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Q&A: Jim Hamilton

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Executive Q & A

Jim Hamilton, an employee-benefits lawyer at Bose McKinney & Evans in Indianapolis, discussed the likelihood of a Republican-controlled U.S. House of Representatives changing or even outright repealing the health care reform law, formally known as the Patient Protection and Affordable Care Act.

IBJ: With Republicans controlling the U.S. House but not the Senate, how much room will they have to try to repeal the health care reform law?

A: My sense is there will be bills introduced in the House to repeal all or part of the Affordable Care Act. However, those bills will largely be symbolic. There is virtually no chance the Affordable Care Act will be repealed before 2013 [due to President Obama’s certain veto]. Even if a Republican president were to win in 2012, I think many of the provisions of the law would remain. Those are the provisions that require an employer to cover a child up to age 26, no pre-existing conditions, no lifetime limits. Those provisions are viewed by most Americans as being positive.

IBJ: Does that leave House Republicans any real options to make good on their campaign promises to repeal or reform the health care law?

A: It’s more likely that Republicans will withhold money needed for agencies to enforce the law--Internal Revenue Service enforcement of the individual mandate and potentially the employer penalty. We should also expect some interesting hearings, with the secretary of Health and Human Services and the director of Medicare. There will be lots of hearings on the health reform bill to continue to keep this issue in the news. Certainly, it has been a major campaign issue in 2010. I believe that some Republicans would like to see this remain an issue until 2012.

IBJ: Are there any changes to the health care reform law for which Republicans could gain Democrat support?

A: It is possible that a Republican-controlled House may get some traction on, like the 1099 issue. If I’m a small business, and over the course of the year I buy more than $600 worth of paper from Staples, I’ve got to [send an IRS Form] 1099 [to] Staples. There is an understanding among many in Congress that this provision is difficult. Also, the ability of an employer health plan to receive grandfather status. There has already been some slippage on this. If you’re fully insured and you change insurance companies, does that automatically result in loss of grandfather status? The initial answer was yes, that causes you to lose grandfather status. But now the federal government is looking at it. Certainly, a Republican-controlled House will enhance the likelihood of exceptions. The federal government may be more lenient in allowing employers to be able to retain their grandfather status.

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  1. These liberals are out of control. They want to drive our economy into the ground and double and triple our electric bills. Sierra Club, stay out of Indy!

  2. These activist liberal judges have gotten out of control. Thankfully we have a sensible supreme court that overturns their absurd rulings!

  3. Maybe they shouldn't be throwing money at the IRL or whatever they call it now. Probably should save that money for actual operations.

  4. For you central Indiana folks that don't know what a good pizza is, Aurelio's will take care of that. There are some good pizza places in central Indiana but nothing like this!!!

  5. I am troubled with this whole string of comments as I am not sure anyone pointed out that many of the "high paying" positions have been eliminated identified by asterisks as of fiscal year 2012. That indicates to me that the hospitals are making responsible yet difficult decisions and eliminating heavy paying positions. To make this more problematic, we have created a society of "entitlement" where individuals believe they should receive free services at no cost to them. I have yet to get a house repair done at no cost nor have I taken my car that is out of warranty for repair for free repair expecting the government to pay for it even though it is the second largest investment one makes in their life besides purchasing a home. Yet, we continue to hear verbal and aggressive abuse from the consumer who expects free services and have to reward them as a result of HCAHPS surveys which we have no influence over as it is 3rd party required by CMS. Peel the onion and get to the root of the problem...you will find that society has created the problem and our current political landscape and not the people who were fortunate to lead healthcare in the right direction before becoming distorted. As a side note, I had a friend sit in an ED in Canada for nearly two days prior to being evaluated and then finally...3 months later got a CT of the head. You pay for what you get...

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