how has the aca changed healthcare careers
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How has the aca changed healthcare careers

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The announcement from the Department of the Treasury stated that such employers would have until to provide coverage to their employees. The administration delayed enforcement of this requirement for a second time in February The announcement stated that midsize employers with 50 to 99 full-time employees would have until January 1, , to offer health coverage.

Additionally, for large employers with or more full-time employees, the requirements would be phased in: they would be required to offer health coverage to 70 percent of employees by January 1, , and to 95 percent by January 1, The administration considers 95 percent "substantially all" of a business' full-time employees. The ACA requires every individual to enroll in health insurance beginning in If a person is uninsured for three consecutive months in a year, he or she will be assessed a penalty.

The first open enrollment period for purchasing health plans on the exchanges ran from October 1, , until March 31, To avoid being uninsured for the first three months of the year and facing a penalty, individuals would have had to sign up by February 15, On October 28, , the administration announced that it would grant a hardship exemption to individuals who signed up after February 15, essentially waiving the penalty these individuals would have otherwise faced.

Prior to the passage of the ACA, most states did not offer Medicaid to low-income childless adults. Most also restricted the eligibility of low-income parents to those with incomes below the federal poverty level. When the ACA was passed, it required states to expand eligibility for their Medicaid programs to all individuals with incomes up to percent of the federal poverty level.

If the state refused to expand, the law said that the federal government could withhold all of its portion of Medicaid funding from the state.

Shortly after the law's passage, 26 states sued the federal government to challenge the requirement to expand Medicaid. The case made its way to the United States Supreme Court , which ruled on June 28, , that the provision was unconstitutionally coercive.

The decision effectively made expanding Medicaid voluntary on the part of the states. The ACA establishes a 40 percent excise tax on high-cost health plans known as the "Cadillac tax. The tax was originally slated to go into effect in In December , President Barack Obama signed legislation that delayed implementation of the tax until , although many have called for a repeal of the tax entirely.

The tax was intended to be one of the major sources of revenue that would offset the costs of the ACA. The ACA requires large employers to provide their employees each year by January 31 a tax-related form that reports information on health coverage offered by the employer over the previous tax year; this information is intended to be used by employees to determine their eligibility for advanced premium tax credits.

While the law set the provision to go into effect in , the Internal Revenue Service IRS delayed the mandate until The IRS delayed the effective date until Affordable Care Act. Centers for Medicare and Medicaid Services.

Ballotpedia features , encyclopedic articles written and curated by our professional staff of editors, writers, and researchers. Click here to contact our editorial staff, and click here to report an error. Click here to contact us for media inquiries, and please donate here to support our continued expansion. Share this page Follow Ballotpedia. Subscribe Donate. Subscribe Subscribe. What's on your ballot? Tell us about what you studied. Without going into the details, people who are below 21 had access to Medicaid coverage even before the Affordable Care Act, whereas people who were just over 21 aged out of Medicaid.

They lost Medicaid coverage just because of the way the Medicaid rules were set up. But with the Affordable Care Act, this false discontinuity was eliminated.

This gives us a nice, neat little experiment where people who are over the age of 21 now suddenly have access to Medicaid because of the Affordable Care Act. This allows us answer this question of what happens when people suddenly get access to insurance coverage. Knowledge at Wharton: Are these the people that are described as being covered by the Medicaid expansion?

But let me just focus on three particular aspects that I think are key. If you just focus on people who are in this age band of 21 to 23 that we looked at, the share of people in that group who are covered by Medicaid goes up by about 20 percentage points. But what we also find is that the decrease in uninsurance, which was the main goal of the Affordable Care Act, is not of the same magnitude. The reason is that some of these people who are gaining Medicaid coverage were earlier covered by other forms of insurance coverage.

Particularly in this case, we find that Medicaid coverage is going towards covering people who were originally covered by county indigent programs. Basically, county tax dollars are now being replaced by federal tax dollars.

This is pretty large in terms of the magnitude. A second takeaway is that we see a fairly robust change in where people are getting their health care. Private hospitals tend to have higher-quality metrics. We take this as a sign that once people have choices, they tend to chose better quality hospitals. It is correlated mainly with ownership and performance on different quality measures.

The third thing that we tried to look at is whether this has resulted in improvement in health outcomes for patients. These people previously did not have access to health care. Let me be more specific. But we do find some suggestive improvements. I think the story really over there is that we might only have short-term effects right now because we only have two years of data post the expansions.

Also, these effects are probably not large enough right now. Gupta: Exactly. Knowledge at Wharton: Were these people covered by Medicaid when they were under 21 because they had medical conditions that made them eligible, or were they covered because of income?

Or both? Gupta: Disability was definitely one reason why some people were covered by Medicaid. On either side of that age threshold, if you were disabled, you would get Medicaid coverage. The main difference is between people who have kids and people who do not have kids.