The year ahead will bring a medium-sized paperwork headache to medium-sized businesses — those with 50 to 100 employees — which will now have to provide healthcare coverage for their employees under a provision of the Affordable Care Act that goes into effect in 2016.

The Obamacare law requires employers to offer the coverage and then verify and report their plans to the federal government. “There are hundreds of pages of compliance. It’s not easy,” says Christine Stearns, a lawyer in the Trenton office of the statewide law firm, Gibbons P.C. “It becomes incredibly complex for companies to ensure that they’re in compliance.”

Stearns became something of an expert in the ACA during the 11 years she was vice president of health and legal affairs for the New Jersey Business & Industry Association. While there, she lobbied on behalf of business interests with a special focus on healthcare law. Last year she left NJBIA to join Gibbons, and her role there expanded last week when she was promoted to administrative director of the office and director of the firm’s government affairs department.

“With her recent background as an executive with the NJBIA and her extensive engagement with industry organizations and state entities, Christine has experience with key constituencies in New Jersey’s public, private, and nonprofit sectors that ideally positions her to manage the administrative and operational functions of our thriving Trenton office,” said Patrick Dunican Jr., chairman and managing director of Gibbons, in a press release.

Though the ACA passed years ago, the lobbying around the bill continues unceasingly as various interests try to influence provisions that have yet to come into effect. A good example of these is the “Cadillac Tax,” which is a tax on generous healthcare plans. While public employee unions have been at the forefront of opposing the Cadillac Tax, businesses that offer good healthcare plans also have a stake in it. Congress voted last week to delay the implementation of the tax by two years.

“That will have a major impact,” Stearns said. “Many companies were aware of this possibility and have been taking action already.”

Even more extreme is the possibility that Obamacare will be repealed entirely. Republican presidential candidates have used the destruction of the healthcare law as a talking point, and if one is elected and follows through, it could change the landscape drastically. Democrats have so far easily rebuked repeated attempts by Republican lawmakers to overthrow the ACA, but the 2016 election could be a turning point. “It will depend on the outcome of the election,” Stearns says.

Stearns was born in New Hampshire but grew up in New Jersey and has spent most of her career here. Her father was a state worker and her mother a teacher. She earned a bachelor’s at Rutgers where she also earned a master’s of public administration and law degree, graduating in 1996. She went to work in politics right out of school, working for several lobbying groups before joining the NJBIA in 2004.

She says she had no intention of making her career in healthcare law in particular, but that she was drawn into it early on. “It just sort of happened,” she said. “Healthcare policy continues to change, and it’s an important piece of the economy and it’s important to individuals, so I have enjoyed being engaged in the healthcare policy debate.”

While Stearns represents businesses, she understands how important health plans are to employees. The U.S. is unique among countries in that most people get their health plans through their workplaces rather than through a government program. This arrangement dates back to World War II, when the government, in an effort to keep rising wartime wages under control, put a cap on raises and gave businesses a tax break on offering healthcare plans as a way of offering perks without contributing to inflation.

“Coverage is generally the number one issue for employees and always has been in terms of other benefits that an employer can offer. People want to know what the salary is going to be, and then whether or not they’re going to get healthcare coverage and what the plan is. Especially here in New Jersey, we have a competitive marketplace.”

Stearns says businesses are now focusing their lobbying efforts on simplifying regulations to reduce the cost of compliance.

She acknowledged the law has had its intended effect of enrolling more people in healthcare plans and reducing the number of uninsured patients. It remains to be seen, however, if it will successfully reduce the cost of healthcare overall. The law has also affected the kind of healthcare plans that are being offered and has spawned new variations of health coverage, such as the controversial “tiered” health insurance plan, which pays more money to preferred healthcare providers.

“There continues to be a focus on innovating healthcare coverage to try to get at that affordability issue,” Stearns said.

The challenge ahead for businesses is to make sure that they pick the right one of the increasingly complex array of options for their employees’ health coverage.

“Midsize companies should spend a fair amount of time this year assessing whether the healthcare plan they’re buying is the right fit for their employees.”

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