With President Barack Obama's victory in hand, it's full steam ahead on implementing the federal health care law.
States face a Friday deadline to say whether they'll build their own heath insurance exchanges in 2014, or else live with a version being designed by the federal government.
Meanwhile, businesses that were sitting on the sidelines now must figure out how to help their workers get insurance.
"The story of this election is that there is nothing anymore that justifies waiting," said Kate Johansen, a lobbyist with the Minnesota Chamber of Commerce.
The work ahead for states is daunting. This will be a new online marketplace, required by the Affordable Care Act, to help consumers and small businesses shop for coverage.
A paucity of details in the run-up to the presidential election and the hurried nature of the law's passage in 2010 have left hospitals, doctors, insurers and business leaders hungry for answers about how the 906-page law will affect them.
"We're trying to figure it all out," said John Puckett, co-owner of Punch Pizza. With 150 workers and seven locations in the Minneapolis-St. Paul area, Puckett needs to pick a path for his employees' health care coverage in the next year.
He's foggy about what medical costs his plan will need to cover, and what penalties the company might face even if it offers the right kind of policy and some of his workers can get a better deal on the state-run exchange.
"If you're General Mills, there are a lot of options," Puckett said. "But for a small- to medium-sized business, it's really unclear. We'll have to get a lot more education."
Health care insurers say they're strained by the unknowns as well. With the election over, they need the feds to clarify the law's requirements in short order, so they can design health plan choices and set rates.
Ken Wilmes, owner of Industrial Fabrication Services in Lake Crystal, Minn., is no fan of the law and sees nothing but trouble ahead. The company pays 100 percent of insurance for all 65 full-time workers.
"Premiums have been going up for years," he said. "It's only going to get more expensive because it'll force us to cover more items that we don't have to cover now ... like contraception coverage. It's just a huge overreach by the federal government."
(Reach Jackie Crosby at email@example.com. Distributed by Scripps Howard News Service, www.shns.com)
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