42 changes that have been made to the ACA
December 22, 2014 11:32 AM
Since Republicans took control of the House in 2011, there have been 54 votes to either repeal or change the ACA, and those efforts are likely to continue in 2015 when the GOP will control both houses of Congress, top broker organizations say. Here's a list of the 42 changes made to the ACA, according to the Galen Institute. [Image: Fotolia]
Medicare changes
1. Medicare Advantage patch.
2. $200 billion in cuts to Medicare Advantage canceled.
3. Congress modified the amount of tax credits individuals would have to repay if they are over-allotted.
4. Congress removed $200 million of the $500 million scheduled for the Medicare trust fund transfer. [Image: Fotolia]
2. $200 billion in cuts to Medicare Advantage canceled.
3. Congress modified the amount of tax credits individuals would have to repay if they are over-allotted.
4. Congress removed $200 million of the $500 million scheduled for the Medicare trust fund transfer. [Image: Fotolia]
SHOP delays
5. The Small Employer Health Options Program deadline was delayed for a month and later for a year, until November 2014.
6. Employee choice on the SHOP exchange was delayed again, until 2015. [Image: Fotolia]
6. Employee choice on the SHOP exchange was delayed again, until 2015. [Image: Fotolia]
Medicaid changes
7. The Supreme Court ruled expanding Medicaid eligibility had to be voluntary.
8. Implementation of the Basic Health Program was delayed until 2015.
9. Medicaid eligibility was changed, eliminating well-off seniors from the program. [Image: Fotolia]
8. Implementation of the Basic Health Program was delayed until 2015.
9. Medicaid eligibility was changed, eliminating well-off seniors from the program. [Image: Fotolia]
Employer mandate delays
10. The employer-mandate was postponed by a year.
11. The employer-mandate was delayed again, by another year. [Image: Fotolia]
11. The employer-mandate was delayed again, by another year. [Image: Fotolia]
Individual mandate changes
12. The individual mandate delayed.
13. The Supreme Court said that violating the individual mandate would result in individuals paying a tax, making it optional for people to comply. [Image: Fotolia]
13. The Supreme Court said that violating the individual mandate would result in individuals paying a tax, making it optional for people to comply. [Image: Fotolia]
Canceled plans permitted
14. The administration said insurance companies could re-offer plans that previous regulations forced them to cancel.
15. The hardship waiver is expanded. [Image: Fotolia]
15. The hardship waiver is expanded. [Image: Fotolia]
Extensions granted
16. Subsidies are extended to individuals who bought plans outside of the federal or state exchanges.
17. Non-compliant health plans receive a two-year extension.
18. The non-refundable adoption tax credit is extended. [Image: Fotolia]
17. Non-compliant health plans receive a two-year extension.
18. The non-refundable adoption tax credit is extended. [Image: Fotolia]
More delays
19. Equal employer coverage is delayed.
20. The March 31, 2014, deadline to sign up for insurance was delayed until mid-April. [Image: Fotolia]
20. The March 31, 2014, deadline to sign up for insurance was delayed until mid-April. [Image: Fotolia]
Military changes
21. Congress said plans provided by the militarys health insurance program constitute minimal essential health care coverage as required by the ACA.
22. Congress said health care provided by the Department of Veterans Affairs constitutes as minimum essential health care coverage as required by the ACA. [Image: Fotolia]
22. Congress said health care provided by the Department of Veterans Affairs constitutes as minimum essential health care coverage as required by the ACA. [Image: Fotolia]
Reporting changes
23. The requirement that employers must report to their employees on their W-2 forms the full cost of their employer-provided health insurance is delayed one year.
24. Self-attestation of income by applicants for health insurance in the exchanges is permitted. This was later partially retracted after congressional and public outcry over the likelihood of fraud.
25. Congress repealed the paperwork mandate that would have required businesses to report to the IRS all of their transactions with vendors totaling $600 or more in a year. [Image: Fotolia]
24. Self-attestation of income by applicants for health insurance in the exchanges is permitted. This was later partially retracted after congressional and public outcry over the likelihood of fraud.
25. Congress repealed the paperwork mandate that would have required businesses to report to the IRS all of their transactions with vendors totaling $600 or more in a year. [Image: Fotolia]
Exchange-related changes
26. The IRS issued a rule that allows premium assistance tax credits to be available in federal exchanges.
27. The administration offers employer contributions to members of Congress and their staffs when they purchase insurance on the exchanges created by the ACA. [Image: Fotolia]
27. The administration offers employer contributions to members of Congress and their staffs when they purchase insurance on the exchanges created by the ACA. [Image: Fotolia]
High-risk pools extended, closed
28. The federal high-risk pool was extended until Jan. 31, 2014, and again until March 15, 2014.
29. The federal high-risk pool is closed.
30. The administration said it will supplement risk corridor payments to health insurance plans with other sources of funding if the higher risk profile of enrollees means the plans would lose money. [Image: Fotolia]
29. The federal high-risk pool is closed.
30. The administration said it will supplement risk corridor payments to health insurance plans with other sources of funding if the higher risk profile of enrollees means the plans would lose money. [Image: Fotolia]
Doubling deductibles
31. Plans are allowed to apply separate patient cost-sharing limits to different services, allowing maximum out-of-pocket costs to be twice as high as the law intended.
32. Congress eliminated the cap on deductibles for small-group plans. [Image: Fotolia]
32. Congress eliminated the cap on deductibles for small-group plans. [Image: Fotolia]
Exemptions
33. Unions exempt from reinsurance fee.
34. U.S. territories are exempt from coverage requirements. [Image: Fotolia]
34. U.S. territories are exempt from coverage requirements. [Image: Fotolia]
Modifications
35. Congress modified the definition of average manufacturer price to include inhalation, infusion, implanted or injectable drugs that are not generally dispensed through a retail pharmacy.
36. TRICARE coverage extended to dependent adult children up to age 26. [Image: Fotolia]
36. TRICARE coverage extended to dependent adult children up to age 26. [Image: Fotolia]
Repeals
37. Congress repealed a program that would have allowed free-choice vouchers.
38. The Community Living Assistance Services and Supports program is eliminated. [Image: Fotolia]
38. The Community Living Assistance Services and Supports program is eliminated. [Image: Fotolia]
Large cuts
39. Congress cuts $400 million from the CO-OP program, $305 million from the IRS and rescinded $10 million for the Independent Payment Advisory Board.
40. Congress cuts $2.2 billion from the CO-OP program. [Image: Fotolia]
40. Congress cuts $2.2 billion from the CO-OP program. [Image: Fotolia]
Louisiana purchase
41. Congress cuts $11.6 billion from the Prevention and Public Health slush fund and $2.5 billion from the Louisiana Purchase.
42. Congress rescinds another $670 million from this bargain. [Image: Fotolia]
42. Congress rescinds another $670 million from this bargain. [Image: Fotolia]
