The National Association of Health Underwriters (NAHU) reported that members of both the Senate and House Small Business Committee expressed concerns over implementation of the Patient Protection and Affordability Act (PPACA): “During a Senate Committee on Finance hearing, Senator Max Baucus (D-MT), the Committee’s chairman, expressed some serious concerns regarding the Obama Administration’s handling of the implementation of the health reform law he helped to draft…HHS Secretary Kathleen Sebelius testified on behalf of her agency and the president’s budget proposals in front of the Senate Finance Committee…During Sebelius’ testimony, Senator Baucus questioned her on the implementation efforts of the law, state exchange preparedness and employer and small business knowledge. Despite the secretary’s efforts to reassure the committee that exchanges will in fact be set up and ready for open enrollment come October 1, 2013, Senator Baucus expressed his fears that unless the administration improves its outreach efforts to businesses in particular, health reform implementation will be a “huge train wreck.”
Baucus expressed concern that “Many consumers…will not have enough information available to them to make informed healthcare decisions. Small businesses are going to struggle if the administration doesn’t provide them with more information and more assistance in the near-term future.”

In rebuttal, “Sebelius informed the committee that, come summer, there will be many people on the ground in every state educating the American people on the law and what to expect in the months to come. Additionally, she promised that HHS will be holding webinars to educate people on the role of navigators and how they may be of help during this process. However, when Senator Baucus asked for concrete data on the people in each state who will be going around educating people, the secretary had no answer.”

Meanwhile Health and Human Services (HHS) “is requesting from Congress an additional $554 million to be used for outreach and education related to implementation of PPACA. While HHS may have a concrete use in mind for the money, it is highly unlikely that a Republican-controlled House will approve the additional funding. Recent surveys have indicated that the majority of the American public do not have enough information and do not have a true understanding of how the health reform law will impact them. There is a clear need for more education and outreach of PPACA.”

In a separate article, NAHU reported that during the same week, “The House Small Business Committee held a hearing to discuss PPACA implementation. During opening remarks, Chairman Sam Graves (R-MO) expressed serious concern over the impact of employer rules, high costs and inevitable staff cuts that will occur as a result of the health reform law. Ranking Member Nydia Velazquez (D-NY) acknowledged the fact that insurance premiums under the health reform law are likely to increase but wanted to discuss ways to improve the take-up of small business tax credits…Specifically, Doug Holtz-Eakin, former director of the Congressional Budget Office, noted that we are still unaware of the true economic impacts of the law. He stated that the law will cost “$24 billion and 80 million hours of paperwork… time spent complying with those regulations, to give you some perspective, that’s 40,000 full-time employees filling out paperwork for a year nonstop….

“A small-business owner who, on behalf of NFIB, testified at the hearing said that the 30-hour requirement is the most detrimental employer requirement because many employers will cut hours to employees so they don’t have to pay the benefits. It is not that the employers do not necessarily want to offer their employees coverage; it is that they cannot afford to. The CFO of another very small business also testified during the hearing. In this case, however, the small business applied and received tax credits made available under PPACA. As a result, for the first time ever, this company’s costs went down 12%.

“The law’s unpredictability was discussed, specifically in terms of the challenges it poses to consumers and small businesses…A whopping 97% of the nation’s small businesses have fewer than 50 employees. Representative Kurt Schrader (D-OR) highlighted that something had to be done within the law to make compliance with PPACA more feasible for businesses with less than 100 employees…Insurance premium cost differences between the young and the old and what that means for small businesses was a hot topic during the hearing too.”

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