Affordable Care Act Resources

The effective date for the employer mandate has been delayed from January 1, 2014 to January 1, 2015. Beginning in 2015, employers with 50 or more full-time or full-time equivalent employees must offer medical coverage.

The non-partisan Kaiser Family Foundation has put together a chart on the employer responsibility. 

Health Insurance Reform and Marketplace

We’ve also developed a number of consumer tips on HealthCare.gov to help people understand their new private insurance coverage.  The topics include: 

• Make sure you're covered.  Consumers who think they’ve signed up for Marketplace health insurance, but haven't heard from their insurance company can get help finding out if they're covered.

• Get prescription medication under your new plan. Marketplace health plans will help pay the cost of certain prescription medications. Consumers can get help finding out if their prescription is covered and how to apply for an exception if the medication is not currently covered by their plan.

• Get medical care and find a doctor.  Consumers can get help finding doctors and other health care providers covered by their new Marketplace plan.

• Get emergency care. Consumers can get important information on utilizing emergency care, and making sure they know that their insurance company can't charge more for emergency room services at an “out-of-network” hospital.

• Appeal a health plan decision.  Consumers have the right to appeal a decision when an insurance company refuses to pay for a specific treatment or service. We can help guide consumers through the appeals process.

Before you go to the doctor or pharmacy using your new insurance for the first time, check out this tip sheet, and make sure to:

• Get your insurance card or a temporary card with your new plan’s information. If you don’t have your card yet, ask your insurance company to give you another way to confirm your coverage.

• Make sure you know when your first premium payment is due and pay it by the due date;

• Check to see which doctors and pharmacies are in your network.

And at your first visit:

• Bring your insurance card with you to the doctor or pharmacy. If you don’t have a card, ask your doctor or pharmacy what other proof of insurance they may accept.

• If you thought you enrolled in health coverage but aren’t showing up in the system, call your insurance company directly. If you don’t have your insurer’s contact information call the Marketplace Call Center (1-800-318-2596) and a trained representative can provide it to you.

Virginia Specific Information

To follow healthcare reform in Virginia, the best place to look is the Virginia Health Reform Initiative Website.

For specific questions, you can also visit the Bureau of Insurance, a division of the Virginia State Corporation Commission. 

Their mailing address is as follows:

Bureau of Insurance
P.O. Box 1157
Richmond, Virginia 23218-1157

Virginia & Medicaid Expansion

The Affordable Care Act included an expansion of Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL). However, a result of the Supreme Court decision on the ACA in 2012, it is now effectively a state choice to decide to expand this coverage. At this time, the Governor and the General Assembly has said that the Commonwealth will not expand Medicaid.

HHS has put together some helpful information for individuals who have questions about states that are not expanding Medicaid.

Virginia has set up the Medicaid Innovation and Reform Commission to review, recommend and approve innovation and reform proposals affecting the implementation of Medicaid. 

Federal Agencies

All IRS information pertaining to the Affordable Care Act can be found here, which they will update as more information becomes available:

Department of Labor Frequently Asked Questions may help provide other answers.

Health and Human Services