February 4, 2014
Postponement of the large-employer mandate until 2015 has left many employers with an urgent need to explore their options and make decisions during the additional time that has been allowed.
Small-business employers also have to decide how to respond to their options during 2014 in order to best meet their business objectives, given the program changes that have been made.
In response, many employees now have options as to how they decide to respond to the ACA during 2014 (and 2015).
Individuals who have been allowed to keep their “old” health plans for another year—and those with cancelled policies who are relying on hardship exemptions for 2014 to prevent penalties—have to decide how to move forward in 2015.
Insurance companies still offering old plans to the public have to decide how to respond to phaseout pressures for these plans by 2015.
Individuals need to remain wary about the non-QHP plans still being offered by some insurance companies, as these may be much cheaper than ACA-based plans—but may also lead to penalties for inadequate coverage.
Few individuals realize how rapidly the penalties will grow in 2015 and 2016.
These ACA accommodations are slowing the rate of implementation and change in 2014—and likely for 2015.
From a positive perspective, individuals and organizations will have more time to adapt and reduce stress.
From a negative perspective, momentum in implementation may be lost, providing more opportunity for the ACA to be modified in ways that offset the long-term viability of the Act.
As the online federal Exchange and most state Exchanges begin to stabilize and operate as desired, all individuals and organizations affected by the ACA will have fewer excuses to postpone “coming to grips” with the decisions that they face.
But the built-in delays may now provide an opportunity to postpone some of the difficult pending choices.
Attorneys may note increased requests for help from clients regarding their personal issues and options, combined with uncertainty about the timing of decisions.
Many choices to be made will only gradually clarified over the next year.
There will be need for more in-depth understanding by attorneys of the evolving choices – and need to help clients customize their responses.
More on these and related ACA topics, with an in-depth discussion of organizational reactions to implementation issues, may be found in a recent book by the authors that describes evolution of the ACA, and in a new Practice Guide by the authors that addresses funding and access issues in health care.