Saturday, March 29, 2014

March 2014 ACA Update Part II

The Centers for Medicare and Medicaid Services and the Department of Treasury issued regulations this week on numerous aspects of the Affordable Care Act. To the surprise of very few, another extension was the major news in these releases.

Here We Go Again.....Politics meets Health Care Policy

The fiasco coincided with the individual policy cancellation tsunami and the results was a gigantic mess which still begs for resolution. The Obama administration eventually provided an option for states to extend ACA non-compliant policies for one year.

This year expires just prior to the mid-term elections, causing a (smaller) torrent of cancellation notices. Prudence being the better part of political non-valor, there is now an option for states to extend the policies for two years until renewals effective October 1, 2016 and after.

Extra Enrollment Month

An extra month was added to the upcoming enrollment season, which coincidentally starts AFTER the midterm election. New deadline is February 15th, 2015.

Out of Pocket Maximums

For 2015, $6,600 for individuals and $13,200 for families. For some a decrease, for many an increase.

Treasury Rules and Regs for Reporting

The IRS is charged with collecting ridiculous amounts of data, is the heavy hand of penalty enforcement and will distribute tax credits.


The small business program MAY be delayed, or maybe not. Management by chaos.

And so......

The slow, painful, dysfunctional implementation of the Affordable Care Act continues.

March Update

ACA (Obamacare) Update March 2014

Sign-ups continue, although the “back room” functions are moving very slowly. Providers are struggling with verification problems and missing insurance cards. The deadline approaches.

Other Changing Policies

A huge number of policies in both the employer-paid sector and the individual policy sector changed as of January 1, creating more messes for patients and providers.

Moving individual policy holders into the exchange system has been a nightmare and will likely continue to be a nightmare for some time. Providers are struggling with a high percentage of patients presenting new insurance cards for both new carriers and the same carriers with different policies. Confusion reigns.

More Cash from Patients

The long term trend of “risk shift” - less coverage from employers and more out of pocket from patients – has been accelerated by Obamacare. This is impacting both patients and providers, and not for the better.

This creates numerous headaches for providers, who have enough headaches already.

Fall will be Interesting

With the ICD-10 adoption deadline October 1 and the EMR/EHR operational deadline January 1, 2015 the fall season will be stressful for providers.

Deadlines ….. don't mean much, it is the extended deadlines that are important.

Compliance programs … both nursing homes and physician groups are supposed to have mandatory compliance plans – except the regulations are not written yet. Stay tuned.

And so.... 2014 may be the single most stressful year in the history of our health care system – until 2015.