Health Care Reform

doctor nurse and patient looking over information

The issue

After unsuccessful efforts in Congress to repeal the Affordable Care Act, the focus has returned to making the controversial health care law more manageable for employers. Reforms NRF have sought include full repeal of the employer mandate that requires large companies to provide health coverage to full-time workers at government-dictated levels, restoration of the 40-hour workweek for benefit eligibility, repeal of the Health Insurance Tax provision, and changes to the byzantine ACA reporting rules.

Why it matters for retailers

pharmacist handing a bagged prescription to a customer

While retailers have experienced the same added payroll costs as other industries, compliance is particularly complicated because of the nature of retail’s workforce. Retailers employ not just permanent, full-time workers, but also a large number of part-time, seasonal and temporary workers, and work hours can change rapidly according to demand. Certain provisions of the law, such as its 30-hour definition of full-time, are problematic under those conditions. As an industry with extremely tight profit margins, retailers are unable to absorb the added costs, and could be forced to lay off workers.

NRF advocates for true health care reform

Since its passage in 2010, the ACA has posed a number of challenges for employers and NRF has worked with Congress to minimize the burdens imposed by the measure. NRF’s priorities have included measures to streamline and simplify reporting requirements, end the now-repealed Cadillac Tax and other tax provisions, and define “full-time” as 40 hours a week rather than 30.

With insurance premiums skyrocketing for years, NRF has a long history of seeking health insurance reform that would lower the cost of medical care and coverage. Instead, the ACA has emphasized mandates that drive up expenses for employers. Among the law’s key provisions is the employer mandate, which requires that businesses with 50 or more workers provide insurance to full-time employees at coverage levels determined by the government. The costs of the mandates are so high some retailers have been forced to stay under the 50-employee threshold to avoid being covered; others have cut workers’ hours so they don’t count as full-time.

Repeal was former President Donald Trump’s top priority after taking office, and passed the House in 2017 but stalled in the Senate.

Nurse taking blood pressure

Over the years, NRF has found a number of ways to ease implementation of the law and help retailers with their compliance burden. NRF helped win repeal of a requirement that would have pushed companies with between 50 and 100 workers into the small-group health insurance market, which carries higher premiums than the large-group market and additional mandates. Also repealed was a requirement for large employers to automatically enroll workers in health care plans whether the workers wanted coverage or not. The Cadillac Tax on high-value health plans was also repealed, the 2.3 percent medical device tax was suspended for two years, and the law’s per-subscriber Health Insurance Tax on insurance companies was delayed from taking effect in 2016 to 2017 instead.