Affordable Care Act


Original airdate: October 17, 2013                

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The new insurance exchanges are finally open, have you been on one yet?

Back by popular demand, Health Matters, Television for Life hosts an extended panel for a discussion of the Affordable Care Act just months before new health care requirements kick in. With information changing rapidly, you can count on Health Matters to bring you the latest updates and information. This will be an hour you can’t afford to miss.


Health Matters, Television for Life is made                                                                             
possible in part with funding from  Providence





Guest Panelists

Resources

Idaho Resources


Some Basic Facts about the Affordable Care Act (Obamacare)

What is ACA – Affordable Care Act; Health Care Reform Law; Obamacare; Health Care & Education Reconciliation Act of 2010 (HCERA); Patient Protection & Affordable Care Act5 (PRACA)

Individual Mandate: Required that all citizen and legal residents (with a few exceptions) to have health coverage in 2014

Exceptions: Religious objections * Undocumented immigrant * Incarcerated * American Indian * Alaska Natives * Income below the tax filing threshold * Lowest plan option exceeds 9.5% of an individual’s income. 
-Individuals covered by IHS (Indian Health Services) satisfy the mandate but can opt to go into the exchange

October 1st – Open enrollment begins, coverage effective January 1st, 2014

Penalty: 2014 $95 per adult & $47.50 per child (up to $285 per family) or 1% of income, whichever is greater.

2015 - $325 per adult & $162.50 per child (up to $975 per family) or 2% of income, whichever is greater.

2016 - $695 per adult & $347.50 per child (up to $2,085 per family) or 2.5% of income, whichever is greater

Tax Credits: Only available to individuals and families with income up to 400% of Federal Poverty Level (FPL), can be used to reduce monthly premiums, can be claimed as a credit on annual tax return, must apply thru WA Healthplanfinder to receive tax credit. 

 Household Size

 100%

 133%

138%

 150%

200% 

 300%

400% 

 1

$11,490

$15,282

$15,856.20

$17,235

$22,980

$34,470

$45,960

 2

15,510

 20,628

$21,403.80

23,265

  31,020

46,530

62,040

 3

19,530

 25,975

$26,951.40

29,295

  39,060

58,590

78,120

 4

23,550

 31,322

$32,499.00

35,325

  47,100

70,650

94,200

 5

27,570

 36,668

$38,046.60

41,355

  55,140

82,710

110,280

 6

31,590

 42,015

$43,594.20

47,385

  63,180

94,770

126,360

 7

35,610

 47,361

$49,141.80

53,415

  71,220

106,830

142,440

 8

39,630

 52,708

$54,689.40

59,445

  79,260

118,890

158,520

 

Medicare – no changes to this plan in direct relation to ACA

Medicaid – now called Washington Apple Health, if already on you will receive a letter letting you know of any changes

 

Changes to private insurance (these are just some examples):

·         Kids can’t be denied health coverage if they are sick

·         Young adults on parents policies to age 26

·         No lifetime monetary caps

·         No more pre-existing conditions stipulations

Qualified Health Plans:               

Bronze – covers 60% of actuarial value of benefits 
Silver – covers 70% of actuarial value of benefits
Gold – covers 80% of actuarial value of benefits
Platinum – covers 90% of actuarial value of benefits
Catastrophic –high deductible plan for individual up to age 30 or individual exempted from the mandate to purchase coverage.

 

Eligibility Determination -

·         Determined for each family member

·         Options displayed based on eligibility

·         If eligible for Qualified Health Plan, the consumer will use tools to compare & select the plan best for them

·         Plan details can be viewed side by side

·         Payment entry finalizes the transaction

o   1st payment must be made electronically, can post date but must be paid by 12/31/2013

Help by Phone

  • Call Center for WA State – (855) 923-4633
  • Your Health Idaho Hotline (855-944-3246