Provision of ACA Limiting Consumer Costs Delayed

Posted by Tim Teague on 8/15/13 2:43 PM

Topics: Health Care Staffing

describe the imageA portion of the Affordable Care Act (ACA) protecting consumers against higher health care costs has been delayed by the Obama administration. Originally scheduled to kick in Jan. 1, 2014, this aspect of the ACA will now begin in 2015.

According to the New York Times' Robert Pear:

"The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014."

This comes on the heels of an announcement in July that delayed until 2015 the mandate for employers with 50 or more full-time employees to offer minimum-value insurance and cover 95 percent of those workers through so-called employer shared responsibility requirements.

The Wall Street Journal's Amy Schatz credited the business community in saying, "corporate America has succeeded in persuading the Obama administration to temporarily postpone a growing number of its provisions."

Pear's Times article also cited a lack of technological readiness among insurance companies as well as the business community. The piece noted:

"Federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs."

Still, beginning in October, health insurance marketplaces will start to open, and some states are taking different approaches.

Oregon, for example, will experience a slight delay in getting its exchanges up and running.

Meanwhile, others, like Colorado, are working to get ahead of the changes. According to a piece written by Katie Kerwin McCrimmon of Health Policy Solutions:

"Colorado's Division of Insurance has approved 242 plans from 13 carriers for the state's health exchange, Connect for Health Colorado, which is slated to open on Oct. 1."

Another state, Maryland, has even opened a bi-lingual call center for residents and small businesses to have their questions answered.

Each state was given the option of running its own health insurance exchange or allowing the federal government to operate the exchange on its behalf.

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