Exploring Options Under the Affordable Care Act

With the implementation of additional sections of the Affordable Care Act (ACA) now less than six months away, it’s a good time for booksellers to start considering their insurance options under the new health care law. As the roll-out date of January 1, 2014 draws closer, more information is being released to help small business owners and their employees make choices. Here is a look at some recent developments with links to help booksellers start preparing for ACA.

A significant aspect of the law is the Health Insurance Marketplaces, which are set to open in January 2014 while enrollment in the exchanges begins October 1.  The exchanges will be “online marketplaces where uninsured people can compare insurance policies, find out whether they qualify for either Medicaid or federal tax subsidies, and purchase insurance,” as reported by Stateline, the daily news service of the Pew Charitable Trust.

Still up in the air is whether every state will expand Medicaid. Currently, Medicaid “mostly” covers pregnant women and young children, disabled adults, and the elderly, Stateline noted, but under ACA, it is expected that Medicaid will be expanded to also cover adults between the ages of 18 and 65 “with incomes up to 138 percent of the federal poverty line.” At present, 21 states and the District of Columbia have decided to expand Medicaid, and the issue is being debated in other states, including Arizona, Florida, Michigan, New Hampshire, and Ohio.

What is certain, however, is that each state will have a Health Insurance Marketplace. According to HealthCare.gov, states can create and run their own Marketplace, or have a Marketplace supported by the Department of Health and Human Services (HHS). States may also choose to partner with HHS to run some functions of their Marketplace. Conditional approval has already been granted to some states that are on track to have a Marketplace starting in October 2013.

States planning to run their own insurance marketplaces are California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont, and Washington.

States that are partnering with HHS to create exchanges are Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, and West Virginia.

To see where all states currently stand in the health exchange planning process, go to the Center for Consumer Information & Insurance Oversight (CCCIIO).

An important part of the Marketplace will be the Small Business Health Options Program, or SHOP, which is focused solely on small businesses. Each state exchange will operate a SHOP that offers small businesses and their employees a variety of qualified health plans. Starting in 2014, SHOP will allow small business owners to make side-by-side comparisons to find a plan that fits their budget and that works for the business and its employees. Beginning in 2015, employers will be able to choose a variety of plans to offer to their employees, and each employee will be able to choose the plan that best suits his or her needs. In at least California and Connecticut, small business owners will have these latter options beginning in 2014.

Using SHOP will give small business owners exclusive access to an expanded Small Business Healthcare Tax Credit. This tax credit covers as much as 50 percent of the employer contribution toward premium costs for eligible employers who have low- to moderate-wage workers. For more information on SHOPs, go to healthcare.gov/marketplace/small-businesses/index.html.

In addition, to help small business owners prepare for ACA, HealthCare.gov has put together a Checklist for Small Businesses and a Checklist for Families and Individuals.