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Healthcare Reform Update from Healthcare Consultants

By HCI

Healthcare Reform Information

	Health Reform Source (Kaiser)
	Healthcare Reform Timeline
	DOL Audits ACA Compliance
	Summary - Benefits & Coverage FAQ
	Subsidy Calculator
	Preventive Services Covered

	Contact HCI for More Information

Our valued clients and friends,

In a 5-4 decision authored by Chief Justice Roberts, the Supreme Court upheld the Affordable Care Act (ACA) and found that the individual mandate provisions of the ACA were constitutional as a tax. The decision does not change our commitment to continue to build and deliver solutions that help improve quality and health outcomes, making care more affordable and convenient for our clients and their employees. At the same time, we recognize that the Affordable Care Act did not do enough to address the serious challenges facing our healthcare system, and we need to fix the problems that remain.

We will continue to keep our focus on compliance with the law. We have been, and will continue to be, ready to meet the requirements of the law as we work to address the complex and challenging issues that confront our healthcare system. Today's decision does not impact the previous reforms you implemented, or those we are working on with you, such as the Summary of Benefits and Coverage, Women's Preventive Coverage and the W-2 reporting obligation. We are committed to working with you to bring about solutions that will make your healthcare plan work better for everyone.

We realize there has been a lot of discussion surrounding the individual mandate, but the ruling makes it clear that the individual mandate is constitutional. Since the individual mandate does not go into effect until 2014, we have time to evaluate this ruling further. We will communicate with you accordingly on future changes that are needed to remain in compliance with the Affordable Care Act.

With the exception of the limitation on the federal government's authority to withhold Medicaid funding, all provisions of the ACA stand and compliance efforts likely will move ahead at full speed. In preparation for the major coverage expansion to occur under the ACA in 2014, the Administration is expected to release a host of regulations dealing with the definition of minimum essential coverage, employer coverage and reporting requirements, and an array of new taxes and fees. Clients should be aware of provisions of the law set to take effect in 2013 and 2014, including those listed in the table below.

Sincerely,

David Neider

Provisions of the Affordable Care Act That Take Effect in 2012, 2013 and 2014

2012
		Medicare hospital value-based purchasing program
		Increase in physician quality reporting requirements in Medicare
		Additional Medicare pilot programs on alternative payment methodologies, e.g., accountable care organizations
		Increased requirements for hospitals to maintain not-for-profit status
		Fees from insured (including self-insured) plans transferred to the Patient-Centered Outcomes Research Trust Fund

2013
		Increase Medicare payroll tax by 0.9% on high-income earners
		Impose a 3.8% tax on net investment income of high-income individuals
		$500,000 cap on health insurers' deduction for executive compensation
		Eliminate employer deduction for Medicare Part D subsidy
		FSA limitations
		Excise tax on medical device manufacturers and importers
		Medical expense deduction floor increases to 10%
		Nationwide bundled payment pilot begins in Medicare
		Increased Medicaid reimbursement for primary care
		Medicare physician comparison data available to the public
		Reductions in Medicare payments for select hospital readmissions
		Expanded coverage of preventive services by Medicaid

2014
		Employer mandate and individual mandate
		Employer and insurer reporting requirements
		New health insurance market reforms take effect
		State health insurance Exchanges established
		Premium tax credits and cost-sharing subsidies available to certain individuals in Exchange insurance products
		Medicaid expansion to new populations (100% federal match to states for newly-eligible populations through 2016)
		Annual fee on health insurers
		Medicare/Medicaid DSH payment cuts begin
		Independent Payment Advisory Board (IPAB) issues first report to Congress if Medicare spending exceeds growth target

Post-2014
		Excise tax on high-cost employer-sponsored coverage (2018)

We have an opportunity - if we take a bipartisan approach-to make changes to the financing and delivery of healthcare so that employers can continue to provide coverage, and Medicare and Medicaid can be made viable long term. As a nation, it is vital that we capitalize on private sector solutions as well as legislative reforms to address the complex and challenging issues that continue to confront our healthcare system.

Your continued trust in confidence you have placed in Healthcare Consultants over the years is appreciated and not taken for granted. We have expanded our firm to over 21 very capable and experienced Advisors. We understand that during these uncertain times you must make decisions based on sound recommendations and our understanding of the marketplace. All of us at Healthcare Consultants have spend endless hours reviewing this new complex law and will keep you informed of the changes over the days to come.

The HCI Advantage
A strong benefits package helps you recruit and retain valuable employees. We can help you to tailor a program that will fulfill both your company's and employees' needs. Please call HCI at 713-626-2838 or use our Contact Form.

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