CHICKASHA —
The future of health care is a system of sticks and carrots for business owners, Jonathan Buxton, State Chamber of Oklahoma, said.
"The carrots make you want to do the right thing and the sticks make sure you do the right thing," Buxton said.
Buxton was the special guest speaker at the Chamber Cafe meeting on March 6, hosted by the Chickasha Chamber of Commerce. These meetings are offered chamber members once a quarter.
Oklahoma is not moving forward, Buxton said. Other states, such as Wisconsin have been more innovative to keep up with the changes.
Some of the sticks take a thwack at businesses, while others hit employees where it hurts.
"ACA doesn't require that you give insurance, it just penalizes you if you don't," Buxton said.
Calculating what makes an employee full time is not as easy as one might think, Buxton said. Whereas most think that full time is 40 hours or more a week, 30 hours a week is the new number. Employers will need to use a formula which calculates the number of hours worked by all employees divided by 120.
This has led some companies to split their employee base, Buxton said. For example, Company A will hire a set of employees for 20 hours and Company B will use the employees for another 20 hours.
Some big decisions will need to be made soon, as enrollment will start eight to 12 months payroll from 2013, which is as soon as April.
The requirements for affordable coverage go beyond "catastrophic coverage" which Buxton said he remembers being adequate for himself when he was 20 and healthy. The new requirements are that the coverage: covers essential health benefits, employee costs exceed 9.5% of income and the insurance doesn't meet 60% coverage threshold.
Some of the sticks for employees may include the ratios being affected by smoking, age and even tanning and pharmaceutical use.
"We may see a larger uninsured population," Buxton said.
Small, rural hospitals might be feeling the hit, Buxton said. There are about 35 rural hospitals in the state that could potentially close.
Benefits may no longer be something that employees can expect, but rather be grateful for, Buxton said. Benefits could be used as a way to draw in workers.
There is a small business health care tax credit, which Buxton said was one of the "carrots." Some of the requirements for this tax break include having employees with 25 or fewer full time equivalent and an average annual wage of $50,000 or less.
Buxton pointed business owners towards research points of interest such as the state chamber website, the National Federation of Independent Business and the Kaiser Family Foundation, where they can learn more.
"All these resources are free and on the web. Google is your friend, just check the date."
Buxton said he hopes that the people will respond to the new changes and work towards improving the carrots and minimizing the sticks.
"We can survive, but it's really a new perspective."
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