The Supreme Court ruling brings some clarity, for now | submitted by Cheryl DeMars

Although the Affordable Care Act (ACA) was passed more than two years ago, the possibility that the Supreme Court would overturn part or all of it created uncertainty. The June Supreme Court ruling upholding the ACA brings some clarity, at least for now.

Elections this fall will play a part in determining the next steps, but in the meantime, what can employers do to understand this kaleidoscopic law?

The first step is to digest the information we’ve been given and identify areas that are still being defined. Where regulations are under development, employers have an opportunity to work together to influence the outcome.

There are two websites that cover most of the near-term provisions that will impact employers. The first is the U.S. Department of Labor’s website at www.dol.gov/ebsa/healthreform. The second is www.irs.gov/aca.

Will the law reform health care?

The ACA is intended to provide health insurance to more Americans. But there are a number of other provisions that have the potential to fundamentally impact the health care system. Here are a few items to watch:

  • Value-based purchasing: Redesigning the way health care is paid for is critical to improving quality and controlling costs. Under the ACA, Medicare, the nation’s largest purchaser of health care, will implement new strategies to reward value rather than paying for care on a fee-for-service basis. This change can transform the way health care is delivered for all.
  • Transparency of information: Consumers and employers need information on cost and quality to make informed decisions about health care. The ACA requires Medicare to publicly report information on cost, quality, and safety. This information helps consumers and employers, but as we’ve seen in many studies, public reporting will drive improvement by providers.
  • Exchanges: The development of state exchanges, though they will be used by a small number of consumers at first, will impact the market for all purchasers and consumers.

Regulations will be introduced soon on important provisions such as employer responsibility (pay-or-play), auto-enrollment, and wellness incentives. When regulations are introduced, employers often have a chance to comment. For example, until Aug. 17, the IRS is requesting comments on regulations governing Flexible Spending Account limits. These comment periods are opportunities for employers to make their voices heard.

For now, ACA is the law of the land. Employers have a vested interest – and an important role to play – in seeing that it is implemented in a manner that leads to better value care.

Cheryl DeMars is the president and CEO of The Alliance, a not-for-profit cooperative of 180 self-funded employers. She can be contacted at cdemars@the-alliance.org.

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