As you may already know, the Supreme Court’s decision to uphold all but one provision of the Affordable Care Act (ACA) means that the overhaul of this nation’s health-care system will be the law of the land. New rules for insurers have already begun taking effect, and will continue to be implemented until the most significant change occurring in 2014. Please note that 2014 is the year that we will begin to experience the transformative changes within our system.
My goal is to update and distribute information on the changes that will occur so we can assist everyone in making responsible decisions for their families and businesses. My office has been monitoring this law very carefully and will continue to do so throughout its implementation and beyond. I will try to simplify the information as much as possible, until I am required to issue detailed information when the time is appropriate.
Q: If I don’t have health insurance, what will happen?
A: Nothing right now. But beginning in 2014, virtually all Americans will have to obtain coverage, or pay a tax penalty. For a single person, the tax will begin at 1% of income, or $95, whichever is greater. This tax will become progressively larger from 2014 through 2016, and may continue to increase beyond that time. One may be exempt from the tax for financial hardship – for example, the least expensive plan option exceeds 8% of your income.
Q: My employer doesn’t offer insurance and I can’t afford to buy it on my own. What are my options?
A: Starting in 2014, everyone will be able to buy private insurance through state-based marketplaces known as EXCHANGES. Individuals can “comparison shop” and purchase private plans that may be affordable. Private Exchanges outside of the state-run exchanges may be available as well.
Q: Will I be able to purchase health insurance even if I have a pre-existing condition?
A: Yes. New York had our “health care reform” in 1993 and the popular provisions of the Affordable Care Act have already been part of our health insurance since that time. In New York, our mandates require that insurance companies offer insurance to everyone, regardless of age, gender or health status. Pre-existing conditions are covered immediately unless there is more than a 63 day lapse of coverage. In that case, the same coverage is available, but there would be up to a one-year wait on benefits for that pre-existing condition. In addition, New York programs already have unlimited coverage, $0 co pays for preventative care, unlimited biologically-based mental health coverage and a rider for dependent coverage through age 29 for most plans.
Q: I have health insurance. Will my rate go up?
A: Some of the rules that the law imposes on insurers could contribute to an increase in your premium. However, the law appears to have ways to curb large increases. In addition, rates may also increase for separate reasons, such as the rise in medical costs.
Q: I currently lost my job and am covered through COBRA. What will happen?
A: Not much will change now. But once the exchanges begin in 2014, they will affect the COBRA law (Consolidated Omnibus Budget Reconciliation Act). Therefore, if you lose your job in 2014, you will no longer have the option of staying on your former employer’s plan for 18 months. Instead, you will be able to buy coverage through the state exchange.
Q: Will my Medicare benefits change?
A: The new health reform law includes numerous Medicare provisions that will take effect over the next few years. For example, some payments to Medicare Advantage plans will be cut, but those plans may be eligible for bonuses if they can show that they provide high-quality health care. If not, Medicare Advantage programs may become eliminated once implementation begins.
Currently, Medicare benefits under the law remain in effect, including coverage of preventative care without co pays or out-of-pocket costs.
The Medicare prescription drug coverage gap, known as the “doughnut hole” will continue to gradually narrow until it is eliminated in 2020. During that year, if your drug expenses place you in the gap, then you would be responsible for 25% of the cost.
Higher income earners will have to pay an increased premium for their Medicare Part D prescription drug coverage.
**Please do not hesitate to contact me should you have any questions regarding New York Life Style or Real Estate market conditions.
Please note that I will continue to email periodic updates on laws and facts that could affect us all, if it impacts us both personally and in business.
Thank you.
Sincerely yours,
Bruna Costa
Your New York Real Estate advisor
