How do most Capitol Region residents and Americans feel about health care in general? They're scared. Alarmed. Not informed. Fear comes with good reason: Most personal bankruptcies result from massive health care bills...even if a person has health insurance.
Time Magazine recently devoted extensive coverage to health care costs in "The Bitter Pill," a widely read article written by journalist Steven Brill.
Here are some health care basics, according to CommunityCatalyst.org:
- Private insurance. The most common way of getting health insurance is through an employer. Most employers offer their workers the opportunity to join a group health plan, and about 92 per cent of private health insurance is provided through employer-sponsored group plans.
- Public insurance. Senior citizens and certain people with disabilities usually qualify for Medicare, a government-sponsored health insurance program. Low-income people and people with disabilities sometimes qualify for Medicaid, a public insurance program that is administered by each state and partially financed by the federal government. Together, Medicare and Medicaid cover about 75 million people.
What changes will Obamacare bring?
Obamacare, or The Affordable Care Act (ACA) makes dramatic changes to the way in which millions of Americans access health care. This comprehensive reform of health insurance attempts to make insurance more affordable, adequate and accessible for people. It also expands Medicaid and imposes new responsibilities on individuals to purchase insurance and on employers to provide it for their employees. Taken together, these changes are estimated to expand insurance to 32 million individuals who were previously uninsured.
Obamacare 101...the specifics
- Individual requirement. Starting in 2014, federal law requires U.S. citizens and legal residents to have qualified health insurance or pay a tax penalty. To help people pay for insurance, the law provides premium subsidies and cost-sharing credits.
- Medicaid expansion. The law expands Medicaid insurance to all individuals under age 65 with incomes up to 133 percent of the federal poverty level (currently about $29,700 for a family of four) starting in 2014. Newly eligible adults would have access to a basic benchmark plan.
- Employer requirements. Large employers (with more than 50 employees) could face a penalty if they fail to offer health insurance to their employees and those employees receive any federal premium subsidies, starting in 2014. Small businesses (fewer than 50 employees) are exempt from the penalties.
- Insurance Exchanges. The law creates state-based Insurance Exchanges designed to provide one-stop-insurance shopping for individuals and small businesses, starting in 2014.
- Insurance reforms. Beginning in 2014, the federal law requires health insurance plans to accept all applicants, regardless of health status or medical history. In addition, plans will no longer be allowed to charge higher premiums or exclude certain benefits because someone has a pre-existing condition.
A number of reforms in the Affordable Care Act are already in effect, including requiring insurers to:
- Cover preventive services without deductibles or cost-sharing.
- Allow parents to keep adult children ontheir plans until age 26.
- Eliminate the practice of dropping coverage when individuals get sick.
"I'm grateful more than ever to have coverage I can count on," says Rotterdam resident Kathleen Corini, who manages her Parkinson's disease symptoms regularly. Capitol Region consumers need to be in the know, for both their financial and physical health.
Dave Balog helps Capitol Region families understand money basics. firstname.lastname@example.org, 355-0967