The Affordable Care Act was passed in 2010, and parts of it have already taken effect. But more provisions will be implemented in 2013.
For example, more federal money is coming to Michigan to pay for an increase in rates from the Medicaid program to cover new preventive services.
"That includes contraceptive services, which applies to employers with health plans that are not grandfathered, and there are certain organizations who have religious exemptions," says Marianne Udow-Phillips is director of the Center for Health Care Research and Transformation in Ann Arbor.
That provision sparked challenges by some organizations, including private employers who don't meet the strict definition for religious exemption.
"It does include churches and organizations primarily religious in nature, but it doesn't include organizations that might have a philosophical objection," Udow-Phillips says.
Another change will be how doctors are paid.
"In 2013 and 2014, primary care physicians will be paid at the higher Medicare rates for treating Medicaid patients, and that's fully funded," Udow-Philips says.
After 2014, the level of federal funding will depend on whether Michigan decides to expand its Medicaid population to include people who currently fall through the cracks. That could include people who are employed but don't have medical benefits and don't earn enough to buy their own insurance coverage.
Beginning in 2014, all states will be required to have in place a health care exchange, operated independently or under a federal program.
