So What’s Going On With Obamacare?

NOTE: This video was recorded before Donald Trump’s election, which has likely changed the course of the Affordable Care Act going forward. But these comments are on the ACA as it now stands. 

Libertarian magazine Reason interviewed its features editor, Peter Suderman, about the status of the Affordable Care Act. He explains how the rising prices will impact consumers and taxpayers. Is this Obamacare’s “death spiral?”

Questions About Open Enrollment? The Indiana Chamber has Answers

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Open enrollment for health care insurance is now upon us, and many businesses are faced with difficult choices for 2017. Premiums are expected to increase sharply under the Affordable Care Act (ACA) according to many experts – the Department of Insurance says some in Indiana have seen premiums go up by almost 70%!

The Indiana Marketplace (Indiana’s federally mandated online health care insurance exchange) has not been the answer many were hoping for. And don’t forget about the penalty for businesses choosing not to offer insurance to their employees – a penalty that will be adjusted each year to account for inflation.

The Indiana Chamber of Commerce has been working since 2004 to provide members with reasonable health care insurance options supported by brands you trust. In 2016 and beyond, we’re excited to offer a new program called ChamberCare Solutions, with a larger portfolio of health plan options.

This partnership between the Indiana Chamber and Anthem Blue Cross and Blue Shield can help you find the coverage that is right for your business. We are committed to coverage that is simple to understand and affordable. All plans comply with the ACA.

ChamberCare Business Resources: A professional employer organization (PEO) administered by Human Capital Concepts (HCC). Why a PEO? PEOs allow employers to outsource their HR functions and employee benefits programs to ensure they’re in compliance with HR laws and the ACA. By outsourcing to a PEO, you can focus on what you do best — running your business. According to the National Association of Professional Employer Organizations, businesses that use a PEO grow 7% to 9% faster, enjoy 23% to 32% lower employee turnover and are over 50% less likely to go out of business.

ChamberCare Savings: An excellent choice for companies with 51-99 employees, with 5% savings on any Anthem plan.

ChamberCare Exchange: Access to flexible, affordable health plans for companies with 2-50 employees.

Which solution is right for you and your employees? Contact your insurance broker today or call/email Brett Hulse, Indiana Chamber, at (317) 264-6858 or BHulse@indianachamber.com.

ChamberCare Solutions Program Provides Health Care Answers

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More than six years after the Affordable Care Act was signed into law, it’s still not an easy process for companies to determine the best health care choices. Important assistance and options are now available through the ChamberCare Solutions program.

The Indiana Chamber has partnered with Anthem Blue Cross and Blue Shield since 2004 on ChamberCare – an insurance discount offering for businesses with between two and 99 employees. More than 25,000 employee lives (and 50,000 lives when spouses and dependents are included) were covered through ChamberCare.

Now, ChamberCare Solutions takes that partnership to an even higher level with a suite of solutions to help meet insurance needs.

“The Indiana Chamber-Anthem partnership has been an excellent one for our member companies, as well as their employees and families,” says Jennifer Elkin, Chamber senior vice president of marketing. “There have been more questions than answers since the Affordable Care Act was signed. We’ve been listening, discussing and searching for the right tools and products – and we’ve found them in this evolution to ChamberCare Solutions.”

The ChamberCare Solutions options include:

  • ChamberCare Savings: This is the previous ChamberCare discount program – now available for companies with between 51 and 99 employees. This was made possible by the late 2015 signing of the PACE Act (Protecting Affordable Coverage for Employees), which returned the definition of a small business back to one with fewer than 100 employees.
  • ChamberCare Exchange: For companies with fewer than 50 employees and a potentially unhealthy, higher-risk population, the exchange might be the best alternative. Important guidance and navigation is available through Anthem.
  • ChamberCare Business Resources or a PEO (Professional Employer Organization): This is an attractive option for companies that, in addition to a competitive health care product, are looking to outsource some of their human resources functions. The multiple employers in the PEO allow the advantage of using a company’s experience rating compared to the generally more volatile community rating.

The Indiana Chamber and Anthem are teaming with Indianapolis-based Human Capital Concepts (HCC) on the PEO. Harlan Schafir, CEO of HCC, started the state’s first PEO in the early 1990s; he and his team have more than 125 years of experience in the industry.

“We are in the midst of an unprecedented talent war,” Schafir explains. “A PEO allows companies to attract and retain talent by improving employee benefit offerings and helps these organizations mold an attractive culture. Working with a PEO allows companies to focus on their core mission. The PEO takes care of compliance with ever-complex laws and regulations; company leaders focus on running their business.”

  • ChamberCare Shared Savings: This is a future offering under development by Anthem. It is expected to allow for self-funding for employers with as few as 25 employees. To date, such plans have only been available for organizations with at least 100 employees.

“The Indiana Chamber has advocated and educated on health care issues for many years. We’re pleased to add this in-depth navigation benefit,” Elkin adds. “Being able to offer these choices – with more to come – will save members money and allow to further invest in their people and businesses.”

Learn more or contact Nick Luchtefeld at (800) 824-6885.

Policy Circle Co-Hosting Women’s Influence & Liberty Event September 17

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The Policy Circle – think a book club for women to discuss policy (not politics) – and the Center for the Study of Liberty will host the Women’s Influence & Liberty half-day conference September 17 in downtown Indianapolis.

Open to all women – and particularly those who are interested in business, entrepreneurship and even those researching various policy issues – the conference will include a chance for participants to discuss policy issues with each other and policy experts during roundtable discussion breakout sessions.

Nina Easton, chair of Fortune’s Most Powerful Women International Summit, will headline as the keynote speaker. A networking reception will follow the conclusion of the event, from 6 to 7 p.m.

The Policy Circle was formed in Illinois and serves as a catalyst for women to join together and share information and opinions, having read data-driven policy briefs prior to group discussions. The non-partisan, 501©3 organization encourages women to join together and discuss policy issues to educate and engage other women in their communities. Following group discussions every other month, members can take action, such as contacting lawmakers to advocate for specific policies, or following along with proposed legislation.

The group guidelines are to leave the social issues at home, however, and follow the direction of former Gov. Mitch Daniels. He urged for a pause on social issues so everyone could focus on other pressing items, such as foreign policy and immigration, education, economic growth, free enterprise and health care.

With 23 circles in 10 states – including Indiana – and almost 900 women involved so far, the organization is growing. For more information on The Policy Circle, including how to join or start a circle, visit the web site at www.thepolicycircle.org.

The registration fee for the Women’s Influence & Liberty event is $75 and includes lunch; register online.

Telemedicine Law Now Officially in Place

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The new telemedicine law went into effect July 1. The legislation (House Enrolled Act 1263), authored by Rep. Cindy Kirchhofer (R-Indianapolis), was enthusiastically supported by the Indiana Chamber because it increases access to care and potentially could reduce costs. Prior to the bill’s passage, Indiana was one of only four states that had not adopted telemedicine legislation.

Telemedicine is defined as the delivery of health care services using electronic communication and information technology, including: secure videoconferencing; interactive audio – using store and forward technology; or remote patient monitoring technology between a provider in one location and a patient in another location. Physicians, physician assistants who have authority to prescribe, licensed advanced practice nurses who have authority to prescribe and optometrists are all authorized to utilize telemedicine.

To provide the telemedicine service, a provider must have established a patient-provider relationship. In that patient-provider relationship, the provider, at a minimum, must obtain the patient’s name and contact info and location; disclose the provider’s name and title; obtain informed consent; obtain the patient’s medical history and other information to establish a diagnosis; discuss that diagnosis with the patient along with the evidence for and risks and benefits of various treatment options including when it is advisable to seek in-person care. The provider must also create and maintain a medical record for the patient and notify the patient’s primary care physician; issue proper instructions for appropriate and follow-up care and provide a telemedicine visit summary to the patient, including any prescriptions.

The law allows for a provider to issue a prescription through telemedicine even if the patient has not seen the provider in person previously as long as: the provider has satisfied the applicable standard of care in treating the patient; the issuance of a prescription is within the provider’s scope of practice; and the prescription is neither a controlled substance nor an abortion-inducing drug. At this time, the law prohibits ophthalmic devices such as glasses, contact lenses or low-vision devices.

An out-of-state provider may conduct telemedicine business in Indiana but must certify to the Indiana Professional Licensing Agency that it agrees to be subjected to the jurisdiction of the courts of law of Indiana and all substantive and procedural laws concerning a claim against the provider.

There was concern during session about liability in providing telemedicine services. Therefore, the General Assembly included a provision that if a provider provides telemedicine services then that provider would be held to the same standards of care as if the health service was provided in an in-person setting.

Regarding the aforementioned prohibition against providing eye glasses and contact lenses, the Indiana Chamber has recently been in discussion with a company that would like to have that provision changed during the next legislative session. This company says it has the capability, via the Internet, of providing a refractive eye exam as accurate as one completed in the doctor’s office. The way the law stands currently, this telemedicine company (based upon its business model) would be prohibited from conducting any business in Indiana.

Health Care Just Keeps Getting Bigger

16446238A few health care economic facts to consider:

  • The United States spends more on health care than any other country – $3 trillion in 2014. That equals $9,523 per person or 17% of gross domestic product
  • In the six years after the recession, health care added 2.1 million jobs, more than the next three industries combined – leisure and hospitality, professional services and education
  • Employment in health care is projected to grow by 19% from 2014 to 2014, adding about 2.3 million new jobs
  • Nearly one in 11 overall jobs is in the health care field. In 2014, that was 12.2 million jobs
  • The top five states with highest percentage of jobs classified as health care jobs: West Virginia, 11.4%; Rhode Island, 11%; Maine, 10.8%; Ohio, 10.6%; and Massachusetts, 10.4%

Letter: Federal Health Insurance Tax Harmful to Employers

The federal Health Insurance Tax is an aspect of the Affordable Care Act that poses a threat to businesses across the country. The following letter of concern from Caryl Auslander, the Indiana Chamber’s vice president of federal affairs, was sent to Sen. Joe Donnelly and explains the Chamber’s position on the issue.

Senator Donnelly,

As Hoosiers, we are proud that our state has shown strong and sustained economic growth ever since the nationwide recession in 2009. It is our concern that the Federal government is hurting, rather than helping, by enacting policies that harm the employer community, specifically small businesses. In particular, we are deeply concerned by the Health Insurance Tax (or “HIT”) that is embedded in the Affordable Care Act.

This provision ensures that those individuals and businesses that have to turn to private insurance companies for coverage are stuck with a disproportionate share of the costs of the ACA. While the original intent of the HIT was supposed to be paid by the insurance companies, in reality the companies really act only as tax-collecting proxies for the Federal government.

When a consumer cannot avoid purchasing a good or service, they have little or no power to resist price increases imposed by suppliers. And when all of the suppliers are charged the same tax, they all have the same incentive to pass it along to their consumers. Thus the HIT forms a hidden tax on health insurance consumers: The families and small businesses who can’t afford to self-insure.

By some estimates, the HIT will cost more than $500 per family every year. A tax burden like that can place real hardship on a middle-class family, push poor families straight into insolvency, and keep small businesses from being able to hire new workers, reinvest in their company or provide other services to consumers. In a small firm with 80 employees, the hidden HIT alone could cost more than $40,000 a year — well over the state’s per-capita income.

The HIT is a hidden and regressive tax, and bipartisan agreement has been enough thus far to delay its full implementation. But middle-class Hoosiers and small business owners here cannot afford the continued uncertainty. On behalf of 24,000 Chamber members and customers across the state of Indiana, it is our request that you place the permanent elimination of the Health Insurance Tax at the top of your agenda. Its unconditional repeal would be a victory for transparency, good government, and economic opportunity for all.

Thank you for your leadership on this issue and for defending the people of Indiana.

Sincerely,

Caryl Auslander
Vice President, Federal Affairs

Telemedicine Movement Moving Forward in Indiana

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Our friends at Gibson Insurance posted a blog today about the advancement of telemedicine in Indiana. They also included comments from Indiana Chamber VP Mike Ripley:

Prior to March 21, 2016, Indiana was one of just a handful of states that had not legislatively addressed the subject of telemedicine. Meanwhile Illinois and Ohio currently have proposed telemedicine parity bills but nothing set in stone – and Wisconsin has no parity legislative activity at this time. Michigan’s laws went into effect in 2012 and Kentucky was well ahead of the game with legislation in 2000, but the first state to address telemedicine by law was actually Louisiana in 1995. 21 years ago?! Why was Indiana so late to answer the call?…

WHAT SHOULD INDIANA EMPLOYERS KNOW?
According to Mike Ripley, the Vice President of Health Care and Employment Law Policy at the Indiana Chamber of Commerce, it was surprising the law was not passed sooner, as it had many supporters. Ripley explained that insurance carriers, employers, and health care providers were ready to embrace telemedicine technology, yet the stakeholders could not agree on exactly how it should work in the Hoosier state.
The competing interests that delayed the law were ultimately united when the stakeholders agreed that the standard of care for a virtual visit would have to be the same as the standard of care for an in-person visit. Once all parties were able to rally around this central concept, the bill passed swiftly through the legislature. The standards of care at the heart of the bill are yet to be clearly defined in terms of telemedicine, but you may read the specific language of Indiana’s House Bill 1263 to gain a better understanding of the law.
Although the issues around the standards of care continue to develop, the law clearly states a phone call is insufficient to satisfy the standard of care. We anticipate technology such as video chatting and Skype will be used to effectuate the provision of care by telemedicine. The law also addresses the types of maladies that may (and may not) be treated through telemedicine. In Mr. Ripley’s words, one easy way to remember what is fair game under the bill is “anything ending with ‘-itis’ – is permissible to treat via telemedicine.” The law prohibits narcotic prescribing and psychiatric services through telemedicine.

Furthermore, see our recent blog about the importance of telemedicine, and its potential impact on many quality of life factors.

Telemedicine a Potentially Healthy Benefit of Broadband Access

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For the upcoming July/August edition of BizVoice, I spoke with Smithville Fiber Executive Vice President Cullen McCarty about developments in broadband — both in Indiana and around the globe.

One aspect he mentioned was the significant impact on health broadband access could play for Americans living in rural areas as telemedicine capabilities increase.

“The importance is having the ability to stay at home and talk with your doctor from there, whether it’s through FaceTime or some type of interactive technology,” McCarty says. “You can have a doctor’s visit without a stethoscope. You can take blood pressure over a device and have that information shot back to the doctor.”

Fitbits and Apple Watches may also be able to transfer diagnostics to doctors as well, he adds, noting aging Hoosiers will need to take advantage of all avenues to increase medical efficiency.

“In Southern Indiana, a lot of hospitals and clinics are a far drive for some in rural areas, like Orange and Greene Counties,” McCarty offers. “It takes a lot of gas and money, so I think that’s where telemedicine will take off. Plus, you have specialists who read X-rays. An example we were given several years ago is that there are people in other parts of the country and the world who read X-rays, and they send it back to the doctor.”

He relays an example of someone getting an X-ray in Bloomington and having it sent to a radiologist who lives on a golf course in Texas.

“There are many different applications for telemedicine,” McCarty points out. “I think it’s a big driver in getting broadband into people’s homes who don’t see the value yet.”

Health Care to be Focus of Connect & Collaborate Events in 2016 (Coming to a City Near You!)

97867199Six years after the Affordable Care Act became law, employers and employees continue to be impacted, and sometimes confused, by its various rules and regulations. You can learn about new tools to answer your questions and benefit your organization as part of the 2016 Connect & Collaborate series.

The events – presented by the Indiana Chamber in partnership with Anthem Blue Cross and Blue Shield and free for Chamber members – will take place in 11 cities across the state. In addition to breakfast or lunch and networking with business leaders from your area, the health care emphasis will include these three important benefits:

  1. Advocacy: The Chamber’s longstanding role in seeking implementation of the best possible public policies at both the state and federal levels
  2. Education: Conferences, publications, the affiliated Wellness Council of Indiana and additional member services to assist companies and their workers
  3. Navigation: New options being made available this year, in conjunction with Anthem and additional partners, to help you produce cost savings while best meeting your employee needs. These products are structured for organizations of all types and sizes

Past Connect & Collaborate series have focused on workforce development, workplace wellness and energy saving guidance. Chamber Communications VP Tom Schuman, Director of Membership Brock Hesler and Anthem representatives will be featured presenters at each event.

The series begins May 4 in Carmel and concludes June 21 in Fort Wayne. Additional stops are Terre Haute, Richmond, Anderson, Lafayette, Bloomington, Evansville, Gary, Winona Lake and Elkhart. Pre-registration is required for the 90-minute programs.

Full lineup and registration. If you have additional questions, contact Nick Luchtefeld (nluchtefeld@indianachamber.com) at (317) 264-6898.