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What provisions of the Affordable Care Act are going to be implemented in the future? Print Share

Monday, May 14, 2012

What provisions of the Affordable Care Act are going to be implemented in the future?

Many key provisions of the Affordable Care Act (ACA) are already in place, and the others are being implemented through 2014. Already, insurers are barred from denying children health insurance from children because of a pre-existing condition, young adults can remain on their parents’ health plans until their 26th birthday, and seniors are getting help paying for prescription drugs and now have access to preventive services, to name but a few changes.

As you can see in the map below from the Kaiser Family Foundation, New Mexico stands to benefit more from the ACA more than most states. Our state has the second-highest rate of uninsurance in the nation, and the ACA is helping to change that. New Mexico has received funding to expand and improve health care around our state, doing things like creating maternal-infant education programs, establishing a high-risk insurance pool for uninsured New Mexicans, and investing in the improvement and expansion of community health centers that serve rural areas.

Who Benefits from the Affordable Care Act Coverage Expansions?

kffmap

But there is more to come. The individual responsibility provision, commonly referred to as the “insurance mandate” will be implemented on January 1 of 2014, and will require most Americans to obtain some form of health insurance. This provision will have no impact on most Americans, who obtain insurance through their employers, and there is financial help available for those who may not be able to afford insurance on their own. You can read more about the mandate elsewhere on my website.

Many of the other provisions within the ACA will also impact New Mexico in a very positive way:

  • Some of the most popular provisions of the ACAprohibiting annual limits on health insurance and eliminating discrimination against individuals because of a pre-existing conditions, sex, gender, or health status—go into effect January 1, 2014. These provisions will ensure that all Americans can access health insurance—and that it provides meaningful coverage.
  • Establishing insurance exchanges, giving individuals and families the option to purchase health insurance on their own. Online health insurance exchanges will provide a marketplace for individuals and families to compare and select the health insurance plan that works best for them. All plans will meet certain benefits and cost standards—giving Americans more choices than ever before. Individuals can even take the money their employer would have spent providing insurance to pick a better plan. In fact, New Mexico has already received over $34 million of federal funding to ensure that our health exchange will be fully operational by January 1, 2014.
  • Tax credits to help the middle class afford health insurance go into effect. Also on January 1, 2014, those with an income between 100% and 400% of the poverty line—in 2010, that range included individuals earning less than $43,000 or a family of four making less than $88,000—will receive an advanceable tax credit (the credit can lower premium rates rather than waiting until a reimbursement at tax time). These tax credits could save a low-income family of four up to $14,900 a year.
  • Innovating health care delivery and coordination through Project ECHO at the University of New Mexico. UNM’s Health Sciences Center recently received $8.5 million to treat patients with multiple chronic diseases that are expensive and complex to treat. These patients will receive care from “primary care intensivists” who are specifically trained to manage complex cases and will receive care from different area organizations and providers. UNM has had eight years of success with this program in New Mexico, and ECHO’s implementation is projected to save $11 million in three years.
  • Increased doctor payments through Medicaid. Starting January 1, 2013, doctors will be paid just as much to treat Medicaid patients as they do to treat Medicare patients for primary care services. This will ensure that doctors can treat seniors, children, and other low-income individuals without taking a loss, and is intended to expand access to health care for Medicaid beneficiaries. These payments are fully financed by the federal government.
  • CHIP coverage extended for another two years. On October 1, 2013, states will receive two more years of funding to provide health care for low-income children who do not qualify for Medicaid. This will benefit well over 9,500 New Mexican children covered by CHIP.
  • Increasing the small business health insurance tax credit, allowing qualified small businesses to deduct up to 50% of the employer’s contribution to provide health insurance for employees. This will ease the burden on small businesses while helping their employees access health insurance.