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September 11, 2013

Daily Briefing primer: The Affordable Care Act's 2014 rollout

Daily Briefing

Jan. 1, 2014 brings the "full implementation" of the Affordable Care Act (ACA). But what does that mean?

Here's the short answer: Millions of Americans will gain health insurance next year because of ACA provisions intended to make coverage mandatory for most residents, make it more accessible and affordable, and end discriminatory practices.

Here's a slightly longer answer...

New coverage requirements

The individual mandate goes into effect on Jan. 1, 2014. The provision requires most U.S. residents to obtain health insurance coverage or pay a penalty. The nine categories of residents exempt from the mandate are:

  • Individuals who cannot afford coverage;
  • Taxpayers with incomes below the filing threshold;
  • Members of Indian tribes;
  • Hardship;
  • Individuals who have short gaps in coverage;
  • Individuals who object to health coverage on religious grounds;
  • Members of a health care-sharing ministry;
  • Incarcerated individuals; and
  • Individuals who are not legally in the United States.

Notably, the ACA's planned employer coverage mandate—which requires employers with at least 50 workers working 30 hours or more per week to provide affordable health coverage or face a $2,000 fine per worker—would have begun in 2014. However, the provision has been delayed until 2015.

More affordable coverage options

In 2014, the ACA rolls out new coverage options for millions of Americans.

More comprehensive coverage

The ACA in 2014 will roll out new consumer protections:

  • Insurers will be prohibited from denying patients with pre-existing conditions and gender. In the exchanges, insurers cannot charge higher prices for individuals based on gender or health status.
  • Annual limits on insurance coverage will be eliminated.
  • Insurers will be barred from dropping beneficiaries because they chose to participate in a clinical trial.

Sources: Treasury fact sheet, 8/27; HHS fact sheet, accessed 9/6; Daily Briefing primer, 9/9; Daily Briefing primer, 5/3

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