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Speaker talks health care

Overhaul topic of presentation at Bay

September 19, 2012
By Ilsa Matthes - staff writer ( , Daily Press

ESCANABA - Representatives from the business community met at Bay College on Tuesday to hear a presentation on the Patient Protection and Affordable Care Act and the future of Michigan health insurance exchanges by Timothy J. Byrne, vice president of M3 Insurance.

The Patient Protection and Affordable Care Act, or simply ACA, was deemed constitutional on June 28 of this year. Many predicted that the law would fail because of the "insurance mandate," which fined citizens and employers who did not have or provide insurance.

Supreme Court Chief Justice John Roberts deviated from his normally conservative views and declared the law as constitutional. Robert's justification was that the government has the right to tax.

"It was ninth grade civics in Robert's eyes," said Byrne.

Now that the law has been deemed constitutional, many employers are struggling to understand the law. Most of the attendees at Tuesday's meeting were representing employers that employ less than 100 people.

Starting on Sept. 23, health insurance issuers and group health plans - including employers offering insurance - will be required to provide a Summary of Benefits and Coverage when the plan is renewed.

The SBC is a short, easy to understand explanation of the offered plan.

"Like every law that's been done in the last 30 years who, if there's a screw up, is ultimately responsible? The answer is you guys. These are almost without exception employer laws, and these are almost without exception employer penalties," said Byrne. Most insurance providers are compiling SBCs, but employers are still responsible for distributing the information to all employees - including employees that are not participants and beneficiaries.

Employees are also required to report the aggregate cost of employer-sponsored health coverage on employee's W-2 forms.

"Most people haven't been able to demonstrate that W-2 reporting is for anything other than to determine that people have coverage," said Byrne.

Also discussed was the creation of a Michigan insurance exchange. Earlier this year, Gov. Rick Snyder attempted to create a state run insurance exchange website, however funding was stalled, and deadlines are approaching.

By Nov. 13, the state has to be able to prove to the federal government that progress has been made towards the creation of a state run exchange.

"They have to demonstrate that they're probably 60 percent of the way to being able to build it. Well, that ain't happening," said Byrne.

Byrne believes Michigan and other states that are not ready by the Nov. 13 deadline will have to accept help from the federal government to establish their exchanges. Even when the exchanges are fully operational, Byrne believes that exchanges created by individual states will probably only be able to serve employers with less than 50 employees and that exchanges created by state and federal partnerships will be able to serve employers with less than 100 employees.

"Understand the fact that it's not a bunch of academicians sitting in a room figuring things out actuarially, they live in a polictial world, and that's what this bill was, that's what this law is, and that's what this debate will continue to be about," said Byrne.



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