The Affordable Care Act Creates Uncertainty for Employers

This week I completed a cover to cover reading of the Affordable Care Act (the Act).  I was stunned (and often times bored) to learn more than 80 percent of the Act will have little or no direct impact on employers.  The overwhelming majority of the Act has to do with changes to the Medicaid and Medicare programs run by the States and Federal government.   I was pleased to see the Act calls for statistical studies to try to make both programs more efficient.  However, I am skeptical the government will be able to achieve its stated goals.

The uncertainty created by the Act will kick into full gear in 2014 which makes planning complicated and scary for employers.  Employers will have to predict myriad questions that will affect the coverage they offer their workforce such as:
  1. How much will premiums rise for small employers (meaning employers with 100 or fewer employees) because of the items the Act requires small employers to cover?
  2. What is the new number of employees in an employer’s workforce where the exploration of self-insurance begins to make sense?
  3. How many employees for whom coverage is not affordable will elect to get coverage through an Exchange?
  4. How many new employees will opt out of being automatically enrolled (a requirement for all employers with 200 full-time employees) in an employer’s plan?
  5. How will an employer’s workforce react if single premiums are affordable, but group and family coverage is unaffordable (a result the Act seems to encourage)?
The answer to these questions and more will be critical to an employer’s decision in electing the type of coverage, if any, it decides to offer its workforce to comply with the Play or Pay Mandate.  It is my hope this blog and the publications section of provide unique ideas to answer these questions and more as employers try to accurately forecast an uncertain future created by the Act.