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What Alabamians Need to Know about the Affordable Care Act (Jennifer Marsden)

  |   By: Jennifer Marsden     |   Letters to the Editor

The news is full of healthcare stories. What does this mean for you and the people you care about?

First off, do you have health insurance now? If it is Medicare, Medicaid,ALL Kids or Tricare, you do not need to change anything. But if you get it through work or privately, you need to pay attention.

The new Affordable Care Act (ACA) — sometimes referred to as ObamaCare — may affect your insurance or your tax bill and it might even save you money. Although I am not happy with the ACA, it will continue in one form or another so the more we know about it the better.

Some employers will stop offering health insurance because the ACA offers it to everyone now. Larger employers will eventually pay an extra tax if they do this. It would be a good idea to check with your workplace if they have not let you know. However you will be able to enroll in ACA plans at the time your work insurance ends, even if this is outside the usual enrollment periods — from now until March 31 and for a shorter period at the end of 2014.

Insurance policies that did not cover all of the required essential benefits under the law will no longer be offered. The insurance companies can continue existing policies (grandfathered policies) but it is inefficient for them to have very few people on a certain plan. The newer policies will often cost more: they are covering more health problems, and the insurance companies are still nervous about how much all the new people they expect to enroll will end up costing.

It is uncertain if costs will go up or even down a little once the insurance companies know more in a few years. The new law does require the insurance companies pay out 80% of their charges as health care and they must refund the excess to us, so maybe you’ll see a refund next year.

If you do not have work based health insurance, or if that coverage is expensive for you, you should check out the cost for insurance through the ACA Marketplace. Families with income between 100% and 400% of the poverty index- for one person about $12,000 to $46,000, for a couple about $15,000 to $62,000, and for a family of four about $23,000 to $94,000- may qualify for reduced cost health insurance through the ACA Marketplace.

You will only be able to get the subsidies in the Marketplace, and they can be thousands of dollars a year for some families. Even my family would save money if we didn’t get Tricare insurance.

Three good ways to do this quickly are these websites: “See plans before I apply” on www.healthcare.govValue Penguin’s Alabama Exchange Plan Comparison, or Kaiser Family Foundation’s subsidy calculator.

The other aspect of the new law is the tax penalty if you choose not to get health insurance and you are eligible for a plan costing less than a certain percentage of your income. Whatever your political views, having health insurance is important. It would be a shame to need it and not have it especially if the costs were very low for you, and you have to pay an extra tax to do so.

Gov. Bentley and many other Republican governors added an ironic twist to this story when they took advantage of the Supreme Court ruling that states can decide whether or not to expand Medicaid (to cover all adults under 133% of the poverty index). The ACA subsidies stop under 100% of the poverty index, except for some legal immigrants.

So here in Alabama we have responsible families or single people without children, US citizens, unemployed or working at minimum wage and unable to get full time work, who do not qualify for Medicaid nor for the ACA subsidy because they make TOO LITTLE. Their neighbors making a few thousand dollars more or who are not US citizens may be getting reduced cost Marketplace insurance. I have been asking Gov. Bentley to change this as have many others in the state. If you fall into this trap let the governor know about your situation.

I told you that people with Medicare,Tricare or Medicaid have few changes. But what about the rest of your family? Have you ever had a child or grandchild ask you for money to buy medicine or to pay for a doctor’s appointment or surgery? If you get your family members to check out how the new law affects them (and maybe even help them pay the new premiums) it might save you a lot of money, and a lot of heartache.

With changes in health insurance and healthcare costs, possible tax penalties, and possible savings or cost increases from the new law we all want to be better informed. Please look into how the new law will affect you and your family. When it comes to your health, knowledge is the best medicine.

Follow Jennifer on Twitter at @ALHouseDems

Dr. Marsden is a Family Practice doctor in Dale County. She is running for State House in District 93.