The Affordable Care Act (ACA)
- Offers affordable insurance to most uninsured young adults:
- Provides insurance tax credits to individuals making up to 400% of the federal poverty level* starting in 2014.
- Allows coverage of young adults on their parent’s policy up to age 26, starting in 2010. (Retiree only plans are excluded.)
- Increases Medicaid eligibility – states are required under the ACA to increase their income eligibility for Medicaid to individuals under age 65 whose income is less than 133% of the federal poverty level* starting January, 2014.
- Adults cannot be denied for pre-existing conditions starting in 2014. In the meantime, the act creates a state-run insurance option for those who have been denied and have been uninsured for 6 months. (HIPmichigan.org)
- Makes quality, easy to use affordable health insurance available through the Exchanges. See explanation of Exchanges on back of sheet.
- Provides for low price plans with catastrophic-only coverage for people under age 30.
- Phases out the annual benefit limits for children and adults. Lifetime benefits limits ended September 23, 2010.
- Requires preventive services as part of coverage and eliminates out of pocket costs on recommended preventive care. This applies to new policies created after March 23 and renewed after September 23, 2010.
- Provides assistance in navigating the complexities of health care coverage – consumer assistance programs will:
- help with enrollment in health coverage,
- provide benefits counseling,
- educate people on their rights and responsibilities and
- aid consumers in filing health insurance complaints and appeals.
The Health Insurance Exchange
In 2014, Health Insurance Exchanges will offer a one-stop shop for us to compare types of insurance and make choices that are cost-effective and competitive. You will hear much more in the news about the Exchanges as details are worked out for Michigan in the next College Studentfew years. But here’s what the ACA has determined will be included:
- Only citizens and legal residents can purchase insurance through the Exchanges (those in the US illegally will be unable to participate in the ACA at all).
- Exchanges will offer different levels of coverage (bronze, silver, gold, platinum levels) with different costs.
- The Exchange will be an on-line resource for shopping for policies – some states may choose to also have physical locations for the Exchange.
- Individuals and families with incomes from 134% to 400% of federal poverty level* will be eligible for subsidies to partially cover the cost of their policies through the Exchange (133% and below will be eligible for Medicaid).
- There will be an Exchange for small businesses to purchase coverage for their employees.
- Policies offered through the Exchange will meet the ACA requirements of offering preventive care with no co-pays or deductibles, won’t charge more for women or those with pre-existing conditions, and won’t have lifetime or annual caps on benefits.