Health Overhaul Benefits Take Effect with New Year

Health Overhaul
Nell Redmond/APHoward Kraft looks over health care information in his Lincolnton, N.C. home Monday. A painful spinal problem left him unable to work as a hotel bellman, but Redmond has coverage because federal law now forbids insurers from turning away people with health problems.
By JULIET WILLIAMS

SACRAMENTO, Calif. -- After a troubled rollout, President Barack Obama's health care overhaul now faces its most personal test: How will it work as people seek care under its new mandates?

Most major pieces of the Affordable Care Act take full effect with the new year. That means people who had been denied coverage because of a pre-existing medical condition can book appointments and get prescriptions.

Caps on yearly out-of-pocket medical expenses will mean people shouldn't have to worry about bankruptcy after treatment for a catastrophic illness or injury. And all new insurance policies must offer a minimum level of essential benefits, ranging from emergency room treatment to maternity care.

The law's benefits apply to individual policies as well as those offered through employers.

But one benefit didn't take effect as expected after Supreme Court Justice Sonia Sotomayor late Tuesday night temporarily blocked the part of the law requiring some religious-affiliated organizations to provide their workers with insurance that includes birth control. Government officials have until Friday to respond to her emergency stay.

Administration officials said this week that 2.1 million consumers have enrolled through the federal and state-run health insurance exchanges that are a central feature of the Affordable Care Act. Millions more have been enrolled in Medicaid, after the federal law allowed states to expand the health insurance program for the poor.

Yet how many of those who signed up for coverage on the exchanges will follow through and pay their premiums won't be known for a couple of weeks. People who signed up on the federal website have until Jan. 10 to pay premiums for coverage retroactive to Jan. 1, while consumers in some states have until Jan. 6.

Those who enrolled during the exchanges' first three months, persisting through serious technological problems and jammed call center phone lines,
are probably motivated to make sure they have a policy in place as soon as possible, said Anthony Wright, executive director of Health Access California, which advocates for lower-income people and supports the federal health care changes.

"These are people who made a point of signing up and signing up before the deadline so they could start on Jan. 1. That suggests to me that that will be a population that is more likely to follow through with the payment," he said.

Premiums paid after the deadline will be applied to coverage starting Feb. 1 or later. Consumers have until March 31 to sign up in time to avoid a federal tax penalty for remaining uninsured. That fine starts at $95 for an individual this year but climbs rapidly, to a minimum of $695 by 2016. There is an additional fine for parents who don't get health insurance for their children.

Although the federal website is apparently fixed for consumers, the start of the year still could bring plenty of confusion.

Insurers say they are receiving thousands of erroneous sign-up applications from the government, and some people who thought they had enrolled for coverage haven't received confirmation. Undoubtedly, some will find out they don't have the immediate coverage they thought they did.

Some states, including Minnesota and Rhode Island, extended their sign-up period until the final day of 2013, leading to a last-minute crush of paperwork for insurers. Call center wait times in Minnesota extended beyond two hours Tuesday, a possible sign of heavy consumer interest.

Anticipating disruptions, major drug store chains such as CVS (CVS) and Walgreens (WAG) have announced they will help customers who face coverage questions, even providing temporary supplies of medications without insisting on up-front payment. Many smaller independent pharmacies also are ready to help.

Some parts of the Affordable Care Act took effect previously, such as the ability of young people to remain on their parents' insurance policies until age 26.

Others have been delayed until 2015, including the law's requirement that companies with 50 or more workers must provide affordable coverage or pay fines. The administration says it's trying to iron out burdensome reporting requirements.


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22 Comments

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evans.mom

Where's that badsomey guy? He sounds like my type of guy. Gullible and dumber than dumb. He could be my sugar daddy--if he can get passed the smell and that lump of garbage that lives in my basement.

January 02 2014 at 2:41 PM Report abuse -1 rate up rate down Reply
evans.mom

My hoo hoo itches.

January 02 2014 at 2:31 PM Report abuse -3 rate up rate down Reply
1 reply to evans.mom's comment
evans.mom

I need to grap a bus ride to the clinic. Evan find my welfare bus pass.

January 02 2014 at 2:35 PM Report abuse -2 rate up rate down Reply
redstateredneck.hillbilly

I hear the republicans want to cut my welfare and food stamps. If they do this they will starve their base.

January 02 2014 at 1:27 PM Report abuse +2 rate up rate down Reply
redstateredneck.hillbilly

I love my food stamps and welfare but I hate the government.

January 02 2014 at 1:25 PM Report abuse +3 rate up rate down Reply
samuri.sansui

No wonder Japan buy most of Rockefeller center and steal car market. You round eye too stupid to see past own nose.

January 02 2014 at 12:28 PM Report abuse -2 rate up rate down Reply
samuri.sansui

Obama bad leader like Toru Hashimoto !! Tyrant take all people's money.

January 02 2014 at 12:21 PM Report abuse -2 rate up rate down Reply
samuri.sansui

Obamacare no good, take from productive citizen to make them poor too. I can't hire more people for small business. Fines would put me out of business and forced in breadline. No good, get rid of stupid law.

January 02 2014 at 12:16 PM Report abuse -1 rate up rate down Reply
2 replies to samuri.sansui's comment
teaparty2implode

Corporations are making record profits while they cut hours and benefits.

January 02 2014 at 12:18 PM Report abuse +1 rate up rate down Reply
2 replies to teaparty2implode's comment
samuri.sansui

Obama give money to bankrupt company, how may people they hire ?

January 02 2014 at 12:24 PM Report abuse rate up rate down
theycallmeroy3

Yes, but that won't always be true going forward. And when there's ying-yang of tax expiration's, doesn't bold well going in future endeavors So come up with solutions for what Bernanke called, " the long term unemployed."
Does expanding social safety nets help or hurt? If one believes it helps, then the only solution is to never run out of people, place or things to tax.

January 02 2014 at 12:27 PM Report abuse rate up rate down
samuri.sansui

You no unnastan, you side with dictator. Corporations hire people, give people job. Where Obama give jobs ?

January 02 2014 at 12:23 PM Report abuse -1 rate up rate down Reply
2 replies to samuri.sansui's comment
teaparty2implode

Corporations rip off consumers by over charging them. They also pay their employees low wages and are providing less benefits. While the majority of Americans want a raise in the minimum wage, 2014 will be the year for a raise in federal minimum wage.

January 02 2014 at 12:30 PM Report abuse rate up rate down
samuri.sansui

You no pay, go start own company take profit away. Dumb round eye.

January 02 2014 at 12:36 PM Report abuse -2 rate up rate down
samuri.sansui

No more cut, copy, paste. No opinions from own brain ? What wrong with you round eye ?

January 02 2014 at 12:12 PM Report abuse -2 rate up rate down Reply
theycallmeroy3

Eventually, the American public will have to ask, if social policies of the last 13 years have helped or hurt the populace. Bush did love the poor. And a large majority of social policy under his administration, validates that. Obama just expanded them.

January 02 2014 at 11:54 AM Report abuse +1 rate up rate down Reply
Lori Richmond Hudnal

While I can understand the intention of the Affordable Care Act to ensure that all American have access to health care, I cannot understand how simply mandating insurance coverage will ensure that Americans receive "good" health care. The are many more factors that need to be addressed within the American health care system. From a financial stand point, I do not see how mandating insurance policy premiums is going to provide enough money to pay all of the claims. In my opinion, something needs to be done to address the disparity of fees charged for services. There is no reasonable explanation as to why the fees for standard testing such as mammograms and colonoscopies vary so widely across the country and across providers such as hospital, clinics and stand alone diagnostic centers. There is no reasonable explanation as to why a prescription for the same medication can cost $100's of dollar in difference from one state to another. The prescriptions are generated by the same company in the same location and distributed across the country. There is no reasonable explanation as to why juries award such astronomical settlements for stupidity. I understand people need compensation for injuries sustained for negligence, but sometimes it appears as if the award for damages far exceed the earning capacity of the injured party or the anticipated costs of future medical expenses. I understand that hospitals, clinics, doctors, pharmaceutical companies operate to generate a profit. It is the American dream. But when is enough considered enough? When does the general public cease to be held hostage to the almighty dollar? Insurance policies are not the complete problem. Nor will the Affordable Care Act be the complete answer that everyone is assuming it will be. Until all facets of the American health care system are addressed, we are only putting a band-aid on the problem.

January 02 2014 at 11:14 AM Report abuse rate up rate down Reply