1. The Affordable Care Act Presented by Marco Giamberardino Executive Director NECA Government Affairs October 14, 2013

2. Protecting Your Interests The Challenge: Legislators and Regulators are making decisions each and every day that are impacting electrical contractors at the National and/or state level: How to get our sector back to work? Can NECA Contractors stay competitive? How can we protect Taft-Hartley Health Plans? Will Congress make any changes to our plans? How much will more will health care cost? $64,000 Question: How will ObamaCare impact NECA contractors nationwide?

3. The Road to Health Care Reform: How We Got Here

4. How We Got Here

5. The Affordable Care Act A Historic Milestone ACA was sold on three general principles: Make Health Care “Affordable” Universal Health Care for All Guaranteed Choice The Art of the Deal: WH Promises to Core Supporters Labor collectively one of the strongest supporters of ACA Taft-Hartley Plans would be taken care of Technical Corrections Package Promised

6. Ad Hoc Legislating: A Case Study Legislation Was Poorly Crafted: Left to Congress to Cull Together Senate 1 st Draft is What Ultimately Passed “Real” House Draft Never Got Considered No Technical Corrections

7. ACA Unveiled

8. Where We Are Now

9. ACA Reality Check The ACA Cannot Be Repealed: Supreme Court Affirmation of ACA President Obama was re-elected Democrats retained control of the Senate

10. ACA Reality Check Reality Sets In: The Facts Are Revealed: Administration unveils ACA rules 3 days after the 2012 election Growing concerns over impact Labor support publicly wanes Congressional Dems publicly grow concerned Administration announces delays & problems Congress held new series of hearings on mandates, escalating costs, exchanges, implementation Shutdown Showdown: Ping-Pong game over “defunding”, delay, shutdown

11. ACA Broken Promises White House-Labor Talks House repealed/modified ACA 43+ times since 2011 Labor met with the WH more than 43 times since enactment of the ACA Friday the 13 th : President Obama tells Labor “NO” Multiemployer Plans will not be Qualified Health Plans No tax subsidies for Taft-Hartleys for employer- provided health coverage Multiemployer Plans hit with $63 per person reinsurance fee No alternative solutions for Multiemployer Plans Labor’s Argument: Our plans serve a different purpose, different workforce, than traditional plans, and deserve waiver Would make the plans extremely, even uniquely, attractive to employers

12. Where We Are Going… NECA Leading the Industry: Questions Answered: NECA Documents ACA FAQs Recorded NECA ACA Webinars NECA ACA Issue Policy paper The Prescription for Rewriting the ACA Has Begun: Meetings held with EVERY Senate Democrat and most Senate Republicans since July Many meetings held with most House leaders

13. Reform and Repair the ACA Repeal Transitional Insurance Fee Repeal the “Cadillac Tax” New insurance market rules must be repealed to combat “Rate Shock” Free-Rider Penalty for Large Employers Must Be Addressed Repeal Restrictions on Health Savings Accounts and Flexible Spending Accounts Enact Medical Malpractice Reform Enact Medicaid Reform

14. Conclusions Elections and Subsequent Policy Decisions have Major Consequences for the Industry The Industry Needs to Participate in the Process NECA is Working to Protect Your Interests Thank You for Your Support!

15. NECA Government Affairs Marco Giamberardino Executive Director NECA Government Affairs marco@necanet.org marco@necanet.org (301) 215-4522