But if you can, wait a few weeks before scheduling your doctor’s visit. This will give time for the insurance companies and doctors to update their systems with all the new plans and enrollees. This way, you help ensure that the medical claim for your doctor’s visit will be processed accurately – and that you dodge some of the early-stage craziness.
Double check – that your doctor is in your new plan’s network . Most of the new insurance plans also came with new provider networks. Its smart to double check that your favorite doctor is in the network for the exact plan you just enrolled in. There are specific networks for different insurance products, so make sure you are checking the right one. If your doctor is not in the network, keep in mind that you may have to pay significantly more money to see an out-of-network doctor, so you may consider switching. See States Pushing Back Against Smaller Networks
Keep records – Keep a record of your payments, calls, emails with your insurance company and physicians. Just in case of a technical glitch in the insurance or doctor’s computer systems, you can show evidence of your payment or confirmations from your insurance company.
Obamacare 2014 Deadline Nearing. You are now more knowledgable than most after reading this article. Given all the new changes thanks to the new insurance plans, new enrollees, and changing deadlines, being aware of these simple tips will help you avoid unnecessary headaches. And remember, if you are still shopping for insurance, you only have until March 31st to enroll in a plan.
For enrollment help before the deadline information please contact our team at Millennium Medical Solutions Corp (855)667-4621. We have Spanish, Russian, and Hebrew speakers available. Quotes can also be viewed on our site.
SHOP Exchange Delayed One Year. The White House just announced that the online Small Business Health Marketplace also known as SHOP Exchange has been delayed until 2015. Small businesses will still have the option to purchase coverage through the new marketplace but will not be able to do so online. Instead, until next fall, employers with fewer than 50 workers will need to work through a broker or agent to buy health plans for their employees.
The Small Business Health Options Program, or SHOP Exchange, has already had a troubled launch with multiple delays as the Obama administration has focused much of its efforts on launching the individual insurance marketplace where Americans can shop for subsidized health insurance coverage.
Small businesses buying coverage will still be eligible for small business tax credits to bring down the cost, according an administration memo. Also, businesses can still purchase the same plans and same rates available on Off-Exchange. Medical Insurance premiums through the business is an ordinary tax deductible expense.
According to NY Times Article, Online Health Law Sign-Up Is Delayed for Small Business – “The announcement of the delay, just before Thanksgiving, is reminiscent of the way the White House announced, just before the Independence Day weekend, a one-year delay in the requirement for larger employers to offer health insurance to employees.”
The recent setback is the latest in a stream of missed deadlines, including a postponement for a Spanish language sign-up tool announced this week. The administration also recently pushed back the enrollment deadline for individuals: People who sign up by Dec. 23 can get coverage that starts on Jan. 1. In an earlier delay, businesses with more than 50 workers were given until 2015 to meet the requirement to provide health insurance without paying a penalty. And the deadline date for individuals to avoid penalties for failing to get coverage was pushed back six weeks.
If you should have any further questions regarding the SHOP program or comments about the above or the attached, please let us know. We will continue to monitor this issue and all ACA implementation in an effort to keep you informed of new developments. In the meantime, please visit our https://360peo.com/about-us/blog to view past blogs and Legislative Alerts.
Obamacare Simplified Using Youtoon by Kaiser is just what the Doctor ordered. With less than 60 days to go to the October 1, 2013 Health Exchanges Open Enrollment Period what better way to ease the confusion than a 7 minute cartoon?
CMS maintains the HealthCare.gov website, and this is where individuals can find more information on health insurance exchanges, the enrollment for which begins on October 1, 2013. Depending on which state individuals reside in, one may be able to enroll in an exchange plan, or may be directed to their state’s own exchange enrollment site. Employers can also use this site to learn about the Small Business Health Options Program (SHOP) which can help them provide coverage for employees.
Several resources have been made available to help people weed through the information and to make you aware of what requirements and deadlines apply to you. The Kaiser Family Foundation (KFF) brought some levity to the topic by creating an animated video explaining the upcoming changes in health coverage under the ACA. Narrated by Charlie Gibson, “The YouToons Get Ready for Obamacare,” explains what is and isn’t changing under the law and is posted on the KFF site, along with other resources on the topic. KFF President, Drew Altman, was quoted as saying, ’[t]his cartoon is meant to demystify a complex law and explain what it means for you, whether you support or oppose Obamacare.”
For a comparison and additional questions on which Exchange – Individual or SHOP Exchanges is right for you please contact our team at Millennium Medical Solutions Corp. Stay tuned for updates as more information gets released. We’re inside of 45 days until exchanges open, and information will be coming quickly in the next few months. Sign up for latest news updates.
In an unexpected announcement pre-July 4th the big news was Obamacare Employer Mandate Delayed with penalties under the Affordable Care Act (ACA) until 2015. The mandate also known as the “Employer Shared Responsibility” requires employers with 50 or more FTEs to offer affordable health insurance coverage to their workers or face financial penalties for not doing so. Those penalties would originally have been applied beginning in 2014.
There has been a follow up guidance issued last week July 9th by the IRS. According to the IRS, the delay will give employers more time to prepare for the change in how health insurance is provided and will also give the Obama Administration time to simplify the insurance-related reporting requirements that employers face. This transition relief appears to come with “no strings attached.” Although the IRS guidance encourages employers to voluntarily comply with the employer mandate and maintain or expand health care coverage in 2014, the IRS will not impose penalties for a failure to do so.
Although the IRS guidance encourages employers to voluntarily comply with the employer mandate and maintain or expand health care coverage in 2014, the IRS will not impose penalties for a failure to do so.Notably, the guidance issued on July 9th also does not require employers to make “good faith” efforts to comply. As a result of this transition year, employers will have the option of deciding to what extent (if any) they will continue efforts to comply with the employer mandate during 2014.
Employers who intended to rely on one of the transition rules previously announced for 2014 should keep in mind that the latest IRS guidance does not provide special transition rules for 2015. Other group health plan requuirements still apply as discussed in our prior blog Essential Health Benefits Not Delayed.
This means that for plan years beginning on and after January 1, 2014, all group health plans must:
Eliminate all pre-existing condition exclusions (regardless of age);
Maximum Cost Sharing Deductible to $2,000/individual ($4,000/family); limit in-network out-of-pocket maximums to $6,350/individual ($12,700/family)
Individual Mandate Still Applies. individuals will still be required to obtain health care coverage or pay a penalty for each month they do not have coverage, beginning January 1, 2014
Exchanges (Marketplaces) Open for Enrollment October 1, 2013.
The IRS notice makes it clear that individuals who enroll in coverage on the marketplaces will continue to be eligible for a premium tax credit if their household income is within a specified range and they are not eligible for other minimum essential coverage.
Employers Must Send Notice of Exchanges (Marketplaces) Before October 1, 2013. These notices must be sent to current employees by October 1, 2013. Then, beginning October 1, 2013, employers must send this notice to new hires within 14 days of their start date.
New taxes still apply – Patient Centered Outcomes Research Institute (PCORI) excise taxes and transitional reinsurance program fees;HRA/HSA/FSA clients also pay a monthly $1/employee tax.
We will continue to monitor ACA developments and will provide you relevant updated information when available. In the meantime, please visit to view past blogs and Legislative Alerts at https://360peo.com/feed.
Obama administration announced that the employer shared responsibility mandate also known as “Pay or Play” aspect of the Patient Protection and Affordable Care Act (PPACA) will be delayed by one year.
This mandate requires businesses with 50 or more workers to provide health insurance coverage to employees. As a result, the administration will start enforcing the mandate in 2015, rather than January 1, 2014, in an effort to give businesses more time to prepare.
There will be additional changes tied to this delay, and the administration has stated that they will provide formal guidance within the next week.
More details will be available for our July 11th WebMeeting. Medical Solutions Corp is working with the various regulatory agencies to understand the specifics surrounding this ruling, and will continue to provide updates through Legislative Alerts and on our blog.
