TUESDAY, Dec. 31, 2013 (HealthDay News) -- It survived a U.S.
Supreme Court challenge, multiple repeal attempts, delays of key
provisions and a disastrous rollout, and now the Affordable Care
Act, also known as "Obamacare," marks a major milestone.
Beginning Jan. 1, millions of uninsured Americans will have
health insurance, many for the first time in their lives. The law
provides federal tax subsidies to help low- and middle-income
individuals and families buy private health plans through new
federal and state health marketplaces, or exchanges. As of Tuesday,
more than 2 million Americans had enrolled in health plans through
the exchanges, government officials said.
The law also expands funding for Medicaid, allowing many
lower-income people to gain access to that public health program.
In 2014, 25 states and the District of Columbia are expanding
"I think from the consumer point of view, 2014 is a banner year," said Elisabeth Benjamin, vice president of health initiatives at the nonprofit Community Service Society of New York.
"We are finally able to get affordable, quality health coverage for most people who live in the United States," said Benjamin, whose organization leads a statewide network of "navigators" helping individuals and families to enroll in health coverage.
In addition to new coverage options, the new year brings the
following new consumer protections for most Americans (with some
exceptions for grandfathered plans):
But, underscoring the fact that nothing has been easy with the
rollout of Obamacare, U.S. Supreme Court Justice Sonia Sotomayor
threw an 11th-hour monkey wrench into the law's introduction late
Tuesday night. She temporarily blocked the Obama administration
from requiring some religious-affiliated groups to offer health
insurance coverage for contraception or face penalties, as required
by the law.
Ruling in favor of a request by an order of nuns in Colorado,
Sotomayor granted the delay just hours before the birth-control
requirement was to take effect on New Year's Day. She gave the
Obama administration until Friday to respond to the ruling,
The New York Timesreported.
Given the botched launch of the HealthCare.gov federal website
and the cancellation of individual policies that don't meet the
law's new coverage standards, public sentiment seems to be souring
somewhat on the massive health-reform legislation, formerly known
as the Patient Protection and Affordable Care Act.
More than one-third of adults (36 percent) support a repeal of
the law, up from 27 percent in 2011, a new
Harris Interactive/HealthDaypoll found.
Likewise, the latest Henry J. Kaiser Family Foundation tracking
poll found nearly half of the public (48 percent) has an
unfavorable opinion of the health-reform law. And a
New York Times/CBS Newspoll showed just a third of uninsured
Americans expect the law to improve the health system, with an
equal proportion saying it will help them personally.
Eyeing "Obamacare" as a deciding factor in the upcoming 2014
elections, many GOP leaders maintain a grim outlook for the law's
"Obamacare is a reality," Rep. Darrell Issa (R-Calif.), chairman of the House Oversight and Government Reform Committee, said Sunday on "Meet the Press." "Unfortunately it's a failed program that is taking a less than perfect health-care system from the standpoint of cost and making it worse, so the damage that Obamacare has already done and will do on Jan. 1, 2 and 3 will have to be dealt with as part of any reform," he said.
2014 is the year most Americans must have health insurance
coverage or pay a penalty. Many uninsured individuals who fail to
enroll in coverage by March 31 -- the end of open enrollment for
2014 -- may face penalties. These can go up to 1 percent of taxable
income or $95 per adult and half of that for kids (up to $285 for a
family of three of more).
There are a number of exceptions to that rule. Consumers whose
individual health insurance policies have been cancelled for
failing to meet the minimum requirements of the Affordable Care Act
may apply for a temporary exemption, the Obama administration
announced in December.
With major pillars of health reform kicking in this year, policy
experts say the law's success hinges on its performance in 2014 and
beyond, with enrollment being just one of the telling factors.
Some 7 million people had been expected to enroll in health
plans through the state and federal exchanges in 2014, while 9
million would enroll in Medicaid and the Children's Health
Insurance Program, according to Congressional Budget Office
projections. By those estimates, early enrollment is lagging.
"The point of the program is to provide people with insurance," Larry Levitt, a senior vice president and co-director of the Henry J. Kaiser Family Foundation's program for the study of health reform and private insurance, said in a recent webinar for journalists. "So for the program ultimately to be a success, people who are currently uninsured and eligible for this coverage need to sign up."
But it doesn't need to happen in the first year, he added.
"There are certainly many examples of new government programs that
took quite a while to ramp up," he said.
"The mix of enrollment is much more important than the total number," Levitt explained.
Another unknown: How many enrollees have actually paid for
coverage? In most states, people who signed up for coverage
effective Jan. 1 have until Jan. 10 to pay the first month's
Through the end of November, 800,000-plus people have been
deemed eligible for Medicaid or the Children's Health Insurance
Program, a government enrollment report indicated.
What's changing in 2014? HealthCare.gov has a
timeline of the health-care law.
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