Dan Nestlehut provides readers with information regarding ACA
As you have heard, October 1, 2013 is the first day you were able to enroll in health insurance through the Affordable Care Act. This is now the fourth day of enrollment. The systems were bogged down and back logged in the beginning as expected. In the short run, I do feel that it was expected to have numerous glitches that must be worked out. In the long run, I feel that they will be worked out and it will go smoothly eventually. Anytime there is a system overhaul such as this, there are going to be issues. Regarding an insurance overhaul, those that were on Medicare recall the Medicare Part D enrollment fiasco we had in the fall of 2005 and the spring of 2006. But in time, that got fixed, as I feel this will as well.
In Arkansas there are 71 plans to pick from, offered by 4 different carriers, with the state of Arkansas broken into 7 different areas/regions for pricing. It is up to each carrier if they would like to charge a tobacco rate or not. The companies offering plans in Arkansas are National Blue Cross, Arkansas Blue Cross, QualChoice of Arkansas and Centene Insurance Company.
The last day to enroll will be March 31, 2014. If you are not enrolled in a qualified health plan by March 31, 2014, you will be subject to a tax penalty. Year 1 is 1% of your modified adjustable gross income, or $95/person, whichever is greater.
There are numerous ways to enroll in a health insurance plan. The Federal Government has set up "exchanges" or a health insurance market place to research and compare plans. My preferred method for a consumer to enroll is through an agent. Of course, being an agent, I do have a personal interest in this no doubt. It is important for consumers to realize that it costs no more going through a licensed, professional agent to assist you in the purchase of health insurance or ANY insurance for that matter. Actually, in the long run it can save you money by the educating he or she gives you in your decision making process.
Not all agents will be offering "Obamacare" There are a series federal, state, and face to face training and tests that had to be completed and passed.
If someone chooses to go at it on their own, an individual can enroll through healthcare.gov and also get information through arhealthconnector.org. These systems are suppose to be a one-stop-shop. There are also trained "navigators" to assist consumers in the enrollment process on a face-to-face basis.
The Affordable Care act does not have impact for those on Medicare because they have insurance. In fact, for those on Medicare who have purchased a private Medicare Part D plan, all know about the coverage gap or donut hole. The affordable care act closes the donut hole complete come 2020. It is slowly closing now, and has been the last couple of years.
Also for those on Medicare, there is a good chance you will receive solicitations in the mail as to how Obamacare will affect your Medicare. This is a marketing scare tactic. If you call the number on there, it is a good chance you will reach someone trying to sell you a different policy. I have heard about these going out, and I wanted you to be aware.
Also, there is an exchange for small business called the SHOP exchange. It allows a small business to receive tax credits if they want to offer group health insurance to their employees.
Consumers need to be warned of the possibility of fraud and deception during this time. Kaiser Health Foundation has done a survey that said 51% of Americans still have no clue how Obamacare is going to work or affect them. There will be "wolves in sheep clothing" talking to the public and trying to gather personal information. Consumers need to be very cautious of who they deal with to prevent identity theft.
The purpose and main push behind the Affordable Care Act is "ACCESS TO AFFORDABLE COVERAGE". What the government deems affordable and what us as consumers deem affordable can be construed as two different numbers, I agree. But the "affordability" is based upon the Federal Poverty Level, or FPL. It is a formula that combines how many dependents you file on your taxes for that year (in this case 2014) and what you think your taxable income will be for that year, (modified adjustable gross income, or MAGI) Based upon that number, an individual or family may receive and advanced premium tax credit (subsidy) to help lower the cost of their premium. It is important to note that if an individual does receive a subsidy to help lower their health insurance premium, they MUST file a tax return in the following year to “square up” with the IRS. I encourage you to discuss this with your accountant.
There are over 500,000 Arkansans who do not currently have health insurance. This is my personal opinion; because the premium is this is based on income, Arkansas is a winner when it comes to Obamacare, because our income is low (median income is ranked 48 according to the 2011 Wikipedia). The lower the income, the lower the health insurance premium.
The plans will be similar to what we are used to now: doctor and drug co-pays, deductibles and out of pocket. Individuals can not be surcharged for their prior health history (pre-existing conditions). Children can stay on their parents plans until age 26. Lifetime limits can not be placed on individuals either.
A qualified plan consists of ten (10) essential benefits. They are outpatient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use services, including treatments, prescription drugs, rehabilitative and
habilitative services, (physical, occupational, and speech therapy) laboratory services, preventive and wellness services and chronic disease management, and pediatric services including dental and vision.
Consumers need to be warned of the possibility of fraud and deception during this time. Kaiser Health Foundation conducted a survey and found that 51% of Americans still have no clue how Obamacare is going to work or how it will affect them. There will be "wolves in sheep’s clothing" talking to the public and trying to gather personal information. Consumers need to be very cautious of who they deal with to prevent identity theft.
Editor’s Note: Because Mr. Nestlehut is educated on the intricacies of insurance and on the new healthcare law, The Sun-Times invited him to write an article regarding the new healthcare options for interested readers. The intent of the article is to provide information for our readers and not an endorsement or rejection of the new Affordable Care Act.