Much has been written about the full implementation of The Affordable Care Act (ObamaCare) in January 2014, but too little communicated. Let’s focus on the essential three provisions:
1. Must buy. Most US citizens and legal residents will be required to maintain a level of health insurance coverage for themselves and their dependents, or pay a small financial penalty (a new tax). The US government will pay none, some, or nearly all of the cost of that insurance, based upon the income level of the individual.
2. Must sell. Health plans (including KP) will be required to accept and renew all individuals wishing to buy, regardless of health status.
3. The Marketplace. A federally run website (also known as the Health Insurance Exchange [HIX]), not unlike amazon.com, will join buyers to sellers. Insurance Plans with similar benefit packages will have similar names: bronze (covering 60% of healthcare costs), silver (covering 70%), gold (80%) and platinum (90%). The buyer will choose his/her health coverage from among the various insurance companies, based upon a comparison of price, quality, service and reputation. The Marketplace goes live October 1, 2013, with coverage beginning January 1, 2014.
In 2014, Small Businesses participating in the HIX will choose one insurance plan for all employees. In 2015, each employee may select his-/her-own insurance company to provide the healthcare coverage, within the metal tier selected by the employer.
Clinicians and staff should begin now helping their patients with individual healthcare coverage understand their options coming in October.
Hope that helps.