Gordon doesn't expect state Attorney General Scott Pruitt's challenge to the Affordable Care Act to prevail. Based on standing, “only citizens, not states, have the right to sue the federal government,” said Gordon, who expects taxpayers will bring challenges — but only after individual taxes are assessed and paid.
Crowe attorney Cori Loomis said 2013 is the critical year for employers to make adjustments to their workforce. Some, Loomis said, are limiting employees' hours to avoid mandates required of businesses with 50 or more full-time equivalent employees. Others, she said, are contracting staffing firms versus hiring employees.
Conference attendee Thomas Belding, who sells stop-loss insurance to companies that self-fund health plans versus contract fully-insured plans, said more Oklahoma companies are following a nationwide trend toward self-funding. Though employers assume more risk, they avoid many government mandates and hold down costs, Belding said.
Analysis published Thursday by the Robert Wood Johnson Foundation showed that, of Oklahoma employers who offer health plans, 38.9 percent were self-funded in 2011, up from 33.5 percent in 2001. Of those with fewer than 50 workers, 14.1 percent self-funded in 2011, up from 10.4 percent in 2001.
Patti Davis, Oklahoma Hospital Association executive vice president, said she hoped state leaders would expand Medicaid. The hospital and nursing home industries agreed to cuts in government reimbursements under the ACA in exchange for a greater number of insured patients, she said. “Without expanding Medicaid, Oklahoma not only will lack those patients, but also the federal funds,” she said. “It'll be a double whammy.”
Davis said expanding Medicaid by 2020 would bring 23,500 new high-salaried jobs to Oklahoma, with associated revenues. Most importantly, research shows increased access to health care translates into better health outcomes she said.
Robert Roswell, physician and associate dean of the University of Oklahoma College of Medicine, focused on the need to coordinate services, thereby improving care and cutting costs. “The ACA's coverage reform will be what drives payment reform, and payment reform ultimately will drive delivery reform,” he said.