What health care reform means to employers

By Dan Anglin

With the passage of the Federal health care reform law, known as the Patient Protection and Affordable Care Act (PPACA), many employers are concerned about the steps that they will have to take to comply with the many mandates that affect their role in a worker’s health benefits.

CACI, in concert with members of the health care industry (insurers, providers and manufacturers of health care related products), is working diligently to determine how Colorado will implement the new requirements of the federal law.

The first issue of the PPACA that Colorado will face is the idea of an “exchange.” An exchange is the concept that a new “entity” will emerge that provides a marketplace for the purchase of health insurance. According to the Colorado Association of Health Plans,

a CACI member, the basic concepts of exchange that must be implemented in Colorado to comply with the PPACA are:

• The entity that administers the exchange must be a governmental agency or nonprofit organization;
• Participants in an exchange must be U.S. citizens or legal immigrants;
• The exchange must include all individuals and small businesses;
• All plans offered in the exchange must include specific benefits;
• Premiums for the plans must be based on adjusted community rating (meaning that the premium is based not on health factors but other considerations) in and out of the exchange; and
• Federal insurance-premium tax credits and cost-sharing subsidies are only available to purchasers within the exchange.

These parameters leave many questions as to how Colorado will approach the implementation of the exchange. For example:

• Who will pay for the exchange?
• What role will an employer have in an employee’s health benefits?
• Who will administer and govern the exchange?
• Will there be more than one exchange available for Colorado residents?
• What insurance carriers will be allowed to offer plans in the exchange?
• What role will brokers have?
• Will Colorado require more benefits to be covered than the basic federal plan?

The first in a series of public discussions on such issues and questions will be conducted by the Colorado Health Reform Implementation Board from 9 a.m. to 11 a.m. on Friday, July 23, at the Molly Blank Center of the National Jewish Hospital.

This forum is open to the public and CACI members who would like to participate in the discussion are encouraged to attend

Another source of information on various issues about the implementation of the PPACA, including health insurance exchanges, is the Henry J. Kaiser Family Foundation.

Dan Anglin is CACI Governmental Affairs Representative.

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