Wenatchee Valley Business World



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This month, we’ve got a very big Act to follow

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Officially called the Patient Protection and Affordable Care Act, the health care overhaul signed into law in 2010 and more commonly referred to as Obamacare is about to become a huge part of the American landscape.

The Act, after overcoming constitutional challenges, is being slowly phased in, but this year and next we will be getting our first big taste of what it will mean for businesses, health care providers and individuals.

In this issue of Business World we attempt to unravel some of the complexity of the Act by looking at the requirements from several different perspectives.

As you read through the scenarios you will find some repetition but it was impossible to avoid that, with the same language in the law sometimes meaning different things under different scenarios.

Businesses, for example, will be under varying levels of requirements under the law, depending on whether you employ 50 or more people. Even then, the differentiation between full- and part-time employees could land you on one side or the other of that number.

Also the plan you offer must meet certain levels of coverage, under the Act. If you employ 50 or more people you will be required to offer health coverage or face a fine, beginning next year.

Eventually, everyone will be required to have some sort of health insurance or be subjected to a fine. Low-income people who are currently uninsured, will be funneled into health plans created at the state level.

If they are unable to pay for the minimum required level of coverage, they will have opportunities for government assistance.

In that regard, it is expected people who now are without insurance will have a level of insurance that will reduce, if not eliminate, the amount of “charity” care provided by hospitals and doctors.

The thinking is that getting rid of these annual massive write-offs for providing care will stabilize or push down the skyrocketing cost of health care.

Those state health exchanges eventually will be available as a coverage option for businesses.

In addition, preventative care will be an emphasis, which in theory will reduce the number of critical care cases doctors and hospitals see today as people, fearful of the cost and without coverage, put off seeking help until their condition has reached a critical stage.

What it will mean to you as an individual is difficult to say, at this point.

It is possible that under your current plan nothing will change. Your employer will still pay the same amount for the plan they provide and your share of that payment will not change. And your coverage will be the same.

That is a possibility. However, insurance companies no longer can deny coverage based on pre-existing coverage and if you have a child on your plan you can keep that coverage until they reach age 26.

Such requirements could eventually result in higher premiums for employers and employers. Possibly, but not certainly.

One thing we learned quickly while compiling these stories is there is a lot of confusion out there. Even with people you’d expect to know. So ideally, we hope these reports can help clear up some of that confusion.