After more than half of eligible North Carolinians received insurance during the Affordable Care Act rollout, the healthcare community is gearing up for the second year of enrollment beginning Nov. 15, 2014.
Lindsay Smith, marketing and public relations director at South East Area Health Education Center (SEAHEC), discussed the law’s rollout and how future implementation could change during the League of Women Voters of the Lower Cape Fear’s July 28 Hot Topic Luncheon.
“We’re at the beginning of the process, so who knows where it’s going to go. This is the beginning of a transformation in healthcare. I work in healthcare and there’s a lot of shake-up going on and it’s not just on the insurance side. The way doctors do medicine is radically changing,” Smith said.
The first open enrollment for the Affordable Care Act took place Oct. 1, 2013, through March 31, 2014. Rates were based on age and location, with federal subsidies available to offset costs for applicants with incomes between 100 and 250 percent of the federal poverty level. Individuals offered insurance through employers were not eligible to receive subsidies.
Although it was not a factor in the first enrollment period, Smith said marketplace insurance plans will eventually consider tobacco use as a factor in determining healthcare costs.
North Carolina opted to offer insurance through the federal marketplace with 26 plans offered by Blue Cross and Blue Shield of North Carolina in the Wilmington region. During the open enrollment period, 357,584 of 581,173 eligible North Carolinians became insured.
Smith said penalties for the uninsured will mount year by year. Uninsured individuals who do not qualify for an exemption from the law will be charged $95 or 1 percent of annual income when 2014 income taxes are filed. By 2015, the fee will increase to $325 or 2 percent of income and by 2016, the fee will increase to $695 per person or 2.5 percent of income.
Some changes will evolve as the law is implemented in increments, like increased penalties for individuals without coverage and tobacco use as a factor considered in coverage costs, while courts will determine other changes as cases disputing the law are considered.
In addition to the U.S. Supreme Court’s Hobby Lobby decision to exempt corporations on religious grounds from covering certain types of contraception for female workers, Smith explained conflicting rulings by the U.S. Court of Appeals for the District of Columbia Circuit and the Richmond-based U.S. Court of Appeals for the 4th Circuit on whether language in the act renders federal subsidies offered through state-operated exchanges illegal.
Smith suggested people keep an eye on the issue, as the Supreme Court could ultimately rule on the two courts’ disagreement and adjust implementation of the law.
“I think people need to pay attention to the legal battles out there because there are still changes that are being made,” Smith said.
The next open enrollment period under the Affordable Care Act will take place Nov. 15, 2014, through Feb. 15, 2015.
SEAHEC serves New Hanover, Pender, Brunswick, Duplin and Columbus counties by providing training and education to improve healthcare services.
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