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Last week, everythingpeople.™ This Week! ran an article summarizing the numerous key dates and provisions of the Affordable Care Act that will take effect in January 2014. This follow-up article looks beyond the month of January to the rest of 2014. Below is a summary of significant dates and healthcare trends tied to the ACA that individuals and employers should be aware of starting in March:

March 31, 2014

Open enrollment for purchasing healthcare insurance through the Marketplace comes to a close. Individuals who do not enroll in insurance that meets the ACA’s minimum coverage standards by this date will face a penalty. Penalties for not purchasing health insurance coverage are not due until federal taxes are filed in 2015 for calendar year 2014. Individuals who enroll in late March will see their coverage take effect on May 1, 2014.

April 1, 2014

The Healthy Michigan program becomes effective. Healthy Michigan will expand Medicaid coverage by roughly 320,000 more low-income adults in 2014, up to about 450,000 additional people becoming covered within three years.

November 4, 2014

Midterm elections take place on this date, at which point there will be almost a full year of the Affordable Care Act under the nation’s belt. As Americans cast their votes, their feelings towards the ACA will undoubtedly play a role in the outcome of these elections. When the ACA was passed in March 2010 it had no Republican support. Even if Republicans win control of both the House and the Senate, President Obama will still be able to veto any attempts by Congress to overturn or alter the ACA for two more years.

November 15, 2014

Open enrollment through the health insurance exchanges (i.e., “the Market” for calendar year 2015) begins. Individuals through the Individual Marketplace, or employers with fewer than 50 (or a 100 in some states) through the SHOP exchanges, may sign up for insurance or switch to different plans. This will be a critical time to see the impact of the Affordable Care Act implementation on rate increases for the next year. Many experts have stated that the success of the program relies on the ability of the program to enroll young and healthy individuals to offset the cost of older, sicker individuals. Failure to do so may have the impact of sending premium increases significantly higher into 2015.

December 31, 2014

Extensions that were granted in late fall 2013 for individual healthcare policies that did not meet the Affordable Care Act minimum standard requirements come to an end. Individuals who carry these policies will need to enroll in other coverage that does meet minimum ACA standards for 2015 or face a penalty.

Trends to watch for in 2014

As individuals begin to use their coverage in 2014, more information will become available regarding how many doctors are covered within the plans purchased through the Exchanges and the affordability of the co-pays and deductibles of this coverage. There are also questions being raised as to whether the number of new enrollments through both the Exchanges and expanded Medicaid will lead to doctor shortages.

Employers will also have some key decisions to make as they review their healthcare plans for the coming year, taking into consideration the employer mandate that goes into effect in 2015. Large employers (i.e., those with more than 50 FTE employees) who choose not to offer health plans, or offer plans that do not meet minimum ACA standards, may face tax penalties. One potential outcome may include businesses dropping their group healthcare coverage, having found it more cost effective to move their employees into the Exchanges and pay the penalty rather than continue to carry a group plan.

As 2014 progresses, answers to these questions will begin to emerge. The year will most certainly be a defining one to the extent it shows whether the ACA will achieve its goals, and/or if there are significant unintended consequences for the 85% of Americans who already had healthcare coverage.

Source: Washington AP, December 28, 2013