Early this month the United States House of Representatives passed a bill, H.R. 4118 “Suspending the Individual Mandate Penalty Law Equals Fairness Act”. This piece of legislation would delay the enactment of certain penalties related to the expansion of the health insurance coverage established by the Affordable Care Act (ACA).  It would delay for one year the possible penalties associated with the requirement that most residents of the United States have health insurance coverage beginning in 2014.

Little refresher: Under current law, most residents of the United States are required to have health insurance coverage beginning in 2014(enrollment delays are in place and expiring soon). Those who do not comply are subject to the individual mandate penalty, which is the greater of a flat dollar amount or a percentage of income in excess of the income threshold for mandatory tax filing. The flat amount per uninsured adult is $95 and the percentage is 1.0%, for 2104.  It increases to $695 per person flat fee, and 2.5% of income in 2016. An overall cap will apply to family payments.  The individual mandate penalty will be adjusted for inflation after 2016, so stay tuned.
 
H.R. 4118 would keep in place the requirement to have health insurance in 2014, just without the penalties for failure to comply. The bill would also shift by one year the schedule of penalties for people who do not comply with the mandate, thus reducing the penalties for not having health insurance for future years. The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) estimate that enacting H.R. 4118 would reduce federal deficits by roughly $10 billion over the 2014-2019 periods and by roughly $9 billion over the 2014-2024 periods. This savings would come from; fewer individuals enrolling for Medicaid and CHIP, savings from refundable tax credits, exchange subsidies savings, and other related ACA related expenses.

On the other side of the coin, the federal government will be losing the revenue expected from penalties charged to uninsured individuals.  The revenue for 2015 would be affected as those in non-compliance with the law in 2014 will pay in 2015.
 
This legislation is now awaiting action in the United States Senate and MBPA’s government relations team will keep you posted as it continues to move through the democratic process. As always, please feel free to contact our team with any questions, comment, or suggestions.  We like them all!  Email: BBochniak@michbusiness.org or by phone: 586-393-8800

As many of you are aware the Michigan Business & Professional Association launched its Health Care Reform Connect™ website and e-publication last fall.

We wanted to take a moment to update you on what we have been working on as it relates to supporting Michigan Businesses and your clients through the implementation of health care reform. Here is a summary of activities in case you missed one:

•    The development and launch of Health Care Reform Connect™ last fall has resulted in thousands of visits to our website by Michigan Businesses and independent agents who are looking for reliable information on health care reform and a source to get their reform questions answered.
•    We have been hosting health care reform seminars, monthly webinars, and reform conferences across the state with several hundred attendees who have learned about the impact of health care reform on their business.
•    We have published numerous health care reform articles from various subject matter experts from around the country – available via our secured site as downloadable PDF’s.
•    Our team has spent countless hours lobbying at the State and Federal level on health care reform and the impact on Michigan Businesses and its employees.
•    We have launched a dozen health care reform tools such as our Small Business Health Care Reform Guide, Tax Credit and FTE Calculators, Health Care Reform Timeline, and Reform Roadmap, to name a few, to help Michigan businesses and their agents through health care reform.
•    We have hosted dozens’ of onsite meetings with members and agents to help educate them on health care reform.
•    We have developed a reform “hotlink” giving members and agents the opportunity to ask their specific health care reform questions with a typical answer back in 24 hours. This free service for our members has saved them countless hours and helped to clear the fog on reform.
•    Health care reform alerts and e-publication available to members and agents. Each month we send out an updated e-publication via our Health Care Reform Connect™ brand with an overview of new tools, articles and white papers on reform. We also send out timely reform alerts when various federal departments make announcements regarding reform. 

Please feel free to connect with our team today to ensure you and your clients are receiving our health care reform communications P: 888.277.8800 / E: info@michbusiness.org

Here at the Michigan Business and Professional Association (MBPA), our government relations team and supporting staff have been working around the clock as changes to the Affordable Care Act (ACA) have been made. We have dedicated a specific website unlike any other to help you better understand the law and how it impacts you and your business.

It has been a long journey for the ACA to finally make its debut on January 1st, 2014. This past January 1st has been a long standing kick-off date for this new healthcare law, despite it’s over 50 provisions that have already been put into effect. Together with the general public, businesses, and of course our elected officials, there have been countless hearings, testimonies, interviews, speeches, and the list goes on, discussing and continuing to debate this topic and its intended and unintended consequences.

Now that the 1st of the year has passed, we wanted to review some of the provisions that have begun. For most, this is just a review, but for new businesses, this is critical information. Please see below.

• January 1: Insurance coverage purchased either through the Federal Health Care Marketplace or through a State Based Exchange (SBEs) by December 24, 2013 became active.  Companies with 50 full-time equivalent employees( FTEs) or fewer (in Michigan; 100 in some other states) that that signed up for coverage for their employees through the Small Business Health Options Program (SHOP) Exchanges will also see their coverage become active. This enrollment in Michigan was achieved by filling out paperwork and sending to the federal government or calling the healthcare.gov line directly(online enrollment available late November 2014). Many insurers have reported problems with the enrollment data that they have received from the federal government website that have included missing data and duplication. This has proven difficult to confirm whether healthcare enrollments are accurate and complete. As individuals show up at their doctor’s offices, hospitals or pharmacies, they will quickly find out whether their coverage is active or not.
 
• January 1: Eligible employers that purchase health insurance for their employees in the SHOP Exchange may receive a tax credit up to 50% of the employer’s contributions toward health insurance premiums. The credit will only be available to an employer for two consecutive tax years.
 
• January 1: The individual mandate goes into effect.  Nearly all U.S. citizens and legal residents are required to carry health insurance that meets minimum standards or face a “shared responsibility payment.” Tax returns filed in 2015 will need to include information regarding health insurance carried. The ACA allows for a 3-month lapse in coverage in a year before a penalty is assessed. Therefore, individuals without coverage will have until March 31, 2014 to sign up in order to avoid the fee. Those who had healthcare coverage that was cancelled as a result of the ACA will be exempt from the penalty this year.*
 
• January 1: Insurers may no longer deny coverage for pre-existing conditions or because of the applicant’s health status or other factors. Employer group health plans may not impose annual dollar limits on essential health benefits.  Plans must limit annual participant out-of-pocket maximums to $6,350 for single coverage and $12,700 for family coverage. Totals include copayments and deductibles but not premiums, and apply only to plans that are not grandfathered.
 
• January 1: Financial assistance through tax credits and subsidies will be available for lower income individuals who purchase health insurance coverage through an Exchange. Credits are available for people with incomes above Medicaid eligibility and below 400% of the poverty level who are not eligible for or offered other acceptable coverage through their employer. The credits and subsidies apply to both premiums and cost-sharing. Individuals that receive either too much or too little in premium subsidies during the year will have those differences reconciled with the IRS in April 2015.
 
• January 10: In most cases, individuals who signed up for insurance through the Marketplace (i.e., either the Federal or State exchanges) by December 24, 2013 have until January 10th, 2014 to pay the first month’s premium in order to receive coverage for the month of January. Individuals should check with their insurance company, since some are not expected to honor the grace period, or actually give additional time to make payments.

• April 1: Lower income individuals who didn’t qualify for Medicaid in the past will now have access to coverage in states that expanded their Medicaid safety net program. Twenty-five states (including Michigan) and the District of Columbia expanded Medicaid under the Affordable Care Act.  Households with incomes between 100 and 138% of the Federal Poverty Level (FPL) are eligible for subsidized health coverage through the Medicaid program.

*Note: Individuals whose healthcare coverage was cancelled as a result of the ACA will be exempt from the individual mandate penalty for the year 2014.  Unless further legislative or executive action is taken, penalties begin again for these individuals January 1st, 2015.

As always, please contact our government relations team with any questions, suggestions, or general comments. We are here to help guide you through the ACA and will continually keep you up to date as more changes occur. You can contact us by email, phone, or via the web. Email: bbochniak@michbusiness.org; Phone: 586-393-8800 or web: michbusiness.org

Although the Michigan Insurance Commissioner announced that carriers can allow customers to maintain their current benefits for an additional year, Blue Cross® Blues Shield® of Michigan and Blue Care Network have decided to move forward with plans to transition their existing business into Affordable Care Act (ACA) Qualified Health Plans (QHP) effective January 1, 2014.

Following is important information:

•    Current MyBlue™ members can still select a Keep Fit™ plan in 2013.
•    Current Keep Fit members who want to switch to a different Keep Fit plan can do so by submitting a Change of Status form or calling Customer Service by December 23, 2013.
•    Please reference the chart below for plan, application deadline, and effective date information:

Plan                  Application Date                          Effective Date
Keep Fit™      Today – December 23             December 31, 2013
QHP              Today – December 23             January 1, 2014
QHP              December 16 – December 23   Option to choose January 1, 2014 or February 1, 2014

• If an existing MyBlue™ member takes no action, they will be migrated from their current plan to the Keep Fit plan that most closely reflects their current premium level.
• Beginning December 24, 2013, Keep Fit plans will no longer be available for purchase.
• If a member pays their premium using ACH/EFT, this payment arrangement will not transfer with the migration. Migrated members will receive a paper invoice that must be paid manually. Once they have paid the first invoice, they can set-up a new ACH/EFT payment arrangement.