Wednesday, April 16, 2014 · 6:47 a.m.
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A couple of major Obamacare milestones have come and gone.

Officials recently announced that more than 1 million people have signed up since marketplaces opened Oct. 1. And an important deadline passed—Dec. 24 was the last day to sign up to get coverage by Jan. 1.

The online marketplaces were plagued with problems when first launched, but the process of signing up has become at least somewhat easier.

Calls for repeals have ebbed and flowed, and federal officials announced "hardship exemptions" for people who are losing coverage because of the new law. 

Keeping up with the ongoing evolution of news related to the Affordable Care Act can be more than a lot of people care to do. But, for better or worse, this is history in the making.

President Barack Obama's Affordable Care Act, commonly called Obamacare, will provide access to health care coverage to 30 million people. Last summer, the Supreme Court ruled that the core of the health care reform act was constitutional.

Some of the act's requirements have already been implemented, and others will continue to be rolled out in coming years.

It includes provisions such as preventing insurers from denying benefits based on pre-existing conditions. It allows people to stay on their parents' insurance until age 26. It requires coverage to include a free annual wellness visit, among an array of other benefits. 

Under the act, marketplaces are being created, which will allow individuals to shop for insurance coverage via Internet-based exchanges.

People who don't already have insurance have to buy it through the exchange or pay a "shared responsibility payment" to the federal government, according to the Supreme Court ruling.

Here are the most recent developments. 

Repeal?
The Obama administration outlined what they said would happen in Tennessee if the law were repealed, as some have called for

David Yoder, co-founder of locally based company American Exchange—whose leaders are helping residents nationwide connect with health insurance through the marketplaces—said repealing the entire law won't and can't happen. 

"There are too many pieces of the legislation already active that can't easily be undone," he said via email. 

For example, health insurance companies built rates for 2013 and 2014 based on benefits and regulations under the Affordable Care Act, he said. 

"If you change that, all policies would have to be re-rated, which we are seeing in states that are allowing coverage extensions for 'forcibly cancelled' policies," he said. "Those policies can be kept, but the insurance companies are changing the rates, usually up."

Tennessee doesn't have its own state-run exchange, so federal rules apply here. 

Protections under the act that the administration outlined include: 

• Free preventive health care services such as mammograms, birth control and immunizations

 More than 1 million Tennesseans are benefiting from this, according to the administration.  

In the first 11 months of 2013, an additional 584,400 people with Medicare have received at least one preventive service at no out-of-pocket cost.

• The elimination of pre-existing conditions 

In Tennessee, up to 2.77 million individuals with pre-existing conditions such as asthma, cancer, or diabetes—including up to 353,000 children—will have access to affordable insurance. 

• Mental health insurance 

About 1.2 million Tennesseans have gained expanded mental health, substance use disorder benefits and/or federal parity protections, according to the administration. 

• Support for health centers 

 Health centers have received more than $100 million to provide primary care, establish new sites and renovate existing centers to expand access to quality health care. Tennessee has about 190 health center sites, which served about 384,000 individuals in 2012.

• Medicare benefits 

About 889,000 uninsured Tennesseans will have new health insurance options through Medicaid or private health plans in the Obamacare marketplace. 

Hardship exemptions 
Leading up to the Dec. 23 sign-up deadline, administration officials announced exemptions for people who would lose their insurance under Obamacare, which requires that everyone have a certain level of coverage. 

So some people who had bare bones policies were told they'd have to change and get more complete coverage. 

But last week, officials announced exemptions for some of these people; and according to NBC News, it will impact about 50,000 people. 

Read more here and here

Deadline extensions 
Some insurers, including BlueCross BlueShield of Tennessee, have announced that consumers who buy a plan through Obamacare's health insurance marketplace by Dec. 24 will have an extended deadline of Jan. 15 to pay the premium.

The previous deadline was Dec. 31, but leaders created an extension because of technical issues with the Healthcare.gov website, according to a news release. 

BCBST leaders also offered tips for consumers who bought insurance through the federally run marketplace to confirm they are enrolled in a plan. Click here for more. 

What's next?
According to some news articles, GOP repeal efforts are quiet for now, and Yoder said that—like most federally run programs—tweaks might continue to be made.

"The most rational and reasonable plan forward is to make changes to the law which better address any unexpected outcomes since its introduction," he said. 

Consumers have through the end of March to sign up for care. But technically, if they want to avoid the penalty, they should sign up by Feb. 15. 

Click here to read why. 

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