Tuesday, October 30, 2012

The Avalanche Of New Obamacare Rules Will Come In January, 2013

When Congress wrote 2,700 pages of legislation to create ObamaCare, that was only the starting point in the government’s re-engineering of our health sector. Tens of thousands of pages of regulation – or more – are needed to provide detailed guidance dictating exactly how its maze of new programs must operate.

But deadlines are looming for ObamaCare for programs that are required to begin in 2014. And the administration is significantly behind schedule, with insiders speculating the White House is waiting until after the election to issue an avalanche of rules, many of which are sure to be controversial.

Government re-engineering of the private marketplace is a complex task. So far, more than 13,000 pages of federal ObamaCare regulations have been issued, but employers, states, and health companies say they need much more.

One recent rule took 18 pages to define a “full time employee.” That’s needed because a company employing 50 or more full-time workers must provide health insurance or pay a fine. But part-time employees working fewer than 30 hours a week are exempt. How the government defines a full-time employee has huge financial implications for a company. The rule describes the difference between “variable hour employees” and “ongoing employees,” for example, and how to determine what time period to measure with definitions of “standard measurement periods” and “look-back measurements.”

Employers are hiring battalions of lawyers to help them decipher the bureaucratese, and some companies already have announced they plan to cut the hours of many of their workers so they fit within the part-time threshold, arguing even the $2,000 to $3,000 per-employee fines would more than wipe out their profit margins.

States also are in a quandary. HHS claims it is giving states “significant flexibility” in implementing ObamaCare, including the controversial health insurance exchanges, but even those supporting the law are increasingly alarmed because they say they simply don’t have enough information to proceed.

The law requires exchanges to be created as a funnel for hundreds of billions of dollars in new health insurance subsidies and also as a vehicle to implement significant new regulations of the health insurance market.

The exchanges are required by law to begin enrolling members on October 1st of next year, and a huge amount of work needs to be done to meet that deadline.

But first, states need information. For example, the law says that if states don’t set up an exchange, the federal government will swoop in and set up its own, and they want to know what a federal exchange would look like before they decide whether to set up their own exchanges.

The Republican Governors Association wrote a letter to President Obama in July saying, “As the exchange issue is currently interpreted, states are essentially being tasked with shouldering all the responsibility without any authority.”

The governors listed 17 critical questions just on the exchanges that they must have answered before they can determine best how to proceed so they can “have full and complete knowledge of all the implications of our decision.” They are still waiting for a reply.

Health plans also are in a dilemma. Health insurers that plan to offer policies through the exchanges need to know what benefits must be covered and at what price so they can design and price their offerings. And they must get state approval for the new plans before they can be offered in the exchanges, a process which can take up to a year – or more in some states – to complete. They also need time to contract with providers, develop marketing materials that meet as-yet-to-be-announced government specifications, and figure out how to navigate the complex web of subsidies, risk adjustment, and calculations for cost-sharing – for starters. They have hundreds of other critical questions.

Full article: http://www.forbes.co … ome-in-january-2013/

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