– Health Care Reform Background

From Blue Cross/Blue Shield, ND

Affordable Care Act

When the Affordable Care Act was passed in 2010 it was estimated that the new health law would extend health insurance coverage to an estimated 30 million uninsured Americans by 2022. The law has increased mandatory benefits that must be provided and prohibits insurance companies from denying coverage based on pre-existing medical conditions or placing lifetime limits on coverage. The Affordable Care Act (ACA) will also lead to the formation of health insurance marketplaces in each state to allow consumers to comparison shop for coverage. Most Americans will be required to possess at least a basic level of insurance coverage or pay a penalty. Businesses with 50 or more employees also must provide health insurance coverage to full-time employees or help pay for those employees to purchase insurance in the marketplace or exchange.

North Dakota has declined to run its own online state insurance marketplace or exchange, meaning that the federal government will set up and run the North Dakota marketplace. Open enrollment for the North Dakota marketplace will begin on Oct. 1, 2013, with coverage beginning on Jan. 1, 2014. The marketplace will offer four metallic levels of coverage:

Platinum
Gold
Silver
Bronze

Here is a brief update on some major provisions of ACA that have already taken effect, and some parts of the health law that have yet to take effect:

What’s Happened

2010

ACA signed into law by President Barack Obama in March 2010.
Dependents allowed to stay on parents’ plan until age 26.
Lifetime limits on the dollar value of coverage no longer permitted.
Children can no longer be denied coverage on the basis of pre-existing medical conditions.

2012

Supreme Court upholds constitutionality of ACA in June 2012.

What’s Coming

2013

Open enrollment begins for health insurance marketplaces in each state on Oct. 1, 2013.

2014

Health insurance marketplace coverage begins on Jan. 1, 2014.
Most Americans required to have health insurance or pay a penalty by Jan. 1, 2014.
Companies with 50 or more employees required to provide qualifying coverage to full-time employees or help pay for insurance costs for employees on an insurance marketplace starting on Jan. 1, 2014.
Annual limits on health insurance coverage no longer allowed starting on Jan. 1, 2014.

Responding to ACA

Blue Cross Blue Shield of North Dakota (BCBSND) has complied with and will continue to comply with all ACA regulations. In addition to adopting ACA provisions that benefit members, BCBSND continues to search for North Dakota solutions to provide affordable health care for its members and all North Dakotans. We are prepared for the coming changes mandated by ACA and we are taking steps to keep our members, employer groups and all North Dakotans informed about the latest health reform developments.

Members on grandfathered plans that were in place before ACA became law are exempt from many parts of ACA. Roughly 75 percent of employer groups with BCBSND coverage have grandfathered plans, meaning those members will see little initial impact from ACA on their plan.

BCBSND stands ready to assist individuals and employer groups through the complex maze of health care reform. BCBSND is hosting a series of sessions around the state to inform businesses that we serve (businesses that offer BCBSND insurance to their employees) what to expect and how to prepare for the coming changes.

Here is a schedule of the informational forums that we will hold throughout the state this summer (sessions will be held from 9 a.m.-noon each day for employers with fewer than 50 employees and from 1 p.m. to 4 p.m. for employers with 50 or more employees):