4 'ObamaCare' Actions To Take Now

Many of the provisions of the Affordable Care Act -- so-called ObamaCare -- will be going to affect in the coming year. Despite its potential benefits for Americans, the law does pose some issues for employers. 

During the AICPA Not-for-Profit Industry Conference, Eddie Adkins of Grant Thornton and Cheryl Press of Tax Exempt and Government Entities (TEGE) at the Internal Revenue Service (IRS) discussed how employee benefits and compensation are affected by healthcare reform, particularly when it comes to full-time and part-time employees. They reminded listeners that the IRS has rules defining exactly who is and who is not a full-time employee, and those rules are complex.

What can nonprofits do to prepare for these regulations? Adkins and Press said that action should be take now, not later. Specifically, they recommended taking the following steps:

• Take time to thoroughly understand the details in the regulations. With complexity comes the chance of misunderstanding or misinterpreting. A few details could make a difference. 
• Convene a meeting of all stakeholders, including individuals responsible for health plans inside and outside the organization. This includes the employee benefits director, the insurance broker and legal counsel.
• Discuss the details of the rules and how they apply to the organization, and identify changes that might be necessary to avoid mandated excise taxes. 
• Follow through with proper implementation.

Breaking: Supreme Court Upholds Affordable Care Act

UPDATE: We have added more information to our story, including reaction from nonprofits


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In just the last few minutes, the United States Supreme Court has voted to uphold the Affordable Care Act (ACA) by a 5-4 vote. Chief Justice John Roberts cast the deciding vote.

The NonProfit Times has continuing coverage of this breaking story, so head on over to our website to follow our developing article on this breaking story. We will update this post whenever we update our story with new information.

Nonprofit Hospitals Accused Of Poor Charitable Care

A recent study by the Congressional Budget Office (CBO) found that many nonprofit hospitals provide only slightly more charitable care than for-profit ones.

A report on North County Public Radio (NCPR) expanded on this study by telling the story of Lori Duff from Columbus, OH. Duff had frequently visited a local nonprofit hospital called Mount Caramel Health for prenatal care while pregnant with her third son. She had assumed that, since she was earning less than 200 percent of the federal poverty level, that the prenatal care would be free. That's why she was shocked when debt collectors demanded $1,800 for her visits to the hospital.

A spokesperson for Mount Caramel, which sued Duff and several other patients for not paying their bills, told NCPR that its mission is to provide as much charitable care as possible, but it must collect payments from those who can afford to pay them.

This is not the first instance that nonprofit hospitals have been accused of stingy health care. Three Illinois hospitals were denied tax-exemption last year after it was deemed they did not provide enough free care. The Affordable Care Act of 2010 attempted to address this type of issue by setting new rules for how nonprofit hospitals report its charity care. These new rules went into effect last year but have not been widely enforced. Here are some of the requirements:

• Nonprofit hospitals are prohibited from charging uninsured low-income payments higher rates than the lowest amounts billed to individuals with insurance.
• They must have a clearly written financial assistance policy describing who is eligible for free or reduced cost care.
• Extraordinary collections actions are not allowed against patients before determining whether the patient qualifies for financial assistance.

You can read the full story on NCPR's website.

Can Illinois Nonprofit Hospitals Keep Their Tax Exemptions?

Illinois governor Pat Quinn last year told the state to stop challenging nonprofit hospitals' property tax-exemptions so the state could come up with a solution.  The goal was to come up with guidelines for what would constitute appropriate levels of care by March 1.  With that deadline quickly approaching, details are emerging about potential proposals.

The Chicago Tribune reported yesterday that the state is considering competing proposals that would set up standards for how nonprofit hospitals could keep their tax exemptions.  This issue came to the forefront after the Illinois Department of Revenue denied three hospitals their tax exemption, citing a 2010 Illinois Supreme Court ruling that defined the amount of money that needed to be put into care.  Gov. Quinn later told the state to hold off on any further rulings so he could work with the hospital industry and legislators to find a compromise.

The first proposal was sent to the Governor's office on Feb. 17 by the Fair Care Coalition, a group of healthcare advocates.  Their plan states that each hospital would have to provide 6 percent of its total revenue for charitable benefits in order to keep tax exempt status.  Eighty percent of that would have to be in the form of free or discounted care for poor patients.  Failing to meet these standards would not only make hospitals ineligible for tax exemption, but would also make them pay into a pool of funds that would be distributed to nonprofit and public hospitals that met this criteria.  It seems unlikely the Illinois Hospital Association would agree to this proposal, as they have opposed similar measures in the past.

Another proposal came on Monday from the Civic Federation.  Under the Federation's proposal, hospitals would be required to provide charitable care and other benefits to the community equal or greater than the amount they would pay if they paid property taxes.

Gov. Quinn's March 1 deadline is only two days away.  It's not clear what will happen if a compromise is not reached before that date.  You can read the full story in The Chicago Tribune.

Pennsylvania Nonprofit To Study Gas Drilling

With concerns rising over gas drilling in a Pennsylvania rock formation, a nonprofit has stepped up to see if there are any health risks as a result of the work.

CBS News reported today that the Southwest Pennsylvania Environmental Health Project has opened an office in western Pennsylvania to study the effects that gas drilling in the Marcellus Shale formations may have on public health.  People in the community worry that, because they live near the drilling sites, their health is at risk.

The project already has several paid staffers, including a nurse who will do house calls in Washington county for citizens who believe they are sick because of the drilling.  The nurse will also provide referrals, help patients with the healthcare system, and consult with environmental health specialists.  The organization's director, Raina Rippel, said all of the services are free of charge.

Rippel told CBS News that the Environmental Health Project has met with public health officials, and will continue to work with them to try and find a definitive answer.  As of now, it is not entirely clear that gas drilling is the reason people are getting sick.  Rippel admitted that the sicknesses seen could have been caused by pollutants from other industries.  Coal mines and oil wells have been identified as possible culprits of methane gas appearing in drinking water wells.

You can read more about this story on CBS News' website.

Nonprofit Insurer Gets Federal Loans

A national membership group of independent workers was awarded federal loans, setting the stage for a new nonprofit insurer.

The Register-Guard reported today that the Freelancers Union was awarded $59.48 million in low and no-interest federal loans on Tuesday.  This money was used to create a nonprofit, consumer-run health insurance plan in Oregon.  The Union was also awarded loans to set up similar plans in New York and New Jersey, and other organizations were given the green light to set up programs in Montana, Iowa, Nebraska, New Mexico, and Wisconsin.

The new insurer will be run as a Consumer Oriented and Operated Plan (CO-OP), a new plan for individuals and small businesses that was created by the Affordable Care Act of 2010.  According to Freelancers Union founder and executive director Sara Horowitz, the CO-OP will be open to all Oregonians, not just members of the Union (though members will get access first).  Customers will be able to join the plan in October 2013, with benefits becoming available in January 2014.  Horowitz told The Register that she anticipates the program will insure 35,000 workers after five years.

The CO-OP plans to give its members insurance through a partnership with Providence Health & Services, a Catholic-sponsored health care system in Oregon that also operates in Alaska, California, Montana, and Washington.  The cost of the plan is yet to be determined.

This is not the first time the Freelancers Union has dabbled in nonprofit healthcare.  In 2009, the organization founded the Freelancers Insurance Co., which provides health insurance to over 23,000 New York Union members and their families.  The insurance costs about a third less than the average plans on the individual market.

You can read more about this story in The Register-Guard.

The NonProfit Times October 1st Issue

The October 1st issue of The NonProfit Times has just been posted online.  This issue features a special focus on healthcare and nonprofits.  Here are some of the articles you can expect to see in this edition of NPT:

• Special Report: Fundraising In A Recession Is A 'Capital' Idea: Flexibility is still resonating with donors.
• It's A Miraculous Turnaround For International Aid: International Aid, Inc., reported shipping a record $116 million worth of health products and reconditioned medical equipment to its partners around the world during its fiscal year that ended this past June 30, marking a sort of resurrection for the Christian relief agency.
• Online Payment Systems: Fundraising used to be pretty simple. Today, there’s an entirely new front in the battle for donations that didn’t even exist 15 or 20 years ago.
• On Board For Term Limits: Until this year, there were no term limits for board trustees of Children's Aid Society.

Columns:

• Take This Job: The charitable sector must lead the way if the economy is to recover.
• Developing Your Board: To unlock your board’s true potential, boards need to constantly re-examine their own performance and make the necessary improvements that have been identified through their assessment process.

Check out this exclusive online preview of the new issue today, before it hits your mailbox!