Affordable Care Act & You

With open enrollment for the Affordable Care Act underway, many truckers are still looking for answers about what effect the new law will have on their own health care, their families and their bottom lines. To help truckers find the answers, the OOIDA Foundation brought in Rick Welsh, an insurance consultant with Welsh and Associates in Kansas City. He conducted a seminar Saturday morning to discuss a "tree-top level" overview of the changes facing individuals.

Welsh said the biggest change for both individuals and insurance providers is that insurance can no longer be denied to anybody based on health status. The ACA also bans lifetime and annual coverage limits; mandates enhanced emphasis on preventive care; and places a maximum 90-day waiting period on enrolling new employees in employer-provided plans.

As far as the new rates, Welsh said he's seen an impact for both older and younger clients.

"What I've seen so far is rates have come down a little bit for older folks," he said. "Younger folks are paying two to three times what they used to."

Welsh noted that the law has also changed the types of plans insurance companies are legally obligated to offer. All plans must now provide "Essential Health Benefits" – a series of 10 criteria that will make all insurance policies much more comprehensive.

About 80 truck show attendees listened to Rick Welsh's
presentation Saturday morning on the Affordable Care Act
and its impact on individuals and small business owners.

Those essential benefits include coverage for outpatient care, hospitalization, prescription drug coverage, emergency room care, mental health services, preventive care, rehabilitative care, laboratory services, pediatric care, and maternity and newborn care.

The caveat with having more comprehensive insurance, according to Welsh, is that comprehensive coverage costs more.

"There's not going to be any shell game anymore," he said. "If you see a policy for $300 a month, that's what you're going to pay. ... It's going to be a lot easier to figure out. You won't have to worry about something hidden in the fine print."

Under the new law, rates will be determined by four factors: age, area, marital status, and tobacco use. With age, rates are capped at a three-to-one ratio, where the most expensive policies can only be up to three times the rate of the least expensive.

Welsh also pointed out the ACA implementation will bring changes to Flexible Spending Accounts, which will now be capped at $2,500 annually.

Annual deductibles will also be capped at $6,350.

The Individual Mandate for Affordable Care Act takes effect on Jan. 1, 2014. Individuals who do not have a health care plan through their employer or those who don't qualify for veterans benefits or Medicare and Medicaid will be required to purchase a qualified health care plan or face a tax penalty.

Penalties will be 1 percent of the individual's adjusted gross income in 2014. For an individual making $40,000 per year, that amounts to a $400 tax hit. Penalty rates will increase to 2 percent in 2015 and 2.5 percent in 2016 before being chained to inflation index in subsequent years.

Open enrollment for this year runs from Oct. 1 to March 31, 2014. This is the only year for the extended open enrollment. Subsequent years will be from Oct. 15 to Dec. 7, the same time period as open-enrollment for Medicare.

OOIDA is currently working to set up a pilot program of private health insurance exchanges in six states. For more information about ACA, contact the Medical Benefits Department at OOIDA.

Boots on the ground

Do you know who your lawmakers are? And, just as importantly, do they know who you are?

One of the greatest assets of this Association is the line of communication that members establish with their elected officials and congressional staffers. But what does it take to establish those relationships?

OOIDA's Washington, D.C., staff hosted a seminar on Friday of truck show weekend to provide tips to members on how to break the ice with their lawmakers and build an ongoing dialogue.

"We are the boots on the ground, the bridge between members and lawmakers," OOIDA Director of Government Affairs Ryan Bowley told an assembled group during Friday events. "But you are the experts."

Getting to know the staffers in congressional offices is important. Often, they are the ones who deal with issues directly and who can track the comments and feedback on important issues.

Staying on topic is important and effective, says Bowley, whether it's about a Call to Action or educating a lawmaker or staffer on an issue.

"Make sure you have an agenda for your call," Bowley told the group. "Focus on one specific thing, whether it's HOS, or CSA. If you establish a relationship, you have a chance to bring up other issues at a later time."

Ryan Bowley and Ben Siegrist from
OOIDA's Washington, D.C. office

OOIDA Legislative Affairs Director Ben Siegrist says a call-in or email campaign can have a direct effect on an issue if the staffers or members of Congress know who is doing the talking.

"Your message carries a whole lot more weight when they are familiar with you and familiar with the issue," he said.

A second part of the seminar dealt with navigating the complex  – and, for many, intimidating – regulatory process. Bowley and Siegrist discussed the importance of filing comments on proposed regulatory changes and rulemakings.

"This is where details are filled in and the rubber meets the road," Bowley said. Again, staying on topic and responding to specific points in a proposal has the most effect.

During a question-and-answer period, OOIDA Member Mark Elrod said a visit to D.C. helped him realize that there's no quick fix on any issue. He added, however, that everyone he met seemed genuinely interested in his perspective.

"It was a real eye-opener for me," Elrod said. "They do like hearing from common people in Washington, and common people can make a difference."