Heads up: Key changes that could be coming for Obamacare
The current version of the healthcare reform law is a lot different from the one that took effect on March 23, 2010 — and more changes are bound to come. While it’s impossible to predict exactly what tweaks the feds will make to Obamacare, experts have pinpointed a number of changes that seem plausible.
HR pros may want to make themselves aware of these possibilities so they’re not completely caught off guard when the feds make one of their infamous last-minute announcements that the law has been altered:
A return to the 40-hour per week threshold
In an effort to prevent employers from reducing employees’ hours to just short of full-time status to avoid healthcare obligations, Obamacare put a new standard in place that reduced the minimum amount of hours employees have to work to be considered full-time under the health law to 30.
But calculating employees’ hours-worked under the law has led to a slew of confusion, employer questions and government guidance on all of the variables that can impact an employee’s full-time status. Using the 40-hour workweek most federal laws recognize would go a long way toward clearing up the confusion, and many benefits experts believe the feds will eventually be pressured into making such a change.
Changes to out-of-pocket maximums
As HR Benefits Alert reported previously, the feds’ recently delayed fully implementing the law’s limits on out-of-pocket costs (deductibles, premiums, etc.) people would have to put out for medical care. The full regulations are now slated to take effect in 2015. But even when they do, there will still be no limit on the charges individuals can incur for using out-of-network doctors.
What it means: If an individual goes to a hospital and winds up getting work done by an out-of-network physician, there’s no ceiling on what he or she could wind up paying out-of-pocket. Keep an eye out for changes to this reg. In the meantime, remind employees of the importance of staying in network.
A cap on hospital stays
Starting in 2014, plans can’t impose dollar limits on the costs of essential health benefits. And many experts are unsure how this reg will impact plans that currently limit hospital stays.
Example: Under certain plans, participants are limited to 120 hospital nights each year. So employers with these types of plans may be wondering how the lifetime limit reg affects their plan.
An increase in coverage-related fines
This year, individuals will be slapped with a $95 fine for not obtaining healthcare coverage. And that number shoots all the way up to $695 by 2016. However, some experts believe the feds may start increasing fines if they continue to have trouble convincing young and healthy individuals (the target of the health exchanges) to sign up for coverage on the exchange marketplace.
This post originally ran on our sister website, HRBenefitsAlert.com.
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