ACA: The Cost of Non-Enrollment

With the March 31 enrollment deadline looming, the Obama administration is working overtime to encourage uninsured Americans to purchase coverage in state or federal marketplaces. Approximately 50 percent of uninsured consumers plan to remain uninsured for a number of reasons, raising the important question: what is the cost of not enrolling in a valid healthcare plan?

Required Coverage

ACA-compliant health insurance policies must meet the law’s requirements for minimum essential coverage, which includes all government-administered plans as well as new and grandfathered employer plans and coverage offered by universities. While other plans may also meet the minimum essential coverage standard, consumers who hold non-compliant policies will be subject to the same penalty as uninsured consumers. Vision and dental-only plans, workers’ compensation, and healthcare savings accounts do not qualify as compliant policies.

Most consumers are required to carry a compliant healthcare plan; however, the ACA provides a number of exemptions for consumers who are unable to afford a qualifying plan or who fit other criteria.

How does the penalty work?

The 2014 penalty for uninsured consumers is the greater of $95 per adult/$47.50 per child, up to $285 per family, or one percent of your family’s gross adjusted income above the tax return filing threshold. (If your income is not high enough to require a tax filing, you are exempt from the individual mandate.)

Despite the focus on the $95 flat fee, more consumers earn more than the $19,650 that matches the $95 fee and will be required to pay a higher amount. For example, a family earning $50,000 annually would have to pay $297, or one percent of their eligible AGI – $12 more than the flat fee maximum. Though penalties are capped at approximately $9,800, many families do not make enough to meet this cap and will be on the hook for their entire penalty.

Can I enroll after the March 31 deadline?

Your ability to enroll in the federal marketplace after the deadline depends on a number of conditions. Currently, consumers who have attempted to purchase a healthcare plan prior to March 31 will be granted a limited extension to complete their enrollment. Once extensions have ended, you must wait until the next open enrollment period unless you have a change in life situation that qualifies you to enroll.

If you signed up for a policy before March 31 that features a gap in coverage (i.e. does not start immediately), you will not have to pay the penalty. Also, if you are without insurance for less than three months after the deadline you will not have to pay the penalty. For periods longer than three months but less than a year, you will be responsible for each month’s portion of the annual penalty for as long as you are uninsured.

For questions about your specific healthcare needs and plans that are available, visit

With Deadline Looming, ACA Enrollments Fall Short

One week from today marks the Affordable Care Act deadline for individual consumers to have an ACA-compliant policy from their employer or the online health marketplaces. Consumers who have not enrolled in coverage by March 31 will face a penalty on their taxes and will be prevented from signing up for subsidized healthcare until next year.

However, despite the time crunch only a quarter of Americans at this point had accessed the exchanges by January and many thousands of others are still uninformed about their responsibility to obtain coverage. Unfortunately, the majority of uninformed consumers are those who would benefit the most from tax credits and subsidies.

Misinformation is a major source of public reluctance to use the online health exchanges. The political debate over the Affordable Care Act is well-documented, and additional state laws governing the implementation of the individual mandate have further complicated the process.

The Obama administration is elbow-deep in a campaign to inform consumers and encourage them to apply for insurance. Volunteers are contacting households via phone banks, email, and door-to-door canvassing with pamphlets and applications. Canvassers hope that by educating consumers they will be able to dispel some of the myths surrounding the cost of health care plans and demonstrate the importance of having a compliant policy by next week’s deadline.

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Obamacare Enrollment Quickens Pace in March

Things didn’t look promising for the Affordable Care Act enrollment numbers in the beginning of March. Reports estimated that one sign up must be completed every 1.4 seconds in order to reach the enrollment goal of 6 million. As of March 1, 2014, sign-ups were sitting at 4.2 million. The enrollment period concludes March 31.

However, the pace is quickening. A rush of sign-ups occurred within the first two weeks of March bringing the enrollment numbers to over 5 million. If enrollment keeps up, the Obama administration may come close to 6 million within the first year. Before the ill-fated rollout, the administration hoped to achieve 7 million sign-ups. The number has been adjusted to address the numerous technical issues.

The information on demographics has not been released. To keep consumer costs down, it’s imperative that a mix of young and old participate in the insurance marketplace. As of last month, it seemed as if only 25% of health insurance buyers fell into the 18-34 age range. Without the young and healthy, insurance premiums are anticipated to rise in 2015. Insurers and experts predict a variety of factors to raise premiums, including the administration’s decision to allow people to hold onto skimpy plans and other delays that accompanied the botched rollout.

31 Percent of Healthcare Facilities Plan to Increase Staffing

Preparing for a wave of newly insured patients thanks to the Affordable Care Act, a new report shows that 31 percent of health facilities are ready to increase their medical staffing.

Staff Care, a subsidiary of healthcare staffing company AMN Healthcare, conducted a survey that polled 230 managers of hospitals and medical practices in the U.S.

Over 16 percent said they plan to hire more nurse practitioners and physician assistants. Additionally, more than 7 percent said they would increase their temporary physician staffing to keep up with growing demand and an aging population. The demand for locum tenens physicians rose from 73% in 2012 to nearly 90% in 2013, showing a significant increase in temporary physician staffing. Demand is also quickly rising for locum tenens nurse practitioners and PA’s.

Data shows that healthcare facilities are moving away from traditional private practice models toward locum tenens staffing to maintain high quality patient care in spite of staffing shortages and increasing demand. This survey is one of many to highlight increasing employment opportunities for healthcare professionals and temporary healthcare staffing companies alike.

Another Obamacare Delay Extends Skimpy Plan Coverage Until 2016

Another Obamacare delay? Indeed. The Obama administration put off another key aspect of the Affordable Care Act on Wednesday and will allow insurance companies to continue selling skimpy plans that don’t meet the new, stricter standards. This is the second delay that involves these types of plans. It was first delayed in 2013 after upset consumers realized their health plans could be cancelled because they didn’t meet minimum requirements.

The series of delays leaves employers wondering how they should implement the healthcare mandate. The employer mandate has also been delayed twice and many businesses won’t have to comply until 2016. That is, if more delays aren’t on the horizon.

Fewer Americans are gaining coverage under the Affordable Care Act than was predicted. Between the catastrophic rollout of and the decisions of many states not to expand Medicaid eligibility, millions of Americans are still without coverage. Younger consumers are failing to enroll, which was a key component to ensure the cost of healthcare coverage remains affordable.

The law was intended to provide affordable coverage to all, but it’s only predicted to make a small dent in the amount of uninsured Americans in 2014. The Congressional Budget office estimates that 30 million Americans may still be uninsured by 2020.

Young Consumers Not Using Healthcare Exchanges

According to reports from the Obama administration about healthcare enrollment in the online marketplace through January, only 25 percent of consumers who have purchased healthcare plans fall into the critical 18-34 demographic. The figure is far lower than the number of young consumers who have created accounts on the exchanges.

Many experts and administration officials have touted the importance of young consumers using the healthcare exchanges to balance the cost of care for older patients. While insurance companies can vary costs to a certain degree based on age, it is not enough on its own to control the difference in healthcare needs between the two demographics. A continued slump of young enrollees could prompt insurance providers to raise premiums significantly within the coming years, which would put a strain on the entire system.

One potential explanation for the lack of enrollment in the younger demographic is its overlap with another provision of the Affordable Care Act which allows parents to keep adult children up to age 26 on their own health insurance. The overlap affects nearly half of the exchanges’ target demographic, specifically college students and young post-graduates.

The federal government is not alone in fretting over low enrollment; states running their own exchanges, such as Minnesota, are also experiencing enrollment that skews toward the older demographic.

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