What’s Next with Healthcare Reform? What’s Next with Healthcare Reform? By Mike Farmer (edited) The Patient Protection and Affordable Care Act (PPACA) is just over two years old now. Its future may or may not be in jeopardy, but for now it is the law. So far we have seen expanded eligibility for children on the parents’ policies, a health insurance credit for employers, and a few other changes. We have also seen some parts of the bill – like the changes to 1099 reporting, W‐2 reporting, and long‐term care insurance – thrown out. The changes for 2012 to 2014 are where the biggest impacts will be felt. Below are some of the upcoming items that may affect you and your business. 2012 Financial incentives will be paid to hospitals that improve quality of care. Fraud and Abuse Prevention 2013 The Medicare bundled payment pilot program will begin. Medicaid reimbursements will be increased. The threshold for claiming itemized deductions of medical expenses on federal taxes will increase from 7.5% to 10%. Limits on the medical portion of flexible spending accounts will increase to $2,500 per year. 2014 U.S. citizens and legal residents will be required to have health insurance. Businesses with more than 50 employees will be charged a $2,000 penalty per employee if they do not offer affordable health insurance. State‐based health insurance exchanges will be developed. Health insurance premium subsidies will be established for families with incomes between 133% and 400% of the federal poverty level in order to facilitate the purchase of insurance through the exchanges. Availability of insurance will be guaranteed. There will be no annual limits on benefits paid. Medicaid coverage will be expanded. Medicaid will be expanded to all individuals not eligible for Medicare under age 65 with incomes of up to 133% of the federal poverty level. Businesses with fewer than 25 full‐time employees with annual average salaries below $50,000 will be eligible for a credit of up to 35% of the premiums paid. In 2014 the credit will increase to 50%. One of the latest estimates is that this bill will cost $1 trillion per year. Congress is planning on cutting Medicare reimbursements to physicians to cover about half of the cost. The other half will be paid by us. With a bill as far reaching as this one, there are many unintended consequences. For instance, many health insurance providers have dropped out of the market or have limited the options that they offer for health insurance. Two major obstacles ahead for this bill are the Supreme Court and the Republicans. The Supreme Court could overturn this bill this summer by saying that Congress has overstepped its authority and that the bill is unconstitutional. If that does not happen and the Republicans win next November, they could overturn the bill. These are just some of the provisions in the law. This will affect just about everyone in the U.S., and there will be many more unintended consequences that develop as different components of the bill take effect. Previous Next