Dr. Jim Spears examines Sarah Ittner, a New York-based actor who does not have health coverage, at the Actors Funds Al Hirschfeld Free Health Clinic on March 23, 2011 in New York City. (Spencer Platt/Getty Images)
After a series of bruising congressional, legal, and presidential campaign battles, the Affordable Care Act is here to stay. How will you be impacted? We’ve answered some of the questions we hear most often, and in the comments below, let us know if you have more questions.
1. Who will be helped most by Obamacare?
Of the 48 million uninsured U.S. residents, about 30 million will get coverage as a result of Obamacare. If your employer doesn’t offer health insurance or you can’t afford to buy your own insurance, you may qualify for an insurance subsidy in the form of a tax credit.
Obamacare also expands benefits to those who already have insurance, through such provisions as bans on lifetime caps on coverage and on co-pay for contraceptives. It also allows parents to keep their children on their plans until age 26. And it says insurers cannot refuse coverage to anyone because of a pre-existing condition.
This interactive can help you see how you would be impacted. The law’s most basic function is to immediately reduce the uninsured population:
By changing the way health-care providers get paid, the law is able to provide health insurance to 30 million more Americans while not speeding up the rate of health-care-cost growth. (Center for Medicare and Medicaid Services)
2. So that means almost 20 million U.S. residents still won’t get insurance? Is that fair?
Immigrants who are in the country illegally do not qualify. Neither do prisoners, whose health-care needs are already covered. Other groups exempt from participation include Indian tribes and religious organizations like the Amish and Mennonites.
Also about 6 million eligible Americans are expected not to sign up, either because of confusion or skepticism. Sarah Kliff has a sobering take on that problem.
3. Okay I qualify, which means as of January 1, I am supposed to have health insurance. How do I get it if my employer doesn’t provide it?
Starting in October 2013, you will be able to go to online insurance exchanges: these have been compared to Travelocity or Expedia but for health insurance policies. At these online marketplaces, you will be able to compare and select health plans. States will run some of these exchanges while the federal government will run others. Each state has until December 14 to decide who will manage its insurance exchange.
4. You mean each state’s marketplace will be different? Will the quality of my plan depend on which state I live in?
According to the law, coverage should not vary significantly, but plan availability could be different state-by-state. While the Affordable Care Act sets minimum standards on a variety of issues, nobody really knows how each state will implement the law.
Some states, especially those with Republican leaders, were waiting to see if Mitt Romney, who was opposed to Obamacare, would win. Now they are scrambling to figure out what to do before the deadline.
5. What if my employer already provides insurance? Will I have to switch or buy more?
No. If you already have a plan that offers sufficient coverage and consumer protections, you can keep it. But because the law is designed to protect you from a variety of unexpected changes like price hikes and sudden reductions in coverage, your existing plan may no longer qualify if it breaks some of these protective “rules.”
6. As I understand it, no company will be forced to provide insurance to their employees. But I’ve heard owners of some fast food franchises say they are now going to have to raise their prices because of Obamacare. Why?
If you work at a company that does not provide insurance, and that company has 50 or more employees, your employer will have to pay a fine to help cover a part of the cost that the government incurs when it helps you pay for insurance. In a way the law does raise the cost of doing business, but the increase is still less expensive than providing insurance to workers.
7. I’d like to know more details about my state. How can I do that?
The Kaiser Family Foundation has a useful map and chart that shows where each state stands on the insurance exchange issue as well as in-depth profiles of each state’s effort to set up exchanges.
Want more details? Check out Wonkblog’s detailed explainer.
Sarah Kliff sits down with The Fold to clarify some details on exchanges. She also breaks down the most important political negotiations that could make the law more complicated for you.
In the comments, please let us know your thoughts, concerns and other questions.