Millions of U.S. Residents Must Upgrade Health Coverage Under ACA

Millions of U.S. residents will have to upgrade their health plans under the Affordable Care Act, KQED's "State of Health" reports (Weiss, "State of Health," KQED, 8/26).

The article was produced by the California HealthCare Foundation's Center for Health Reporting. CHCF publishes California Healthline.

Starting Jan. 1, 2014, coverage sold through the ACA's health insurance exchanges must cover 10 categories of essential health benefits, such as prescription drugs and maternity care (California Healthline, 8/15).

Many Must Upgrade Coverage

According to "State of Health," millions of individuals have "bare bones" health plans that do not cover the essential benefits required by the ACA.

Micah Weinberg -- a senior policy consultant at the Bay Area Council -- said that a small portion of individuals might be able to keep less comprehensive coverage if they had it before the Affordable Care Act was signed.

Unless consumers are enrolled in such "grandfathered" plans, they "are going to have to buy more comprehensive policies, generally, in 2014," Weinberg said.

Although some individuals will have access to federal subsidies to purchase new plans, only about one-third of the two million California residents who currently purchase their own insurance will qualify for such subsidies.

Sarah Aquino with Integrated Benefits and Insurance Services said that individuals who do not qualify for a subsidy likely will face higher premiums than they currently pay.

"[T]he question is will people who are healthy and don't qualify for a subsidy come into the system" or instead choose to pay the penalty of $95 or 1% of their income to not have insurance, Aquino said ("State of Health," KQED, 8/26).