FARMINGTON — Many aspects of the Affordable Health Care Act are still mysteries to local government officials, but it is certain, they say, that employee healthcare costs will grow.
"The fact is," Farmington City Manager Rob Mayes said, "our costs have gone up for providing healthcare for our employees."
President Barack Obama's administration championed the Affordable Health Care Act, known as Obamacare, and it was passed in March 2010. The administration regularly updates the act, changing policies, increasing fees and confusing providers, local government officials said. Because of that, they say, tracking indirect and long-term healthcare expenses is not yet possible.
Questions emailed and calls placed to the federal Centers for Medicare & Medicaid Services seeking more information about the healthcare act were not returned by the end of the day Wednesday.
Local government officials say two variables that increase employee healthcare costs are certain — fees and claims.
One fee providers must pay compensates healthcare insurance companies that attract a high percentage of people who may have high medical costs. Tom Swenk, the city's human resources director, said it's like insurance for insurers.
This fee requires that the county pay $63 per person covered under their plan, and in January 2015 it will pay in total $64,197, said Cricket Long, the county benefits coordinator. Farmington has apportioned in its preliminary fiscal year 2015 budget $100,000 for the fee, Swenk said.
"It's complicated," said Long, "very complicated."
The other fee providers pay helps fund the Patient-Centered Outcome Research Institute, an agency authorized by Congress to conduct research to help patients and healthcare providers make better informed decisions. Providers must pay $1 per person covered under their plan to the institute. In 2015, that fee will increase to $2 per person.
San Juan County will pay $1,063 for the fee in July, Long said. Farmington paid $1,440 for the fee last year and has set aside $4,000 in its preliminary fiscal year 2015 budget, Swenk said.
Long said 497 employees are enrolled in the county's medical plan, 480 in its dental plan and 499 in its vision plan. Farmington has enrolled 590 employees in its healthcare plan, Swenk said.
San Juan County and Farmington currently employ about 730 people each.
The county pays 79 percent of premium costs and people covered under the plan pay 21 percent, Long said. Those covered under the county's plan pay all dental and vision fees, she said.
County officials have budgeted the same sums to pay for healthcare claims this fiscal year, Long said, "but we know at the end of 2014 our claim experience has the potential of being much larger because of the things the plan has to pay for at 100 percent."
For example, she said, the healthcare act requires that the county pay all preventative service costs for those covered under its plan.
Also, the act removed annual or lifetime maximum limits that were paid on claims, she said. The county used to have a $2 million limit on each claim, she said.
County Executive Officer Kim Carpenter said the act is "not as affordable as it was perceived."
"This has a direct impact also on our indigent program — between Obamacare and (Gov. Susana Martinez), and her initiatives," he said, referring to a legislative mandate for New Mexico counties to provide millions of dollars to a statewide hospital fund. "It's placing a huge dent in our budget."