Like many other Americans, you’ve probably asked yourself: What is happening with health insurance reform? How does it apply to me?
We have heard the words Obama Care, healthcare reform, and The Affordable Care Act, and many of us are wondering what they actually mean. Here is the breakdown: In 2013 congress passed the Affordable Care Act, a.k.a. Obama Care. This new law has been labeled as ‘health insurance reform,’ or ‘healthcare reform.’ So now that we have the words straight, how does all of this apply to you, me and the rest of the country?
The ultimate goal of the Affordable Care Act is to make health insurance more available to people with various income levels and health concerns. The actual law is 900 pages long, but is available for anyone to read at: http://www.gpo.gov. In regards to an average person’s busy schedule we will condense this law into a few bullet points.
A quick note: each state has different rules regarding health insurance, and your rights do depend on where you live.
If You Have Health Insurance Now
There are no longer lifetime limits to your benefits. This means your coverage will be there when you need. You also now have the right to appeal a benefit you do not agree with, and your insurance can not cancel your coverage if you get sick. Preventative care is also covered, such as cancer screenings.
Children & Teens
Children under 19-years-old cannot be denied coverage if they get sick and an insurance company cannot deny coverage for a child’s preexisting condition. There is a catch though – until 2014 an insurance company can charge higher premiums for sick children, and some insurers have threatened to end ‘child-only’ policies.
Your college graduate is able to stay on your health insurance until they turn twenty-six. Your insurer cannot charge you a different health premium for that child. Your teen does not have to be financially dependent on you, a student nor do they have to live at home to qualify. This coverage does not extend to your child’s spouse or to their children if they have any of their own.
You cannot be denied coverage if you have a pre-existing condition. Premiums are not based on pre-existing conditions, but rather are based on age.
If you qualify for Medicare, you no longer have to pay out-of-pocket for preventative tests and exams. If you have had to pay full price for drugs, you will receive a 50% discount on brand-name drugs and a 7% discount on generic drugs. The discounts will increase until the year 2020.
Your insurance company must publicly post and give reasoning for an increase in rates. States will determine if this increase is reasonable. The ability to reject rates depends on each state’s individual laws.
Mandatory Health Insurance
By January 1, 2014 everyone is required to have health insurance. If you do not have insurance the IRS will send a reminder, and there will be a fine. This fine will increase every year that you do not get insurance.
The number one question on everyone’s mind: Who pays for this? Obviously if everyone now has healthcare, and many of them signing up for government programs, the tax payer will be affected. If you earn more than $200,000 as an individual taxpayer (or more than $250,000 for a couple), you will see an increase in the amount you owe for Medicare taxes beginning in 2013. Also in 2013, if your income is more than $200,000 ($250,000 as a couple), you will pay a 3.8% tax on some of your investment income.
All in all the recent health care reform’s goal is to increase the availability of healthcare, while also trying to keep costs down. There are some exceptions and a lot of ‘fine print’ to read when it comes to these laws. Your best bet is to ask your healthcare provider questions about your personal plan, and any changes the Affordable Healthcare Act could bring.