What ACA Regulatory Surprises Will the Administration Unveil Over the Holidays?

December 13, 2013

With the Administration’s history of rolling out significant Affordable Care Act regulations around holiday periods, expectations are that the final employer penalty and IRS reporting regulations could be posted just before Christmas Eve or shortly thereafter.  The final rule will likely require employers to make costly changes to their HRIS and payroll systems, and the final employer penalty rule could settle the following outstanding issues:

  • How to determine if a new employee is "reasonably expected" to work full-time (average 30+ hours per week);
  • The definition of seasonal employees that may include a specific number of months and how to address breaks in employment;
  • What special rules, if any, should be put in place to determine the full-time status of short-term employees;
  • How the employer penalty provisions should apply to high-turnover positions as well as those positions where employment may terminate within three months of an employee’s start date; and
  • How the employer penalties should apply to employers participating in multi-employer plans.
Separately, the Administration announced several actions this week to help people whose plans were cancelled this fall for not complying with the ACA mandates, seeking to avoid potential coverage gaps because those adversely affected can’t get through Healthcare.gov to sign up by December 23.  Further, the House passed a three-month Medicare "Doc Fix" along with its budget bill to ensure provider payments are not cut by 20 percent on January 1.  The House measure also provides time for a permanent fix next year that could include provisions improving the transparency of Medicare provider payments.