How Will The Affordable Care Act Affect North Carolinians?

In March of 2010 Congress passed the Affordable Care Act (ACA).  Some parts of the law have already been implemented but the majority will take effect in 2014.  These include:

  • Individual mandate to purchase health insurance (coupled with federal subsidies for individuals and families that qualify based on 2012 income.  Estimate 2/3 North Carolinia's uninsured will qualify)
  • Insurers must accept ALL applicants, regardless of health status Guarantee Issue
  • Eliminate medical underwriting cannot rate due to health status
  • Pre-existing conditions covered without waiting periods or exclusions
  • Community rating limits premium to a person's age to no more than 3:1 ratio
  • Maternity covered on all plans
  • Establish Exchanges for individuals to purchase health insurance
Initial Enrollment for 2014 coverage through the exchanges will begin October 1, 2013 and end March 31, 2014.

The part that I feel will affect most people that live in North Carolina will be rates and subsidies.  Lets look at each briefly:

Rates:
As noted above above plans will be guaranteed issue, no rate ups, community rating, and maternity covered on all plans.  All these will impact rates when compared to what they are today.  Think about it, a person with Cancer will be paying the same rate as a person that runs marathons and is in the best shape of their life.  Having a higher claim ratio will make rates increase.  My understanding from various carriers is that we can expect rates to be 35-50% higher than they are today.

Subsidies:
So most will see an increase in rates but also most will have these rates offset by a Governement subisdy. According to one carrier, approximately 2/3 of the current uninsured North Carolinians will qualify for the subsidy.  This will be based on your 2012 income and will be available for individuals and families under 400% Federal Povery Level (FPL).  To put this in perspective 400% FPL for a single individual is $45,960 and for a family of four it would be $94,200.

As you can gather some people are going to get hit a lot harder than others and on the flip side some people are going to get a much better "deal".

As we continue to learn more about the changes ahead we will continue to bring you more information.

Tagged as NC health insurance reform, north carolina health insurance exchange.

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