Health care reform is coming and businesses need to be prepared.


That was the theme of the Walla Walla Valley Chamber of Commerce's quarterly luncheon held at the Marcus Whitman Hotel & Conference Center on July 19th.

"There has been a lot of heat surrounding the discussion of health care reform to date," said David Woolson, Chamber president and chief executive. "But to date that discussion really hasn't shed any light on the practical implications for businesses -- small or large."

To provide the business community with a more practical discussion of health care reform, the Chamber brought in two guest speakers from the Washington Policy Center: Carl Gipson, who heads up its Center for Small Business, and Dr. Roger Stark, who serves as its health care policy analyst.

The main theme of the presentation focused on the fact that while the Patient Protection and Affordable Care Act consists of about 2,800 pages of text, many details have yet to be determined or worked out. And that makes it difficult for the business community to plan ahead.

"Despite its length, there are a lot of gray and wishy-washy areas in the bill," Stark said.

Nonetheless, the speakers did provide the following timeline of key requirements and when the years they were or still remain to be phased in:


* All employer health plans must cover employees' children up to age 26.

* Plans may not exclude children up to age 19 based on pre-existing conditions.

* Coverage for preventive care is required.

* Small businesses that pay 50 percent or more of the total premium cost for employees' health insurance may qualify for a tax credit of up to 50 percent of the premium cost.

* Tanning salons are subject to a 10 percent excise tax.


* Employers required to enroll employees in long-term care program.

* Employers must report the value of health benefits on employees' W-2 forms.

* Excise tax on insurance providers.


* Employers that offer health benefits must file reports with the Department of Health and Human Services.

* Excise tax on pharmaceutical manufacturers.

* Increase in Medicare income tax on high wage earners. High wage earners will also be required to pay a new tax on unearned income.


* Elimination of the tax deduction employers receive for Medicare Part D retiree drug subsidy payments.

* Excise tax on medical device manufacturers.


* Large companies with 200 or more employees must automatically enroll employees in a health insurance plan.

* States must begin operating insurance exchanges that will offer individual consumers and employers with less than 100 employees access to health insurance coverage.

* Individuals and families earning up to 400 percent of the federal poverty level will be eligible for federal subsidies for the purchase of health insurance.

* Employers with more than 50 employees will face a fine of $3,000 for every worker who receives a health insurance subsidy. If the employer chooses not to offer any health insurance plan to its employees, it will face a fine of $2,000 per employee.

* All health plans must comply with federally mandated minimum requirements.


* Tax increase for drug manufacturers and private insurance companies.

* Forty percent excise tax on high-value health insurance plans.

While the speakers recognized the timeline provides some details about the health care reform legislation, they repeatedly emphasized that many of the specifics regarding its implementation remain to be resolved.

"Health care is a complex problem and we have enacted a complex solution," Stark said.

He and Gipson both acknowledged that the unknowns can be frustrating for the business community.

"Small businesses tend to treat their employees like family," Gipson said. "They want to provide access to quality health care coverage, but figuring out exactly how to do that can be difficult."

Damien Sinnott is vice president of public policy and business development for the Walla Walla Valley Chamber of Commerce.


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