The Patient Protection and Affordable Care Act, Obamacare, mandatory health insurance — whatever you call it, it's on its way.
1. What it does: According to the U.S. Department of Health and Human Services, the regulatory overhaul — makes preventive care, such as family planning and other services, more accessible and affordable for many Americans. Insurance enrollment begins Oct. 1 for coverage that would begin Jan. 1, 2014. Open enrollment closes March 31, 2014. The law requires nearly every U.S. citizen or legal resident who does not currently have health insurance to get coverage or pay a penalty each year (prison inmates, those facing financial hardship, illegal immigrants and religious objectors are exempt).
2. How much it costs: There are various levels of plans, and most low- and middle-income families will qualify for subsidies. Cost estimators, by county of residence, income and household size are found at www.InsureKS.org
3. How you get it: The Health Insurance Marketplace online allows individuals and small businesses to compare health plans, discover potential tax credits for private insurance or health programs and enroll in a plan that meets their needs. Consumers who already have health insurance through their employer do not need to enroll under the Affordable Care Act (those who bought an individual plan outside of an employer can switch to the marketplace plans). Larger companies, however, are looking for ways to cut costs ahead of a tax in 2018 for their insurance plans that have been termed "Cadillac" coverage, so employees may have to shoulder the price of the new mandates — including workers who had previously opted out of coverage but now are required to have health insurance.
4. The benefits: The key to the Affordable Care Act is its focus on prevention. Several preventive services will be available to consumers, including more for pregnant women, children and seniors. Consumers can choose and keep their primary care doctors from their plan's network, seek emergency care outside of their plan's network and be warned of insurance rate hikes before they happen. They also can't be turned away now because of pre-existing conditions. Policy analysts have been cited in the media as saying average premiums will go up for younger, healthier people (though they'll get better insurance coverage), and go down for older, sicker Americans.
5. The challenges: Several surveys — from those conducted at the Kaiser Family Foundation to Bankrate.com — have shown that a majority of Americans have no idea how the Affordable Care Act will affect them. A lot of states took a long time to get the ball rolling on whether or not they would run their own insurance exchanges, and the educational campaign by the federal government hasn't been far-reaching. Bottom line: Consumers who don't carry health insurance coverage in 2014 will face a tax, starting at $95 or 1 percent of household income, whichever is greater. Consumers can obtain coverage without paying a penalty at the Health Insurance Marketplace until March 31, 2014, but must sign up by Dec. 15 for the benefits to kick in on Jan. 1, 2014. The marketplaces also might not be available to everyone in time, so people may have to enroll through call centers or by mail. New patients in certain geographic areas also may overburden the local health system; there is an ongoing debate about adjusting the regulation of nurse practitioners to match more primary care needs in a doctor shortage.
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