National Council on Medicaid Home Care Sends Letter to State Medicaid Directors on the Potential Effects that the Employer Mandate May Have on Home Care Paid for by Medicaid
May 16, 2014 10:06 AM
NAHC’s affiliated National Council on Medicaid Home Care (The Council) recently sent a letter to all state Medicaid directors on the subject of the Affordable Care Act’s Employer Mandate and its effects on Medicaid. The Council’s Executive Director, William A. Dombi, sent the letter to all state Medicaid Directors to highlight, “a Medicaid impact of the Affordable Care Act that may have been overlooked, but is in need of quick and comprehensive action.”
According to the letter:
“The employer mandate under the ACA poses a serious threat to the future availability and quality of Medicaid home care services. A recently conducted survey of home care companies across the nation shows that well over three-quarters do not offer health insurance to their caregiver employees. As a result, these companies face a significant cost increase for compliant health insurance (approximately $2-3 an hour) or a $2,000 penalty for each full-time employee working 30 hours or more per week. Current Medicaid payment rates are insufficient to cover these added costs...
Medicaid programs have increasingly rebalanced their spending on long-term services and supports towards home care and saved millions of dollars in doing so while enhancing the quality of life for Medicaid beneficiaries. To continue down this successful path, a remedy for the cost increases triggered by the ACA employer mandate must be found, and soon.
Home care companies have evaluated the option of reducing working hours such that few if any caregivers work more than the ACA full-time standard of 30 hours per week. That option is not realistic as it will lead to unmet needs, higher training, supervision, and recruitment costs, and risks to quality of care as part-time workers become the norm. Further, it will add complications for beneficiaries as multiple new caregivers replace a known single caregiver.”
The letter goes on to offer a call to action for Medicaid Directors:
“The best solution to these concerns at the moment is to extend “transitional relief” (a delay) for Medicaid home care employers. Delaying the ACA employer mandate until such time as state Medicaid programs have devised and implemented program changes to accommodate the mandate is necessary if care to the vulnerable people receiving Medicaid home care in your state is to continue.”
To read the full letter, please click here.
The letter to Medicaid directors is one part of a broad strategy that NAHC is employing to address the adverse effects of the ACA employer mandate. Earlier this year, NAHC joined other organizations advocated for a general delay in the mandate. The IRS recently delayed the mandate for certain employers and modified it for larger companies. In addition, NAHC supports legislation that redefines "full time employee" from the current 30 hour a week standard to 40 hours per week, reflecting the normal definition in business practice.
Additionally, NAHC has sought the establishment of a tax credit for individuals who purchase home care services thereby supporting home care clients who Ned help to cover the higher cost of care necessitated by providers raising charges to cover ACA costs.
Finally, NAHC continues to seek an exemption of home care employers from the mandate if there is no federal funding or tax relief that supports the new ACA costs.
To learn more about the National Council on Medicaid Home Care, please click here.