FAQ: What does the ruling on healthcare mean to me?
June 28, 2012 at 3:28 PM CDT - Updated June 27 at 9:36 AM
The court says Congress has the power to require individuals to purchase health insurance. Will the government help me if I can't afford it?
Since the penalty for not purchasing minimally adequate health coverage is essentially a tax, the court ruled it constitutional. The Urban Institute concluded 18.2 million Americans – 6 percent of the population – will be required to purchase coverage. Of that number, 10.9 million low-income people will be eligible for federal subsidies to help pay for coverage. Just 2 percent of Americans – 7.3 million people – will have to buy new coverage, and won't receive federal subsidies to do so.
Will I have to pay more for healthcare? Will my premiums go up?
The White House has said that the portion of the law that covers insurance reforms caps out-of-pocket expenses and requires preventative care to be fully covered without out-of-pocket expense. The Obama Administration has said this will "reduce" what families will have to pay.
The Wall Street Journal says most consumers can expect to see their premiums rise because healthcare costs are expanding, and the law expands coverage. Some people will see their premiums go down because of new age ratings in place. However, comparing plans will be made easier, and money could be saved by buying into insurance pools.
Changes to the healthcare industry were passed with the law. Do those changes still stand?
Yes. The White House says these changes imposed upon insurance companies include:
• You cannot be denied coverage for pre-existing conditions.
• Small business owners will be eligible for billions of dollars in tax credits to help employees pay for coverage.
• Immunization and preventive care must be offered at no cost.
• Enrollee's dependent children up to age 26 will receive coverage.
• An appeals process will be set up for consumers can appeal insurance company decisions.
• Insurance companies will be blocked from imposing "excessive" premium increases.
• Arbitrary lifetime limits on coverage in all plans will be removed.
• Insurance companies will be blocked from dropping coverage while a patient is sick.
My sister is supporting three children on very little income. Does the law affect her?
As of Jan. 1, 2014, ALL low-income individuals who are not disabled or elderly will be eligible for Medicaid. You must earn less than $29,000 for a family of four. However, the federal government will not be allowed to deny states' existing Medicaid funding if the state declines to opt in to new Medicaid expansion. The Medicaid expansion will cover 17 million more people. Currently, 62 million Americans receive coverage under Medicaid.
Some states have already opted in to expanded Medicaid programs, including California, Connecticut, Colorado, Minnesota, Missouri, New Jersey and Washington. The government will support states that expand their Medicaid coverage by offering 100 percent of coverage for the new enrollees through 2016.
Won't all these newly insured people crowd doctor's offices and make it harder for me to get care?
Republicans argue that the medical community will not be able to keep up with the increased demand for healthcare. The Wall Street Journal has reported that at current graduation rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years. However, there has been a push nationwide to attract students to mid-level programs, such as nurse practitioners and physician assistants, who could treat patients and prescribe medication.
No one knows if the increase in covered Americans will create a logjam for care.
I own a small business, and employ 28 people. What will happen to my business?
Businesses will fewer than 50 employees would be exempt from the mandate. However, they could earn tax credits for paying employee premiums if they choose to. Businesses with 50 or more could opt out and pay a penalty, which might be cheaper than the premiums.
Businesses with more than 50 employees will be blocked from forcing employees to pay more than 9.5 percent of their household income in premiums. However, the New York Times has pointed out that employers have no way of knowing an employee's household income, and cannot determine whether an employee's required premiums would be deemed "unaffordable" and subject the employer to penalties.
Does this mean there is nothing that can be done to repeal the law?
No. It depends on which party controls the White House and Congress after the November elections. Congress could vote to repeal the law. The president would have to sign the repeal.
*Sources: Poynter Institute, Wall Street Journal
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