• Changes, Exchanges in Healthcare

  • MAY 25, 2012 | BIZ TIPS, HEALTHCARE REFORM, NYS GOV'T, US GOV'T

  • Tips for Business to Prepare for January's Changes in the Healthcare System

  • A top private attorney in national health care law and policy expects the U.S. Supreme Court to strike down a key provision of the federal health care reform bill that requires individuals to obtain health insurance coverage...


    L-R: Nancy Taylor, Esq., Greenberg Traurig, LLP; Danielle Holoran, State of New York; and Shawn Nowicki, Healthpass.

    Nancy Taylor, a lawyer at Greenberg Traurig L.L.P. in Washington, D.C., found most people in her audience at The Westchester County Association’s recent luncheon panel on health insurance exchanges agreed with her prediction.

    Of the several legal challenges to the Affordable Care Act being considered by the Supreme Court, “There’s only really one question,” said Taylor, “and that is whether or not the individual obligation to have (insurance) coverage is unconstitutional.”

    She said justices are split 4-4 on that question, with one justice holding the deciding vote. “It will probably be 5-4 unconstitutional,” she predicted.

    If the insurance mandate is upheld as constitutional, the vote will likely go 6-3, with Chief Justice John Roberts adding his vote to the majority, she said.

    Meanwhile, 34 states continue to prepare for the scheduled opening of public health insurance exchanges for individuals and small businesses on Jan. 1, 2014. In New York, all planning studies for the new insurance marketplace will be completed by June, said Danielle Holohan, the state’s project director for health exchange planning. No state tax dollars are being used to fund those studies, she said. The Affordable Care Act requires state exchanges to be financially self-sustaining by Jan. 1, 2015.

    Sol Ross, director of business outreach at the U.S. Department of Health and Human Services, said federal officials have seen “a less than anticipated uptick” in the number of qualified small businesses claiming tax credits of up to 35 percent on health care premium costs for providing group coverage to their employees. The credits began in 2010 and in 2014 will rise to a maximum credit of 50 percent.

    Ross said the limited volume of tax credit claims could be because accountants for small businesses do not know about the program.

    Taylor and Russell J. Carpentieri, managing director and co-founder of Opus Advisory Group L.L.C., a benefits consulting firm in Purchase with more than 300 clients, said employers are not dropping their group premium plans and telling employees to shop for individual coverage on the exchanges.

    “Employers are unwilling to vacate the employer-sponsored marketplace,” Carpentieri said. “They say, we’re really committed to the market.”

    -John Golden

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