The Health Insurance Marketplace is open, and individuals are deciding which coverage is best for them. However, many still have questions about the Affordable Care Act.
To help explain the law and how it will affect Americans, the Indiana Youth Institute recently hosted a forum at Ivy Tech Community College featuring Kate Keller, Interact for Health, Cincinnati, vice president of policy and external relations.
“The law was passed in March 2010, and most of the law is already in effect .... (It) is massive and affects all parts of the health care system.
“The biggest changes will occur in 2014 and 2015, but the requirements to have insurance are happening now.”
There will be tax penalties for those without coverage: 2014: $95 or 1 percent of income; 2015: $325 or 2 percent of income; 2016: $695 or 2.5 percent of income. “The fines are per adult in your family. Children are at 50 percent. There are expectations that these fines will go higher,” she points out.
There are a few exemptions to the requirement: Persons who have religious objections and American Indian tribe members. In addition, “very low-income people, who make below $15,000 a year,” will not be penalized for being uninsured.
Keller explained some private insurance changes. “There will be no co-pays for physicals or well checks, but you will pay for sick visits.” Benefits could also include coverage for hospitalization, emergency services, dental and vision for kids, prescription drugs, maternity care, mental health and substance abuse.
“Every single state mandates different things under insurance, so this benefit package will be different in every single state, with the exception of wellness checks.”
Other changes for insurance include “no exclusion for pre-existing conditions. On Jan. 1, they can’t deny you. This is where Obamacare (ACA) comes in. There are no lifetime dollar limits on coverage. If someone is that sick, they can’t kick you off.
“There is coverage for dependents up to age 26, but this was already in effect. This is to help them through college and graduate school and for those who get a job and don’t have insurance. It’s cheap because that age group doesn’t normally get sick.”
For employers, “if you have less than 50 employees, you are not required to provide insurance for them .... A lot of businesses thought this was a blessing, and they could finally get out of it.”
The Health Insurance Marketplace (www.healthcare.gov) is open through March 31, 2014, for people to apply for coverage. “If you want coverage by Jan. 1, 2014, you have to be enrolled by Dec. 15,” Keller noted.
Diane Raver can be contacted at firstname.lastname@example.org or 812-934-4343, Ext. 114.