Trying to explain health reform is likely to invite plenty of pain

Tuesday’s Republican electoral victories were a shellacking for President Barack Obama, and J. Todd Taylor did not fare so well, either.

The Randall Danskin attorney has agreed to speak first in a series of three Greater Spokane Incorporated workshops on the Patient Protection and Affordable Health Care Act – Obamacare to its detractors.

A tax specialist, Taylor says he became a student of the legislation because so many of his clients were asking about the implications for their businesses. And Randall Danskin likes to designate a lead attorney when a new issue compels the firm to get up to speed quickly, if only to get ahead of the scam artists already peddling “gap” policies and other snake oil.

Now, Republicans in the U.S. House of Representatives are positioned to impede implementation of health care reform until the party has the numbers in the U.S. Senate, and their candidate in the White House, to repeal it altogether. The bulk of the bill’s provisions do not take effect until 2014, giving foes lots of time to meddle and supporters equal time to promote benefits that are already becoming popular.

Or, in the meantime, the courts could find unconstitutional the bill’s provision requiring everyone to obtain health insurance or pay a penalty.

Which is where Taylor says the misconceptions among business owners start.

“They just assume there are going to be massive changes,” he says.

If they offer insurance, the plans will be grandfathered unless significant changes are made in co-pays, contributions or benefits.

If they have fewer than 50 employees, “pay or play” is not an issue for them, only their employees.

Many, according to news reports, are seizing on tax credits of up to 35 percent initially for employers of 10 people or fewer. The credit shrinks as the work force or salaries increase. More than 100,000 Washington small businesses may be eligible.

A provision that has the government paying a portion of health insurance premiums for employees who retired early has already taken effect. The program expires in 2014, or when a $5 billion appropriation is exhausted.

Although many presume premium increases will accelerate — how much faster can they go? — Taylor says the insurance exchanges that are supposed to be in place in 2014 are fundamental, competitive free markets that will remove the opacity that characterizes health insurance and health care today.

“It’s a massive machine, and there’s so much money in it,” says Taylor, who could well have been describing American elections.

Taylor will not speak to a happy audience at the first workshop Tuesday morning. Nor will accountant Greg Stewart, who follows on Dec. 14, and Payne Financial Group Managing Executive Angela Downing, who’s up on Jan. 11.

A GSI survey found overwhelming hostility to the reform bill based on a broad belief it will increase costs, compromise care and discourage job formation.

What it does for sure, and what repeal efforts will exacerbate, is create uncertainty, the worst of worlds for anyone trying to do long-range planning for health or anything else. But pending further developments, Taylor’s basic advice is this:

“You have to plan for compliance.”