With only days to go before open enrollment, questions continue to surround the new health care law commonly known as “ObamaCare.”
Beginning in 2014, Americans will be required to have health insurance and to provide proof of that insurance with their tax form. Failure to comply will result in an initial penalty of $95 or one percent of your income, whichever is greater. The penalty is more for families and will increase in both cases over the coming years.
One of the big questions right now involves where a person will get insurance.
According to Devon Herrick, senior fellow with the nonprofit and nonpartisan National Center for Policy Analysis, the answer varies.
“The Congressional Budget Office assumes that most of us will still get our health insurance through our job,” says Herrick. “But if you look at the topic over time, I suspect that increasingly more people will begin to get their health coverage through the yet-to-be-opened health insurance exchanges and some will get it through Medicaid.”
The cost of health insurance will also depend on your situation.
Herrick explains the cost: “If you are a moderate income family, and if you qualify for the new health insurance exchanges, you can get some really very generous coverage – in some cases for no more than two percent of your income, for example.”
A family with an income of $32,000, for example, would be required to pay only a “few hundred dollars” for health insurance.
Now if you make more than, say, $94,000 for a family of four, you get no help from the government,” says Herrick. “And you could find yourself paying $10,000, $12,000, even $15,000 for a health plan.”
The federal government will offer subsidies to qualifying individuals and families who cannot afford their health plan.
Meanwhile, Michael Ramlet of The Morning Consult points out that even though consumers can purchase or enroll in a health plan October 1, nothing takes effect in terms of subsidies and coverage until 2014.
The exchanges under the Affordable Care Act (“ObamaCare”), which are scheduled to begin October 1, will involve Americans going online to acquire health insurance on an electronic exchange in their state. But not every state has opted to run an exchange – so what does that mean for consumers?
Devon Herrick, senior fellow with the nonprofit, nonpartisan National Center for Policy Analysis, explains both state and federal governments will be involved.
“In those states that have declined to have their own exchange, the federal government will operate it for them,” he says. “So essentially there will be a lot of outreach by the respective state and the Department of Health and Human Services explaining to consumers where they can buy coverage.”
It will be essentially a “one-stop shop,” he says, that is “designed to tell you if you qualify for, say, Medicaid or if you qualify for the state children’s health insurance or whether or not you will qualify for a subsidy in the exchange.”
According to Herrick, individuals who are qualified to enroll in Medicaid won’t be allowed to go to the exchange. The same goes for someone who has Medicare coverage or someone with access to employer coverage that is deemed affordable.
The government plans to offer subsidies to qualified individuals who do go on the exchange in order to help cover the expense of the health plan.
As for individuals and families who don’t have Internet access, Herrick says there will be outreach by state and federal agencies with phone numbers for people to call.
What does the advent of ObamaCare mean for the unemployed who, according to law, must buy insurance under the healthcare law?
High unemployment remains an issue for America and the economy – and those who currently out of work may very well be concerned what their options are under the Affordable Care Act. According to Devon Herrick, senior fellow with the nonprofit, nonpartisan National Center for Policy Analysis, unemployed individuals could try and get on their spouse’s insurance.
“But assuming that you don’t have access to a spouse and their job, you would have two options,” he explains. “One would be to check and see if you are eligible for Medicaid; and if you are that would be what you would have to enroll in.
“But if you are not eligible for Medicaid, then you would have access to subsidized coverage in the exchange.”
According to HealthCare.gov, eligibility and government subsidies will be determined by household size and income – not by employment status.
The exchanges are set to begin October 1, and will be operated by either the applicant’s state or, in states that choose not to create an exchange, by the federal government. According to data provided by the Kaiser Family Foundation, most exchanges will be operated by the U.S. Department of Health and Human Services (HHS).
Associated Press reports the federal government has had to take the lead in setting up markets in 36 states – a development unforeseen when the law was passed.