[December 16, 2014]

BeneStream CEO: The Affordable Care Act in 2015 Profoundly Changes Health Care Offerings for Full-Time Employees

The Affordable Care Act (ACA) will profoundly change the health benefits employees are offered in 2015. This is being driven by coverages mandated by the ACA and the requirement that employers with companies of 100 or more employees now offer health benefits to all full-time staff under the Employer Mandate, which goes into effect on January 1.

"The Employer Mandate is the core of the ACA. It will drive a significant increase in the number of people insured," said Ben Geyerhahn, CEO and Founder of BeneStream, a company that facilitates Medicaid migration for employers and employees. "In the lower income segments of the economy companies are looking for and offering employees a range of options that are very different from what's been offered in the past."

Full-time employees who have previously received health insurance are likely to have fewer plan options than previous years, and those options will come with narrower networks. Many employees will experience an increase in monthly premium pricing with higher deductibles along with a smaller range of in-network doctors. And some plans no longer cover out of network doctors.

Also, family coverage has been eroding for years and will evaporate for many this year. If this happens, families can go to the exchange to get the remaining members covered, and some may qualify for CHIP (the government's Children's Health Insurance Program.)

The upside is that many more people ill be offered coverage this year than in the past.

The working poor will experience the most impact from the Mandate. Prior to implementation of the ACA, this was the largest uninsured demographic because most of the time their employers did not offer health benefits.

This year the working poor are being offered a range of options by employers, which means that in 2015 many will have health insurance for the first time. However, for this demographic any additional cost to the monthly budget is more than they can afford. This is why 29 states have passed Medicaid expansion. Medicaid expansion goes hand-in-hand with the ACA and was implemented to ensure that full-time workers who fall into this gap can still access coverage. Because of the expansion, Medicaid now covers up to 138% of the poverty rate, which for a family of four is $32,900 in income per year.

As we've already seen from the independent exchanges, access to health insurance is translating to more preventative care versus emergency care, and more people have health insurance upon arrival to the emergency room, which ultimately lowers costs. With the Employer Mandate taking effect, these factors will continue to improve.

"If you believe that everyone should have access to health insurance, and if you want overall costs to go down for things like emergency care, then the final rollout of the ACA through the Employer Mandate is a good thing," said Geyerhahn.

Geyerhahn has been featured in The Wall Street Journal print and radio, Fox Business News, NY1, and Inside Health Policy among others.

ABOUT BENESTREAM

BeneStream provides the only alternative solution for employers to satisfy the Employee Mandate portion of the Affordable Care Act by handling the enrollment of qualifying employees in Medicaid, rather than private insurance. Medicaid enrollment is a personal benefit that companies do not typically endeavor to handle for their staff. BeneStream was founded by Benjamin Geyerhahn, a healthcare policy expert and member of New York Governor Cuomo's Health Benefit Exchange Regional Advisory Committee. The company employs a combination of screening and monitoring software and a multilingual call center.

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