Insurance under the Affordable Care Act
Transforming Health | 01.03.13
Eric Beittel, President of the Central Pennsylvania Health Underwriters Association, explains that the Affordable Care Act calls for some changes in health insurance coverage starting in 2014.
Beittel says that one of the changes is that everyone will be required to have health insurance. Those that can afford health insurance and don’t sign up for it will be required to pay a fine that is set to increase as time goes on.
Watch the video to learn more about the changes to insurance under the Affordable Care Act:
“What is new and what will be different is how you get coverage,” he says. “Lets say you are an individual that has coverage now through your employer and you want to know what’s going to change in 2014. But if your employer continues to offer coverage and it meets the new guidelines as far as what it costs you to be enrolled in it and what it covers, that’s pretty much your only choice. And, basically your cost has to be 9½ % of your income.”
What will be different under the Affordable Care Act is how you get coverage.
Large employers that don’t offer sufficient coverage will be subject to fines.
Beittel says that for employers that have less than 50 employees, there is no fine for them to discontinue offering coverage. “That will be the big test to see which of those employers will continue to offer coverage and which ones aren’t.”
If your employer decides not to offer coverage anymore if you’re uninsured now, he explains that you can go to a health insurance exchange.
Exchanges are new organizations that will be set up to create a more organized and competitive market for buying health insurance. They will offer a choice of different health plans, certifying plans that participate and providing information to help consumers better understand their options. Beginning in 2014, Exchanges will serve primarily individuals buying insurance on their own and small businesses with up to 100 employees, though states can choose to include larger employers in the future. (Kaiser Family Foundation)
“The idea of an exchange is to make one central place where you can get information on healthcare coverage.”
States are expected to establish Exchanges--which can be a government agency or a non-profit organization--with the federal government stepping in if a state does not set them up. Click here to learn more about Pennsylvania's health insurance exchange.
Policies that are offered through an exchange, the one difference with those is an individual, if eligible, can get tax subsidy to help pay for that coverage. And, that is only available for policies offered through an exchange. If you are below 400% of poverty level, you can get a tax subsidy. Or, it may mean they wind up in Medicaid, but those are the avenues they can tale to get coverage.
Beittel says that it is hard to predict how much things will change. “It really depends a lot on what coverage you get now and how you get it, and first and foremost, what your employer decides to do.”