Trumpcare and California Single-Payer Measures Gain Approval. What Does That Mean For Your Small Business?
What Is Trumpcare’s Potential Impact On Small Business?
Trumpcare, formally known as The American Health Care Act (AHCA) – the GOP-backed alternative to the Affordable Care Act (ACA) – narrowly passed the U.S. House of Representatives in a 217 to 213 vote on Thursday, May 4, 2017. As drafted, the AHCA would make some significant changes to President Obama’s health care measure that was signed into law in 2010. It would do away with the individual mandate that most Americans have health insurance or pay a penalty. It would also eliminate the employer mandate for businesses with 50 or more full-time employees to furnish them with health coverage or pay a penalty. It would allow states to seek a waiver on the ACA’s 10 essential health benefits (and, instead, give them the option to create their own list of required benefits).
For employer-sponsored health plans, the AHCA would allow health insurance companies to, again, impose lifetime and annual caps on benefits. It would further delay the planned 40 percent excise tax on high-end health plans to 2026 (after already being pushed back to 2020). And it would require a 30 percent increase in premiums to regain insurance for consumers who lose coverage for more than 63 days in a year, adversely affecting those with a pre-existing health condition. The bill has moved across the Capitol to the U.S. Senate, which has already made clear that it cannot be voted on without some changes. With just a two-vote Republican majority in the Senate and strong Democratic opposition to eliminating (or overhauling) the ACA, it would take just three GOP “no” votes for the AHCA to go down.
What Is SB 562’s Potential Impact On Small Business?
Meanwhile, lawmakers in Sacramento moved forward last month with legislation that would dramatically overhaul the health care system in the Golden State. California Senate Bill (S.B.) 562 would replace the current system of multiple health insurance companies vying for the business of California businesses and residents with a single-payer, government-run health care system. S.B. 562 passed out of the state Senate Health Committee on April 26 on a 5-2 vote after three-hour hearing. It was discussed by the Senate Appropriations Committee on May 22 – where it faced tough questions about funding for the sweeping overhaul of health care in California. An analysis of the legislation released at the committee hearing says creating a single payer health system in the state will cost an estimated $400 billion a year, including $200 billion in new tax revenue. Half of the $400 billion would come from existing local, state, and federal spending on health care.
The additional $200 billion would have to be raised through a new 15 percent payroll tax on employers and employees. According to one of the bill’s co-sponsors, State Sen. Ricardo Lara (D-Bell Gardens), the state analyst’s fiscal estimate is a “starting place” and details on financing the bill are expected in September. At $400 billion, the projected cost would be more than double the current annual state budget of $180 billion. That could make it a tough sell for residents. Already a wide variety of groups oppose the measure, including health insurance companies, employers, manufacturers, and business groups. The California Chamber of Commerce says S.B. 562 is a significant job killer. To learn more about national and state legislative efforts to change how businesses and employees get their health insurance, talk with your employee benefits broker. If you don’t already have a broker, we’ll help you find a CaliforniaChoice broker to speak with about health insurance options for your group.
[Infographic] Small Businesses Can Save Money On Health Insurance and Offer Great Provider Coverage With an EPO Plan From Anthem Blue Cross
An Exclusive Provider Organization (EPO) Medical Plan from Anthem Blue Cross offers access to a great provider network while still delivering affordable premiums. Anthem’s EPO provides access to some of the state’s premier names in health care. The infographic below highlights the coverage options available to small businesses and their employees in Orange County.
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Anthem Blue Cross EPO Plan Offers Flexibility & A Great Provider Network For Small Companies In California
If you and your employees want access to a great provider network and competitive rates, an Anthem Silver or Bronze Exclusive Provider Organization (EPO) plan, available through the CaliforniaChoice private exchange, may be something you will want to consider. What is an EPO? An EPO is a sort of hybrid plan that offers some of the flexibility of a Preferred Provider Organization (PPO) plan and the cost savings of a Health Maintenance Organization (HMO) plan. With an EPO, you don’t need to choose a Primary Care Physician like with an HMO; instead, you can directly connect with a specialist when you need care as long as you choose a provider from the EPO network. With the Anthem Blue Cross EPO, you get access to the Anthem Prudent Buyer Network – the largest network in the CaliforniaChoice portfolio. Plus, there are no more out-of-network provider charges when using an in-network hospital (if your coverage is effective July 1, 2017, or later). The Anthem Blue Cross Silver EPO A plan even offers no deductible on prescription drug benefits. (As you probably know, since the Affordable Care Act (ACA) was enacted, health plan benefit levels are divided into four metal tiers: Bronze, Silver, Gold, and Platinum.) With Anthem Blue Cross EPO coverage through CaliforniaChoice, from north to south and from the Pacific Ocean to the borders of Nevada and Arizona, enrolled groups can access some of California’s most sought-after providers.
In Orange County, the Prudent Value Network includes:
Hoag Memorial Regional Medical Center;
Mission Hospital Laguna Beach;
Mission Hospital Regional Medical Center in Mission Viejo;
Joseph Hospital in Orange;
Jude Medical Center in Fullerton;
Saddleback Memorial Medical Center in Laguna Hills;
University of California Irvine Medical Center.
In the Inland Empire, CaliforniaChoice members enrolled in an Anthem EPO plan enjoy access to:
- Community Hospital of San Bernardino;
- Desert Regional Medical Center, Palm Springs;
- Desert Valley Hospital in Victorville;
- Eisenhower Medical Center in Rancho Mirage;
- Loma Linda University Medical Center;
- Riverside Community Hospital;
- Mary’s Medical Center in Apple Valley.
In San Diego and Imperial counties, the Anthem Blue Cross Prudent Buyer Network includes:
- Rady Children’s Hospital, San Diego;
- Scripps Memorial Hospital in Encinitas and La Jolla;
- Sharp Memorial Hospital in San Diego;
- University of California San Diego (UCSD) Medical Center.
In Los Angeles and Ventura counties, providers in the Anthem Blue Cross EPO include:
- Cedars-Sinai Medical Center, Los Angeles;
- Community Memorial Hospital of San Buenaventura in Ventura;
- Glendale Adventist Medical Center;
- Huntington Memorial Medical Center in Pasadena;
- Keck Hospital of USC, Los Angeles;
- PIH Hospital Health in Downey;
- Providence Little Company of Mary in Torrance;
- Providence Saint John’s Health Center, Santa Monica;
- Ronald Reagan/UCLA Medical Center in West Los Angeles;
- Valley Presbyterian Hospital, Van Nuys;
- Ventura County Medical Center in Ventura.
In Northern and Central California, the Anthem Prudent Buyer network includes a roster of premier facilities stretching from the Bay Area to Sacramento County, San Joaquin County, Stanislaus County, Santa Clara County, and south to Fresno County.
Among others, the Anthem Blue Cross EPO providers in Northern & Central California include:
- Alta Bates Summit Medical Center;
- California Pacific Medical Center;
- Good Samaritan Hospital;
- Mercy General Hospital, Sacramento;
- Mills Peninsula Medical Center;
- NorthBay Medical Center;
- O’Connor Hospital, San Jose;
- Saint Agnes Medical Center, Fresno;
- Stanford Health Care;
- Sutter Medical Center (and other Sutter facilities);
- UCDavis Medical Center;
- UCSF Benioff Children’s Hospital Oakland.
The Anthem Prudent Buyer Network gives employers and employees access to more than 60,000 doctors and specialists and 330 hospitals. The appeal of Anthem’s EPO plans is reinforced by the fact that 96 percent of claims are processed in-network. Of course, an EPO is just one of a variety of great health plan options you and your employees can choose with the CaliforniaChoice private health insurance exchange. If you want like to learn more about EPO choices or the Anthem Blue Cross provider network, or if you want to learn about the CaliforniaChoice private exchange, talk with your employee benefits broker. If you don’t already have a broker, we’ll help you find a CaliforniaChoice broker to speak with about your group’s health insurance choices.
CaliforniaChoice Delivers More Choice
When it comes to employee health insurance, employers are in a tough spot. Every employee’s needs are different, so picking a one-carrier-solution is not likely to be satisfying for everyone in your group.
Fortunately, CaliforniaChoice offers you and your employees a variety of plans from which you can choose. And it delivers a variety of other benefits for your group, too, as highlighted in the infographic below.