Individuals can purchase plans on the healthcare exchanges as of 10/1 with an effective date of 1/1, as can small businesses (under 50 ees). However, the types of plans that will be available (at least in my state) are likely going to have worse coverage than what is available to you through your employer.
One of the biggest things that the PPACA eliminates is pre-existing conditions exclusions. If you have a pre-existing condition, you can not be denied health insurance coverage, and the plan has to cover treatments related to your pre-existing conditions.
This is a double-edged sword though, as people with pre-existing and chronic conditions who are now going without health insurance are going to enroll. This is going to result in higher rates, either now so the insurance companies can mitigate the extra $$ paid out in claims, or next year when the first round of renewals comes about. And healthy people are not going to enroll, because they don't have any conditions, as of right now, that need to be monitored.
One of the biggest things that the PPACA eliminates is pre-existing conditions exclusions. If you have a pre-existing condition, you can not be denied health insurance coverage, and the plan has to cover treatments related to your pre-existing conditions.
This is a double-edged sword though, as people with pre-existing and chronic conditions who are now going without health insurance are going to enroll. This is going to result in higher rates, either now so the insurance companies can mitigate the extra $$ paid out in claims, or next year when the first round of renewals comes about. And healthy people are not going to enroll, because they don't have any conditions, as of right now, that need to be monitored.
Do you have government- or employer-sponsored insurance? Yes? Nothing changes*.
Okay, so you are either uninsured or purchase an individual policy. Do you make less than 133% of FPL? Yes? Is your state run by troglodytes? No? Great, you're eligible for Medicaid. If your state is run by trogolodytes, send a letter to your state elected officials asking them to get over the fact that a black guy is president and take the FREE MONEY to give health care to The Poors.
Do you make 133-400% of FPL? Yes? Then you get some subsidy to purchase insurance. This is true whether or not your state is run by trogolodytes. The Vermont Health Care Authority publishes a nice table showing how much you can expect to pay.
If you make more than 400% of FPL, you can go onto your state's insurance exchange (just google "yourstate affordable care act exchange") and see what you can expect to pay for insurance.
Sadly, Obamacare does nothing about my personal pet peeve, which is playing phone tag between insurer and provider as they argue over the bill, correct errors, etc. #iwantapony
* Well, not nothing. Lots of small changes will take effect. But most of these changes are invisible to the consumer. The big one that you might see is that if your employer offers crappy insurance, it will eventually become Real Insurance. Their premiums might rise People in sectors like retail and fast food will probably be most affected.
Also, insurance companies can no longer put caps on what they consider to be preventative care (aka, baby and child well child visits, annual ob/gyn visits, immunizations). That is a huge bonus to our family because before, we paid out of pocket each year just for check ups and shots.
I've been wondering how it will effect companies with less than 50 employees.
niq, do you know if that table is net or gross income?
I believe it's AGI or some form of MAGI. They've tried to make it line up with an existing line on your 1040. ETA from wonkblog, it's AGI -- so, doesn't count 401k, etc. -- plus some adjustments that won't matter for a lot of people:
Let’s say my income changes. What income does the government look at? When figuring out who is eligible for what, the federal government will look at a family’s “modified adjusted gross income,” or MAGI in health wonk terminology. MAGI includes any income filed for federal taxes plus foreign income and tax-exempt interest (those last two are traditionally excluded from the federal definition of income).
There was some news about a delay for SHOP, which is the thing for small businesses. Obviously the employees can buy insurance on the open market. If you work for or run such a business I'd check with the relevant state agency (might be Social Services, might be the Insurance Commissioner, might be something else) to see what the options are. I believe there is some tax credit to the employer to offset a fraction of the insurance premiums if they insure everyone. It's like 25% or 33% or something?
Also, insurance companies can no longer put caps on what they consider to be preventative care (aka, baby and child well child visits, annual ob/gyn visits, immunizations). That is a huge bonus to our family because before, we paid out of pocket each year just for check ups and shots.
The above is also quite likely to raise the premiums you pay today. Insurance policies have to cover a bunch of new stuff without copay, so those policies will cost more than they did before.
Also, insurance companies can no longer put caps on what they consider to be preventative care (aka, baby and child well child visits, annual ob/gyn visits, immunizations). That is a huge bonus to our family because before, we paid out of pocket each year just for check ups and shots.
The above is also quite likely to raise the premiums you pay today. Insurance policies have to cover a bunch of new stuff without copay, so those policies will cost more than they did before.
Will insurance premiums be expected to rise for 2014?
We just learned from our insurance broker at work that they are going to start charging a separate premium for each child. Before, any number of children was the same cost under a family plan. Now, you will pay per child. Has anyone else heard this? I hope the premiums go down per child because I already pay about $350 just to add my son and couldn't afford another $350 extra for child #2.
Also, insurance companies can no longer put caps on what they consider to be preventative care (aka, baby and child well child visits, annual ob/gyn visits, immunizations). That is a huge bonus to our family because before, we paid out of pocket each year just for check ups and shots.
The above is also quite likely to raise the premiums you pay today. Insurance policies have to cover a bunch of new stuff without copay, so those policies will cost more than they did before.
Let's be real here, my premiums had gone up every year, even pre-Affordable Care Act. If they are going to be raised, I might as well be getting a benefit.
And at least 80% your premiums must go to care/treatment or they have to refund you. Right?
I would be shocked if this is true. How would there ever be enough money to pay for people with actual medical issues? (vs. people w/ only colds/preventative care/etc.)
The above is also quite likely to raise the premiums you pay today. Insurance policies have to cover a bunch of new stuff without copay, so those policies will cost more than they did before.
Let's be real here, my premiums had gone up every year, even pre-Affordable Care Act. If they are going to be raised, I might as well be getting a benefit.
Yes, but now they're going to go up even more. Just because you aren't shelling out $$$ at an appointment doesn't mean you're not still paying for it.
The above is also quite likely to raise the premiums you pay today. Insurance policies have to cover a bunch of new stuff without copay, so those policies will cost more than they did before.
Let's be real here, my premiums had gone up every year, even pre-Affordable Care Act. If they are going to be raised, I might as well be getting a benefit.
Yep- I feel exactly the same way. And, I'm fine paying a little extra so that everyone can have decent insurance.
Let's be real here, my premiums had gone up every year, even pre-Affordable Care Act. If they are going to be raised, I might as well be getting a benefit.
Yes, but now they're going to go up even more. Just because you aren't shelling out $$$ at an appointment doesn't mean you're not still paying for it.
When does the pre-existing conditions thing change? January 1st?
My sister lost her health insurance when she turned 26 last month and wasn't able to get private insurance because of pre-existing conditions. She'll be able to be back with health insurance as of January 1st, right? I wonder if her premiums will be higher because she was out of insurance for just a short time. If she can enroll on 10/1 she'll be about 70 days without insurance at that point. Anyone know?
And at least 80% your premiums must go to care/treatment or they have to refund you. Right?
I would be shocked if this is true. How would there ever be enough money to pay for people with actual medical issues? (vs. people w/ only colds/preventative care/etc.)
It's not 80% of each individual's premiums. It's 80% of premiums overall. Meaning only 20% of money charged for the policies can go to non medical expenses like administration and profit.
The above is also quite likely to raise the premiums you pay today. Insurance policies have to cover a bunch of new stuff without copay, so those policies will cost more than they did before.
Will insurance premiums be expected to rise for 2014?
Yes, but my premium goes up a fair bit each year anyway.
I would be shocked if this is true. How would there ever be enough money to pay for people with actual medical issues? (vs. people w/ only colds/preventative care/etc.)
It's not 80% of each individual's premiums. It's 80% of premiums overall. Meaning only 20% of money charged for the policies can go to non medical expenses like administration and profit.
Correct.
Some carriers, at least in my state, have already started doing this, but it was limited to maybe 5% of my company's clients. They have to meet certain criteria for the rebates to be paid out. In 2012 it was some small groups with 1 carrier. So far all we've heard for 2013 with another carrier, it's only large groups.
The above is also quite likely to raise the premiums you pay today. Insurance policies have to cover a bunch of new stuff without copay, so those policies will cost more than they did before.
Will insurance premiums be expected to rise for 2014?
It varies by state, your age, whether or not you smoke, etc. Speaking broadly, states where the typical individual market plan was already decent insurance will see moderately lower premiums for middle age people and older, and moderately higher premiums for younger people. States where there were a lot of "insurance" "plans" that don't meet the layperson's expectation of insurance -- annual caps, lifetime caps, monstrous deductibles ($25K!) etc. -- will see higher premiums. On the other hand, they're be getting more value for their money, especially if they get sick.
I would be shocked if this is true. How would there ever be enough money to pay for people with actual medical issues? (vs. people w/ only colds/preventative care/etc.)
It's not 80% of each individual's premiums. It's 80% of premiums overall. Meaning only 20% of money charged for the policies can go to non medical expenses like administration and profit.
Ah, this makes much more sense. I've hear a bit about this, but never the exact percentages.
Yes, but now they're going to go up even more. Just because you aren't shelling out $$$ at an appointment doesn't mean you're not still paying for it.
So does this mean you aren't an Obamacare supporter?
There are aspects that I'm very excited about. Everyone should have access to purchase affordable health care, regardless of your workplace. I'm simply saying that covering preventative care 100% doesn't mean it's free--someone has to pay for it.
So does this mean you aren't an Obamacare supporter?
There are aspects that I'm very excited about. Everyone should have access to purchase affordable health care, regardless of your workplace. I'm simply saying that covering preventative care 100% doesn't mean it's free--someone has to pay for it.
It means that if you are on a deductible plan it will be 'free'- covered by insurance instead of being used toward meeting your annual deductible. On HMOs it means that there is no copay for the annual wellness appointment. So yes you are technically paying for it through your monthly premiums BUT you are not paying extra for it. Does that make sense?
As someone who is currently paying $450 a month for 1 person for HI and is unemployed I cannot wait for the exchange to open up. The rates that I have seen in California are cheaper than what I pay now and if I am still unemployed I can get the same level of coverage I have now for a lot less.
When I was employed my HI rates doubled in 2009 and then every single year they increased 35%.