Healthcare Reform: Increase Your Knowledge in 2014
Healthcare Reform: Increase Your Knowledge in 2014
Starting this year, the ACA requires insurance companies to offer coverage to adults regardless of preexisting conditions and can no longer charge higher rates based on gender or health status. Premiums may vary based on age, tobacco use, family size, and geography. Also, insurance companies can't drop or limit coverage because an individual chooses to participate in a clinical trial for cancer or other life-threatening disease.
Individuals and small groups can purchase insurance through an ACA-mandated marketplace. These marketplaces fill a gap for individuals without employer-provided coverage, those not old enough or poor enough to qualify for Medicare or Medicaid, and those with preexisting conditions who previously couldn't get coverage. Private insurance companies and two national nonprofit plans will offer options that minimally include the ACA-mandated essential health benefits and maximum amounts for deductibles ($2,000 for individuals) and out-of-pocket expenses ($5,950 for individuals).
States were given the option of setting up their own insurance marketplace system or using the federal health exchanges. Individuals looking for health insurance can search for information and sign up for coverage online. People who can afford insurance but don't buy it will pay a penalty of $95 per adult and $47.50 per child up to $285 per household or 1% of yearly household income (whichever is greater). By 2016, this penalty increases to $695 per adult and $347.50 per child, up to $2,085 per household or 2.5% of yearly household income (whichever is greater).
Medicaid eligibility has expanded to include people who earn less than 133% of the federal poverty level ($14,000 for individuals and $29,000 for a family of four). Most of this expansion is funded by the federal government. States can opt out of offering the expansion; very poor working people without employer coverage are likely to be hit the hardest if their state opts out. As of early November 2013, 25 states and the District of Columbia had agreed to the Medicaid expansion, and four others were considering it.
New Health Reforms for 2014
Starting this year, the ACA requires insurance companies to offer coverage to adults regardless of preexisting conditions and can no longer charge higher rates based on gender or health status. Premiums may vary based on age, tobacco use, family size, and geography. Also, insurance companies can't drop or limit coverage because an individual chooses to participate in a clinical trial for cancer or other life-threatening disease.
Individuals and small groups can purchase insurance through an ACA-mandated marketplace. These marketplaces fill a gap for individuals without employer-provided coverage, those not old enough or poor enough to qualify for Medicare or Medicaid, and those with preexisting conditions who previously couldn't get coverage. Private insurance companies and two national nonprofit plans will offer options that minimally include the ACA-mandated essential health benefits and maximum amounts for deductibles ($2,000 for individuals) and out-of-pocket expenses ($5,950 for individuals).
States were given the option of setting up their own insurance marketplace system or using the federal health exchanges. Individuals looking for health insurance can search for information and sign up for coverage online. People who can afford insurance but don't buy it will pay a penalty of $95 per adult and $47.50 per child up to $285 per household or 1% of yearly household income (whichever is greater). By 2016, this penalty increases to $695 per adult and $347.50 per child, up to $2,085 per household or 2.5% of yearly household income (whichever is greater).
Medicaid eligibility has expanded to include people who earn less than 133% of the federal poverty level ($14,000 for individuals and $29,000 for a family of four). Most of this expansion is funded by the federal government. States can opt out of offering the expansion; very poor working people without employer coverage are likely to be hit the hardest if their state opts out. As of early November 2013, 25 states and the District of Columbia had agreed to the Medicaid expansion, and four others were considering it.
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