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Employers consider Obamacare delay

Jeff Selle | Hagadone News Network | UPDATED 11 years, 10 months AGO
by Jeff Selle
| July 4, 2013 9:00 PM

COEUR d'ALENE - The sudden year-long delay of a major part of the Affordable Care Act, known as the employer mandate, is raising questions locally about potential impacts as a result of that decision.

"It's a pretty big deal," said Mark Fisher, president of Advanced Systems in Coeur d'Alene. "It's a creative maneuver. They can't do this statutorily, but through regulations they can avoid charging employers the penalty."

The requirement that many employers provide coverage is just one part of a complex law known as Obamacare. But its one-year postponement has thrown a wrench into the process many employers, and providers are planning for to meet the previous deadline of Jan. 1, 2014.

According to the Associated Press, the White House action means that some companies that would have offered health insurance next year to avoid fines will not do so now. They're mainly firms with many low-wage workers, such as restaurants, hotels and temporary staffing companies. The workers, however, will still be able to get coverage. Many may qualify for subsidized insurance through new marketplaces to debut Oct. 1, less than three months away.

"That is potentially true," Fisher said. "Employees who do that may get used to the federal subsidies, but once their employers provide insurance in 2015, those employees won't be eligible for the subsidies anymore."

Because the individual mandate is still in effect, some are speculating that many individuals, who otherwise may have received insurance from their employers, will lean heavily on the Idaho State Insurance Exchange to avoid being fined next year.

That could pose a problem for the administration, Fisher said. He was on a conference call with his company's attorneys on Wednesday and they indicated that the lack of employer fines could raise the cost of the program exponentially.

"The attorneys are speculating that they may even suspend the individual mandate," Fisher said. "In order to fund the subsidies for individuals, they need the employer penalties."

Those penalties are also part of the revenue stream that was to be used to help finance the state insurance exchanges.

Amy Dowd, executive director of the Idaho State Health Insurance Exchange, said she has heard nothing from the Center for Consumer Information and Insurance Oversight on how the move could impact the exchange.

"There are multiple funding sources for the exchanges," she said. "But the lack of employer penalties is concerning. That could be a direct impact."

She said other than the revenue issue, the delay in the employer mandate should have very little direct impact on the exchanges.

"It's possible that it might change the employer's decision on when to offer insurance," she said, adding she doubts it will be much of an impact.

Dowd said even if employees go to the exchange for a year and then have to switch over to an employer plan, they will pay the same price for the plan.

"In a plan offered on the private market and a plan offered on the exchange, they have to be the same price," she said.

However, as Fisher pointed out, the employee will not be eligible for the federal subsidies.

The Associated Press reported that new problems popping up at this late stage could be a sign of additional troublesome issues ahead. It underscores a recent warning by the Government Accountability Office that the "timely and smooth" rollout of the new insurance markets can't be guaranteed, partly because much of the technology to run them hasn't been fully tested.

That is a problem employers have had locally, as well. The city of Coeur d'Alene has been scrambling for most of the year to come up with a way to restructure the way the city deals with part-time and seasonal employees.

Many of those employees are experienced and valued employees, said Troy Tymesen, the city finance director.

"We are looking for a way that we might modify things," he said. "With the delay, we might be going to a two-stage process to implement this."

He said, now that the city has time, he can look for more ways to try and absorb the potential financial impact of insuring the part-time staff. The city will now have time to analyze where it can cut additional hours and costs.

"We can take the time to restructure the part-time employees," he said. "Those are the ones we really need to study."

He said the city is looking at creative ways to retain valued employees while cutting hours to avoid the insurance costs. One way he said was to potentially share an employee with another city, such as Post Falls.

"That way they can still make a living," he said, adding they are really looking outside the box at several creative ways to deal with the issues.

The so-called employer mandate requires companies with 50 or more employees working 30 or more hours a week to offer coverage or face a series of fines. Companies below that size are under no obligation to offer coverage.

Some local employers were looking to limit employee hours to avoid the requirement, or trying to stay below the 50-employee mark. Now, they will have a little more time to analyze which way to go.

Jim Hightower, owner of four Domino's Pizza franchises, said he was pleased to have a little more time to work Obamacare into his business model, but the fact remains he will have to do something eventually.

"What this did for me is that it allows me to give my current employees more hours for another year," he said, adding there is no way that he could afford to offer insurance to his 80 employees. "It would put us out of business."

He said his business is right on the cusp of having to offer insurance, or being exempt.

Hightower would have to raise the price of his pizzas from $6 to $15 in order to offer insurance, and his market won't bear that. But, the cost of the fines he would receive for not offering insurance would total more than $105,000.

"That's just the first year. It would go up from there," he said.

His only options are to cut hours or reduce his staff to below the 50 employee threshold, or sell a franchise to reduce the number of people he employs. He has been looking at both.

Before this week's announcement, Hightower said his plan was to cut hours to a point where he was no longer above the threshold, and just pay the fine if he went over.

"It's not a terrible law for what it was intended to do," Hightower said. "But it's certainly an unpopular law from our perspective.

"Either way, this gives us another year to work things out," he said. "It's still not a done deal yet. A lot of Domino's owners are selling off their stores."

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