Payroll & Business Experts Blog

What's Happening in 2013 and 2014 With Health Care Reform?

Posted by PrimePay Business and Experts Blog

Apr 5, 2011 12:15:00 PM

health care reform timeline 2013 and 2014In last Friday’s blog posting… Health Reform: The Timeline for 2011 and 2012, we discussed what programs and services will go into effect between now and the end of 2012 as part of the Affordable Care Act.  This article will focus on what health care reform changes are scheduled to happen in 2013 and 2014. 

More detailed information on the programs that go into effect in the coming years can be found on the HealthCare.gov website in their timeline of the Affordable Care Act.

2013: Health Care Reform

IMPROVING QUALITY AND LOWERING COSTS

  • Improving Preventive Health Coverage.  To expand the number of Americans receiving preventive care, the law provides new funding to state Medicaid programs that choose to cover preventive services for patients at little or no cost.  Effective January 1, 2013.
  • Expanding Authority to Bundle Payments.  The law establishes a national pilot program called “Payment Bundling” to encourage hospitals, doctors, and other providers to work together to improve the coordination and quality of patient care.  Effective no later than January 1, 2013.

INCREASING ACCESS TO AFFORDABLE CARE

  • Increasing Medicaid Payments for Primary Care Doctors.  As Medicaid programs and providers prepare to cover more patients in 2014, the Act requires states to pay primary care physicians no less than 100 percent of Medicare payment rates in 2013 and 2014 for primary care services.  The increase is fully funded by the Federal government.  Effective January 1, 2013.
  • Providing Additional Funding for the Children’s Health Insurance Program.  Under the new law, states will receive two more years of funding to continue coverage for children not eligible for Medicaid.  Learn more about the Children’s Health Insurance Program (CHIP)Effective October 1, 2013.

2014: Health Care Reform

NEW CONSUMER PROTECTIONS

  • Prohibiting Discrimination Due to Pre-Existing Conditions or Gender.  The law implements strong reforms that prohibit insurance companies from refusing to sell coverage or renew policies because of an individual’s pre-existing conditions.  Also, in the individual and small group market, the law eliminates the ability of insurance companies to charge higher rates due to gender or health status.  Effective January 1, 2014.
  • Eliminating Annual Limits on Insurance Coverage.  The law prohibits new plans and existing group plans from imposing annual dollar limits on the amount of coverage an individual may receive.  Effective January 1, 2014.
  • Ensuring Coverage for Individuals Participating in Clinical Trials.  Insurers will be prohibited from dropping or limiting coverage because an individual chooses to participate in a clinical trial.  Effective January 1, 2014.

IMPROVING QUALITY AND LOWERING COSTS

  • Making Care More Affordable.  Tax credits to make it easier for the middle class to afford insurance will become available for people with income between 100 percent and 400 percent of the poverty line who are not eligible for other affordable coverage.  Effective January 1, 2014.
  • Establishing Health Insurance Exchanges.  Starting in 2014 if your employer doesn’t offer insurance, you will be able to buy insurance directly in an Exchange -- a new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans.  Effective January 1, 2014.
  • Increasing the Small Business Tax Credit.  The law implements the second phase of the small business tax credit for qualified small businesses and small non-profit organizations.  In this phase, the credit is up to 50 percent of the employer’s contribution to provide health insurance for employees.  Download the brochure… The Affordable Care Act Increases Choice and Saving Money for Small BusinessesEffective January 1, 2014.

INCREASING ACCESS TO AFFORDABLE CARE

  • Increasing Access to Medicaid.  Americans who earn less than 133 percent of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in MedicaidEffective January 1, 2014.
  • Promoting Individual Responsibility.  Under the new law, most individuals who can afford it will be required to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for uninsured Americans.  Learn more about Individual ResponsibilityEffective January 1, 2014.
  • Ensuring Free Choice.  Workers meeting certain requirements who cannot afford the coverage provided by their employer may take whatever funds their employer might have contributed to their insurance and use these resources to help purchase a more affordable plan in the new health insurance Exchanges.  Effective January 1, 2014.

Topics: health care reform

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