need a primer on the health care law?

I’d like to thank the Washington Post for this one, since many people are still very confused about the Affordable Care Act (aka Obamacare), and many of the major provisions of the law begin in just 6 months.

1. The law is still in effect. 

When the Kaiser Family Foundation polled the public, 30% of individuals with an annual household income of less than $30,000 thought the law had been repealed by Congress or the Supreme Court.  Despite the fact that House Republicans have tried to repeal the law 37 times, the law remains in place.

2. You will be required to have health insurance.

I mean – this one shouldn’t be a surprise… this is kinda the big enchilada of the law, the measure that sparked so much debate and led to a Supreme Court case about the law.  Starting in 2014, most US citizens and legal residents must obtain coverage or pay a penalty.  The annual penalty starts at $95 per adult, or 1 percent of family income, whichever is greater.  It gradually rises over the next few years.  Note: some exemptions have been carved out for groups that include Indian tribe members, prisoners and individuals who belong to health care sharing ministries.

3. There’s a few huge milestones coming up.

In addition to requiring everyone to obtain insurance, the ACA will take two major steps next year.  The first is that Medicaid will be expanded in states that allow it.  The second is that many will receive income-based subsidies to buy insurance coverage.  These subsidies are reserved for people who can’t get health insurance through an employer and who don’t qualify for Medicaid, Medicare or military-based coverage.  Online state-based insurance exchanges will debut this October, allowing consumers to compare 2014 coverage terms and prices and then use subsidies, if they qualify, to buy a policy.

4. Financial help extends to the middle class.

A lot of people think these subsidies are just hand-outs to the poor, when in fact, they will be available to help individuals and families making up to four times the federal poverty level. For 2013, that equates to an income of $94,200 for a family of four in all states except Alaska and Hawaii.

The subsidies are also income based; the closer to the poverty line, the bigger the subsidy.  These credits won’t lower premiums, but they can ease the insurance bill depending on a person’s income. Also starting next year, the ACA also will help individuals get coverage regardless of their health.  This was the “pre-existing condition” clause that consumers loved but insurers hated, because as it currently stands, if you already have a medical condition, insurers can either reject your application or charge a much higher price.

5. Insurance prices are going to change.

The issue here is no one knows by how much just yet.  In some cases, premiums will probably rise.  As a previous article in New York Magazine points out, “no one ever denied that the hypothetical healthy 25-year-old male will pay higher insurance premiums under Obamacare. But now, this 25-year-old male probably won’t pay higher premiums under Obamacare if he does smoke, or have any potentially worrisome medical history, or have family members with any potential medical history, or even if he’s a perfectly healthy non-smoker from a perfectly healthy family but has a low enough income to qualify for tax credits to cover his premium costs. And of course he’d be unaffected if he already gets insurance through his employer.”


About justgngr

the ramblings of a medical professional by day, judgmental ginger by night
This entry was posted in health policy, medicine, newspaper, politics and tagged , , , . Bookmark the permalink.

One Response to need a primer on the health care law?

  1. sqhc says:

    Reblogged this on Students for Quality Health Care and commented:
    The Affordable Care Act – in 5 easy steps

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