The Affordable Care Act is now more than six years old. While the majority of its provisions have been rolled out, the law is still both complex — and controversial — enough to have some changes in its future. So, what’s next?
Premiums heading higher
“Expect the state-by-state premium requests to reflect what insurers see as the bottom line: The health law has been a financial drain for many companies,” according to the Associated Press. “They’re setting the stage for 2017 hikes that could reach well into the double digits.”
Markets haven’t yet stabilized, and insurers didn’t realize how much care their new customers would use.
However, two factors will help with the rising costs, according to the AP. “More than eight out of 10 customers in the health law’s markets get subsidies to help pay their premiums, and that financial assistance will increase as premiums rise. Many have also shown they’re willing to shop around for lower-priced coverage,” according to the story. “Also mitigating the pressure for higher premiums is a one-year moratorium — for 2017 — on a health law tax on insurers, part of last year’s federal budget deal.”
Employers checking compliance
“It’s time to review the steps that you took to get into compliance and document evidence of your efforts,” Jay Starkman for The Business Journals. “Though the chances of an IRS audit remain relatively small this year, it is always best to adopt a defensive strategy to avoid any potential audit penalties.”
By examining your processes, you can find weaknesses and gaps you didn’t previously notice. And, make sure you respond to any correspondence you receive about your compliance.
“Responding to any IRS notice letter should always be handled with care. ACA compliance notices are no different,” Starkman writes. “This is new territory for employers, which is why many companies are turning to ACA-compliance experts to manage the bulk of their ACA reporting tasks throughout the year and plan accordingly to avoid the potential for costly penalties.”
The debate over the law is far from over, and 2016 is an election year. “A premium spike for 2017 would fire up the long-running political debate over the divisive law,” according to the Associated Press.
The election’s outcome could drastically affect the law, writes Stephen Miller for the Society for Human Resource Management. A Republican-controlled White House and Congress could mean a complete repeal, while a split government would equal more gridlock. “Both Democratic presidential nominee Hillary Clinton and Republican nominee Donald Trump have said they favor repeal of the Cadillac tax, making it possible this could be the one big change that goes through whichever party wins the White House,” Miller writes. “But to keep in place the ACA’s subsidies and tax credits for many who buy coverage through public exchanges, as Democrats favor, alternative funding would need to be found.”