Surprising Parts of the Health Insurance Reform Initiative

Surprising Parts of the Health Insurance Reform Initiative

If you were unable to follow the twists and turns of the health care reform effort for the past year, you have my sympathy.  I try to hold back and wait until a law has been enacted to study up on it, to avoid confusion.  But it could be that even the lawmakers and those that enforce the laws will be playing catch-up to come to grips with new employee protections.

The Patient Protection and Affordable Care Act of 2010 makes changes to the Fair Labor Standards Act and the Family and Medical Leave Act.  These changes apply to employers with 200 or more full-time employees.  (Warning, this document is 906 pages long, without the “fixes!”)

First, all new hires must be automatically enrolled in a health insurance plan. This requirement is consistent with the underlying goal of enrolling everyone into a health plan so that health insurance companies are not stuck insuring only the sick. The employees may opt out of the coverage (for example, married couples may have two options for couples or family health insurance).  This provision is in section 1511 of the new law.

Second, these larger employers have to provide information to the employees about their coverage options and the availability of health insurance exchanges that may provide a more attractive plan.

Third, Section 1558 prohibits retaliation against employees for obtaining a subsidy or tax credit for their health insurance, or for providing information about violations of this new law The fifth provision is particularly strong: retaliation is prohibited against an individual who
objected to, or refused to participate in, any activity, policy, practice, or assigned task that the employee (or other such person) reasonably believed to be in violation of any provision of this title (or amendment), or any order, rule, regulation, standard, or ban under this title (or amendment).

Fourth, the law specifically incorporates the nondiscrimination provisions of the civil rights laws, barring discrimination on the basis of age, race, gender, religion, national origin, and disability.  It provides that no individual shall “be excluded from participation in, be denied the benefits of, or be subjected to discrimination under” health program or activity if it receives federal financial assistance.

Fifth, and most widely reported, the new health care law, in section 4207, requires employers to allow nursing mothers to pump milk at work.  If an employer has more than 50 employees, it must provide a private place (not a bathroom) and time (not necessarily paid) for up to a year after the baby’s birth.  Smaller employers may claim an exemption if providing this space and time “would impose an undue hardship by causing the employer significant difficulty or expense when considered in relation to the size, financial resources, nature, or structure of the employer’s business.”

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