Health & Science
5:36 pm
Mon June 3, 2013

Consumers, Employers Still Uncertain About Health Care Reform's Impact

Lake Effect's Mitch Teich interviews health care attorney Barbara Zabawa.

With the largest portion of the healthcare reform bill not set to go into law until next year, new research indicates the law is already having an impact on one population.

What do doctors, patients and businesses need to know about the Affordable Care Act's provisions going forward?
Credit Alex E. Proimos, Flickr

The study by the Rand Corporation and the U.S. Department of Health and Human Services indicates healthcare reform measures are already shielding young adults - under age 26 - from steep medical costs linked to emergency medical care.

But Barbara Zabawa says many questions remain for consumers and business owners about the impact the law will have - especially in Wisconsin, which has declined to set up a state-run healthcare exchange.

Zabawa is a Madison-based attorney who specializes in health care litigation at the firm of Whyte Hirschboeck Dudek SC.

She says consumers' concerns are mostly centered around pricing - which likely won't be known until Wisconsin's exchange is set up by the federal government by the end of the summer or early fall. But Zabawa says many predict insurance costs will be significantly higher than what they are today.  costs will be higher than what they are today.

That's because consumers will likely have to cover the costs of new taxes on insurers and an influx of newly insured people who previously couldn't get insured to the system. But she says not all states that have set up their health insurance exchanges have seen huge increases.

"California, for example, has seen an increase that was lower than expected, so maybe we'll be pleasantly surprised," Zabawa says.

Like consumers, employers are also asking questions about the changes under the Affordable Care Act. Zabawa says most are weighing whether to offer insurance coverage or modify current plans, or risk penalties:

  • Employers with more than 50 workers must offer health insurance, or pay a $2,000 per full-time employee penalty (minus the first 30 employees).
  • If they already offer insurance, an employer must meet minimum value and affordability requirements or face a $3,000 penalty per employee who gets their insurance from an exchange.

Starting in July, employers will also start paying a $1 fee per covered life insurance policy to fund a federal research institute to study the effectiveness of health care.

The final word hasn't even been spoken on the health care exchange being operated by the federal government in Wisconsin. Zabawa says Wisconsin could always take over the exchange if it so chose. In the meantime, federal authorities say the exchange will be staffed and operational as of Oct. 1st.

"I've also heard that this exchange will look a lot like a website that you would use to purchase airline tickets," she says.

But Zabawa says some are worried about navigating such a site.

"I think it will be difficult for anyone who doesn't have access to a navigator to call the federal government and actually find a reasonable reliable resource," she says. "I know some people in Wisconsin are concerned that the customer service won't be quite as good as if it had been a state-based exchange."

Wisconsin's separate Office of the Commissioner of Insurance will also provide a "robust insurance market outside of the exchange," Zabawa says. That could create competition and lower prices.