Bracing for Obamacare

By Gigi Wood

CEDAR RAPIDS – Typically in the Corridor, when people talk about looking forward to October, they’re referring to Hawkeye football games or leaves changing colors.

But last week, a room of nearly 200 people was talking about a different event in October, the start of enrollment in health care exchanges, one of the first publicly noticeable milestones of Obamacare, formally known as the Patient Protection and Affordable Care Act.

Health-care reform was the topic of discussion at the Healthcare Reform Power Breakfast hosted by the Corridor Business Journal on Aug. 14 at The Hotel at Kirkwood Center.

Panelists included Becky Blum, project manager for the plan management team at Iowa Insurance Exchange; Brian Bourke, healthcare consultant manager for Honkamp Krueger & Co.; Cliff Gold, founding director and COO of CoOportunity Health; Mark Lehman, CFO of Twin Rivers Insurance; Bob Mreen, compliance solutions and financial analyst for TrueNorth Companies; and Dr. Tim Sagers, medical director of MercyCare Business Health Solutions; with Scott Fisher, president of McCrossen Consulting, a workplace benefits consultant, serving as moderator.

Health Insurance Exchanges enrollment begins Oct. 1, which will be the first time consumers, brokers and others will be able to take a look at prices and plans for Obamacare health-care coverage. Exchanges are online marketplaces for buying health-care coverage and coverage can start as early as Jan. 1.

“It’s going to be an opportunity for each of us as individuals to embrace this idea of health-care financing,” Mr. Mreen said. “In the past, we haven’t had to deal with that. In the past, our employers told us what plans we were going to be given and what they were going to cost. Now we’re going to have different delivery models. We’re going to have to make individual decisions. I liken it to the 1970s when employers got away from pension plans and went with 401ks. Everybody should have gotten more educated, more engaged with how their funds were being allocated in a 401k. That same situation is going to happen with health insurance. We’re going to have more options to choose from. And there are going to be some pretty big consequences if you choose incorrectly.”

Mr. Sagers expanded on that notion.

“From a care-delivery standpoint, the biggest thing I see happening – and again, I’ve said before, the Affordable Care Act does nothing to improve health care – this is a payment and insurance reform act. There’s nothing in there that makes any patient healthier,” he said. “But I do think it will help push people into a little better financial health-care consumerism.”
People will be following their wallets when shopping on the exchanges.

“We have a lot of clients who are curious about the options that are going to be out there,” Mr. Bourke said. “And the big variable out there for us is this public exchange.”
Mr. Gold, who started the nonprofit, health-insurance co-op CoOpportunity Health as a way to add more competition to the health-insurance market.

“I think the biggest change (with the introduction of Obamacare) is no underwriting,” he said. “It’s a massive way of thinking. What really hit home for me was, I was out at the (Iowa State) Fair the other day, at our booth, talking to people who had pre-existing medical conditions and first, I was surprised they didn’t already know that there were going to be no problems with existing medical problems come Jan. 1.”

He said he talked to people who pay five figures a year for insurance.

“There are people out there paying $15,000, $20,000 a year in premiums who are going to find that they are going to pay substantially less for actually better coverage starting Jan. 1,” Mr. Gold said. “There are going to be people paying more. Younger, healthier people are going to be paying more under that system. But the elimination of that (pre-existing condition restrictions, charges) changes the way everybody thinks about health insurance.”

There will likely be additional regulations and tweaks in existing rules, including documentation required by the IRS and how employees are counted, Mr. Mreen said.

“But by and large, all the things we were gearing up to do in 2014, we’ll have to do in 2015,” he said.

Each panelist said it’s important to prepare for and research the legislation, partly because employees will likely go to employers for advice and information on the legislation and exchanges.

“Employers are going to need to become familiar with the details of the exchanges because let’s face it, you are going to be the No. 1 source that your employees are going to turn to,” Mr. Mreen said. “They’re going to trust that you’re going to be able to give them some unbiased information. Unfortunately right now, there’s not a lot of information to share. I think that’s what drives a lot of the nervousness right now. This law was passed three and a half years ago and now we’re all scrambling during the next six weeks to hopefully have something up and running.”

While they should be knowledgeable, it’s too early for employers to over-prepare, panelists said.

“We’re pretty sure that not everybody is going to jump on the (exchanges) on Oct. 1,” Ms. Blum said. “We really want everybody to take their time and look at what’s out there.”

Although portions of the legislation were delayed, it’s important to stay prepared for the changes.

“Nobody wait a year to do what you were about to do; I think it’s probably a three or four month reprieve,” Mr. Bourke said.