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January 24, 2014

Rep. Bucshon heeds local views on health law fixes

Roundtable talk brings varied voices on issue

TERRE HAUTE — Improving preventative health measures, problems of increasing costs and worker hours were among concerns as well as benefits presented during a roundtable discussion of the Affordable Care Act conducted Friday by Eighth District U.S. Rep. Larry Bucshon, R-Newburgh.

The roundtable was hosted on the campus of Saint Mary-of-the-Woods College with 13 people, including county government officials, business people and professionals.

Bucshon, a heart surgeon, opposes the act and has voted to repeal and replace it. “I think the Affordable Care Act is not the right approach,” he told the roundtable. Bucshon said the act is a move to make the federal government the sole provider of health insurance and eliminate the private sector.

Mary Ann Conroy, chief executive officer of Terre Haute Regional Hospital, voiced more optimism for the health care law.

She said with the advancement of medical technology, drugs and more efficiencies in treatments, many surgeries, such as knee replacement, are done as out-patient surgeries.

“I am optimistic. I think that we will figure this out,” Conroy said. “This is a way of evolving to a better place. We will never be finished, and one piece of legislation is not the final answer.”

Conroy said she is concerned about a potential shortage of primary care physicians and nurses, as patient numbers increase and more people obtain coverage. However, Conroy referred to Marian University in Indianapolis, which has opened a new medical school.

“That is music to my ears,” she said.

“In Terre Haute, we have not had the layoffs. I would also say there are plans, whether it is ACA related or prior to ACA, there will always be negotiations with providers with panels at hospitals based upon some quality and cost measures,” Conroy said.

Conroy said Terre Haute has more than 15,000 people in Terre Haute and more than 25,000 people in the Wabash Valley who are uninsured. “They need health care,” Conroy said.

She said more than 16 percent of patients going to the hospital’s emergency room are either no-pay or self-pay. “That is not Medicaid, which is considered a payer,” she said. “We are optimistic that the ACA will change that.”

Conroy said she thinks the cost curve of health insurance will change “when we take more responsibility for being healthier. I think we need to be much more aggressive with our kids and us.” She said wellness clinics offered by companies can increase preventative care measures.

Patrick Carney, vice president of employee benefits for Old National Insurance, asked Bucshon how much momentum there is in the U.S. House and Senate to designate 40 hours as full time for workers under the health care law.

Bucshon said he thinks there is no momentum in Congress to do that.

“I am sure there is no momentum to get it to 40, but if there can be progress to go to 32 hours or 33 hours as full time. I think that would be for a lot of employers, large employers, a pretty big win,” Carney said.

Large employers, especially manufacturers, are facing new fees. “The re-insurance fee is $63 per month per employee. That can be $60,000, $70,000 or $150,000 of additional cost. When you look at the re-insurance fee and what is it there for, it is to stabilize the individual market,” Carney said.

“So you have large employers helping to stabilize the individual market. I understand someone has go to pay for this bill. We all are in some aspect,” Carney said.

Carney said fully insured, self-fund plans pay the $63 along with an additional fee that adds 2.6 percent to the premium cost.

“These are costs that employers are having to pay in 2014, even though Indiana did not expand Medicaid,” Carney said.

“Managing hours and fees are hitting large employers,” he said, which may result in some large employers not offering health insurance to part-time workers.

Carney said small employers with up to 50 workers will see rates rise 30 percent to as much as 80 percent or higher at the end of this year. “They can accept it and move on; drop their health insurance and allow their employees to go into the exchange; go self-funded if they have the capital and the risk to take that on; join a PEO (professional employer organization); or join an association. I think you will see a lot of small groups just dropping their health insurance,” Carney said.

Scott Womack, president of Womack Restaurants, said his company under the health care law had to offer insurance to about 300 people. However, most part-time employees have opted not to take the insurance because of the expense.

“They have access to insurance plans now that cost less money, but they do not buy those either,” Womack said. “That is what we are waking up to in our industry. The industry employs 13 million people [nationwide] and roughly 10 million are not insured. Those folks will probably not buy a plan because they can’t afford it or don’t want to buy it,” he said.

Womack added that the restaurant industry is “seeing a shifting of providers from employer plans and individual plans to Medicaid and Medicare, but we are not seeing all these uninsured folks saying they will [get insurance],” Womack said. “I think we will have this large chunk of people who won’t buy the coverage, but we will have all the regulations that go along with it.”

Scott Bieniek, an attorney from Greencastle, said he was self-insured, but “I got one of those famous cancellation notices.” Bieniek said market place insurance would have doubled his costs. He was fortunate to get onto an insurance plan through his wife’s employer, he said.

“Without my wife’s insurance, we might be among the uninsured because we don’t have the room in our budget to afford that sort of cost,” he said. Bieniek said the health care act is a subsidy, “but the problem is it is a blind subsidy. It doesn’t impact each of us the same way. I would carry a disproportionate share if I join the market place to help others get insurance.”

Bieniek said he also would be forced to move to a large metropolitan area if he were to lose insurance from his wife’s employer in order to afford insurance.

The roundtable also included others such as Danny Tanoos, superintendent of the Vigo County School Corp., Terre Haute Mayor Duke Bennett, and Vigo County Commissioner Mike Ciolli.

Reporter Howard Greninger can be reached at 812-231-4204 or howard.greninger@tribstar.com.

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