Obamacare brings unknowns for employers and individuals alike

A Massachusetts maven on health care laws in his state and nationally said Wednesday in Carson City that Obamacare is akin to a famous quote by a former defense secretary.

Russell Sullivan, vice president of health care solutions for Associated Industries of Massachusetts, told a business-oriented Carson Nugget luncheon audience the federal law can be summed up by the 2002 defense news briefing quote from Donald Rumsfeld regarding known and unknown factors. He put the quote up during a power point presentation.

“There are known knowns; there are things that we know we know. There are known unknowns; there are things that we now know we don’t know. But there are also unknown unknowns — there are things we do not know we do not know.”

Sullivan, who has a law degree but doesn’t practice, focused on human resources problems in that thicket of knowns and unknowns during the talk sponsored by Carson Tahoe Health, the Carson City and Carson Valley chambers of commerce, and the Carson Nugget, which is a member of the Nevada Business Group on Health also involved in Wednesday’s program.

The health benefits expert was as precise as possible with recommendations based on what is known, but warned that people in government don’t yet have all the answers and take awhile to provide them. For employers, the law kicks in 2015 but he urged readiness well before that. The individual mandate, however, takes effect in 2014 and Sullivan predicts continuing problems with that.

Even though his presentation dealt mainly with employers and their “incredible” bramble of decisions on human resources going forward, his warning about the individual mandate rollout was clear.

“I don’t see how it’s going to make it,” Sullivan said. “It’s a lot of decision-making that’s unguided.”

He didn’t speak directly of the botched beginning for the national exchange website, though it was included as an item in his presentation.

Sullivan warned employers and their human resources personnel of “information overload and moving targets” both from current law or regulations and what may transpire even as the law rolls out and years roll by.

He also cautioned listeners about unintended consequences stemming from the Affordable Care Act, which is the more formal name for Obamacare. One he identified deals with spousal coverage.

Because the law doesn’t require that employers cover spouses as well as their employees, he said, an uncovered spouse who can get coverage through an exchange won’t be able to get in on subsidies aimed at making such insurance coverage more affordable. Another point he made is that only a few poorly paid employed people, those earning under $30,000 annually, would qualify for subsidies.

Sullivan at one point amused his audience with an anecdotal example to show why people may have trouble with ACA decisions, whether about coverage through employers or individually.

He said people don’t like sitting in a room for extended periods to learn how they might save thousands on health care benefits, though some will stand in line for hours during inclement weather late on Thanksgiving or early on Black Friday to save $2 on a toy purchase.