Did the ACA Repeal Hype Take Your Eye Off the Ball? 3 Tips to Get Back on Track

After months of continuous discussion about how to change healthcare, the Senate finally voted on an Affordable Care Act (ACA) repeal bill. Early on the morning of July 28th the bill was narrowly defeated, leaving the country with questions as to what comes next. With all the uncertainty, ACA compliance and reporting may have taken a back seat to your other priorities. But regardless of what happens with healthcare reform in the future, 2017 reporting will be required, and employers need to be ready.

What should employers do now?

While change is inevitable, so is reporting, and 2017 reporting is only four short months away. To be ready for the reporting season, employers should focus on the following:

  1. Actively manage compliance
    Unlike reporting, which is an end-of-the-year effort, active compliance management must happen year-round. Employers must measure, assess, offer and ensure compliance with the ACA each month to avoid potential penalties. Though the penalties stipulated by the ACA have not been enforced in the past two reporting years due to ‘good faith effort’ practices, as of today, there is nothing stopping the IRS from imposing penalties for 2017. If you don’t manage your compliance diligently, ACA penalties could cost your organization millions of dollars in the years to come.
  2. Use your data to better manage costs
    ACA solutions, like Health e(fx), that transform data into time-aware data sets allow employers to predict future costs and risks so they can adapt and better align their benefits with operational strategies. For example, self-funded plans should be using this data to compare budgeted healthcare premium costs with actual monthly total costs, and identify where and why there are differences. Employers should also be assessing benefit eligibility and enrollment as well as the need for employee education.
  3. Never take your eye off the ball
    The world of healthcare is constantly changing, which means you need to stay informed and prepared for change. Many states are starting to make moves to find stability in this time of great uncertainty. This means compliance and reporting requirements may be different depending on which states and municipalities you operate in. We’ve seen these complexities play out with the Seattle Initiative 124, which requires that large hotels provide low-wage employees with a specified level of health benefits. Changes like these are only going to continue so it is imperative employers don’t lose focus.

What’s next for reform?

The Senate Parliamentarian has indicated the fast-track procedure that Republicans have used to try to repeal the ACA will expire on September 30. While it’s possible new efforts to repeal the law may be pushed forward, the likelihood is slim, given the shift in focus to tax reform and other national and international challenges. The Hill, an American political journalism newspaper and website, reports it would also be difficult to use the same fast-track procedure to pass the law next year, supporting the idea that the ACA is here to stay for the foreseeable future.

Now that the ACA repeal bill has been defeated, there are a couple of directions healthcare reform could go, one of which is a bipartisan approach. In any direction, there are a couple of key things that will likely be addressed, the most critical of which is the continuation of Cost-Sharing Reduction (CSR) payments through the end of 2019. President Trump has threatened to cut off these payments, which will drive up the cost of premiums, copayments and deductibles, and insurers aren’t sure how to proceed. If these payments are discontinued, insurance companies would be forced to raise premium prices by about 20%, according to the CBO. The CBO also estimates that halting CSR payments would increase the federal deficit by $194 billion through 2026.

Other reforms a bipartisan group is pushing for are greater flexibility for state innovations in healthcare, specifically in the form of guidance as to how to fully take advantage of the waivers from coverage regulations they can request; to increase the ACA’s Employer Mandate to companies with more than 500 Full-Time employees; the creation of a stability fund to help states reduce premiums and other costs for insurance customers with expensive medical needs; and scrapping the medical device tax, which manufacturers claim has led to a loss of jobs in the medical device industry and higher prices for consumers. While there is no set timeline for any of these changes, the group hopes to have a temporary stability bill drafted by mid-September that will include funding to insurers for the lost CSR payments.

Changes in the world of healthcare will continue, and reporting is here to stay for the foreseeable future. That’s why Health e(fx) was built to be flexible and adaptable. We are able to absorb each new reform as it happens so that we can help you remain compliant with the current laws. Change is coming, and we are ready.

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