Healthcare 411: What You Need to Know About How the New Law Affects YOUR Business and How NFIB is Fighting For YOU! July 28, 2010

Transcription

1 Healthcare 411: What You Need to Know About How the New Law Affects YOUR Business and How NFIB is Fighting For YOU! July 28, 2010 Amanda Austin, Director of Federal Public Policy for NFIB. Karen Harned, Executive Director, NFIB Small Business Legal Center.

2 How can you help? Donate today. Whether you are a small business owner yourself, or are a proud supporter of local business any amount will help increase the power of our message.

3 Healthcare 411: What You Need to Know About How the New Law Affects YOUR Business and How NFIB is Fighting For YOU! Chat Session immediately following

4 Healthcare Overview Part 1: What You Need to Know About How the New Law Affects YOUR Business. How did we arrive at this debate? NFIB s 2-Year Involvement Grandfathered Status Individual Mandate Employer Mandate Exchanges Subsidies Part 2: How NFIB is Fighting for YOU Healthcare Lawsuit Overview Background What s at Stake Litigation Timeline What the Future Holds

5 The New Healthcare Law The newly passed Patient Protection and Affordable Care Act represents the most significant transformation of the American healthcare system since Medicare and Medicaid.

6 How Did We Arrive at This Debate? Many thought 2009 was the perfect storm for healthcare reform. Why? Double digit costs increase. No large reform effort since Clinton attempt. Business, labor and consumers frustrated with the healthcare system and its inability to reduce or control costs.

7 NFIB: Deeply Involved in a 2-Year Process Healthcare costs remain a top priority for NFIB. Multi-stake holder meetings. Business community discussions. NFIB released marketdriven solutions.

8 NFIB: Deeply Involved in a 2-Year Process NFIB nation-wide tour with small business speaking out on high cost of healthcare. NFIB members say healthcare cost #1 problem for > 20 years.

9 The Writing On The Wall Began to Show It was clear towards the end of the long winded discussion, that those in charge of Congress and the Administration did not want to listen to the payer community - employers. Summed up the government addressed coverage as opposed to cost.

10 Key Components Things you need to know now and how to prepare for the new law: Grandfathered Status Individual Mandate Employer Mandate Exchanges Subsidies

11 What Does Grandfathered Mean? Everyone is now Grandfathered as of March 23 rd, Think of it as your healthcare plan is frozen in time. Minimal changes allowed.

12 Why You Might Want to Remain Grandfathered Protected from complying with new minimum essential coverage requirements. Protected from complying with first-dollar preventive service requirements. Protected until 2014 from tighter rating bands.

13 Reporting Requirement to Maintain Grandfathered Status For a plan to maintain its grandfathered status, the regulations require that a statement asserting grandfathered status be included in participants plan materials. The regulations include a model statement that can be used to satisfy this requirement. Plan documents in effect on March 23, 2010, current plan documents and other plan documentation must be open for inspection.

14 Things That Trigger Loss of Grandfathered Status Entering into a new policy or insurance contract after March 23, Elimination of all or substantially all benefits to diagnose or treat a particular condition.

15 Things That Trigger Loss of Grandfathered Status Any increase in a percentage cost-sharing requirement. An employer or employee organization decreases its contribution rate toward cost of any tier of coverage for any class of individuals by more than 5% points.

16 Requirement to purchase health insurance Individual Mandate

17 Individual Mandate The new healthcare law contains an individual mandate effective A legal requirement that every American obtain health insurance coverage that meets the government s definition of minimum essential coverage

18 This is the first time the federal government has ever required individuals to purchase something just because they are alive..(see slides 33-56).

19 Individual Mandate Minimum Essential Coverage (MEC) and grandfathered plans MEC = Federal floor of coverage for all U.S. citizens. Everyone will be required to either have MEC or maintain a qualified grandfathered plan in order avoid paying penalties.

20 Individual Mandate Tax penalties if you do not purchase qualified insurance $95 or one percent of annual income, whichever is greater $325 or 2 percent of annual income, whichever is greater. After 2015, $695 or 2.5 percent of annual income, whichever is greater.

21 Employer Mandate Employer Mandate = $52 billion in new taxes

22 Employer Mandate Mandate for employers with 50 or more full time workers. Part-time workers are included in this count. For offering firms If coverage is deemed unaffordable to employee (based on income) the firm could be penalized up to $3,000 per full time worker.

23 Exchanges Starting 2014 Purchasing insurance as you know it today will begin to change in Health plans offered through exchanges must meet minimum essential coverage requirements set by federal government. Individual subsidies will run through exchanges.

24 Exchanges Starting 2014 A change you will see in all new health plans No deductibles higher than $2,000. Family policies are limited to deductibles of $4,000 or less. Individuals under the age of 30, who will be allowed to purchase a catastrophic policy with a deductible of $4,000 for an individual, $8,000 for a family plan.

25 Subsidies to Individuals Eligibility 133% to 400% FPL. Subsidies will affect employers due to employer mandate. Federal government will pay 100% of costs until Starting in 2017, states will be required to pick up some of the costs.

26 Year 2014 Individual mandate and employer mandate. Government defines the standard benefit package for all consumers (minimum essential coverage). New tax on private plans that small business and individuals purchase. Creation of state exchanges. Medicare cuts and expansion of Medicaid.

27 Our Job is to Fight This On All Fronts - Legislatively Regulatory Legally

28 Parallel Strategy NFIB will pursue all avenues to repeal provisions and protect business at all costs.

29 Valuable Resources For more information: On the New Healthcare Law On How You can Take Action

30 How NFIB is Fighting for YOU Health Care Lawsuit Overview

31 Background On May 14, 2010 NFIB joined 20 states on the lawsuit challenging the constitutionality of the Patient Protection and Affordable Care Act.

32 Background The 20 participating states are: Florida, South Carolina, Nebraska, Texas, Utah, Louisiana, Alabama, Colorado, Michigan, Pennsylvania, Washington, Idaho, South Dakota, Indiana, North Dakota, Mississippi, Nevada, Arizona, Georgia, Alaska.

33 Background Why NFIB Joined the Lawsuit The healthcare law directly undermines the rights of small business owners to own, operate and grow their business.

34 Background Why NFIB Joined the Lawsuit NFIB takes the Constitution seriously and believes that all laws must pass Constitutional scrutiny. The healthcare law fails this test.

35 What is at Stake? Our basic liberties as human beings -- the healthcare lawsuit is not just about having the freedom to make your own healthcare decisions.

36 What is at Stake? This is the first time the government is telling individuals they have to do something simply because they are alive. The military draft is the only exception to this.

37 What is at Stake? How Far Congress is Allowed to Go -- If Congress can require all Americans to buy a product simply because we are alive, what else could congress tell us to do? Real people in power have no problem eroding our liberties even further.

38 What is at Stake? When Senator Coburn asked Supreme Court nominee, Elena Kagan, if a law requiring all Americans to eat three vegetables and three fruits everyday was constitutional, she refused to commit to saying no. Kagan also declined to say no when asked if Congress has the power to tell people what they have to eat everyday!

39 What is at Stake? What other liberty limiting laws will the Washington elite find acceptable?

40 Legal Claims: The Basis of the Lawsuit The healthcare law violates multiple parts of the Constitution including: The Commerce Clause The Fifth Amendment Due Process Clause Article I, 2,9 Unconstitutional Tax

41 The Commerce Clause The Congress shall have power To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes.

42 The Commerce Clause The Commerce Clause of the Constitution does not permit Congress to regulate inactivity. Requiring individuals to purchase health insurance is unprecedented.

43 The Commerce Clause Under the law, Americans truly would be forced to purchase insurance simply because we are alive. While we are required to buy car insurance, the choice to own a car still belongs to us. If the individual mandate is upheld, there would be no clear limit to what else the government could require of small business.

44 The Commerce Clause How We Got Here The Supreme Court struck down laws in two recent cases because those laws violated the Commerce Clause.

45 The Commerce Clause How We Got Here 1. In United States v. Lopez (criminalized possession of handguns near schools). 2. United States v. Morrison (criminalized gender motivated violence).

46 The Commerce Clause How We Got Here The Supreme Court stated that the laws at issue in these cases concerned non-economic activity and were found unconstitutional under the Commerce Clause. The healthcare mandate does not regulate any activity, economic or non-economic; it regulates inactivity.

47 The Commerce Clause How We Got Here In the Lopez and Morrison cases, the Court pointed out that allowing the laws to continue to exist would blur the line between state and federal powers.

48 The Commerce Clause How We Got Here Similarly, if the healthcare law continues to exist, Congress s power under the Commerce Clause would be so broad, they could regulate just about anything. What powers would states still have that couldn t be usurped by the federal government?

49 The Commerce Clause How We Got Here Wickard v. Filburn In Wickard v. Filburn, the Court stated that when a class of activity is regulated (such as the national market for wheat) the Congress can regulate individuals or companies who have only a trivial influence on that class of activity (like individuals growing wheat in their back yard).

50 The Commerce Clause How We Got Here Wickard v. Filburn This case is often used by people arguing that the individual mandate is constitutional BUT Wickard only upheld the regulation of a market where people choose to participate and did NOT require people to enter that market.

51 The Fifth Amendment No person shall be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.

52 The Fifth Amendment The Fifth Amendment of the Constitution does not permit congress to require individuals to buy certain products like health insurance.

53 The Fifth Amendment Requiring individuals to maintain healthcare coverage deprives members of their liberty and property without due process. Forcing people to buy insurance coverage or be fined deprives them of their property rights.

54 Article I, 2,9 Unconstitutional Tax Article I, 2 direct Taxes shall be apportioned among the several States Article I, 9 No capitation, or other direct, Tax shall be laid, unless in Proportion to the Census

55 Interests of States Violation of the 10 th Amendment, which states that the powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.

56 Interests of States Interest of the States in Litigation The States share NFIB s concern about the unconstitutional individual mandate. The States are challenging the massive expansion of the Medicaid program that will unconstitutionally require states to spend billions more on this program at a time when state budgets are already in crisis.

57 Litigation Facts The suit was filed on behalf of NFIB by the NFIB Small Business Legal Center in U.S. District Court for the Northern District of Florida Pensacola Division. Judge Roger Vinson will hear the case.

58 Litigation Facts Regardless of the outcome of the litigation in the District Court, there will be an appeal. That appeal will go to the United States Court of Appeals for the Eleventh Circuit. Regardless of the outcome of the case in the Eleventh Circuit, the Supreme Court will be asked to hear the case.

59 Litigation Timeline Summer 2010: Government s motion to dismiss NFIB s motion in opposition. Sep 14, 2010: Oral argument on motion to dismiss. Sep 15 Oct 15: Estimated dates for Judge Vinson to issue order ruling on motion to dismiss. Nov Dec 2010: Pleadings on merits of the case.

60 Litigation Timeline Dec 15- Jan 15, 2011: Estimated dates for oral argument on motion for summary judgment. Feb-Mar 2011: Anticipate final ruling on case by Judge Vinson either upholding the law or ruling that the law, or portions thereof, is unconstitutional. Remainder of 2011: Appeal to 11 th Circuit.

61 Litigation Timeline Estimated timeframe for decision by 11 th Circuit federal court of appeals. Estimated timeframe for appeal to the U.S. Supreme Court.

62 What Does the Future Hold? Likelihood of Success NFIB has the Constitution on its side. Possible Outcomes: whole law is struck down parts are struck down whole law is upheld There is no severability clause in the healthcare law

63 Resources for Lawsuit Updates Latest court filings Petition to support the lawsuit Contribution button Latest news on the lawsuit and law Online community

64 Contact Us NFIB Small Business Legal Center NFIB (6342)

65 How can you help? Donate today. Whether you are a small business owner yourself, or are a proud supporter of local business any amount will help increase the power of our message.

66 Ask Karen and Amanda questions. Get real-time answers. PLUS, links, useful documents, charts, graphs and more NOTE: The chat session, and all links will be available to view later.

67 For more information about the Small Business Webinar Series visit: We want your feedback. If you enjoyed today s webinar or have suggestions for the future, please fill out the short survey that you will receive via after this webinar. Did you know NFIB is on Facebook? Stop By and Leave a Comment.