Texas Tech University Health Sciences Center
Affordable Health Care Act: The End of the Beginning

Affordable Health Care Act: The End of the Beginning

Affordable Health Care Act: The End of the Beginning- image0After a series of military defeats in the early part of World War II, Winston Churchill could finally tell the House of Commons, "We have a new experience. We have victory - a remarkable and definite victory." The way he described it shows his wonderful command of the English language. He said, “Now, this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.

The same thing might be said for the Affordable Health Care Act, commonly known (I don’t like to call it this)—but, ObamaCare. We are not at the end of how it will eventually look nor are we at the beginning, but we might say we are at the end of the beginning.

President Obama’s re-election stopped any questions about whether this law, that so changes the U.S. health care system, would take effect. The various states, including Texas, will have to establish (or the federal government will do it for us) an insurance exchange. An insurance exchange, where the currently uninsured can purchase insurance, needs to be ready to go two months before January 1, 2014, or about a year from now. Most people getting private insurance through exchanges will receive subsidies through tax credits to help pay for the premiums. They can access the subsidies in January 2014. Texas has plenty of people that need help --about 6 million uninsured residents, roughly a quarter of our population — higher than any other state. According to media reports, the Texas Health and Human Services Commission, which manages the Medicaid program, will ask the Legislature for an additional $6.7 billion in the next legislative session.

Employers and individuals face decisions and deadlines. Businesses with 50 or more workers will essentially be assessed a fee of $2,000 to $3,000 per full-time employee for not offering coverage. Their deadline is Jan. 1, 2014. People who do not have insurance will have until January 2014 to decide whether to buy insurance through the exchange or face a penalty assessed through the Internal Revenue Service. About half of the currently uninsured will likely get insurance through an exchange and the other half will be covered by an expansion of Medicaid. But, time will tell.

Fines for those who choose to remain uninsured will start in 2014 at $95 per adult and $47.50 per child, and then increase to $695 per adult and $347.50 per child by 2016, according to the Kaiser Foundation. So, now you see why I say regarding the Affordable Health Care Act, we are not at the end, nor are we at the beginning. We are at the end of the beginning—but the rest of the trip should be most interesting.