If you're looking for a readable summary of the new federal health care reform law, Margaret Levi has written it.
Levi, a lawyer with the Lexington firm of Wyatt, Tarrant & Combs, is the author of a new publication titled The Impact of Health Care Reform on Kentucky Employers. The 68-page booklet, published by the Kentucky Chamber of Commerce, was released Sept. 6.
The Affordable Care Act was signed into law in March 2010, and it has been a political lightning rod before and after its passage. Levi's booklet includes short, succinct chapters on the law's history and its highlights.
"There's a lot of criticism of it from people who haven't read it, and I think you have to know it before you can criticize it," said Levi, a Danville native and resident, said of the law.
"I'm not taking a political position one way or another. I am neutral and I tried very hard to remain neutral."
The booklet was the idea of the Kentucky Chamber, the statewide business association that offers booklets about issues facing employers. The Chamber approached Wyatt, Tarrant & Combs about writing the booklet because the law firm has the largest health care practice in the state. Levi is a member of the firm's "health care service team," and her clients include hospitals, physicians and other health care providers.
Before joining the law firm, Levi, a Centre College graduate, was the in-house counsel for Ephraim McDowell Health Inc. in Danville.
Levi's first task in preparing the booklet was to read all 2,555 pages of the Affordable Care Act.
"I started in February," she said. "It took a while. I couldn't tell you how long it took me.
"The hard part in reading it is, it will have a section that says, 'This amends 43 USC (United States Code) by inserting this.' So you not only have to read the Affordable Care Act, but you have to go out and pull up what it's changing so you can see what the true effect of it is."
Levi waited for the U.S. Supreme Court to rule on the law's constitutionality in late June before finishing her summary. She wasn't surprised by the court's ruling, "but some of the legal sophistry in crafting the opinion I was surprised at," she said. "Because for one purpose of the argument, they said the individual mandate is not a tax, it's a penalty. And then for another section they said, 'It's a tax.'"
Of all the misconceptions about the law, the one Levi has heard most "is that all health care is going to be free and people can get all the care they want," Levi said. "So there are some unrealistic expectations on behalf of consumers."
Some provisions of the law affect larger employers now while small businesses are exempt from certain other aspects, she said.
"It depends upon the provisions. Some affect businesses with 250 employees, some with 50, some with 100 and some with 25. For example, there's a small-business tax credit if they have less than 25 employees," Levi said.
Critics say the Affordable Care Act already has cost jobs because employers don't want to hire until they know the law's full effects.
Levi doesn't take a position on that. But she said employers are weighing the "pay or play" mandate that takes effect in 2014.
Under that provision, employers with 50 or more employees must provide "minimum essential" health plan coverage to their eligible employees or pay a penalty if an eligible employee obtains coverage through a state-sponsored health insurance exchange and qualifies for benefits subsidized by the government.
An employer who offers no health coverage will be subject to a penalty equal to $2,000 a year per employee after the first 30 employees.
"I think some employers are doing the math as to whether they pay the penalty or provide insurance for their employees," Levis said. "I saw a report that said 88 percent of employers are still going to provide the coverage."
Most people who have purchased the booklet work in human resources and "want to know, 'What do I need to be prepared for?'" said Jim Ford, vice president of business education for the Kentucky Chamber.
"The book doesn't pontificate on what's right or wrong," Ford said. "It basically says here are the rules, here's what it means, here's what implementation means. We're leaving politics at the door. Here's what you need to know."
The booklet concludes with a 1932 quote from President Franklin Delano Roosevelt, who suggested during the Depression that "the country demands bold persistent experimentation. It is common sense to take a method and try it: If it fails, admit it frankly and try another. But above all, try something."
For her part, Levi said changes need to be made in the United States, where 50 million people are uninsured and an additional 25 million are inadequately insured.
"Is this the perfect change? Probably not," Levi said of the Affordable Care Act. "But I think our health care system is in crisis. I think it's time to do something. If it doesn't work, tinker with it. But I don't want to just get rid of this with no plan to improve."