Health care reform refers to the Patient Protection and Affordable Care Act (PPACA, or ACA). The ACA is a federal law that was passed in March 2010. It is intended to give more people access to affordable health care coverage and medical care.
What Do I Need to Do Now?
The answer depends on what your particular situation is now, and what you think it will be beginning in January 2014. Most of us will be impacted by the ACA in some way, either by changes to our employer-sponsored or privately purchased plan, or because of the requirement for individuals without coverage to purchase it or pay a fine. You first need to find out how your existing coverage (if any) will be affected, or if you will be required to purchase coverage on your own.
Beginning in 2014, most people will be required to have health insurance or pay a fine. This is often referred to as the individual mandate. The individual mandate will be satisfied by private insurance obtained on your own or through your job, or through government programs including Medicare, Medicaid, CHIP, Veterans Affairs, Indian Health Service, or TRICARE.
I Already Have Coverage Through My Employer
If you have health care coverage from your employer you most likely will continue to do so, particularly if you work for a large employer. Your employer may make changes to plan specifics such as copays, deductibles, premiums, and so on. You can get those details from your employer.
If you work for a small employer, other changes may be coming and your employer should keep you informed. Some small employers are opting to no longer offer coverage to their employees.
I Do Not Get Health Care Insurance From My Employer
Beginning in 2014, if you do not get health insurance through your employer you must purchase an individual health plan or pay a penalty. If you already have coverage purchased on your own, you can keep your current plan or you can shop around for a new plan. If you do not have health insurance now, you will need to purchase a plan that is effective in 2014. Beginning in 2014, adults with pre-existing conditions cannot be denied coverage.
The penalty for individuals who do not obtain qualified health insurance in 2014 starts at $95 per year or up to 1% of income, whichever is greater. The penalty will rise to $695 per year or 2.5% of income by 2016.
If you do not get health insurance from your employer and you cannot afford to buy your own, you may qualify for Medicaid or federal subsidies. If you do not qualify for Medicaid but still can’t afford health insurance, you might be eligible for government subsidies to pay for private insurance sold in the health insurance marketplace or state insurance exchanges. The exchanges are the federal and state-run health insurance marketplaces where you can shop, compare and buy health care coverage.
You can buy coverage on the exchanges beginning in October 2013, but coverage will start no sooner than January 1, 2014.
Premium subsidies will be available for individuals and families with incomes between 133% and 400% of the poverty level, or $14,856 to $44,680 for individuals, and $30,656 to $92,200 for a family of four. If you qualify for federal subsidies, you can only receive the credit if you purchase coverage through the exchange. If you do not qualify for a subsidy, you can purchase coverage through the exchange or directly from an insurance company.
New Hampshire Health Insurance Exchange Run by Feds, Limited to One Carrier
Former New Hampshire Governor John Lynch (D) signed a bill in June 2012 that prohibits New Hampshire from operating or facilitating a state-run exchange, but the bill does allow state agencies to cooperate on a federally operated exchange. On February 13, 2013 Governor Maggie Hassan (D) informed federal officials that New Hampshire would pursue a state-federal partnership exchange. This arrangement allows for state control over plan management and consumer assistance—with the federal government in control of everything else.
The exchanges were designed to encourage competition among insurers in the individual insurance market in order to drive down prices for consumers. Only one company is currently authorized to “compete” in New Hampshire’s exchange for 2014: Anthem BlueCross Blue Shield. Other insurers may elect to participate in future years, but for now consumers will be left with very little choice if they must purchase a plan on the New Hampshire insurance exchange.
It is important to learn all you can about health care reform and how it will affect you, your family and your employer. Will your employer continue to provide coverage, or will you need to purchase coverage on your own? Will you be getting health care coverage for the first time?
Don’t go it alone. RW Insurance has the knowledge, experience and resources to make sure that you are meeting your obligations and making the best choices for you, your family and your business.
