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Affordable Care Act Update: Pay or Play Delay, and What Does it Say Today?

By Robert E. Slavkin & Beth Alcalde on July 3, 2013
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Late Tuesday afternoon, July 2, 2013, the federal government issued a statement through the US Department of the Treasury, announcing that the controversial employer shared responsibility provisions, coined the ‘pay or play’ provisions of the Affordable Care Act (ACA) have been delayed for one year.  This pushes the enforcement date of this provision from January 1, 2014 to January 1, 2015.  This portion of the ACA requires employers with greater than fifty (50) employees to either provide health insurance that the employees can afford, or pay a penalty to the federal government for failing to do so.

The release from Mark Mazur, Assistant Secretary of the Treasury for Tax Policy, reads, in part,  as follows:
The Administration is announcing that it will provide an additional year before the ACA mandatory employer and insurer reporting requirements begin.  This is designed to meet two goals.  First, it will allow us to consider ways to simplify the new reporting requirements consistent with the law.  Second, it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees.
Mr. Mazur goes on to state that within the next week, the Department of the Treasury will publish formal guidance regarding this change.
While every political commentator with a pulse has weighed in since this announcement, this provision is not as significant as it first seems.  There are approximately 6 million employers in the United States.  Of those, approximately 200,000 employ more than 50 individuals.  Of that group, approximately 90% to 95% of them already offer health insurance to their employees.  This requirement would affect none of these employers. Rather, only approximately 10,000 employers nationwide would have been impacted by the requirement to offer health insurance.
While the employer pay or play requirement is not insignificant, it does not affect nearly the numbers of individuals nationwide as other provisions of the ACA. Those other relevant portions of the ACA have not, at least as of yet, been delayed. For example, the provisions that create insurance exchanges in 2014, remain in effect and stand to influence the health care coverage and costs for millions of people.  Also, the individual mandate remains untouched, and it also will impact millions of Americans.  That said, yesterday’s announcement does raise some practical questions about how the government will enforce the individual mandate without any reporting mechanism for employers effective for 2014.  Moreover, many commentators have questioned whether the state and regional insurance exchanges will be ready to begin operations as of January 1, 2014, as currently required by the ACA.  It would not be surprising to see the government announce a similar one-year delay in implementation of the individual mandate and the insurance exchanges.
For more information about the announcement, please see the HR Defense Blog.
Photo of Robert E. Slavkin Robert E. Slavkin

Robert Slavkin is the chair of the Healthcare Practice Group, a multidisciplinary team recognized nationally for representing sector participants in regulatory compliance, insurance, and transactional issues. A former healthcare corporate counsel, compliance, and privacy officer for a publicly traded healthcare company, Robert represents…

Robert Slavkin is the chair of the Healthcare Practice Group, a multidisciplinary team recognized nationally for representing sector participants in regulatory compliance, insurance, and transactional issues. A former healthcare corporate counsel, compliance, and privacy officer for a publicly traded healthcare company, Robert represents a variety of clients within the healthcare sector, providing guidance on complex issues and compliance with all appropriate federal and state statutes and regulations. These include federal anti-kickback, Stark laws, Medicare, Medicaid, HIPAA, and FDA regulations, as well as providing guidance on daily operational and compliance issues facing healthcare entities. Robert has significant experience with the Affordable Care Act and the ever-evolving role accountable care plays in U.S. health reform. Additionally, Robert counsels clients on Medicare Managed Care and the Part D programs. He possesses a keen understanding of the momentous legislative changes of this sector as well as potential resulting implications.

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Photo of Beth Alcalde Beth Alcalde

A noted employee benefits lawyer, author, and speaker, Beth Alcalde represents Fortune 500 companies and other public and private entities, including those in the hospitality, healthcare, and higher education sectors, throughout the United States. As a leader within the firm, Beth is a…

A noted employee benefits lawyer, author, and speaker, Beth Alcalde represents Fortune 500 companies and other public and private entities, including those in the hospitality, healthcare, and higher education sectors, throughout the United States. As a leader within the firm, Beth is a longtime member of Akerman’s Board of Directors, and is also a current member of Akerman’s Executive Committee. Previously she chaired the firm’s Professional Development Committee, and served as office managing partner of the firm’s Palm Beach County offices. Noted in Chambers USA as “terrific at coming up with imaginative solutions,” Beth provides counsel on employer-sponsored benefit plans, from compliance with ERISA, the Affordable Care Act, and other federal regulations, to internal audits and benefits-related implications of corporate transactions. She assists clients in defending and responding to audits conducted by the Internal Revenue Service (IRS), U.S. Department of Labor (DOL), and U.S. Department of Health and Human Services (HHS). Of particular emphasis, Beth has represented group health plan sponsors in responding to audits of the quantitative and non-quantitative treatment limitations within their plans, as required by the Mental Health Parity and Addiction Equity Act.

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  • Posted in:
    Health Care and Life Sciences
  • Blog:
    Health Law Rx
  • Organization:
    Akerman LLP
  • Article: View Original Source

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