Got Health Insurance??? Debbie Rzepczynski Library Skills Trainer Lake County Public Library February 2014

March 23, 2010

PL (42 USC 18001) Patient Protection & Affordable Care Act (PPACA) + PL (42 USC 1305) Health Care and Education Reconciliation Act of 2010 = 964 pages

June 28, 2012 United States Supreme Court National Federation of Independent Business v. Sebelius

Key Features 2010 Increased Consumer Protections 2011 Increased Services to Medicare Recipients 2012 Accountable Care Organizations Formed 2013 Health Insurance Marketplace Debuts 2014 Expansion of Medicaid in some states 2015 Physicians Pay Based on Value, not Volume

Protection Under the Law Creates the Health Insurance Marketplace Coverage with pre-existing health conditions Free preventive care Covers young adults under age 26 Clear Summary of Benefits and Coverage Holds insurance companies accountable by reviewing rate increases Cannot arbitrarily cancel your health insurance Protects your choice of doctors Ends lifetime and yearly dollar limits (by 2015) Guarantees your right to appeal

The individual mandate helps to keep the cost of coverage affordable for everyone. Remember that the law says you can’t be turned down for health insurance just because you have health problems. Without the individual mandate, healthy people wouldn’t have to get insured. So health plans would be left to cover mostly people who need more health care. That means a higher cost of care for a smaller group of people. The result: Premiums would be much too high. The individual mandate aims to have more people covered and more people contributing, whether sick or healthy, and keep premiums under control. Health Insurance Plans – Individual Mandate Kicks In Anthem.com – Healthcarereformforyou.com When an uninsured person requires urgent—often expensive—medical care but doesn’t pay the bill, everyone else ends up paying the price. That’s why the Health Care Law requires all people who can afford it to take responsibility for their own health insurance by getting coverage or paying a fee (penalty, or shared responsibility payment). People who choose not to obtain health coverage will also have to pay the entire cost of all their medical care. They won’t be protected from the kind of very high medical bills that can sometimes lead to bankruptcy. The Health Insurance Marketplace 101

“Medicare isn’t part of the Health Insurance Marketplace. If you have Medicare, you’re already covered and don’t need to make any changes.” The Health Insurance Marketplace 101

Indiana 909,636 (16%) uninsured & eligible 860,656 (95%) may qualify for tax credits or purchase coverage How the Health Care Law is Making a Difference for the People of Indiana

Uninsured in Lake County 21,501 17,831 21,112 15,332

NENWMidSouth Uninsured (0-64 y/o) 17,83121,50121,11215,332 % Residents younger than %22.4%14.7%13.9% 0-18 y/o uninsured 10%15%12%19% %14%17% %25%22%18% %40%37%36% %7%13%10% White 9%29%59%89% Black 83%31%29%3% Hispanic 3%38%10%3% 2010 Lake Co total 496,005 Over 65 65,870 Under ,135 Uninsured Lake Co. 75,776

NOTE- Next open enrollment: October 15, 2014 – December 7, 2014 Your first premium payment must be received before enrollment begins. 12/23!!

In states that don’t implement Medicaid expansion, people between the state’s Medicaid ceiling (it varies by state) and 100% of the FPL will not be eligible for Medicaid or the new tax credit. However, these individuals will not be subject to a fee (penalty) if they do not obtain coverage through the Marketplace. People with income above 100% of the FPL will be eligible for the tax credit.

You may get an exemption from the fee for reasons of religious conscience; if you are a member of a recognized health care sharing ministry; a member of a Federally recognized Indian tribe; you have no tax filing requirement (household income below minimum threshold); if you have a short coverage gap (less than 3 consecutive months); you suffered a hardship; you have unaffordable coverage options (minimum amount you must pay for premiums is more than 8% of your household income); you are incarcerated; or if you are not lawfully present (neither a U.S. citizen, a U.S. national, nor an alien lawfully present in the U.S.).

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Got Health Insurance??? Debbie Rzepczynski Library Skills Trainer Lake County Public Library February 2014