Employer Mandate

Health Care and the Employer Mandate
By Ryann Roberts, Health Policy Intern  

The employer mandate portion of the Affordable Care Act stipulates that any company with over 50 employees must provide insurance to employees working 30 or more hours a week. This past July the Administration delayed the mandate until January 2015. The mandate impacts part-time workers, full-time workers and small business owners. Employers are not required to provide insurance to part-time workers, only to full-time workers. This has been the source of much concern because there has been some movement by employers to reduce employee hours to meet the part- time threshold so that they will not have to provide employer mandated health insurance. Moreover, those part-time workers will have to secure private health insurance for one year until the employer mandate is instituted in January 2015.

Employees should determine whether their insurance status will be impacted by the delay of the employer mandate. Because 97% of companies with 50 or more employees already provide health insurance, the vast majority of employees may not be impacted by this delay. If an employer does plan on taking advantage of the delay, the employee must obtain health insurance through the insurance marketplace found on Helathcare.gov. It is important for employees seeking insurance through the marketplace to prepare to apply for open enrollment that specifically fits their needs and budget.

Open Enrollment and the Market Place

Beginning October 1st, the insurance marketplace will help individuals find and purchase health insurance that fits their budget and meets their needs. Getting covered is especially important for the Hispanic community. Hispanic Americans represent one third of the nation’s uninsured, and often have higher rates of chronic diseases. Hispanic women are almost twice as likely to die from cervical cancer as non-Hispanic white women, and Hispanic Americans are twice as likely to have diabetes as non-Hispanic whites of similar age. Hispanics also use prenatal and preventive services at lower rates than Non-Hispanic whites.

The Health Insurance Marketplace will allow insurance seekers to purchase insurance from private health plans which will cover a comprehensive set of benefits, including doctor visits, hospital stays, preventive care, and prescriptions. An important aspect of these plans is that they cannot deny coverage because of a pre-existing condition. With a single application, individuals can also determine whether or not they qualify for Medicaid, the Children’s Health Insurance Program, or various savings that lower health insurance premiums.