Affordable Care Act: What should you know?

The Affordable Care Act (ACA), better known as “Obamacare,” is here to stay, but it’s implementation has had its ups and downs.

A business leadership network luncheon and community forum was held Nov. 12 at Clarke County Fairgrounds event center to discuss health care. It was hosted by the University of Iowa College of Public Health.

Sue Curry, dean of the University of Iowa College of Public Health, attended the forum and introduced the keynote speaker. Approximately 35 other people were also in attendance.

The event’s keynote speaker was Dan Shane, who joined the University of Iowa’s Department of Health Management and Policy in 2012.

Shane gave a broad overview of the Affordable Care Act, as well as insight to its effects on businesses in rural Iowa and small communities.

Information on the ACA given by Shane includes:

• The ACA and its patient protection became effective March 23, 2010.

• Shane said the primary goal of the ACA is to increase health care to the public.

• Under the ACA, people 26 and under may stay on their parent’s insurance plan. Shane said 8 to 10 million children and young adults have gained health-care coverage since the provision was implemented. He said this provision has been “very successful.”

• Reports that refer to the "Marketplace" may mean the ACA website www.healthcare.gov. People may also access coverage through a phone number and some offices located across the country. However, Shane said access to health care through the website depends on the "glitch of the day." The ACA rollout has been troubled with website problems on www.healthcare.gov.

• According to U.S. Department of Health and Human Services, the ACA guarantees that all Americans – regardless of their health status or pre-existing conditions – will
have access to health coverage. Enrollment has already begun and coverage will start in 2014. "Being a woman was a pre-existing condition. The ACA has done away with that," Shane said.

• Beginning in 2014, most people are required to have health coverage, or fees will have to be paid for not having coverage.

What effects will the ACA have in Iowa?

• Shane said some rural areas may only have one insurance provider offering health coverage via the “Marketplace.”

• Starting in 2014, there will be tax credits for small businesses with 50 or fewer employees, Shane said.

• The ACA has a small business health options program (SHOP) through the “Marketplace” for small businesses with under 50 full-time equivalent employees.

• Shane said the vast majority (more than 95 percent) of small businesses in Iowa have 50 or fewer employees.

• Shane said, “Smaller employers are much less likely to offer coverage,” and, “Smaller companies are also facing higher increases in their health-care policy, so they’re feeling the pinch much more than the large companies. These trends are making it much more difficult for small employees.”

What’s the current status?

The glitches and problems with people signing up for health coverage through www.healthcare.gov are starting to show in enrollment.

According to a Nov. 13 report from U.S. Department of Health and Human Services, 106,185 people nationwide have signed up for health care through the ACA “Marketplace” since Oct. 1. The reporting period is Oct. 1 through Nov. 2.

This is significantly less than the 500,000-person goal the White House was reportedly hoping for.

New figures from the department showed the bulk of those enrollees — nearly 75 percent, or 79,391 people — signed up through state-run websites that serve 14 states and the District of Columbia. The report said that California led the nation, with more than 35,364 enrollees.

As for Iowa, the report said the number of individuals who have selected a “Marketplace” plan is 136. There are 290 other selections pending.

In Iowa, the total number of completed applications is 5,547 and total individuals applying for coverage in completed applications is 10,884.

Information from U.S. Department of Health and Human Services contributed to this article.