Health Reform Changes Coming In 2014

The Affordable Care Act has already led to many changes in the U.S. health care system. Even more change is expected in 2014.

Here’s a peek forward to some of the health reform changes coming in 2014:

January 1, 2014 Pre-existing conditions allowed Starting with policy years beginning on or after January 1, 2014, health insurance companies may no longer deny insurance coverage to those with pre-existing medical conditions, including serious and expensive medical conditions, such as cancer. Starting in 2014, insurers are also no longer able to set annual or lifetime dollar limits on member coverage .

January 1, 2014 Medicaid expansion begins The Medicaid expansion, which will take effect on January 1, 2014, will provide coverage for all eligible North Dakotans to age 65 with household income at or below 138 percent of the federal poverty level ($31,809 for a family of four). The Medicaid expansion is expected to extend eligibility to an additional 20,000 to 32,000 North Dakotans who were previously not eligible. North Dakotans who believe they may qualify can apply for Medicaid expansion coverage through the North Dakota marketplace at

April 1, 2014 Insurance requirement The requirement that most Americans have qualifying health insurance coverage (also known as the Individual Mandate) will take effect on April 1, 2014. North Dakotans have until March 31, 2014, to sign up for a qualifying insurance plan to avoid a tax.

Individuals and families that don’t make enough money to be required to file an income tax return are exempt from the tax. Other exemptions include:

  • Those who can prove religious objections
  • Those for whom the lowest-cost plan option exceeds 8 percent of their annual income
  • Undocumented immigrants
  • Incarcerated people
  • American Indians with coverage through the Indian Health Service
  • Americans living outside the U.S.

Some who have had their insurance plans discontinued because the plan did not comply with the Affordable Care Act and who are unable to find marketplace coverage as affordable as their old policy may also be eligible for a hardship exemption and would be able to purchase catastrophic coverage.

For 2014, the tax for not having qualifying insurance equates to $95 per adult and $47.50 per child per year, or 1 percent of annual taxable income, whichever is greater. The tax for not having insurance is scheduled to increase substantially in future years.

Discontinued plans Some BCBSND individual and small group plans that do not meet Affordable Care Act requirements will be discontinued in 2014. We will contact you if you are one of the roughly 7 percent of our members who are impacted by this change. Those whose plans are being discontinued will be offered other coverage options, with many members receiving greater benefits from the new plans. The timing of when individual and small group plans will be discontinued will depend on the plan. Call the number on the back of your BCBSND member ID card if you have questions on how your coverage is affected.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.