Health care reform: Can we hurry carefully?
By Peter J. Martin, Terrence J. Briggs and John S. Ziemba
Many implementation deadlines are looming for the state’s new health care reforms. Decisions that remain will have a profound impact on Massachusetts’ business climate and its reputation as a national leader on health care. The Governor-elect and the Legislature will soon need to address numerous policy, management and fiscal questions in implementing the new law.
Those currently implementing the law and those who have made necessary legislative changes are being careful to get the details right. They are under tremendous time pressure. In order to expand health coverage quickly and to ensure federal funding, the Legislature established some very tight deadlines. However, to date, the Legislature and the Administration have given themselves enough flexibility to avoid bad impacts on business that come from rushing too quickly.
For example, the Department of Health Care Finance and Policy (DHCFP) recently pushed back until July the implementation date of on a new provision that would have penalized employers if their workers receive too much free health care from the state. DHCFP pushed the date back to give the state and businesses time to set-up health care payment mechanisms, so-called Section 125 plans, which will allow more workers to get health coverage and thusly negate need for a penalty. Given the potential impact to businesses, we encourage those implementing the act to continue to promote education and implementation of the new law without the red tape that can drown small businesses and hurt our economy.
While some businesses may not be pleased that the new law requires them to pay a $295 per employee fee for workers without at least a minimum level of health care coverage, the Legislature and the implementing agencies are working to make sure that the process to collect and enforce the fee doesn’t itself become a problem. For example, in a recent change, responsibility for implementing the fee was given to the Division of Unemployment Assistance. With the on-line payment systems and the business experience that the Division will bring to the table, we can be hopeful that the collection mechanisms will be as efficient as possible.
Businesses will need to understand how the rules treat independent contractors, what employee records must be kept, and how to count employee hours to determine if they have eleven or more "full-time equivalents," the minimum for the $295 fee.
Massachusetts has too much on the line to rush implementation of the Health Care Reform Act. Many here and around the nation are watching. So, let’s give those in charge the flexibility to get implementation right the one chance we have.
Peter J. Martin and Terrence J. Briggs are Partners in the Healthcare Services Practice Group at Bowditch & Dewey LLP. John S. Ziemba is Of Counsel in the Government Practice at Bowditch & Dewey.
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