University prepares for health care changes

The state-operated health insurance marketplace will go online in less than two weeks, which will begin another large phase of the Affordable Care Act. Millions of Americans will be able to shop the health insurance marketplace as it becomes part of their monthly budget.

As the ACA expands Medicaid to cover adults between the ages of 19 and 64, who are currently not eligible for Medicaid, experts say it can increase health care costs over the short term. Jeffrey Kemp Rinderle, representative of the Champaign-Urbana Public Health District, explained how people can make the best out of the situation.

“People can buy insurance from private health plans that cover a comprehensive set of benefits, including doctor visits, hospital stays, preventive care and prescriptions,” he said.

Rinderle said plans in the marketplace must treat people fairly; they can’t deny coverage because of pre-existing conditions. With a single application, people can also see if they qualify for Medicaid, the Children’s Health Insurance Program or other savings programs they can use right away to lower health insurance premiums.

The ACA aims at catering to a large population, allowing parents to extend their health benefits to their children until they reach the age of 26. On the other hand, those individuals who don’t have health care coverage, especially undocumented immigrants, can face heavy penalties for remaining uninsured. The ACA requires people to have health insurance, and those who don’t comply will face heavy taxes.

ACA and students

Starting in 2014, students can receive health insurance through their families, university or new exchanges that the law calls on states to set up. Kimberly Dalluge, supervisor at Student Health Insurance, said in an email that the students who will be affected are those employed by the University in some capacity.

“If a student is receiving a paycheck from the University of Illinois they must have health insurance,” Dalluge said.

She said if the students already have insurance and if they are exempted out of the Student Health Insurance plan, then they satisfy the requirement, and nothing further is needed.

“However, if a student who exempted out of this plan lost their insurance and they never bothered to reinstate into the Student Health Insurance plan or purchase another comparable plan, then they would be required to either reinstate into the Student Health Plan or purchase another plan,” she said. “The exchanges would be one place they could purchase a plan.”

ACA and extra help employees

The University has about 3,450 extra help employees in areas that involve maintenance, professional service, secretarial, accounting and information technology-related responsibilities. Because extra help employees work in temporary assignments, there are no benefits associated with the employment.

Katie Ross, senior director at the University Human Resources Office, said the University provides medical benefits to all of its permanent employees, but those who work on need-based status will need to seek other options.

“As the provision has been postponed (until) 2015, the University is considering its options for extra help employees, but no decision has been made so far,” she said.

The ACA has a provision that requires employers to provide health benefits to employees who work 30 hours a week or more.

Michael Leroy, professor in the School of Labor and Employment Relations and the College of Law, said that in coming years, part-time employees will be in a very tough position.

“Obamacare requires everyone to have a health insurance. With limited resources, it is difficult for uninsured or underinsured to consider enrolling for a health plan,” he said.

Leroy also suggested some possible solutions. He said in addition to expanding health care coverage to the uninsured, the ACA can help bring relief to the underinsured, or the millions of people who have health insurance but who have plans with inadequate coverage that leave them exposed to unaffordable medical costs. Health reform has the potential to help by providing premium assistance and lowering out-of-pocket costs, he said.

Ross said the University remains undecided if it will provide extra health employees with health benefits, as per ACA provisions.

ACA and small businesses

According to the Kaiser Family Foundation, more than 48 million Americans were uninsured in 2011. The ACA requires small business owners to provide their employees, working more than 30 hours, with health benefits. Leroy said the provision may be good news for some employees, but many small businesses that can’t afford this additional cost.

Those unable to afford health care benefits for part-time employees are reducing the number of hours their employees work, so they are below the 30-hour limit, Leroy said. Although the mandate has been postponed to Jan. 1, 2015, many businesses are thinking of alternatives.

Rinderle explained how the Small Business Health Options Program (SHOP) can simplify the process of buying health insurance for small businesses.

“Employers can control the coverage they offer and how much they pay toward employee premiums,” Rinderle said.

He said employers may qualify for a small business health care tax credit, worth up to 50 percent of premium costs. Additionally, the SHOP Marketplace will be open to employers with 50 or fewer full-time-equivalent employees in 2014.

According to the Congressional Budget Office, two million fewer people may receive their insurance through their employers in 2014. The number is not directly related to the new provisions of ACA but to the overall cost of health benefits.

Zara can be reached at [email protected]