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ObamaCare Update As
we all know, ObamaCare is the law of the land, but many questions remain about
the massive legislation. To the extent possible, we will try to analyze some
general aspects of the new medical insurance law and its implementation.
Health Insurance Marketplace
As we explained in our Summer Newsletter,
health care exchanges were scheduled to open for business earlier this month. We
recommended that our readers go online to visit and navigate the websites. It
would appear that many people did just that, especially on the 1st of this
month. Unfortunately, the sheer numbers were too much, and technical problems
abound. It would appear that it is going to take some time for the federal
website to be operational.
The federal government has released
information that, once fully operational, approximately 100 insurers will be
federal participants, which is wonderful for the consumer. The more options for
the potential insured, the better. (See HealthCare.gov, but a word to the wise:
I made several attempts to navigate the website, and my computer froze each
time. I could neither advance nor escape without shutting down my computer
entirely. If you attempt to shop medical insurance online at the federal level,
go to your state website as soon as you can leave the federal. Navigating the
New York State website is easier and more productive than trying to navigate the
federal one.)
Early data suggests that premium costs vary widely, from
insured to insured and geographic location to geographic location, which one
would expect.
New York State Health Plan Marketplace
In order to
navigate the New York exchange, go to HealthCare.gov, and then immediately click
on “Find the Marketplace in Your State.” That will get you to “Get State
Information,” and find New York through the drop-down window. Click New York and
then click, “Visit New York State of Health now to apply.” That is your link to
the New York State exchange.
Once you have arrived, there is a good deal
of general information, but if you want specifics, then you must open an
account. That can be accomplished online, and also on the telephone and at
various community agencies. One must be a lawfully present New Yorker to gain
access; once you have opened the account, you can shop for various medical
insurance plans. Come January 2014, the Internal Revenue Service will require
that taxpayers have medical insurance with minimum essential coverage. If you do
not, absent an exemption, a penalty will be assessed. For an adult, the penalty
is fixed at 1% of income or $95.00, which ever amount is greater. The penalty
for each uninsured child is $47.50 with a cap to each family at $285.00 for
2014.
Exemptions and Penalties
Basically, ObamaCare provides that
if you can afford it, you must have medical insurance with minimum essential
coverage. If you do not have the required coverage, and you can afford medical
insurance, you will be forced to pay a penalty, as indicated above. You will not
be penalized if you have any of the following coverage:
- Health insurance
purchased on the New York Marketplace
- Health insurance received from a job,
COBRA, or retiree plans
- Medicare
- Medicaid
- Child Health Plus
- TRICARE
- Veterans health care programs
- Peace Corps Volunteer plans
Exemptions may
be claimed by the following individuals:
- People who have an affordability
hardship
- People who experience hardships such as homelessness, domestic
violence, facing eviction or are experiencing a fire or flood
- People whose
income is so low that purchasing health insurance during the tax year was
unaffordable
- Members of a recognized religious sect with religious objections
to health insurance
- Members of a health care sharing ministry
- Members of a
federally recognized Indian tribe
- People who are incarcerated
- People who
are not required to file a federal income tax return because their income is too
low
- People who are not lawfully present in the United States
- People who
are without health insurance coverage for less than 3 months during the year
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The above information on exemptions and penalties was taken from the New York
State of Health, Official Health Plan Marketplace website. Our Winter Newsletter
will focus on navigation specifics for individuals and families who wish to
obtain medical insurance through the New York website.
The above list is for general information purposes
only. It is not intended to constitute individual legal advice or a specific
recommendation to any particular client.
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