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See the first story in The Columbian's ongoing coverage: 'Health homes': Effort aims to improve care for Medicaid clients, save money
Some of the most significant changes to the U.S. health care system will go into effect in January, following more than three years of planning and incremental implementation.
The changes are the result of the Affordable Care Act signed by President Barack Obama on March 23, 2010.
The Affordable Care Act — often referred to as simply "health care reform" or "Obamacare" — put in place comprehensive health insurance reforms that began rolling out in 2010. By 2014, nearly all of the law's new rules and regulations will be in place.
The Affordable Care Act affects everyone — seniors, the uninsured, Medicaid clients, the currently insured and employers.
Yet, most people are unsure just how it will affect them.
Poll results released by the Kaiser Family Foundation in April revealed that 49 percent of Americans say they don't have enough information to understand how the changes will impact their own family.
Through a series of upcoming stories, The Columbian hopes to help Clark County residents understand the impact of health care reform locally and across the state.
Over the next several months, The Columbian will publish stories addressing various components of the Affordable Care Act — including Medicaid expansion, the individual and small-business health insurance exchanges, and other new programs — and how local families, employers and health care providers are grappling with the changes.
After the Jan. 1 implementation date, we'll take a look at how the system is faring in Clark County.
Changes so far
Several components of the Affordable Care Act have been implemented in the last three years. Here's a look at some of those changes:
• Children can no longer be denied coverage based on pre-existing conditions.
• Insurance coverage cannot be rescinded due to a customer's application error.
• Preventive services, such as mammograms and colonoscopies, are covered without co-pays.
• Insurance access is available to certain people with pre-existing conditions.
• Young adults can stay on their parents' insurance plans until age 26.
• Medicaid payments to primary care physicians are increasing.
Later this year, on Oct. 1, open enrollment will begin for individuals and small businesses to purchase insurance coverage.
And in 2014, even more components of the law will go into effect.
Some of the upcoming changes will:
• Prevent insurance companies from refusing coverage or policy renewal due to a person's pre-existing conditions.
• Prevent companies from charging higher rates due to gender or health status.
• Prohibit annual dollar limits on the amount of coverage an individual may receive.
• Provide tax credits to people with income between 100 and 400 percent of the poverty level (who are not eligible for other coverage) to reduce the cost of insurance coverage.
• Open health exchanges offering insurance plans for individuals without employer-provided insurance, and small businesses to purchase.
• Increase the tax credit for qualified small businesses that purchase coverage for their employees
• Expand Medicaid to include people who make up to 138 percent of the federal poverty level.
• Require coverage of most individuals who can afford it. Those who don't comply and don't have an exemption will be required to pay an annual fine of $95 or 1 percent of their income, whichever is greater.
The White House recently announced implementation of another significant component of health care reform — the large employer requirement — will be delayed until 2015. When implemented, this component of the law will require large employers — those with more than 50 employees — to provide affordable insurance coverage to their employees or face a penalty.