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How delays have altered the ACA timeline (in one chart)

March 24, 2014

    Juliette Mullin, Editor

    If polls about the Affordable Care Act (ACA) tell us anything, it's that people are still really confused by the health reform law. That's no surprise—it's a complex law that aims to fix some of the country's most challenging (and politically sensitive) problems.

    But attempts to explain and clarify the law to the millions of people that it affects have been obfuscated  by a slew of changes to its timeline and rules.

    A Kaiser Family Foundation survey found that, as of February, about half of uninsured individuals still didn't understand how the law would affect their families. Moreover, only 24% of uninsured survey respondents knew that the deadline purchase coverage was March 31.

    Making sense of the changes

    To make sense of the confusion, we've broken down the biggest timeline changes to the ACA, outlining when certain components were supposed to start (or end) and how the dates have been revised.

    Click to expand this graphic.

    Most of the changes to the ACA were made through federal regulations. For instance, the Treasury Department has twice announced delays for the ACA's employer mandate, and CMS has delayed the opening of the small business exchanges.

    (It's worth noting that the federal government has made several smaller changes that we did not include in this timeline. For example, the Obama administration recently decided to keep a special insurance program for individuals with pre-existing conditions open for an additional month—until the end of April.)

    Meanwhile, there's one major change to the law that didn't come from the executive branch: Allowing states to opt out of the Medicaid expansion.

    Instead, this change took effect thanks to the Supreme Court's June 2012 ruling on the ACA. As a result, half of the U.S. states have not expanded their Medicaid programs this year, as was originally called for in the law.

    Share this graphic with your colleagues now.

    • Which states have opted out of the Medicaid expansion?

      At the start of 2014, 25 states had not yet expanded their Medicaid programs using ACA funding.

      Find out the latest expansion news in your state with our interactive Medicaid Map.

    Are you ready for the ACA?

    The ACA means more insured patients with coverage for a wide range of services. For hospitals to take advantage of this, they’ll need to streamline their patient access processes to handle the increased complexities of insurance verification and eligibility, point-of-service collections, and coverage enrollment.

    Watch the video to learn how to address these unique challenges.

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