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Affordable Care Act 2013 Update:
Federal healthcare act provisions take effect

1/13/13; Updated 3/14/13

More portions of the 2010 Affordable Care Act (ACA) kick in this year as the law aims to increase access to affordable healthcare.

Different parts of federal
 healthcare reform were scheduled to go into effect gradually. Several requirements took effect over the last two years and more changes will come this year and next.

CSEA has been an advocate at the local, state and federal levels to ensure members get the best healthcare possible without sacrificing pay or other benefits. Still, many CSEA members don’t qualify for health insurance through their employer. Those who have health insurance find that the costs of premiums, co-payments and deductibles eat up a bigger chunk of their paychecks. The ACA was championed by President Barack Obama to ensure more people have the health coverage they need.

Starting this year, the law will provide more federal funds to cover preventative care at little or no cost to MediCal recipients. The goal of this provision is to increase the number of people who get preventative care. California lawmakers are are meeting in a special session to determine how to implement this portion of the law.

The federal mandate now requires the state to pay MediCal primary care providers as much as Medicare providers. The federal government will pay for the increase. This is designed to ensure there are enough doctors to care for everyone when the mandate to have insurance kicks in next year.

A major goal of the ACA is to increase the number of people who can afford healthcare. States are required to create healthcare exchanges, where private insurers can offer state-approved plans that will allow consumers to easily compare and purchase healthcare. The insurers in the exchange will have to comply with cost and coverage guidelines set by the law. So far, 33 different private insurance plans have applied to become part of California’s exchange.

California’s healthcare exchange, called Covered California (Covered CA), is expected to be up and running by October. The open enrollment period for the exchange will be from October 2013 to January 2014 and coverage will begin on Jan. 1, 2014.

Anyone who is not covered by MediCal but meets income guidelines will have to buy health insurance through Covered CA in order to receive government subsidies for premiums and out-of-pocket costs.

Californians can visit the Covered California website to see descriptions of the four types of health plans that will be available through the exchange and to use an online calculator to see if they qualify for subsidies. Once the website is fully functional, Californians will be able to purchase insurance through this website. Guidance will be available for those who need help navigating through the exchange and eventually call centers will be opened to help people find coverage and register.

Another goal of the law, besides reducing costs to consumers, is increasing patient protection. In order to provide more transparency in the healthcare industry, the law now requires healthcare providers such as doctors, hospitals and pharmacists to tell patients in writing if they make money from drugs or treatments they recommend to patients.

RELATED RESOURCES

Covered California 
CSEA Guide to Affordable Care Act
Healthcare Reform Subsidy Calculator
Healthcare Reform Education (American Fidelity)
Healthcare Reform Checklist
2009 Healthcare Reform Principles Flyer 
Healthcare Reform