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A.D. 2014: Experts Say, “Plan for the Worst”

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Prudent insurers, employers and benefits advisors should take the same “better safe than sorry” approach to planning for the Patient Protection and Affordable Care Act that they’d take to planning for computer problems, or a major hurricane.

Panelists agreed on that point Monday during a panel discussion on employer implementation of PPACA organized by Ernst & Young L.L.P., New York, and cosponsored by Financial Executives International, Morristown, N.J.

Edward Pudlowski, a benefits expert at the firm, participated along with Michelle Reinke Neblett, director of labor and workforce policy at the National Restaurant Association (NRA), Washington.

Pudlowski and Neblett touched briefly on the view of some employers that PPACA might “just go away,” either because of congressional action or possibly because the Supreme Court will find that the provision requiring many individuals to own coverage or else pay a penalty is unconstitutional.

The NRA is no fan of PPACA, but Neblett shrugged when asked about the idea of PPACA vanishing.

Federal agencies “are certainly implementing this law,” Neblett said. “You don’t just stop that overnight.”

If the 2012 elections break in favor of Republicans and Democrats with concerns about PPACA, that could change the situation, Neblett said.

But, Neblett said, even if the mix in Congress changes, some of the regulations are already written.

“It’s very hard to roll those back,” Neblett said. 

Pudlowski said depending on the idea of a change in Washington leading to the disappearance of PPACA is unwise.

“This snowball is rolling downhill and getting bigger and faster every day,” Pudlowski said. “Quite honestly, I think it’s hard for it to be repealed.”

Insurers, employers and advisors should start to plan for the worst case scenario now rather than count on repeal, Pudlowski said.

The speakers talked about the possibility that an employer that offers solid health benefits could still be penalized as if it offered none if the cost to the employee exceeds 9.5% of a full-time employee’s wages from that employer.

Aside from the fact that the provision seems burdensome, applying the provision will be complicated, Pudlowski said.

“One of the big struggles is determining who’s a full-time employee,” he said.

The task is especially difficult at restaurants and other employers with hourly workers and rapidly changing schedules, Neblett said.

“You may not know who’s going to be full-time when they walk in the door,” she said.

Another concern is that federal agencies are releasing the regulations and other documents implementing PPACA in dribs and drabs, Neblett said.

“Business owners want to know the full picture,” Neblett said.


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