Ask Joy: This Week – Affordable Care Act
We’ve been looking at the government incentive programs that apply to doctors, but what about the programs that apply to patients? It looks as though the Affordable Care Act, lovingly coined Obamacare, is here to stay. So, without any political overtones or opinions about whether this is the right plan or wrong plan for our country, here’s a breakdown of how Obamacare may affect you.
I’m a small business owner with 2 employees in Washington state. What do I need to know about Obamacare?
Soon, it’ll be open enrollment. On October 1, 2013, the Health Insurance Marketplace opens up and you’ll be able to do some comparison shopping for a plan that’s right for you and your company. You’ll have six months to decide what you’re going to do, as open enrollment closes March 31, 2014.
The Health Care Changes Wizard is a great resource that gets straight to the information that’s applicable to you. Based on your business size, state, and current health insurance offering, it navigates you to resources that explain the new insurance options as well as other health care related resources.
I am a young and healthy independent contractor. What happens if I don’t buy health insurance?
Starting in 2014, under Obamacare, unless one of these exclusions applies to you, you will need to have at least the minimum essential health insurance coverage.
If you don’t have the minimum essential coverage in 2014, you may have to pay a fee. The fee in 2014 is 1% of your yearly income, or $95 per person for the year, whichever is higher. Additionally, if you have kids and they are uninsured, it will cost $47.50 per child. The maximum fee a family would have to pay in 2014 is $285. That doesn’t seem like much now, but in 2016, the fee increases significantly to 2.55% of income or $695 per person, whichever is higher.
Plus, you will also have to pay the entire cost of any medical treatment you may need during the year, and while no one plans to get sick or hurt, most people need medical care at some point.
So, you have from October 1, 2013 until March 31, 2014 to find a plan through the Health Insurance Marketplace. After that, you won’t be able to get health coverage through the Marketplace until the next annual enrollment period, unless you experience a qualifying life event (get married, get divorced, have a baby, or become pregnant).
I already have health insurance through my job. Do I need to worry about Obamacare?
As long as your job-based health plan meets the minimum essential coverage, you can keep your insurance and don’t need to do anything. You won’t get fined. Everything will stay as-is, so long as you keep working for your current employer.
You have the option to compare your current plan to ones that are offered on the Marketplace. If you find one that you like, you can switch, but know that your employer is not required to make any contributions to your premiums, like she likely does with your current plan.
The new health care law provides new rights and strong protections for consumers. It’s in your best interest to get to know them. And if for some reason you should lose your job-based health insurance, here’s a breakdown of your options.
About the Author: Joy Rios has worked directly with multiple EHRs to develop training programs for both trainers and practice staff. She has successfully attested to Meaningful Use for multiple ambulatory practices in both Medicare and Medicaid. She also authored the Certified Professional Meaningful Use course for www.4Medapproved.com. Joy holds an MBA with a focus in sustainability. She is Health IT certified with a specialty in Workflow Redesign, holds HIPAA security certification, and is a great resource for information regarding government incentive programs.Ask Joy is a regular column on 4Medapproved HIT Answers.