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What's Ahead for the Affordable Care Act in 2013?

Apr 1, 2013 5:00:00 AM

This month marks the third anniversary of the Patient Protection and Affordable Care Act becoming law.

Consumers have gained access to many new benefits under the law including free preventive services, new rights to appeal insurers' decisions, drug discounts for seniors on Medicare, and tax credits for small businesses.

Yet the biggest changes are set to take place less than a year from now, on Jan. 1, 2014, when all Americans will be guaranteed access to health insurance coverage.

Health Insurance Marketplace

One of the biggest changes will come in the form of health insurance exchanges also known as the Health Insurance Marketplace. Starting in October, individuals without access to affordable health insurance through a job will shop for, compare, and enroll in health plans through the Marketplace. People will also find out if they qualify for tax breaks to help them pay for their insurance coverage.

While both federal and state governments are working furiously to get the markets up and running in time for October's open enrollment, the public remains largely in the dark about what's to come.

According to a new poll by the Kaiser Family Foundation, nearly 6 in 10 U.S. residents say they don't have enough information to understand how they'll be affected by the law.

Starting in late summer and early fall, you can expect to be bombarded with messages about the health insurance marketplaces from a wide range of sources, including the media, federal and state governments, state departments of insurance, the state-based health insurance marketplaces, tax preparers, health care providers, private groups, and social service agencies.

The information that you will hear the most about will most likely cover:

  1. The marketplaces are opening their doors for open enrollment in October for insurance benefits that will take effect Jan. 1, 2014.
  2. There will be new protections for you and your family. Health insurance companies can't refuse to cover you or charge you more just because you have a chronic or pre-existing condition, and they can’t charge more for women than for men.

Individuals and families will be able to get help paying for health insurance costs through the Health Insurance Marketplace. Many people (even those that are working and whose incomes are currently too high for assistance) will qualify for a new kind of tax credit (often called a subsidy) to use immediately to lower monthly premiums.

Employer Sponsored Insurance

If you're one of the nearly 140 million Americans who gets your health benefits through your job, the law's biggest changes won't have much impact on you. Most employers who offered insurance before the law was passed will continue doing so. And keeping the insurance through your employer rather than buying it on your own is still likely to be your best option. Still, expect to hear from your company about all the upcoming changes.

Employers are required by federal law to send workers a notice telling them about the new insurance marketplaces before Oct. 1, 2013. Even earlier than that, companies will be eager to help employees understand the differences between the health insurance coverage they provide and what will be available through the marketplaces.

One of the biggest concerns is that during this fall's advertising blitz, many people will wrongly assume they can lower their costs by dropping their employer's benefits to buy a health plan on the marketplace, where tax credits will be available. You won't be eligible for tax credits unless your company's health insurance plan costs more than 9.5% of your annual income.

It’s important for those with employer sponsored benefits to pay attention to your company’s communications and make sure you understand the law and how it may affect you.

Controlling Cost of Health Care Spending

Gibson

Written by Gibson

Gibson is a team of risk management and employee benefits professionals with a passion for helping leaders look beyond what others see and get to the proactive side of insurance. As an employee-owned company, Gibson is driven by close relationships with their clients, employees, and the communities they serve. The first Gibson office opened in 1933 in Northern Indiana, and as the company’s reach grew, so did their team. Today, Gibson serves clients across the country from offices in Arizona, Illinois, Indiana, Michigan, and Utah.