The state of health care is constantly changing, especially now with the Trump Administration in full effect. FirstPerson Managing Director and General Counsel, Katy Stowers, shares trending updates centered around the Affordable Care Act and what this might mean for employers. Watch the video or read the transcript below to learn more.
Paul: Hello and welcome to the FirstPerson video blog. I'm Managing Director Paul Ashley and today I'm joined by Katy Stowers, fellow Managing Director and General Counsel. Important that she's here because we're going to talk about the topsy-turvy world of Health Care Reform.
Katy: Yes, it has been a tumultuous few months, at least in the media, for Health Care Reform.
Paul: What's actually going on in D.C.?
Katy: Well we do know that the repeal and replacement of the ACA has been a key tenant of the Trump Administration platform. It's been out there since the election, and it's out there now. The first executive order after inauguration related to enforcement of the ACA and basically directed all of the Federal Agencies to essentially loosen the reigns of ACA regulation and really make things easier. Both for employers, insurance companies, and industries. So, we know that's on their mind.
Paul: And we think that might lead to relaxed enforcement potentially.
Katy: Potentially, yes. The first attempt to make this chance was the American Healthcare Act. Which we all probably heard about, it didn't go far enough in the minds of many Republicans. So, it did not actually get voted on, either in the Senate or the House. What this means is the ACA currently remains the law of the land.
Paul: When they make another attempt, what do you think is going to stay for the ACA?
Katy: There are some provisions of the ACA that have been widely popular since they were passed, and now have really gotten incorporated in planned provisions. So things like the mandate to provide preventive care at 100% with no cost-share for people. The requirement to keep adult children on the plan until age 26, should a parent opt to do so . Those are popular provisions and they likely won't change. That's something that the Trump Administrations has stated.
Paul: There's some less-popular provisions that we think they're going after. What do you think are some of those?
Katy: The mandate to provide health insurance, so that excise-taxed employers will pay if they don't provide health insurance. And also, the requirement that the individual pay a tax if they don't purchase insurance.
Paul: While they didn't have success in replacing and repealing yet, the initial draft legislation they tried to get through signals a couple things they're working on. What does that look like?
Katy: Yes, absolutely. So, things like encouraging health care savings. Promoting the use of the individual health savings accounts. Extending provisions in state risk pools to allow insurance to be priced a little more fairly in the small and individual market. Medical malpractice tort reform is an important provision that has been in the Republican platform for a while that would also be seen as part of this. Putting caps on Medicaid reimbursements. Reinstating the high-risk pools that we had in states prior to the ACA. And then there's a lot of talk about this concept of selling insurance across state lines. You are being able to increase competition by allowing insurance companies to go into other states to compete.
Paul: Which sounds popular as a nice sound bite but the practical application doesn't necessarily accomplish what they hoped it would.
Katy: Yes exactly. Because it is hard for out-of-state insurers to come into states and sell insurance with network agreements and things of that nature. And, just the pooling of risk.
Paul: So, bringing it back Indiana more specifically. Indiana has HIP 2.0. So, let's talk a little bit about this and how this can actually help employers.
Katy: It's a component of Indiana's Medicaid program, it's a high-deductible health plan that's combined with something that's called a Power Account, that individuals can make contributions to in order to save for health care. And that the state also makes contributions to. It's intended to work much like an HSA and encourage health care savings.
Paul: Absolutely. And there's a component in there called the HIP Link Program. What is that? How does that help employers.
Katy: HIP Link helps employers connect employees to HIP 2.0. Which would allow them access to these accounts and then also gives them premium credits so that they can use to participate in the employers' plan. So, for employers that have a group of lower-wage employees that could use this type of assistance to pay their health care premiums, it's a great way to connect them to that program.
Paul: And just so you know our advisory firm has partnered with the state to do some education. So, we know how the HIP Link program works and we can help you think through whether that's a good or bad decision for your employer-sponsored plan.
Katy: And one reason to really think about that now is because we believe HIP 2.0 is here to stay. And that's because Mike Pence is now Vice President and the architect of Indiana's programs is now the head of the Center for Medicare and Medicaid Services, so we think it's going to be something that's in place for quite some time.
Paul: And other states might likely repeat their version of it. And last thing, really quick, FLSA overtime pay rule. Where does it stand? What's next?
Katy: Right, this was originally to go into effect December of 2016. There was then an injunction in the Fifth Circuit that stopped it from going into effect. That's where it stands. So, it's working its way through the Fifth Circuit appeals process. So those employers that took action to comply before 12/1 kept those changes in place with their workforce, those that didn't can wait it out. But for now, we don't have a time frame.
Paul: Great. Well thanks, Katy! Lots of interesting things going on as it relates to healthcare reform and compliance. Stay tune for more, we'll certainly have more to share with you. This has been the FirstPerson video blog, we'll see you next month!
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