GREENSBURG — For this reporter, listening to Cameron Wilson of Southeastern Indiana Health Organization (SIHO) give a presentation on navigating the implementation of the Patient Protection and Affordable Care Act (ACA; colloquially known as “ObamaCare”) was something akin to listening to a lecture on theoretical physics.
Cameron, who serves as SIHO’s director of fully insured products, is an expert on the ACA and knows its ins-and-outs and nuances. Cameron was on hand Tuesday morning to provide an overview of the ACA to member businesses of the Greensburg-Decatur County Chamber of Commerce. The public signup for the ACA began Oct. 1, runs through March 31, 2014, and is done exclusively online.
The basic requirements of the ACA are fairly straightforward and easily understood. At its core, the ACA requires all individuals to purchase health insurance. That coverage is purchased through government-run “exchanges,” which have recently been renamed simply, “the marketplace.” Marketplaces have been established and are run through either the Federal government or by each individual state, depending upon whether the state in question chooses to establish its own. Although Wilson is in no way a partisan player in the ACA rollout and has been tasked with simply clarifying and disseminating information, he conceded that, in large measure, the choice by states to establish individual marketplaces has largely been dictated by political-party affiliation.
In striving to achieve its goal of providing affordable coverage to all, Wilson explained, the ACA will expand both Medicare and Medicaid coverage; it also seeks to expand employer-provided insurance coverage, a fact which has made the law controversial in the business community.
Certain aspects the ACA began immediately after passage in 2010, while the bulk of the legislation won’t come into law until Jan. 1, 2014. Other pieces of the act that went into effect in 2010 will be significantly altered on Jan. 1, 2014. For example, under the ACA, from 2010 until the end of 2013, it’s illegal to deny health insurance coverage to anyone age 19 and under. Come 2014, with full ACA implementation, no one purchasing health insurance coverage, regardless of age, can legally be denied coverage because of a pre-existing condition. Full ACA implementation will also mean no annual lifetime or annual dollar limits can be place on coverage. The law will also establish caps on out-of-pocket deductibles that insured individuals and families can be required to pay; a single person can be required to pay no more than $6,350 per year out-of-pocket under the ACA, while a family can be required to pay no more than $12,700. The law also eliminates lifetime and annual dollar limits on essential health benefits.