Healthcare Reform — So What? Now What?

Thursday, June 28, 2012 was a history-making day in the United States when the Supreme Court (SCOTUS) ruled the Patient Protection and Affordable Care Act (PPACA) was constitutional. It was a decision that shocked many — including me!

For the record, I believe the US system of healthcare absolutely needs reform. And I believe all Americans should have access to affordable care. It baffles me that this battle is still being waged and is so fiercely debated in one of the richest, most powerful countries in the world … However, I also recognize the potential fines on employers could cripple and permanently shut the doors on many already struggling businesses. So I understand why the legislation makes corporations nervous. That reality often makes the legislation feel bittersweet for me.

Ultimately, we’re a long way from full implementation of all aspects of this legislation. Although 2014 is the goal, it isn’t a hard and fast deadline; I suspect there will be lots of modifications to the timeline as the infrastructure is put into place on how this will work. In the meanwhile, I choose to have faith that things will work out for everyone’s good — and I focus my energy on what is going on right now as it relates to the PPACA instead of what could or might be. I encourage you to do the same.

Now that the SCOTUS has ruled in this matter and the PPACA will press forward, it’s time to think about “what’s next” for the organizations we serve. Here’s my tips on that:


  • Strengthen your benefits program. Work with your broker/reps/consultants to find options that will strengthen the options your organization offers. Add new benefits or make enhancements to existing plans where you can. Use caution in making any changes to plans that might cause you to lose grandfathered (GF) status, if you’ve already received a waiver from the Department of Health & Human Services. Once you lose GF status, there’s no turning back! But there are lots of enrichments you can make to your programs that won’t force a forfeit.


  • Monitor full-time and part-time designations. Employers are only in danger of being penalized for failure to provide adequate coverage to full-time equivalents (FTEs). The standards for “adequate coverage” still haven’t been defined and a definition isn’t expected until some time in 2013. However, FTE is a definition that we already know within our state and our organization. Audit to ensure your current workforce is properly designated and make changes if necessary. Keep in mind that designation changes might qualify adversely impacted employees for unemployment benefits and/or might persuade employees to seek employment elsewhere — not to mention general complaints surrounding fairness and employee morale overall. Anticipate issues and make sure you have a plan to address them. Discuss it with your attorney or union as well.


  • Educate yourself. Business leaders, especially HR, cannot afford to rely on television and printed news to gain knowledge about this issue. It is far too complex and politically charged. Instead, we need to find ways to learn about it on our own from sources that are as neutral as possible. I am already seeing free webinars, conference calls and seminars popping up to discuss the impact of the ruling on employers and benefits plans heading into the 2013 enrollment season. Sign up and listen up — for more than just one. If you can’t find anything, check with your insurance broker or with your attorney; I am sure they can point you in the right direction. If not, check with me — I am absolutely willing to help!


There is no doubt that Healthcare Reform is one of the top 5 “Issues of Our Time.” And it gives HR another opportunity to be front-and-center and shine, as we help our organizations to navigate through it.

That’s an honor and a privilege. Don’t screw it up.

Hey You!!! Stop Dissing Obamacare!

And stop calling it Obamacare, while you’re at it. It’s the Patient Protection and Affordable Care Act — or the PPACA (Pee-pack-uh). Healthcare Reform Act works, too.

But if you can’t say “Obamacare” without obvious disdain or excitement, you should probably use another word. At least while you’re at work. Especially if you work in HR or some related function.

A couple weeks ago, I conducted training with our HR Administrators, Payroll Specialists and A/P Clerks on our benefits plans. Since these 3 groups spend a lot of time working together on our benefits, premium deductions and premium payments; it made sense to bring them all together for refresher and to roll-out updated procedures.

We were about half way through the session and everything was going great. Great discussion, great questions and great nodding in all the right places. I was so pleased.

Then I moved into a segment on the PPACA. It was 4 – 5 slides about the history of the law, the current provisions we are required to enforce, the pending Supreme Court case and what the Court’s decision would mean for us and our plans, depending on what all they decide. I deliberately kept it very dispassionate and middle of the road. I wanted the group to walk away with the facts of what was, what is and what could be as it relates to our company and this law, separate and apart from any personal or political feelings.

Which is why I was really surprised when one of our A/P clerks walked out during the session. I heard her mumble something about “Obamacare” and a bunch of expletives, get up and leave. I was shocked and shaken by it. In over a decade in HR, I’d never had someone get so upset over a topic that they’d walked out of a training before. I didn’t know what to do. So I just kept going. There were 20 other people in the room who were still there and willing to listen and learn. I wasn’t going to further interrupt things by calling more attention to the outburst of one person. She returned about 30 minutes later and the rest of the day went off without incident.

I wasn’t going to just let the incident go, though. Clara the Clerk’s behavior was beyond inappropriate. I spoke with her supervisor about it and learned this wasn’t the first time this woman had an outburst or stormed out when she didn’t like the topic. The previous incidents had not been formally documented.

Well, this one was definitely going to be.

We brought Clara the Clerk into the office to discuss these issues with her. We wanted her to understand that her behavior during the training was disrespectful, disruptive and dangerously close to insubordinate. Since this was not the first time, we wanted her to understand that this was not acceptable and would no longer be tolerated.

Clara apologized for her outburst and for anything she’d said or done that made me and others feel disrespected. She said that wasn’t her intention. She said the current Presidential Administration and its actions upset her so much that she just couldn’t contain herself sometimes. She assured us that it wouldn’t happen again. She signed the warning without any fanfare.

The case was closed, but I still felt … some kind of way … about it.

I can’t imagine feeling so charged about something that I couldn’t even sit through a ten minute review of the subject. And I can’t imagine ever thinking it would be acceptable to walk out on any workplace training because I didn’t like the topic. Perhaps this is another one of the ways working in HR has made me soft? Perhaps I am too deferential, too “company” for my own good?

In this case, I say no.

Ultimately, whether we are in HR or some other support function, we are responsible to know, understand and enforce the laws applicable to our job and our industry. We may disagree with the law and dislike the people who enact it … but we’re still responsible to abide by it. Period.

You don’t like Obamacare … or SarbOx … or OSHA … or whatever the laws and regulations … That’s your prerogative. Now shut up about it and do your job.

Please and thank you very much.

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