With nearly two million uninsured people in the State of Georgia, it is important to get the facts about the Affordable Care Act and how it will impact your family. Oct. 1 kicked off of the Open Enrollment period that will allow you to now get “affordable” healthcare. ACA is projected to save lives and reduce health care costs.
Healthcare spending in the U.S. is unsustainable and in spite of high spending, the nation’s health outcomes are still poor. With a host of health disparities that exist among various population groups, and a healthcare system that emphasizes treatment instead of prevention, there was a major need to develop a multi-level solution that would address the nation’s toughest health care issues.
The goal of the Affordable Care Act is to expand and improve access to healthcare in four main areas:
I. Individual Mandate – requires most U.S. citizens and legal residents to purchase a “qualifying” health plan. These plans are designed to provide you with a variety of options and various levels of affordability and many individuals and families will qualify for “premium credits” provided by the Federal Government that will make premiums more affordable. Individuals without coverage by March 31, 2014 will have to pay a tax penalty.
Tax Penalty Timeline
2014 – $95
2015 – $325
2016 – $695
After 2016 – It will be increased annually based on the current cost of living adjustment
II. Medicaid Expansion – The ACA offers states the opportunity to expand the eligibility for Medicaid to adults without children based on their incomes if they make up to 138 percent of federal poverty (less than $15,282 a year). Medicaid Expansion in Georgia would result in health care coverage for an additional
Affordable Care Act estimated 640,000 uninsured Georgians who are exempted from the Individual Mandate for health insurance coverage. The state of Georgia however has not elected to expand Medicaid.
As a result, Georgia citizens that cannot afford coverage and that are not subject to the individual mandate will not have access to insurance through the state’s Medicaid program.
III. Health Insurance Marketplace – is a U.S. government web based portal that will help you make comparisons between available health insurance plans to select the one that is best for you and your budget.
The Family and Individual Marketplace will help with enrollment in private health insurance, Medicaid and the Children’s Health Insurance Program (CHIP). Go to www.Healthcare.gov and a navigator (person trained to assist) will guide you through your options and the process.
IV. Employer Requirements – As of January 2015, employers with 50 or more full-time employees will be required to offer qualified health insurance coverage. Employers that do not offer coverage will be assessed a penalty fee of $2,000 per full-time employee. Employers with 50 or more full-time employees, that offer coverage that does not meet the minimum federal requirements, will have to pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full time employee.
V. Employers with less than 200 employees can purchase affordable insurance from the Small Business Health Options Program (SHOP was developed to aide businesses in purchasing health insurance for their employees and receive tax-credits to assist with the cost of insurance). While not required for business with less than 50 employees, the mandate states that if an employer pays at least 50 percent of their full-time employees’ premium costs, you will receive a tax credit for the remaining 50 percent (35 percent for tax-exempt employees).
Affordable Care Act Important Dates for You to Remember
• October 1st – Open enrollment for the uninsured begins.
• March 31, 2014 – Open enrollment closes.
• After March 31, 2014 when open enrollment closes, you can only get insurance for 2014
through a special open enrollment period for a qualifying life event a job loss, birth, or divorce. If you do not secure coverage by March 31, 2014, you will have a to pay a tax penalty
Effective Dates of Healthcare Coverage
• If you get health insurance October 1 through December 15, 2013, your coverage will start on January 1, 2014.
• December 16, 2013 to March 31, 2014 – If you enroll during this period and pay your monthly premium between the 1st through the 15th, your coverage starts the first day of the next month (Example: Pay premium on February 10, coverage begins March 1).
• If you enroll between the 16th and the end of the month, your coverage will begin the first day of the second month after you pay your premium (Example: Pay for coverage on February 16. It is effective April 1).
If it all still seems a little confusing don’t be afraid to ask questions by visiting the www.Healthcare.gov website. To speak with someone directly call Healthcare.gov at 1-800-318-2596 (TTY: 1-855-889-4325) 24 hours a day/7 days a week to speak with someone directly.
For additional information call the Urban League of Greater Atlanta at 404-659-1150 or Morehouse School of Medicine at 404-752-1500.
Affordable Health Care
The Urban League of Greater Atlanta and Morehouse School of Medicine are collaborating to educate Georgians about the Affordable Care Act and the new way to purchase health insurance for individuals, families and businesses. The goal is to provide the information that will allow people to make the best choice for their circumstances and get enrolled with the ultimate goal of improving health disparities and outcomes for all.