Home Health & Hospice

New bill would delay employer mandate for certain Medicare, Medicaid providers

Homecare Insider, July 21, 2014

Representative Steve Daines (R-Montana) recently introduced legislation that would delay the employer mandate provision of the Affordable Care Act (ACA) until January 1, 2016 for businesses that offer services through Medicare and Medicaid.
The bill, entitled “Ensuring Medicaid and Medicare Access to Providers Act” (H.R. 5098), would exempt certain healthcare providers that receive 60% or more of their revenue from Medicare and Medicaid from the Affordable Care Act (ACA) employer health insurance mandate until January 1, 2016.
The employer mandate would require all businesses with over 50 full-time equivalent (FTE) employees to provide health insurance for their full-time staff. Under the current stipulations, employers of more than 99 full-time employees would need to cover 70% of their full-time employees by January 1, 2015 and 95% beginning in 2016 to avoid facing a penalty. Employers with 50-99 FTEs in 2014 will not be subject to the health insurance obligations or the penalty for failing to offer qualified health insurance until 2016.
Critics of the ACA provision fear that the employee mandate would threaten provider operations, employee jobs, and beneficiary access to care by forcing many long-term care providers to cut jobs or slash employee hours and wages to continue offering services.
“While CMS has listened to these concerns, no concrete action has yet to occur. Another year delay in the employer mandate would provide much needed breathing room to allow such a summit to be convened,” NAHC, who has launched and/or backed many relief efforts in this arena, stated in its announcement of the bill. “It can be a stepping-stone to more comprehensive relief.”
The proposed bill comes on the heels of a bicameral letter sent to Sylvia Mathews Burwell, Secretary of Health and Human Services, in late June urging her to consider the potential ramifications of the impending provision on strapped providers and their employees.