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Health Reform Implementation: Resources for Pediatricians

  Updated Small Business Marketplace Fact Sheets: October 1, 2013 ACA Notification Requirement

Since it took effect in 2010, the Affordable Care Act (ACA), has made important changes to the way health care coverage works for children and families. Starting October 1, 2013, people can compare insurance options in state marketplaces. The American Academy of Pediatrics has developed state-specific resources for pediatricians and parents to help understand how to find a health insurance plan that meets the needs of children and families. 

Share your Story with AAP
The AAP is collecting feedback from pediatricians about how the ACA is working for children across the country. Click here to share your experiences.

Resources to share with families
Research shows that when parents have health insurance, children are healthier. The interactive map below links to state-specific fact sheets for parents to learn more about the health insurance options in their state, including links to each state’s health insurance marketplace. Pediatricians are encouraged to share these resources with families and in their pediatric offices.

  • Here is a universal fact sheet for families. Click on a specific state in the map below for a customized version.
  • Visit www.healthychildren.org/ACAmarketplace to learn more about how health insurance works and what the Affordable Care Act means for children and families.



For pediatrician small business owners
The Affordable Care Act also provides health insurance coverage options for small business owners, which include many pediatric practices. The American Academy of Pediatrics has developed this fact sheet to help pediatrician small business owners understand their options for covering their employees and whether they are eligible for financial assistance to help do so.

The ACA requires employers subject to the Fair Labor Standards Act (generally employers with at least 1 employee and at least $500,000 in annual revenue) to provide notification to all employees of “New Health Insurance Marketplace Coverage Options and Your Health Coverage.” Employers are required to provide this notice to all current employees by October 1, 2013 and to each new employee at the time of hire beginning on that date. This notification is to:

  • Provide information about your state’s marketplace, including contact information and services provided
  • Inform employees that they could be eligible for tax credits if they buy a qualified health plan through the marketplace
  • Inform employees that if they purchase a qualified health plan through a marketplace, they could lose any employer contribution to a health benefits plan offered by the employer

The Department of Labor has issued guidance, a Q&A document, and two model notices for employers to provide this notification, one for employers providing insurance and one for employers not providing insurance. The Small Business Administration clarified on September 12, 2013 that there is no penalty for failure to provide this notice.

For states with their own marketplaces, use the following fact sheets:
California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Massachusetts, Maryland, Minnesota, New Mexico, Nevada, New York, Oregon, Rhode Island, Washington, Utah, Vermont.

For all other states: this fact sheet has the information you need about health insurance options for small businesses.

Where to learn more

  • Parents should visit www.healthychildren.org/ACAmarketplace for more information on what the Affordable Care Act means for families
  • Family Voices has resources to educate and enroll parents and families in health insurance coverage
  • For information on health insurance cost estimates, tax savings, coverage options, legal rights and more, visit the Small Business Majority Web site
  • For more information on dental coverage for children, visit the Children’s Dental Health Project 
  • Children’s Hospital Association has a health reform resource page
  • Go to www.healthcare.gov to explore how the health insurance marketplace will work in each state and visit http://marketplace.cms.gov/ for fact sheets and other materials about health reform implementation and the marketplace
  • Download either "The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act" or "Los YouToons Se Preparan Para Obamacare" by visiting the Kaiser Family Foundation Web site.