In 2013, the National Association for Home Care & Hospice along with its affiliates, the National Council on Medicaid Home Care and the National Private Duty Home Care Association, conducted the first and only national survey on the impact of the ACA employer mandate on home care. The findings were eye-opening for the home care industry, government officials, and policymakers. Overall, the findings showed that home care companies – particularly those that primarily provided Medicaid-funded services or focused on private pay personal care services – were at high risk of significant ACA penalties.
The ACA employer mandate survey has been used extensively by HCAF and others in the advocacy efforts on the employer mandate. Those efforts led, in part, to the initial postponement of the mandate in late 2013 and the additional postponements and adjustments effective for 2014. This advocacy also triggered a series of congressional proposals to modify or delay the mandate, including H.R. 5098 and S. 1330 that would further delay the start date of the mandate. H.R. 5098 is completely focused on a delay for Medicaid and Medicare dependent health care businesses. Also, both houses of Congress have legislation pending, S. 1188 and H.R. 2988, which would redefine “full-time” at 40 hours per week.
NAHC has prepared a new survey to get a “real-time” understanding of the likely impact of the ACA employer mandate. Home care businesses have made a number of adjustments to prepare for the start of the mandate. This new survey will create the opportunity for further evidence-based advocacy.
HCAF encourages every company that provides any form of home care to complete the survey as soon as possible. NAHC is working with other state home care and hospice associations to get the word out on the survey. Other national stakeholder organizations are joining this effort as well.
The survey can be found here.
The employer mandate responsibilities In the Affordable Care Act are scheduled to take effect on January 1, 2015. Employers of 100 or more full-time equivalent employees (FTEs) will be required to either offer a qualified health plan to all their full-time employees or face a potential financial penalty. For purposes of this law, a “full-time employee” is an individual who works 30 hours or more per week. The Internal Revenue Service (IRS) has determined that the requirement will be applied on a monthly basis using 130 hours per month as the standard for full-time.
For employers of 50-99 FTEs, the mandate takes effect on January 1, 2016.
The employer mandate involves a fairly complex formula for determining whether and how it applies to businesses. Each business should be individually evaluated to determine if and how the requirements apply to it. The cost of a qualified health insurance can be quite high. Likewise, the penalty cost can be as well, with the penalties set at $2000 each for all full-time employee (after the first 30 are exempted) when the employer does not offer a qualified plan so long as one of the full-time employees qualifies for a receive a federal subsidy. The penalty is set at $3000 for each full-time employee that qualifies for a federal subsidy through the insurance exchange when the employer does offer a qualified health insurance.