| With the arguments made, and the nine Justices of the Supreme Court left to decide the fate of the Patient Protection and Affordable Care Act, the attention of the media, pundits, lobbyists, and industry experts is now squarely focused on predicting the decision of the Court. “Justice Kennedy sure seemed skeptical with his questions; boy those liberal justices seemed to think that severability was not going to be possible; did you hear that Sotomayor called Obama to tell him it was coming down?” Phrases like that have been written about, spoken about, and recycled ad-nauseum, but, in Maryland, does it even matter?
Many of the provisions already put in place as a result of PPACA have been done so by insurers and employers. Plan adjustments such as covering dependents up to age 26, and covering preventive services at 100% have had such a miniscule effect on ratings, and have been received so well, that it’s unlikely to go away, even if the law itself does. New regulatory compliance requirements, such as W-2 reporting, have come so far, that it’s likely to come back in some way, shape, or form, even if the law is struck down. And then there is the State Health Insurance Exchange.
Maryland has already signed into law the requirement to create a State Health Insurance Exchange. Regardless of what happens to PPACA, the law of the land in Maryland requires an Exchange. Even if PPACA is found to be unconstitutional, it is almost certain that the State would implement its own requirements and laws to ensure the viability of the Exchange. A Federal health insurance mandate may get struck down, but you can be certain that, if that were to happen, a State mandate would crop up during the next legislative session.
So where would the loss of PPACA really impact all of the stakeholders?
The Carriers have already made adjustments to plan designs, and adjusted pricing and commissions to come in line with the MLR requirements. Plus, they are so heavily regulated by the State, that PPACA barely impacted the way they did business to begin with.
Agents, producers, and brokers have already felt a sting in their paychecks, and regardless of the Supreme Court ruling, that won’t change. If they wish to work through the State Exchange, they have a seat at the table, otherwise, they will continue to operate as usual with their carrier partners and clients.
Small businesses will continue to have the benefits of Maryland Small Group Reform, including guarantee issue and no pre-existing condition limitations. In addition, while Federal tax credits would go away, the just as generous Maryland Health Insurance Partnership remains in force and available for the same target businesses.
Individuals will still be able to purchase insurance from private insurance carriers, through MHIP, and eventually through the Exchange, with the benefits of any new state laws enacted to remove pre-existing condition limitations and underwriting requirements.
Larger employers will still have the flexibility that they currently have with their benefits offerings, but would now incur zero financial penalties if they were to dismantle their group benefits and send their employees to a State Exchange.
In short, Marylanders need not worry about PPACA and the Supreme Court, because regardless of the outcome, our path is already set. Instead, our time would be better spent focusing on the Maryland Health Insurance Exchange, and making sure that it is going to be a self-sustaining, simple working, well-oiled machine, aimed at providing an easy conduit for insuring the 800,000 Marylanders who currently do not have health insurance.
Scott Mayer
Media Chair |
| President - Kathleen A. Janocha, WorkforceTactix
President Elect - April Coughlin, Kelly & Associates
Secretary & Media - Monique Snider, DentaQuest
Treasurer - Bryce Engel, WorkforceTactix
Education - Kevin Curran, The Standard
Communications - Rebecca Bayne, Allied Resource Management
Sponsorship - Julia Salamon, Healthplan HeadQuarters
Legislative - Scott Mayer, WorkforceTactix
Membership - Christina McJimpsey, Humana
HUPAC - Ryan Gregoire-Cope, Assurant
Awards - Carolyn Kinsey, HMS
Public Service - Jamie Kahn, WorkforceTactix
Immediate Past President - David Noel, WorkforceTactix
Sub-Committee Members (non voting bodies)
Noreen Odham, BenefitMall
Jared Cohen, The Hartford
Joe Seifert, Kelly & Associates
Dan Single, Group Benefit Services
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