Pay or Play Delayed – ACA

Now that we received word from the federal government that the “pay or play” rule has been delayed until 2015, the next question is what does this mean?

As I was listening to Morning Joe this morning, Ezra Klein from the Washington Post was on talking about the impact.  He thinks in the grand scheme of things, that this isn’t a huge deal.  The more I think about it, I can see where he’s coming from, but I disagree slightly.  This is just another complication that has arisen with this law.  Whether it’s the Long-Term Care provision that was included originally, or the auto-enrollment inclusion which has since been delayed, we’re continuing to see some of the major flaws in this law.  Let’s not overlook the maximum deductible requirements of non-grandfathered plans  that start in 2014.  That’s going to be huge, when a group that has a High Deductible Health Plan with a Health Savings Account and their deductible is $5000, and their going to be required to carry a smaller deductible.  What do you think that will do to their premiums?  There is still more to come…

Some of the things that I’m hoping get reviewed:

Modified Community Rating.  I feel personally that this is a much bigger deal than the delay.  In Kentucky, you’re going to see some rate shock, and from what I hear from my clients, and others,  the price of insurance is their major concern, both on an individual level and an employer sponsored level.

Another item this does nothing with is the individual responsibility to carry insurance next year.  The “Public Exchanges” are here to stay.  The subsidies look to be here as well.  Americans (and Kentuckians) are still going to be faced with a decision in three months – can they go off their employer plan and still qualify for a subsidy?  What happens when an employee goes off a large employers plan in 2014, will the Internal Revenue Service still investigate that employer?  If so, what will be the ramifications?  I’m assuming there won’t be for 2014, but what will the employer have to do to get that employee back on their plan for 2015?  If someone is getting subsidized coverage in 2014, how difficult will it be to convince that employee to come back to his or hers employer-sponsored plan?  A lot of questions that still need an answer.

Just like most writers have pointed out this morning, most 50+ employers are already offering coverage.  The delay will delay the penalties that will be enforced, which is a big deal.  However, I’m not sure that in 2015 we will have the necessary clarification that businesses needed going forward.  We’ve already had three years of this, what’s another 17 months?  Hopefully I’m wrong and we’ll all understand it, but only time will tell.

So, what does this mean?  It means the IRS has another 17 months to learn the law and enforce in a better way starting in 2015.   It also means employers with more than 50 employees have a bit more time in deciding on what to do – however, I believe this depends on price.  Unfortunately those prices aren’t available until 2015.

Stay tuned….

Here’s a link to a Politico article:




Speak Your Mind