The Election Is Over- So Now What?


More than anything, Obama now faces new urgent task…
President Barack Obama faces a new urgent task now that he has a second term, working with a status-quo Congress to address an impending financial crisis that economists say could plunge the country into further recession if not resolved.
“You made your voice heard,” Obama said in his acceptance speech, signaling that he believes the bulk of the country is behind his policies. It’s a sticking point for House Republicans, sure to discredit that fact.
The same voters who gave Obama four more years in office also elected a divided Congress, sticking with the dynamic that has made it so hard for the president to advance his agenda. Democrats retained control of the Senate; Republicans kept their House majority.  Obama’s list of promises to keep includes many holdovers he was unable to deliver on in his first term, such as rolling back tax cuts for upper-income people, overhauling immigration policy and reducing federal deficits. Six in 10 voters said in exit polls that taxes should be increased, and nearly half of voters said taxes should be increased on incomes over $250,000, as Obama has called for.
Obama’s re-election means his signature health care overhaul will endure, as will the Wall Street overhaul enacted after the economic meltdown. The drawdown of troops in Afghanistan will continue. With an aging roster of justices, the president probably will have at least one more nomination to the Supreme Court.
President Obama’s re-election ensures the survival of his Patient Protection and Affordable Care Act, but it doesn’t mean the law stays without continuing challenges.  Republican challenger Mitt Romney had vowed to repeal the law if elected; calling it a costly government expansion though the massive law was partly based on his own health care reform in Massachusetts.
“President Obama’s re-election provides American employers with the referendum to fully begin implementing the Affordable Care Act,” says International Foundation of Employee Benefit Plans CEO Michael Wilson. “Even after this summer’s Supreme Court ruling, many of our members were still awaiting the outcome of this general election before they addressed health care reform.”
The decision last night cements that it’s full steam ahead for the massive and long-panned out law, but it doesn’t mean it will be an easy road ahead. The majority of Americans are still unsure of their feelings on the law and what it means for them, and many experts believe the administration hasn’t done a good enough job of explaining it.
The biggest implementations haven’t yet gone into effect. There are a couple dozen lawsuits that seek to overturn the contraception mandate, which requires even church-affiliated institutions to cover birth control for their employees.
States also pose threats to the law. State officials have considerable sway over how the law is carried out after the Supreme Court gave them the power to reject the expansion of Medicaid. They are also battling the federal government over the law’s new insurance exchanges. Though states are due to give the government a plan detailing how they will roll out their exchange in a matter of days, less than half have begun setting up their exchanges, or have even agreed to do so. The law states that the federal government will set up exchanges in states that haven’t.
Unresolved issues
Though the health insurance industry congratulated Obama on his victory, they say cost within the health care industry is still a large and unresolved issue.
“As the health care reform law is implemented, policymakers must prioritize affordability for consumers and employers,” says America’s Health Insurance Plans president and CEO Karen Ignagni.
“The nation must also address the soaring cost of medical care that is driving up the cost of coverage, taking up a greater share of federal and state budgets, and threatening the long-term solvency of our nation’s public safety net programs,” she says.
It’s important to note that PPACA addresses only one of the three broad issues plaguing health care: access. Now, he says, both employers and government will need “more time to address the other two issues: cost and quality of care.” But now that the law is here to stay, businesses will have no other choice but to work with the president on the law’s requirements.
HHS Expected To Provide Rules On Exchanges, Other Provisions Of ACA. Modern Healthcare (11/8, Zigmond, Subscription Publication) reports, “While President Barack Obama’s victory Tuesday night ensured the continued implementation of the Patient Protection and Affordable Care Act, it also added pressure on the administration to offer healthcare interest groups more clarity on several provisions of the landmark 2010 law.” Many in the industry expect the Administration will “release a wave of policies and regulations quickly, especially as states have just until the end of next week to decide if they will establish a health insurance exchange.” Given the immediacy, rules regarding the exchanges are anticipated first. Next “to be issued are a rule on essential health benefits and guidance for employers about what constitutes part-time and full-time employees, as employers will face penalties for not offering coverage to their workers.”
Though an Obama victory wasn’t what the broker community at large wanted, many say it gives them clarity about the future as well as potential new opportunity.
“I think the best thing to come from last night, professionally, is the clarity that the Affordable Care Act will be implemented, and that we can all get past the excuses and on to the serious business of helping employers with what’s to come,” says David Smith, vice president of health and welfare benefits at Ebenconcepts in North Carolina.
Just as the Supreme Court ruling that verified the constitutionality of PPACA wasn’t the end of the world, neither is the news of Obama’s re-election.
Employers will need to be navigated through all the changes brought on by PPACA and it’s a broker’s opportunity and responsibility to be that trusted navigator. Brokers must get educated on PPACA, implement benefits administration technology for their office and their employers, and explore new products such as voluntary benefits or they should plan on exiting the business.

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