NAHC Initiates Nationwide Impact Survey on ACA Employer Mandate

The National Association for Home Care & Hospice has developed a survey on the impact or potential impact of the Patient Protection and Affordable Care Act (ACA) requirement that certain employers pay a penalty when they do not provide a qualified health plan to employees. NAHC believes that many home care companies will be subject to penalties under the ACA as a result of not having a qualified health plan for their employees. The penalties will likely jeopardize the existence or financial stability of the companies and thereby create serious access to care problems.

At this point the level of impact is only speculative. The survey will help quantify the impact. It will also be used to support NAHC advocacy efforts that are designed to mitigate or eliminate the negative financial consequences of the employer mandate under the ACA. With the election now behind us, it is expected that the Congress and the White House will recognize the need to “refine” the ACA to deal with the various unintended consequences. We see the loss of home care to our most vulnerable citizens as an unintended consequences.

Click here to complete the survey. Please complete the survey as soon as possible. The survey will be kept open through December 31, but early information will be useful during the lame-duck congressional session.

Summary of ACA Employer Mandate Standards

The ACA does not require employers to provide health insurance to employees and employers with fewer than 50 employees from any ACA-related penalties.

However, if an employer of more than 50 full time equivalent (FTE) employees does not provide insurance that meets the criteria of a qualified health plan health insurance and just one of its employees qualifies for a subsidy for the purchase of non-group coverage offered in a health insurance exchange under the ACA, that employer will be required to pay a penalty equivalent to $2,000 per FTE (minus the first 30 workers).

Subsidies are available to individuals if their incomes fall between 138 and 400 percent of the Federal Poverty Level. In states that do not chose to implement a state health insurance exchange, individuals with incomes as low as 100 percent of the FPL will quality for subsidies. These income levels are likely to encompass most employees of home health providers.

An FTE is an individual who works 30 or more hours per week. Tax credits also may be available to certain employers of less than 25 FTEs (defined as number of total hours worked divided by 2080).

If the employer offers a qualified health plan to its employees, the employer will be is penalized by the lesser of $3000 for each full-time employee that receives a subsidy or $2000 per full time employee that qualifies for a premium subsidy under the ACA (minus the first 30 workers).

The exact content of a “qualified health plan” is not yet determined, but these plans will be required to offer coverage of ten categories of essential health benefits. However, indications are that a qualified health plan it would be the equivalent to the average type of health insurance that is in place in each individual state’s small group plan or a plan offered to public employees.

Learn More

HCAF’s Fall District Meeting series offers more insight into the employer mandate and its impact on the home care industry. Click here to register now!

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