Sudden Impact: Coping with Health Care Reform's Provisions and Ever-Changing Rules

Article excerpt

ON MARCH 24, 2010, THE DAY AFTER President Obama signed sweeping health care reform legislation into law, Robert T. Kakuk's phone didn't stop ringing.

Employees were eager to add their adult children under the age of 26 back on to their health insurance policy, one provision of the Affordable Care Act, explains Kakuk, director of total compensation and human resources information systems at Western Michigan University, which supports approximately 2,800 benefits-eligible employees.

For years, WMU allowed employees to keep their adult children on their health plan until they reached their 26th birthday as long as they were enrolled in school full time. Last year, officials had lowered the age to 25, changing it back after the bill passed. Under the new health care law, adult children can stay on their parent's health plan until the age of 26, whether or not they're full-time students.

"In my view, that actually has been an equalizer," Kakuk says of the law, explaining that since adult dependent children may be enrolled in one semester but not the next, it was often difficult to verify their student status. "On one hand, we really want to make our coverage available to those who are full-time students. [But] a dependent's age is easier to administer."

Nothing on college campuses will spark a fierce debate more than health care reform. Many believe the laws intent is good--more Americans will now have health insurance. On the flip side, some say the law is off balance because it requires institutions to deliver more health care to more people without providing financial relief. Regardless of their opinions, officials at many colleges and universities are sitting on the sidelines, not making any major changes to their health plans because they expect many aspects of the law to be reviewed, revised, or repealed.

At WMU, Kakuk says 99 adult children were added back on to employees' health plans. Since the plan never contained clauses for pre-existing conditions, which has since been outlawed, no changes were needed. The same applies to the bill's exclusion of lifetime dollar limits. The plan's limits were already high--up to $5 million per member which no one had ever reached.

So far, he says only two minor changes need to be addressed: waiving deductibles for preventive services like colonoscopies and, unless a doctor writes a prescription, eliminating over-the-counter drugs, such as aspirin, as reimbursable expenses under health care flexible spending accounts and health savings accounts.

"I really haven't seen adverse outcomes with health care reform," he says, adding that HR built in a 2.2 percent increase for health care costs in its 2011 budget. "I don't have anything keeping me up at night."

Neither does Janis Townsend, HR director at the University of Dallas, which supports about 500 benefits-eligible employees.

The university is part of CARES, a health care consortium that includes Texas Christian University and Austin College. She says the consortium hasn't made changes solely based on the new law. For example, it recently selected a new insurance carrier "based on what we know today," she says.

Last year, the consortium added a prevention plan as a cost control strategy. Each year, a third-party vendor administers free, onsite biometric screenings, which include a full blood panel test. All results are kept confidential between employees and the vendor. Staff can also store their health records on the vendor's website and are contacted by a nurse if they skip important, routine exams.

The consortium's focus, she says, is not on what may happen with health care reform over the next several years, but on minimizing claims by helping employees develop a healthy lifestyle.

"I'm still at the 'Let's wait and see how this comes out [stage]'," she says. "Organizations spend a great deal of money analyzing how it impacts them. …

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