THE AFFORDABLE CARE ACT – A PRIMER
BOISE ID (May 15, 2013) – The Affordable Care Act (ACA), or Obamacare, has left many people confused about how it affects them. The Idaho Department of Insurance is preparing a series of articles and website links to help consumers understand the implications of the ACA.
“Informed consumers will be better prepared to make the best choices for their individual situations,” Department of Insurance Director Bill Deal said. “We encourage Idaho citizens to learn all they can about the ACA and how it may impact them. We have information and links on the Department website to help consumers wade through the many changes associated with health care reform.”
Although aspects of the ACA were challenged by the states – including Idaho – the impact is that most all Americans are required to have health insurance. Many provisions have already been implemented. More changes will take effect on January 1, 2014, including:
· Idaho’s state-based Health Insurance Exchange – a marketplace for individuals (many of whom will qualify for subsidies or tax credits) and for small employers
· Minimum coverage requirements – policies will be required to cover an established list of essential health benefits
· Individual mandate – you will be required to buy health insurance if you don’t have other qualifying coverage such as Medicare, Tricare, Medicaid or employer-sponsored coverage, or be subject to a penalty
Individual insurance plans in 2014 may look different from current coverages. Costs are expected to increase because of expanded coverage, broadened benefits, changes in how insurers are allowed to calculate premiums, and increased taxes and fees on health insurance required by the federal government.
Insurance rates are affected by the makeup of individuals in the pool of insureds. In a pool comprised of young, healthy insureds, the rates can be lower because risk is lower. In 2014, previously uninsured consumers will become a part of the insurance pool. All consumers will be eligible for health insurance without restriction due to health history or preexisting medical conditions, contributing to an increase in premium rates.
Insurers also determine rates based on the age of the insured. Age groups – or bands – are being compressed from five bands to three – resulting in higher costs for those in younger age groups.
Individuals and families without access to qualified health insurance through an employer may be eligible for subsidies to help them pay for insurance through the Idaho Health Insurance Exchange. These subsidies will be available through the Exchange for people with incomes from 100 percent to 400 percent of the federal poverty level.
Small employer groups with 50 or fewer employees will be eligible to buy through the Idaho Health Insurance Exchange. Groups with fewer than 25 full-time employees may qualify for an employer tax credit.
The Department of Insurance encourages Idaho citizens to visit the website, www.doi.idaho.gov, to learn more about the ACA and to keep abreast of upcoming changes. Consumers may call the Department, 334-4250 in the Boise area or 800-721-3272 toll-free statewide.
Every health insurance plan sold in the Marketplace will offer 10 essential health benefits.
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