Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act (often just called the Affordable Care Act (ACA) puts in place strong consumer protections, provides new coverage options and tools to assist Americans in making informed choices about their health and insurance coverage. It was signed into law in March 2010, and many aspects of the ACA have already been implemented. Many provisions that expand consumer access such as expansion of Medicaid and the introduction of Affordable Health Exchanges, will launch on January 1, 2014.
Key Features of the ACA
The healthcare law offers new choices for consumers and changes many aspects of insurance industry practices. Key features of the ACA include broadened consumer protections and access to coverage:
- Rights & Protections—expanded consumer protections, such as curbing insurance cancellations, help in filing complaints and appeals, and access to non-network emergency care
- Insurance Choices—elimination of pre-existing conditions, expansion of young adult coverage under 26, and the introduction of Affordable Insurance Exchanges and CO-OP Insurance Plans, expansion of Medicaid
- Insurance Costs—limits on insurer profits, and elimination of lifetime and annual limits
- Strengthening Medicare—discounts and rebates for prescription coverage gap, expansion of cost-free preventive services, and increased waste, fraud and abuse oversight
- Employer Market—tax credits for small businesses and non-profits, and early retiree reinsurance options
Key Consumer Provisions that Become Effective January 1, 2014
|Establishing Affordable Insurance Exchanges||Starting in 2014, if your employer doesn’t offer insurance, you will be able to buy it directly through a federal or state-managed marketplace Exchange offering affordable and qualified health benefit plans. Workers meeting certain requirements who cannot afford the coverage provided by their employer may take whatever funds their employer might have contributed to their insurance and use these resources to help purchase a more affordable plan in the new Affordable Insurance Exchanges.|
|Individual Mandates||Under the new law, most individuals who can afford it will be required to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for uninsured Americans. If affordable coverage is not available to an individual, he or she will be eligible for an exemption.|
|Increasing Access to Medicaid||Americans who earn less than 133% of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid.|
|Tax Credits||Tax credits to help the middle class afford insurance will become available for those with incomes between 100% and 400% of the poverty line who are not eligible for other affordable coverage. The tax credit is advanceable, so it can lower your premium payments each month rather than making you wait for tax time. These individuals may also qualify for reduced cost-sharing, such as co-payments, co-insurance and deductibles. Use this calculator to see if you get help in 2014 to pay for individual insurance coverage.|
|Eliminating Annual Limits on Insurance Coverage||The law prohibits new plans and existing group plans from imposing annual dollar limits on the amount of coverage an individual may receive.|
|Eliminating Pre-Existing Conditions or Gender||The law implements strong reforms that prohibit insurance companies from refusing to sell coverage or renew policies because of an individual’s pre-existing conditions, and it eliminates the ability for insurance companies to charge higher rates due to gender or health status.|
|Increasing Small Business Health Insurance Tax Credit||The law implements the second phase of the small business tax credit for qualified small businesses (up to 50% of the employer’s contribution) and small non-profit organizations (up to 35%). Use this calculator to find out what your tax credit will be in 2014 when offering health insurance to your employees.|
For a comprehensive implementation timeline highlighting key provisions of the Affordable Care Act, the Kaiser Family Foundation provides an interactive tool detailing various provisions by year.
Or visit the What’s Changing and When timeline on healthcare.gov.