The Affordable Care Act: What to Expect in 2014

Article at a Glance

• Some of the most significant changes with the Affordable Care Act will be coming in 2014.
• More individuals and families will be eligible for financial assistance to help pay insurance premiums.
• In October, Utah will have a new online health insurance marketplace where you can shop for health insurance.
• In 2014, every U.S. citizen and legal resident will be required to have health coverage.

With the Affordable Care Act (ACA), commonly known as Obamacare, there will be a lot of changes in health insurance this coming year. Although provisions of the ACA have been rolling out since 2010, we will see some of the most significant provisions beginning in October and into 2014.

To help you know what to expect in the coming months, we have put together a series of articles on the ACA and how it might affect families here in Utah.

First we will cover changes that have already taken place and give a summary of some upcoming changes.

Changes We Have Already Seen
Many of the provisions of the law went into effect in 2010. Here are a few of the changes that have already occurred.

• Children with pre-existing conditions can no longer be denied coverage by insurance companies.
• Young adults can remain on their parents’ insurance plan until age 26, even if the young adult is married.
• Insurance companies are no longer allowed to set a lifetime limit on coverage. They can also not set unreasonable annual limits on coverage.
• Rescission, or the act of dropping enrollees if they become sick, is now against the law.
• Seniors can now get better coverage for their prescription medications.
• Small businesses with 25 or fewer employees can receive a tax credit of up to 35% to help cover employee health benefits.
• Insurance companies can no longer charge co-pays for preventative care like immunizations, well child visits, and blood tests.
• Companies get help covering the health benefits of retired employees until the retired employees quality for Medicare.
• State and federal governments now regulate any insurance premium increases. Insurance companies are required to justify any increases.
• Insurance companies must spend at least 80 percent of your premiums on health care. If insurance companies spend more than 20 percent of your premium payments on non-medical costs like overhead, executive salaries, and marketing, they must issue you a rebate.
• States can now provide Federal Medicaid to anybody up to 138 percent of the federal poverty level. The federal government will give these states funding to cover the additional costs.
• Insurance companies are required to use simpler, standardized forms—helping to reduce complex paperwork.
• Utah has received almost $9 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. The money is to be used to support policies that work to prevent illness and promote health.

What to Expect in 2014
Some of the biggest changes are coming in 2014. Here are a few that might affect you and your family.

• Insurance companies will no longer be able to refuse coverage to those with pre-existing medical conditions. Your current health status cannot be used to determine the price of your premiums.
• Insurance companies must distribute the price of premiums more fairly so that insurance coverage is affordable to everybody.
• Families and individuals who earn less than 400 percent of the federal poverty level will be able to receive financial assistance to help pay for health insurance.
• States will start a new online health insurance marketplace where individuals and small businesses can shop for health insurance. The goal is to make the process of shopping for health insurance easier and more transparent. The exchanges will be open for enrollment on October 1, 2013.
• Every U.S. citizen and legal resident will be required to have health coverage. Those who do not will have to pay a tax penalty that will gradually increase over time.
• Annual limits on health coverage will be banned by 2014.
• Originally businesses with more than 50 employees were going to be required to offer health insurance by 2014. Recently this has been pushed back to 2015 to give companies more time to comply with the law and the new reporting requirements.

In the next article we will cover what you need to do to get ready for the upcoming Health Insurance Marketplace in October.