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Drivers for Success in 2014: Health Care

December 7, 2013
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If you’re still digging through the details of the Affordable Care Act (ACA), often called Obamacare, you aren’t alone. The legislation is more than 20,000 pages long, with many of its various rules still a work in process. To help sift through the newness of ACA, Roberta Riportella, Kansas Health Foundation professor of community health at Kansas State University School of
Family Studies and Human Services, answers several common questions.

Do I have to sign up for health insurance? ACA mandates that every U.S. citizen or legal resident who makes above a set income level must buy it or pay a fine (with few exemptions). Individuals who have insurance through their employer, private market or public programs such as Medicaid and Medicare are considered insured. Those individuals who can afford health insurance but choose not to buy it might be fined $95 or 1% (whichever is greater) of their 2014 taxable income. Because software problems hindered the online sign-up process, the deadline for being
insured has been moved to March 31, 2014. Proof of insurance will need to be submitted with 2015 income tax filings.

Where do I go to get insurance? Go to www.healthcare.gov and choose from a selection of the insurance products.

What are the key provisions? All of the insurance plans have no limits on how much they pay out to cover 10 essential health benefits. No one can be denied insurance because of pre-existing conditions. Higher premiums will not be imposed based on gender or other health-risk factors, although older people and smokers will pay more. Policies cannot be canceled.

Am I required to provide health insurance to my employees? Farms and businesses with fewer than 50 employees are not required to provide insur­ance for their workers, but they can. Small businesses with fewer than 25 full-time employees can receive tax credits of up 50%. If you have 50 or more full-time employees, you’ll need to offer "affordable and adequate" (which is clearly defined in the law) health insurance beginning in 2015. ACA defines a full-time employee as one who works 30 hours or more each work week or an average of 130 hours per month. Even if you cut employees’ hours to less than 30 hours per week, you might still have to cover their insurance, depending on your total number of employees and the total number of hours they work.

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