Health care reform is a signature issue for the Obama administration, which has called for an overhaul of the existing health insurance and delivery systems to ensure that all Americans have access to affordable health care. Congress completed action on two reform bills that were designed to achieve these goals. Nonprofit organizations engaged in the policy debate because reforms presented the opportunity to reduce the costs that nonprofits pay as employers and to extend health care coverage to the individuals served by the nonprofit community.
President Obama signed into law and the U.S. Supreme Court upheld the majority of the Patient Protection and Affordable Care Act, ("ACA"). By 2014, Health and Human Services (HHS) must write the regulations for employers in providing insurance, and states that choose to do so must set up their own health insurance exchanges. The federal government is assuming the responsibility for states that refuse to set up their own exchanges.
The Affordable Care Act, among other reforms, extends access to coverage for the uninsured and prevents the denial of insurance for pre-existing conditions. It contains several provisions that would help nonprofit employers control health care costs, including the mechanism for individuals and employers to buy lower-cost health insurance as a part of purchasing pool. The Marketplaces that will be available in each state will offer all employers with fewer than 100 employees and individuals with incomes between 133% and 400% ($24,352 – $73,240) of federal poverty level the option to participate in the exchanges, effective January 1, 2014. (Enrollment starts October 1, 2014.) Larger employers (with more than 100 employees) are expected to be able to participate in the Marketplaces after 2017. Read about the SHOP Marketplaces where small nonprofit employers can purchase insurance for their employees and where individuals can purchase health insurance for themselves.
Nonprofits can claim the full 25 percent of the health credit if they pay at least half of the employee premium and employ fewer than 10 workers that are each paid average wages of less than $25,000. The employer can apply the full credit to the aggregate amount of actual premiums paid or a lesser average premium amount, as determined by the U.S. Department of Health and Human Services (HHS). More information about which employers are eligible, and how to file for the credit.
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