MHA Health Care Aide

Welcome to MHA's Health Care Aide

The health care environment is constantly changing and business leaders need to stay informed about these changes. The Mississippi Hospital Association (MHA) recognizes that you need resources to help you make the critical decisions required to ensure affordable, quality health care for your employees, and we hope that MHA's Health Care Aide will be an invaluable resource to our state's businesses.

We will keep the Web site updated with timely, pertinent information. Feel free to suggest resources to share with others too. (Email suggestions to Shawn Rossi at srossi@mhanet.org.)

Tell us what you think and what you'd like to see on this site in the future. Together, we can make a difference.

Sam W. Cameron
President/CEO
Mississippi Hospital Association

Department of Labor Delays Deadline for Certain ACA Notice Requirements

On January 24, 2013, the Department of Labor issued guidance delaying the deadline for employers to provide employees with notice of coverage options available through the health care exchanges. Learn more here.

Health Care Reform Update: Large Employers Must Offer Health Coverage or Pay Assessment

Beginning in 2014, large U.S. employers that do not offer a minimum level of affordable health coverage to their full-time employees may be required to pay an assessment of up to $3,000 per employee. For plan years beginning in 2015, the Internal Revenue Service (“IRS”) is proposing to extend this assessment to employers that fail to offer adequate health coverage to the children (up to age 26) of their full-time employees.

Proposed “pay or play” regulations released on December 28, 2012 also include rules for determining whether an entity is a “large employer” subject to the shared responsibility requirements, identifying which employees and dependents must be offered coverage, and calculating any payment that may be due.

Read more from JDSupra Law News here.

New Brief Examines Proposed Regulations for Private Health Plans

With the effective date for major changes in the private insurance market under the Affordable Care Act (ACA) less than a year away, a new Kaiser Family Foundation brief looks at three new proposed federal regulations that detail how the ACA’s rules will operate.

Health Care Reform Blog: Pay or Play Provisions of the Affordable Care Act

Recently, the IRS released proposed regulations implementing the employer “play or pay” provisions in the Affordable Care Act. The rules are applicable to employers with 50 or more full-time equivalents and outline the requirements for employers to provide affordable, minimum value health insurance to full-time employees to avoid penalties.

Much of the proposed rule adopts guidance previously released by the IRS over the past year; however, it does contain the following new information.

IRS Issues Proposed Regulations On Employer Shared Responsibility Mandate

On December 28, 2012, the Internal Revenue Service (IRS) issued proposed regulations providing guidance on the employer shared responsibility provisions under the Affordable Care Act (ACA). Additionally, a new set of questions and answers regarding the shared responsibility requirements has been posted on the IRS website.

Read more here.

Pay the penalty, or insure your staff? Small-business owners face tough healthcare decisions

Companies must decide before the start of 2014 what they’ll do to comply with the healthcare law. Right now, no one knows how much the insurance will cost, and owners aren’t sure if they’d be better off not buying it and paying a government a penalty of $2,000 per worker. Some owners are even threatening to defy the law. The big challenge for most small businesses is that they just don’t have enough information to make concrete plans.

Read the full article from AP/Washington Post.

Healthcare: A real fixer-upper

With healthcare reform unfolding and no end in sight to soaring medical costs, employers are playing a key role in transforming healthcare delivery. They are helping to rebuild the healthcare system with a do-it-yourself approach that takes picking the right tool. The new options include value-based design, workplace clinics and direct primary care.

Read the full article from Workforce Management.

What small business owners should know about each possible Supreme Court health-care ruling

The Supreme Court is set to release its ruling on the constitutionality of President Obama’s controversial health reform law, the Affordable Care Act (ACA), as early as this week. In addition to the highly divisive individual insurance mandate, the ACA contains a variety of provisions designed to broaden access to health insurance coverage, end perceived unfair insurance practices, bend the cost curve and modernize payment methods. Some of these changes have already kicked in.

Read more from the Washington Post here.

Health Law Is Mixed Bag For Employers

A decision to invalidate the entire health care law would have vastly different effects on employers, depending on their size. Learn more here.

Report Finds Small Employers Don’t Use Health Care Credit

The Obama Administration is particularly proud of the small business friendly provisions in the Patient Care and Affordability Act. For example, there is a tax credit available for small employers that pay at least half their low-wage employees’ health insurance premiums (“low-wage” here means earning $11.50 an hour or less).

It turns out that only 170,300 small employers from a pool estimated at between 1.4 million and 4 million eligible firms claimed the tax credit. The cost of the credit, pegged by the Congressional Budget Office at $2 billion in fiscal 2010, was only $480 million.

Read more here.

Small Businesses Pay More For Health Care Coverage

In a 2009 study by the White House, small businesses pay 18% more in premiums for health coverage than their big box competitors per employee. As a small business owner are you surprised by this statistic?

Of course not.

Report: Millions of employers fail to claim healthcare tax credit

Millions of small businesses failed to claim tax credits they could have received under President Obama’s healthcare law, according to a new report from the advocacy group Families USA. Read more from The Hill's health care blog here.

HHS: Nearly 50,000 people enrolled in Pre-existing Condition Insurance Plan

Nearly 50,000 people are enrolled in the Pre-existing Condition Insurance Plan, according to a report released Feb. 23 by the Department of Health and Human Services. The Patient Protection and Affordable Care Act created the program as a bridge to 2014, when the ACA prohibits denying coverage to people with pre-existing conditions. Twenty-seven states have elected to administer their own programs, often in coordination with existing high-risk pools, while HHS operates the program in the remaining states.

Many PCIP participants have serious health conditions, which has contributed to higher per-member claims costs in state-based PCIPs than traditional state high-risk pools, HHS said.

[ via AHA News Now ]

CMS issues FAQs on intended approach to essential health benefits

The Centers for Medicare & Medicaid Services on Feb. 17 issued answers to Frequently Asked Questions on the agency’s intended approach to defining “essential health benefits” for individual and small group health insurance plans under the Patient Protection and Affordable Care Act. In December, CMS issued a bulletin outlining proposed EHB policies the agency plans to define in future rulemaking.

The FAQs are intended to provide additional guidance to states and others working to establish health insurance exchanges. For more information, e-mail CMS at EssentialHealthBenefits@cms.hhs.gov.

The agency also plans to release future guidance on Medicaid benchmarks and essential health benefits.

Administration highlights business healthcare tax credits in Obama budget

President Obama's proposed budget would expand the health law's healthcare tax credits by about $14 billion over a decade, the administration highlighted Feb. 16. Under the law, companies with 25 or fewer workers that pay for at least half of employees' healthcare coverage can claim progressively higher tax credits (up to 50 percent starting in 2014). The president's budget would increase the size of eligible companies to those with 50 or fewer workers, make it more generous and make it easier to claim.

Read more here.

Small Business Health Insurance Exchanges: Potential And Pitfalls

The Affordable Care Act’s state health insurance exchanges for small businesses present a host of opportunities for states now creating them, but they also present design and regulatory challenges that could make or break the success of the program, according to a cluster of articles in the February issue of Health Affairs, released Feb. 8.

Read more here.

 

How will the Affordable Care Act affect small businesses and their employees?

A new Kaiser Family Foundation fact sheet summarizes key provisions in the Affordable Care Act that may affect small businesses and their employees. The fact sheet explains the law’s small business tax credits and the Small Business Health Options Program exchanges to be established in each state by 2014, both of which are designed to make it easier for small businesses to purchase insurance for their workers.

The fact sheet also describes the penalties employers who employ more than 50 full-time workers would face if they do not offer affordable coverage starting in 2014; smaller employers are exempt from that requirement and would not face any penalties. The fact sheet is available online.

Law won't lead most employers to drop health coverage, study finds

A study by the Urban Institute found that even after enactment of the federal health care law, most employers will still offer coverage to workers rather than pay fines and leave employees to get insurance from state health exchanges. The study found that employers' desire to keep highly skilled workers will prompt them to continue offering health insurance, but employers with many low-wage workers are likely to drop coverage.

Read more here.

Study looks at competition in state insurance markets

The health insurance market for individuals and small groups is highly concentrated in many states, according to a new study by the Kaiser Family Foundation. The study found a single health insurer dominates at least half of the individual market in 30 states and at least half of the small group market in 26 states.

The market share for a state's largest insurer in the individual market ranged from 86% in Alabama to 21% in Wisconsin, while the market share for the largest insurer in the small group market ranged from 96% in Alabama to 24% in Oregon and Pennsylvania. "As state policymakers consider their options as implementation of the [Patient Protection and Affordable Care Act] proceeds, they may want to examine the level of competitiveness in their insurance markets as a factor in the choices they make with respect to insurance market rules, exchanges and rate review," the authors state.

IOM issues guidelines for ACA essential benefits package

A new Institute of Medicine report recommends criteria and methods to guide the Department of Health and Human Services in developing a package of essential benefits for qualified health plans under the Patient Protection and Affordable Care Act. The ACA requires HHS to define the minimum package of benefits that certain health plans must cover, including those participating in health insurance exchanges.

The report recommends that the cost of the average premium for the initial package not exceed the national average premium for the typical small employer plan. It says HHS should gauge potential services and products against a set of criteria, including medical effectiveness, safety and relative value compared with alternative options, and evaluate whether the package as a whole protects the most vulnerable individuals, promotes services that have proved effective, and addresses the medical concerns of greatest importance to the public.

The report also recommends creating an independent National Benefits Advisory Council to advise the HHS secretary on annual updates to the benefits package.