cent in 2020," Urquhart says. "Most states have not formally
decided whether or not to participate. Many states hoped
that the administration would permit 'partial expansion,'
meaning increasing eligibility to something less than the 138
percent level provided by the ACA. However, in December
2012, the Department of Health and Human Services
squelched that notion by announcing that states must fully
participate in the expansion or forfeit their portion of federal funds that would have paid for the expansion. The ACA
Medicaid expansion kicks in 2014. A state deciding not to
participate will forfeit millions of dollars in federal funds."
Currently, 18 states and the District of Columbia are
generally assumed as opting for participation in Medicaid
expansion and seven states have committed to a state/federal partnership to establish and run the exchanges in their
states. The governments of each state will make the formal
determination about participation.
The ACA also provides states with the option of setting up
their own insurance exchanges to provide health care insurance for those who do not qualify for Medicare or Medicaid
and are not covered by an appropriate employers plan.
"Specifically state-based health insurance exchanges are
to be established in each state," explains Tanya Reed, a labor
www.npnweb.com n NPN Magazine
and employment attorney at Gunster in West Palm Beach,
Fla. "A health insurance exchange is an online marketplace
where people can shop for private health insurance and secure
federal subsidies to assist with the cost of the insurance."
"For states presenting the federal government with a qualifying exchange, those states would have latitude in the structure of the exchange and its operation," Urquhart says. "The
federal government will establish and operate health insurance exchanges in those states that do not present the federal
government with a qualifying exchange of their own."
Reed says that in 2013, the federal government and its
agencies will continue to issue regulations that interpret and
implement the ACA. "Employers, insurers and the states will
have to carefully watch the regulations to ensure that they
are prepared to be in compliance with the fully-enacted law
in January 2014," Reed says.
Insurance agents and legal counsel are generally good
resources for questions employers may have about the
Affordable Care Act. In addition, the federal government
maintains a website (www.healthcare.gov/law/index.html)
that provides a number of consumer-oriented and
employer-oriented resources regarding the Affordable
Care Act.
January/February 2013
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