Shoot first, ask questions later That the Patient Protection and Affordable Care Act is the foremost accomplishment of Barack Obama's first term says something revealing about the president.
The 2,700-page law, nearly two years after its signing, has spawned more than 13,000 pages of regulations and sent a book called the "ObamaCare Survival Guide" to No. 13 on the New York Times Bestseller list in its category and No. 22 overall among paperbacks.
And a survival guide is just what small- to midsized businesses will need. They certainly won't get a clear rulebook to follow in time to make good decisions for their businesses and employees.
Despite the work of three Cabinet departments -- Treasury, Labor, and Health and Human Services -- the rules businesses must follow to avoid huge tax penalties have not yet been finalized.
That's right. Employers of 50 or more "full-time equivalent employees" are expected to offer their full-time employees affordable and "minimum essential coverage" by Jan. 1, 2014. Failure to do so leaves them open to tax penalties of $2,000 per full-time employee (minus the first 30) or $3,000 per full-time employee not considered to have been offered adequate and affordable coverage under the law.
And yet, just exactly how to figure out what qualifies as minimum essential coverage is among the several vital details still being worked out by the Obama administration. HHS is working to finalize those rules.
Another yet-to-be-written set of guidelines led the U.S. Department of Labor to delay a March 1 deadline mentioned in the text of the law itself. The Affordable Care Act set March 1, 2013, as the date by which employers were to begin informing their employees about health marketplaces called health benefit exchanges -- state or federally chartered online marketplaces for health coverage in each state. But, never mind, the Labor Department said recently, we haven't written those rules yet. So, we'll give you employers until late summer or early fall to get started with that.
Now consider an employer who decides to offer coverage, either to avoid tax penalties or to retain good help. Besides the uncertainty imposed by federal rule-writers' dithering, such an employer will shop for coverage in a marketplace in which the law's "affordable" promise has not been delivered. A study by the Kaiser Family Foundation projected health premiums to rise 7 percent in 2013, well ahead of an expected inflation rate of 2.5 percent. And the Centers for Medicare & Medicaid Services projects similar growth in 2014, and 6 percent growth each year through 2020.
Like the "shovel-ready jobs" of the nearly $1 trillion federal "stimulus" measure of February 2009 that the president later acknowledged were "not as shovel ready as we thought," the Affordable Care Act also looks like a case of pass-it-quick, think-it-through-later lawmaking.
"We have to pass the bill so that you can find out what is in it," then-House Speaker Nancy Pelosi said of the Affordable Care Act just before its passage in March 2010.
It turns out that not even that's true. Employers are still waiting to find out precisely what the law has in store for their businesses and employees. What businesses know for sure is the law's incentives for cutting employees' hours below 30 per week to avoid penalties for not offering coverage, and staying below the magic 50 full-time-equivalent employees to avoid penalties for failing to offer affordable coverage.
While unlikely, it would seem that the administration that can't write its rules on time should delay the law's Jan. 1, 2014 start date, so we don't have to wait until after it takes effect to find out how many jobs, hours and pay Obamacare will cost American workers.
Employers are still waiting to find out precisely what Obamacare has in store for their businesses and employees.