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Healthcare Law 101

In 2010, the Affordable Health Care Act was passed into law to ensure that all Americans could easily access affordable healthcare. This new health law requires practically everyone to have health insurance by 2014. Whether your employer provides you with coverage or not, the law calls for you to have some type of health insurance or pay a penalty.

INDIVIDUAL MANDATE

Yes, due to the new health laws just about everyone in the U.S. will be required to have health insurance. However, the federal government has made some exceptions.

You are not required to have health insurance, if any of the following describes you:

  • It is against your religion to receive health insurance coverage.
  • You are currently living in the US as an undocumented immigrant.
  • You are currently serving time in prison.
  • Your annual income is lower than is required to file a tax return.
  • You are a member of a Native American tribe.

EVERYONE IS NOW INSURABLE

With the Afordable Health Care Act, pre-existing conditions will not impact the cost of your insurance premiums and you cannot be denied coverage. Starting in 2014, the cost of your health insurance policy is only determined by your age, geographic location, family size, and tobacco usage. This means that all individual and group health plans must guarantee issue policies to all applicants, regardless of health status or other factors.

FEDERAL PREMIUM ASSISTANCE

Not everyone can afford to pay for health insurance. For those who can't, the government offers financial help in the form of insurance premium credits.

Better known as a subsidy, the government funds can help you pay for individual health insurance plans from your state's health insurance marketplace. The amount of the subsidy you are eligible for will depend on how much money you make. Those with an income of up to 400% of the federal poverty level ($45,960 for an individual and $94,200 for a family of four in 2013) are eligible for a subsidy to purchase individual health insurance plans.

The following are exceptions:

  • If your income (or your family's income) is below 133% of poverty level, you may be eligible for Medicaid.
  • If your income is below 133% of the poverty level, you will be required to spend only 3% of your income on health insurance.
  • If your income is between 300-400% of the poverty level, you will be required to spend only 9.5% of your income on insurance.

PENALTY FOR NOT HAVING INSURANCE

Choosing not to get health insurance could cost you. According to the Affordable Health Care Act, the federal government will charge a financial penalty (simply put, a fine) each year to individuals and families that do not have a health insurance plan.

The government will begin charging these fines in 2014 and will increase in the coming years. Here's what the penalty will look like:

  • 2014: 1% of a family's income OR $95 for uninsured adults and $47.50 for each uninsured child (up to $285 per family)—whichever is greater.
  • 2015: 2% of a family's income OR $325 for uninsured adults and $162.50 for each uninsured child (up to $975 per family)—whichever is greater.
  • 2016: 2.5% of a family's income OR $695 for each uninsured adult and $347.50 for each uninsured child (up to $2,085 per family)—whichever is greater.

WHERE CAN I BUY HEALTH INSURANCE?

If your employer doesn't offer you health insurance coverage, you can choose to purchase individual health insurance plans from your state's health insurance marketplace, which may include less choices, support and guidance.

If you are looking for a simple, resourceful way to participate in the insurance process, InsureXsolutions is here to help.

We are a private health insurance marketplace, which offers more plan choices, personalized support tools and guidance from insurance professionals.