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Health Care Reform, Part II: How Health Care Reform Will Impact Doing Business in the U.S. in 2014

Posted on April 12th, 2010 | Author: admin

Guest Blogger: Stefanie R. McNamara, General Counsel at St. Peter’s University Hospital (formerly a Senior Associate with Norris McLaughlin & Marcus, P.A.)

After the initial reforms in the health care law go into effect later this year, the bulk of the reforms applicable to U.S. employers and insurance carriers will be effective in 2014.  A few key provisions are detailed below:

  • As of January 1, 2014, individuals must obtain minimum essential health care coverage for themselves and their dependents.  Employee waiting periods for coverage may not exceed 90 days.  U.S. employers with more than 50 employees must offer qualified coverage to all employees.  An employer’s failure to do so will subject them to a $2,000 penalty per employee after the first 30 employees.

  • Individuals will be penalized, as well, for a failure to obtain minimum essential coverage, whether through their employer, the government sponsored plans, existing health plans (as of March 23, 2010), or other available plans in the market.
  • A plan will be considered qualified under the law if, among other things, it provides the essential health benefits package, does not charge the participant for preventive care services and limits annual deductibles. 
  • For U.S. employers with more than 200 employees, the employer must automatically enroll new employees in the employers’ health care plan.
  • By 2014, all health plans will be prohibited from excluding participants on the basis of pre-existing conditions.

As there is a gap between the passage of the law and the majority of the provisions going into effect, it is likely that health insurance companies will begin to raise premiums between now and 2014, in order to raise as much money as possible in an attempt to offset the impact there may be of increased expenses under the new law. 

More on these issues to come….stay tuned!