The Patient Protection and Affordable Care Act Increase the quality and affordability of health insurance Lower the uninsured rate by expanding public and private insurance coverage Reduce the costs of healthcare for individuals and the government mandates insurance exchanges subsidies

Provisions of PPACA Guaranteed coverage Individual mandate pre-existing conditions same premiums by age group and geographic area regardless of gender Individual mandate insurance required for everyone Employer mandate > 50 full-time employees ≥ 30 hours

Provisions of PPACA Individual “shared responsibility fee” or tax penalty 2014 - 1% annual modified adjusted gross income or $95/adult, $47.50/child, $285 max 2015 – 2% annual modified adjusted gross income or $325/adult 2016 – 2.5% annual modified adjusted gross income or $695/adult 2017 – increases based on rate of inflation, 2.5% minimum small business fines $2000 - 3000/employee

Provisions of PPACA Health insurance exchanges/marketplaces Minimum standards for insurance policies four levels of coverage based on premium : out-of-pocket expenses no lifetime coverage caps dependents covered until age 26 80 – 85% medical loss ratio Subsidies tax credits 100 – 400% poverty level Expansion of Medicaid raised income ceiling to 133% poverty level 25 states & District of Columbia

Essential Health Benefits Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care

Important Dates 10/1/13 – 3/31/14 – open enrollment 12/14/13 cut-off for coverage to begin 1/1/14 1/1/14 – penalties begin to accrue 2/15/14 – cut-off for coverage to begin by 3/31/14

Do It NOW! You know more about personal finance after reading this chapter, so get started right now by: Check out the health insurance exchange and compare $$$ and coverage. Pay attention to spousal surcharges. Don’t forget the kids! Flexible spending arrangements—healthcare v. dependent care. You do not have to wait to get started on managing health expenses. Get started today by doing these three things. Learn exactly what group health care coverage you actually do have through your job, your school, and/or your parents. 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or on a password-protected website for classroom use.