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Obamacare: What to expect -- and when

Health reform has been implemented in stages, and we're nearing some key deadlines. Here are some important dates and what they mean, particularly for the uninsured.

By Mitch Lipka Aug 8, 2013 10:38AM
Pills (© MedicalRF.com/Corbis)Obamacare began stirring up strong emotions long before any parts of the complex law were implemented. But with key provisions of the Affordable Care Act taking effect Oct. 1, the controversy will soon yield to more practical concerns.

To get an idea of what's coming and when -- dates can change -- here is the current timeline for the various aspects of the law.

Oct. 1: Open enrollment starts for a new health insurance marketplace. Consumers and small businesses will be able to shop for health insurance policies here.

You'll be able to see what insurers are charging for different levels of coverage and sign up for plans that take effect on Jan. 1, 2014.

The marketplace -- to be run by states that chose to operate their own and by the federal government for everyone else -- opens the door to those who want to buy health insurance but aren't eligible through their employers, or are self-employed. (If you get health insurance through your employer, you don't need to buy coverage through the marketplace.) Small businesses, which won't be required to provide coverage for their employees until 2015, can also begin shopping for policies.

Jan. 1, 2014: This is a huge day for Obamacare. Many of the old rules of health insurance will go out the window and move sharply in favor of some consumers, particularly those most in need of health care.

The first policies issued by those who have shopped through the marketplace will start. In addition, a series of consumer protections will take effect. Insurers will not be allowed to refuse coverage to someone because of a pre-existing condition or charge more because of their health or gender.

In addition, caps on how much coverage someone can have in a given year will be dropped. Another change prevents an insurer for changing or eliminating coverage for anyone who chooses to participate in a clinical trial to treat a life-threatening disease, including cancer.

This is also the day that middle-income families become eligible for tax credits. Those who earn up to 400% of the poverty line (roughly $43,000 for an individual and $88,000 for a family of four) will be eligible. Because the tax credit can be applied in advance -- you don't have to wait until you file your taxes -- it can be applied to lower your monthly premiums.
Greater access to Medicaid is supposed to become available to those who earn less than 133% of the poverty level (about $29,000 for a family of four). However, this is a state-by-state decision and 21 states have indicated they are not going to comply with that provision. However, just about anyone who can afford health insurance will be required to buy at list minimal coverage or be assessed a penalty.

Jan. 1, 2015:
Small businesses -- those with at least 50 employees who work more than 30 hours a week -- will be required to offer health insurance to its employees. The deadline is a year later than had initially been planned, but appeals to delay implementation as some of the complexities of the law are sorted out were heeded. Those businesses face a $3,000 per person penalty if they fail to provide coverage.

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