What to Know About the Affordable Care Act

The Affordable Care Act (ACA) was designed to give all Americans access to affordable health insurance. That’s a good thing. However, the political bickering over the law often drowned out efforts to explain how the new system works, how it affects the average consumer, and what services it offers. Not so good. Here is a quick primer on the top five questions people have about the Affordable Care Act.

Affordable Care Act

  1. Can I Stay on My Current Health Coverage?
  2. If you already have health insurance through your employer, Medicare, Medicaid, or your parents’ insurance plan and it meets minimum standards under the new health care law, you can stay on your existing health plan.

    However, if your insurance costs more than 9.5 percent of your income or it doesn’t cover an average of 60 percent of your annual medical expenses, you can shop for insurance through your state’s marketplace. Please note that if you are insured through Medicaid, Medicare, or another government program, you are not eligible to buy insurance in the marketplace.

  3. What Happens If I Don’t Have Insurance?
  4. If you go without health insurance coverage, you may have to pay a penalty starting in 2014. Currently, the penalty is equal to 1 percent of your yearly household income or $95 per person, whichever is greater. For 2015, the fee will increase to 2 percent of your income or $325 per person; in 2016, it will be 2.5 percent of your income or $695, whichever amount is higher. In other words, it’s better to pay for insurance and avoid the penalties than pay significant penalties and still be without coverage.

  5. Are There Any Exceptions to Paying a Penalty?
  6. Yes, there are several exceptions. If your annual income is less than $9,350 or your household has income that’s less than $18,700, you were not required to get health insurance in 2014. If you would have to pay more than 8 percent of your annual income on health insurance premiums, you are also exempt. Other exemptions include:

    • Your income is low enough that you’re exempt from having to file taxes.
    • Your income qualifies you for Medicaid coverage but you live in a state not expanding its Medicaid program under the law.
    • You can’t afford the health insurance offered by your employer, and you don’t qualify for a tax subsidy on the marketplaces.
    • You are of American Indian descent.
    • You belong to certain religious sects.
    • You have been living abroad for more than one year.

  7. Are the Health Insurance Marketplaces Only for the Uninsured?
  8. While the health insurance exchanges were established primarily for people who buy their own insurance, such as the self-employed, and for those who don’t have any insurance, anyone is free to secure coverage through the exchanges.

  9. Who Qualifies for Tax Credits?
  10. Tax credits are only available on health plans purchased through the marketplaces, and your total household income has to be between 100 and 400 percent of the federal poverty level (FPL). So if you’re a single person making less than $46,000 or have a family of four and are making less than about $94,000, you may get a tax credit from the government to help pay your premium. The marketplace will determine your eligibility for tax credits based on the personal and income information you supply when applying.

    Even though the window for 2014 open enrollment has passed, the window to enroll for coverage starting in 2015 is scheduled to be open from Nov. 15, 2014, to Feb. 15, 2015. At that time, if you’re uninsured, you can shop for health insurance in the online Health Insurance Marketplace, which outlines different coverage options and costs.

  11. Are My Chiropractic Visits Covered?
  12. It depends. Each policy is different, and coverage varies. So if chiropractic treatments are an integral part of your wellness, look for a policy that covers trips to the chiropractor. For example, it may come with a $25 co-payment. If you choose a policy that does not include chiropractic care, then each visit would be paid entirely out of your own pocket. A couple decades ago, few if any policies covered chiropractic treatments, but the medical field has become much more accepting and now recognizes the benefits. As such, insurance companies have followed suit, so you should be able to find an affordable policy that covers at least some chiropractic care.

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