AP looks at PPACA implementation

PPACA envisioned millions of the neediest Americans gaining health insurance by enrolling in Medicaid, with coverage starting in January. But the Supreme Court threw a wrench in that plan last year when it gave states the right to opt out of the Medicaid expansion plan. Because of Republican opposition in many states, it looks like nearly 2 in 3 of those who would qualify for new Medicaid coverage may be out of luck because their state lawmakers have not agreed to expand the program.

What about the workers? A longer wait.

PPACA requires companies with 50 or more workers to offer affordable coverage to full-time employees or risk a series of escalating tax penalties. Originally, that requirement was supposed to take effect on Jan. 1, 2014. But now the administration is pushing that requirement back a year, citing the complexity of the undertaking. Most medium and large business already offer health insurance. Those most likely to be affected by the delay: low-wage workers at hotels, restaurants and stores.

What’s left? For now, at least, plenty. 

Under the current timetable, starting next year individuals will be required to carry health insurance or face fines.

People who are uninsured will be able to shop for affordable coverage through exchanges, or online marketplaces.

Middle-class people who don’t have coverage through their jobs will use the marketplace to apply for tax credits to help pay their premiums. Low-income people will be steered to the Medicaid expansion — if their state participates. Insurance companies will be required to accept people regardless of their medical problems.

A number of other changes already have taken effect, including a provision that allows young adults to stay on their parents’ insurance until age 26 and a ban on lifetime limits on insurance coverage.

Associated Press writer Ricardo Alonso-Zaldivar contributed to this report.

See also:

• On the Third Hand: Time
• States Eagerly Awaiting Final Rule on Exchanges from NAIC Expected “Soon”
• GAO: IRS Behind on PPACA