Health Care Reform Friend or Foe?
The word “Obamacare” means different things to different people, but make no mistake about it, the Affordable Care Act is here to stay. This legislation represents the opportunity to get decent health care for millions of Americans who otherwise may not have had the chance. With all of the controversy surrounding Obamacare, including the issues with the healthcare.gov website, it is important that you understand exactly what health care reform means to you.
Quick Questions & Answers
Q. What Exactly is “Health Care Reform”?
Health care reform refers to the Affordable Care Act or ACA which is also sometimes referred to as Obamacare. The goal of these laws is to help people who would otherwise not be able to receive affordable insurance become insured.
Q. How Does this Affect My Current Health Insurance?
You should learn as much as you can about health care reform. You need to determine if using one of the medical exchanges will save you money or if you are better off staying with an employer sponsored plan. Your insurance provider should contact you if Obamacare will affect your insurance plan.
Q. What are Health Insurance Marketplaces?
Health insurance marketplaces or exchanges as they are sometimes called are federal or state programs which allow individuals to purchase health care coverage. These marketplaces include call centers, web sites, as well as physical locations where you can obtain health insurance through the Affordable Care Act. You can obtain health insurance in Illinois through these exchanges online (GetCoveredIllinois), in person or over the phone.
These exchanges also offer what they are calling the Small Business Health Options Program or SHOP which allows small business owners to purchase health insurance through the Marketplaces for their employees.
Q. Do I have to Purchase Health Insurance from the Marketplace?
With the new health care reform law, you are not required to purchase health insurance through the Marketplace. However, if you are planning on receiving any sort of subsidy based on your income, you will need to purchase your health insurance through the Marketplace. One exception to this is in Washington, D.C., if you are purchasing individual health care coverage you do have to purchase it from the Marketplace.
Q. Who Has to Purchase Insurance and What are the Key Dates?
- Open enrollment began on October 1, 2013. While you don’t have to buy health insurance at this time, you can enroll if you choose to do so.
- As of January 1, 2014, the ACA or Affordable Care Act requires that most US citizens have health coverage. Some will have coverage through their employers or through Medicaid or Medicare, but others will be required to purchase insurance through the Marketplace. Those who do not purchase health insurance could be subject to a tax penalty.
- March 31, 2014 is the last day for open enrollment. No one will be able to enroll you into a plan after this dates.
Q. What if I can’t Afford to Pay My Health Insurance Premiums?
If you can’t afford insurance, there are two types of federal assistance that may be offerred to you depending on your income. One assists with your monthly insurance premium and the other helps to cover out of pocket expenses related to medical care. We have included a quick chart below which gives you a general sense of the type of income guidelines that will offer assistance from the government.
- If you are single and make less than $45,960 or $52,920 in Hawaii, you could qualify for assistance through the ACA.
- If you are a couple and make less than $62,040 or $71,400 in Hawaii, you could qualify for assistance through the Affordable Care Act.
- For families of four, you may qualify for assistance with Obamacare premiums if you make less than $94,200 or $108,360 in Hawaii.
Q. What if I Decide Not to Buy Health Insurance in 2014?
If you are required to have health coverage and decide to not buy a policy, you could face a tax penalty if you are without health insurance for 3 months or more.
Q. Will Everyone be able to get Health Insurance?
One of the primary benefits of Obamacare is that insurance companies can no longer deny individuals because of a pre-existing condition and there are no medical exams required for coverage.
Q. What Services Will be Covered with the ACA?
Basically, the following categories will be covered through most plans offered with the Affordable Care Act.
- Immunizations
- Preventative Care
- Routine screenings for cancer, mammograms, etc.
- Maternity Care
- Newborn Care
- Pediatric Care
- Emergency and Hospital Care
- Lab services
- Prescriptions
- Mental health services including substance abuse
Check with your state and federal programs for more specifics as to the exact coverages offered through your ACA plan.
Bottom Line
As you can see, the Affordable Care Act will bring about significant change in the US healthcare arena. It is important to be armed with the necessary information before making a decision about your health
Additional Health Care Reform Resources
Recommended Health Care Information Websites
GetCoveredIllinois – This is the Official Health Care Market Place for the State of Illinois. If you live in Illinois and are looking for health insurance for yourself or your family, it is highly recommended that you use this website to shop for health care options.
HealthCare.gov – This is the official health care Marketplace website of the Federal Government. HealthCare.gov is a new Web site that allows you to do comparison shopping for health insurance. It was specifically designed created under the provisions of the Patient Protection and Affordable Care Act, for residents of the 36 US states that opted not to create their own state healthcare exchanges. Note: Illinois residents should use GetCoveredIllinois as opposed to this site.
HealthLawHelper.org – This link will take you to Consumer Reports’ online tool. All you need to do is just answer a few short questions about your family situation. Note: your answers are anonymous and you will get personalized information on what steps, if any, you may need to take. Even if you have coverage, it’s worth checking out.
Health Care Reform and You – Health insurance is changing. Do you know how these changes affect you? Get to know more with Health Care Reform and You. This link will take you to the Blue Cross Blue Shield of Illinois health care reform micro-site.
WebMD Quick Start Guide – WebMD provides coverage of health care reform, Medicare, Medicaid, health insurance, and the Affordable Care Act, including benefits, costs, coverage, financial assistance, and much more.
Information Downloads (PDFs)
Things to Think About When Choosing a Health Plan
Protect Yourself from Fraud in the Health Insurance Marketplace
Get Covered: A One-Page Guide to the Health Insurance Marketplace
Videos on Health Care Reform
WebMD Health Care Reform Center
The New Health Care Reform Law: What you need to know
Consumer Reports Video Hub on Health Insurance
President Obama and President Clinton Talk Health Care Reform
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