Affordable Care Act

In late 2012, Governor Corbett announced that Pennsylvania would not pursue a state-based health insurance exchange. The administration is considering Medicaid expansion, but Governor Corbett maintained that implementation of an exchange under the Affordable Care Act (ACA) will be operated at the federal level. According to the administration, Medicaid expansion would cost Pennsylvania $367 million in 2013-2014, with the state's share rising to $1.2 billion in 2020-2021. Pennsylvania joined 28 other states in this decision. By law, governors can re-evaluate their decision to establish a state-based exchange on a yearly basis.

Since its passage in Congress in 2010, many questions remain about how the ACA will impact health insurance, health care providers and patients. The expansion of medical insurance coverage and changes to how health care is financed could have a transformative impact on dentistry in Pennsylvania and across the country. Aspects of the ACA impact dentists not only as health care professionals, but also as small business owners and consumers of medical care. The full impact of the ACA on dentistry remains uncertain at this stage, but PDA can highlight some of the potential changes that will most likely occur in the near future.

Affordable Care Act Webinar, presented by PDA and PDAIS on Vimeo.

Sponsored by Capital Blue Cross, Delta Dental and United Concordia(Please note, this webinar file may take some time to load. If you have issues viewing it, please try viewing it on Firefox or Chrome browsers.)
  • Watch the webinar to learn how the ACA impacts dentists
  • Panelists include nationally recognized experts on Health Care and Dental Insurance

Panelists Biographies

Download the ACA Webinar PowerPoint presentation. 

How will ACA affect the following?

Impact of Medical Excise Tax on Dentistry
As of January 1, a new 2.3 percent federal excise tax went into effect. The medical device excise tax, which is part of the Affordable Care Act, is raising numerous questions from dentists nationwide.

In addition to these policy and regulatory changes under the ACA, the public health infrastructure will also impact dentistry. ACA provides for increased funding for Centers for Disease Control and Prevention (CDC) oral health programs and national oral health surveillance programs; increased grant opportunities for general, pediatric or public health dentists; funding for National Health Service Corps loan repayment programs; and CDC initiation, in consultation with professional oral health organizations, of a five-year national public education campaign focused on oral health prevention and education. PDA will continue to monitor and report how the ACA will affect dental providers and their patients in the coming months.

Employer Notifications Mandated by ACA:
October 1 Deadline

ACA amended the Fair Labor Standards Act, creating a requirement that all employers, regardless of size, must provide a notice to their employees by October 1, 2013, informing them about the new ACA insurance marketplace coverage options.

Health insurance marketplaces, created by the ACA, will open on October 1. State and federal insurance marketplaces are websites on which individuals and small businesses can shop for health plans. Most small employers (those with 50 or fewer full-time employees) are not required to offer health insurance under the ACA.

However, the health care law's notification requirement and October 1 deadline applies to any business regulated under the Fair Labor Standards Act, which covers all companies with at least one employee and $500,000 in annual revenue. There are no exceptions for small employers, which means a majority of dental offices will need to notify their employees.

Employers must provide the notice to employees, regardless of plan enrollment or full-time or part-time status. The notice must be provided to every employee free of charge and written in language that the average employee can understand. It must also be provided to all new hires beginning October 1. For 2014, the Department of Labor will consider the new employee notification requirement satisfied if the notice is provided within 14 days of the employee's start date.

PDAIS has provided sample cover letters and sample notices for your use. If you have additional questions, please contact PDAIS at (877) 732-4748.

Additional Resources