Just like any other employer, Kansas counties are scrambling to understand the impact of the Affordable Care Act on the bottom line.
Commissioners from across the state learned more about the federal law Wednesday at the Kansas County Commissioners Association’s 37th annual conference in Wichita.
Martie Ross of Pershing Yoakley & Associates, an Overland Park firm that does health care consulting, told commissioners that the goal of the law is to make adequate health insurance coverage more available and affordable for Americans.
She noted that it will be less expensive for some smaller employers to pay a penalty for not providing insurance than to offer insurance to staff.
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That won’t be the case for larger employers such as Sedgwick County, which ended last year with about 2,600 employees.
“I think Bill (County Manager William Buchanan) and the staff are analyzing all that now,” Sedgwick County Commissioner Tim Norton said of the impact of insurance costs on the county. “We do worry about cost. Even in years where we’ve lowered the cost, we’ve looked toward the future. The cost escalation in health care has been an ongoing issue for 25 years. Any large employers have had to look at health care as a cost of doing business — an escalating cost of doing business.”
Sedgwick County responded last year by making employees more responsible for their own health. Instead of looking at salaries and benefits as separate pots of money, the county this year reduced costs by using one to offset the other.
Paul Beddoe, associate legislative director of the National Association of Counties, gave conference attendees background about health care since the early 1900s.
In the 1920s, he said, opponents of expanded health coverage started calling such efforts socialized medicine, just as some opponents of the Affordable Care Act have done.
But an illness in the 1930s often led to bankruptcy, Beddoe said.
Medical bills remain a major factor in personal finance and a trigger for bankruptcies.
Beddoe noted that the United States spends more on health care per capita than anywhere else in the world but still has bad health outcomes.
Lifestyle is the No. 1 factor in health, he said. Smoking, obesity, stress, nutrition, blood pressure, alcohol and drug use affect health more than genetics, the environment or access to health care, he said.
"We’re spending way more than pretty much anybody, and we’re not doing as well," Beddoe said.