The new year brings change with it in the realm of healthcare. Some provisions of the Affordable Care Act will start to phase in this year. While most of the biggest changes will occur in 2014, we still have some things to get used to: here is what you should know.
The Medicaid expansion will kick in this coming year, however, the Supreme Court’s decision last June made the expansion optional so we can expect some recalcitrant Governors to fight compliance. So far, 17 states have agreed to participate, while 9 have said they will not. The rest will have to make the decision next year. But since the Obama administration has refused to allow partial compliance, and those who need – and sell – the coverage will likely pressure those governors, we can probably guess how long they will hold out. Medicaid payments to providers are going up as part of the ACA, too. That’s perfectly fine with the doctors, as well as with the patients who will have an easier time finding providers. But it will really bug those who think it already costs too much.
Those insurance exchanges will be in the news a lot next year as they must all go “live” on October 1st. Again, some states are being stubborn, refusing to form local exchanges and leaving it in the federal government’s hands. Either way, it will be a lot of work. Even people who have chronic conditions will be covered by these exchanges and anyone between 133% and 400% of the poverty level will be subsidized so that they can afford to join them.
The country will also be gearing up for Medicare reform, with the Medicare tax going up by less than 1% and a new tax on investment income of 3.8%. These take effect on January 1st and are expected to raise about $245 billion in revenue by 2019, to help pay for the 33 million people who will be covered under the ACA provisions. As for other reforms, such as raising the eligibility age or converting Medicare to a voucher program, most experts believe those are dead. There have been other proposals but they will not have any affect in the near future if they go through.
Another small but significant benefit of the ACA will also begin on the first day of the new year. Those of us who don’t speak or read insurance-ese will get a huge break as insurance companies will be required to use easy-to-understand English in all their plan paperwork. It won’t be perfect but it will certainly help.
The cost of healthcare, even though it is projected to rise more slowly, will still be a topic of much discussion. After all, nearly $3 billion – about $8,200 per person - is an awful lot to spend on healthcare. That is over 17% of our GDP and more than any other industrialized nation in the world spends. We can expect to be hearing more about that.
No matter what kind of healthcare you have, expect to be making some adjustments this coming year. Thanks to the Affordable Care Act, more and more Americans will be covered and that is good for all of us.
T. Steelman is a life-long Liberal. She has been writing online about politics since 2007. She lives in Western Washington with her husband, daughter, 2 cats and a small herd of alpacas. How can anybody be enlightened? Truth is, after all, so poorly lit…