Implementers of the Patient Protection and Affordable Care Act of 2010 (PPACA) are preparing to change how regulators define “small group,” or “small employer,” for purposes of applying PPACA coverage requirements.
See also: PPACA: How Small is Small?
State insurance regulators are joining with business groups to back the ”Protecting Affordable Coverage for Employees Act” bill. Sen. Tim Scott, R-S.C., is the lead sponsor for the Senate version, S. 1099, and Rep. Brett Guthrie, R-Ky., is the lead sponsor for the companion bill, H.R. 1624.
Monica Lindeen, the president of the National Association of Insurance Commissioners (NAIC), and other NAIC officers have sent Congress a letter expressing support for the bills.
The U.S. Chamber of Commerce has also written to Congress to support the bills.
See also: Nebraska Defines “Small”
Defenders of the current Obama administration strategy for applying the PPACA definition rules, which are given in PPACA Section 1304(b), say that the U.S. Department of Health and Human Services (HHS) has already given insurers, employers and regulators years to get used to Section 1304(b); that making U.S. health insurance rules more uniform will eventually make the U.S. health insurance system more efficient; and that applying uniform rules will help ensure that people in one part of the country get the same protections that people in other parts of the country get.
Backers of the group definition bills argue that the small-group markets in many states have had trouble handling the PPACA provisions already in effect, and that states need as much flexibility as possible to prevent future problems.
See also: PPACA small-group exchange program fights for life
For a look at some of the details from the NAIC and Chamber of Commerce letters, read on.
1. Federal PPACA rules that now apply to employers with 1 to 50 employees are supposed to apply to employers with 1 to 100 employees starting Jan. 1, 2016.
PPACA and HHS regulators have let states apply their own local definitions of small group up until New Year’s Day next year.
HHS has extended the time the insurance community has to prepare for a national shift to the 1-to-100 definition by stating that it will not enforce some small-group market regulations for existing plans if the plans are renewed on or before Oct. 1, 2016. States and the District of Columbia can choose whether or not to use the transition option.