Affordable Care Act is here to stay, expert says, but interpreting it will take a while

For those who still expect the Affordable Care Act to go away: “Can you imagine repealing Medicare five years after it was passed?”

The rhetorical question, from Kathryn Wilber, senior counsel for health policy at the American Benefits Council, prompted an obvious answer of “no.”

Any “repeal and replace” legislation has little chance of supplanting the centerpiece of the recent national health overhaul, the health benefits expert said Friday at the annual Employee Benefits Institute conference in Overland Park.

But, she told the benefits plan administrators, accountants and lawyers in attendance, significant regulations will continue to interpret the legislation.

A recent example is that employers received more detailed guidelines to determine which workers should be considered full time under the act’s definition of a 30-hour-a-week employee. The law requires covered employers to offer access to health insurance benefits to such full-time workers.

Wilber acknowledged that the more detailed instructions aren’t answering all the technical questions by plan administrators. And they’re certainly not ending debate.

House Republicans, she said, are pushing a change that would redefine “full time” as 40 hours a week. That has little chance, though, of passing in the Senate, and the president has promised a veto should the change reach his desk, she said.

Wilber said benefits plan administrators have a tough role keeping track of regulatory updates, deadline delays and a parade of rules from the federal Health and Human Services, Labor and Treasury departments. The Internal Revenue Service, for example, has a big role in policing Affordable Care Act adherence, but many rules are yet to be published.

She also suggested that COBRA may no longer be needed, given that the act makes it possible for workers who lose their jobs and their employer-sponsored health benefits to obtain coverage through the health insurance exchanges.

Plan administrators also might watch for legislative changes to allow the purchase of insurance across state lines, which many advocate as a cost sharing move, she said.

Health insurance changes will take years to interpret and implement, Wilber said, “but most stakeholders believe the ACA is here to stay.”

Lest they get comfortable with that, she told plan administrators to hold on to their hats: “Comprehensive tax reform,” if and when it passes, “is more likely to significantly affect employee benefits.”

This story was originally published April 25, 2014 at 12:53 PM with the headline "Affordable Care Act is here to stay, expert says, but interpreting it will take a while."