What is Health Care Reform?

On March 23, 2010, President Obama signed the Affordable Care Act (ACA) also known as health care reform into law. The law put in place a significant number of health insurance reforms. Some of the final and most notable changes of the law took effect on January 1, 2014.

The best way to summarize the impact of the ACA is to say that it will make insurance more accessible to you. There are a number of provisions throughout the law that help you afford coverage, as well as guarantee you access to insurance with a minimum level of benefits.

Primary among these reforms is assistance for individuals and families to purchase health insurance through federal subsidies and expanded eligibility for Medicaid; as well guaranteed access to health insurance regardless of your age or health status.

Since January 1, 2014, you could no longer be declined coverage or be charged extra for health insurance because of a health issue you have now or in the past. You will also be guaranteed a minimum set of health benefits known as “Essential Health Benefits"

Other notable market reforms include:

  • Extending dependent coverage to age 26.
  • Coverage with no expense to the consumer of most preventive services and immunizations.
  • Insurers in the individual and small group market but spend at least 80 cents of every dollar collected from consumers on medical care and services.
  • Annual and lifetime dollar limits are prohibited on essential health benefits.

Help Affording Health Insurance: Are you Eligible for Premium Assistance?

The premium assistance subsidy reduces the amount that an individual or family pays for health insurance coverage by providing a tax credit. These subsidies are only available through Nevada Health Link. Subsidies are determined on a sliding scale, based on income, so that individuals at the lower end of the income scale get the most help. 

Premium assistance can be estimated by using the premium cost calculator at NevadaHealthLink.com.

Federal Individual Mandate

For plan years through 2018, if you can afford health insurance but choose not to buy it, you may pay a fee called the Individual Shared Responsibility Payment when you file your federal taxes. (The fee is sometimes called the "penalty," "fine," or "individual mandate.")

Starting with the 2019 plan year (for which you will file taxes by July 15, 2020), the Shared Responsibility Payment no longer applies. 

Health Insurance Rates

One result of the ACA is that Nevada expanded its review of health insurance rates. Nevada continues to review all health insurance rate changes in the individual and small group insurance markets, however now that review can includes additional staffing, greater reliance on technology and outside actuarial consulting analysis of submitted data.

The law also requires insurance companies to spend the majority of your premium dollars on health care. This means that insurers selling policies to individuals or small groups must spend at least 80% of premiums on direct medical care and efforts to improve the quality of care or provide a premium rebate to their customers.

A similar requirement applies to large group health insurance; insurers selling to large groups (usually 50 or more employees) must spend 85% of premiums on care and quality improvement.

The Nevada Division of Insurance is committed to consumer protection and transparency in regards to the cost of your health insurance, read more about health insurance rates in Nevada here.

More Information

Read more about how Health Care Reform affects you and your family.