October 14, 2013
Those who have been tracking the implementation of the Affordable Care Act (ACA) and applicable state laws have looked to 2014 as a pivotal year, when many provisions of health care reform will begin impacting the general public. This upcoming year will bring significant changes to health care; some of these changes will be uniform across the country, while others will be unique to Washington state. These changes will affect our membership, both as providers and consumers of health care. Phrases such as “Health Benefit Exchanges,” “Essential Health Benefits,” “Accountable Care Organizations,” and “Washington Healthplanfinder” will become common health care vocabulary. Today, as we stand on the precipice of reform, it is imperative that we prepare for what lies ahead.
At the WSDA, we have been preparing for these reforms for the past several years. Our Board of Directors and Committee on Government Affairs have been discussing health care reform implementation since the passage of the ACA in 2010. I have had the pleasure of chairing the WSDA Task Force on Health Care Reform and, for nearly a year, the task force and WSDA staff have deliberated the nuisances of the ACA and how it will be implemented in Washington. As with many dental and health care policies, Washington is on the cutting edge of implementing health care reform. Our state-based Exchange, called Washington Healthplanfinder, has often been ahead of other states and the federal government in developing the new insurance marketplace. Our legislators and other policy makers made state-specific decisions on health care reform years before many states organized committees to begin looking into implementation. All of this action has been noticed by dental and other health care organizations across the country. In the dental community, the ADA and other state associations have looked to Washington as a case study, and learned about important issues as they were deliberated here.
Included in Issue 1 of the WSDA News (see page 23), there is a document called “The Affordable Care Act and You” to serve as your navigational guide for the ACA and how it is being implemented in Washington state. This document is organized into more than 40 questions and answers related to how health care reform will impact us as individuals, employers, and providers of dental care. A glossary has been provided at the beginning to clarify terminology that is frequently used when discussing health care reform here in Washington. A version of this report lives online in a new ACA section of the award-winning WSDA Source, which can be accessed online at www.wsdasource.org. The WSDA Source material will be updated throughout the year to provide the membership with up to date information.
The materials we have provided cover very complex issues that can be very difficult to fully comprehend in one sitting. We encourage you to review and think through these issues in the days and weeks ahead. If you only remember a few points during your first review of these health care reform materials, I think the following points are the most important:
• The insurance mandate included in the ACA is a mandate on individuals and not employers. Employers with less than 50 full time employees (FTEs) are not required to offer medical insurance to their employees.
• Starting in January, all children in Washington state will be required to have dental coverage. Adults are not required to purchase dental insurance under the ACA.
• Tax credits and subsidies for purchasing medical insurance will be available for individuals and employers though there are very specific criteria that determine if you are eligible.
You may have several questions about health care reform that are not addressed by this edition of the WSDA News. If you need answers, the staff at WSDA and the Washington Dentists Insurance Agency (WDIA) are always available to help. The WSDA staff can be reached by calling 800-448-3368, and the WDIA staff can be reached by calling 800-282-9342. Though the new health care reform environment may be confusing, the WSDA leadership and staff are ready to help walk you through this important year of transition and beyond.