Delay in Implementation Will Affect Very Few

Media coverage of a delay in implementation of the Affordable Care Act’s (ACA) limit on out-of-pocket insurance costs for consumers was extensive last week. As of 2014, the ACA sets an annual cap on out-of-pocket costs for an individual at $6,350 and $12,700 for a family. But the U.S. Department of Labor outlined in February a one-year limited transition period for implementation of the requirement. Coming in a summer of renewed political battles over the ACA and a widely covered delay in implementation of the ACA’s employer mandate, the delay was widely covered just last week as a new development adversely affecting many consumers. However, the decision to delay is six months old and it has limited applicability. The one-year transition period does not change the out-of-pocket limits for major medical plans subject to the regulatory requirements in 2014. The transition only applies to customers who have medical benefits administered with one carrier and pharmacy benefits administered with a different company.