
Another ACA Provision to be Delayed Until 2015
The health reform key is in, but the implementation ignition just won't start.
The health reform key is in, but the implementation ignition just won’t start. The Affordable Care Act (ACA) employer mandate has been pushed to 2015, states are still heavily wagering Medicaid expansion, healthcare insurance exchanges are
The
A senior administration official, who spoke with the NY Times, said the delay came after many insurance companies voiced concern as to whether their data collection systems would be effective enough in administering coverage in a timely manner.
“We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person’s out-of-pocket costs,” the official
The wait is a relief for insurers and payers. “If you work for a large employer, it's a good bet that you have one insurance company for your medical benefits, like hospital and doctor's visits, and another company, like Express Scripts or CVS Caremark, which handles your prescription drugs. Employers like this setup because the insurers focus on controlling medical costs and Pharmacy Benefit Managers, or PBMs, as they're called, keep a lid on drugs,” Sarah Varney said a recent
Ed Kaplan, a senior vice president at the health benefit advisory company Segal Consulting, added that many experts are struggling with how to comply. The data is simply not managed efficiently between payers and providers.
However, some healthcare professionals worry what the delay will mean for those with chronic conditions. If a consumer has one plan for their healthcare, and another for their prescription benefits, they may end up paying up to $6350 for doctor’s services or hospital care, and another $6350 for prescription drugs through a PBM.
“We have wonderful new drugs, the biologics, to treat rheumatoid arthritis, but they are extremely expensive,”
Around the Web
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Oregon to Delay Insurance Exchange Enrollment
Federal Officials Delay Another Health-law Provision for Employers
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A Limit on Consumer Costs Is Delayed in Health Care Law
Obama Delays Implementing Another Part Of Affordable Care Act
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