The Treasury Department announced that the Employer Mandate in the Accountable Care Act (ACA) is being delayed (at least) until 2015. They stated that businesses were "confused about reporting requirements". Boo Hoo! So the Obama Administration, always concerned about their friends in the business community just said "never mind, don't worry about it until after the 2014 elections". In Oregon we heard this same crying from employers and the Employer Mandate disappeared from the legislation creating the Oregon Health Plan (OHP) in the 1990's which was to become expanded Medicaid that would eventually cover everyone in the state. Dropping the Employer Mandate was a killer. It meant that OHP did not expand Medicaid as envisioned and actually restricted the number of people on the plan. At this time, even if an individual has no income and no resources (in the past making them eligible for Medicaid) then they go into a literal "Lottery" system where the State just pulls a certain number every month. Oregonians can be in the lottery for years. The elimination of the Employer Mandate however did not stop those of us working for the OHP from getting calls from low wage part time workers. I remember getting calls from new employees of Burger King who said they were given our number and told we were their health insurance. This way businesses like Burger King were hiring workers and telling them that they will have health coverage. What a deal!
So now with the ACA there was supposed to be a penalty on employers of more than 50 employees if they did not offer qualified health insurance coverage or if their workers do not access coverage through one of the Health Care Exchanges.
But what about the workers? If they work for an employer who offers health coverage they are not eligible for income based subsidies. They must purchase on their own or pay a fine. Now if there is no enforcement of the Employer Mandate that means there is also no way to determine whether the insurance offered is "ACA qualified"(until maybe 2015). Will the workers get a subsidy or will they be fined because of the actions of the employer? Will the employee be fined because the Obama Administration is eliminating the fines for the employer?
Now that is confusing. Thankfully in Oregon (and already in Vermont) plans are being made for a not for profit, publicly financed, nobody out, everybody in single payer system as soon as the ACA allows a waiver to be filed. Health Care For All Oregon (HCAO) is working to build a grass roots movement to demand it. There are already 5,000 Oregonians who have signed up to get the word out. Currently there are over 40 cities and towns across Oregon that have HCAO chapters and their aim is to get to 90 chapters this year. Clearly one of the biggest projects we have before us is to put a magnifying glass over every problem that pops up in the roll out of Obama Care. There will be no greater argument why profit needs to be taken out of the health care system than to watch the ACA which was a law written by and for the health care industry. So look for a chapter near you and volunteer to bring real change in our health care system.