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When will the ACA affect City employees?

The Affordable Care Act is a set of health insurance reforms that started in 2010 and will continue to be phased in 2014 and beyond.

Starting October 1, 2013, a new way to get health insurance begins- Open Enrollment in the Health Insurance Marketplace. The Health Insurance Marketplace will offer a new way for people without insurance to get coverage and to find out if they can get lower costs for private insurance. They can also find out if they qualify for Medicaid or the Children’s Health Insurance Program (CHIP). Each state has its own Insurance Marketplace or participates in the federal Insurance Marketplace. New Mexico has its own, called the New Mexico Health Insurance Exchange.

Also starting in 2014, people who do not have health coverage may have to pay a fee. As part of the Affordable Care Act, starting January 1, 2014*, most taxpayers will be required to maintain medical plan coverage or pay a tax penalty (applied on their personal income tax filing).  The tax penalty for 2014 for failing to maintain coverage (referred to as an individual shared responsibility mandate) is the greater of: $95 per adult ($47.50 per child), up to $285 per family (3x the single penalty) or, 1.0% of taxable income.

This means that by electing medical coverage (either through your employer, your spouse, through a government-sponsored program like Medicare or Medicaid, or through the Health Insurance Marketplace), a taxpayer can help avoid paying the new individual shared responsibility mandate.  For this reason, you may want to determine if it is best to enroll or keep coverage under your employer-sponsored medical plan or instead, enroll in coverage through the Health Insurance Marketplace, or forego coverage and pay the personal income tax penalty (the individual mandate) for not having medical plan coverage.  It may also be helpful to discuss this individual mandate with your tax advisor.

PLEASE NOTE:  If you are covered under a medical plan offered by City of Albuquerque, YOU DO NOT NEED TO SHOP FOR INSURANCE IN THE MARKETPLACE.

The month of November 2013 has been designated to give eligible employees, and their qualified dependents, an opportunity to enroll in the City's health insurance program that are not currently participating.  Newly elected coverage will be effective December 28, 2013.

Medicaid is expanding the income qualifications effective January 1, 2013.  Employees ineligible for coverage through the City may qualify for free health care coverage through the State's Medicaid program.