While the uninsured rate in America reaches historic lows, payer departures from ACA marketplaces are complicating the law's promise to increase access to healthcare for all. At least 1.4 million people across 32 states will lose their current ACA plans in 2017, due to this departure of major health plans, according to Bloomberg.
However, the law is not going anywhere — at least, not any time soon. Healthcare stakeholders will have to contend with the law's impact for years to come.
Arthur Tacchino, principal and CIO of SyncStream Solutions, a software development and consulting company, discusses how he sees the law evolving over the next year and how employers can circumnavigate the challenges it may present.
Question: What can healthcare providers expect from the ACA in 2017?
Arthur Tacchino: It'll be more of the same regulations. Currently, we are seeing rising healthcare costs, and individuals and employers will see rising premiums.
We can also expect to see continued health care reform. President-elect Donald Trump has spoken openly about his plans to replace the ACA. While we can expect it to be one of the first concerns he addresses, change won't be immediate, and I don't think the law will be repealed, at least not in its entirety. We could see pieces of the law repealed — for example, the Cadillac tax. But portions of the law, like the Dependent Coverage Age Extension and the Prohibition on Pre-Existing Condition Exclusions, are fan favorites and would be much more difficult to take away.
Q: What are some of the biggest challenges to the ACA at the moment?
AT: There is still a lot of confusion over the ACA, but the biggest challenge for employers is employee tracking and reporting. The tax forms employers must fill are difficult to interpret, and often employee data in payroll and benefits systems does not easily translate into ACA requirements. Some employers also struggle to maintain current employee records, for instance, updating an employee's status if they were terminated or put on leave, which creates issues when it comes time to report. .
Q: What are some ways in which the ACA will evolve over the coming year?
AT: The law was implemented nearly six years ago. For a law of this size, it's still very early. The ACA is in its infancy and it will continue to be refined. Last year the IRS granted a blanket extension for the reporting deadline and extended it to all employers.
The IRS was willing to push back the deadline. This shows a willingness to refine the law, which will continue to happen in 2017. It may never be refined to the extent that employers will be happy, but it will be easier than it is today.
Q: What are some best practices healthcare practitioners can employ to weather/deal with the upcoming changes?
AT: Firstly, they should document their decisions to show how they are complying. While the law requires employers to track employees, it offers two different methods for doing so — the look-back measurement method or the monthly measurement method. Employers can choose whichever method they prefer, but they should document their process in the case of an audit.
Also, consult with an advisor. The regulations governing the healthcare industry are complex. Speak with a third-party advisor to make sure you are in compliance.
Employers need to find a system or solution they can use. Most employers have a payroll vendor because they cannot handle all the payroll-related regulations. Similarly, the ACA is complex, and it becomes very difficult to track compliance and report under the mandate. It's just the nature of the law, so take advice from experts.