You’ve heard of Obamacare, Healthcare Reform, and the Healthcare Law. All 3 of these terms refer to the Affordable Care Act. Since it became law in March 2010, changes (or mandates) have started to take effect. More changes will roll out in 2013 and beyond.
At over 2,500 pages, we can assure you, the law is complex. Through a series of posts, we’ll try to give you a better understanding of:
- The intention of the law
- What’s included
- How it impacts you
- When the changes go into effect
The 3 Main Issues with Healthcare
Experts say there are 3 main issues the healthcare law needs to address: access, cost, and quality.
- Access: Having access to medical care and health insurance. Right now there are about 47 million uninsured Americans.
- Cost: When we do receive care, we need to be able to pay for that care. Americans are paying almost double what other countries are paying for healthcare, and those costs keep going up.
- Quality: Getting the right care at the right time with the right outcome.
Increased Access to Healthcare
Today, we’ll dive a little deeper into the issue of access to healthcare. “Obamacare,” or the Affordable Care Act, intends to increase access to healthcare in several ways.
1. Individuals Can Buy Their Own Insurance on Exchanges
Starting on Jan. 1, 2014, individuals can purchase health insurance (that meets basic coverage requirements) on what is called an exchange. An exchange is an organized marketplace where consumers can purchase insurance for themselves or their family.
If individuals and families meet certain financial requirements (based on the federal poverty levels) they can receive tax credits or government subsidies to help them pay the premium.
2. Exchanges Just for Small Businesses
There will also be separate health insurance exchanges for small businesses (up to 100 employees). Insurers who offer coverage in the exchanges will have to meet certain qualifications to protect consumers.
3. Medicaid will be Expanded in Some States
Starting on Jan. 1, 2014, Medicaid is expanded to include people who are at 133% of federal poverty level.
The Supreme Court said that states cannot be penalized for deciding not to expand Medicare so states are deciding whether or not they will accept Federal money and expand Medicaid.
4. Employers Can Be Penalized if They Don’t Offer Coverage
Effective in 2014, if an employer has 50 or more full-time employees (30+ hours a week) and chooses not to offer coverage, they can be penalized if one of their employees goes to the exchanges and qualifies for a premium credit.
The penalty ranges from $2000-$3000 per employee over 30 employees.
We’re already starting to see employers cutting employee hours to below 30 so they don’t have to offer coverage.
5. Everyone Must Have Health Coverage
Everyone is required to have health coverage or pay a penalty starting Jan. 1, 2014. This is referred to as the “individual mandate.”
There are exceptions for:
- Financial hardship
- Religious objections
- Native Americans
Penalties will be phased in from 2014-2016. The maximum penalty will be $695 for each individual to a maximum of $2085 for a family (3 X $695).
6. Small Business Tax Credits
Small businesses with 25 employees or fewer can get tax credits if they offer coverage to their employees. These tax credits are already being phased in.
7. You Can Stay on Your Parent’s Plan Until Age 26
Currently in effect, kids can stay on their parents’ coverage until they are 26 years old.
8. Large Employers Must Auto-Enroll Employees in Coverage
If large employers with 200+ employees offer coverage, they must auto-enroll employees in one of their plans unless the employee opts out.
9. High-Risk Pool for Those with Pre-Existing Conditions
A temporary high- risk pool was put into place until Jan. 1, 2014 for those with pre-existing conditions who haven’t had coverage for 6 months. This makes coverage available for those who normally would have trouble buying insurance.
We’ll talk more about cost and quality in upcoming posts, so stay tuned. Thoughts? Questions? Leave a comment.