It seems like there is weekly news to report on the Affordable Care Act—generally about a provision being delayed, infrastructure that’s not quite ready or some other administrative or technical gum in the works.
If you’re wondering how to keep track of what’s delayed, what’s not and what the current slate of ACA deadlines are, wonder no more. Here’s a rundown of where things stand to date:
However, ACA’s individual mandate remains in effect for January 1, 2014. Here’s what you need to know about what to tell employees and our advice on how to communicate your plan’s value.
Caps on out-of-pocket costs—which hold health plan participants to spending no more than $6,350 (for individuals) and $12,700 (for family coverage) per year—also has been delayed until 2015, but only for plans with an employer using two separate vendors for its medical and pharmacy benefits. For employers using a single vendor, the cap provision remains in effect for Jan. 1, 2014.
Technical delays. Oregon, one of just 14 states that chose to finance and operate its own health insurance exchange under ACA, hit some stumbling blocks in its effort to open the marketplace by Oct. 1 (24 days from now). Applicants to the Oregon exchange won’t be able to purchase health coverage completely independently on Oct. 1—rather, for at least two weeks, they’ll need the assistance of a third-party broker or similar organization. Similar functionality delays are occurring in states building DIY exchanges, including Connecticut and Nevada. Oregon aims to have the exchange be fully functional within the first two weeks of October.
The government-run super computer—a $267 million system known as the “Hub,” which pulls together data from seven federal agencies from the IRS to the Peace Corps and aims to keep track of which Americans have health insurance and/or are eligible to buy it with a federal subsidy through the exchange system—will be unable to verify whether people who buy insurance via exchanges are eligible to receive the subsidy by Oct. 1, when the marketplaces start enrolling new members. No word from the administration about when the Hub might be operating at full functionality.
Another government computer glitch will relieve smokers from premium penalties due to their tobacco status. Although ACA allows insurers to make smokers pay higher premiums (up to a 50% penalty), the glitch has delayed the penalty for at least a year. The problem is that ACA also prohibits carriers from charging older plan members more than three times the premiums of the young and hardy. So, the government’s computers are unable to apply both the premium cap and the smoker penalty at once. The same penalty must apply equally to young and old, or not at all.
Yet, despite the delays, all exchanges still are required to open their doors to new applicants on Oct. 1. Also, your communications to-do list remains, and may be more important now than ever!