Impact of the Patient Protection and Affordable Care Act on Employees and Small Businesses

June Kirwin, BPharm
Director of Pharmacy
Harris Family Medical Center

First Report Managed Care conducted an interview with June Kirwin, BPharm, one of our Editorial Advisory Board members, to discuss how the Patient Protection and Affordable Care Act (ACA) is affecting coverage and pharmacy use for employees and small businesses across the nation. Here you will find Ms. Kirwin’s take on current events related to the healthcare system.

Q: Can you explain the Harris Family Medical Center and your role as director of pharmacy? What are your day-to-day and long-term responsibilities?

A: The Harris Family Medical Center is a family practice clinic and pharmacy exclusive to employees, dependents, and retirees of Harris Corporation, a communications company headquartered in Melbourne, Florida. As director of pharmacy, my primary focus is coordinating the activities of the pharmacy staff. The staff includes pharmacists and technicians engaged in the preparation of prescriptions, as well as educating the patients about medication, disease management, healthy lifestyles, etc.

An important responsibility for me is to ensure the pharmacy is compliant with federal and state laws and regulations pertaining to the dispensing of drugs and controlled drugs and the maintenance of required records. [I also] maintain
liaison relationships with the medical staff, collaborate with the client to design [an] effective prescription benefit, and negotiate competitive pricing with wholesalers, manufacturers, and buying groups.

Q: How has the ACA changed employer-
based healthcare? Are you seeing any trends in the past few years? What trends are you projecting for the future?

A: The [ACA] has influenced change in
employer-based healthcare. The employer clearly has incurred additional expenses with the obligation to offer multiple
categories of preventative medications at no cost. Benefit design is trending [toward] a higher cost-share to the member.

Q: Earlier this year, the Obama administration announced it would delay the
requirement that companies with 51 to 99 employees must offer coverage to anyone working >30 hours per week. Were you surprised by the decision? Why do you think it was delayed?

A: The delay was not a surprise. [It was] likely due to pushback from small businesses nationwide.

Q: Will this requirement of offering coverage to anyone working >30 hours per week impact small businesses? Can you speak to how this requirement is being received by employers?

A: Small businesses are very concerned about increased expenses for healthcare benefits. Many are considering reducing their full-time workforce to avoid the
additional costs involved.

Q: According to a recent survey from the Kaiser Family Foundation, premiums have increased at a slow rate in recent years, although wage increases and inflation have slowed too. How are employees dealing with health costs? Are they seeing doctors less or filling fewer prescriptions?

A: Employees are definitely feeling the pinch of higher healthcare costs without income keeping pace. The good news is that they are becoming better con-
sumers—researching costs and evaluating all [of] their options. There clearly is also the downside where employees are seeing their doctors less often and going without medications because they can no longer afford to do so.