Health insurance Q&A

Here’s how you might be affected:

I don’t have health insurance. Will I have to get it, and what happens if I don’t?

Under the legislation, most Americans will have to have insurance by 2014 or pay a penalty. The penalty would start at $95, or up to 1% of income, whichever is greater, and rise to $695, or 2.5% of income, by 2016. This is an individual limit; families have a limit of $2,085. Some people can be exempted from the insurance requirement, called an individual mandate, because of financial hardship or religious beliefs or if they are American Indians, for example.

I want health insurance, but I can’t afford it. What do I do?

Depending on your income, you might be eligible for Medicaid, the state-federal program for the poor and disabled, which will be expanded sharply beginning in 2014. Low-income adults, including those without children, will be eligible as long as their incomes didn’t exceed 133% of the federal poverty level, or $14,404 for individuals and $29,326 for a family of four, according to current poverty guidelines.

What if I make too much for Medicaid but still can’t afford coverage?

You might be eligible for government subsidies to help you pay for private insurance that would be sold in the new state-based insurance marketplaces, called exchanges, slated to begin operation in 2014.

Premium subsidies will be available for individuals and families with incomes between 133% and 400% of the poverty level, or $14,404 to $43,320 for individuals and $29,326 to $88,200 for a family of four.

The subsidies will be on a sliding scale. For example, a family of four earning 150% of the poverty level, or $33,075 a year, will have to pay 4% of its income, or $1,323 annually, on premiums. A family with income of 400% of the poverty level will have to pay 9.5%, or $8,379.

In addition, if your income is below 400% of the poverty level, your out-of-pocket health expenses will be limited.

How will the legislation affect the kind of insurance I can buy? Will it make it easier for me to get coverage, even if I have health problems?

Probably one of the most simple Q&A’s on healthcare reform I have seen. Don’t let the LA Times heading scare you. The article was written by the independent Kaiser Health Group (although, is anyone really independent on this issue)?

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