Health Care Reform

Health care reform could mean big changes to your health plan. We’re here to help you understand those changes so you can make the best decisions for your health care. See how health care reform could impact you.

Individual

If you buy health coverage on your own

Uninsured

If you are uninsured

Small Business Employee

If you work for a business with up to 50 full-time employees

Large Business Employee

If you work for a business with more than 50 full-time employees

Small Business Employer

If you own a small business with up to 50 full-time employees

Large Business Employer

If you own a large business with more than 50 full-time employees

What’s health care reform?

Health care reform is a federal law that changes how you receive health care. It was passed by Congress and signed into law by President Barack Obama in March 2010.

Why was it created?

Health care reform was created to:

  • Help more people get health care
  • Improve people’s health
  • Slow rising health care costs

Who’s affected?

Health care reform affects almost all Americans:

  • Insured. People with insurance can get more preventive coverage at no charge to them. They may also receive more options to get insurance.
  • Uninsured. Almost everyone is required to have insurance starting in 2014 or pay a fine. People with major health problems cannot be turned down for coverage.

What’s changed?

  • People up to age 26 can be covered under their parent’s family health plan.
  • Adults can receive more preventive screenings and immunizations at no charge to them.
  • Women can receive certain health care services at no charge to them.

What will change starting January 1, 2014:

  • Most people must have health insurance coverage by March 31 or pay a fine.
  • You won’t be denied coverage even if you have a serious health condition.
  • Most Insurance premiums won't be based on your health status anymore. Premiums for Affordable Care Act plans will be based on your age and rates may be adjusted based on tobacco use. (For people who get coverage through a small business with up to 50* employees or an individual plan.)
  • Affordable Care Act plans must cover 10 essential health benefits (For people who get coverage through a small business with up to 50 full-time employees or through an individual plan.)
  • We’ll cover services from chiropractors, acupuncturists, naturopaths, and other complementary and alternative medicine practitioners if their services are within the scope of their Hawaii license, are deemed medically necessary, and are a benefit of your plan. Complementary and alternative services for Health Plan Hawaii members will need preauthorization by your primary care provider. Small business or individual health plans that were in place on October 2013 won’t cover this benefit. Neither will HMSA QUEST or Akamai Advantage.
  • The news about keeping your current health plan doesn’t apply to Medicare plans.

This information is based on HMSA’s review of the Affordable Care Act (ACA). This overview is intended for educational purposes only and should not be used as tax, legal, or compliance advice.