Tuesday, January 7, 2014

ACA Update: Ringing in the New Provisions

By Emily McKinley, Health Information Specialist

The stroke of midnight rang in more than the New Year. This year, it also rang in the final individual consumer provisions of the Affordable Care Act.

Consumers will now benefit from many long-anticipated and debated provisions, such as coverage for pre-existing conditions and the elimination of yearly limits on coverage. Consumers who are shopping for insurance on the Marketplace may also qualify for premium tax credits and cost-sharing subsidies, depending upon income. Further, out-of-pocket limits are now capped at $6,350 for an individual and $12,700 for families who use covered services.

As we move forward, it is important for consumers to be aware that open enrollment on the Marketplace ends March 31. During open enrollment, consumers may purchase new coverage and may change plans. After March 31, consumers must experience a qualifying event, such as the loss of employer-sponsored coverage, certain changes in income, an interstate move, marriage, or the birth of a child to purchase insurance on the Marketplace.

For consumers in states that chose to expand Medicaid, more individuals and families will qualify for Medicaid, which will provide comprehensive health coverage. While Indiana is not one of these states, Indiana does still have the opportunity to do so with federal dollars largely footing the bill.

In addition to individual consumers, small business owners who provide health benefits to employees may also see tax credits in 2014. These credits range in amount based upon the number of employees, their wages, and other factors. For more information about small business tax credits and the small business Marketplace, SHOP, please visit https://www.healthcare.gov/will-i-qualify-for-small-business-health-care-tax-credits/.

Largely, the Affordable Care Act is now fully implemented. (Employer Shared Responsibility Payments will be effective in 2015). 2014 is the time for Americans, as consumers and citizens, to note the legislation’s benefits and areas in need of improvement. Feedback on both fronts may prove beneficial to our Congressmen and women as the ACA continues to be scrutinized by private citizens as well as public bodies.

If you have questions about the ACA and how it affects you or general questions about affording and navigating health care systems, please contact Family Voices Indiana at info@fvindiana.org or 317.944.8982. We also encourage you to visit our website, www.fvindiana.org, for more information about this and variety of other topics.

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