Linda L. Kordes, Attorney At Law Official Newsletter
Autumn 2013
Inside This Issue
ObamaCare Update
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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