off the charts

You are here

Delay Won’t Keep People From Obtaining Health Coverage

July 3, 2013 at 3:25 PM

Here’s the bottom line about the Obama Administration’s announcement yesterday to delay health reform’s employer responsibility requirement and related reporting rules until 2015:  it will not keep people from getting health coverage, which is the key goal of health reform.

The vast majority of large employers — the only companies that are subject to the requirement to offer coverage and the related penalty if they don’t — already offer health coverage and are unlikely to stop.  (Most employers who don’t offer coverage now aren’t likely to change that decision either.)

What’s key is that the delay won’t affect a core component of health reform:  in 2014, workers who do not get coverage through their jobs will be able to get good coverage in the new marketplaces, with subsidies available to those with low and moderate incomes (incomes of up to 400 percent of the poverty line, or about $78,000 for a family of three).  In addition, workers whose companies offer coverage that is not affordable — because the employee’s share of the premium costs would exceed 9.5 percent of his or her income — or is not adequate to provide protection from injury or serious illness because it fails to meet standards that the Health and Human Services and Treasury departments have set for minimum coverage, also will qualify for subsidies to enable them to purchase coverage in the new marketplaces.  All of that will go forward.

Delaying the employer reporting rules (under which the first reports on whether firms offered coverage in 2014 wouldn’t have been due until 2015 anyway) won’t affect the information that employed individuals will need to provide to obtain subsidies to help them purchase coverage in the new marketplaces.  The application that workers will fill out when applying for subsidies will include a form that their employers must help them fill out so that the insurance marketplace can determine whether the employer coverage is affordable and adequate.  This involvement by employers will go forward on schedule.  (If the worker cannot get this information, either because the employer doesn’t provide it or for some other reason, the marketplace will make a decision based on the best available information.)

The goal of health reform is to provide coverage for all Americans — whether through Medicaid, private plans in the marketplace, or employer coverage.  Nothing in yesterday’s announcement puts a roadblock in these pathways.