P ATIENT P ROTECTION AND A FFORDABLE C ARE A CT (PPACA) By: Malcolm F. Buckhanan.

W HAT IS PPACA?  Federal statute  Signed by President Obama. March 23, 2010

O THER NAMES OF PPACA.  Affordable Care Act (ACA)  Obamacare  Health Reform Law

O BAMA C ARE R ULES & R EGULATIONS.  Guaranteed Availability of Coverage  Fair Health Insurance Premiums  Single Risk Pool  Guaranteed Renewability of Coverage  Catastrophic Plans

E SSENTIAL H EALTH B ENEFITS 1.Ambulatory patient services 2.Emergency services 3.Hospitalization 4.Maternity and newborn care 5.Mental health and substance use disorder services, including behavioral health treatment 6.Prescription drugs 7.Rehabilitative and facilitative services and devices 8.Laboratory services 9.Preventive and wellness services and chronic disease management 10.Pediatric services, including oral and vision care

T HE A FFORDABLE C ARE A CT — T AX I MPLICATIONS F OR E MPLOYERS Tax Points.

P AY - OR PLAY  Employer contributions, employer penalty Tax-deductible business expenses for the employer. Payments are not tax-deductible.  Profit Paying $3,000 in premiums is a lower net cost than paying $3,000 in penalties.  New reporting requirements Allowed the to calculate the penalties.  IRS (Internal Revenue Service) The IRS has not yet issued guidance on those requirements, but it is expected during the coming year.

PCORI FEES T RANSITIONAL R EINSURANCE FEES S MALL B USINESS T AX C REDITS & A DDITIONAL M EDICARE T AX.  PCORI fees Tax-deductible business expenses for the employer.  Transitional Reinsurance fees Tax-deductible business expenses for the employer.  Small Business Tax Credits The maximum credit is 35 percent of employer (2013); The maximum credit is 50 percent of employer (2014); The credit reduces the amount that the employer would otherwise be able to claim as a deductible expense.  Additional Medicare Tax. The employer does have to calculate it, withhold it from the employee’s pay.

C ONSUMER C OST  Not exceed to: $6350 per individual $1270 per family  Employers identified the top three costliest provisions as: The Patient-Centered Outcomes Research Institute fee—38 percent General administrative costs—35 percent Explaining provisions to participants—28 percent

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