The Patient Protection and Affordable Care Act (ACA, or “Obamacare”) was passed in 2010, and provisions of the law have been going into effect since then. One of the biggest changes resulting from the ACA goes into effect starting with the new year.
Beginning in 2014, everyone is required to have health insurance coverage or pay a fine. There are exceptions to this rule, and there are those who would rather pay the fine — at least for now — than get the coverage. For the first year, the fine is relatively small. As implementation progresses, though, the fine gets bigger, so it might not be worth it to skip the insurance in two or three years.
So, what does this mean for you as a consumer? Jacqueline Garry Lampert is the founder of Lake Street Strategies, a public policy strategy and consulting firm, and consultant to UPMC. She has many insights about the ACA’s impact, and here are the three groups she thinks will be most affected:
Individuals Who Purchase Their Own Plans
“The vast majority of Americans who receive health insurance through their employer will largely be unaffected by the ACA,” Lampert says. “Individuals who purchase insurance on their own, outside of a group in the individual market, and those in small group plans will likely see some changes.”
Even those whose plans remain largely unaffected by the ACA might see some changes in terms of cost. “Insurance market reforms, such as restrictions on how much insurers may vary premiums due to age and tobacco status, and the elimination of premium variation due to gender and health status, will cause premiums to rise for some, but may have little to no premium impact for certain groups,” she says.
Individuals Who Are Currently Uninsured
Those without health insurance right now are those most likely to see the biggest changes, and that’s not surprising. “Many individuals without access to group insurance will be able to purchase insurance for the first time,” Lampert points out.
“For example, under existing rules, individuals with pre-existing conditions could simply be denied coverage by an insurer, leaving them with no protection from astronomical health care costs. These individuals will now be able to purchase insurance and, depending on their income, may receive a tax credit from the government to help reduce their premiums and cost-sharing responsibilities.”
Individuals with Bare-Bones Coverage
There has been a lot of concern over changes involving the cancellation of certain plans. “It is important to remember that plan cancellations are impacting a small number of Americans who purchase their insurance outside of a group,” says Lampert.
Many of these plans are those that don’t meet the basic requirements imposed by the ACA. “Anecdotally, we’re seeing that a lot of these plans have very low premiums because they offer bare bones coverage,” she continues. “Some don’t offer any hospital coverage at all, or have sky high deductibles and no out-of-pocket limits to protect a consumer from bankruptcy.”
In some cases, the fact that more comprehensive plans are offered — and possibly with the help of a tax benefit to offset some of the increased costs — can be a good thing.
Ultimately, though, whether or not you’re affected substantially by the ACA depends on your situation. Research the options to find out what you can do to make the most of your health care.
How has the ACA affected you?