Affordable Care Act

prezi-picThe Patient Protection and Affordable Care Act, most commonly referred to as the Affordable Care Act or ACA, was created in response to unsustainable health care costs, and sought to bend the cost curve by improving quality and access to care for all Americans.

The shift, nationwide and in Hawaii, in health care from pay-for-performance (volume) to pay-for-quality (outcomes) will continue to move forward over the next several years. Reimbursement will be increasingly tied to quality metrics and patient outcomes, a shift that Hawaii has already been embracing.

HAH works actively to educate its member organizations on upcoming changes due to ACA implementation; and to work collaboratively with its members and other stakeholders toward the underlying goal of the law: improving quality and access to care.

Gains Hawaii will see from Affordable Care Act – highlights

Small Business Health Insurance Tax Credit

Under this program, employers may be eligible for up to 35% tax credits to help pay for health insurance for 2011- 2013. In 2014, this credit will increase to a maximum of 50%.

The credit is given to employers with less than 25 full-time employees or a combination of full-time and part-time employees. Two half-time employees equal one employee for the purposes of the credit). Additionally, the average annual wages of employees must be less than $50,000, and the employer must pay at least half of the insurance premiums.

Due to Hawaii’s Prepaid Health Care Act of 1974, the overwhelming majority of small businesses (79%) in Hawaii provide health insurance for their employees. This is significant since nearly 27,000 businesses in Hawaii have less than 20 employees.

Hawaii’s Insurance Exchange (Hawai’i Health Connector) will close the gap in insurance coverage

Health care insurance exchanges will provide options for an underserved market, including:

  • Part time workers who do not meet the 20 hour minimum for four consecutive weeks;
  • New immigrants who are not eligible for Medicaid due to the PRWORA Act of 1996, which restricts eligibility for the first 5 years of residency;
  • Retirees who do not qualify for Medicare due to working less than 40 quarters in Medicare covered employment;
  • Early retirees not eligible for Medicare and are restricted from obtaining insurance coverage due to medical underwriting or excessive premiums;
  • Dependents currently enrolled on PHCA plans; and
  • Dependents not eligible for their own coverage.

ACA: What to Expect for 2014 Prezi   |   PDF