Holly Taylor of True North gave a 'bird's eye' view of the Affordable Care Act at the chamber's Wednesday breakfast meeting.
WILLIAMSTOWN, Mass. — Holly Taylor attempted the difficult task of hitting the most pertinent points in the U.S. Affordable Health Care Act in 15 minutes.
It took her nearly twice that.
"This represents the most sweeping piece of legislation affecting the health system and the health status of Americans since the passage of Medicare in 1965," she told the packed banquet room at the Williams Inn on Wednesday morning. "It is an immense, complex legislation and each day we see it unfolding with unintended consequences for business, individuals and the government."
Taylor, vice president and insurance broker at True North and a member and past president of Ecu Health Care, had a rapt audience as the keynote speaker at the Berkshire Chamber of Commerce's August Good News Salute Breakfast sponsored by TD Bank.
Pulling up an editorial cartoon showing the act as a mishmash of parts — with the president saying, "Maybe I should have been more specific," Tayor said, "I would suggest maybe he should have looked more to the Massachusetts model."
The state's achieved the highest percentage of insured adults in the country, implemented an individual mandate "with teeth," increased the number of insurance provides and is attempting to address the cost of health insurances and health care services, she said.
The federal act may jeopardize some of those successes and the state is lobbying for waivers on some items.
With a number of sections of the act set to begin on Jan. 1, Taylor looked at what will happen, what won't and what may never.
First, the 30-hour-a-week level for full employer premiums contribution has been delayed — and will probably be out.
"It will probably be the sacrificial lamb to the greater vision of health care reform," said Taylor, after reports that some companies were cutting hours to 29.5 to avoid the regulation. She expected that the federal level will be 40 with states getting the option to lower, such as Massachusetts at 35 hours. "We know this piece is in trouble if the Democrats have filed an amendment to the Affordable Care Act seeking it make the eligibility 40 hours."
That could also delay the imposition of fees on small businesses with more than 50 employees: if a company doesn't offer coverage, it would be fined $2,000 for each workers over first 30. For a company with 100 employees, that would mean a fine of $140,000.
"There isn't a single employer around the country who hasn't looked at this and said, 'hmm, that's interesting,'" she said, "because it is significantly less than what employers are paying for their group health plans."
Businesses can expect the imposition of other fees, including $5 per person covered (not just the employee) to raise the billions required to subsidize the number of people coming into the plan and other aspects such as research. Employers, on the other hand, will be able to add certain surcharges on employees, such as if they are tobacco users.
Gwen Davis introduced Taylor and gave the Good New Salutes.
Massachusetts is expected to have its exchange — a place to compare and buy plans — up and running by Oct. 1, with plans in effect by the Jan. 1 deadline. That will be for people who buy individual insurance or whose premiums are too high since most will find their employer's group plans the best buy.
Nine insurers in Massachusetts will offer 100 plans. Taylor said it's nice to have that choice if your shopping for shoes, but "I'm not sure the average consumer is going to find this a manageable process."
As for how the act will affect individual businesses — it depends. Some can expect their rates to rise, some to lower.
"There is incredible turmoil ahead in terms of how the premiums are going to be calculated for your business," she said, and brokers will no longer be able to wheel and deal.
"Stay tuned for a lot more excitement next year."
Emcee was Gwen Davis, vice president of commercial lending at TD Bank, who gave the salute Guido's Fresh Marketplace for marking 30 years and for its commitment to health by obtaining and training its staff on an automatic defibrillator; implementing an AED program and going through the training; Molari Employment, also at the 30-year mark, for providing temporary workers for companies around the region while also providing those workers have benefits; and Hillcrest Dental Care, which opened in 1985 to service the special needs children at Hillcrest Educational Center but which has since opened to the public and will be opening a new office in North Adams.
Correction at 1 p.m. on Aug. 30, 2013: The date that the state will open its insurance exchange was incorrect in the original version because of an editing error.