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Taking Leadership on Health Care Reform: A Call To Action For Business Owners and Operators

As the Affordable Care Act's new regulations roll out over the coming years, business owners and operators will be faced with additional obligations that will carry new manpower, budgeting and cost implications. These include the responsibility of tracking part time/variable hour employees, aggregating data and reporting as well as obligations to look at redesigning benefits plans and issues around implementation.

HCR call out"There are various changes that both companies and individuals will feel," said Sibyl Bogardus, JD, Chief Compliance Officer, HUB International. "Families will be fragmented, with separate deductibles, co-pays and benefit structures. The Cadillac Tax will drive down the value of some employer benefits because companies will do what they need to do to avoid paying the 40% excise tax." (see The Luxury Ride Ends Here: Prepare for the Cadillac Tax Today).

With first-hand knowledge and early exposure to the new regulations and their side effects, employers are in a unique position to take a leadership role in today's healthcare reform debate and ultimately create a better outcome for all.

"The saddest moment in healthcare reform for me was when I read the rules for measuring the hours of adjunct professors or part-time teachers at the college or university level," said Bogardus. "It said, 'As for teachers in kindergarten through twelfth grade, we are not providing a rule here because no one commented or gave us any advice on how to address this. We had no comments to take into consideration.'"

We have to speak up for our voices to be heard.

Making Your Case 

How do you position your business to make a positive impact at the federal level? The key issue will be dealing with the facts and brainstorming practical solutions to the challenges.

"Identify a specific issue - focus on something that's particularly important to you and then explain it very clearly in terms of its practical impact. This is what is happening, this is what we're facing," said Bogardus. "Finally, tell the regulators what you want to happen, to be different. If you have an idea that could be a win-win argument or a good solution, they will accept that. They're hungry for information at the federal agencies about how to address these issues."

Businesses should first consider leveraging their existing relationships. Start with lawmakers or agencies with which you or your company has an existing relationship. A familiarity based on previous trust and respect can go a long way. Where prior contacts don't exist, find a formal process for submitting comments as well as email addresses and phone numbers for non-formal responses at the end of each government provision. Search the one that affects your business the most and make your position known.

"You'd be surprised how effective this strategy can be," said Bogardus, who offers a few examples of success. 

Example A: An attorney in Dallas, Texas, organized a conference call with Bogardus and personnel from the Department of Labor, the Internal Revenue and the Department of Health and Human Services, to discuss the issue of insurance carriers and their participation requirements. (Health insurance carriers have traditionally required employers to cover a certain percentage of eligible employees or the carrier would either pull the policy, revoking coverage, or charge the employer higher rates.) "As we explained the issue and how it is currently playing out in the business world, we heard one of the regulators at Health and Human Services say, 'I find this very disturbing,' over and over." Compliance with the employer mandate might have been impossible, exposing employers to penalties. The agencies listened. Regulations now provide that insurers can no longer pull these large group policies.

Example B: In December 2013, Bogardus and several small business owners testified before the House of Representatives Small Business Committee on the complexity of health reform issues affecting small businesses. Shortly afterward, a further one-year compliance deadline delay was instituted for smaller employers. 

Now Is The Time 

Unfortunately, not every nuance and outcome of the ACA regulations was thought out or simulated before the law was passed. Therefore, we are left with "the law of unintended consequences," as Bogardus sometimes calls it. But, these consequences don't have to be unintended forever. Bring the issues that affect your business to the attention of the regulator. Make your voice heard.

"If you have any passion around creating change, if there's something that very heavily impacts you as a business person or individual, make the issue known," said Bogardus. "Become an unsung hero yourself."