The delay and the domino effect: How delaying the employer mandate might affect ACA

I find the concept of falling dominoes both fascinating and fearsome. Fascinating that one simple—and perhaps inadvertent—act of physics can have such a profound affect on all actions that follow, and fearsome for the same reason.

I’ve found myself thinking of falling dominoes in recent weeks when I consider the ramifications of the federal delay of ACA’s employer mandate. As in, employers now have been relieved until 2015 of the requirement to provide health insurance coverage (and the reporting requirements that go with it). With that, it seems the first domino in the line looks a bit wobbly.

If employers aren’t required to report insurance information about their workforce—and the government also is relying on employees “self-reporting” their eligibility for subsidies when they apply for coverage through insurance exchanges—can the individual mandate, still on track for 2014, effectively be enforced? All of a sudden, that wobbly first domino looks like it’s full-on leaning.

Then, employees—especially the young and healthy ones who are being courted most aggressively by state exchanges—might start to think, “Maybe I really can get a better deal on the exchange. And maybe I am eligible for this subsidy … or at least claim that I am. Who would know? What’s the harm? I could save a lot of money.”

Or, they might think, as many do today, “I’m pretty healthy. Is it even worth buying health insurance at all?”

Get enough people who start connecting those dots, and that leaning first domino tips right on over. And the rest, as they say, will be history.

Is all of this conjecture at this point? Of course, especially when you factor in that a solid chunk of employees don’t know ACA is even the law of the land. Not to mention, even for employees who are aware of the nuances of self-reporting, it would be a pretty big risk to lie to the IRS (an agency that will already have their benefits info from their W-2s). And finally, researchers from the health care and economics fields have concluded that it’s a small sliver of Americans that will be subject to the individual mandate—the Kaiser Family Foundation estimates the number may be as low as 10%.

But is the falling domino effect feasible? Absolutely. And I’m not the only one who thinks so. ACA watchers talking to The Washington Post see the dominoes the same way I do.

“If Americans begin to figure out that the individual requirement is toothless for 2014 ... younger, healthier uninsured people will stay away in droves,” Edward Fensholt, director of compliance services for benefits consultancy Lockton, told the paper.

Your employee communications can help to make sure all health care dominoes stay firmly upright. And certainly keep you, your team and your call centers from tumbling over…Tell your employees in clear and certain terms:

• You are not eligible for the government subsidy.
• Do not try to apply for it through the exchanges.
• The benefits you get from our company are better and offer a fuller coverage value than anything you’ll get on the exchange.

Say it, and say it a lot.