As an authorized agency and online health insurance quote provider, in North Carolina, we wish to share with readers the main outcomes of the new health care law. Our goal is to present the information in easy-to-read terms. We encourage those interested to refer to the federal health care website for all updates, details, legal definitions and the most accurate terminology on the subject. Information may also be found online at BCBSNC’s website. Our goal is to cover the “broad strokes” of what we know about the law.
Many aspects of the health care law that went into effect this past March will be determined and put into effect in the next 8 years. It’s a process that will unfold over time.
-Most adults in the US will be mandated to be covered by a health plan. If one does not have insurance through an employer, and one doesn’t buy their own insurance, the penalty will rise over a few years to a maximum of $695 per person per year by 2014, or 2.5% of the household income, whichever is more.
-Which adults are mandated? It appears that if the least costly plan one can buy costs more than 8% of one’s income, and if that income is below the federal poverty line, then this rule does not apply. With this person, it appears that Medicaid eligibility would apply.
-No one can be turned away from having insurance for pre-existing conditions and no one will be delayed from having insurance coverage because of pre-existing conditions.
-Health status and pre-existing conditions will not affect the cost of health coverage, though people will be able to buy plans that have varying levels of coverage.
-Health plans will no longer have annual or lifetime benefit limits.
-The only way a people will be dropped from insurance coverage is if they make false statements on the insurance application in order to obtain plan acceptance or get better terms or rates.
-Employers with small companies may be given money by the government if they provide their employees with health plans and meet other requirements. (Employers must have fewer than 25 employees, and employees must earn under $50,000 each.)
-Starting in 2014 “American Health Benefit Exchanges” will be available and will be started either by the states or by the US government. With this plan, those who need to buy insurance can shop at the exchange. The exchange is likely to be available also for small employers and for employees who don’t have coverage. One of the goals of the exchange is to help people maintain their insurance when they change jobs, but there are issues with this, and the insurance obtained through the exchanges might not be completely “portable”. How exchanges might otherwise function is not yet known.
-For those who cannot afford insurance: The federal agencies are working out how to deal with subsidies. About 20 million households will be able to be subsidized. Medicaid is the program by which state and federal programs offer medical assistance to those who are considered poor or disabled. The Medicaid pool will increase considerably as the new health care bill allows more people to fit into this category.