During a brief September legislative session, the House of Representatives approved a bill defining a full-time employee under the Patient Protection and Affordable Care Act (PPACA) using a 40-hour-per-week standard. Another House bill would allow insurers to sell certain health plans that fail to meet PPACA requirements. Although Senate action is not expected, these provisions could reappear on the legislative agenda in 2015.
Jobs for America Act would redefine full-time employee
The Jobs for America Act (H.R. 4) incorporates the Save American Workers (SAW) Act (H.R. 2575), which would raise the threshold for a full-time worker under the PPACA from 30 hours per week (or 120 per month) to 40 hours per week (or 174 per month).
Other PPACA-related provisions in the Jobs for America Act would:
- Allow employers to disregard employees with certain coverage through the Department of Defense (DOD) or the Department of Veteran’s Affairs (VA) when determining whether the employer mandate applies
- Repeal the excise tax on medical device manufacturers, retroactive to 2013
- Require the House and Senate to approve a joint resolution before major rules — including those implementing the PPACA — could take effect
The provisions of the Jobs for America Act were drawn from other House-approved bills that have not seen Senate action. For example, the House had approved the SAW Act as a stand-alone bill in April. The provision allowing employers to exclude employees with DOD or VA coverage is from the Hire More Heroes Act (H.R. 3474) approved in May. The regulatory reform provision is from the Regulations from the Executive in Need of Scrutiny (REINS) Act (H.R. 367), which passed the House in August.
The House approved the Jobs for America Act on September 18 by a vote of 253 to 163. Senate action is not expected.
Continued availability of plans that do not meet PPACA standards
The House also approved the Employee Health Care Protection Act (H.R. 3522), which would allow health insurance issuers to sell group health coverage that was on the market in 2013, even if the coverage does not meet current PPACA requirements.
In the wake of controversy over some individual and small group plans being cancelled in 2013 for failing to meet 2014 market reform requirements, such as providing essential health benefits and not imposing annual dollar limits, the administration allowed individuals and small groups to reenroll in noncompliant coverage. The administration’s temporary exception did not apply to plans sold in the large group market.
The Employee Health Care Protection Act would apply to the individual, small group and large group markets. Under the act, health insurance issuers could sell group health coverage that was on the market for any day during 2013 through 2018. The coverage would be considered grandfathered and thus would constitute minimum essential coverage under the individual mandate. The act also would allow issuers to sell the coverage to groups that were not previously enrolled.
The act does not apply to self-insured coverage and gives states discretion in allowing insurers to offer such noncompliant plans.
The House approved the Employee Health Care Protection Act on September 11 by a vote of 247 to 167, with 25 Democrats voting in favor of the legislation. The Senate is not expected to vote on the legislation and the White House has issued a veto threat.