Health Care Reform Update

By Kathleen Pohlid Founder & Managing Member, Pohlid, PLLC | October 07, 2012

On June 28, the Supreme Court settled the debate looming over the constitutionality of the Affordable Care Act, upholding the individual mandate scheduled to go into effect in 2014. Since enacted on March 23, 2010, the Act continues to phase-in significant reforms many of which impose requirements affecting employers. Although legislative attempts and political discussions continue to swirl for repeal of the Act, the time-line for full implementation of the Act continues. Businesses, including those in the hospitality industry, should be in compliance with those provisions that have gone into effect and ready for those remaining to be phased-in.

The Affordable Care Act has initiated comprehensive reforms of private and public health coverage, with many of those reforms directly affecting employers. The Act phases-in its reforms, several of which have already gone into effect. Employers in the hotel industry should be aware of those provisions and the obligations and decisions they may pose for their business. Below is a synopsis of several provisions that have already gone into effect, and those which will be implemented in the future.

Currently In Effect

a. Health Coverage for Adult Children Until Age 26. Insurers that offer dependent coverage are required to extend the availability of coverage to children of the insured until the child reaches the age of 26. This provision applies even if the child is married. However, adult children who are eligible to enroll in an employer-sponsored health plan (other than their parent’s) are not covered under this provision until 2014.

b. Prohibition of exclusions for children with pre-existing conditions. Children under the age of 19 cannot be denied health coverage for pre-existing conditions.

c. Pre-Existing Condition Insurance Plans (PCIP). States have the option of running a PCIP to provide new coverage options to individuals who have been uninsured for at least six months due to a pre-existing condition. For states that opt not to run a PCIP, the Secretary will establish a plan in that state. PCIPs will continue until 2014, when discrimination against pre-existing conditions will be prohibited for all individuals.

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Sales & Marketing: Opinions Matter

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