In a topsy-turvy landscape, workers must take time to educate themselves

Understanding healthcare law is rapidly becoming a personal responsibility for U.S. based employees. In previous years, the annual enrollment cycle for American employer-sponsored healthcare programs brought with it a bevy of publications and articles explaining the choices each employee faced. For 2012, many employees will no longer be receiving even a pretense at such advice.

The reason? Guidance is simply not available. 2012 marks the beginning of a new healthcare landscape for many U.S. firms, meaning they haven’t had the lead time or experience with new legislation to develop reliable employee guidelines. Professionals at all levels will therefore have to change their behavior to allow for extensive research into the real costs of their 2012 healthcare choices.

The Legislative Background

The passage of ObamaCare has been followed by selective repeal of its provisions. Though the legislation was always set to roll out in stages, the overall timeline has now been called into question. As a result, even former healthcare experts aren’t sure what provisions are in, out, or dead in the water.

This frustration with the will-we-or-won’t-we debate has caused many healthcare professionals to seek other kinds of work. First to leave have been sales agents, who saw that their commissions and business structure would be significantly altered or even obliterated if the new plan went through. Billing specialists have also been negatively affected. Both of these groups formed a major source of healthcare information for HR managers, who in turn passed the required information on to their workgroups. Without that data pipeline, confusion has arrived at many formerly up-to-date firms, since there are few remaining trustworthy sources of healthcare plan data.

Now, employees have to make a point of keeping abreast of these developments by themselves. State by state implementation of ObamaCare provisions varies. Some states are rejecting provisions outright, while others have already set up competing programs. Workers have to be able to understand what’s legal and available in their specific space to make smart healthcare plan enrollment choices and budget appropriately for healthcare expenditures if their current plan is being discontinued.

Economic Drivers at Work

Speaking of budgets, there is no doubt that the ongoing economic challenges are factors in health policy changes. Pension plans and retiree healthcare costs are top talking points in many large corporations, making news well outside the financing division. Workers are at the mercy of accountants in some industries, with the government’s own struggles there as a compelling backdrop. Dry numbers are heating up in the debate of who pays for what – and how.

There are a number of different factors that go into these debates. Union status, regional healthcare norms, and gender issues are just a few of the major concerns. Politicians and corporate leaders can talk around all of these issues without coming to a decision or being definite about the likely outcomes of various choices for cost containment.

For most workers, the outcome will be a higher healthcare burden, especially if tax breaks for health savings accounts or flexible spending accounts disappear. Talking with a knowledgeable professional would help, but they are very hard to find. With the legislation evolving and local government budgets straining, everyone seems to be waiting for someone else to move first. No one wants to be liable for giving the wrong advice, though conflicting statements, rumors, and opinions are shared freely.

Workers have to look at their own numbers carefully. With minority populations among America’s highest groups of uninsured, even professional employees can find themselves one medical emergency away from bankruptcy. Doing independent research into plan options and building a rainy-day fund for unexpected medical expenses will help cushion any decision made at a corporate or national level. Relying on hard facts over rumors or speculation will also help ensure the right decision is made.

Finding a Personal Balance

Ultimately, workers are going to be responsible for finding their own personal balance. It is likely that the guarantee of employer-sponsored healthcare picking up most healthcare costs is headed out the door. What replaces it is unknown, so workers must strive to find the balance between operating under the present scenario and preparing for what lies ahead.

The first step, of course, is being honest about healthcare needs. Workers have to consider what routine expenditures will be for the coming years, and what “unexpected” events they will need to plan for over time. Preventative care costs should not be neglected, and statistically likely events should be built into the requirements for doing apples-to-apples comparisons of health insurance policies. Higher premiums now for lower co-pays over time are a reasonable trade, as are better coverage levels for children’s accidents vs. low premiums.

This is an area where professional advice is helpful, but the final decision will need to be something that resonates with each individual’s gut instincts. Workers can no longer rely on healthcare to always be provided. Understanding the legislative situation, being realistic about the economic climate, and planning for a good balance will lead to workable options under the current paradigm – or whatever comes down the road next.

U.S.-based employees have gotten used to strong levels of guidance about healthcare from the corporations that employ them. However, the emerging trends of the moment are for a decided lack of guidance, and the future looks ever more murky. Workers will simply have to build time in their schedules to take matters into their own hands. Healthcare choices can be confusing, but by taking the time to do their own research, workers caught in the middle of this changing landscape can find their way to a solution that works for them over the long run.