Nursing homes & home care agencies seek health law exemptions
An interesting article in Sunday’s New York Times points to the financial difficulties many nursing homes and home health care agencies will face starting in 2014 in order to comply with the new federal health care law. The new health care law is supposed to guarantee access to affordable coverage for all. But many nursing homes and home care agencies have started lobbying efforts seeking some kind of exemption or special treatment. Starting in 2014, the law will require employers with 50 or more full-time employees to offer affordable coverage or risk paying a penalty. For a midsize nursing home, that penalty could easily exceed $200,000 a year. The American Health Care Association, the largest trade group for nursing homes, says the problem is that reimbursement rates for Medicaid and Medicare do not pay them enough to offer their employees medical coverage.
When nursing homes do offer health insurance to employees, the benefits are often limited and the coverage is probably not up to what will be required by the federal law. The group is lobbying for options that would give nursing homes more time to comply with the requirement to offer coverage. Another option would waive or reduce the penalties for nursing homes placed in financial distress as a result of the new mandates and fines. Another option could allow nursing homes to take tax deductions for the penalties, which under the 2010 law are nondeductible.
According to the National Association of Home Care, the new law will impose huge costs to its members that provide medical care and social services to people living at home. Home care agencies, which are even less likely than nursing homes to offer coverage to employees, are also seeking an exemption or financial assistance, contending that they would otherwise have to increase charges to their clients, older Americans and people with disabilities. The association recommends that Congress exempts home care providers from the employer responsibilities or require Medicare and Medicaid help defray the costs. Others argue against the lobbying efforts to rewrite these particular provisions of the health care law. Proponents of the law maintain that with the provisions to expand Medicaid and subsidies to those employees that cannot otherwise afford coverage, and there is no need to provide exemptions or special treatment to eliminate the employers obligation to provide coverage to employees. Currently one in four care workers at nursing homes are uninsured, while one in three are uninsured for those providing care to people living at home.
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