Obamacare Ruled Constitutional: What It Means for You

[Update: for a good understanding of what the decision means sector by sector, start with this analysis by Skadden: Supreme Court Narrowly Upholds Health Reform Law but Limits Congress’ Authority Over States… includes a look at the implications for employers, insurers, hospitals and institutional providers, and drug and device manufacturers.]

See below for growing reading list of legal commentary and analysis

On June 28, 2012, the Supreme Court ruled that the Patient Protection and Affordable Care Act is constitutional. What does the decision mean for employers like you?

It’s time to get to work.

The debate over the law is far from over: Congressional Republicans have already begun to promote a complete repeal of the law (see, for example, Supreme Court Doesn’t Have the Final Word on Obamacare).

Until that happens – if it does at all – it’s up to employers to meet the requirements established by the law. Here’s how law firm Bryan Cave framed those obligations before the decision was handed down:

“The short immediate list of ‘to dos’ includes:

  • Summaries of benefits and coverage are due for the first open enrollment beginning on or after September 23.
  • Form W-2 reporting of the cost of health coverage will be required for most employers for 2012.
  • Employers will need to amend their health FSAs by the end of 2014 plan year to comply with the $2,500 limit on employee contributions.
  • The comparative effectiveness fee will be due this year.
  • The first medical loss ratio rebates will be due this year.
  • Prepare for the 2013 increase in Medicare tax

Additionally, for 2014, employers will need to prepare for:

  • 90-day limitations on waiting periods.
  • The complete elimination of pre-existing conditions (to the extent group health plans have those).
  • The ‘shared responsibility’ (aka ‘play or pay’) penalties for employers who either (a) fail to offer health coverage or (b) offer health coverage that is either ‘unaffordable’ (as defined by PPACA) or does not provide “minimum value” (as to be defined by the agencies).
  • The filing of new information returns to the IRS and their delivery to certain full time employees.
  • Increased incentives for wellness programs of 30% of the cost of coverage (and up to 50%, if HHS increases the incentive, as the statute allows).

And at some yet-to-be determined date(s), employers will need to prepare for:

  • Non-discrimination rules for insured health plans.
  • Automatic enrollment in health plans for employers with at least 200 employees.

And last, but not least, the ‘Cadillac Tax’ on high-cost health plans, to come into effect in 2018.”

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