The first broadcast in the new MedHQ webinar series, “How Rumored Changes to the Affordable Care Act Could Impact Your ASC Employees,” MedHQ shared insights and quick reactions to the Congressional “repeal and replace” plan released less than 24 hours before the webinar aired.


Moderated by Tom Jacobs, CEO of MedHQ, the discussion focused on the latest information available on a situation that is still very much in flux.

“Our goal is to help ambulatory surgery center (ASC) employers plan ahead for possible updates to the Patient Protection and Affordable Care Act (PPACA), one of the greatest drivers of business change in HR today,” Jacobs said. PPACA is commonly referred to as ACA, or Obamacare.

Jacobs explained that while a full repeal of the ACA cannot be accomplished through the current budget reconciliation process, a budget reconciliation bill can address provisions that directly relate to budgetary issues — specifically, federal spending and taxation, which cover many areas of impact for surgery centers.

A former ASC administrator himself, Jacobs shared several key takeaways based on his research and interpretation of the just-released plan. For example:

  • The proposed bill would significantly level the playing field for the self-employed – i.e., those that access the individual insurance market. “In the long run, this could pose a challenge for ASCs and other businesses,” he said, “because cheaper, better health insurance is a big part of attracting employees to work at an ASC. With government tax policy changing, to enable things like deductibility of insurance premiums for the self-employed, some employees may feel less loyalty to their employer. Overall, this would have an impact of our ability to recruit and retain staff.”
  • The proposed bill also creates refundable tax credits for those that get their coverage through the individual market, or through COBRA continuation. These are tied to age, with credits of up to $2,000 for those under 30 and up to $4,000 for individuals 60 or older. Current language caps the total refundable tax credit of $14,000 for a family. These tax credits begin to phase out for individuals who make more than $75,000 per year (and couples who make more than $150,000 per year).
  • Another area of the plan that could impact ASC employees proposes changes to rules governing healthcare savings accounts (HSAs). On the table now is an increase in the maximum contribution limit for HSAs to equal the amount of your plan deductible and out-of-pocket limitation. Other changes would allow HSAs to pay for over-the-counter drugs and allow both spouses to make catch-up contributions to the same HSA.
  • Finally, insurance premium cost differences between “grandmothered” plans (those put into place after ACA was signed but before all the rules went into effect) and ACA-compliant plans may impact ASC employees, reflecting core insurance market realities. “Grandmothered plans are lower in cost and a lot of small businesses have used them,” Jacobs said. “One issue, however, is that not all states opted to go that direction.” The proposed Congressional plan favors federal funding for state high-risk pools as a primary strategy to address cost differences.

The purpose of the MedHQ series is to provide continuing education and counsel that will help leaders and decision-makers navigate changes to continuously evolving employment market. The ongoing series will cover changes to ACA, employment regulations and up-to-date industry intelligence related to the drivers of business change in healthcare today, providing healthcare administrators and operations executives with greater access to news and expertise, and a knowledgeable place to turn with questions.